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[Geriatric Assessment in the Hospital - An Overview of Clinical Guidelines]. [医院的老年评估-临床指南概述]。
Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-06-01 Epub Date: 2025-05-19 DOI: 10.1055/a-2353-0680
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":"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}
引用次数: 0
[GLP-1 agonists - new kid on the block in nephrology]. [GLP-1激动剂——肾脏病学领域的新产品]。
Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-06-01 Epub Date: 2025-05-19 DOI: 10.1055/a-2420-6176
Leonie Kraft, Moritz Schanz, Jörg Latus
{"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":"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}
引用次数: 0
[Polyvascular Atherosclerosis: prevalence and prognosis]. 【多血管粥样硬化：患病率和预后】。
Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-06-01 Epub Date: 2025-05-28 DOI: 10.1055/a-2360-7551
Jörn Fredrik Dopheide, Mathias Kaspar
{"title":"[Polyvascular Atherosclerosis: prevalence and prognosis].","authors":"Jörn Fredrik Dopheide, Mathias Kaspar","doi":"10.1055/a-2360-7551","DOIUrl":"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}
引用次数: 0
[Health Effects of Wildfires]. [野火对健康的影响]。
Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-06-01 Epub Date: 2025-05-28 DOI: 10.1055/a-2542-8711
Thomas Münzel, Andreas Daiber
{"title":"[Health Effects of Wildfires].","authors":"Thomas Münzel, Andreas Daiber","doi":"10.1055/a-2542-8711","DOIUrl":"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}
引用次数: 0
[Risk Factor Management for Polyvascular Atherosclerosis]. 多血管粥样硬化的危险因素管理。
Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-06-01 Epub Date: 2025-05-28 DOI: 10.1055/a-2362-4893
Annika Reuser, Ulrich Laufs
{"title":"[Risk Factor Management for Polyvascular Atherosclerosis].","authors":"Annika Reuser, Ulrich Laufs","doi":"10.1055/a-2362-4893","DOIUrl":"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}
引用次数: 0
[Implementation of guideline-based basic therapy for obesity in Germany]. [在德国实施基于指南的肥胖基础治疗]。
Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-06-01 Epub Date: 2025-05-19 DOI: 10.1055/a-2548-1202
Hans Hauner, Anne Lautenbach, Matthias Blüher
{"title":"[Implementation of guideline-based basic therapy for obesity in Germany].","authors":"Hans Hauner, Anne Lautenbach, Matthias Blüher","doi":"10.1055/a-2548-1202","DOIUrl":"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}
引用次数: 0
[Heart and Diabetes - what's new?] 心脏和糖尿病-有什么新消息吗？]
Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-06-01 Epub Date: 2025-05-19 DOI: 10.1055/a-2349-9962
Katharina Marx-Schütt
{"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}
引用次数: 0
[Viral Hemorrhagic Fever (VHF) with a Potential for Human-to-Human Transmission]. [具有人际传播潜力的病毒性出血热（VHF）]。
Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-06-01 Epub Date: 2025-05-28 DOI: 10.1055/a-2241-4173
Stefan Schmiedel, Timo Wolf
{"title":"[Viral Hemorrhagic Fever (VHF) with a Potential for Human-to-Human Transmission].","authors":"Stefan Schmiedel, Timo Wolf","doi":"10.1055/a-2241-4173","DOIUrl":"https://doi.org/10.1055/a-2241-4173","url":null,"abstract":"<p><p>Lassa virus, Ebola virus, Marburg virus and Crimean Congo virus, as well as much rarer viruses that cause Viral Hemorrhagic Fevers (VHF), are zoonoses. Where these viruses are endemic, they cause both individual diseases, so-called \"spill-over events\" with isolated human cases after transmission from their animal reservoir, as well as epidemic outbreaks with cases of disease transmitted from person to person, and often high mortality. In this article, the focus will be on VHFs with the potential for human-to-human transmission; these diseases are so-called \"high-consequence infectious diseases (HCID)\" with partly considerable potential for epidemic spread and the risk of nosocomial disease transmission. In some cases, other viral infections without the possibility of human-to-human transmission, such as yellow fever or dengue fever, can also be accompanied by bleeding or multi-organ failure.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 13","pages":"758-771"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176189","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
[84-year-old patient with ring-shaped foreign bodies on the x-ray]. [84岁患者x线上环状异物]。
Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-06-01 Epub Date: 2025-05-28 DOI: 10.1055/a-2520-1781
Klaus Muehlenberg, Niels Zorger, Oliver Pech
{"title":"[84-year-old patient with ring-shaped foreign bodies on the x-ray].","authors":"Klaus Muehlenberg, Niels Zorger, Oliver Pech","doi":"10.1055/a-2520-1781","DOIUrl":"https://doi.org/10.1055/a-2520-1781","url":null,"abstract":"","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 13","pages":"733-734"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175962","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
[Hypoglycaemic ketoacidosis - an endocrine emergency]. [低血糖酮症酸中毒-内分泌急症]。
Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-06-01 Epub Date: 2025-05-19 DOI: 10.1055/a-2540-9824
Christina Sieger, Johannes Wolfgang Dietrich
{"title":"[Hypoglycaemic ketoacidosis - an endocrine emergency].","authors":"Christina Sieger, Johannes Wolfgang Dietrich","doi":"10.1055/a-2540-9824","DOIUrl":"10.1055/a-2540-9824","url":null,"abstract":"<p><p>A 20-year-old female patient was admitted via the medical emergency service to an accident and emergency department. Apart from obesity, no pre-existing medical conditions were known.The patient presented with hypotension, tachycardia, fever, somnolence and a brownish complexion. Computerised tomography revealed a diffuse cerebral oedema. Laboratory investigations demonstrated elevated inflammatory biomarkers, hyponatremia, renal failure, combined metabolic acidosis with severe ketonemia and slight lactatemia, primary hypothyroidism and adrenal failure. No indications for diabetes mellitus were obtained. The source of the infection could not be identified.Acute Addisonian crisis in the course of sepsis as the primary manifestation of autoimmune pluriglandular syndrome (APS) type 2.Due to treatment with initial hydrocortisone and broad-spectrum antibiotics, supportive measures and levothyroxine (in the further course) the situation could be stabilised within several days.The combination of the metabolism of starvation and endocrine diseases can lead to ketoacidosis in the absence of diabetes. The differential diagnosis of adrenal failure should be considered in this situation.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 12","pages":"713-719"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103380","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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