Margarete Olivier, Florian Stehling, Christian Taube, Matthias Welsner
{"title":"[Transition in patients with cystic fibrosis and asthma].","authors":"Margarete Olivier, Florian Stehling, Christian Taube, Matthias Welsner","doi":"10.1007/s00108-025-01912-6","DOIUrl":"10.1007/s00108-025-01912-6","url":null,"abstract":"<p><p>Adolescence represents a period of significant transformation for individuals with chronic conditions such as cystic fibrosis (CF) and asthma. Due to substantial progress in highly effective cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapy, nearly everyone with CF now reaches adulthood, necessitating ongoing interdisciplinary medical care. Conversely, approximately 70% of children with asthma experience a resolution of symptoms as they reach adulthood. Factors contributing to the persistence of asthma into adulthood include the presence of severe asthma, diminished lung function in childhood and allergic comorbidities. Especially for young adults with severe asthma, continuous pneumological care including uninterrupted access to biologics, must be provided. During the transition process, considerations regarding career choices are pertinent for both patient groups. Additionally, issues related to family planning and prenatal diagnostics become particularly relevant for young adults with CF and should be addressed during the transition process. In both patient groups, an early and structured initiation of the transition process is essential. The use of checklists and transition plans can facilitate the transfer of critical information and ensure a seamless transition. Joint pediatric and internal medicine consultations foster trust and ensure medical quality. Ultimately, a successful transition should enable individuals with CF as well as those with asthma to assume responsibility for their condition and treatment, recognize clinical deterioration, and seek timely assistance.</p>","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"586-592"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Philipp Klemm, Nils Schulz, Uwe Lange, Björn Bühring
{"title":"[Diagnostics and treatment of osteoporosis in 2025 : An update on current guidelines].","authors":"Philipp Klemm, Nils Schulz, Uwe Lange, Björn Bühring","doi":"10.1007/s00108-025-01884-7","DOIUrl":"10.1007/s00108-025-01884-7","url":null,"abstract":"<p><p>Osteoporosis is a relevant public health issue characterized by reduced bone mass and impaired bone microarchitecture, leading to an increased fracture risk. Osteoporosis is diagnosed based on low bone mineral density (BMD), specific fragility fractures and/or an elevated fracture risk. The BMD is one of the most important risk factors for the increased fracture risk that defines osteoporosis, alongside age and sex. Accordingly, treatment strategies focus on reducing the fracture risk. Risk gradients and an algorithm for fracture risk assessment guide treatment decisions. A primary osteoanabolic treatment is recommended for individuals with a 3-year fracture risk of 10% or higher and antiresorptive treatment where the risk exceeds 3%. The high disease burden and gaps in care highlight the need for targeted interventions. The introduction of new guidelines in Germany and Austria provides clear and individualized recommendations for action for the diagnosis and treatment of osteoporosis.</p>","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"603-614"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[A rare differential diagnosis of fever of unknown origin].","authors":"Sabrina Welland, Linus Risser, René Abu Isneineh","doi":"10.1007/s00108-025-01864-x","DOIUrl":"10.1007/s00108-025-01864-x","url":null,"abstract":"<p><p>A 22-year-old male patient with a clinical picture similar to that of sepsis was diagnosed with macrophage activation syndrome in adult Still's disease on the basis of clinical and laboratory criteria. The diagnostic work-up included the differentiated clarification of a persistent fever syndrome and the differential diagnosis of hemophagocytic lymphohistiocytosis. Immunosuppressive therapy with dexamethasone, immunoglobulins and anakinra was initiated and a sustained clinical remission was achieved.</p>","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"646-650"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Obesity as a chronic disease].","authors":"Pia Roser, Jens Aberle","doi":"10.1007/s00108-025-01883-8","DOIUrl":"10.1007/s00108-025-01883-8","url":null,"abstract":"<p><p>The global prevalence of obesity has more than tripled since 1975 and represents a substantial public health challenge. Obesity is a chronic disease with a high tendency to recurrence and is associated with numerous comorbidities, such as diabetes mellitus, high blood pressure and cardiovascular diseases. Every year around 2.8 million people die from the sequelae. Obesity is defined as the excessive accumulation of fatty tissue. In routine clinical practice obesity is diagnosed by measuring the body mass index (BMI); however, there are numerous professional associations that recommend the additional determination of another biometric parameter (waist to height ratio or waist circumference). This not only reduces inaccuracies in the BMI but also makes it easier to identify patients with a particularly high risk of cardiovascular and metabolic diseases. Regardless of the definitions and diagnostics of obesity, the aim of treatment for those affected is not just to reduce weight but more to improve the quality of life, overall survival and the improvement or prevention of obesity-related diseases.</p>","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"447-452"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Pancreatitis from drugs-Drugs for treatment of pancreatitis].","authors":"Max Ole Hubert, Julia Mayerle, Simon Sirtl","doi":"10.1007/s00108-025-01888-3","DOIUrl":"10.1007/s00108-025-01888-3","url":null,"abstract":"<p><strong>Background: </strong>Drugs are a rare but important cause of acute pancreatitis (AP) due to potential therapeutic consequences, accounting for up to 5% of all cases of AP. The diagnosis of drug-induced AP is challenging due to mostly weak evidence and complex diagnostic criteria.</p><p><strong>Objective: </strong>This review article defines drug-induced AP, summarizes the evidence for drugs associated with AP and highlights the challenges in the diagnosis of this condition. The second part of the article focuses on the main pillars of AP treatment.</p><p><strong>Current data: </strong>The association of most drugs associated with AP is based on case reports and case series but there are no high-quality studies. There is sufficient evidence of a causal relationship for only 40 of more than 500 drugs associated with AP and for almost none of the drugs the causal mechanism has been definitively clarified. Several classification systems and criteria have been proposed to assess whether a drug causally triggers AP, with criteria including the temporal association, the exclusion of other causes and recurrence of AP after re-exposure.</p><p><strong>Conclusion: </strong>The diagnosis of drug-induced AP remains a challenge, with many common drugs being incorrectly associated with AP. There is an urgent need for the development of biomarkers to facilitate the diagnosis of drug-induced AP. Drug treatment for AP is still primarily a needs-based fluid management and efficient analgesia. New and causal therapeutic approaches need clinical validation.</p>","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":"66 5","pages":"524-532"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tilman Sauerbruch, Stefan Aretz, Helge Hebestreit, Harald Kaemmerer, Lutz Nährlich, Britta Siegmund, Georg Ertl
{"title":"[Rare diseases: the role of internal medicine].","authors":"Tilman Sauerbruch, Stefan Aretz, Helge Hebestreit, Harald Kaemmerer, Lutz Nährlich, Britta Siegmund, Georg Ertl","doi":"10.1007/s00108-025-01892-7","DOIUrl":"10.1007/s00108-025-01892-7","url":null,"abstract":"<p><p>Rare diseases, defined in the European Union as conditions affecting fewer than five per 10,000 inhabitants, often manifest themselves in childhood, but are playing an increasingly important role in internal medicine due to the significantly improved long-term prognosis and a number of diseases that primarily occur in adulthood. Although noteworthy structures already exist nationally and internationally (networks, registers, databases, self-help groups), awareness of these diseases in daily routine and knowledge of the partly divergent care structures must be improved. There are no specific treatments for many of these diseases, but drugs are increasingly being developed-particularly in oncology-that are subject to special orphan drug status.</p>","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":"66 5","pages":"533-539"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}