Innere Medizin (Heidelberg, Germany)最新文献_第9页

[Testosterone-"Fuel" for old men?] 睾丸素-老年人的“燃料”？］

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-01-01 Epub Date: 2024-12-21 DOI: 10.1007/s00108-024-01824-x

Michael Zitzmann

{"title":"[Testosterone-\"Fuel\" for old men?]","authors":"Michael Zitzmann","doi":"10.1007/s00108-024-01824-x","DOIUrl":"10.1007/s00108-024-01824-x","url":null,"abstract":"Testosterone is a natural hormone which is an essential factor to maintain the physical and emotional well-being in men, regardless of age. Male hypogonadism is an endocrinal condition of testosterone deficiency with the potential to cause multiple physical complaints and psychosocial problems. The condition can be of primary (due to testicular injury), secondary (due to diseases of the hypothalamus or pituitary gland) or functional nature (due to comorbidities, such as inflammatory diseases, obesity, type 2 diabetes mellitus). Testosterone deficiency causes problems of a sexual nature, promotes metabolic disequilibrium and can impair physical abilities (reduction in muscle mass, increase in fat mass). In addition, in the condition of hypogonadism depression, osteoporosis and/or anemia often develop. A testosterone replacement therapy should not be initiated in cases of a desire to have children, unclear processes of the prostate glands or mammary glands or an elevated hematocrit value. The diagnosis as well as treatment and monitoring of the treatment should follow the international guidelines and then a clear improvement in the abovenamed complaints can be expected. Particularly functional hypogonadism, which is mostly but not exclusively diagnosed in older men, always requires treatment of the underlying comorbidity prior to starting testosterone administration.","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"114-123"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873598","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}

引用次数: 0

[Treatment of severe flares in Crohn's disease and ulcerative colitis]. 治疗克罗恩病和溃疡性结肠炎。

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-01-01 Epub Date: 2025-01-10 DOI: 10.1007/s00108-024-01825-w

Andreas Stallmach, Johannes Stallhofer, Carsten Schmidt, Raja Atreya, Philip C Grunert

{"title":"[Treatment of severe flares in Crohn's disease and ulcerative colitis].","authors":"Andreas Stallmach, Johannes Stallhofer, Carsten Schmidt, Raja Atreya, Philip C Grunert","doi":"10.1007/s00108-024-01825-w","DOIUrl":"10.1007/s00108-024-01825-w","url":null,"abstract":"Background: In chronic inflammatory bowel diseases (IBD), severe flares are characterized by intense inflammatory activity and a high disease burden for patients. Treatment addresses both short-term goals (e.g., symptom reduction, prevention of complications) and long-term goals (sustained clinical steroid-free remission and healing of inflammatory lesions, known as \"mucosal healing\").Objective of the study: To present evidence-based, targeted diagnostics and stepwise treatment of severe flares in Crohn's disease (CD) and ulcerative colitis (UC), in order to prevent complications, including mortality, and to achieve rapid remission.Materials and methods: Selective literature review, including German and European guidelines for the treatment of severe flares.Results and discussion: After ruling out complications (e.g., infections, strictures, abscesses, toxic megacolon), based on a structured assessment of disease severity, intravenous steroid therapy is indicated in severe acute flares for both CD and UC, which should lead to improvement within the first 72 h. If no improvement occurs, medical therapy must be intensified. Various therapeutics, including biologics targeting tumor necrosis factor (TNF)-α, α4ß7 integrins, interleukin (IL)-12/23 or IL-23, as well as Janus kinase (JAK) inhibitors, sphingosine 1‑phosphate receptor (S1PR) modulators, and calcineurin inhibitors, are available today, but there is no clear algorithm preferring one drug for CD or UC. Instead, treatment should be selected based on approvals, the patient's medical history, prior treatment, risk profile, and potential complications. Surgical options must always be considered as part of close interdisciplinary care.","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"22-30"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959902","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}

引用次数: 0

[Imaging in chronic inflammatory bowel disease]. [慢性炎症性肠病的影像学检查]。

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-01-01 Epub Date: 2024-12-20 DOI: 10.1007/s00108-024-01831-y

Christoph F Dietrich, Kathleen Möller

{"title":"[Imaging in chronic inflammatory bowel disease].","authors":"Christoph F Dietrich, Kathleen Möller","doi":"10.1007/s00108-024-01831-y","DOIUrl":"10.1007/s00108-024-01831-y","url":null,"abstract":"In patients with chronic inflammatory bowel disease (IBD), endoscopic techniques (including capsule techniques and balloon enteroscopy for the small intestine), ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) are primarily used as often complementary imaging techniques. Radiation exposure needs to be kept in mind when using CT and conventional X‑ray-techniques. Therefore, most importantly, ultrasound and MRI have changed the routine diagnostics of intestinal diseases. US, CT and MRI not only assess the lumen but, similarly importantly, also the wall and the surrounding structures of the gastrointestinal tract. Furthermore, functional processes can be visualized and provide important information about passage and perfusion, which is mainly true for real-time ultrasound. CT and MRI are usually carried out with the use of contrast agents as contrast-enhanced CT (CECT) and contrast-enhanced MRI (CEMRI). Ultrasound is performed conventionally or with intravascular (CEUS) and/or extravascular intracavitary contrast agent application (icCEUS). This article provides an overview of the current significance of the mentioned imaging procedures in patients with IBD and discusses the typical indications.","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"40-54"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866379","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}

引用次数: 0

Mitteilungen der DGIM. DGIM通讯。

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-01-01 DOI: 10.1007/s00108-024-01834-9

引用次数: 0

[New treatment targets for inflammatory bowel disease?] 炎症性肠病的新治疗靶点？］

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-01-01 Epub Date: 2024-12-23 DOI: 10.1007/s00108-024-01826-9

K R Herrlinger, E F Stange

引用次数: 0

[Efficient treatment of mild Crohn's disease and mild ulcerative colitis]. [有效治疗轻度克罗恩病和轻度溃疡性结肠炎]。

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-01-01 Epub Date: 2024-12-23 DOI: 10.1007/s00108-024-01840-x

Gerhard Rogler

引用次数: 0

[Application of advanced treatment in chronic inflammatory bowel diseases]. 【先进治疗在慢性炎症性肠病中的应用】。

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-01-01 Epub Date: 2025-01-02 DOI: 10.1007/s00108-024-01833-w

Benjamin Misselwitz, Sebastian Zeißig, Stefan Schreiber, Axel Dignass

{"title":"[Application of advanced treatment in chronic inflammatory bowel diseases].","authors":"Benjamin Misselwitz, Sebastian Zeißig, Stefan Schreiber, Axel Dignass","doi":"10.1007/s00108-024-01833-w","DOIUrl":"10.1007/s00108-024-01833-w","url":null,"abstract":"Background: The treatment options for chronic inflammatory bowel diseases (IBD) have been greatly expanded due to a better understanding of the underlying pathogenesis. A total of five classes of advanced treatment are available.Objective: A practical overview of advanced treatment of IBD.Methods: Narrative review.Results and discussion: Advanced treatments are indicated for moderate to severe IBD. A timely use is recommended to achieve better response rates and to avoid irreversible bowel damage. Tumor necrosis factor (TNF) inhibitors and Janus kinase (JAK) inhibitors have a broad efficacy, also for extraintestinal disease manifestations. The risk of reactivation of varicella zoster virus is increased with JAK inhibitors. In high-risk patients and an age >65 years there is possibly a moderately elevated cardiovascular risk and neoplastic side effects. The integrin alpha4beta7 inhibitor vedolizumab and the interleukin (IL) 12 and 23 inhibitor ustekinumab have very good safety profiles. Selective IL-23 inhibitors are sometimes superior to ustekinumab with comparable safety profiles with respect to efficacy. The sphingosine-1-phosphate receptor modulators ozanimod and etrasimod are approved for oral treatment of ulcerative colitis. The treatment success of the medications remains still limited and a minority of patients will not respond to every individual treatment. Thus, sequential administration of several treatments is often needed. Due to the lack of comparative studies, the personalized choice, sequence and decision for treatments are usually based on personal experience and should take patient preferences, efficacy, safety and individual patient profiles into consideration.","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"3-14"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923971","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}

引用次数: 0

Ampel-Aus. Ampel-Aus .

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-01-01 DOI: 10.1007/s00108-024-01836-7

引用次数: 0

[Inflammatory bowel diseases in children and adolescents : An overview with particular attention to genetic testing]. [儿童和青少年的炎症性肠病：特别关注基因检测的概述]。

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-01-01 Epub Date: 2025-01-08 DOI: 10.1007/s00108-024-01827-8

Tobias Schwerd

{"title":"[Inflammatory bowel diseases in children and adolescents : An overview with particular attention to genetic testing].","authors":"Tobias Schwerd","doi":"10.1007/s00108-024-01827-8","DOIUrl":"10.1007/s00108-024-01827-8","url":null,"abstract":"Pediatric-onset inflammatory bowel disease (PIBD) is increasingly recognized in Germany. Patients with PIBD often present with more extensive and active disease. Clinical suspicion of IBD requires early initiation of the diagnostic work-up (e.g., non-invasive fecal marker for inflammation) and referral to a pediatric gastroenterology center. In the presence of very early-onset IBD, as well as further criteria such as family history, relevant comorbidities, and extraintestinal manifestations, genetic testing for monogenic forms of IBD should be considered. The aim of treatment is to normalize quality of life and prevent bowel damage and complications, thereby enabling normal physical, social, and emotional development of the child. The selection of treatment is based on individual risk stratification, which considers disease severity and activity. PIBD patients often receive more intensified therapies, including biologics and small molecules. However, anti-tumor necrosis factor (TNF) antibodies are the only approved biologics for PIBD (above the age of 6 years). Therefore, licensed anti-TNF is a mainstay of PIBD therapy. Regular PIBD and drug monitoring should be performed according to the treat-to-target approach. Patients with PIBD and their families have special health care needs and require an interdisciplinary team of specialized medical doctors, psychologists, social workers, dieticians, and nurses. Close cooperation between the local pediatrician/family doctor and the pediatric gastroenterologist is important to achieve the long-term goals. Psychosocial consequences are important but are often underestimated.","PeriodicalId":73385,"journal":{"name":"Innere Medizin (Heidelberg, Germany)","volume":" ","pages":"31-39"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959885","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}

引用次数: 0

[First diagnosis of ALCAPA syndrome in adulthood: a rare cause of cardiac arrest]. [成年后首次诊断出 ALCAPA 综合征：心脏骤停的罕见病因]。

Innere Medizin (Heidelberg, Germany) Pub Date : 2025-01-01 Epub Date: 2024-09-20 DOI: 10.1007/s00108-024-01782-4

Tim Urban, Sebastian Grundmann, Franziska Klein, Tobias Wengenmayer, Katharina Müller-Peltzer, Hans-Jörg Busch

引用次数: 0