Johannes Heck

In popular music, references to (illicit) drugs are widespread and may influence attitudes and behaviors in relation to substance use and abuse, especially among younger generations. While substance-related content in international pop and rap music has been studied extensively, the German rap scene has received comparatively little attention thus far. This study aimed to systematically analyze the lyrics of one of the most well-known German rappers, Haftbefehl (literal translation: “arrest warrant”), regarding pharmacological and toxicological references to psychotropic substances. To this end, a content analysis was performed on the lyrics of the artist’s seven studio albums released between 2010 and 2022, comprising a total of 121 songs. The lyrics were obtained from the online platform genius.com. Both explicit and contextual references to psychotropic substances were recorded and assigned to pharmacological substance classes. Also, slang terminology and contextual references to drug consumption or trafficking were documented. Descriptive statistical methods were applied to summarize the distribution of references to psychotropic substances. In addition, inferential statistical techniques were used exploratively for cross-album comparisons. A clinical trial number is not applicable. Substance-related references were highly prevalent in Haftbefehl ’s lyrics. Cocaine was the most frequently mentioned substance (being referenced in 82.6% of songs), followed by cannabis (52.9%) and alcohol (38.0%). References to μ-opioid receptor agonists (9.1%) and amphetamine-type substances (7.4%) were less prominent, while there were no references to benzodiazepines. Also, it was noted that Haftbefehl ’s lyrics contained a large variety of slang terms, particularly for cocaine. In conclusion, psychotropic substances constitute a prominent stylistic element in Haftbefehl ’s oeuvre. These findings point to the importance of rap lyrics as a cultural medium that may reflect and shape the approach to drug-related content within music-related youth culture.

This study sought to evaluate the characteristics of clinical-pharmacological (CP) medication reviews conducted by the Institute for Clinical Pharmacology of Hannover Medical School for older, multimorbid, polymedicated insurants of the German statutory health insurance fund Kaufmännische Krankenkasse (KKH). Special emphasis was put on potential sex-specific differences between female and male insurants, prescriptions of potentially inappropriate medications for older individuals (PIMs), and potentially inappropriate duplicate prescriptions (PIDPs). Medication reviews conducted for KKH insurants between 2019 and 2023 ( n = 334) were analyzed retrospectively. Clinical trial number is not applicable. The median age of KKH insurants (58.1% female) was 74 years (first quartile (Q1): 68; third quartile (Q3): 80). Insurants displayed a median of 7 diseases (Q1: 5; Q3: 9) and took a median of 13 drugs (Q1: 11; Q3: 16). A median of 4 CP recommendations was issued per medication review (Q1: 3; Q3: 5). The number of CP recommendations was significantly higher for female compared to male insurants (median of 4 (Q1: 3; Q3: 6) vs. median of 3 recommendations (Q1: 2; Q3: 4); p < 0.001), while the number of drugs was identical and the number of diagnoses was higher for female insurants. The most frequently prescribed PIMs were tricyclic antidepressants, benzodiazepines, and Z-drugs. At least one PIDP was detected in 16.5% of medication reviews. The sex-specific difference in the number of CP recommendations between female and male insurants may point to an unmet pharmacotherapeutic need in older women. PIM prescriptions and PIDPs were relevant topics of CP recommendations, suggesting possibilities for pharmacotherapeutic optimization in older, multimorbid, polymedicated patients.

Ein 32-jähriger Patient stellt sich mit einer seit einigen Monaten bestehenden Veränderung am Genitale vor ([Abb. 1]). Der Befund wird als kosmetisch störend empfunden, ansonsten bestünden aber keine weiteren Beschwerden; Juckreiz oder Schmerzen werden verneint. Klinisch relevante Vorerkrankungen bestünden nicht. Bis auf eine gelegentliche Einnahme von Nichtopioidanalgetika (Ibuprofen, Diclofenac) bei unspezifischen muskuloskelettalen Beschwerden erfolge keine Medikamenteneinnahme. Die inguinalen Lymphknoten stellen sich in der Palpation unauffällig dar. In der klinischen Untersuchung zeigte sich ein pathologischer Befund. Article published online: 19 June 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

Certain medications may adversely affect health during hot days and heatwaves by altering chronic conditions, comorbidities, fluid balance, or impairing heat adaptation. This study aims to develop evidence-based cross-sectoral recommendations for the safe administration of heat-sensitive medications, compiled into a so-called ‘CALOR’ list (calor: Latin for ‘heat’). Development of the CALOR list will follow a four-pillar process. First, a scoping review of scientific literature and best practices will identify potentially inadequate medications during heat events (heat-PIMs) and adaptation measures, resulting in a first draft. Second, an expert panel will refine this draft through a Delphi process to reach consensus on clinically relevant recommendations. Third, German statutory health insurance (SHI) claims data will be analysed to determine heat-PIMs prevalence; data from Cologne residents will additionally be linked with climate data to investigate health outcomes during heat events. Fourth, thirty health professionals (i.e., medical doctors, nurses, pharmacists) will field-test the CALOR list in summer, providing qualitative feedback on feasibility, leading to further refinement of the CALOR list. To our knowledge this study protocol presents the first study attempting to collate a comprehensive and actionable list of recommendations for drug safety management during hot days and heatwaves.

Drug information centers (DICs) are institutions dedicated to providing independent and up‐to‐date information on medications and their usage to healthcare professionals. Here, we provide an update from the clinical‐pharmacological DIC of Hannover Medical School, covering the period from April 2022 to December 2024. In total, 438 queries were evaluated. Potential differences between patient‐specific and general queries were analyzed with Pearson's chi‐squared test or Fisher's exact test. The Holm–Bonferroni method was applied to counteract the problem of multiple comparisons. A curated selection of ten clinically interesting and educational queries is presented and discussed. 85.2% of the queries were patient‐specific, and 95.7% were submitted by physicians, predominantly internists, psychiatrists, and surgeons. Indications/contraindications, adverse drug reactions, and pharmacodynamic interactions (PDIs) represented the three most frequent query categories. Compared to our previous research, we observed increases in queries about pharmacotherapy in advanced age and drug use during pregnancy or breastfeeding. As compared to general queries, patient‐specific queries were significantly more often related to indications/contraindications (26.2% vs. 49.6%; p < 0.001) and PDIs (24.6% vs. 44.5%, p = 0.003) after adjusting for multiple comparisons. The query characteristics remained relatively stable between our previous investigation and the current analysis (2022–2024), in particular with respect to type of queries, profession of inquiring healthcare professionals, medical specialties of inquirers, and query categories. Changes mainly pertained to higher proportions of queries about pharmacotherapy in advanced age and drug use during pregnancy or breastfeeding.

Since its inception in North America in 1999, the Pokémon trading card game has become a global phenomenon, combining strategic gameplay with collectible culture. The economic value of Pokémon trading cards, particularly as collector’s items, underscores their significance beyond mere playthings, making them a subject of both academic and commercial interest. In the present study, a convenience sample of 300 Pokémon trading cards were offered on the e-commerce platform eBay between 28 May 2024 and 27 May 2025, with a minimum follow-up period of 3 months per card. All cards were sold nationally in Germany to avoid high shipping costs for international transactions. The aim of the study was to comprehensively analyze sales characteristics of Pokémon trading cards, using both descriptive and inferential statistical techniques including “survival” analyses and Cox regression models. 73.3% (220/300) of the trading cards were sold during the study period, generating a total revenue of 923.60 €. Sales prices showed a markedly skewed distribution, with a median of 1.95 € per trading card. Rare and holofoil cards contributed overproportionately to the total revenue. Uncommon cards exhibited an interesting economic potential due to rapid sales kinetics. Cards from the expansions Team Rocket and Gym Challenge were considerably more popular than Base Set 2 cards, as reflected by shorter “survival” times. The vast majority of buyers were male, but female buyers spent more money per trading card on average. The German federal states Thuringia and Hamburg emerged as Pokémon trading card hubs, with numbers of cards sold and cumulated revenues exceeding expectations based on population sizes.

This study sought to investigate the frequency and characteristics of duplicate prescriptions (DPs) in psychiatric inpatients with substance use disorders using a DP classification that differentiates between appropriate DPs (ADPs) and potentially inappropriate DPs (PIDPs). The study was conducted as a monocentric retrospective cross‐sectional study on the addiction‐specific ward of the Department of Psychiatry, Social Psychiatry and Psychotherapy of Hannover Medical School, a large university hospital in northern Germany. The outcome measures were the nature and frequency of PIDPs compared with ADPs. Medication records of 1174 patients enrolled between January 2016 and December 2021 were reviewed. The median age of the study population (27.8% female) was 48 years (interquartile range (IQR) 39–56). Patients took a median of 4 drugs (IQR 2–6). 12.8% of the study population were exposed to at least one PIDP (at least one grade‐1 PIDP: 12.0%; at least one grade‐2 PIDP: 1.3%; at least one grade‐3 PIDP: 0.3%). Sedatives were the most common cause of grade‐1 PIDPs, while grade‐2 PIDPs were elicited predominantly by opioids. Nearly one third of the study population (29.0%) displayed at least one ADP. Physicians treating patients with substance use disorders should carefully monitor for PIDPs, particularly PIDPs elicited by sedatives and opioids. Addressing PIDPs may help prevent adverse drug reactions and reduce drug expenses.

Aims: To assess the utility of the artificial intelligence (AI) chatbot ChatGPT (openly available version 3.5) in responding to real‐world pharmacotherapeutic queries from healthcare professionals. Methods: Three independent and blinded evaluators with different levels of medical expertise and professional experience ( beginner , advanced , and expert ) compared AI chatbot‐ and physician‐generated responses to 70 real‐world pharmacotherapeutic queries submitted to the clinical‐pharmacological drug information centre of Hannover Medical School between June and October 2023 with regard to quality of information, answer preference, answer correctness and quality of language. Inter‐rater reliability was assessed with Krippendorff's alpha. Two separate investigators not otherwise involved in the conduct or analysis of the study selected the top three clinically relevant errors in chatbot‐ and physician‐generated responses. Results: All three evaluators rated the quality of information of physician‐generated responses higher than the quality of information of AI chatbot‐generated responses and, accordingly, thought that the physician‐generated responses were better than the chatbot‐generated responses (answer preference). All evaluators detected factually wrong information more frequently in chatbot‐generated responses than in physician‐generated responses. Although the beginner and expert evaluators rated the quality of language of physician‐generated responses higher than the quality of language of chatbot‐generated responses, there was no significant difference according to the advanced evaluator. Conclusions: ChatGPT's responses to real‐world pharmacotherapeutic queries were substantially inferior compared to conventional physician‐generated responses with regard to quality of information and factual correctness. Our study suggests that to date it must be strongly cautioned against the use of ChatGPT in pharmacotherapy counselling.

Zusammenfassung: Rituximab (RTX) bewirkt durch Bindung an das CD20-Antigen eine B‑Zell-Depletion. Eine weniger bekannte unerwünschte Arzneimittelwirkung von RTX ist die ca. 6 Monate nach Therapiebeginn auftretende Late-onset-Neutropenie (LON). Als klinisches Management sollten unter RTX-Therapie regelmäßige Differenzialblutbildkontrollen erfolgen. Bei akuten LON-Episoden kann neben einer Watch-and-Wait-Strategie eine unterstützende Gabe von G‑CSF („granulocyte colony-stimulating factor“) diskutiert werden. Die Reexposition mit RTX nach stattgehabter LON wird nach Abwägung von Risikofaktoren und ausführlicher Aufklärung im Allgemeinen als vertretbar erachtet. In dieser Fallserie möchten wir 2 Fälle von rheumatologischen Patienten mit schwerwiegender LON nach RTX-Gabe vorstellen.