Deutsche medizinische Wochenschrift (1946)最新文献

Recently approved immunotherapeutic agents in Europe mostly consist of monoclonal antibody-based products. For solid cancers, these comprise the antibody-drug-conjugate Mirvetuximab Soravtansine for platinum-resistant ovarian cancer, the monoclonal antibody Zolbetuximab for Claudin-18.2 positive gastric adenocarcinoma and the checkpoint inhibitor Tislelizumab for esophageal squamous cell carcinoma. For the treatment of relapsed or refractory hematologic B cell malignancies, the use of bispecific T cell engaging antibodies like the BCMA-CD3 targeting Teclistamab and CD20-CD3 targeting Glofitamab were approved by the EMA recently.Combinatorial approaches of conventional chemotherapy and checkpoint inhibitors for the treatment of cholangiocarcinoma, urothelial carcinoma and endometrial carcinoma received recent approval.A CD38 antibody-based bridging therapy for the treatment of newly diagnosed multiple myeloma and the Glofitamab-based approach in combination with Gemcitabine and Oxaliplatin for relapsed DLBCL are the latest additions for hematologic malignancies after promising clinical trials.The first T cell products for the treatment of solid cancers using either tumor-infiltrating lymphocytes or TCR-engineered peripheral blood T cells were approved by the FDA in 2024, for the treatment of advanced melanoma (Lifileucel) and synovial sarcoma (Afamitresgene autoleucel). To further expand the success of T cell products to solid tumors, promising preclinical studies suggest solutions to main obstacles, such as modular CAR T cells, targeting of two antigens simultaneously or generation of cytokine-secreting 4th generation CAR T cells.

When we think of addiction, we don't automatically think of elderly people. Rather, we see young to middle-aged alcohol or drug addicts in our mind's eye. The following article shows that this is a misconception and also how important the topic of addiction is in old age - even if it is different for senior citizens.

In 2023, tuberculosis (TB) caused 1.25 million deaths among 10.8 million cases, remaining the deadliest infectious disease worldwide. In Germany, incidence declined for decades but rose slightly in 2022-2023, driven mainly by migration from high-prevalence countries (e.g., Syria, Afghanistan, Ukraine). While most cases are pulmonary TB (PTB), 22.8% are extrapulmonary TB (EPTB), which can affect any organ and is often hard to diagnose due to nonspecific symptoms. Diagnosis uses microscopy, PCR, and culture; treatment typically lasts at least 6 months, extended for CNS, bone, or miliary TB. Treatment response is assessed clinically and radiologically; reliable blood-based markers are urgently needed.

Chronic viral hepatitis, particularly chronic hepatitis B and C, is among the leading global causes of liver cirrhosis and hepatocellular carcinoma (HCC). Despite effective treatment options such as virus suppressive nucleos(t)ide analogues for HBV and curative direct acting antiviral therapies for HCV, many infections remain undetected. The WHO aims to eliminate hepatitis B and C as public health threats by 2030, targeting a 90% reduction in new infections and a 65% reduction in deaths. Germany supports these objectives through its BIS 2030 strategy, which emphasizes prevention, identification of at-risk groups, education, and treatment. A central component is screening to diagnose chronic infections early and initiate therapy promptly. This article summarizes practical current recommendations for the prevention and early detection of chronic viral hepatitis, with a particular focus on hepatitis B and hepatitis C, including complementary aspects regarding hepatitis D and hepatitis E in immunocompromised individuals.

Tuberculosis remains the leading cause of death by a single infectious agent worldwide, with over 10 million cases annually. Despite global efforts, delayed or missed diagnoses continue to fuel transmission and mortality, particularly in resource-limited settings. This review outlines both the current diagnostic standards - microscopy, culture, and nucleic acid amplification tests - and highlights promising innovations aimed at improving diagnosis of tuberculosis disease. Novel approaches include stool polymerase chain reaction (PCR), CRISPR (clustered regularly interspaced short palindromic repeats)-based detection of circulating cell-free DNA (cfDNA), transcriptomic signatures, molecular bacterial load assay (MBLA), lipoarabinomannan (LAM) detection in urine or sputum, and non-invasive sampling techniques using exhaled breath condensate, face masks or oral swabs. Furthermore, advancements in imaging technologies and AI (artificial intelligence)-based tools may enhance diagnostic accuracy. Together, these developments have the potential to accelerate and simplify tuberculosis diagnostics in the future.

The process of becoming a medical specialist is a transformative phase with professional competence as well as personal development. This study examines the role of crisis in the moral development of physicians during their postgraduate training.Based on Carol Gilligan's ethics of care and interviews with 45 physicians in Germany, the study demonstrates that crises can be an opportunity for the reflection on ethical problems and of moral maturity.The results show that more than half of the participants experienced at least one crisis during their training that significantly impacted their emotional and professional balance. Main triggers were workload, challenging patient situations, and conflicts with supervisors. Women were more frequently affected. These crises not only led to professional changes such as job change or temporary career breaks but also influenced the physicians' self-conception and moral values. Profound ethical reflections and changes such as an increased awareness of compassion, and moral integrity were observed. Peer exchange proved to be an important resource in coping with these situations. Many respondents expressed a desire for more structural and institutional support.The study highlights the importance of ethical competencies and interpersonal care in medical training. By integrating ethics of care, physicians can grow not only professionally but also morally, thereby contributing to holistic patient care.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is one of the most common causes of liver cirrhosis and hepatocellular carcinoma. The severity of the metabolic syndrome and in particular type 2 diabetes are major risk factors for the progression of liver disease, but also for the frequent occurrence of cardiovascular complications. Patients therefore benefit in particular from an interdisciplinary treatment. This article provides an overview of recommended strategies for the prevention and treatment of MASLD.