Deutsches Arzteblatt international最新文献

{"title":"Incidental Finding: Aberrant Right Vertebral Artery.","authors":"Sabine Weinbrecht-de Jongh, Marion Dittrich","doi":"10.3238/arztebl.m2025.0093","DOIUrl":"https://doi.org/10.3238/arztebl.m2025.0093","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"122 17","pages":"474"},"PeriodicalIF":7.1,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136695","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":"Mental Comorbidity and Psychosocial Care in Patients with Cancer.","authors":"Andreas Dinkel, Ute Goerling, André Karger, Martin Teufel, Tanja Zimmermann, Andreas Stengel","doi":"10.3238/arztebl.m2025.0086","DOIUrl":"10.3238/arztebl.m2025.0086","url":null,"abstract":"<p><strong>Background: </strong>Patients with cancer suffer from cancer- and treatment-specific, psychosocial and care-related stress and mental disturbances.</p><p><strong>Methods: </strong>This article is based on pertinent publications retrieved by a search in PubMed, as well as on the German clinical practice guideline on psycho-oncology.</p><p><strong>Results: </strong>The most common mental disorders in cancer patients are anxiety disorders, affective disorders, and adjustment disorders. The point prevalence of any mental disorder in patients with cancer is 20% to 50%. Common disease-associated psychological symptoms include distress (a non-specific experience of emotional discomfort), demoralization, and fear of cancer recurrence or progression. These can cause severe suffering even if they do not meet the diagnostic criteria for any particular mental disorder. Mental comorbidity is associated with complications of treatment, lesser adherence to treatment, lower quality of life, and increased mortality. Psychotherapeutic interventions are effective and show moderate to large effects in current meta-analyses with respect to the reduction of anxiety and depression and improvement in quality of life. These effects persist over several months of follow-up. The empirical evidence for psychopharmacotherapy in cancer patients is limited. Psychopharmacological treatment should be integrated into an overall psycho-oncological treatment plan.</p><p><strong>Conclusion: </strong>A large body of evidence shows that mental comorbidity is common among cancer patients and harmful to them. Psychotherapeutic interventions lessen the symptoms of mental distur - bances and improve quality of life. Nonetheless, despite improvements in recent years, there are remaining barriers to the adequate provision of psychosocial care.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":" Forthcoming","pages":"475-482"},"PeriodicalIF":7.1,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215228","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 Successful Prevention of a Thromboembolic Event with an Inferior Vena Cava Filter in a Patient with Fracture-Dislocation of the Tibial Head.","authors":"Simon Yacoub, Christian Kleber, Katja S Mühlberg","doi":"10.3238/arztebl.m2025.0075","DOIUrl":"https://doi.org/10.3238/arztebl.m2025.0075","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"122 17","pages":"454"},"PeriodicalIF":7.1,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136793","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":"Clinical Practice Guideline: Preventive Measures and Treatment Options for Atrial Fibrillation.","authors":"Stephan Willems, Felix Wegner, Lars Eckardt","doi":"10.3238/arztebl.m2025.0082","DOIUrl":"10.3238/arztebl.m2025.0082","url":null,"abstract":"<p><strong>Background: </strong>With approximately 1.6 million people affected in Germany, atrial fibrillation (AF) is the most common arrhythmia. The management of AF, from prevention to treatment, including anticoagulation, is therefore of major clinical importance in terms of these patients' quality of life and their mortality.</p><p><strong>Methods: </strong>This first German clinical practice guideline on AF was developed in accordance with the Regelwerk Leitlinien (rules for guidelines) of the Association of the Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlichen Medizi - nischen Fachgesellschaften e. V., AWMF). The available evidence on all relevant issues was retrieved by a systematic literature search and evaluated with the participation of many medical specialty societies.</p><p><strong>Results: </strong>AF is classified on clinical grounds as paroxysmal, persis - tent, longstanding persistent, or permanent. It is associated with a 1.5- to 2-fold increase in mortality and a 4- to 5-fold increase in the risk of stroke. Nonetheless, general screening for AF is not currently recommended, as the data on this question are conflicting. Lifestyle interventions and the reduction of risk factors lessen the frequency of AF. Female sex is only a minor risk factor; the CHA2DS2-VA-Score is recommended to assess the risk of thromboembolic events. If it is 2 or higher, oral anticoagulation (OAC) is indicated, of a type that should be decided on an individual basis. In patients with cardiovascular risk factors, early rhythm control has been shown to reduce prognostically relevant cardio - vascular endpoints (3.9 versus 5.0 per 100 patientyears). Multiple studies have shown that catheter ablation is superior to drug-based antiarrhythmic therapy in patients with paroxysmal symptomatic AF as well as in those with heart failure and AF.</p><p><strong>Conclusion: </strong>It is hoped that the recommendations contained in this guideline will lead to intensified measures for the prevention of AF, resulting in a lower prevalence of AF and its adverse sequelae. The available evidence supports the evaluation of the indications for OAC, early rhythm control, and the use of catheter ablation, especially in patients with paroxysmal AF or heart failure.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":" Forthcoming","pages":"439-444"},"PeriodicalIF":7.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316156","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":"Erratum.","authors":"","doi":"10.3238/arztebl.m2025.9980","DOIUrl":"https://doi.org/10.3238/arztebl.m2025.9980","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"122 16","pages":"438"},"PeriodicalIF":7.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039415","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":"Treatment Options for the Comorbidity of Multiple Sclerosis with Other Chronic Inflammatory Diseases.","authors":"Stefan Bittner, Martin A Kriegel, Britta Siegmund, Tania Kümpfel, Robert Sabat","doi":"10.3238/arztebl.m2025.0088","DOIUrl":"10.3238/arztebl.m2025.0088","url":null,"abstract":"<p><strong>Background: </strong>Approximately 280 000 people in Germany suffer from multiple sclerosis (MS), an autoimmune disease of the central nervous system. Of these, approximately 5% have a comorbid chronic inflammatory disease: the more common ones are psoriasis, rheumatoid arthritis (RA), and chronic inflammatory bowel diseases (IBDs, of which the main types are ulcerative colitis and Crohn's disease).</p><p><strong>Methods: </strong>This narrative review is based on pertinent publications retrieved by a literature search in PubMed, as well as relevant guidelines. All statements in this article reflect a consensus among the authors, who represent different medical disciplines.</p><p><strong>Results: </strong>As the data from clinical trials to date are limited, judgments about the proposed treatments are a matter of expert opinion. In general, TNFα blockers should not be used in patients with MS, as they can worsen the disease. In patients with MS and psoriasis, dimethyl fumarate is a useful option for mild disease activity. In MS with comorbid RA, azathioprine and leflunomide/teriflunomide are suitable for mild disease activity. For more severe disease activity, anti-CD20 antibodies have been approved for both diseases and should be used. In MS with comorbid IBD, azathioprine is suitable for mild disease activity. Ozanimod has been approved for patients who have MS and comorbid ulcerative colitis with more severe disease activity, especially those who are JCnegative; it shares its mechanism of action (VLA-4 blockade) with natalizumab.</p><p><strong>Conclusion: </strong>The treatment of patients who have both MS and another chronic inflammatory disease should be interdisciplinary and personalized, and treatments must be planned with due attention to potential adverse effects. Further studies of treatment for this group of patients are needed.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":" Forthcoming","pages":"427-432"},"PeriodicalIF":7.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316157","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":"Media Consumption by Preschool Children: The Risk of Autism and Developmental Disorders.","authors":"Inge Kamp-Becker, Luise Poustka","doi":"10.3238/arztebl.m2025.0087","DOIUrl":"10.3238/arztebl.m2025.0087","url":null,"abstract":"<p><strong>Background: </strong>Autism spectrum disorder (ASD) is a persistent neu - rodevelopmental condition characterized by impaired social communication and the presence of restricted, repetitive patterns of behavior, typically manifesting in early childhood. The rising prevalence of ASD has been discussed in relation to increased media consumption.</p><p><strong>Methods: </strong>A selective literature search was conducted in the Medline database on the topics of media consumption and mental disorders, particularly autism, in preschool children. Seven systematic reviews and meta-analyses and 36 original studies were included in the analysis.</p><p><strong>Results: </strong>The findings across studies consistently demonstrated that media consumption in preschool children was associated with deficits in language and cognitive development (adjusted odds ratio [aOR] 1.67-2.28) and was a risk factor for the development of emotional, behavioral, and developmental disorders (aOR: 1.34-3.06). Symptoms consistent with ASD were also found to be associated with increased media consumption (OR 1.97, 95% confidence interval [1.30; 3.00]). However, these observed effects were consistently identified in the context of multiple other risk factors for mental health problems-such as low socioeconomic status, a family history of mental disorders, or parental stress-which mediated these effects, either directly or indirectly. Intervention studies showed that reducing media consumption, combined with an increase in constructive parent-child interactions, led to a reduction in symptom severity.</p><p><strong>Conclusion: </strong>In the context of additional risk factors, increased media consumption in young children is associated with atypical or delayed development. The extent of developmental disorders can be reduced through targeted support for parents. When risk factors are present, it is therefore essential to educate parents and implement preventive measures to promote the long-term healthy development of children.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":" Forthcoming","pages":"433-438"},"PeriodicalIF":7.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207982","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 Changing Rates of Lower-Limb Amputations in Germany: An Analysis of Data from the Federal Statistical Office, 2005–2023.","authors":"Christoph Egen, Andrea Bökel, Anika Großhennig, Jennifer Ernst, Christian Sturm, Jörg Schiller","doi":"10.3238/arztebl.m2025.0104","DOIUrl":"https://doi.org/10.3238/arztebl.m2025.0104","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"122 16","pages":"449-450"},"PeriodicalIF":7.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039343","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":"\"Insel\" in Early Gastric Cancer: A Unique Endoscopic Finding.","authors":"Akira Hokama, Yuzuru Kinjo","doi":"10.3238/arztebl.m2025.0098","DOIUrl":"https://doi.org/10.3238/arztebl.m2025.0098","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"122 16","pages":"432"},"PeriodicalIF":7.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039360","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":"Pharmacogenetic Testing for DPD Deficiency: Four and a Half Years' Experience in a Large German Laboratory.","authors":"Thomas Pretzsch, Matthias Schwab, Olga Blau, Bernhard Wörmann, Sebastian Stintzing, Lars Bullinger, Thomas Burmeister","doi":"10.3238/arztebl.m2025.0092","DOIUrl":"https://doi.org/10.3238/arztebl.m2025.0092","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"122 16","pages":"445-446"},"PeriodicalIF":7.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039330","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}