Deutsches Arzteblatt international最新文献_第5页

Problematic Consumption of Alcohol, Cannabis and Cigarettes. 有问题的酒精、大麻和香烟消费--一项关于精神病理学、压力、心态和生活质量的德国全国性调查。

IF 6.5 2区医学

Deutsches Arzteblatt international Pub Date : 2024-06-28 DOI: 10.3238/arztebl.m2024.0061

Lutz Wartberg, Matthias Belau, Nicolas Arnaud, Rainer Thomasius

{"title":"Problematic Consumption of Alcohol, Cannabis and Cigarettes.","authors":"Lutz Wartberg, Matthias Belau, Nicolas Arnaud, Rainer Thomasius","doi":"10.3238/arztebl.m2024.0061","DOIUrl":"10.3238/arztebl.m2024.0061","url":null,"abstract":"Background: Even among minors, the use of psychotropic substances is widespread in Europe. Data on the use of tobacco, alcohol and cannabis are regularly reported in Germany, but data on problematic use are lacking. In the present study, established screening instruments were used to investigate the prevalence of problematic use of cigarettes, alcohol and cannabis among children and adolescents.Methods: A survey that was designed to be representative was conducted across Germany in a sample of 4001 persons aged 12-17. The survey consisted of established screening instruments for problematic consumption patterns and related psychosocial aspects. Prevalences were estimated, and bivariate and multivariate associated characteristics were studied.Results: Among 12- to 17-year-olds in Germany, the prevalence values (with 95% confidence intervals) of problematic use were: for cigarettes, 0.5% [0.3; 0.7]; for alcohol, 11.3% [10.3; 12.3]; and for cannabis, 0.5% [0.3; 0.7]. For the problematic use of cigarettes, alcohol and cannabis, there were both bivariate and multivariate statistically significant associations with greater psychopathology, lower mindfulness, and a lower quality of life. For example, greater psychopathology and stress experience were both associated with an increased risk of problematic cannabis use (odds ratios 1.21 [1.11; 1.31] and 1.59 [1.33; 1.88]).Conclusion: A comparison with the few available previous findings implies that problematic alcohol consumption has become more prevalent. There were both similarities and differences across the three substances studied with respect to patterns of problematic consumption, particularly in relation to the experience of stress.","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":null,"pages":null},"PeriodicalIF":6.5,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855020","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}

引用次数: 0

The Early Diagnosis and Treatment of Chronic Renal Insufficiency. 慢性肾功能不全的诊断与治疗》。

IF 6.5 2区医学

Deutsches Arzteblatt international Pub Date : 2024-06-28 DOI: 10.3238/arztebl.m2024.0072

Kai-Michael Hahn, Frank Strutz

{"title":"The Early Diagnosis and Treatment of Chronic Renal Insufficiency.","authors":"Kai-Michael Hahn, Frank Strutz","doi":"10.3238/arztebl.m2024.0072","DOIUrl":"10.3238/arztebl.m2024.0072","url":null,"abstract":"Background: Chronic renal insufficiency (CRI) is becoming more common and has an increasing impact on public health. In Germany, approximately one in ten adults has CRI. Its most serious consequence is generally not the development of end-stage renal failure, but rather the markedly increased cardiovascular risk as kidney function declines.Methods: This review is based on the findings of a selective search in PubMed for literature about the treatment options for CRI, and on our overview of the existing guideline recommendations on diagnostic testing. .Results: Patients with diabetes mellitus and arterial hypertension are at especially high risk of developing CRI. For these patients, some of the guidelines recommend regular testing for albuminuria and measurement of the glomerular filtration rate (GFR), though sometimes only when specific risk constellations are present. The treatment of CRI has evolved in recent years. At first, aside from general measures, only RAS inhibitors were available as a specific therapy for CRI. With the extension of the approval of SGLT-2 inhibitors to non-diabetic CRI patients, the options for treatment have become wider. Two randomized controlled trials have revealed the benefit of SGLT-2 inhibitors with respect to their primary combined endpoints: time to a specified eGFR reduction and renal/cardiovascular death (HR 0.61 [0.51; 0.72] and 0.72 [0.64; 0.82]). The potential side effects and contraindications of SGLT-2 inhibitors must be taken into account. A further treatment option for diabetics with CRI has become available with the approval of the non-steroidal mineralocorticoid receptor antagonist finerenone.Conclusion: In patients with risk factors, renal function should be regularly tested.","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":null,"pages":null},"PeriodicalIF":6.5,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141174830","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}

引用次数: 0

Lumbar Disc Herniation—the Significance of Symptom Duration for the Indication for Surgery. 腰椎间盘突出症--症状持续时间对手术指征的意义。

IF 6.5 2区医学

Deutsches Arzteblatt international Pub Date : 2024-06-28 DOI: 10.3238/arztebl.m2024.0074

Nikolaus Kögl, Ondra Petr, Wolfgang Löscher, Ulf Liljenqvist, Claudius Thomé

{"title":"Lumbar Disc Herniation—the Significance of Symptom Duration for the Indication for Surgery.","authors":"Nikolaus Kögl, Ondra Petr, Wolfgang Löscher, Ulf Liljenqvist, Claudius Thomé","doi":"10.3238/arztebl.m2024.0074","DOIUrl":"10.3238/arztebl.m2024.0074","url":null,"abstract":"Background: Lumbar disc surgery is among the more common spinal procedures. In this paper, we report the current treatment recommendations for patients with symptomatic disc herniation.Methods: This review is based on pertinent publications retrieved by a selective literature search in PubMed using the terms [timing] AND [lumbar disc herniation], supplemented by other relevant articles and guidelines.Results: Symptoms resolve in 60% to 80% of patients with herniated discs in 6-12 weeks, and in 80% to 90% over the long term (≥ 1 year). According to the guidelines, 6-12 weeks of conservative treatment are recommended in the absence of significant neu - rologic deficits. Early surgery is indicated in case of worsening pain or new onset of neurologic deficits. Lumbar disc herniation associated bladder or bowel dysfunction (cauda equina syndrome) is considered an absolute surgical emergency that requires immediate decompression (within 24 to 48 hours). Patients with severe motor deficits (MRC ≤ 3/5) benefit from early intervention and should be offered surgery within three days, if possible, for the best chance of recovery. The degree of weakness and the duration of symptoms have been identified as risk factors for incomplete recovery. Early surgery can be considered in patients with mild paresis (MRC 4/5) in case of functional impairment (e.g., quadriceps paresis).Conclusion: Longer symptom duration and lower motor scores are associated with worse outcome and a lower chance of neurologic recovery. The recovery rate for motor deficits ranges from 33% to 75%, depending on the timing and modality of treatment as well as the motor score.","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":null,"pages":null},"PeriodicalIF":6.5,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247461","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}

引用次数: 0

Initial Medical Assessment by the 116117 Patient Service. 由 116117 病人服务处进行初步医疗评估。

IF 6.5 2区医学

Deutsches Arzteblatt international Pub Date : 2024-06-28 DOI: 10.3238/arztebl.m2024.0047

Beate Zoch-Lesniak, Edgar Steiger, Lars E Kroll, Dominik von Stillfried

引用次数: 0

Idiopathic Plastic Bronchitis. 特发性塑料支气管炎。

IF 6.5 2区医学

Deutsches Arzteblatt international Pub Date : 2024-06-28 DOI: 10.3238/arztebl.m2023.0238

Christopher Nicolaus, Cornelia Zur Nieden, Fabian Dusse

引用次数: 0

Orthogeriatric Co-management of Spine, Arm, Forearm, and Pelvis Fractures. 脊柱、手臂、前臂和骨盆骨折的老年矫形共同管理。

IF 6.5 2区医学

Deutsches Arzteblatt international Pub Date : 2024-06-28 DOI: 10.3238/arztebl.m2024.0035

Kilian Rapp, Clemens Becker, Patrick Roigk, Claudia Konnopka, Hans-Helmut König, Thomas Friess, Dietrich Rothenbacher, Gisela Büchele

引用次数: 0

Initial Evidence of a Possible Effect of HPV Vaccination on Cancer Incidence in Germany—Focus on Cervical Cancer. 德国 HPV 疫苗接种对癌症发病率可能产生影响的初步证据--聚焦宫颈癌。

IF 6.5 2区医学

Deutsches Arzteblatt international Pub Date : 2024-06-28 DOI: 10.3238/arztebl.m2024.0062

Paula Grieger, Nora Eisemann, Friederike Hammersen, Christiane Rudolph, Alexander Katalinic, Annika Waldmann

{"title":"Initial Evidence of a Possible Effect of HPV Vaccination on Cancer Incidence in Germany—Focus on Cervical Cancer.","authors":"Paula Grieger, Nora Eisemann, Friederike Hammersen, Christiane Rudolph, Alexander Katalinic, Annika Waldmann","doi":"10.3238/arztebl.m2024.0062","DOIUrl":"10.3238/arztebl.m2024.0062","url":null,"abstract":"Background: Infection with human papillomavirus (HPV) is one of the more common sexually transmitted diseases in Germany. Vaccination against HPV was introduced in Germany in 2007. In this study, we sought to detect a population-based decline in the incidence of cervical cancer in women under age 30 who were eligible for vaccination in the first 11 years after its introduction.Methods: Data on new diagnoses of HPV-associated cervical cancer from 2004 to 2018 were obtained from the cancer registries of the German federal states (Bundesländer) through the German Center for Cancer Registry Data (ZfKD). Trends in the incidence of invasive and in situ cervical cancer were determined with log-linear joinpoint regression and age-period-cohort models.Results: The incidence of cervical cancer, which had been rising in the previous decades, has been falling since 2010, with a marked decline among women in all age groups eligible for vaccination (e.g., from 70.0 to 41.8 cases per 100 000 persons per year from 2010 to 2018 in women aged 24 to 26). Women born in 1992 were the first to become eligible for vaccination and have a 24% lower incidence than the reference cohort of women born in 1989 (relative risk 0.76, 95% confidence interval [0.68; 0.86]). Larger effects were found in later birth cohorts, in which vaccination was more widespread.Conclusion: Eleven years after the introduction of HPV vaccination, a drop in the incidence of cervical cancer was observable at the population level in the birth cohorts eligible for vaccination.","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":null,"pages":null},"PeriodicalIF":6.5,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862565","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}

引用次数: 0

Additional Comments. 补充意见。

IF 6.5 2区医学

Deutsches Arzteblatt international Pub Date : 2024-06-14 DOI: 10.3238/arztebl.m2023.0284

Jörg Großmann