Deutsche medizinische Wochenschrift (1946)最新文献_第4页

[Climate and the Heart]. [气候与心脏]。

IF 0.7

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-08-01 Epub Date: 2025-08-07 DOI: 10.1055/a-2420-6262

Thomas Münzel, Alexandra Schneider, Andreas Daiber

引用次数: 0

[Antibiotic Stewardship in Nosocomial Pneumonia]. 院内肺炎的抗生素管理。

IF 0.7

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-08-01 Epub Date: 2025-08-05 DOI: 10.1055/a-2337-3496

Irit Nachtigall, Jessica Rademacher, Evelyn Kramme

{"title":"[Antibiotic Stewardship in Nosocomial Pneumonia].","authors":"Irit Nachtigall, Jessica Rademacher, Evelyn Kramme","doi":"10.1055/a-2337-3496","DOIUrl":"10.1055/a-2337-3496","url":null,"abstract":"Pneumonia is one of the most important nosocomially acquired infections in Germany. Rational management strategies contribute to optimizing treatment and minimizing the development of resistance. The calculated antimicrobial therapy should take into account the severity, the risk of multi-resistant pathogens and P. aeruginosa as well as the local resistance situation. The infection occurs more frequently in non-ventilated patients, yet the evidence for ventilator-associated pneumonia is better, mainly due to easier microbiological diagnostics. The spectrum of pathogens does not differ significantly between the two disease entities. E. coli, K. pneumoniae, P. aeruginosa and, in the gram-positive spectrum, S. aureus and S. pneumoniae are the most common pathogens detected. Early detection, particularly in sepsis, followed by targeted diagnostic measures are relevant managing the disease. Calculated antibiotic therapy taking into account the severity of the disease and the patient's individual risk of multi-resistant pathogens, should be administered promptly. A re-evaluation of the diagnosis and therapy after 48-72 hours is crucial for the success of treatment and the rational use of antibiotics. All findings obtained to confirm the diagnosis and assess the course of the disease should be reviewed with regard to the accuracy of the diagnosis, the therapeutic response and the possibility of optimizing antibiotic therapy. If there is a response to treatment, which is primarily expressed in a clinical improvement, the recommended treatment duration of 7 days should not be exceeded. If there is no improvement in symptoms, microbiological findings, complications and differential diagnoses should be checked. Pharmacokinetic and pharmacodynamic principles should be considered with regard to the substances and the duration of application and dosage.","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 16","pages":"980-990"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791117","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

[Endocrinological Emergencies]. (内分泌系统紧急情况)。

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-08-01 Epub Date: 2025-07-21 DOI: 10.1055/a-2602-8428

Uwe Janssens

引用次数: 0

[58-year-old patient with rheumatoid arthritis and leg edema]. [58岁类风湿关节炎合并腿部水肿患者]。

IF 0.7

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-08-01 Epub Date: 2025-08-07 DOI: 10.1055/a-2594-1956

Luisa Schneider, Jörg Henes, Andreas Goldschmied

引用次数: 0

[74-year-old patient with dermatological findings on the shaft of the penis]. [74岁患者，阴茎轴有皮肤病学发现]。

IF 0.7

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-08-01 Epub Date: 2025-08-05 DOI: 10.1055/a-2555-8919

Julian Philipp Kionke, Valentina Laura Müller, Alexander Kreuter

引用次数: 0

[Proportion of women on the executive boards and committees of 183 professional associations of the Association of the Scientific Medical Societies in Germany (AWMF)]. [德国科学医学学会协会（AWMF） 183个专业协会的执行委员会和委员会中的妇女比例]。

IF 0.7

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-08-01 Epub Date: 2025-07-21 DOI: 10.1055/a-2618-0902

Uwe Janssens, Louisa Jahnke, Teresa Deffner, Monika Nothacker, Florian Hoffmann

{"title":"[Proportion of women on the executive boards and committees of 183 professional associations of the Association of the Scientific Medical Societies in Germany (AWMF)].","authors":"Uwe Janssens, Louisa Jahnke, Teresa Deffner, Monika Nothacker, Florian Hoffmann","doi":"10.1055/a-2618-0902","DOIUrl":"10.1055/a-2618-0902","url":null,"abstract":"The growing proportion of women in medical studentship and medical practice contrasts with their under-represented role in leadership positions in medical professional associations in Germany. Against this background, the proportion of women in top positions of medical professional associations in Germany has been analysed.A total of 1460 individuals were counted in the analysis of the composition of the boards/presidia of the 183 professional societies. The proportion of women on the boards/executive committees was 32.6%. Of the 183 professional societies, 47 (25.7%) were led by a woman as president. 72 (39.3%) women served as vice presidents. Only 39 (21.3%) professional societies had a proportion of women on the boards/executive committees ≥50%.There is a significant imbalance of female leadership positions in medical professional associations in Germany. To address this inequality, a strategy with multiple initiatives is needed that includes both career development programmes such as mentoring and the design of congress participation to ensure a balanced gender representation.","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 15","pages":"899-904"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683888","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

[From renal crisis to lung fibrosis - systemic sclerosis in the course of time]. [从肾危象到肺纤维化-系统性硬化症]。

IF 0.7

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-08-01 Epub Date: 2025-08-05 DOI: 10.1055/a-2615-9127

Kai Martin Jahns, Matthias Dreher, Konstantinos Triantafyllias, Lennart Haßdenteufel, Andreas Schwarting

引用次数: 0

[Acute pancreatitis: Progress through Restraint?] 急性胰腺炎：通过克制的进展？］

IF 0.7

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-08-01 Epub Date: 2025-08-07 DOI: 10.1055/a-2286-0469

Jonathan Frederik Brozat, Frank Tacke

{"title":"[Acute pancreatitis: Progress through Restraint?]","authors":"Jonathan Frederik Brozat, Frank Tacke","doi":"10.1055/a-2286-0469","DOIUrl":"10.1055/a-2286-0469","url":null,"abstract":"Acute pancreatitis (AP) is a potentially life-threatening disease, often progressing in 2 phases: initial sterile inflammation, followed by later infected necrosis. Advances in care have shifted management toward a minimally invasive, step-up approach. AP is diagnosed based on typical abdominal pain, elevated lipase, or characteristic imaging - amylase is no longer essential. In hypertriglyceridemic AP, plasmapheresis offers no proven benefit. (Endo)sonography is mandatory. Contrast-enhanced CT should be delayed unless necrosis is suspected or diagnosis remains uncertain; optimal timing is ≥72h, ideally after 7 days. Prognostic tools (BISAP, Ranson) and markers (hematocrit, lactate, BUN) are insufficient to predict severe or necrotizing AP. Post-hoc, the revised Atlanta classification may be more effective than the determinant-based classification. Emergency ERC (<24h) is only warranted in cholangitis. Without cholangitis, ERC within 72h is adequate; biliary sphincterotomy and pancreatic stenting reduce post-ERC pancreatitis. Opioids are superior to NSAIDs and are first-line for analgesia. Early, goal-directed fluid resuscitation with balanced crystalloids improves outcomes, while excessive fluids (>3mL/kg/h) should be avoided. Enteral/oral nutrition within 24h reduces the risk of infected necrosis and is preferred over parenteral feeding. Antibiotic prophylaxis is not recommended, even in necrotizing AP; infected necrosis is rare in the first 2 weeks. Procalcitonin may support therapeutic decisions. Necrosis should be managed stepwise: antibiotics, then drainage, then delayed minimally-invasive necrosectomy. Endoscopic access is preferred; open surgery is obsolete. Outcomes improve significantly in specialized, high-volume centers with critical care, interventional endoscopy/radiology, and pancreatic surgery expertise.","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 17","pages":"1027-1033"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144801295","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

[Immunosuppression in Cancer: Strategies for Infection Prevention]. 肿瘤免疫抑制：感染预防策略

IF 0.7

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-08-01 Epub Date: 2025-08-07 DOI: 10.1055/a-2414-8494

Charlotte Schwicht, Michael von Bergwelt-Baildon, Karsten Spiekermann

{"title":"[Immunosuppression in Cancer: Strategies for Infection Prevention].","authors":"Charlotte Schwicht, Michael von Bergwelt-Baildon, Karsten Spiekermann","doi":"10.1055/a-2414-8494","DOIUrl":"10.1055/a-2414-8494","url":null,"abstract":"Antimicrobial prophylaxis is an important cornerstone for reducing morbidity and mortality of cancer patients. Important strides have been made in recent years in vaccination, drug prophylaxes and the use of growth-factor support. We detail these changes to the respective recommendations here.Patients with malignant disease are recommended to receive vaccinations against common respiratory pathogens (COVID-19, influenza, pneumococci, and RSV). For both influenza (now trivalent vaccine) and pneumococci (now PCV20), the preferred vaccine has changed. A VZV vaccination using an inactivated virus-subunit is also recommended to prevent reactivations. The profound B-cell depletion caused by CAR-T cell therapy is increasingly being considered in vaccination recommendations.In high-risk situations, antibiotic prophylaxis using fluoroquinolones can be used. However, due to increasing resistance and significant side effects, this approach is being critically evaluated.Posaconazole is recommended as the standard prophylaxis for patients with neutropenia >7 days (<0,5G/L) and hematologic malignancies. Isavuconazole offers an effective alternative for patients who cannot tolerate posaconazole. Interactions between antifungal agents and oncological therapies are becoming increasingly relevant, with particular attention to the CYP-450-enzyme inducing/inhibiting substances. Non-pharmacological measures to prevent fungal infections are now part of the recommendations. These include smoking cessation.Pharmacological prophylaxis for COVID-19 is generally not recommended.The thresholds for primary growth-factor-support have been lowered: G-CSF is generally recommended if the risk of febrile neutropenia is >20%, or, if patient inherent risk factors are present, >10%. A new long-acting, non-PEG-containing G-CSF preparation was approved in 2024.Good collaboration between oncologists and general practitioners is essential to translate these recommendations into clinical practice.","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 17","pages":"1013-1018"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144801300","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

[Adrenal Crisis]. (肾上腺危象)。

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-08-01 Epub Date: 2025-07-21 DOI: 10.1055/a-2318-7541

Dirk Weismann

引用次数: 0