{"title":"[Bronchiectasis disease].","authors":"Judith Smith, Michael Dreher","doi":"10.1055/a-2145-7495","DOIUrl":"https://doi.org/10.1055/a-2145-7495","url":null,"abstract":"<p><p>Bronchiectasis is a worldwide inflammatory disease with different epidemiology and heterogenous etiology. The disease burden is high for patients and economic costs can be immense. So far there are no special disease modifying drugs available for patients with bronchiectasis other than cystic fibrosis. With rising numbers of newly diagnosed patients (prevalence 120/100000 in Germany) due to different reasons (idiopathic, postinfectious, genetic, asthma, COPD etc.) the awareness for this once called orphan disease should rise - not only among pulmonologists but also among general care practitioners. This article focuses on diagnostic algorithms and multimodal treatment options based on the latest studies and the recently published German bronchiectasis guideline from May 2024. It outlines what general care practitioners can do for their patients, what they should consider when treating an exacerbation and that special surveillance of these patients is needed in centers with expertise in this disease due to its complexity. With upcoming treatment options just as disease modifying drugs like DDP-1 inhibitors or inhaled antibiotics one can expect a change in disease treatment and outcome. Therefore, it is more and more important to raise awareness for bronchiectasis starting at the very basis when patients present at their general care practitioner with recurring productive cough, exacerbations, and further cardinal symptoms of bronchiectasis disease.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 12","pages":"703-712"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103366","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}
Barbara Kumlehn, Simone Brefka, Filippo Maria Verri, Michael Denkinger
{"title":"[Geriatric Assessment in the Hospital - An Overview of Clinical Guidelines].","authors":"Barbara Kumlehn, Simone Brefka, Filippo Maria Verri, Michael Denkinger","doi":"10.1055/a-2353-0680","DOIUrl":"https://doi.org/10.1055/a-2353-0680","url":null,"abstract":"<p><p>According to forecasts, 27 % of the German population will be aged 65 or over by 2050. Age-associated multimorbidity, functional impairment and need for care have a considerable impact on the healthcare system. A comprehensive geriatric assessment (CGA) is therefore essential to identify health risks at an early stage and make targeted treatment decisions. Numerous studies prove effectiveness of CGA regarding relevant clinical outcomes. In Germany, an S3 guideline with recommendations on CGA in hospitalised patients was published in 2024. There is also an S1 guideline with recommendations on assessment tools. Internationally, the UK, the Netherlands and Italy have published corresponding recommendations. In oncology, two guidelines recommend the systematic integration of CGA before starting cancer treatment. Guidelines emphasise the multidimensional and interprofessional implementation of CGA using standardised, validated instruments. In acute geriatrics, CGA has established as an integral part of care. Focussed screening is recommended in the emergency department. Orthogeriatric co-management has been shown to be associated with lower mortality and improved treatment outcomes. In oncology, CGA is becoming increasingly important for customising treatment. Prognostic tools such as the multidimensional prognostic index (MPI) enable targeted risk stratification. The implementation of CGA is hampered by limited time resources, staff shortages and inconsistent billing modalities. Clear recommendations on the selection of suitable assessment tools could improve utilisation and integration in the future. New technologies such as artificial intelligence and digital applications offer promising approaches for increasing efficiency. The development of a European guideline could help to establish CGA in various care structures.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 12","pages":"675-681"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103369","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":"[GLP-1 agonists - new kid on the block in nephrology].","authors":"Leonie Kraft, Moritz Schanz, Jörg Latus","doi":"10.1055/a-2420-6176","DOIUrl":"https://doi.org/10.1055/a-2420-6176","url":null,"abstract":"<p><p>GLP-1 receptor agonists (GLP-1-RA) are emerging as promising agents beyond their established role in type 2 diabetes mellitus (T2DM) and obesity treatment, showing significant nephroprotective effects. The FLOW study demonstrated that semaglutide significantly slows the progression of chronic kidney disease (CKD) in T2DM patients. The nephroprotective mechanisms are multifactorial, including improved glycemic control, blood pressure reduction, antifibrotic, and anti-inflammatory effects. Early studies suggest that GLP-1-RA may also benefit patients without T2DM. Additionally, their combination with SGLT2 inhibitors is gaining relevance. Current evidence suggests that GLP-1-RA could play a key role in CKD management. Future studies will determine whether they can be established as a standard therapy to optimize care for high-risk patients.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 12","pages":"696-702"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103373","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":"[Antithrombotic therapy for polyvascular atherosclerosis].","authors":"Christine Espinola-Klein","doi":"10.1055/a-2359-4422","DOIUrl":"https://doi.org/10.1055/a-2359-4422","url":null,"abstract":"<p><p>Patients with polyvascular atherosclerosis are twice as likely to have cardiovascular events as patients with monovascular atherosclerosis. Anticoagulant therapy improves the prognosis and is therefore clearly recommended. Intensified anticoagulation is more effective in reducing risk but is associated with a higher risk of bleeding. Compared to patients with monovascular atherosclerosis, patients with polyvascular atherosclerosis benefit more, as the absolute risk of ischemic events is higher - with the same risk of bleeding.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 13","pages":"741-746"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176129","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":"[Polyvascular Atherosclerosis: prevalence and prognosis].","authors":"Jörn Fredrik Dopheide, Mathias Kaspar","doi":"10.1055/a-2360-7551","DOIUrl":"https://doi.org/10.1055/a-2360-7551","url":null,"abstract":"<p><p>Polyvascular diseases are a severe, generalized form of atherosclerotic disease. They are often overlooked in routine clinical practice, despite being characterized by one of the highest cardiovascular event and mortality rates. Registry studies (e.g., REACH) recognized and investigated the severity of the disease early on. Randomized trials specifically designed for polyvascular diseases are needed in the future, especially with a view to adapting therapy accordingly. Until appropriate adaptations are scientifically supported, polyvascular patients should be identified and, if necessary, treated more strictly regarding their risk constellation.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 13","pages":"735-740"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176152","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":"[Health Effects of Wildfires].","authors":"Thomas Münzel, Andreas Daiber","doi":"10.1055/a-2542-8711","DOIUrl":"https://doi.org/10.1055/a-2542-8711","url":null,"abstract":"<p><p>The increasing frequency and intensity of wildfires, exacerbated by climate change, pose a significant threat to both the environment and human health. In addition to destroying ecosystems, these fires cause severe air pollution, particularly through fine particulate matter (PM2.5, diameter ≤ 2.5 µm), which can be transported over long distances. A recent example are the wildfires in Canada, whose smoke enveloped New York City in dense smog. Fine particulate matter increases the risk of cardiovascular and respiratory diseases, especially among vulnerable groups such as children, pregnant women, individuals with preexisting conditions, and the elderly. Globally, emissions from wildfires are linked to hundreds of thousands of premature deaths annually. Protective measures such as early warning systems, air filtration systems, and the use of masks can help reduce exposure. However, knowledge gaps remain, particularly regarding the specific components of pollutants and their interactions with environmental factors. Long-term research is essential to better understand the health impacts and to develop targeted prevention strategies. Wildfires underscore the urgent need for global climate protection measures and innovative approaches to public health preparedness.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 13","pages":"772-779"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176148","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":"[Risk Factor Management for Polyvascular Atherosclerosis].","authors":"Annika Reuser, Ulrich Laufs","doi":"10.1055/a-2362-4893","DOIUrl":"https://doi.org/10.1055/a-2362-4893","url":null,"abstract":"<p><p>Polyvascular atherosclerosis is characterized by atherosclerosis in several vascular territories, leading to an extremely high risk of myocardial infarction, ischemic stroke, and cardiovascular death. These patients derive a higher absolute risk reduction from preventive measures compared to individuals with monovascular atherosclerosis. The most important lifestyle factors are non-smoking and physical exercise. Pharmacological management includes lipid-lowering with an LDL-cholesterol target of <40mg/dl (1,0mmol/l) and blood-pressure control with a systolic target of 120mmHg. Diabetes type 2 in patients with polyvascular atherosclerosis should be treated with SGLT2-inhibitors and/or GLP1-receptor agonists. Patients with obesity and polyvascular disease should receive GLP1RA - regardless of the presence of diabetes. Thus, a comprehensive risk factor management in patients with polyvascular atherosclerosis is essential to improve long-term cardiovascular outcomes.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 13","pages":"747-753"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176185","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":"[Implementation of guideline-based basic therapy for obesity in Germany].","authors":"Hans Hauner","doi":"10.1055/a-2548-1202","DOIUrl":"https://doi.org/10.1055/a-2548-1202","url":null,"abstract":"<p><p>The updated German S3 guideline on the prevention and treatment of obesity strongly recommends a multimodal lifestyle intervention, consisting of nutrition, exercise, and behavior therapy. Other options such as pharmacotherapy and bariatric surgery should be used in combination with this basic treatment. Current nutritional strategies for moderate energy restriction are equivalent. Regular physical activity of 30-60 minutes per day is advised. At present, there is only rather limited access to obesity management programs in groups or individual face-to-face dietary counseling with only facultative and partial reimbursement by statutory health insurance (SHI). Recently, 2 digital health applications (DiGAs) have been approved for obesity treatment. Both DiGAs can be prescribed by medical doctors and are fully paid by SHI. Shared decision making is recommended considering patient-specific criteria and choices. The recently approved disease management program for obesity will hopefully facilitate an evidence-based obesity management.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 12","pages":"668-674"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103383","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":"[Heart and Diabetes - what's new?]","authors":"Katharina Marx-Schütt","doi":"10.1055/a-2349-9962","DOIUrl":"https://doi.org/10.1055/a-2349-9962","url":null,"abstract":"<p><p>People with diabetes mellitus have a significantly increased risk of developing cardiovascular diseases. The coexistence of these two conditions has a considerable impact on prognosis. In August 2023, the European Society of Cardiology published new guidelines that include specific recommendations for risk reduction in affected individuals. The key points of these guidelines, along with newly published data since then and their respective practical relevance, are presented in the following article.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 12","pages":"690-695"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103376","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}