Deutsche medizinische Wochenschrift (1946)最新文献_第5页

[Atrial fibrillation in ion channel diseases and cardiomyopathies]. [心房颤动在离子通道疾病和心肌病中的应用]。

IF 0.7

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-08-01 Epub Date: 2025-08-05 DOI: 10.1055/a-2498-1571

Fabienne Kreimer, Michael Gotzmann, Lars Eckardt

引用次数: 0

[Guideline-based treatment of atrial fibrillation in heart failure]. [心衰患者心房颤动的指南治疗]。

IF 0.7

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-08-01 Epub Date: 2025-08-05 DOI: 10.1055/a-2498-1637

Manuel Vogel, Thomas Fischer

引用次数: 0

[Green intensive care unit]. [绿色重症监护病房]。

IF 0.7

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-08-01 Epub Date: 2025-08-07 DOI: 10.1055/a-2286-0436

Matthias Kochanek, Uwe Janssens, Victoria König

{"title":"[Green intensive care unit].","authors":"Matthias Kochanek, Uwe Janssens, Victoria König","doi":"10.1055/a-2286-0436","DOIUrl":"https://doi.org/10.1055/a-2286-0436","url":null,"abstract":"The \"Green Intensive Care Unit\" addresses the challenge of reducing the ecological footprint of the healthcare sector, which is responsible for 4.4% of greenhouse gas emissions worldwide. In Germany, the healthcare sector accounts for 5.2% of national emissions. Intensive care units in particular are resource-intensive due to their high energy consumption, waste generation and the use of disposable materials. Sustainability in intensive care medicine aims to combine ecological responsibility with excellent patient care. This includes the introduction of overarching sustainability strategies, greater digitalization and the efficient use of resources. Energy-efficient equipment, improved waste management systems and the targeted optimization of processes reduce the consumption of resources. Conscious handling of medicines, appropriate use of protective materials and the use of sustainable materials also help to minimize the ecological footprint. In addition, the promotion of palliative care and advanced care planning makes it possible to avoid overuse while ensuring the quality of patient care. These approaches are based on a current S1 guideline (by the DGIIN) and offer practicable solutions to promote sustainability in intensive care medicine without compromising on care. Successful implementation requires a deep awareness of sustainable action and close integration with higher-level healthcare structures.","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 17","pages":"1019-1026"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144801298","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

[50-year-old patient with atraumatic painful swelling of the neck]. [50岁患者，颈部非外伤性疼痛肿胀]。

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-08-01 Epub Date: 2025-07-21 DOI: 10.1055/a-2535-5511

Jörg Herold, Emine Atac-Carpenter

引用次数: 0

[Thyroid Storm and Myxedema Coma]. [甲状腺风暴和黏液性水肿昏迷]。

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-08-01 Epub Date: 2025-07-21 DOI: 10.1055/a-2318-7637

Matthias Auer, Eleni Pappa

{"title":"[Thyroid Storm and Myxedema Coma].","authors":"Matthias Auer, Eleni Pappa","doi":"10.1055/a-2318-7637","DOIUrl":"https://doi.org/10.1055/a-2318-7637","url":null,"abstract":"Thyrotoxic crisis and myxedema coma are rare but highly life-threatening endocrinological emergencies. Both conditions require rapid clinical diagnosis and intensive care treatment, as mortality remains high despite treatment (up to 30% in thyrotoxic crisis, up to 60% in myxedema coma). While thyrotoxic crisis is characterized by hypermetabolism with fever, tachycardia, agitation, and multiorgan failure, myxedema coma manifests as a hypometabolic state with hypothermia, bradycardia, impaired consciousness, and respiratory failure. Diagnosis is primarily based on the clinical picture; laboratory findings should not delay initiation of treatment. Both emergencies usually arise from decompensation of a known thyroid disorder under the influence of precipitating factors, the identification and treatment of which are essential. Treatment for thyrotoxic crisis includes the simultaneous administration of beta-blockers, high-dose antithyroid drugs, glucocorticoids, and intensive care support. In myxedema coma, immediate intravenous hormone replacement (L-thyroxine) and hydrocortisone administration are paramount. Interdisciplinary care and consistent follow-up treatment of the underlying disease are crucial for the prognosis.","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 15","pages":"873-882"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683889","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

[Management of Risk Factors and Comobordities in Atrial Fibrillation]. [心房颤动的危险因素和共病的管理]。

IF 0.7

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-08-01 Epub Date: 2025-08-05 DOI: 10.1055/a-2516-8410

Melanie Gunawardene, Boris Schmidt

引用次数: 0

[Autoimmune and genetic-cholestatic liver diseases: the new guidelines]. [自身免疫性和遗传性胆汁淤积性肝病：新指南]。

IF 0.7

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-08-01 Epub Date: 2025-08-07 DOI: 10.1055/a-2462-8656

Marcial Sebode, Christian Hudert, Ansgar W Lohse, Philip Bufler

{"title":"[Autoimmune and genetic-cholestatic liver diseases: the new guidelines].","authors":"Marcial Sebode, Christian Hudert, Ansgar W Lohse, Philip Bufler","doi":"10.1055/a-2462-8656","DOIUrl":"10.1055/a-2462-8656","url":null,"abstract":"Autoimmune liver diseases are rare, but among rare diseases they are relatively frequent. Autoimmune hepatitis (AIH) is a very heterogeneously presenting disease and lacks specific diagnostic tests. Unfortunately, steroid-free treatment can be achieved for only a minority of patients in real-life settings. Treatment algorithms provided by clinical practice guidelines help to reduce the rate of side effects and to increase the response rate. Diagnosis and first-line treatment of primary biliary cholangitis (PBC) is easier than in AIH. The challenges of PBC are to identify patients at risk for disease progression and to offer the most effective and safest second-line treatment for the individual patient. Treatment options for primary sclerosing cholangitis (PSC) are very limited. Therefore, the clinical focus should be on identification of patients at risk for the need of liver transplant and on screening for malignant complications such as cholangiocarcinoma or colorectal carcinoma in case of associated colitis. Genetic cholestatic liver diseases (GCD) are rare monogenetic disorders presenting in early infancy to later in life and are associated with significant morbidity. Cholestatic pruritus is a hallmark symptom in most GCD significantly impacting of quality of life and requiring surgical or pharmacologic intervention or even liver transplant. Selective inhibitors of ileal bile acid transport (IBAT) have been introduced as novel treatment option interrupting enterohepatic circulation of bile acids. Aside from their proven effect on pruritus, it remains unclear whether chronic liver damage by bile acid toxicity may also be reduced. Besides the risk for development of biliary cirrhosis, an elevated risk for hepatobiliary malignoma is present in GCD, and patients need lifelong tumor surveillance. The often multisystemic nature of GCD requires highly specialized multidisciplinary treatment in dedicated centers and careful transition to adult medicine is warranted.","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 17","pages":"1006-1012"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144801296","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

[Home mechanical ventilation: What's new?] 家用机械通风：有什么新进展？］

IF 0.7

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-08-01 Epub Date: 2025-08-07 DOI: 10.1055/a-2368-1546

Sarah B Stanzel, Maximilian Wollsching-Strobel

{"title":"[Home mechanical ventilation: What's new?]","authors":"Sarah B Stanzel, Maximilian Wollsching-Strobel","doi":"10.1055/a-2368-1546","DOIUrl":"10.1055/a-2368-1546","url":null,"abstract":"Home mechanical ventilation (HMV) has evolved significantly over the past decade. While initially used primarily for neuromuscular diseases, the increasing application of non-invasive ventilation (NIV) for chronic obstructive pulmonary disease (COPD) has demonstrated significant benefits in reducing mortality and hospitalizations. Concurrently, the prevalence of obesity hypoventilation syndrome (OHS) is rising, necessitating adapted treatment strategies. The newly updated German S3-guideline differentiates between NIV and invasive ventilation and includes refined indication criteria, particularly for COPD. Furthermore, it incorporates ethical considerations regarding decision-making in ventilation therapy and end of life. Alternative treatment options for chronic respiratory insufficiency are also gaining clinical and scientific attention. High flow therapy, which is already being used effectively for acute respiratory insufficiency, is increasingly being used for chronic respiratory insufficiency. Furthermore, the implementation of the Intensive Care and Rehabilitation Strengthening Act (IPREG) has established new quality standards in long-term mechanical ventilation, yet challenges persist in its nationwide application.","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 17","pages":"1040-1045"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144801299","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

[Type 1 Diabetes and Sports: What to Consider?] 1型糖尿病和运动：要考虑什么？］

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-08-01 Epub Date: 2025-07-21 DOI: 10.1055/a-2500-5830

Johanna Kramme, Othmar Moser, Tim Heise, Dominik Pesta

引用次数: 0

[An Endocrinological Perspective on Electrolyte Imbalances]. [电解质失衡的内分泌学观点]。

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-08-01 Epub Date: 2025-07-21 DOI: 10.1055/a-2318-7580

Charlotte Fries, Wiebke Fenske

{"title":"[An Endocrinological Perspective on Electrolyte Imbalances].","authors":"Charlotte Fries, Wiebke Fenske","doi":"10.1055/a-2318-7580","DOIUrl":"https://doi.org/10.1055/a-2318-7580","url":null,"abstract":"Background: Electrolyte disorders are among the most frequent presentations in emergency internal medicine and may represent initial manifestations of underlying endocrine disease. This review highlights the pathophysiological background, diagnostic strategies and therapeutic recommendations for electrolyte imbalances in endocrine emergencies.Content: Hyponatremia still marks the most prevalent electrolyte disorder and may indicate underlying adrenal insufficiency, hypopituitarism, the syndrome of inappropriate antidiuresis (SIAD), or immunotherapy-induced endocrinopathies. The diagnostic evaluation includes clinical volume assessment and paired measurements of serum and urine sodium and osmolality. Acute symptomatic hyponatremia requires immediate correction using hypertonic saline, overcorrection can be avoided by using proactive or reactive desmopressin protocols. SIAD remains a diagnosis of exclusion, with fluid restriction remaining first-line therapy and osmotic agents and tolvaptan as second-line options. Hypernatremia may occur in the context of diabetes insipidus and requires careful fluid management and, in central forms, desmopressin substitution. Hypokalemia can result from hyperaldosteronism or hypercortisolism and should prompt endocrine evaluation, especially in patients with hypertension. Hypercalcemia is frequently caused by hyperparathyroidism but may also be present in thyrotoxicosis, adrenal insufficiency or due to excessive intake of cholecalciferol or lithium.Conclusion: Electrolyte disturbances may serve as important clinical indicators and red flags of endocrine disorders. Early recognition and targeted diagnostic and therapeutic strategies are essential to prevent life-threatening complications. This review provides a structured approach for clinicians to evaluate and manage electrolyte disorders with a focus on endocrine etiologies in acute care settings.","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 15","pages":"883-889"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683885","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