Deutsches Arzteblatt international最新文献

{"title":"Communication on Rounds: The Role of Rounds Culture and Communication in Patient Care and Teaching.","authors":"Flavio Gössi, Christoph Becker, Sebastian Gross, Armon Arpagaus, Stefano Bassetti, Sabina Hunziker","doi":"10.3238/arztebl.m2025.0080","DOIUrl":"10.3238/arztebl.m2025.0080","url":null,"abstract":"<p><strong>Background: </strong>The daily visit by the treating doctor or medical team at the bedside of the hospitalized patient («rounds») is essential for patient-centered care and interprofessional exchange.</p><p><strong>Methods: </strong>This narrative review is based on pertinent publications (up to December 2024) that were retrieved by a selective search in the PubMed/Medline database.</p><p><strong>Results: </strong>Bedside rounds are used to fulfill multiple tasks: medical, communicative, and educational. Complex social interactions, in particular, require precise and empathetic communication. 71% of patients say they primarily expect clear information about their medical situation. Information exchange can nonetheless be difficult, particularly with older and frail patients. So-called teach-back techniques improve patients' understanding of medications and behavioral instructions (OR 1.84 [1.09; 3.12] and 1.83 [1.07; 3.13], respectively). Although many patients would like to take active part in discussions on rounds, the physicians explicitly encouraged them to do so in only 54% of cases. If the team discusses the patient outside the room before entering, the patient's understanding of their condition is no different, but they are less likely to be confused by medical technology (21.3 versus 13.7); team satisfaction is higher (78.0 versus 68.3), and there is more opportunity to discuss sensitive topics (84.3 versus 59.3, each on a visual analog scale VAS 1-100).</p><p><strong>Conclusion: </strong>Interprofessional discussion of the patient and suitable communication on rounds can improve patient care and are essential for undergraduate, postgraduate, and continuing medical education.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":" Forthcoming","pages":"362-370"},"PeriodicalIF":6.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157394","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":"Prevalence of Fractures in the Adult Population of Germany: An Evaluation of Inpatient and Outpatient Cases.","authors":"Nike Walter, Dominik Szymski, Susanne Bärtl, Christoph Biehl, Gero Knapp, Siegmund Lang, Volker Alt, Christian Heiß, Markus Rupp","doi":"10.3238/arztebl.m2025.0070","DOIUrl":"10.3238/arztebl.m2025.0070","url":null,"abstract":"<p><strong>Background: </strong>Fractures are a major public health problem, especially in older people. A better understanding of epidemiological trends and risk factors is essential for the development of prevention strategies.</p><p><strong>Methods: </strong>We analyzed ICD-10 data provided by the German Federal Statistical Office and the Central Institute for Health Care (Zi) on inpatient and outpatient treatments for fracture in the year 2022. The frequency and distribution of fractures were examined according to anatomical site, sex, and age. The prevalence of inpatient cases was standardized to the German population and compared with figures from 2019.</p><p><strong>Results: </strong>In 2022, there were 683 185 recorded fracture treatments in the inpatient setting, 1% fewer than in 2019. 63% of fractures were in women, and 71% in persons over age 65. The most common types were femoral neck fractures (129 per 100 000 population), pertrochanteric femur fractures (115/100 000), and distal radius fractures (106/100 000). Compared to 2019, there were more fractures of the femoral neck (+8%), femoral shaft (+7%), and distal humerus (+7%), and fewer fractures of the scaphoid bone (-31%), carpal and metacarpal bones (-30%), and ribs (-29%). 2 400 606 fractures were treated in the outpatient setting in 2022, corresponding to a prevalence of 2845.71/100 000. The most common types were distal radius fractures (210.76/100 000), finger fractures (186.1/100 000), and rib fractures (156.51/100 000 population).</p><p><strong>Conclusion: </strong>Although the overall fracture prevalence declined slightly between 2019 and 2022, certain fracture types remained prevalent or even increased in frequency. This highlights the continued need for targeted preventive strategies, particularly for older adults.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":" Forthcoming","pages":"355-359"},"PeriodicalIF":7.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157397","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":"Mycoplasma-Related Acute Hemorrhagic Leukoencephalomyelitis.","authors":"Mathias Fousse, Jakob Stögbauer, Michael Kettner","doi":"10.3238/arztebl.m2024.0237","DOIUrl":"https://doi.org/10.3238/arztebl.m2024.0237","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"112 13","pages":"347"},"PeriodicalIF":6.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689517","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":"Thrombotic Thrombocytopenic Purpura as a Rare Stroke Mimic.","authors":"Juri Mattern, Björn Jacobi, Markus Munder","doi":"10.3238/arztebl.m2025.0046","DOIUrl":"https://doi.org/10.3238/arztebl.m2025.0046","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"112 13","pages":"369"},"PeriodicalIF":6.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689518","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":"In Reply.","authors":"Jean-François Chenot","doi":"10.3238/arztebl.m2025.0060","DOIUrl":"https://doi.org/10.3238/arztebl.m2025.0060","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"122 13","pages":"m1041-m1042"},"PeriodicalIF":6.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689520","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 Relation of Multiple Sclerosis to Family History, Lifestyle, and Health Factors in Childhood and Adolescence: Findings of a Case-Control Study Nested Within the German National Cohort (NAKO) Study.","authors":"Anja Holz, Nadia Obi, Tobias Pischon, Matthias B Schulze, Wolfgang Ahrens, Klaus Berger, Barbara Bohn, Hermann Brenner, Carina Emmel, Beate Fischer, Karin Halina Greiser, Volker Harth, Bernd Holleczek, Rudolf Kaaks, André Karch, Verena Katzke, Thomas Keil, Lilian Krist, Michael Leitzmann, Claudia Meinke-Franze, Karin B Michels, Katharina Nimptsch, Annette Peters, Oliver Riedel, Tamara Schikowski, Sabine Schipf, Börge Schmidt, Sigrid Thierry, Kerstin Hellwig, Karin Riemann-Lorenz, Christoph Heesen, Heiko Becher","doi":"10.3238/arztebl.m2025.0069","DOIUrl":"10.3238/arztebl.m2025.0069","url":null,"abstract":"<p><strong>Background: </strong>Multiple sclerosis (MS) is a neuroinflammatory disease of presumed autoimmune origin. A combination of genetic susceptibility and exposure to certain environmental and lifestyle factors might trigger the onset of MS. The currently known risk factors include a genetic predisposition, infection with the Epstein-Barr virus (EBV), smoking, and an increased body mass index.</p><p><strong>Methods: </strong>In 2021-22, we carried out a case-control study nested within the German National Cohort (NAKO) to investigate associations of potential risk factors with MS.</p><p><strong>Results: </strong>The subjects included 576 persons with MS (cases) and 895 without MS (controls). Beyond the known risk factors, we observed associations between MS and the cumulative number of common childhood infections (odds ratio (OR) 1.14 per additional infection, 95% confidence interval (CI): [1.03; 1.25]), major stressful life events (SLE) (OR 1.25 per additional event, [1.06; 1.48]), being the firstborn child of a mother aged 30 or older (OR 2.11, [1.08; 4.13]); higher amounts of physical activity in the teenage years were associated with a lower risk of MS (OR 0.82 per unit increase in activity level, [0.71; 0.95]).</p><p><strong>Conclusion: </strong>We confirmed known risk factors for MS and found associations with a number of new ones, e.g., the cumulative number of common childhood infections. These findings may shed light on the etiology of MS and merit further study.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":" Forthcoming","pages":"348-354"},"PeriodicalIF":7.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109741","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":"Immobilization in a Schede Cast as a Treatment Option for Distal Forearm Fractures in Children and Adolescents: Findings on Efficacy and Safety.","authors":"Kristofer Wintges, Jurek Schultz, Till Rausch, Benjamin Schoof, Meltem Sahin, Laura Altmeier, Josephine Hertel, Michael Esser, Boy Bohn, Guido Fitze, Justus Lieber, Dirk Sommerfeldt, Simon Scherer","doi":"10.3238/arztebl.m2025.0084","DOIUrl":"https://doi.org/10.3238/arztebl.m2025.0084","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"112 13","pages":"360-361"},"PeriodicalIF":6.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689516","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":"Complication-Free Examination Method.","authors":"Friedrich Lübbecke","doi":"10.3238/arztebl.m2025.0059","DOIUrl":"https://doi.org/10.3238/arztebl.m2025.0059","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"122 13","pages":"m1041"},"PeriodicalIF":6.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689519","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":"Case not Clear.","authors":"Stefan Bittmann","doi":"10.3238/arztebl.m2025.0047","DOIUrl":"10.3238/arztebl.m2025.0047","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"122 12","pages":"m1040"},"PeriodicalIF":7.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599666","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.m2025.9990","DOIUrl":"10.3238/arztebl.m2025.9990","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"122 12","pages":"333"},"PeriodicalIF":7.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599668","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}