Deutsche medizinische Wochenschrift
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The interstitial lung diseases ILDs are a heterogeneous group of diseases that often lead to progressive fibrosis of the lungs with corresponding functional impairment. With nintedanib, a tyrosinkinase inhibitor and angiokinase inhibitor, as well as pirfenidone, which unfolds its effect among other things by inhibiting the transforming growth factor β, there are currently 2 approved antifibrotic drugs. In the rapidly progressing idiopathic pulmonary fibrosis IPF, the antifibrotic drugs nintedanib and pirfenidone have been established and approved in therapy for several years. ⋯ This describes the course of various disease entities such as connective tissue disease associated ILDs (CTD-ILDs), fibrosing hypersensitivity pneumonitis or fibrosing courses of non-IPF idiopathic interstitial pneumonitis (non-IPF IIPs) that have a corresponding fibrose-related worsening of respiratory symptoms, a deterioration of lung-functioning parameters or a disease progression in CT. Although pirfenidone also shows positive signals for this group of patients in some selected studies, its use in PF-ILD is not yet recommended. In particular, gastrointestinal side effects can occur under therapy with antifibrotic drugs and require a long-term close interdisciplinary connection of patients.
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Early detection and competent treatment of sexually transmitted diseases (STDs) is essential to maintain or restore the sexual health of those affected and to prevent further transmission. In this context, counselling on Sexually transmitted infections (STI) is of particular importance, both in terms of prevention and rapid diagnosis and treatment. STI are not rare in Germany: syphilis, gonococcal and chlamydial infections even occur with increasing frequency, especially among MSM. ⋯ Syphilis and other STIs also occur with completely unspecific symptoms. Even asymptomatic infections by gonococci, chlamydia, mycoplasma, HPV, HBV, HCV and HPV can lead to serious complications and late consequences. For STI (HIV, HBV, syphilis), highly effective post-exposure prophylaxis (PEP) is available in some cases.