Deutsches Arzteblatt international最新文献

{"title":"Clinical Practice Guideline: The Treatment of Cleft Lip and Palate Deformities.","authors":"Anna Katharina Sander, Cathleen Muche-Borowski, Bernd Lethaus","doi":"10.3238/arztebl.m2025.0052","DOIUrl":"10.3238/arztebl.m2025.0052","url":null,"abstract":"<p><strong>Background: </strong>Cleft lip and palate deformities (CLPD) constitute one of the more common types of congenital malformation. In Germany, the prevalence is more than 1 in 500 births. The treatment is complex; multistep interdisciplinary treatment is needed for full recovery. In this S3-level clinical practice guideline, we provide evidence- and consensus-based recommendations for the treatment of patients with CLPD.</p><p><strong>Methods: </strong>A systematic literature search based on key questions was carried out. All recommendations and statements were formulated by specialists from multiple disciplines and were adopted in a formal consensus procedure.</p><p><strong>Results: </strong>Despite the epidemiological and clinical importance of CLPD, no clear treatment recommendations are available; the major treatments for it are debated and variably provided. If a fetus is at elevated risk of CLPD, ultrasonography in the second or third trimester of pregnancy is recommended. For a newborn child with CLPD, adequate food intake must be ensured. Orthodontic treatment is carried out in an interdisciplinary manner and in multiple developmental phases. Controversy surrounds the timing and sequence of reconstructive procedures for defor mities that affect all structures. In children who have them, normal ventilation of the middle ear is impaired or obviated, making tympanic effusions and hearing loss more likely. In all children with CLPD, speech can be impaired and there can be a secondary impairment of language acquisition.</p><p><strong>Conclusion: </strong>Most of the evidence concerning the treatment of CLPD is of low level. Standardization of the treatment approach should improve long-term outcomes and quality of life in patients with CLPD. Standardized, long-term, multicenter data acquisition would help increase the yield of useful information from future studies.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":" Forthcoming","pages":"328-333"},"PeriodicalIF":7.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990812","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":"A Work-Related Health Check to Identify the Need for Rehabilitation and Preventive Care (Check-Up 45+): A Multicenter Randomized Controlled Trial in General Practice (PReHa45).","authors":"Jennifer Marie Burchardi, Paul Gellert, Martin Brünger","doi":"10.3238/arztebl.m2025.0055","DOIUrl":"10.3238/arztebl.m2025.0055","url":null,"abstract":"<p><strong>Background: </strong>General practitioners are the main mediators of rehabilitation and prevention services for their patients, yet many who could benefit from such services do not receive them because there has not, to date, been any structured means of detecting need. We studied the efficacy of a work-related health check for persons aged 45 and over (\"check-up 45+\") to identify the need for rehabilitation and preventive care in general practice.</p><p><strong>Methods: </strong>In a pragmatic, multicenter, 1:1 randomized controlled trial (registration no. DRKS00028303), the participating patients (aged 45 to 59) received, in addition to usual care, either a short questionnaire alone (695 patients) or, additionally, the \"check-up 45+\" (706 patients), in which the need for rehabilitation or prevention services was assessed with a validated \"screening 45+\" questionnaire and subsequent evaluation by the general practitioner. The primary endpoint was the number of applications for rehabilitation and prevention services, as determined from routine data derived from the German Pension Insurance (Deutsche Rentenversicherung). The secondary endpoints were approvals of services, actual provision of services, and needs identified by the \"check-up 45+\".</p><p><strong>Results: </strong>Applications for rehabilitation and prevention services were four times more common for patients who received the \"check-up 45+\" than for those who did not (12.0% vs. 2.9%; p<0.001). The percentages of approved and completed services were higher as well (8.4% vs. 2.4%; 7.2% vs. 2.3%; p<0.001 for both). The \"checkup 45+\" identified a need for rehabilitation in 17.7% of patients and a need for preventive services in 26.3%.</p><p><strong>Conclusion: </strong>These findings indicate that the use of the \"check-up 45+\" in primary care increases the number of applications for rehabilitation and prevention services. The \"check-up 45+\" can improve needs-based access to rehabilitation and prevention services through early, structured recognition of the patient's needs and ensuing application for these services.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":" Forthcoming","pages":"315-320"},"PeriodicalIF":6.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964267","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 Implementation of Broad Consent at University Hospitals.","authors":"Tim Herrmann, Johannes Mallow, Markus Plaumann, Rüdiger Lehmann, Sebastian Baecke, Jakob Berger, Marko Rak, Martin Franke, Philipp Heinrich, Daniel Tiller, Anna Pirkl, Johannes Bernarding, Christian Bruns","doi":"10.3238/arztebl.m2025.0078","DOIUrl":"https://doi.org/10.3238/arztebl.m2025.0078","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"122 12","pages":"338-339"},"PeriodicalIF":6.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599673","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":"Drug-Related Deaths in Germany.","authors":"Heiko Bergmann, Esther Neumeier, Regina Kühnl, Franziska Schneider, Axel Heinemann, Eva Hoch","doi":"10.3238/arztebl.m2025.0027","DOIUrl":"https://doi.org/10.3238/arztebl.m2025.0027","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"122 12","pages":"336-337"},"PeriodicalIF":6.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599667","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":"Glomuvenous Malformations.","authors":"Friedrich Stock, Stefan Krüger, Georg Lodde","doi":"10.3238/arztebl.m2025.0063","DOIUrl":"https://doi.org/10.3238/arztebl.m2025.0063","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"122 12","pages":"327"},"PeriodicalIF":6.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599669","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":"Quality Assurance in Perioperative Acute Pain Therapy The Validity of Claims Data Compared to Registry Data.","authors":"Johannes Dreiling, Marcus Komann, Norman Rose, Winfried Meißner, Christine Kubulus, Thomas Volk, Daniel Schwarzkopf","doi":"10.3238/arztebl.m2025.0061","DOIUrl":"https://doi.org/10.3238/arztebl.m2025.0061","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"122 12","pages":"334-335"},"PeriodicalIF":6.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599672","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":"Konstantinos Anagnostakos, Ismail Sahan, Winfried Häuser","doi":"10.3238/arztebl.m2025.0048","DOIUrl":"https://doi.org/10.3238/arztebl.m2025.0048","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"122 12","pages":"m1040"},"PeriodicalIF":6.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599670","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":"Notalgia Paresthetica Following an Osteoporotic Compression Fracture.","authors":"David Gaycken, Silke Hofmann, Axel Pommer","doi":"10.3238/arztebl.m2025.0017","DOIUrl":"https://doi.org/10.3238/arztebl.m2025.0017","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"122 12","pages":"340"},"PeriodicalIF":6.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599671","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":"Instability of the Distal Radioulnar Joint.","authors":"Andreas Harbrecht, Frank Unglaub, Martin Franz Langer, Lars Peter Müller, Urs Hug, Christian Karl Spies","doi":"10.3238/arztebl.m2025.0054","DOIUrl":"10.3238/arztebl.m2025.0054","url":null,"abstract":"<p><strong>Background: </strong>Instability of the distal radioulnar joint (DRUJ) is an often unrecognized complication of distal radius fractures and softtissue injuries that can impair function. Its incidence and prevalence in Germany in 2023 were 23.55 and 30.55 per 100 000 inhabitants, respectively.</p><p><strong>Methods: </strong>This narrative review is based on publications retrieved by a selective search in PubMed and the Cochrane Library (4 of 10 studies were included in the analysis). Current guidelines and expert recommendations were considered as well, and a query on the topic of this review was submitted to the Central Institute for Statutory Health Insurance and to the German Federal Statistical Office.</p><p><strong>Results: </strong>After clinical examination and specific test procedures (press test, ulna-fovea sign, dorsopalmar stress test and ballottement test), plain films of the wrist are obtained in two strictly orthogonal projections (lateral and dorsopalmar). Thin-slice computed tomography (CT) (radioulnar quotient method) may be performed as well. Magnetic resonance (MR) arthrography displays DRUJ lesions sensitively (100%) and with increasing specificity (80-100%). Arthroscopy is considered the reference standard for the objective demonstration of triangular fibrocartilage complex lesions with regard to DRUJ instability. Depending on the type of injury, anatomical reconstruction of the injured structures may be recommended, e.g., with refixation techniques, ligament replacement grafts, or osteotomies. Fractures of the styloid process of the ulna (PSU) often accompany distal radius fractures and do not always need to be treated by refixation.</p><p><strong>Conclusion: </strong>Instability of the DRUJ should be recognized and treated specifically to prevent pain and functional impairment. Further studies are needed to provide better scientific evidence for surgical or conservative treatment.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":" Forthcoming","pages":"321-327"},"PeriodicalIF":6.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957764","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":"Hereditary Pyropoikilocytosis—a Frequently Fatal Prenatal Blood Disorder.","authors":"Daniel Ebrahimi-Fakhari, Claudia Rössig, Andreas H Groll","doi":"10.3238/arztebl.m2025.0062","DOIUrl":"https://doi.org/10.3238/arztebl.m2025.0062","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"122 11","pages":"297"},"PeriodicalIF":6.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599663","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}