Deutsches Arzteblatt international最新文献

{"title":"Pathological Fractures in Children and Adolescents—A Registry-Based Analysis of Benign Tumors.","authors":"Nikos Karvouniaris, Jörn Zwingmann, Justus Lieber, Florian Bergmann, Björn Wilkens, Ramona Sturm, Peter Schmittenbecher, Miriam Adrian, Sebastian Reinecke, Hagen Schmal","doi":"10.3238/arztebl.m2024.0203","DOIUrl":"https://doi.org/10.3238/arztebl.m2024.0203","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"122 5","pages":"135-136"},"PeriodicalIF":6.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526824","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 Genetics of Female and Male Infertility.","authors":"Frank Tüttelmann, Margot Julia Wyrwoll, Johanna Steingröver, Peter Wieacker","doi":"10.3238/arztebl.m2024.0259","DOIUrl":"10.3238/arztebl.m2024.0259","url":null,"abstract":"<p><strong>Background: </strong>An estimated 17% of all couples worldwide are involuntarily childless (infertile). The clinically identifiable causes of infertility can be found in the male or female partner or in both. The molecular pathophysiology of infertility still remains unclear in many cases but is increasingly being revealed by genetic analyses.</p><p><strong>Methods: </strong>This review article is based on pertinent publications retrieved by a selective literature search.</p><p><strong>Results: </strong>The clinical diagnostic evaluation of an infertile couple may yield an indication for genetic analysis. Women with premature ovarian insufficiency should undergo chromosomal analysis and study of the FMR1 gene. If congenital adrenal hyperplasia is suspected, the CYP21A2 gene should be investigated. In men, genetic diagnosis is based primarily on the findings of semen analysis. Klinefelter syndrome and deletions of the Y-chromosomal azoospermia factors may severely limit sperm production. In both male and female partners, the analysis of a gene panel selected on the basis of the individual indication may identify the cause of infertility, e.g., hypogonadotropic hypogonadism, premature ovarian insufficiency, or severe disturbances of spermatogenesis. In some cases, genetic analysis can help determine the likelihood of success of sperm retrieval via testicular biopsy in men, and the potential indication for oocyte cryopreservation in women.</p><p><strong>Conclusion: </strong>Genetic causes, disease patterns, and the related investigations are becoming increasingly important in the diagnostic evaluation of infertile couples and have implications for further treatment, for the children of the affected couple, and for other family members.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":" Forthcoming","pages":"115-120"},"PeriodicalIF":6.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001900","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 Diagnosis and Treatment of Sarcopenia and Sarcopenic Obesity.","authors":"Basel Habboub, Robert Speer, Markus Gosch, Katrin Singler","doi":"10.3238/arztebl.m2025.0004","DOIUrl":"10.3238/arztebl.m2025.0004","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia is a progressive, generalized disease of skeletal muscle characterized by a loss of muscle strength and muscle mass. The combination of obesity and sarcopenia is called sarcopenic obesity. Because of the aging of the population in many countries around the world, sarcopenia and sarcopenic obesity are a challenge for global health policy.</p><p><strong>Methods: </strong>This review is based on pertinent publications retrieved by a selective literature search.</p><p><strong>Results: </strong>The effects of sarcopenia on health and quality of life are far-reaching and include difficulty coping with everyday life, an increased risk of falling, frequent hospitalization, and increased mortality. A population-based study in Germany revealed a 7% prevalence of sarcopenia in adults aged 65 and above. The prevalence of sarcopenic obesity was 4.5%. Persons aged 65 and above who are at increased risk for sarcopenia should be screened, e.g., with the SARC-F questionnaire. If screening yields a suggestive finding (SARC-F ≥ 4 points), the diagnosis of sarcopenia should be confirmed or ruled out by measurements of muscle strength (e.g. hand-grip strength, reference values: women <16 kg, men <27 kg) and appendicular muscle mass (women <5.5 kg/m2, men <7.0 kg/m2). The demonstration of reduced muscle strength is sufficient to initiate treatment. For the diagnosis of sarcopenic obesity, increased fat mass is additionally required. The goal of treatment is to improve mobility and reduce negative health outcomes. The treatment consists of resistance training and nutritional interventions.</p><p><strong>Conclusion: </strong>A targeted and structured approach to the detection and treatment of sarcopenia and sarcopenic obesity can make a major contribution to the maintenance or improvement of these patients' functionality and quality of life.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":" Forthcoming","pages":"121-126"},"PeriodicalIF":6.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001898","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":"Acute Corneal Hydrops.","authors":"Marie Elisabeth Burghardt, Arne Viestenz","doi":"10.3238/arztebl.m2024.0226","DOIUrl":"https://doi.org/10.3238/arztebl.m2024.0226","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"122 5","pages":"143"},"PeriodicalIF":6.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526821","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":"Erythematous Plaques and Systemic Inflammation in VEXAS Syndrome.","authors":"Nikolas Ruffer, Martin Krusche, Olaf Determann","doi":"10.3238/arztebl.m2024.0142","DOIUrl":"https://doi.org/10.3238/arztebl.m2024.0142","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"122 5","pages":"126"},"PeriodicalIF":6.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526823","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":"Collaborative and Stepped Care for Mental Disorders: Results of a Cluster-Randomized Controlled Trial in Outpatient Care (The COMET Study).","authors":"Daniela Heddaeus, Tharanya Seeralan, Kerstin Maehder, Sarah Porzelt, Anne Daubmann, Judith Dams, Thomas Grochtdreis, Hans-Helmut König, Olaf von dem Knesebeck, Bernd Löwe, Amra Pepić, Moritz Rosenkranz, Ingo Schäfer, Thomas Zimmermann, Bernd Schulte, Angelika Weigel, Karl Wegscheider, Silke Werner, Antonia Zapf, Martin Scherer, Jörg Dirmaier, Martin Härter","doi":"10.3238/arztebl.m2025.0011","DOIUrl":"10.3238/arztebl.m2025.0011","url":null,"abstract":"<p><strong>Background: </strong>Collaborative and stepped care (CSC) models are recommended in guidelines because of their effectiveness in treating depression and anxiety disorders. The evidence for other mental disorders is, however, limited. The aim of this study was to evaluate the effectiveness of a collaborative and stepped care model (COMET) for patients with depressive, anxiety, somatoform, and/or alcohol-related disorders and related comorbidities in the routine care setting in Germany.</p><p><strong>Methods: </strong>A prospective, cluster-randomized, controlled, parallelgroup superiority trial was conducted; the subjects were patients in primary care practices. The primary endpoint was the change in mental health-related quality of life, assessed with the SF-36 Mental Health Component Summary Score (MCS) at 6 months in the intention-to-treat population. The secondary endpoints were symptom severity, remission, and response.</p><p><strong>Results: </strong>Forty-one primary care offices were randomized either to COMET (n = 20) or treatment as usual (TAU, n = 21), and 615 patients were recruited (CSC: n = 307; TAU: n = 308). Data were available for 62% (COMET) and 55% (TAU) of the participants at 6 months. No significant group difference was found with respect to the primary endpoint (-1.96 ,95% confidence interval [-4.39; 0.48], p = 0.113) or any of the secondary endpoints.</p><p><strong>Conclusion: </strong>We found no superiority of the COMET model for the mental disorders addressed. Methodological issues, including differences at baseline and high dropout rates, make these findings challenging to interpret. Future studies should ensure comparability of groups, allocate resources for quality management, and investigate more suitable outcome measures, paying attention to factors of implementation.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":" Forthcoming","pages":"127-134"},"PeriodicalIF":6.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254723","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 Acute Abdomen: Structured Diagnosis and Treatment.","authors":"Nikolaus Börner, Alina-Sophie Kappenberger, Sabine Weber, Florian Scholz, Philipp Kazmierczak, Jens Werner","doi":"10.3238/arztebl.m2025.0019","DOIUrl":"10.3238/arztebl.m2025.0019","url":null,"abstract":"<p><strong>Background: </strong>The acute abdomen is a life-threatening clinical entity that requires immediate diagnostic evaluation and appropriate treatment. 15-20% of emergency room patients with acute abdominal pain need interventional or surgical treatment.</p><p><strong>Methods: </strong>This narrative review is based on publications retrieved by a PubMed search, current textbooks and guidelines, and the authors' personal experience.</p><p><strong>Results: </strong>The acute abdomen presents with the sudden onset of maximally intense abdominal pain, sometimes with guarding, and often with impaired general well-being, ranging to manifestations of shock. Its more common causes, aside from nonspecific abdominal pain (30-41%), are acute appendicitis (8-30%), cholecystitis (9-11%), and ileus (4-5%). The diagnosis is established by the history and physical examination, laboratory tests, imaging studies, and, in some cases, exploratory laparoscopy. The acute abdomen is generally a surgical condition, but it often requires interdisciplinary, multimodal treatment and follow-up. It carries a 2% to 12% mortality, with the figure rising for every elapsed hour until specific treatment is provided.</p><p><strong>Conclusion: </strong>Structured, quality-controlled, rapid, and targeted diagnosis and treatment markedly lower the morbidity and mortality of patients presenting with an acute abdomen.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":" Forthcoming","pages":"137-144"},"PeriodicalIF":6.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457249","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 Surgical Treatment of Renal Cell Carcinoma—Nationwide Trends, 2012–2021.","authors":"Jens-Uwe Stolzenburg, Clara Steiner, Claus Fahlenbrach, Christian Gilfrich, Christian Gratzke, Christian Günster, Elke Jeschke, Gralf Popken, Jan Roigas, Hanna Leicht","doi":"10.3238/arztebl.m2024.0234","DOIUrl":"https://doi.org/10.3238/arztebl.m2024.0234","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"122 4","pages":"109-110"},"PeriodicalIF":6.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526820","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":"Dissection of a Left Internal Mammary Artery Bypass.","authors":"Sebastian Weyand, Stephanie Löbig, Peter Seizer","doi":"10.3238/arztebl.m2024.0217","DOIUrl":"https://doi.org/10.3238/arztebl.m2024.0217","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"122 4","pages":"95"},"PeriodicalIF":6.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526818","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":"Tele-Ophthalmological Check-Up in Nursing Homes: Results from the TOVIS Pilot Study.","authors":"Leon von der Emde, Claus Gruber, Lilith Arend, Robert P Finger, Jennifer Nadal, Matthias Schmid, Frank G Holz, Thomas Ach","doi":"10.3238/arztebl.m2024.0176","DOIUrl":"https://doi.org/10.3238/arztebl.m2024.0176","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"122 4","pages":"113-114"},"PeriodicalIF":6.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526819","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}