Promising data are also available for pirfenidone in the treatment of patients with progressive, non-IPF lung fibrosis and unclassifiable progressive fibrosing ILD. In this article, we summarize the new approvals of antifibrotic drugs in non-IPF ILD, the results from the underlying clinical trials and the clinical implications.Intact osmoregulation prevents osmotic gradients thereby limiting cell swelling and shrinking. Hyponatremia is a state of an osmole-free water excess compared to the amounts of solutes and clinical management of hyponatremic patients requires pathophysiology-oriented approaches to select appropriate treatments. Clinicians need to assess the patient's volume status to differentiate hyponatremia with volume depletion, expansion or normovolemia, respectively. In addition, work-up includes differentiation between acute and chronic and asymptomatic and symptomatic hyponatremia. Estimation of free water-clearance helps predicting Serum-Na+ changes and is important to prevent overcorrection of hyponatremia. Water restriction, hypertonic salt, urea, V2-receptor-blockers and recently sodium glucose cotransporter 2 (SGLT2) inhibitors were employed to treat patients with hyponatremia.An evidence based clinical guideline for cardiac rehabilitation (CR) has been published in collaboration between the German Association of Cardiac Rehabilitation and Prevention of Cardiovascular Diseases (DGPR) and the working groups of prevention and rehabilitation of the cardiac societies of Austria (ÖKG) and Switzerland (CPRS). This guideline has been consented by relevant medical societies in Germany (cardiologists, cardiac surgeans, sports medicine, psychosomatic medicine, rehabilitation scientists). In addition, patients suffering from cardiovascular diseases were involved to emphasize shared decision making in the recommendations. As return to work is a major goal of CR, German pension insurance (DRV-Bund) was associated in the development of this guideline as well. Evidence of CR was evaluated by systematic review of the literature and new meta-analysis performed and published by the guideline committee for patients with coronary artery disease and systolic heart failure. In addition, psychosocial intervention during CR was evaluated by new meta-analysis as well. Other indications for CR and interventions during CR were evaluated by literature review and were consented between collaborating medical societies. This guideline published on 7th of January 2020 in German language (www.awmf.org).Therapeutic plasma exchange (TPE) is used to eliminate toxins, hormones or antibodies from the blood and replace the lost volume with fresh frozen plasma, albumin or crystalloids. In this article, recent advances in the usage for TPE for four different critical disease entities are explored Septic shock, acute liver failure, catastrophic antiphospholipid syndrome (CAPS) and thyrotoxic storm.  Even though randomized controlled trials have not been able to demonstrate a clear benefit of TPE in septic shock, recent data demonstrates a sufficient safety profile for usage in critically ill, highly catecholamine dependent individuals. Moreover, an improvement in several surrogate parameters has been demonstrated.  High volume TPE has been shown to improve outcome in patients in acute liver failure in a multicenter, randomized controlled trial. However, this was only true for a subgroup of patients which did not receive a liver transplant. This raises the question about the effectiveness for TPE as a bridge to transplant therapy. CAPS  Retrospective data analysis demonstrates a clear benefit in survival when a triple therapy containing anticoagulation, corticosteroids and TPE or intravenous immunoglobulin is used. However, there was no difference in survival between the usage of intravenous immunoglobulin or TPE and no added benefit in using both.  Thyroid hormones can be eliminated using TPE. This has been shown in a retrospective data analysis of 2018 and caused the ASFA to view TPE as a second line therapy for thyrotoxic storm in the most recent 2019 guidelines. Thyroid hormones can be eliminated using TPE. This has been shown in a retrospective data analysis of 2018 and caused the ASFA to view TPE as a second line therapy for thyrotoxic storm in the most recent 2019 guidelines.Corticosteroids have been found as useful adjunctive therapy in patients with various infections and hyperinflammation-associated disease. They are recommended in practice guidelines for patients with tuberculous and pneumococcal meningitis and patients with immune reconstitution syndrome associated with antiretroviral therapy. A new indication is severe COVID-19. Valproate Evidence from clinical trials is insufficient to allow the routine use of steroids among patients with septic shock, community-acquired pneumonia or tuberculous pericarditis.Soft tissue sarcomas are rare tumors that represent a major challenge due to varying clinical presentations and often interdisciplinary treatment concepts. Gold standard for the treatment of localized resectable soft tissue sarcomas is complete surgical removal. So far, multimodality treatment does not represent a clininal standard. However, several newer analyses and studies suggest that a subgroup of patients seems to derive an overall survival benefit from perioperative chemotherapy. In metastatic soft tissue sarcoma systemic therapy is the treatment of choice. Most active drugs are the anthracyclines and ifosfamide. Combination chemotherapy has improved both response rate and progression-free survival at the costs of increased toxicity in comparison to single agent therapy but without impact on overall survival in first-line therapy. In pretreated patients, treatment options consist of trabectedin, pazopanib, gemcitabine plus docetaxel or DTIC, and eribulin. Recent data have shown that histiotype-specific treatment options including targeted therapy represent a major improvement for several sarcoma subtypes.In GIST, imatinib is the gold standard for patients with advanced or metastatic disease. In imatinib refractory or intolerant patients, sunitinib in an individualized treatment schedule is recommended. Regorafenib has been approved for third-line therapy. Recently, avapritinib has been approved for treatment of patients with the so far resistant D842V mutation in the PDGFRA exon 18. Ripretinib has shown very promising activity in forth and further lines of therapy and is already approved in the US. The use of adjuvant imatinib therapy in patients with completely resected localized GIST with a high risk of recurrence has significantly improved overall survival with a treatment duration of 3 years. These results have now been confirmed with a 10 years follow-up analysis.