Deutsche medizinische Wochenschrift (1946)最新文献_第3页

[89-year-old patient with epigastric pain and hematin vomiting].

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-03-01 Epub Date: 2025-02-21 DOI: 10.1055/a-2432-8704

Janine Hus, Aliriza Celik, Nele Thießen

引用次数: 0

[Anti-inflammatory therapeutic advances in nephrology: can we learn from cardiology?]

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-03-01 Epub Date: 2025-02-21 DOI: 10.1055/a-2376-0783

Laura Katharina Sievers, Roland Schmitt

引用次数: 0

[Hypovolaemic and haemorrhagic shock].

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-03-01 Epub Date: 2025-03-14 DOI: 10.1055/a-2295-1929

Stephan Braune, Martin Rieck, Angela Ginski

{"title":"[Hypovolaemic and haemorrhagic shock].","authors":"Stephan Braune, Martin Rieck, Angela Ginski","doi":"10.1055/a-2295-1929","DOIUrl":"10.1055/a-2295-1929","url":null,"abstract":"Hypovolemic and hemorrhagic shock are life-threatening conditions that, if untreated, rapidly lead to multi-organ failure and death. These conditions result from significant intravascular fluid or blood loss, causing critical organ hypoperfusion. The underlying pathophysiology involves complex hemodynamic, inflammatory, and coagulation disturbances that may progress to irreversible organ dysfunction. Rapid diagnosis, early hemorrhage control, and targeted hemodynamic and hemostatic therapy are crucial to improve patient outcomes. Diagnosis is based on clinical symptoms, laboratory parameters, and imaging or endoscopic assessments. The primary therapeutic approach focuses on addressing the underlying cause while implementing fluid resuscitation and vasopressor support. In hemorrhagic shock, coagulation management is of paramount importance. Essential treatment principles include maintaining normothermia, a pH above 7.2, and normocalcemia. If no contraindications exist, permissive hypotension should be applied to limit ongoing bleeding. Early goal directed administration of tranexamic acid and fibrinogen is recommended to stabilize coagulation. For patients experiencing severe hemorrhagic shock, transfusion strategies must be optimized. A hemoglobin target of 7-9g/dL is generally recommended, and in cases requiring massive transfusion, a ratio of red blood cells, plasma, and pooled platelets of 4:4:1 should be used. Additionally, patients receiving effective anticoagulation require specific reversal agents to restore hemostasis. In summary, the successful management of hypovolemic and hemorrhagic shock depends on early recognition, rapid hemorrhage control, and individualized goal directed resuscitation and hemostatic strategies.","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 7","pages":"347-358"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631067","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

[Update COPD and cardiovascular events].

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-03-01 Epub Date: 2025-02-21 DOI: 10.1055/a-2326-7636

Maximilian Leitner, Anna Maria Blum, Robert Bals

{"title":"[Update COPD and cardiovascular events].","authors":"Maximilian Leitner, Anna Maria Blum, Robert Bals","doi":"10.1055/a-2326-7636","DOIUrl":"https://doi.org/10.1055/a-2326-7636","url":null,"abstract":"Chronic Obstructive Pulmonary Disease (COPD) is closely linked to cardiovascular disease (CVD), with up to 70% of COPD patients experiencing cardiovascular comorbidities. The coexistence of COPD and CVD significantly increases hospitalization rates, symptom burden, and mortality, particularly during acute exacerbations of COPD (AECOPD), which impose an increased risk of cardiovascular events - both during and shortly after these episodes. Mechanistic links between COPD and CVD include systemic inflammation, oxidative stress, endothelial dysfunction, and hypoxemia, all of which contribute to the progression of both conditions.Current management guidelines stress the importance of early screening and risk factor control for cardiovascular comorbidities in COPD patients. Different COPD therapies can affect cardiovascular outcomes in distinct ways. Recent research suggests that inhaled corticosteroids (ICS), either alone or as part of triple therapy (long-acting muscarinic antagonist [LAMA], long-acting beta-agonist [LABA], and ICS), may help reduce mortality and morbidity, particularly for those at higher risk. Furthermore, beta-blockers and statins have shown potential benefits for COPD patients with CVD, although their exact role is not entirely clear. Newer antidiabetic agents, such as SGLT-2 inhibitors, have also demonstrated promise in reducing exacerbation rates.This review emphasizes the need for an integrated care approach, highlighting the importance of personalized, guideline-driven therapies to enhance quality of life and clinical outcomes for COPD patients with cardiovascular comorbidities.","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 6","pages":"298-302"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473329","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

[Septic shock].

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-03-01 Epub Date: 2025-03-14 DOI: 10.1055/a-2288-2366

Ulrike Olgemöller, Christian Becker

引用次数: 0

[Lymphedema].

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-03-01 Epub Date: 2025-02-21 DOI: 10.1055/a-2361-0838

Katja Sibylle Mühlberg

{"title":"[Lymphedema].","authors":"Katja Sibylle Mühlberg","doi":"10.1055/a-2361-0838","DOIUrl":"https://doi.org/10.1055/a-2361-0838","url":null,"abstract":"The 5 most important pillars of conservative lymphoedema therapy are (1) compression, (2) manual lymphatic drainage (MLD), (3) exercise, (4) skin and wound care, and (5) self-management. Without compression therapy the risk of cellulitis is increased and causes an elevated health/economic burden. The use of nocturnal compression shows advantages and a high degree of treatment adherence. The previous recommendation that compression should not be used for cellulitis has been cancelled. On the contrary, compression therapy is explicitly desirable for inflammatory dermatoses. The fact that lymphedema extremities show a 3-fold higher association with malignant skin tumours compared to unaffected extremities deserves attention. Using ICG lymphography, 4 different functional regions of lymphatic leg bundles were differentiated. The severity of the lymphoedema correlated with the kind of affected bundles. Vascularized lymph node transfer, which is a reconstructive lymphatic surgery procedure, was found to show evidence in terms of volume reduction, improved functionality, and better quality of life. The higher the BMI, the higher the risk of developing lymphoedema. Meta-analyses confirm the benefits of an active lifestyle with exercise and sporting activities in conjunction with patient education. Apparative systems for decongestion (intermittent pneumatic compression) usually force patients to remain immobile during application. Portable apparative compression systems are a promising alternative but are not yet available in Germany. Primary lymphoedema is not a uniform entity. The St. George's classification system shows the association of primary lymphoedema with systemic or syndromic diseases and vascular malformations as well. As a work-in-progress algorithm, it is a valuable aid in classifying primary lymphoedema, confirming the diagnosis and finding therapeutic approaches.","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 6","pages":"253-259"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473323","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

[Cardiogenic shock - State of the art pathophysiology, therapy and prognosis].

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-03-01 Epub Date: 2025-03-14 DOI: 10.1055/a-2288-2256

Alexander Kersten

{"title":"[Cardiogenic shock - State of the art pathophysiology, therapy and prognosis].","authors":"Alexander Kersten","doi":"10.1055/a-2288-2256","DOIUrl":"10.1055/a-2288-2256","url":null,"abstract":"Cardiogenic shock is not a singular disease but rather a complex syndrome - characterized by systemic hypoperfusion, elevated intracardiac pressures, and insufficient cardiac output due to various possible underlying causes, leading to an acute, life-threatening, and critical condition.Significant advancements have been made in recent years in understanding the epidemiology, clinical course, phenotyping, hemodynamics, and the standardized classification of disease severity. However, progress in therapeutic interventions aimed at improving prognosis has been comparatively limited, with only a few therapies demonstrating significant evidence in randomized controlled trials. Among these, early revascularization in infarct-related cardiogenic shock (Acute Myocardial Infarction with Cardiogenic Shock - AMICS) has remained a key therapy for more than 20 years, and more recently, the use of percutaneous left ventricular assist devices in selected patients.Many questions remain unanswered, including the optimal pharmacotherapeutic regimen, the role of other mechanical support systems, the management of secondary organ dysfunction, and the best approach to supportive care.","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 7","pages":"325-332"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631132","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

Schock. 震惊

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-03-01 Epub Date: 2025-03-14 DOI: 10.1055/a-2519-4603

Uwe Janssens

引用次数: 0

[Protein-energy-malnutrition].

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-03-01 Epub Date: 2025-02-21 DOI: 10.1055/a-2358-3187

Rainer Wirth, Maryam Pourhassan, Dorothee Volkert

{"title":"[Protein-energy-malnutrition].","authors":"Rainer Wirth, Maryam Pourhassan, Dorothee Volkert","doi":"10.1055/a-2358-3187","DOIUrl":"https://doi.org/10.1055/a-2358-3187","url":null,"abstract":"Loss of appetite is part of the so-called \"sickness behavior\", which is a uniform reaction to many diseases, mainly triggered by inflammatory signals. Whereas this pattern may have been an evolutionary advantage long time ago, loss of appetite with consecutive malnutrition nowadays represents more a collateral damage of many acute and chronic diseases.Protein-energy-malnutrition should be diagnosed with the recently globally consented criteria of the \"Global Leadership Initiative on Malnutrition\" (GLIM). These criteria comprise 3 phenotypic and 3 etiologic criteria. If one criterium of each group is fulfilled, the diagnosis can be made.Besides the disease related loss of appetite, there are many potential causes of malnutrition. The entire spectrum may reach from malignancies to insufficient support in functionally impaired older subjects. Frequently, several factors may play a role. The very complex spectrum of potential and frequent causes of malnutrition has been summarized in the DoMAP model.Malnutrition may lead to severe consequences such as muscle atrophy and sarcopenia, leading to falls and fractures, impaired function of the immune system with an increase of infections and impaired wound healing, all of which are connected with increased morbidity and mortality.Many meta-analyses and guidelines have demonstrated the effectiveness of nutritional therapy in malnourished patients. There is good evidence for various approaches, that may be utilized alone or in combination, depending on the situation and disease of each individual patient. Particularly, the EFFORT-study, a large prospective randomized controlled trial, has demonstrated, that a structured, but individualized approach may be most effective.","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 6","pages":"260-265"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473326","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

[Lethal course: When plants affect the liver].

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-03-01 Epub Date: 2025-03-14 DOI: 10.1055/a-2433-1903

Lisa van der Lely, Rea Andermatt, Barbara Lienhardt

引用次数: 0