Deutsches Arzteblatt international最新文献

{"title":"Same-Day Discharge Versus Overnight Stay After Catheter Ablation: An Observational Matched-Cohort Study on Safety and Feasibility.","authors":"Sorin S Popescu, Felix Behn, Charlotte Eitel, Jan-Per Wenzel, Sascha Hatahet, Roman Mamaev, Bianca I Popescu, Anna Traub, Suzanne de Waha, Julia Vogler, Christian-H Heeger, Mirco Küchler, Karl-H Kuck, Roland R Tilz","doi":"10.3238/arztebl.m2026.0148","DOIUrl":"10.3238/arztebl.m2026.0148","url":null,"abstract":"<p><strong>Background: </strong>Catheter ablation is an established therapy for arrhythmias. As the incidence of atrial fibrillation (AF) rises, the associated burden on the health-care system is expected to increase. Same-day discharge (SDD) may help optimize resource utilization and increase patient comfort and satisfaction.</p><p><strong>Methods: </strong>Consecutive patients undergoing SDD electrophysiology procedures were prospectively enrolled in the study and compared in a non-randomized manner with consecutive overnight stay (ONS) patients who were matched to them according to procedure type. SDD patients were evaluated on the day after the procedure. SDD Patients who were not discharged on the day of the procedure were excluded. Baseline, periprocedural, and 30-day outcomes were documented and compared.</p><p><strong>Results: </strong>100 patients underwent SDD electrophysiology procedures from September 2022 to March 2025. The SDD patients were younger and had a lower prevalence of coronary artery disease and chronic kidney disease than their counterparts in the ONS cohort. The most common procedure was AF ablation. Procedural complications arose in 2% (95% confidence interval: [0.6; 7.0]) vs. 6% [2.8; 12.5] in SDD and ONS patients, respectively, p =0.279. Complications up to the day of discharge, or up to the evaluation on post-procedure day 1 in the SDD group were reported in 10% [5.5; 17.4] and 17% [10.9, 25.6] of patients, respectively, p = 0.214. Complications were identified on post-procedure day 1 in 8 SDD patients, none of whom needed to be readmitted to the hospital. The numbers of emergency room consultations, unplanned outpatient visits, and rehospitalizations were similar in the two groups. In a subsequent analysis from January to May 2026, 85.8% of patients scheduled for SDD ablation were successfully discharged on the day of the procedure.</p><p><strong>Conclusion: </strong>In this prospective study, SDD after electrophysiology procedures was found to be a safe alternative to ONS in selected patients. None of the patients who were discharged on the same day as the procedure needed to be rehospitalized on the day after.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"123 22","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refractory Chronic Inflammatory Bowel Disease in Childhood and Adolescence: Options in Primary Non-Response or Secondary Treatment Failure.","authors":"Frank Rommel, Christa Bergheim, Ralph Melchior, Thomas Krause, Matthias Zilbauer, Andreas Jenke","doi":"10.3238/arztebl.m2026.0128","DOIUrl":"10.3238/arztebl.m2026.0128","url":null,"abstract":"<p><strong>Background: </strong>The incidence of inflammatory bowel disease among children and adolescents in Europe is approximately 10 per 100 000 per year. Refractory disease courses are clinically significant and associated with delayed growth and development, recurrent hospitalizations, and the need for surgery. 10-40% of patients have a primary nonresponse to anti-TNFα therapies, and a further 5-20% per year have secondary treatment failure, defined as loss of response after an initial response while on maintenance treatment. The aim of this review is to summarize current treatment options for primary non-response or secondary treatment failure.</p><p><strong>Method: </strong>This narrative review is based on current guidelines and pertinent publications retrieved by a selective search in the PubMed, Ovid MEDLINE, and Cochrane databases.</p><p><strong>Results: </strong>Before switching to another drug class, a standardized reevaluation is essential, incorporating clinical findings, biomarkers, endoscopy and/or imaging, and therapeutic drug monitoring. Following failure of anti-TNFα therapy, ustekinumab (approved for Crohn’s disease for patients ≥ 2 years of age) and vedolizumab (currently exclusively off-label) represent the best-established options in pediatric care. Reported clinical remission rates are 51% at week 52 for ustekinumab and 32% (Crohn's disease) and 42% (ulcerative colitis) at week 14 for vedolizumab. For IL-23p19 antibodies, Janus kinase inhibitors, and sphingosine-1-phosphate receptor modulators, the available evidence is still derived predominantly from adult studies, with very limited data from pediatric practice. Surgery remains an important option in complicated disease courses.</p><p><strong>Conclusion: </strong>Given the limited pediatric evidence and the frequent off-label use of newer agents, there is a need for prospective studies, registry data, and structured treatment algorithms to more reliably define the efficacy and long-term safety of treatments for pediatric chronic inflammatory bowel disease. In our view, children and adolescents with refractory inflammatory bowel disease should be managed by an interdisciplinary team in a center with the requisite experience.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"123 20","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fractures in Patients With Hip and Knee Prostheses: Epidemiology, Diagnosis, and Treatment.","authors":"Felix Werneburg, Karl-Stefan Delank, Alexander Hagel","doi":"10.3238/arztebl.m2026.0127","DOIUrl":"10.3238/arztebl.m2026.0127","url":null,"abstract":"<p><strong>Background: </strong>Fractures in patients with hip or knee prostheses (periprosthetic fractures, PPF) are rare but clinically significant complications whose absolute number is steadily increasing as implantation rates rise. In Germany, approximately 200 000 hip and 170 000 knee joints are primarily replaced each year: PPFs account for approximately 15% of all revisions of hip surgery and 3% of all revisions of knee surgery.</p><p><strong>Methods: </strong>This review is based on publications retrieved by a selective search in the PubMed/MEDLINE and Google Scholar databases up to December 2025. Registry analyses, meta-analyses, systematic reviews, and clinical trials were included.</p><p><strong>Results: </strong>Key risk factors for PPF are advanced age (OR 1.4-1.7), female sex (OR 1.6-2.1), and osteoporosis as the overarching risk modifier. The 1-year mortality rate of 11-24% is comparable to that after fractures around the hip joint. History-taking and physical examination serve not only to assess fracture morphology but also to rule out implant loosening and low-grade infection. Most of the available evidence on treatment is derived from retrospective cohort and registry studies. The choice of treatment is mainly determined by implant stability: if the implant is stable, angle-stable osteosynthesis is performed; if it is loose, it must be replaced. The goal of surgery is a reconstruction that is stable under full weight-bearing, so that early functional mobilization can ensue and secondary complications can thereby be avoided.</p><p><strong>Conclusion: </strong>Interdisciplinary treatment planning for the early resumption of function, along with low-threshold osteoporosis screening in the presence of risk factors, are key strategies for lowering mortality and preventing further fractures.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"123 20","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommendations on Switching or Deprescribing Hypnotic Medications for Insomnia.","authors":"Göran Hajak, Ingo Fietze, Christoph Schöbel, Michael Saletu, Birgit Högl, Yaroslav Winter","doi":"10.3238/arztebl.m2026.0141","DOIUrl":"10.3238/arztebl.m2026.0141","url":null,"abstract":"<p><strong>Background: </strong>10-30% of the world's population suffers from insomnia. One-quarter of those who take hypnotic medication become dependent on it. Given the wide variety of available drugs, switching them is complex. The existing recommendations do not cover all drug classes. There is a need for practical, evidence-based recommendations that take account of specific aspects of care both in Europe as a whole and regionally.</p><p><strong>Methods: </strong>This narrative review is based on publications from May 1953 to February 2026 that were retrieved by a search in six English- and German-language databases, including guidelines, meta-analyses, systematic reviews, randomized controlled trials, and observational studies. Following the literature review, new recommendations were developed in a consensus process (consensus conference followed by the Delphi method) to supplement the current insomnia guideline.</p><p><strong>Results: </strong>Treatment can be discontinued abruptly after short-term use (1-2 weeks) or if the drug in question does not produce withdrawal symptoms, e.g., daridorexant (an orexin receptor antagonist), melatonin, antihistamines, and phytotherapeutic drugs. Benzodiazepine receptor agonists, antidepressants, antipsychotics, and gabapentinoids should be tapered off gradually after medium- or long-term use (> 2 weeks), with a weekly dose reduction of 10-25%. Various gradual tapering methods can be used, depending on the drug, dose, duration of use, treatment regimen, and intended subsequent treatment. A longer taper is advisable after use at high doses (≥ 2/3 of the maximum dose) or over the long term (≥ 1 year). Withdrawal symptoms from benzodiazepine receptor agonists can be alleviated with the overlapping administration of daridorexant or eszopiclone. Cognitive behavioral therapy is recommended as an accompanying nonpharmacological treatment (relative risk [RR]: 1.68; 95% confidence interval: [1.19; 2.39]).</p><p><strong>Conclusion: </strong>A drug-specific approach with evidence-based and practice-oriented protocols should be used when hypnotic medications are switched or discontinued.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"123 19","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatic Steatosis: A Pandemic Disease Causing Serious Secondary Diseases.","authors":"Ali Canbay, Anja Figge, Polykarpos C Patsalis, Theodor Baars, Mustafa K Özçürümez, Oliver Götze","doi":"10.3238/arztebl.m2026.0074","DOIUrl":"10.3238/arztebl.m2026.0074","url":null,"abstract":"<p><strong>Background: </strong>At least one-quarter of the world's population now suffers from hepatic steatosis (fatty liver disease), which, in current terminology, is called metabolic dysfunction-associated steatotic liver disease (MASLD). This disease and its more dangerous inflammatory variant, metabolic dysfunction-associated steatohepatitis (MASH), promote the development of serious secondary conditions including cardiovascular diseases (CVDs), type 2 diabetes mellitus, and hepatocellular carcinoma (HCC).</p><p><strong>Methods: </strong>This review is based on pertinent publications retrieved from the PubMed-MEDLINE and Google Scholar databases and on current guidelines.</p><p><strong>Results: </strong>Conditions that are known to be associated with MASLD and/or MASH include obesity (with or without insulin resistance), dyslipidemia, hypertension, type 2 diabetes mellitus, obstructive sleep apnea, CVDs, and chronic kidney disease (CKD). The frequency of serious secondary diseases (CVDs, CKD, HCC, and extrahepatic malignancies) increases with the degree of fibrosis progression. Cardiovascular events are the main cause of death. Intensive lifestyle changes, including a hypocaloric, low-sugar diet and physical activity and exercise in an adequate amount and intensity, are the first line of treatment and the basis for further treatment options (resmetirom, incretin analogues, bariatric surgery).</p><p><strong>Conclusion: </strong>In view of its high prevalence and its associated profile of elevated cardiovascular risk, MASLD should be recognized as clinical evidence of the danger of major secondary disease and integrated into a structured, interdisciplinary management program with strict risk stratification. Drugs are part of the therapeutic spectrum but are no substitute for lifestyle modification, which remains the basis of treatment.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"123 19","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13667342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148053312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burnout and Work-Life Balance: A Longitudinal Study Into the Transition From Medical School to Postgraduate Training.","authors":"Selina Dural, Sandra Decker, Philip Walter, Michael Merkle, Pascal O Berberat, Alexander Hapfelmeier, Antonius Schneider","doi":"10.3238/arztebl.m2026.0102","DOIUrl":"10.3238/arztebl.m2026.0102","url":null,"abstract":"<p><strong>Background: </strong>Much discussion currently surrounds the intense occupational stress of the practical year (the final year of medical school in Germany) and the early years of postgraduate medical training, yet the extent of subjectively experienced stress during the transition from medical school to postgraduate training has not been measured to date.</p><p><strong>Methods: </strong>We conducted a longitudinal survey of medical students in their 9th and 10th semesters and in their practical year, with a 2-year follow-up. Data were acquired with the Maslach Burnout Inventory (MBI), the Trier Abbreviated Scale on Work-Life Balance, and questions about patient care. Trends were analyzed with linear mixed models.</p><p><strong>Results: </strong>321 students participated; 216 (67.3%) were female. The mean values for exhaustion and depersonalization/loss of empathy rose over time, while personal performance remained steadily low. Classification in categories revealed a high level of emotional exhaustion in 10.3% of subjects, rising to 47.4% in the first year of postgraduate training. It also revealed that 43.6% of subjects exhibited a very high level of depersonalization/loss of empathy as early as the 9^th semester of medical school, with a further rise at later times. Personal accomplishment was very low at the beginning in 48.7% of subjects, and then dropped even lower. Work-life balance declined from medical school to the practical year and continued to decline from the practical year to postgraduate training.</p><p><strong>Conclusion: </strong>The MBI scale scores were unfavorable at the outset and worsened over time, indicating high stress throughout. There is an urgent need to improve the structural framework of undergraduate and postgraduate medical education.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"123 19","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Guideline-Compliant Prescriptions of Benzodiazepines and Z Drugs: Effects of Social Norm Feedback. A Randomized Controlled Trial.","authors":"Odette Wegwarth, Hubert Pawlowski, Andreas Bartels, Christian Nehling, Claudia Spies, Helge Giese","doi":"10.3238/arztebl.m2026.0093","DOIUrl":"10.3238/arztebl.m2026.0093","url":null,"abstract":"<p><strong>Background: </strong>In Germany, long-term prescribing of benzodiazepines and Z drugs remains common even though their use for no more than 30 days is recommended in the guidelines because of risks including dependence, cognitive impairment, and falling. In this randomized controlled trial, we studied whether social norm feedback can reduce non-guideline-compliant prescribing in outpatient practices.</p><p><strong>Methods: </strong>Using routine prescribing data that we obtained from the Rhineland-Palatinate Association of Statutory Health Insurance Physicians (KV RLP) for the third and fourth quarters of 2022, we identified 1258 outpatient primary care practices that had issued non-guideline-compliant benzodiazepine or Z-drug prescriptions (≥30 days). These practices were randomized (1:1) to receive either social norm feedback or no feedback (629 practices in each group). The practices in the intervention group were sent a letter in June 2023 containing their prescribing percentile rank relative to other practices in the same specialty, as well as guideline recommendations; those in the control group were not contacted. The primary outcome was the change in defined daily doses (DDD) of non-guideline-compliant prescriptions per 1000 patients from Q3/Q4 2022 to Q3/Q4 2023. The data were analyzed by the intention-to-treat principle. 108 practices were lost to follow-up.</p><p><strong>Results: </strong>The intervention group displayed a larger reduction in DDD of non-guideline-compliant prescriptions per 1000 patients (-6.5%, from 408.97 to 382.40) than the control group (-3.0%, from 401.38 to 389.30; <i>p</i> = 0.006), as well as in the percentage of patients receiving inappropriate prescriptions (-20.2% vs -6.6%; <i>p</i> < 0.001). The strongest effect was seen among practices that had been below the 65th percentile of non-compliant prescribing at baseline.</p><p><strong>Conclusion: </strong>This first randomized controlled trial on social norm feedback in Germany demonstrates that a simple, low-cost social norm intervention can reduce inappropriate benzodiazepine and Z-drug prescribing and help address an ongoing public health concern.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"123 19","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Infectious Syndromes in the Post-Pandemic Phase Among the German General Population.","authors":"Jonas Frost, Friederike Peter, Nadine Glaser, Thomas Frese, Michael Heuser, Michael Gekle, Matthias Girndt, Nils Opel, Thomas Behrens, André Karch, Saskia Muellmann, Hajo Zeeb, Oliver Tüscher, Rafael Mikolajczyk","doi":"10.3238/arztebl.m2026.0134","DOIUrl":"10.3238/arztebl.m2026.0134","url":null,"abstract":"<p><strong>Background: </strong>Persistent symptoms after a respiratory infection can impair daily life, as has been shown, for example, for \"long COVID.\" In this study, we determined the frequency and impact of symptoms that persisted for 12 weeks or more after a respiratory infection. A further endpoint was health care utilization for such symptoms in the general population.</p><p><strong>Methods: </strong>A cross-sectional study was conducted within the population-based digital cohort DigiHero in Germany (DRKS00025600). 39.3% of invited participants responded by completing an online questionnaire. 46 915 adults were included in the analysis. Participants were asked about symptoms that persisted 12 weeks or longer after a respiratory infection between September 2024 and August 2025.</p><p><strong>Results: </strong>48.3% of participants (95% confidence interval: [47.9; 48.8]) reported having had at least one respiratory infection during the study period. Among them, 18.8% [18.3; 19.3] stated that they still had symptoms 12 weeks or more afterward. The frequency of persistent symptoms was higher in older persons (13.1% for ages 20 to 29, 21.4% for ages 60 to 69). Most (86.8%) of those affected reported at least moderate functional impairment, and 57.9% consulted a physician. The pathogen causing the original infection was known for 24.3% of those reporting persistent symptoms: there were 483 cases of SARS-CoV-2 infection, 102 of influenza, and 36 of RSV. The symptom duration, functional impairment, and symptom pattern were similar after infection with SARS-CoV-2 and influenza. The most common symptoms in all pathogen groups were impaired physical performance, shortness of breath, rapid exhaustion, and fatigue.</p><p><strong>Conclusions: </strong>Persistent symptoms after respiratory infections are common and similar across pathogens in frequency and severity.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"123 19","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13667304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prevalence of Hospitalized Cases of Necrotizing Fasciitis: Anatomical Distribution, Amputations, and In-Hospital Mortality, 2019-2024.","authors":"Belal Abdo, Lukas Bönnen, Christopher Tuffs, Nike Walter, Christian Heiss, Markus Rupp","doi":"10.3238/arztebl.m2026.0124","DOIUrl":"10.3238/arztebl.m2026.0124","url":null,"abstract":"<p><strong>Background: </strong>Necrotizing fasciitis is a life-threatening soft-tissue infection that still carries an in-hospital mortality of 11-30% and an amputation rate of 7-22% despite modern treatment. Only limited population-based data have been available for Germany to date.</p><p><strong>Methods: </strong>We carried out a retrospective, nationwide descriptive analysis of aggregated administrative routine data from the German DRG system. All hospitalizations with a main diagnosis of necrotizing fasciitis (ICD-10-GM: M72.6) from 2019 to 2024 were included. The prevalence, demographic features, and anatomical distribution of necrotizing fasciitis were studied, as well as the rate of major amputations and in-hospital mortality.</p><p><strong>Results: </strong>There were 12 799 hospitalized cases of necrotizing fasciitis over the years of the study. The mean annual prevalence was 2.6 cases per 100 000 people; an upward trend was seen from 2022 onward. Men and patients over age 50 were overrepresented. The most commonly affected sites were the pelvic/femoral region and the lower leg. Major amputations, mainly of a lower limb, were performed in 6.7% to 9.3% of cases. The in-hospital mortality rate averaged 14.9% and remained high throughout the study period. In-hospital mortality largely depended on the anatomic site and was higher with more extensive disease.</p><p><strong>Conclusion: </strong>In Germany, necrotizing fasciitis is associated with a considerable disease burden, high mortality, and high amputation rates. Men and patients over age 50 are at higher risk of developing this disease, and its mortality is highest in patients with extensive disease or involvement of the proximal lower limb. These are the first robust population-based data on necrotizing fasciitis in Germany.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"123 19","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Physician Parents Treat Their Own Children.","authors":"Achim Mortsiefer, Annabel Zemke, Vera Kalitzkus, Stefan Wilm, Christine Kersting","doi":"10.3238/arztebl.m2026.0094","DOIUrl":"10.3238/arztebl.m2026.0094","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"123 18","pages":"512-513"},"PeriodicalIF":8.7,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}