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[Unstable heart failure: practical guidelines for avoiding frequent hospital admissions].
Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-02-05 DOI: 10.1055/a-2447-7654
Stephan von Haehling, Birgit Aßmus, Stefan Frantz, Stefan Störk, Rolf Wachter, P Christian Schulze, Johann Bauersachs
{"title":"[Unstable heart failure: practical guidelines for avoiding frequent hospital admissions].","authors":"Stephan von Haehling, Birgit Aßmus, Stefan Frantz, Stefan Störk, Rolf Wachter, P Christian Schulze, Johann Bauersachs","doi":"10.1055/a-2447-7654","DOIUrl":"https://doi.org/10.1055/a-2447-7654","url":null,"abstract":"<p><p>Heart failure is the leading cause of hospital admissions in Germany. The prevention of hospitalizations due to heart failure has recently improved, encompassing guideline-based basic therapy, targeted medication escalation options, and structured outpatient care incorporating telemedicine. An early identification of parameters that precede or indicate acute heart failure is crucial. The term \"worsening heart failure\" is broader than the term \"acute heart failure\". Worsening heart failure includes patients identified through clinical examination, biochemical methods (especially natriuretic peptides), and imaging (echocardiography, chest X-ray, lung ultrasound, computed tomography, magnetic resonance imaging), and innovative cardiac telemonitoring. Early detection of worsening heart failure is only beneficial if followed by appropriate management that stabilizes heart failure, reduces mortality, and decreases hospital admissions and emergency contacts. Dedicated guidelines for the treatment of worsening heart failure are not yet available. It is recommended to start or up-titrate guideline-recommended medical therapy and additionally initiate treatment with the soluble guanylate cyclase stimulator Vericiguat in patients with heart failure with a reduced ejection fraction. Initiation and up-titration should begin during hospitalization and should be completed during careful follow-up within the first 6 weeks after discharge. This guide provides recommendations for the comprehensive and coordinated treatment of worsening heart failure, considering all these aspects which are crucial for improving patient outcomes.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257433","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
[83-year-old with angina pectoris, hemoglobinuria and icterus].
Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-02-01 Epub Date: 2025-01-29 DOI: 10.1055/a-2432-3518
Franziska Dickmann, Uwe Janssens
{"title":"[83-year-old with angina pectoris, hemoglobinuria and icterus].","authors":"Franziska Dickmann, Uwe Janssens","doi":"10.1055/a-2432-3518","DOIUrl":"https://doi.org/10.1055/a-2432-3518","url":null,"abstract":"<p><p>An 83-year-old female patient presented with angina pectoris, hemoglobinuria and jaundice. Laboratory diagnostics proved difficult due to hemolysis in all blood tubes, following re-evaluation after warming the blood sample.With low haptoglobin, elevated lactate dehydrogenase and elevated indirect bilirubin, we made a suspected diagnosis of autoimmune hemolytic anemia with cold antibodies, which was confirmed through a positive Coombs test and detection of C3d-loaded erythrocytes. Complications included NSTEMI type 2 in the context of hemolysis and acute kidney damage. A Proteus mirabilis bacteremia was diagnosed as the cause of the AIHA.After treatment of the underlying infection and high-dose prednisolone therapy, the hemolysis parameters regressed and the patient could be discharged to outpatient hematologic follow-up.Interdisciplinary and multi-professional collaboration with laboratory staff and transfusion medicine is crucial for both rapid diagnosis and further treatment. Blood transfusions in AIHA should only be carried out according to strict indications.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 4","pages":"163-166"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070316","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
[Community acquired gastroenteritis].
Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-02-01 Epub Date: 2025-01-29 DOI: 10.1055/a-2301-6781
Marie Leibenguth, Siegbert Rieg, Robert Thimme, Daniel Hornuss
{"title":"[Community acquired gastroenteritis].","authors":"Marie Leibenguth, Siegbert Rieg, Robert Thimme, Daniel Hornuss","doi":"10.1055/a-2301-6781","DOIUrl":"https://doi.org/10.1055/a-2301-6781","url":null,"abstract":"<p><p>Gastrointestinal infections are widespread and a major cause of global mortality, mainly affecting young children and the elderly. In Germany, each resident typically experiences one episode yearly. After COVID-19 pandemic, gastrointestinal infection rates have significantly increased again. Acute gastroenteritis typically presents with sudden stool changes, vomiting, and fever. In Germany, common pathogens include norovirus, rotavirus, Campylobacter spp., and Salmonella spp. New German guidelines on infectious gastroenteritis (published 2023) reflect recent studies and international treatment standards. The diagnosis of acute gastroenteritis should be based on clinical presentation and a thorough medical history, with stool testing reserved for severe cases or suspected outbreaks. Symptomatic treatment and rehydration of the patient are usually sufficient. Antibiotic treatment is generally not recommended except in severe cases, risk situations or the detection of specific pathogens.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 4","pages":"133-139"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070321","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
[Career as a Female Physician in Specialist Training].
Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-02-01 Epub Date: 2025-02-12 DOI: 10.1055/a-2313-5079
Astrid Bühren, Elpiniki Katsari, Doreen Richardt
{"title":"[Career as a Female Physician in Specialist Training].","authors":"Astrid Bühren, Elpiniki Katsari, Doreen Richardt","doi":"10.1055/a-2313-5079","DOIUrl":"https://doi.org/10.1055/a-2313-5079","url":null,"abstract":"<p><p>Following medical studies and licensing, the choice of a specialty represents a critical starting point for female physicians' careers in Germany. With female doctors comprising 49,2% of the total physician workforce by the end of 2023, their influence in the medical field is undeniable. This demographic shift necessitates effective career planning, as women increasingly dominate medical specialties, including 62,8% in general practice and 51,9% in internal medicine compared to surgery (26,8%).The training phase is sensitive, coinciding with personal decisions regarding partnerships, family planning, and potential relocations. A structured approach to training is essential to navigate the complexities of specialty selection while managing personal aspirations and responsibilities. Regulatory frameworks from regional medical boards outline requirements and provide opportunities for part-time training to accommodate family needs. Networking and mentorship play pivotal roles in facilitating career advancement and addressing the unique challenges faced by female physicians.Building professional networks is crucial for career development. Mentorship offers invaluable guidance, while social media facilitates broader connections within the medical community. Effective communication is a key competency, fostering trust with patients and enhancing interdisciplinary collaboration.As female physicians continue to rise in numbers and influence within Germany's medical landscape, targeted strategies for career development, including networking and effective communication, are vital. The evolving training landscape underscores the importance of supportive structures that empower women in medicine to navigate their professional journeys successfully.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 5","pages":"200-206"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412116","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
[57-year-old patient with an unusual expansion in upper abdomen].
Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-02-01 Epub Date: 2025-01-29 DOI: 10.1055/a-2414-2343
Maya Ahlers, Jule Marie Protzmann, Katrin Sänger
{"title":"[57-year-old patient with an unusual expansion in upper abdomen].","authors":"Maya Ahlers, Jule Marie Protzmann, Katrin Sänger","doi":"10.1055/a-2414-2343","DOIUrl":"https://doi.org/10.1055/a-2414-2343","url":null,"abstract":"","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 4","pages":"131-132"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070270","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
[62-year-old patient with progressive thyroid enlargement].
Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-02-01 Epub Date: 2025-02-12 DOI: 10.1055/a-2432-7174
Karsten Müssig, Barjo Turck, Jens Packeisen
{"title":"[62-year-old patient with progressive thyroid enlargement].","authors":"Karsten Müssig, Barjo Turck, Jens Packeisen","doi":"10.1055/a-2432-7174","DOIUrl":"https://doi.org/10.1055/a-2432-7174","url":null,"abstract":"","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 5","pages":"191-192"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412100","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
[Atypical hemolytic uremic syndrome: differential diagnosis and therapy - A clinical practice guideline for diagnosis and therapy].
Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-02-01 Epub Date: 2025-01-29 DOI: 10.1055/a-2382-6433
Anja Gäckler, Paul Thomas Brinkkötter
{"title":"[Atypical hemolytic uremic syndrome: differential diagnosis and therapy - A clinical practice guideline for diagnosis and therapy].","authors":"Anja Gäckler, Paul Thomas Brinkkötter","doi":"10.1055/a-2382-6433","DOIUrl":"https://doi.org/10.1055/a-2382-6433","url":null,"abstract":"<p><p>Atypical hemolytic uremic syndrome (aHUS) is an important differential diagnosis in thrombotic microangiopathy (TMA). The absence of definitive biomarkers usually allows for aHUS to be diagnosed only through a process of exclusion. Due to the unfavorable prognosis if adequate therapy is delayed or not provided, differential diagnostic considerations and initiation of treatment must occur promptly. The presented guideline is intended to serve as an aid in this process.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 4","pages":"167-172"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070319","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
[Phlebological or lymphological compression bandage: What are the differences?]
Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-02-01 Epub Date: 2025-01-29 DOI: 10.1055/a-2424-2336
Michaela Knestele, Knut Kroeger, Oliver Gültig
{"title":"[Phlebological or lymphological compression bandage: What are the differences?]","authors":"Michaela Knestele, Knut Kroeger, Oliver Gültig","doi":"10.1055/a-2424-2336","DOIUrl":"https://doi.org/10.1055/a-2424-2336","url":null,"abstract":"<p><p>Compression therapy is a recognized method for reducing oedema and should be used for venous and lymphatic disorders. It is important to differentiate between phleboedema and lymphoedema, as different bandaging techniques and materials are used in each case. This article provides an insight into this.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 4","pages":"173-178"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070331","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
[Standards in inpatient care of infectious diseases].
Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-02-01 Epub Date: 2025-02-12 DOI: 10.1055/a-2498-1395
Siegbert Rieg, Norma Jung, Tobias Tenenbaum, Winfried V Kern, Gerd Fätkenheuer
{"title":"[Standards in inpatient care of infectious diseases].","authors":"Siegbert Rieg, Norma Jung, Tobias Tenenbaum, Winfried V Kern, Gerd Fätkenheuer","doi":"10.1055/a-2498-1395","DOIUrl":"https://doi.org/10.1055/a-2498-1395","url":null,"abstract":"<p><p>In addition to the one-year advanced training program in infectious diseases that has been in place for several years, a six-year-full specialist training in internal medicine and infectious diseases (ID) has recently been introduced in Germany. While recommendations for ID training program curricula were developed, there is no description of genuine ID activities in Germany, nor have any working standards been defined to date. However, this seems to be necessary, both for the structural implementation of ID in German hospitals and for ensuring the quality-of-care. The current article therefore outlines standards for core ID activities as well as quality requirements for efficient ID training programs. As long as no separate speciality for pediatric ID is established in Germany, these principles should also apply in paediatrics and adolescent medicine.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 5","pages":"230-236"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411669","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
[Nosocomial gastrointestinal infections and Clostridioides difficile].
Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-02-01 Epub Date: 2025-01-29 DOI: 10.1055/a-2303-3321
Tobias Weirauch, Maria J G T Vehreschild
{"title":"[Nosocomial gastrointestinal infections and Clostridioides difficile].","authors":"Tobias Weirauch, Maria J G T Vehreschild","doi":"10.1055/a-2303-3321","DOIUrl":"https://doi.org/10.1055/a-2303-3321","url":null,"abstract":"<p><p>German surveillance data from 2022 reported a prevalence of nosocomial infections among hospitalized patients of 5,2%. Clostridioides-difficile-infections (CDI) are the most frequent cause of nosocomial diarrhea. They are usually caused by antibiotic exposure and the subsequent changes in the gut microbiota. Clinical manifestation ranges from asymptomatic colonization over moderate diarrhea to severe pseudomembranous colitis. According to the current German Gastrointestinal Infection Guidelines, fidaxomicin is the preferred treatment option for CDI, especially in patients at high risk of recurrence or those already suffering from recurrence. Vancomycin can also be used as an alternative for initial CDI treatment. Fecal microbiota transplantation is considered a treatment approach for patients with multiple recurrences.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 4","pages":"149-156"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070328","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
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