Journals Deutsches Ärzteblatt Intern...

Deutsches Ärzteblatt International
Pia Grabbe, Milena S Borchers, Kathrin M Gschwendtner, Sophia Strobel, Beate Wild, Marietta Kirchner, Katharina Kälber, Adriana Rendon, Julian Steininger, Friedegund Meier, Jessica C Hassel, Christiane Bieber
BACKGROUND: Treatment decisions in metastatic melanoma (MM) depend on patient preferences and require the patients' involvement in the decision-making process. Patients often feel overwhelmed by the complexity of treatment options with their individual advantages and disadvantages. We developed an online patient decision aid (PtDA) to facilitate shared decision making (SDM). METHODS: We conducted a two-center, two-armed, prospective, open randomized controlled trial with MM patients who were facing a decision about first-line treatment...
June 14, 2024: Deutsches Ärzteblatt International
Cornelius Courts, Annica Gosch, Markus Rothschild
BACKGROUND: Different types of RNA take on multiple crucial functions in living cells and tissues. Messenger RNA (mRNA) is a temporary molecular carrier of genetic information. Analysis of the composition of all mRNA contained in a cell at a given moment, the so-called transcriptome, enables the determination of the type of cell and its condition, e.g., in pathologically altered states. METHODS: This review is based on pertinent publications retrieved by a selective literature search...
May 31, 2024: Deutsches Ärzteblatt International
Johannes Kruse, Hanna Kampling, Soufiane Filali Bouami, Thomas G Grobe, Mechthild Hartmann, Johanna Jedamzik, Ursula Marschall, Joachim Szecsenyi, Samuel Werner, Beate Wild, Sandra Zara, Gereon Heuft, Hans-Christoph Friederich
BACKGROUND: A structural reform of the German psychotherapy guideline in 2017 was intended to facilitate access to outpatient guideline psychotherapy. In the present study, we evaluate the effects of this reform in particular for patients a comorbidity of mental disorders and chronic physical conditions (cMP). METHODS: Pre-post analyses of the two primary endpoints "percentage of mentally ill persons who have made an initial contact with a psychotherapist" and "waiting time for guideline psychotherapy" were carried out employing population-based and weighted routine statutory health insurance data from the German BARMER...
May 17, 2024: Deutsches Ärzteblatt International
Monica Christine Ciorba, Marc Maegele
BACKGROUND: Inadequate clinical experience still causes uncertainty in the acute diagnostic evaluation and treatment of polytrauma in children (with or without coagulopathy). This review deals with the main aspects of the acute care of severely injured children in the light of current guidelines and other relevant literature, in particular airway control, volume and coagulation management, acute diagnostic imaging, and blood coagulation studies in the shock room. METHODS: This review is based on literature retrieved by a selective search in PubMed, Medline (OVIDSP), the Cochrane Central Register of Controlled Trials, and Epistemonikos covering the period January 2001 to August 2023...
May 17, 2024: Deutsches Ärzteblatt International
Elias Kellner, Peggy Sekula, Jan Lipovsek, Maximilian Russe, Harald Horbach, Christopher L Schlett, Matthias Nauck, Henry Völzke, Thomas Kroencke, Stefanie Bette, Hans-Ulrich Kauczor, Thomas Keil, Tobias Pischon, Iris M Heid, Annette Peters, Thoralf Niendorf, Wolfgang Lieb, Fabian Bamberg, Martin Büchert, Wilfried Reichardt, Marco Reisert, Anna Köttgen
BACKGROUND: Population-wide research on potential new imaging biomarkers of the kidney depends on accurate automated segmentation of the kidney and its compartments (cortex, medulla, and sinus). METHODS: We developed a robust deep-learning framework for kidney (sub-)segmentation based on a hierarchical, three-dimensional convolutional neural network (CNN) that was optimized for multi-scale problems of combined localization and segmentation. We applied the CNN to abdominal magnetic resonance images from the population-based German National Cohort (NAKO) study...
May 3, 2024: Deutsches Ärzteblatt International
Freerk T Baumann, Wiebke Jensen, Anika Berling-Ernst, Sebastian Theurich, Michael Leitzmann, Miriam Götte
BACKGROUND: The diagnosis and treatment of cancer are highly stressful. Exercise therapy is often used to mitigate the adverse effects of treatment. But how good is the evidence base, and what has changed in recent years? In this narrative review, we present the current data and what it implies for the care of adults with cancer. METHODS: This review is based on data from meta-analyses and systematic reviews concerning 16 relevant clinical endpoints (outcomes) of exercise therapy for cancer patients RESULTS: The literature evaluated for this paper reveals that targeted exercise therapy is feasible and safe under appropriate supervision...
May 3, 2024: Deutsches Ärzteblatt International
Seven Johannes Sam Aghdassi, Sonja Hansen, Luis Alberto Peña Diaz, Alexander Gropmann, Selin Saydan, Christine Geffers, Petra Gastmeier, Brar Piening, Michael Behnke
BACKGROUND: A national point prevalence survey (PPS) of healthcare-associated infections (HAI) and antibiotic use (AU) was carried out in Germany in 2022 in the framework of the European PPS conducted by the European Centre for Disease Prevention and Control (ECDC). The objective was to determine the prevalence of HAI and AU in German hospitals and to compare the obtained values with those of the most recent previous PPS, which was carried out in 2016. METHODS: The German National Reference Center for the Surveillance of Nosocomial Infections was entrusted with the organization of the PPS of 2022...
May 3, 2024: Deutsches Ärzteblatt International
Heinke Adamczewski, Dietmar Weber, Judith Klein, Manuela Behling, Matthias Kaltheuner
BACKGROUND: Gestational diabetes mellitus (GDM) affects more than 50 000 pregnant women in Germany every year. In postpartum diabetes screening, a 75 g oral glucose tolerance test (OGT) is recommended. This is time-consuming and can have side effects, and only 40% of mothers take it. The determination of pre-test probabilities might obviate the need for OGT except in women who are at particular risk. METHODS: We analyzed 5444 cases of GDM from the GestDiab registry over the period 2015-2019...
April 19, 2024: Deutsches Ärzteblatt International
Julia Hurraß, Dennis Nowak, Birger Heinzow, Marcus Joest, Jannik Stemler, Gerhard A Wiesmüller
BACKGROUND: According to self-reported frequencies, every fifth or sixth dwelling in Germany is affected by dampness and/or mold. This carries a potential risk to health. METHODS: This review is based on pertinent publications retrieved by a selective literature search and inquiry in the GENESIS database, on the AWMF guideline on the medical clinical diagnosis of indoor mold exposure, as updated in 2023, and on the relevant contents of other current guidelines. Based on this research, we present an algorithm for the evaluation of health problems that may be due to mold in indoor environments...
April 19, 2024: Deutsches Ärzteblatt International
Robin Brünn, Jale Basten, Dorothea Lemke, Alexandra Piotrowski, Sara Söling, Bastian Surmann, Wolfgang Greiner, Daniel Grandt, Petra Kellermann-Mühlhoff, Sebastian Harder, Paul Glasziou, Rafael Perera, Juliane Köberlein-Neu, Peter Ihle, Marjan van den Akker, Nina Timmesfeld, Christiane Muth
BACKGROUND: Inappropriate drug prescriptions for patients with polypharmacy can have avoidable adverse consequences. We studied the effects of a clinical decision-support system (CDSS) for medication management on hospitalizations and mortality. METHODS: This stepped-wedge, cluster-randomized, controlled trial involved an open cohort of adult patients with polypharmacy in primary care practices (=clusters) in Westphalia-Lippe, Germany. During the period of the intervention, their medication lists were checked annually using the CDSS...
April 19, 2024: Deutsches Ärzteblatt International
Farhad Rezvani, Dirk Heider, Hans-Helmut König, Lutz Herbarth, Patrick Steinisch, Franziska Schuhmann, Hannes Böbinger, Gundula Krack, Thomas Korth, Lara Thomsen, Daniela Patricia Chase, Robert Schreiber, Mark-Dominik Alscher, Benjamin Finger, Martin Härter, Jörg Dirmaier
BACKGROUND: Supervised exercise programs are commonly used to treat intermittent claudication (IC). Home-based exercise programs have been developed to lower barriers to participation. We studied the effects of one such program (TeGeCoach) on self-reported walking ability in patients with IC. METHODS: In a pragmatic, multicenter, randomized and controlled trial (registration number NCT03496948), 1982 patients with symptomatic IC, insured by one of three German statutory health-insurance carriers, received either telephone health coaching with remote exercise monitoring (TeGeCoach; n = 994) or routine care (n = 988)...
April 19, 2024: Deutsches Ärzteblatt International
Christian Eckmann, Seven Johannes Sam Aghdassi, Alexander Brinkmann, Mathias Pletz, Jessica Rademacher
BACKGROUND: Postoperative surgical site infections (SSI) account for almost 25% of all nosocomial infections in Germany and are a source of increased morbidity and mortality. METHODS: This review is based on pertinent publications retrieved by a selective search in PubMed and on national and international guidelines. RESULTS: The individual risk factors for SSI must be assessed before any surgical procedure. A body-mass index above 30 kg/m2 is associated with an unadjusted risk ratio of 1...
April 5, 2024: Deutsches Ärzteblatt International
Michael J Stein, Beate Fischer, Anja M Sedlmeier
BACKGROUND: Obesity is a worldwide health problem. We conducted detailed analyses of anthropometric measures in a comprehensive, population-based, current cohort in Germany. METHODS: In the German National Cohort (NAKO), we analyzed cross-sectional data on body-mass index (BMI), waist and hip circumference, subcutaneous (SAT) and visceral adipose tissue (VAT) as measured by ultrasound, and body fat percentage. The data were stratified by sex, age, and self-reported physicians' diagnoses of cardiovascular diseases (CVD), metabolic diseases (MetD), cardiometabolic diseases (CMD), and cancer...
April 5, 2024: Deutsches Ärzteblatt International
Udo Bonnet, Norbert Scherbaum, Andreas Schaper, Michael Soyka
BACKGROUND: Phenibut (β-phenyl-γ-aminobutyric acid) is an analog of the neurotransmitter gamma-aminobutyric acid (GABA). Like gabapentin and pregabalin, it inhibits α2-δ-subunits of voltage-dependent presynaptic calcium channels. The potential harm resulting from the use of these gabapentinoids is currently a matter of debate. METHODS: This review is based on pertinent publications retrieved by a selective literature search and on cases reported to the Giftinformationszentrum-Nord (GIZ-Nord), a poison information center at the University of Göttingen, Germany...
April 5, 2024: Deutsches Ärzteblatt International
Dorothea Thieme, Birgit Linnemann, Katja Mühlberg, Thomas Noppeney, Maria Kreutz, Marcus Thieme
BACKGROUND: After an acute deep venous thrombosis (DVT) of the lower limb, 20% to 65% of patients develop post-thrombotic syndrome (PTS). In this review, we address the efficacy of compression therapy in the treatment of acute DVT of the lower limb, and for the prevention of PTS. METHODS: 12 randomized controlled trials (RCTs) and one meta-analysis, with a total of 3759 patients, were identified in a structured literature search. RESULTS: Two RCTs showed that adding compression therapy to drug treatment in the first 9 days of the acute phase of lower limb DVT led to more rapid pain relief (p<0...
March 22, 2024: Deutsches Ärzteblatt International
Dagmar von Bubnoff, Daniel Koch, Hannah Stocker, Ralf J Ludwig, Friederike Wortmann, Nikolas von Bubnoff
BACKGROUND: Hereditary alpha-tryptasemia (HAT) is a genetic predisposition of autosomal dominant inheritance that leads to a high normal (≥ 8-11.4 μg/L) or pathologically elevated (>11.4 μg/L) basal serum tryptase (BST) concentration. Its prevalence in the United Kingdom and France is reportedly 5%-6%; its prevalence in Germany is unknown. Symptomatic persons with HAT suffer from a complex constellation of symptoms. As described in this review, HAT is an important differential diagnosis in interdisciplinary practice...
March 22, 2024: Deutsches Ärzteblatt International
Lisa Braunheim, Ayline Heller, Claudia Helmert, Christoph Kasinger, Manfred E Beutel, Elmar Brähler
BACKGROUND: It is still debated in Germany whether early childhood care outside the family might cause mental stress in adulthood. In the German Democratic Republic (GDR-the former East Germany before unification), children were often cared for outside the family from a very early age. METHODS: To determine the relation between early childhood care outside the family and mental stress in adulthood, we carried out a survey among 1575 persons who were born and socialized in the GDR...
March 22, 2024: Deutsches Ärzteblatt International
Susanne Singer, Alexander Wünsch, Andreas Ihrig, Gudrun Bruns, Franziska Holz, Johannes Jakob, Markus Besseler, Deborah Engesser, Maria Blettner, Jochem König, Oliver Bayer
BACKGROUND: Men make use of outpatient cancer counseling less commonly than women, even when they stand to benefit from it. METHODS: In a cluster-randomized trial (registered under DRKS00032181), we studied whether measures on multiple levels (information for referring physicians, public information, structural changes, offerings specifically for male patients) over a period of 12 months would be able to increase the percentage of men among patients seeking outpatient cancer counseling (primary endpoint, initial contact; secondary endpoint, all contacts)...
March 22, 2024: Deutsches Ärzteblatt International
Tim Bothe, Anne-Katrin Fietz, Nina Mielke, Julia Freitag, Natalie Ebert, Elke Schaeffner
BACKGROUND: Chronic kidney failure (CKF) is often treated with dialysis, which is invasive and costly and carries major medical risks. The existing studies of patients with CKF requiring dialysis that are based on claims data from German statutory health insurance (SHI) carriers employ varying definitions of this entity, with unclear consequences for the resulting statistical estimates. METHODS: We carried out a cohort study on four random samples, each consisting of 62 000 persons aged 70 or above, from among the insurees of the SHI AOK Nordost, with one sample for each of the years 2012, 2014, 2016, and 2018...
March 8, 2024: Deutsches Ärzteblatt International
Katrin Neumann, Christina Kauschke, Annette Fox-Boyer, Carina Lüke, Stephan Sallat, Christiane Kiese-Himmel
BACKGROUND: It is estimated that 9.9% of children have developmental language disorders (DLD), 7.6% in the form of circumscribed DLD without any serious accompanying impairment and 2.3% with comorbidities that have a bearing on language, such as hearing disorders. Developmental language disorders are among the more commonly treated childhood disorders; if they persist, they often adversely affect educational attainment and social standing later in life. Developmental language delay during the third year of life is an important risk factor for developmental language disorders...
March 8, 2024: Deutsches Ärzteblatt International
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