Deutsche medizinische Wochenschrift (1946)最新文献

{"title":"[Obesity in intensive care].","authors":"Michael Haap","doi":"10.1055/a-2286-6542","DOIUrl":"https://doi.org/10.1055/a-2286-6542","url":null,"abstract":"<p><p>The prevalence of obesity and its associated comorbidities are increasing worldwide, leading to a rising proportion of obese patients in hospitals and intensive care units. This trend is causing a significant additional burden on our healthcare system. An obese patient requiring intensive care treatment presents major challenges for the entire team, not only in terms of economic aspects but also medically, in nursing care, and in physiotherapy. Additionally, psychosocial and organizational factors play a role that must be considered. For nursing and physiotherapy, appropriate aids such as lifters, special large hospital beds, suitable rooms, and adequate staffing should be provided. The medical challenges include intubation and airway management, hemodynamic monitoring, vascular access, adequate nutrition, appropriate dosing of medication, and difficult ultrasound conditions at the bedside. Furthermore, this patient population has an increased risk of developing pressure ulcers, pneumonia, and thrombosis, which increase the overall care requirements and further challenge the intensive care setting.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 11","pages":"632-644"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046146","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":"[Generation X and millennials are at greater cancer risk than previous generations: Possible causes and implications].","authors":"Hans Scherübl","doi":"10.1055/a-2531-9761","DOIUrl":"https://doi.org/10.1055/a-2531-9761","url":null,"abstract":"<p><p>The incidence of early-onset malignancy (EOM) diagnosed under the age of 50 has been increasing worldwide. In the USA, Generation X and the millennials are up to 2 times more likely to develop 17 of the 34 most common cancers than the baby boomers at any given age. Globally, the incidence of EOM increased by 79.1% between 1990 and 2019. Early-life exposure may be linked with EOM development and may forecast a greater disease burden in the future. Possible causes and consequences are discussed with regards to cancer prevention.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 10","pages":"575-583"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039619","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":"[Diagnostic of the chronic coronary syndrome].","authors":"Katharina A Riedl, Renate Schnabel","doi":"10.1055/a-2463-2902","DOIUrl":"https://doi.org/10.1055/a-2463-2902","url":null,"abstract":"<p><p>The chronic coronary syndrome can be attributed to different pathophysiological epicardial or microvascular mechanisms. In the current ESC guideline from 2024, a diagnostic algorithm was developed based on a risk-factor-weighted individual pre-test probability. The baseline diagnostic includes anamnesis, electrocardiogram, and a laboratory chemical analysis, especially to exclude an acute coronary syndrome. The early and direct assessments for risk-factor-weighted individual pre-test probability are calculated by taking into account clinical symptoms, individual cardiovascular risk factors, age, and gender. Resting ECG, echocardiography and the evaluation of the peripheral arteries and data on possible known vascular calcifications in previous imaging examinations can further adjust and modify the pre-test probability. Non-invasive imaging methods (computed tomography angiography, magnetic resonance imaging, stress echocardiography, SPECT, PET) or invasive coronary angiography can be used to confirm or exclude the diagnosis of chronic coronary syndrome.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 11","pages":"607-614"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014998","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":"[Invasive treatment of chronic coronary syndrome].","authors":"Julinda Mehilli, Arben Perani","doi":"10.1055/a-2430-0255","DOIUrl":"https://doi.org/10.1055/a-2430-0255","url":null,"abstract":"<p><p>The 2024 guidelines of the European Society of Cardiology for the treatment of chronic coronary syndrome provide a comprehensive overview covering prevention, diagnostics, as well as pharmacological and invasive therapies. Based on the latest scientific evidence, the guidelines for myocardial revascularization, valid since 2018, have been updated, and treatment recommendations have been adjusted accordingly. Myocardial revascularization, as an adjunct to optimal pharmacological therapy, remains a key treatment strategy for symptom relief, as well as for improving quality of life and long-term clinical outcomes in patients with chronic coronary syndrome. The decision between percutaneous coronary intervention and coronary artery bypass surgery depends on the anatomical complexity and functional severity of coronary artery disease, as well as comorbidities, patient preferences, and expectations. A careful risk-benefit assessment and an individualized treatment approach are essential to ensure optimal care for each patient. The current guidelines provide an evidence-based framework for this complex decision-making process.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 11","pages":"623-627"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995134","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":"[Chronic Coronary Syndrome].","authors":"Stefan Frantz","doi":"10.1055/a-2551-1592","DOIUrl":"https://doi.org/10.1055/a-2551-1592","url":null,"abstract":"","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 11","pages":"595"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046312","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":"[Malignant melanoma].","authors":"Mascha Binder, Michael von Bergwelt-Baildon","doi":"10.1055/a-2500-0975","DOIUrl":"https://doi.org/10.1055/a-2500-0975","url":null,"abstract":"","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 10","pages":"535"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014999","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":"[Adjuvant and neoadjuvant therapy of melanoma].","authors":"Dirk Debus, Axel Hauschild, Erwin S Schultz","doi":"10.1055/a-2453-8887","DOIUrl":"https://doi.org/10.1055/a-2453-8887","url":null,"abstract":"<p><p>The treatment of malignant melanoma with (neo-)adjuvant therapy represents a promising approach to reducing recurrence and metastasis. At the same time, due to the risk of potential side effects, a risk-benefit assessment is required in advance, taking into account the stage-dependent risk of recurrence. The article presents the current study situation on adjuvant and neoadjuvant therapy.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 10","pages":"555-561"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001759","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":"[68-year-old patient with pain of the left hip und thigh].","authors":"Oanh Vo, Philipp Klemm, Nils Schulz","doi":"10.1055/a-2497-3686","DOIUrl":"https://doi.org/10.1055/a-2497-3686","url":null,"abstract":"","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 10","pages":"545-546"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000754","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":"[Rare side effect in the treatment of bacterial endocarditis].","authors":"Carola Andrea George, Fabian Gisler, Ursula Flückiger","doi":"10.1055/a-2505-8860","DOIUrl":"10.1055/a-2505-8860","url":null,"abstract":"<p><p>A patient went to the hospital due to persistent febrile temperatures. Positive blood cultures for Enterococcus faecalis as well as a vegetation on the mitral valve in the echocardiography were detected. Therefore the diagnosis of E. faecalis endocarditis was made. An appropriate antimicrobial combination therapy with amoxicillin and gentamicin was initiated. During the course of treatment, gentamicin was switched to ceftriaxone because of an acute kidney injury KDIGO stadium AKI 1. Furthermore a mechanical mitral valve replacement was performed. After a continuous 5-week antimicrobial therapy, the patient was urgently transferred back from cardiological rehabilitation to the hospital due to acute flank pain with emesis.Clinically, the 64-year-old patient presented with tenderness in the right abdomen. Laboratory tests revealed acute kidney injury AKI 3 with microhematuria in the urine analysis. Sonographically, there was evidence of hydronephrosis in the right kidney. An abdominal CT revealed a calculus in the urinary bladder.The calculus, measuring 7 × 3 × 2 mm, was expelled through micturition and consisted 100% of amoxicillin. Therefore, the diagnosis of amoxicillin-induced urolithiasis was made.The antimicrobial therapy with amoxicillin was adjusted according to kidney function. Due to an initially unclear inflammatory condition associated with Dressler syndrome, the combination therapy was completed after 8 weeks instead of 6 weeks. At this time, the creatinine level was slightly elevated. After two weeks, it was back within the normal range. Two years later, the patient is free from recurrence of endocarditis.In the case of intrarenal precipitation of crystals, crystal nephropathy occurs, which presents a rare side effect of amoxicillin. As in this case, massive precipitation of macroscopic crystals in the renal pelvis can even lead to urolithiasis with obstructive nephropathy. This case demonstrates the importance of regular monitoring of renal function during treatment with amoxicillin, particularly in high-dose therapy with prolonged treatment duration.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 11","pages":"628-631"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046313","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":"[Healthcare landscape in internal medicine in Germany: A trend analysis over 10 years for the German Society of Internal Medicine (DGIM)].","authors":"Dirk Müller-Wieland, Elke Berger, Phillip Hengel, Reinhard Busse, Georg Ertl, Norbert Suttorp","doi":"10.1055/a-2328-6929","DOIUrl":"10.1055/a-2328-6929","url":null,"abstract":"<p><p>The aim of the project is to analyse the status of the inpatient and outpatient care landscape with regard to medical staff, care structures and performance developments for internal medicine and its specialities.Various data sources were used, including the German Medical Association, the National Association of Statutory Health Insurance Physicians, the Federal Statistical Office and structured hospital quality reports.According to the German Medical Association, 58000 internists were registered in 2020, 45% (n=26,400) of whom worked in the inpatient sector and 48% (n=28,000) in the outpatient sector. The proportion of female, younger, part-time and salaried employees is increasing. The proportion of internists among all general practitioners rose from around 25% or 25,200 in 2013 to over 30% or 29,300 in 2020.According to the structured quality reports, 34% (n=166000) of the 494000 hospital beds in 2019 were allocated to internal medicine and 33% of these (n= 54500) to the various specialties. The number of beds per population remained almost unchanged from 2010 to 2017, both for internal medicine as a whole and across all specialities.In 2019, a good 7.2 million (36%) of the almost 20 million inpatient cases were treated in internal medicine departments. Of these, 69% or 5.0 million were in general internal medicine with an average length of stay of 6.9 days. In relation to general and specialized internal medicine, number of hospital beds, medical staff and cases differed from region to region.The proportion of younger, female, part-time and salaried doctors in internal medicine is increasing. The development of internal medicine varies regionally, which should be taken into account when reforming the healthcare system.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":" ","pages":"e28-e40"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733723","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}