{"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}
{"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}
{"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}
{"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}
{"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}
{"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}
{"title":"[The road to prevention - navigating vision zero strategies in oncology].","authors":"Julia Löffler, Michael von Bergwelt-Baildon","doi":"10.1055/a-2381-4586","DOIUrl":"https://doi.org/10.1055/a-2381-4586","url":null,"abstract":"<p><p>Modern medicine, despite successful strategies to reduce preventable deaths in areas like traffic and workplaces, lacks comparable strategies. As cancer incidences are on the rise globally, early detection and intervention by targeted therapies can significantly improve treatment success. Furthermore, over 50% of severe cancer cases could be avoided or detected very early through targeted prevention. Especially for primary preventive measures so-called \"Vision Zero\" concepts could already be a reality today. Studies show the effectiveness and safety of the HPV vaccine, leading to significant reductions in HPV-associated cancers in countries where vaccination coverage is high. Despite improved national efforts, Germany ranks second to last in a European comparison of vaccination rates in eligible girls and boys.Similar trends are seen for early cancer detection programs. Only a fraction of eligible Germans participates in colorectal cancer screening, while the national program in the Netherlands achieves a 71% participation rate by being a low threshold offer. Molecular profiling and biomarker-guided therapy decisions after initial tumor diagnosis offer efficient and quality-assured treatment options. Installment of nationwide networks, that combine clinical competence centers and decentralized providers, enable a democratized access to modern diagnostics and precision treatment options.Vision Zero strategies, established in many societal areas, could be a blueprint for similar approaches in modern oncology. Despite significant health expenditures, the share for preventive measures remains low. Studies show that investments in prevention not only improve health but also have a high return on investment. A Vision Zero in oncology could not only improve care but also cut overall costs.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 12","pages":"683-689"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103387","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":"[Correction: Implementation of guideline-based basic therapy for obesity in Germany].","authors":"Hans Hauner, Anne Lautenbach, Matthias Blüher","doi":"10.1055/a-2624-7006","DOIUrl":"https://doi.org/10.1055/a-2624-7006","url":null,"abstract":"","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 12","pages":"e41"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585953","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":"[73-year-old female patient with abdominal pain and nausea].","authors":"Olaf Krause, Peter Landwehr, Lars Haeder","doi":"10.1055/a-2519-0787","DOIUrl":"https://doi.org/10.1055/a-2519-0787","url":null,"abstract":"","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 12","pages":"659-660"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103346","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":"[Update Raynaud Phenomenon].","authors":"Ludwig Caspary","doi":"10.1055/a-2365-0537","DOIUrl":"https://doi.org/10.1055/a-2365-0537","url":null,"abstract":"<p><p>Several new aspects concerning Raynaud's phenomenon (RP) are highlighted. Low weight is a known factor for the manifestation of RP, but RP may also be triggered by intended or unintended weight loss. RP is more frequent in presence of depression or anxiety disorders which may be revealed by questionnaires. The socioeconomic effect of RP is small in most of the patients; as far as they aren't engaged in professions with cold exposition, ability to work is not restricted. However, if systemic sclerosis (SSc) is the underlying disease of RP, disability rates are considerable due to finger necrosis and soft tissue damages. Capillaroscopy may be a decisive tool to disclose SSc being the underlying disorder for RP. However, a pathological capillaroscopy pattern is no proof of SSc and not diagnostic if antinuclear antibodies are absent; the predictive value of puffy fingers and specific antibodies is superior. Medical treatment is restricted to severe forms of RP, which are often caused by SSc. Calcium channel blockers have the highest propagation but should not be used in case of digital ulcers. Prostanoids seem to be of greater value, phophodiesterase inhibitors have a small effect and Bosentan may reduce the appearance of new ulcers. Botulinum-A may be considered if ulcers and pain are prevailing. With all options of treatment a considerable placebo effect has to be regarded. Promising case series for several drugs were followed by disillusioning controlled studies. Autologous fat or adipose-derived stem cell grafting is a recent therapeutic approach for SSc patients with severe and disabling course of disease who cannot use their hands anymore, but the best form of application is not yet determined.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"150 12","pages":"661-667"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103394","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}