Kilian Rapp, Clemens Becker, Patrick Roigk, Claudia Konnopka, Hans-Helmut König, Thomas Friess, Dietrich Rothenbacher, Gisela Büchele
{"title":"Orthogeriatric Co-management of Spine, Arm, Forearm, and Pelvis Fractures.","authors":"Kilian Rapp, Clemens Becker, Patrick Roigk, Claudia Konnopka, Hans-Helmut König, Thomas Friess, Dietrich Rothenbacher, Gisela Büchele","doi":"10.3238/arztebl.m2024.0035","DOIUrl":"10.3238/arztebl.m2024.0035","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"121 13","pages":"438-439"},"PeriodicalIF":6.5,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008426","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}
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":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":" Forthcoming","pages":"415-421"},"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}
{"title":"Screening Tool For Dehydration Risk.","authors":"Christian A Koch, Arshag D Mooradian","doi":"10.3238/arztebl.m2023.0285","DOIUrl":"10.3238/arztebl.m2023.0285","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"121 12","pages":"411"},"PeriodicalIF":6.5,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859315","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 Definition of Control Groups Is Inappropriate.","authors":"Alfred Böcking, Volker Siller","doi":"10.3238/arztebl.m2023.0282","DOIUrl":"10.3238/arztebl.m2023.0282","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"121 12","pages":"413"},"PeriodicalIF":6.5,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859317","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":"Special Aspects of Cholesterol Metabolism in Women.","authors":"Ioanna Gouni-Berthold, Ulrich Laufs","doi":"10.3238/arztebl.m2024.0063","DOIUrl":"10.3238/arztebl.m2024.0063","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular diseases due to arteriosclerosis are the most common causes of death and disability in both men and women. Hypercholesterolemia, a treatable risk factor, is often detected after a delay in women, and then inadequately treated. It is, therefore, important to know the sex-specific aspects of cholesterol metabolism and to address them specifically.</p><p><strong>Methods: </strong>We conducted a selective literature search in PubMed with particular attention to current guidelines.</p><p><strong>Results: </strong>In the population as a whole, the age-associated rise in serum cholesterol levels occurs approximately 10 years later in women than in men. Women are exposed to a higher cholesterol load than men at the beginning of their lives, and especially after menopause. This is correlated with a later, but nonetheless clinically relevant rise in the incidence of myocardial infarction in older women. Because women's LDL cholesterol and lipoprotein(a) levels rise after menopause, their lipid profiles should be re-evaluated at this time. Moreover, conditions that are specific to women such as polycystic ovary syndrome, contraception, and especially the phases of life-such as planning to become pregnant, pregnancy, and breastfeeding-need to be considered for both diagnostic and therapeutic purposes. Sex-specific differences and cholesterolassociated risks are particularly pronounced in women with familial hypercholesterolemia (prevalence 1:250).</p><p><strong>Conclusion: </strong>Lowering high cholesterol levels, especially in postmenopausal women, may prevent the development of cardiovascular diseases.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":" Forthcoming","pages":"401-406"},"PeriodicalIF":6.5,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862305","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}
Eva Sophia Rickers, Michael Sommerauer, Kai Laukamp
{"title":"Air in the Fourth Ventricle After Lumbar Puncture.","authors":"Eva Sophia Rickers, Michael Sommerauer, Kai Laukamp","doi":"10.3238/arztebl.m2023.0240m2023.0240","DOIUrl":"10.3238/arztebl.m2023.0240m2023.0240","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"121 12","pages":"384"},"PeriodicalIF":6.5,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859312","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}
Pia Grabbe, Milena S Borchers, Kathrin M Gschwendtner, Sophia Strobel, Beate Wild, Marietta Kirchner, Katharina Kälber, Adriana Rendon, Julian Steininger, Friedegund Meier, Jessica C Hassel, Christiane Bieber
{"title":"An Online Decision Aid for Patients With Metastatic Melanoma—Results of the Randomized Controlled Trial “PEF-Immun”.","authors":"Pia Grabbe, Milena S Borchers, Kathrin M Gschwendtner, Sophia Strobel, Beate Wild, Marietta Kirchner, Katharina Kälber, Adriana Rendon, Julian Steininger, Friedegund Meier, Jessica C Hassel, Christiane Bieber","doi":"10.3238/arztebl.m2024.0053","DOIUrl":"10.3238/arztebl.m2024.0053","url":null,"abstract":"<p><strong>Background: </strong>Treatment decisions in metastatic melanoma (MM) are highly dependent on patient preferences and require the patients' involvement. The complexity of treatment options with their individual advantages and disadvantages is often overwhelming. We therefore developed an online patient decision aid (PtDA) to facilitate shared decision making (SDM).</p><p><strong>Methods: </strong>To evaluate the PtDA we conducted a two-armed, twocenter, prospective, open randomized controlled trial with MM patients who were facing a decision about first-line treatment. The patients were allotted randomly in a 1:1 ratio to an intervention group (IG) with access to the PtDA before discussion with a physician or to a control group (CG) without access to the PtDA. The primary endpoint was knowledge about the options for first-line treatment (multiple-choice test, 10 items, range 0-40 points). The secondary endpoints were the SDM (third-party ratings of audio recordings of the treatment discussions) and satisfaction with the decision at the follow-up visit.</p><p><strong>Results: </strong>Of the 128 randomized patients, 120 completed the baseline questionnaire and were analyzed (59% male, median age 66 years). The primary endpoint, i.e., the mean difference in knowledge after discussion with a physician, differed significantly between the IG and the CG (-3.22, 95% CI [-6.32; -0.12], p = 0.042). No differences were found for the secondary endpoints, SDM and satisfaction with the decision. The patients in the IG rated the PtDA as very useful.</p><p><strong>Conclusion: </strong>The PtDA improved the knowledge of patients with MM about the options for treatment. Both groups were highly satisfied with their treatment decisions. However, additional physician training seems necessary to promote SDM.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":" Forthcoming","pages":"385-392"},"PeriodicalIF":6.5,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140854112","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}
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