Eitel I, Emrich I, von Haehling S
… +5 more, Schleß B, Schmitt R, Strutz F, Wassmann S, van der Giet M
Dtsch Med Wochenschr
· 2026 Feb · PMID 41554294
·
Publisher ↗
Chronic hyperkalemia is an electrolyte imbalance that occurs mainly in patients with progressive kidney failure. It usually develops over a long period of time and symptoms are often mild. As chronic hyperkalemia is asso...Chronic hyperkalemia is an electrolyte imbalance that occurs mainly in patients with progressive kidney failure. It usually develops over a long period of time and symptoms are often mild. As chronic hyperkalemia is associated with increased morbidity and mortality, it should be treated. Treatment begins with a review of the medications that may be responsible for the hyperkalemia and careful therapy and correction of the metabolism. Dietary assessment now focuses on potassium intake from non-vegetable sources. Reducing the dose and/or discontinuing renin-angiotensin-aldosterone inhibitors should be discouraged, as these drugs improve the prognosis in patients with heart failure and proteinuric kidney disease. In addition to other conservative measures, specific potassium-binding substances should be used.
Dtsch Med Wochenschr
· 2026 Jan · PMID 41371247
·
Publisher ↗
Status epilepticus is a common neurological emergency. Despite significant advances in emergency and intensive care medicine in recent years, status epilepticus continues to be associated with high mortality. In addition...Status epilepticus is a common neurological emergency. Despite significant advances in emergency and intensive care medicine in recent years, status epilepticus continues to be associated with high mortality. In addition to knowledge and implementation of guideline-based treatment algorithms, an important factor for successful treatment of status epilepticus is, above all, the administration adequately high dose of benzodiazepines in the initial phase.
Satirer Ö, Feist E, Satirer Y
… +1 more, Kuemmerle-Deschner J
Dtsch Med Wochenschr
· 2026 Jan · PMID 41371246
·
Publisher ↗
In particular, the use of next-generation sequencing has led to the identification of many monogenic autoinflammatory diseases in recent years. This enormous increase in knowledge has contributed significantly to underst...In particular, the use of next-generation sequencing has led to the identification of many monogenic autoinflammatory diseases in recent years. This enormous increase in knowledge has contributed significantly to understanding new disease mechanisms and clearly defining clinical pictures. In addition, these studies make it possible to classify diseases into groups based on common pathophysiological mechanisms.
Pourhassan S, Dovzhanskiy D, Voshege M
… +3 more, Gregor S, Knauf A, Kroeger K
Dtsch Med Wochenschr
· 2026 Jan · PMID 41371245
·
Publisher ↗
Antiaggregation with platelet function inhibitors (PFI) is an integral part of secondary prevention in patients with clinically manifest atherosclerotic vascular disease. The role of PFI in primary prevention is controve...Antiaggregation with platelet function inhibitors (PFI) is an integral part of secondary prevention in patients with clinically manifest atherosclerotic vascular disease. The role of PFI in primary prevention is controversial. The current guidelines on peripheral arterial disease (PAD) and carotid stenosis recommend that patients who are clinically asymptomatic regarding vascular disease should not take PFI. However, the data on which this decision is based has a low level of evidence, and other international guidelines recommend antiaggregation in any case of plaques in the carotid.The present analysis of the literature shows that the blanket statement that patients with asymptomatic carotid atherosclerosis (stenosis degree <50%) and PAD do not require prophylactic PFI neither considers the extent nor the morphology of the underlying atherosclerosis. The indication for PFI in patients with asymptomatic atherosclerosis should always be determined individually, considering both the extent of the atherosclerosis and the personal risk of bleeding and ischemia.
Dtsch Med Wochenschr
· 2026 Jan · PMID 41371244
·
Publisher ↗
Early Warning Systems (EWS) enable timely detection of clinical deterioration in hospitalized patients by systematically assessing vital signs. Tools like NEWS2, MEWS, and qSOFA help identify risk and trigger interventio...Early Warning Systems (EWS) enable timely detection of clinical deterioration in hospitalized patients by systematically assessing vital signs. Tools like NEWS2, MEWS, and qSOFA help identify risk and trigger interventions, including activating Medical Emergency Teams (MET). Common causes of decline include infections, cardiovascular, respiratory, neurologic, or metabolic events. Regular monitoring - especially in high-risk or elderly patients - is essential. EWS improve patient safety and are increasingly part of quality measures, such as mandatory sepsis screening in Germany from 2026. Integration into digital records and staff training are key for effective implementation and outcome improvement.
Dtsch Med Wochenschr
· 2026 Jan · PMID 41371243
·
Publisher ↗
Intensive care units must always be prepared to admit or accept critically ill patients for intensive care monitoring or therapy. External admissions can take place via the emergency physician or transfers from other hos...Intensive care units must always be prepared to admit or accept critically ill patients for intensive care monitoring or therapy. External admissions can take place via the emergency physician or transfers from other hospitals, while internal patients can be transferred, for example from normal wards, the emergency department or functional areas such as the operating room (OR), cardiac catheterization laboratory, interventional radiology. All relevant information should be communicated during these handovers to ensure maximum patient safety. We would like to raise awareness of the possible dangers and risks of handovers in intensive care medicine and, at the same time, offer a proposal for a comprehensive, structured patient handover, taking into account existing handover schemes with a "4-phase model", with a focus on the necessary thought processes before and after the actual handover.
Dtsch Med Wochenschr
· 2026 Jan · PMID 41371242
·
Publisher ↗
In recent years, the care of critically ill patients in the emergency room has become increasingly complex. The transition from the shock room to the intensive care unit is a particularly critical point at which it is de...In recent years, the care of critically ill patients in the emergency room has become increasingly complex. The transition from the shock room to the intensive care unit is a particularly critical point at which it is decided whether initial stabilization will be transferred to structured care or whether there will be delays, loss of information or deterioration. Despite its importance, the interface between the resuscitation room and the intensive care unit is often poorly managed in terms of organization and communication in many hospitals. This article aims to highlight the various aspects of this interface, identify risks and suggest strategies for improvement.
Knochel K, Fritzsche MC, Henking T
… +3 more, Schleidgen S, Seidlein AH, Friedrich O
Dtsch Med Wochenschr
· 2026 Feb · PMID 41325983
·
Full text
Medical indications are based on a synthesis of medical expertise, professional ethical standards, and legal requirements. This paper examines the extent to which value judgments influence these determinations and how th...Medical indications are based on a synthesis of medical expertise, professional ethical standards, and legal requirements. This paper examines the extent to which value judgments influence these determinations and how they can be ethically approached.The interdisciplinary conceptual and normative analysis incorporates theoretical approaches from medical science, case studies, empirical findings, and legal considerations to identify and critically discuss the various levels of value judgments involved in the indication process.Value judgments influence determining medical indications, particularly with regard to the choice of one of the goals of medicine and how probabilities, uncertainties, personal attitudes, and social norms, are handled. Some judgments do not fall within the physician's scope of responsibility, at least not in the context of medical indication, e.g., economic or allocation considerations. For clarity, it is essential to differentiate physicians' assessments and patients' preferences, to explicate professional values, and to integrate assessments and individual values within decision-making processes.Value judgments made in determining a medical indication are unavoidable and must be carefully considered. Values should be made transparent in order to justify medical interventions that are judged to be indicated or not by physicians on a case-by-case basis and to strengthen patients' self-determination. A social debate is needed on how to appropriately address considerations (such as economic) which should not be mixed up with medical indications.
Dtsch Med Wochenschr
· 2025 Dec · PMID 41290041
·
Publisher ↗
Friedrich Theodor von Frerichs (1819-1885) was born in the rural northern German region of East Frisia and rose to fame as one of the most influential physicians and medical scientists in 19-century Europe. His work pave...Friedrich Theodor von Frerichs (1819-1885) was born in the rural northern German region of East Frisia and rose to fame as one of the most influential physicians and medical scientists in 19-century Europe. His work paved the way for the 19-century transition of medicine from a practice largely based on doctrines and traditions to an empirical science. As an internist, he was a pioneer in the fields of hepatology, gastroenterology, nephrology, and diabetology. His approach to academia and teaching set an example for medical schools around the world. In 1882, he founded the German Society of Internal Medicine and the Congress of Internal Medicine, the 132 edition of which will take place in its inaugural city of Wiesbaden in 2026.
Dtsch Med Wochenschr
· 2025 Dec · PMID 41290040
·
Publisher ↗
Lemuel Gulliver's travelogues were published 300 years ago. Gulliver's fame is well-founded: only a limited number of sailors endured one long sea voyage, while he survived four, experiencing numerous strange and challen...Lemuel Gulliver's travelogues were published 300 years ago. Gulliver's fame is well-founded: only a limited number of sailors endured one long sea voyage, while he survived four, experiencing numerous strange and challenging adventures. Some of his encounters raise medical questions or have found their way into medical terminology; others relate to long forgotten diseases or reflect the travel literature and fantastic tales of his era; still others make direct reference to scientific experiments entirely new in those days; and ultimately, all of them question the seemingly obvious values of humanity and medicine.
Dtsch Med Wochenschr
· 2025 Dec · PMID 41290039
·
Publisher ↗
The 1960s saw a fundamental shift in everyday nursing care, from an understanding of nursing that encompassed the body and soul of the sick to a biomedical understanding of illness. Due to economic constraints and a shor...The 1960s saw a fundamental shift in everyday nursing care, from an understanding of nursing that encompassed the body and soul of the sick to a biomedical understanding of illness. Due to economic constraints and a shortage of nursing staff, nursing work became more intense - as a result of rationalization and the resulting acceleration of work. This led to a reduction in contact between nurses and patients. Nurses responded by developing concepts of patient-oriented care or holistic care. The research for this article is based on the evaluation of nursing textbooks and the review of nursing journals.
Arta CJ, Sandberger W, Meyer F
… +2 more, Piatek S, Piatek S
Dtsch Med Wochenschr
· 2025 Dec · PMID 41290038
·
Publisher ↗
Christian Albert Theodor Billroth (1829-1894) is primarily known as a pioneer of modern surgery among medical professionals today. During his entire life, however, he was also very musically inclined and was at the cente...Christian Albert Theodor Billroth (1829-1894) is primarily known as a pioneer of modern surgery among medical professionals today. During his entire life, however, he was also very musically inclined and was at the center of musical life wherever he worked. As a student, he was an active member of Göttingen University's musical circles, later he wrote concert reviews and organized private concerts in his home. In late 1865, he invited the composer and pianist Johannes Brahms (1833-1897) to such a soiree in Zurich. Henceforth, Brahms appreciated the surgeon as a correspondent on an equal footing - several letters to Brahms are proof of Billroth's effusive enthusiasm for new works by Brahms, and primarily also of his musical expertise. Billroth's soirees in Vienna often focused on Brahms, when luminaries such as the Hellmesberger String Quartet or Joseph Joachim played his newest works for Brahms, so that he could make final amendments before printing them. The present article sheds a light on the fascinating friendship of two central 19th-century figures.
Dtsch Med Wochenschr
· 2025 Dec · PMID 41290037
·
Publisher ↗
In 1875, two German neurologists simultaneously described a previously unknown phenomenon in the same medical journal: Carl Westphal (1833-1890) referred to it as the "phenomenon of the lower leg", while Wilhelm Erb (184...In 1875, two German neurologists simultaneously described a previously unknown phenomenon in the same medical journal: Carl Westphal (1833-1890) referred to it as the "phenomenon of the lower leg", while Wilhelm Erb (1840-1921) called it the "patellar tendon reflex".This novel observation quickly attracted significant attention from the international medical community. Yet many questions remained unanswered: Was this truly a reflex transmitted via the tendons? Nothing comparable had been described before. Where in the spinal cord could its neural circuitry be localized? And how might this phenomenon be clinically useful?Further complicating its classification was the observation that the reflex could occur in both patients and healthy individuals - but inconsistently, and at times not at all.Moreover, critical voices from neighboring France repeatedly claimed that Erb and Westphal had merely repackaged previously known findings as their own.Drawing on extensive research of 19-century medical literature, this account traces the initial descriptions of the reflex, the subsequent scientific investigations, and its eventual incorporation into clinical neurological practice.
Dtsch Med Wochenschr
· 2025 Dec · PMID 41290036
·
Publisher ↗
The Hippocratic Oath is one of the most known medical texts. Despite its importance, it was rarely used in art and music. There exist only two complex musical settings of the Hippocratic Oath: "SERMENT-ΟΡΚΟΣ pour chœur m...The Hippocratic Oath is one of the most known medical texts. Despite its importance, it was rarely used in art and music. There exist only two complex musical settings of the Hippocratic Oath: "SERMENT-ΟΡΚΟΣ pour chœur mixte" ("Oath for mixed chorus") by Iannis Xenakis (1922-2001) and "Der Eid des Hippokrates für Klavier zu 3 Händen" ("The Hippocratic Oath for piano three hands") by Mauricio Kagel (1931-2008). Both being among the most important composers of the 20 century: Xenakis attempted to apply stochastic processes to his compositional techniques and Kagel is considered a pioneer of instrumental theatre. Both musical settings of the Hippocratic Oath were commissioned by medical institutions: Xenakis composed the work "Serment" in 1981 as a commission for the 15 World Congress of the "International Society of Cardiovascular Surgery" in Athens. "Der Eid des Hippokrates" was composed by Kagel in 1984 on behalf of the German medical journal "Deutsches Ärzteblatt". Both works are therefore intended for medical practitioners and both are influenced by the pathography of the two composers. This article will present results of the analysis and interpretation from a medical-historical perspective.
Dtsch Med Wochenschr
· 2025 Dec · PMID 41290035
·
Publisher ↗
Despite its cultural association with peace and joy, the Christmas season can act as a psychosocial stressor, triggering or exacerbating various fears or anxiety-related disorders. This article reviews the psychological...Despite its cultural association with peace and joy, the Christmas season can act as a psychosocial stressor, triggering or exacerbating various fears or anxiety-related disorders. This article reviews the psychological and somatic dimensions of anxiety in the context of the holiday period, drawing from literature, art, and clinical observations. Specific phobias (e.g., santaclausophobia, decidophobia, dendrophobia), social anxiety disorder, and generalized anxiety disorder are discussed related to seasonal triggers. From a pathophysiological perspective, anxiety can induce dyspnea, tachycardia, palpitations, gastrointestinal symptoms, sweating and dizziness. Mechanisms such as sympathetic overactivity, hyperventilation-induced hypocapnia, corticotropin-releasing hormone effects and the function of the enteric nervous system with respect to anxiety are reviewed. Finally, the article discusses current therapeutic approaches for anxiety symptoms and anxiety- or fear-related disorders including cognitive behavioral therapy (CBT) with exposure exercises, pharmacological options (SSRIs, SNRIs), and complementary interventions such as breath-based relaxation techniques as well as spiritual approaches. In sum, the present article highlights the clinical importance of recognizing anxiety as a transdisciplinary phenomenon frequently encountered not only in psychiatry and psychotherapy, but also across cardiology, gastroenterology, pulmonology, neurology, and dermatology - particularly during periods of psychosocial vulnerability such as the holiday season.