Pub Date : 2022-02-01Epub Date: 2021-09-01DOI: 10.1007/s00108-021-01133-7
H Matthews, S Schmiedel
{"title":"[25/m-Sexual risk exposure : Preparation for the medical specialist examination: part 114].","authors":"H Matthews, S Schmiedel","doi":"10.1007/s00108-021-01133-7","DOIUrl":"https://doi.org/10.1007/s00108-021-01133-7","url":null,"abstract":"","PeriodicalId":54924,"journal":{"name":"Internist","volume":"63 Suppl 1","pages":"69-71"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8758993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39390363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-01Epub Date: 2022-01-20DOI: 10.1007/s00108-021-01253-0
M Privoznik
{"title":"[72/f-Sudden onset of palpitations : Preparation for the medical specialist examination: part 125].","authors":"M Privoznik","doi":"10.1007/s00108-021-01253-0","DOIUrl":"https://doi.org/10.1007/s00108-021-01253-0","url":null,"abstract":"","PeriodicalId":54924,"journal":{"name":"Internist","volume":"63 Suppl 1","pages":"128-134"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39934525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-01Epub Date: 2022-01-20DOI: 10.1007/s00108-021-01252-1
C Bauer-Büntzel, M Abu-Tair
{"title":"[74/f-Vigilance reduction and left-sided hemiparesis : Preparation for the medical specialist examination: part 121].","authors":"C Bauer-Büntzel, M Abu-Tair","doi":"10.1007/s00108-021-01252-1","DOIUrl":"https://doi.org/10.1007/s00108-021-01252-1","url":null,"abstract":"","PeriodicalId":54924,"journal":{"name":"Internist","volume":"63 Suppl 1","pages":"105-109"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39934528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-01Epub Date: 2022-01-28DOI: 10.1007/s00108-021-01259-8
Thomas Zander, Michael Hallek
Biologics that influence the immune system play a crucial role in the treatment of autoimmune and malignant diseases. Overall these drugs have revolutionized treatment as they demonstrate high efficacy and a relatively low amount of side effects. This leads to longer treatment of patients with a high quality of life. Side effects, especially longer-term side effects, become ever more important as patients are simultaneously seen by different physicians due to comorbidities. Infections, mainly of the upper airway or urogenital tract, represent the main side effect of immunosuppressive biologics, but atypical infections by fungi or mycobacteria may also occur. Biologics that enhance the immune response such as checkpoint inhibitors lead to autoimmune phenomena necessitating the interruption of treatment or immunosuppressive treatment.
{"title":"[What should specialist in internal medicine be aware of in patients treated with biologics? : Infections and autoimmune phenomena].","authors":"Thomas Zander, Michael Hallek","doi":"10.1007/s00108-021-01259-8","DOIUrl":"https://doi.org/10.1007/s00108-021-01259-8","url":null,"abstract":"<p><p>Biologics that influence the immune system play a crucial role in the treatment of autoimmune and malignant diseases. Overall these drugs have revolutionized treatment as they demonstrate high efficacy and a relatively low amount of side effects. This leads to longer treatment of patients with a high quality of life. Side effects, especially longer-term side effects, become ever more important as patients are simultaneously seen by different physicians due to comorbidities. Infections, mainly of the upper airway or urogenital tract, represent the main side effect of immunosuppressive biologics, but atypical infections by fungi or mycobacteria may also occur. Biologics that enhance the immune response such as checkpoint inhibitors lead to autoimmune phenomena necessitating the interruption of treatment or immunosuppressive treatment.</p>","PeriodicalId":54924,"journal":{"name":"Internist","volume":"63 2","pages":"165-170"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39964503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-01Epub Date: 2021-12-09DOI: 10.1007/s00108-021-01224-5
E Pappe, R-H Hübner, M Raspe
{"title":"[57/m-Hemoptysis : Preparation for the medical specialist examination: part 122].","authors":"E Pappe, R-H Hübner, M Raspe","doi":"10.1007/s00108-021-01224-5","DOIUrl":"https://doi.org/10.1007/s00108-021-01224-5","url":null,"abstract":"","PeriodicalId":54924,"journal":{"name":"Internist","volume":"63 Suppl 1","pages":"110-115"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39794971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-01Epub Date: 2021-09-22DOI: 10.1007/s00108-021-01140-8
C Meyer-Schwickerath, K Schmidt-Hellerau, N Jung
{"title":"[32/f-Pain in the right knee : Preparation for the medical specialist examination: part 123].","authors":"C Meyer-Schwickerath, K Schmidt-Hellerau, N Jung","doi":"10.1007/s00108-021-01140-8","DOIUrl":"https://doi.org/10.1007/s00108-021-01140-8","url":null,"abstract":"","PeriodicalId":54924,"journal":{"name":"Internist","volume":"63 Suppl 1","pages":"116-120"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39441091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-01Epub Date: 2022-01-04DOI: 10.1007/s00108-021-01216-5
E Büscher, J Wälscher
{"title":"[35/f-Dry cough, fatigue and weight loss : Preparation for the medical specialist examination: part 116].","authors":"E Büscher, J Wälscher","doi":"10.1007/s00108-021-01216-5","DOIUrl":"https://doi.org/10.1007/s00108-021-01216-5","url":null,"abstract":"","PeriodicalId":54924,"journal":{"name":"Internist","volume":"63 Suppl 1","pages":"77-82"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39660806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-01Epub Date: 2021-09-22DOI: 10.1007/s00108-021-01145-3
U Helwig
{"title":"[35/m-Fatigue, lower abdominal pain and fecal blood : Preparation for the medical specialist examination: part 106].","authors":"U Helwig","doi":"10.1007/s00108-021-01145-3","DOIUrl":"https://doi.org/10.1007/s00108-021-01145-3","url":null,"abstract":"","PeriodicalId":54924,"journal":{"name":"Internist","volume":"63 Suppl 1","pages":"31-34"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39441089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-01Epub Date: 2021-10-15DOI: 10.1007/s00108-021-01186-8
Dimitrios David Papazoglou, Salome Weiss, Pascal Kissling
This article presents the case of a 28-year-old male patient with a renal infarction due to an embolizing traumatic postdissection aneurysm of a renal segmental artery. He presented with abdominal and flank pain 1.5 years after a motorcycle accident. The C‑reactive protein (CRP) and lactate dehydrogenase (LDH) levels were elevated and the diagnosis was made by computed tomography (CT) angiography. Other causes of renal infarction were excluded. After an interdisciplinary discussion we decided to use interventional coiling in this young and athletically active patient in order to avoid long-term anticoagulation.
{"title":"[Rare cause of renal infarction in a 28-year-old male patient].","authors":"Dimitrios David Papazoglou, Salome Weiss, Pascal Kissling","doi":"10.1007/s00108-021-01186-8","DOIUrl":"https://doi.org/10.1007/s00108-021-01186-8","url":null,"abstract":"<p><p>This article presents the case of a 28-year-old male patient with a renal infarction due to an embolizing traumatic postdissection aneurysm of a renal segmental artery. He presented with abdominal and flank pain 1.5 years after a motorcycle accident. The C‑reactive protein (CRP) and lactate dehydrogenase (LDH) levels were elevated and the diagnosis was made by computed tomography (CT) angiography. Other causes of renal infarction were excluded. After an interdisciplinary discussion we decided to use interventional coiling in this young and athletically active patient in order to avoid long-term anticoagulation.</p>","PeriodicalId":54924,"journal":{"name":"Internist","volume":"63 2","pages":"221-223"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8518887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39525189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-01Epub Date: 2021-10-19DOI: 10.1007/s00108-021-01181-z
H G Haller, S von Vietinghoff, P Spearpoint, A Deichmann, I Buchholz, M P Schönermark, P Rutherford, D Götte
Background & objectives: Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) represents a group of rare chronic autoimmune diseases characterized by recurrent systemic inflammation provoking multiple morbidities. AAV patients suffer from various organ manifestations and treatment-related severe adverse effects. This retrospective study investigated the concrete burden of AAV disease on patients in Germany.
Methods: Based on anonymized longitudinal German statutory health insurance (SHI) claims data from the years 2011-2016, a representative cohort of approximately 3 million insured persons was used to identify patients with granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA), and selected clinical aspects were systematically assessed.
Results: The most frequent concomitant morbidities of GPA and MPA were renal and respiratory disorders. Severe renal involvement occurred in 11.6% of GPA and 24.3% of MPA patients within 15 quarters of diagnosis. Severe infections developed in one third of AAV patients within the first three quarters post-diagnosis. The annual rate of major relapses was 5-8%. AAV patients with renal impairment or infections showed increased annual mortality rates of 14.4 and 5.6%, respectively.
Conclusion: Based on this analysis of German health care data, disease-specific assumptions regarding the burden on AAV patients were confirmed and concretized for the German context. AAV patients suffer from a high burden of morbidity, including multiple disease manifestations, relapses, and severe complications due to AAV treatment.
{"title":"[High burden of disease in patients with ANCA-associated vasculitis : A claims data study in Germany].","authors":"H G Haller, S von Vietinghoff, P Spearpoint, A Deichmann, I Buchholz, M P Schönermark, P Rutherford, D Götte","doi":"10.1007/s00108-021-01181-z","DOIUrl":"https://doi.org/10.1007/s00108-021-01181-z","url":null,"abstract":"<p><strong>Background & objectives: </strong>Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) represents a group of rare chronic autoimmune diseases characterized by recurrent systemic inflammation provoking multiple morbidities. AAV patients suffer from various organ manifestations and treatment-related severe adverse effects. This retrospective study investigated the concrete burden of AAV disease on patients in Germany.</p><p><strong>Methods: </strong>Based on anonymized longitudinal German statutory health insurance (SHI) claims data from the years 2011-2016, a representative cohort of approximately 3 million insured persons was used to identify patients with granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA), and selected clinical aspects were systematically assessed.</p><p><strong>Results: </strong>The most frequent concomitant morbidities of GPA and MPA were renal and respiratory disorders. Severe renal involvement occurred in 11.6% of GPA and 24.3% of MPA patients within 15 quarters of diagnosis. Severe infections developed in one third of AAV patients within the first three quarters post-diagnosis. The annual rate of major relapses was 5-8%. AAV patients with renal impairment or infections showed increased annual mortality rates of 14.4 and 5.6%, respectively.</p><p><strong>Conclusion: </strong>Based on this analysis of German health care data, disease-specific assumptions regarding the burden on AAV patients were confirmed and concretized for the German context. AAV patients suffer from a high burden of morbidity, including multiple disease manifestations, relapses, and severe complications due to AAV treatment.</p>","PeriodicalId":54924,"journal":{"name":"Internist","volume":"63 2","pages":"210-216"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8813869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39530581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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