Deutsches Arzteblatt international最新文献

{"title":"The Performance of Artificial Intelligence on a National Medical Licensing Examination—The Answers of Large Language Models to Text Questions.","authors":"Mark Enrik Geissler, Merle Goeben, Kira A Glasmacher, Jean-Paul Bereuter, Rona Berit Geissler, Isabella C Wiest, Fiona R Kolbinger, Jakob Nikolas Kather","doi":"10.3238/arztebl.m2024.0231","DOIUrl":"https://doi.org/10.3238/arztebl.m2024.0231","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"121 26","pages":"888-889"},"PeriodicalIF":6.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406388","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":"Shoulder Arthroplasty—An Analysis of Data From the German Federal Statistical Office, 2010–2021.","authors":"Matthias Aurich, Daniel P Berthold, Jan Theopold, Bernd Bittersohl, Milad Farkhondeh Fal, Felix Krane, Jörn Kircher","doi":"10.3238/arztebl.m2024.0154","DOIUrl":"https://doi.org/10.3238/arztebl.m2024.0154","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"121 26","pages":"882-883"},"PeriodicalIF":6.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406386","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":"The Partial Pressure of Oxygen Under Long-Term Oxygen Therapy With Various Types of Face Masks.","authors":"Arno Mohr, Maria M Mercado, Nina M Sicker, Stefanie Zahn, Michael Pfeifer, Maximilian V Malfertheiner, Bernd Salzberger, Florian Hitzenbichler, Florian Geismann","doi":"10.3238/arztebl.m2024.0153","DOIUrl":"https://doi.org/10.3238/arztebl.m2024.0153","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"121 26","pages":"884-885"},"PeriodicalIF":6.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406387","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":"The Heidelberg Decision Aid for Patients With Lung Cancer (HELP)—Findings of a Randomized Controlled Trial.","authors":"Matthias Villalobos, Laura Unsöld, Nicole Deis, Rouven Behnisch, Anja Siegle, Michael Thomas","doi":"10.3238/arztebl.m2024.0228","DOIUrl":"10.3238/arztebl.m2024.0228","url":null,"abstract":"<p><strong>Background: </strong>Advanced lung cancer typifies the challenges of shared decision-making in oncology. With a limited prognosis for survival, the increasingly numerous and complex treatment options must continually be weighed against issues of fragility, quality of life, and the end of life.</p><p><strong>Methods: </strong>This randomized, controlled trial, carried out on 138 patients, concerned the use of a decision aid combined with decision coaching, versus standard care. The primary endpoint was clarity of the patient's personal attitude, as assessed on the Decisional Conflict Scale. The secondary endpoints were self-efficacy, decisional conflict, perceived preparedness and participation in decision-making, and anxiety/depression. The data were analyzed with descriptive statistics and intergroup comparisons. The trial was entered into the German registry of clinical trials (DRKS00028023).</p><p><strong>Results: </strong>No statistically significant difference with regard to the primary endpoint (clarity of the patient's personal attitude concerning the decision) was found in a comparison between the intervention group and the control group (IG: median/IQR: 41.67/47.92; CG: median/IQR: 33.33/43.75; p = 0.35). The descriptive statistics revealed a high level of decisional conflict in the overall group of study participants: 57.6% had a very high level of decisional conflict, composed in particular of the dimensions of feeling inadequately informed (64.4%) and of uncertainty (58.9%). Most participants judged the intervention to be helpful in preparing them to make a decision.</p><p><strong>Conclusion: </strong>Even though the intervention was perceived as helpful preparation for decision-making, it did not bring about any improvement in the high level of decisional conflict. With the continual development of new treatments and the associated increase in prognostic uncertainty, there is an important role for individualized patient information and the training of physicians in how to deal with uncertainty.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":" Forthcoming","pages":"861-867"},"PeriodicalIF":6.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142783718","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":"A Retrospective, Single-Center Analysis of the Time of Diagnosis of Congenital Cataract Requiring Surgical Treatment.","authors":"Hanna Faber, Martin S Spitzer, Vasyl Druchkiv, Frank Schüttauf, Diana Bittersohl","doi":"10.3238/arztebl.m2024.0131","DOIUrl":"https://doi.org/10.3238/arztebl.m2024.0131","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"121 26","pages":"886-887"},"PeriodicalIF":6.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406384","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":"Loss of Head Voice Function in Long-Standing Hashimoto's Thyroiditis.","authors":"Martin J P Kampmann, Thomas Steinmüller, Philipp P Caffier","doi":"10.3238/arztebl.m2024.0202","DOIUrl":"10.3238/arztebl.m2024.0202","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"121 26","pages":"881"},"PeriodicalIF":6.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406385","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":"Whole-Body Pain in a Case of a Phosphaturic Tumor.","authors":"Konstantinos Anagnostakos, Ismail Sahan, Winfried Häuser","doi":"10.3238/arztebl.m2024.0149","DOIUrl":"https://doi.org/10.3238/arztebl.m2024.0149","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"121 26","pages":"890"},"PeriodicalIF":6.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406389","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":"The Epidemiology and Diagnosis of Measles—Special Aspects Relating to Low Incidence.","authors":"Dorothea Matysiak-Klose, Annette Mankertz, Heidemarie Holzmann","doi":"10.3238/arztebl.m2024.0211","DOIUrl":"10.3238/arztebl.m2024.0211","url":null,"abstract":"<p><strong>Background: </strong>Measles is a highly contagious viral disease (contagion index near 100%) with a complication rate of up to 30%. The worldwide incidence for 2022 was calculated as 29 cases per million people. Measles can be eliminated if 95% of the population is either vaccinated or immune and measures are taken to limit its spread as soon as an initial suspected case is encountered. However, the worldwide immunization rate has fallen since 2020 (from 86% in 2019 to 81% in 2021).</p><p><strong>Methods: </strong>To assess the epidemiological situation and describe the state of scientific knowledge regarding laboratory tests for measles, we analyzed recent epidemiological data from the Robert-Koch Institute (RKI) and reviewed pertinent publications retrieved by a selective literature search.</p><p><strong>Results: </strong>Repeated importations of measles virus have led to a new rise in case numbers in Germany since last year. 79 cases of measles were reported to the RKI in 2023, and 475 in the first eight months of 2024. The latter figure corresponds to the pre-pandemic level. There are still immunization gaps in the population: for instance, by the age of 24 months, 93.7% of children have received their first immunization, and only 80.5% have received the second. Every suspected case must be confirmed by laboratory testing so that targeted measures can be initiated. Serology is no longer considered sufficiently reliable; a reliable diagnosis now requires a poly merase chain reaction (PCR) test. The specimen can be a throat swab or a urine sample. PCR also enables the differentiation of measles virus variants and the tracing of transmission chains.</p><p><strong>Conclusion: </strong>Reliable laboratory testing makes it possible to detect measles cases rapidly, initiate measures to slow the spread of the disease, trace infection chains, and assess the risk exposure for measles in Germany.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":" Forthcoming","pages":"875-881"},"PeriodicalIF":6.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142727039","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":"Pretreatment With Unfractionated Heparin in ST-Elevation Myocardial Infarction—A Propensity Score Matching Analysis.","authors":"Sascha Macherey-Meyer, Sebastian Heyne, Max Maria Meertens, Karl Finke, Victor Mauri, Ingo Ahrens, Frank Michael Baer, Frank Eberhardt, Marc Horlitz, Jan-Malte Sinning, Axel Meissner, Benjamin Rosswinkel, Stephan Baldus, Christoph Adler, Samuel Lee","doi":"10.3238/arztebl.m2024.0212","DOIUrl":"10.3238/arztebl.m2024.0212","url":null,"abstract":"<p><strong>Background: </strong>Patients with ST-segment elevation myocardial infarction (STEMI) are often pretreated with unfractionated heparin (UFH) before a primary percutaneous coronary intervention (PPCI). UFH pretreatment is intended to lessen the thrombotic burden, but there have been conflicting study findings on its safety and efficacy. We assessed the risks and benefits of UFH pretreatment with a retrospective analysis of registry data from the STEMI network of a German metropolitan region.</p><p><strong>Methods: </strong>Data from patients with STEMI referred for PPCI from 2005 to 2020 were evaluated with an adjusted outcome analysis, including propensity score matching (PSM). The endpoints included the patency of the infarct-related artery (IRA) after PPCI, in-hospital mortality, access-site bleeding, and the peak creatine kinase (CK) level.</p><p><strong>Results: </strong>We assessed data from 4632 patients with STEMI: 4420 (95.4%) were pretreated with UFH, and 212 (4.6%) were not. After PSM of 511 vs. 187 patients, the adjusted odds ratios for the various endpoints were (pretreatment vs. no pretreatment, with 95% confidence intervals): for impaired flow of the IRA, 1.01 [0.59; 1.74]; for in-hospital mortality, 1.46 [0.88; 2.42]; and for access-site bleeding, 0.59 [0.14; 2.46]. The peak creatine kinase levels were similar in the two groups (median, 1248.0 vs. 1376.5 U/L, estimated difference -134 [-611; 341]).</p><p><strong>Conclusion: </strong>UFH pretreatment was less frequently performed in STEMI patients who had undergone cardiopulmonary resuscitation. UFH pretreatment was not associated with increased access-site bleeding, nor was it found to have significantly higher efficacy with respect to the relevant endpoints. The risks and benefits of UFH pretreatment should be weighed individually in each case, as evidence from high-quality clinical trials is lacking. Data from the existing literature suggest that no pretreatment is an option to be considered, as are certain alternative antithrombotic strategies.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":" Forthcoming","pages":"833-839"},"PeriodicalIF":6.5,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544337","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":"Intraesophageal Malposition of a Subclavian Catheter.","authors":"Andreas Schneider, Sebastian Bergrath, Andreas Kirschniak","doi":"10.3238/arztebl.m2024.0192","DOIUrl":"https://doi.org/10.3238/arztebl.m2024.0192","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"121 25","pages":"839"},"PeriodicalIF":6.5,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398434","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}