Deutsches Arzteblatt international最新文献

{"title":"Out-of-Hospital Cardiac Arrest at the Workplace: A Retrospective Analysis of the German Resuscitation Registry.","authors":"Christoph Hüser, Christine Eimer, Jan Wnent, Jan-Thorsten Gräsner, Stephan Seewald","doi":"10.3238/arztebl.m2026.0087","DOIUrl":"10.3238/arztebl.m2026.0087","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"123 16","pages":"457-458"},"PeriodicalIF":8.7,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905368","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":"Adeno- And Squamous Cell Carcinoma of the Esophagus and the Esophagogastric Junction: Long-Term Incidence Trends in Saarland (Germany), 1986-2024.","authors":"Andreas Stang, Ina Wellmann, Hiltraud Kajüter, Bernd Holleczek","doi":"10.3238/arztebl.m2026.0082","DOIUrl":"10.3238/arztebl.m2026.0082","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"123 16","pages":"455-456"},"PeriodicalIF":8.7,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905378","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":"Ascertainment of Cancer Cases in the German National Cohort (NAKO): Methods and Initial Results.","authors":"Verena A Katzke, Volker Arndt, Karin Halina Greiser, Florian Karpa, Dorothee Zoller, Renée Fortner, Karen Steindorf, Michael Hoffmeister, Hermann Brenner, Peter Schirmacher, Michael Leitzmann, Katharina Nimptsch, Ulrike Haug, Katharina Hofmann, Christoph Stallmann, Ulrich Mueller, Andrea Werdecker, Iris Pigeot, Enno Swart, Wolfang Ahrens, Martin Meyer, Sabine Luttmann, Alice Nennecke, Anne von Rüsten, Joachim Kieschke, Tobias Hartz, Andreas Stang, Wolfgang Hoffmann, Bernd Holleczek, Hans Gert Fabian, Annette Peters, Stefan N Willich, Lilian Krist, Matthias B Schulze, Kathrin Guenther, Hajo Zeeb, Nina Ebert, Börge Schmidt, Anna Köttgen, Alexander Kluttig, Rafael Mikolajczyk, Volker Harth, Nadia Obi, Carolina Klett-Tammen, Manuela Harries, Wolfgang Lieb, Heiko Becher, Heike Minnerup, André Karch, Claudia Meinke-Franze, Hansjörg Baurecht, Ute Mons, Lena Koch-Gallenkamp, Klaus Berger, Henry Völzke, Tobias Pischon, Alexander Katalinic, Rudolf Kaaks","doi":"10.3238/arztebl.m2026.0061","DOIUrl":"10.3238/arztebl.m2026.0061","url":null,"abstract":"<p><strong>Background: </strong>The German National Cohort (<i>NAKO Gesundheitsstudie</i>) is a prospective cohort study with 205 053 participants. Its goal is to investigate risk factors for chronic diseases, including cancer.</p><p><strong>Methods: </strong>We describe the methods of ascertaining cancer cases in NAKO (linkage with cancer registries and self-reporting), the incidence and prevalence figures obtained so far, and the ratio of observed to expected (O/E) case numbers.</p><p><strong>Results: </strong>Altogether, 2774 prevalent (diagnosed within the 5 years prior to study enrollment) and 4295 incident (diagnosed up to 5 years after enrollment) cancer cases were identified. Breast, prostate, lung, and colorectal cancers made up 55% of the incident cases. Fewer incident cases were found than would have been expected on the basis of incidence rates in the general population (O/E ratio 0.80, 95% confidence interval [0.76;0.83] for the first 2 years of prospective follow-up). The O/E ratio varied, however, across tumor sites (breast 1.02, prostate 1.12, lung 0.38, colorectal 0.62). Possible explanations include bias caused by the fact that most study participants were healthy, delayed tumor reporting, incomplete data linkage, and incomplete self-reporting.</p><p><strong>Conclusion: </strong>Rising case numbers for the most commonly occurring types of cancer are expected in the next few years. This will enable comprehensive epidemiological analysis of the risk factors for cancer.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"123 14","pages":"439-446"},"PeriodicalIF":8.7,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155841","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 Incidence, Pathogen Spectrum, and Resistance Profile of Pyogenic Spondylodiscitis: A Nationwide Retrospective Evaluation of G-DRG Data.","authors":"Simon Amberger, Frank Hanses, Siegmund Lang, Nils-Ole Schmidt, Sebastian Siller","doi":"10.3238/arztebl.m2026.0078","DOIUrl":"10.3238/arztebl.m2026.0078","url":null,"abstract":"<p><strong>Background: </strong>The incidence of the spinal infection pyogenic spondylodiscitis is rising, particularly in the aging, multimorbid segment of the population. The goal of this study was to analyze nationwide trends in the epidemiology, pathogen spectrum, and antimicrobial resistance profile of this disease in Germany over the period 2005–2023.</p><p><strong>Methods: </strong>All hospital discharges were analyzed retrospectively using nationwide German Diagnosis Related Groups (G-DRG) data. Hospitalizations with a primary ICD-10-GM diagnosis of spinal osteomyelitis, pyogenic intervertebral disc infection, or discitis, not otherwise specified (M46.2*, M46.3*, M46.4*) were included for analysis. The age-adjusted incidence was calculated using population data from the Federal Statistical Office. Pathogen determinations and resistance phenotypes were ascertained from supplementary pathogen codes.</p><p><strong>Results: </strong>A total of 151 544 cases were identified. Over the study period, the age-adjusted incidence doubled (from 5.41 to 10.02 cases per 100 000 persons), the patients’ mean age increased from 65.8 to 72.2 years, and the proportion of patients aged 70 years or more rose (from 42.6% to 62.3%). The mean length of hospital stay decreased, while in-hospital mortality doubled (from 3.25% to 6.79%). At the same time, the rate of pathogen determination improved. The proportion of <i>Staphylococcus aureus</i> fell markedly (from 34.5% to 17.2%), while other gram-positive pathogens increased. Gram-negative pathogens remained stable. Resistant <i>S. aureus</i> isolates became rarer, while resistant enterobacterales and enterococci were identified more frequently. There was an overall downward trend in the rate of resistant pathogens in the final 6 years of the study period (from 14.1% in 2017 to 6.9% in 2023).</p><p><strong>Conclusion: </strong>In Germany, pyogenic spondylodiscitis mainly affects older patients, and the associated in-hospital mortality is rising. Changes in the pathogen spectrum and in resistance patterns indicate the need for corresponding adjustments to empirical treatment regimens.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"123 16","pages":"433-438"},"PeriodicalIF":8.7,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13519122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148053223","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":"Cardiac Amyloidosis: Pathogenesis, Diagnosis, and Treatment.","authors":"Sophie Beckmann, Ibrahim Akin, Arash Haghikia, Tienush Rassaf, Nazha Hamdani, Ibrahim El-Battrawy","doi":"10.3238/arztebl.m2026.0088","DOIUrl":"10.3238/arztebl.m2026.0088","url":null,"abstract":"<p><strong>Background: </strong>The administrative prevalence of cardiac amyloidosis is approximately 50 per 100 000 person-years. The pathophysiology of amyloidosis involves a misfolding of proteins with a beta-pleated sheet structure. This leads to the deposition of insoluble fibrils in the interstitium, which, in turn, impair organ function and cause a variety of diseases. Systemic types are the most common, especially light-chain (AL) and transthyretin (ATTR) amyloidosis with cardiac involvement. In this article, we present the diagnostic evaluation of amyloidosis and recent developments in its treatment.</p><p><strong>Methods: </strong>This review is based on publications retrieved by a selective search in PubMed for registry studies, meta-analyses, randomized controlled trials, systematic reviews, guidelines, and current position papers on \"cardiac amyloidosis,\" \"ATTR amyloidosis,\" \"cardiac amyloidosis epidemiology,\" \"cardiac amyloidosis treatment,\" and \"ATTR amyloidosis treatment.\"</p><p><strong>Results: </strong>Cardiac amyloidosis markedly impairs cardiac function and carries a poor prognosis as well as elevated mortality. The diagnosis is mainly based on specialized imaging studies including echocardiography, cardiac magnetic resonance imaging, and scintigraphy. The goal of treatment is to slow amyloid deposition. In ATTR amyloidosis, transthyretin stabilizers or RNA silencers can stabilize the clinical course: the use of tafamidis has been found to be associated with better outcomes and lower overall mortality at 30 months compared with placebo (HR 0.70 [0.51; 0.96]). Vutrisiran also lowers overall mortality and reduces recurrent cardiovascular events compared to placebo (HR 0.72 [0.56; 0.93]). Cardiac complications and comorbidities can be treated, depending on left ventricular function and drug tolerability, with SGLT2 inhibitors, beta-blockers, and mineralocorticoid receptor antagonists, among other drugs.</p><p><strong>Conclusion: </strong>Advanced cardiac amyloidosis carries a poor prognosis; early diagnosis and targeted treatment are of decisive importance. Better outcomes are now possible with the aid of improved imaging methods, disease-modifying treatment options, and the treatment of cardiac complications. Further approaches are now being studied.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"123 16","pages":"447-452"},"PeriodicalIF":8.7,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13519123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210394","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":"In Reply.","authors":"Alexander Benkendorff, Markus Hufnagel, Siegbert Rieg, Jörg J Meerpohl","doi":"10.3238/arztebl.m2026.0106","DOIUrl":"10.3238/arztebl.m2026.0106","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"123 16","pages":"m1069-m1070"},"PeriodicalIF":8.7,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905331","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":"Digital Health Navigators for the Integration of Digital Mental Health Applications in Ambulatory Care: A Prospective Feasibility Study.","authors":"Laura Freisberg, Eva Meier-Diedrich, Julia Schönbeck, Darja Schubert, Jan Wolff, John Torous, Julian Schwarz","doi":"10.3238/arztebl.m2026.0091","DOIUrl":"10.3238/arztebl.m2026.0091","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"123 16","pages":"453-454"},"PeriodicalIF":8.7,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905362","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":"Polytrauma: Cardiac Compartment Syndrome Caused by an Unstable, Bleeding Thoracic Vertebral Body Fracture.","authors":"Dominik M Haida, Stefan Huber-Wagner, Thorsten Möhlig","doi":"10.3238/arztebl.m2026.0097","DOIUrl":"10.3238/arztebl.m2026.0097","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"123 15","pages":"422"},"PeriodicalIF":8.7,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13484539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879400","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 Current State of Care Delivery in Cardiac Rhythm Monitoring After Ischemic Stroke.","authors":"Deborah Bochert, David Petroff, Tobias Uhe, Wolf-Rüdiger Schäbitz, Martin Köhrmann, Johannes Brachmann, Ulrich Laufs, Götz Gelbrich, Christiane Prettin, Johanna Rosemarie Leyhe, Klaus Gröschel, Rolf Wachter, Katrin Wasser","doi":"10.3238/arztebl.m2026.0081","DOIUrl":"10.3238/arztebl.m2026.0081","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"123 15","pages":"418-419"},"PeriodicalIF":8.7,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13472176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879447","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":"Not a Reliable Method for Determining Death.","authors":"Rainer Beckmann","doi":"10.3238/arztebl.m2026.0100","DOIUrl":"10.3238/arztebl.m2026.0100","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"123 15","pages":"m1067"},"PeriodicalIF":8.7,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13484544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879461","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}