Deutsches Arzteblatt international最新文献

{"title":"Awareness of the Patient Service Telephone Number 116117 and Willingness to Use a Symptom Checker.","authors":"Sarah Oslislo, Kalina Witt, Philipp Kellner, Hajo Schmidt-Traub, Christian Wrede, Rajan Somasundaram","doi":"10.3238/arztebl.m2025.0065","DOIUrl":"https://doi.org/10.3238/arztebl.m2025.0065","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"122 11","pages":"306-307"},"PeriodicalIF":6.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599661","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":"Symptomatic Pineal Cysts Without Ventricular Enlargement: Diagnosis and Treament.","authors":"Mariam Al Mutawa, Ina Lange, Michael Kirsch, Agnes Flöel, Steffen Fleck, Henry W S Schroeder","doi":"10.3238/arztebl.m2025.0053","DOIUrl":"10.3238/arztebl.m2025.0053","url":null,"abstract":"<p><strong>Background: </strong>Pineal cysts that are not associated with ventricular enlargement can lead to manifestations of intracranial hypertension, usually paroxysmal. If these are due to local mass effect or narrowing of the entrance to the aqueduct, surgery may be indicated.</p><p><strong>Methods: </strong>This is a narrative review based on publications retrieved by a search in PubMed.</p><p><strong>Results: </strong>Autopsy studies have revealed pineal cysts in 40% of subjects. Pineal cysts that are not associated with ventricular enlargement can cause intermittent attacks of headache; the second most common symptom is visual disturbance. Patients often also report many non-specific symptoms such as dizziness, fatigue, lethargy, drowsiness, a decline in performance, gait disturbances, impaired memory, or sleep disorders. Because the symptoms are often nonspecific and pineal cysts are common, surgery should not be performed on a pineal cyst unless a comprehensive diagnostic work-up for other potential causes has been carried out with the aid of specialists in all relevant disciplines. In multiple clinical studies, the rate of total relief of symptoms by surgery ranged from 46.8% to 96.4%, while the rate of partial relief ranged from 3.6% to 47.6% and that of persistent symptoms from 3.3% to 18.8%. Permanent complications are rare.</p><p><strong>Conclusion: </strong>If there are manifestations of intracranial hypertension that are clearly attributable to the pineal cyst, such as severe, holocephalic headaches, vomiting (usually projectile), and brainstem signs that can be triggered by the Valsalva maneuver, and if no other cause of these manifestations can be identified, surgery has a high likelihood of success. A prerequisite to surgical treatment is that the MRI reveals that the pineal cyst is exerting mass effect and/or narrowing the entrance to the aqueduct, even if the ventricles are not enlarged. Because pineal cysts are common and have nonspecific manifestations, surgery must only be performed for strict indications. It should be noted that only low-level evidence supports surgical treatment.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":" Forthcoming","pages":"298-303"},"PeriodicalIF":6.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962505","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":"Dorothea Matysiak-Klose","doi":"10.3238/arztebl.m2025.0050","DOIUrl":"https://doi.org/10.3238/arztebl.m2025.0050","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"122 11","pages":"m1038-m1039"},"PeriodicalIF":6.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599664","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":"Sexual Violence Against Children and Adolescents: A German Nationwide Representative Survey on Its Prevalence, Situational Context, and Consequences.","authors":"Harald Dreßing, Andreas Hoell, Leonie Scharmann, Anja M Simon, Ann-Christin Haag, Dieter Dölling, Andreas Meyer-Lindenberg, Joerg M Fegert","doi":"10.3238/arztebl.m2025.0076","DOIUrl":"10.3238/arztebl.m2025.0076","url":null,"abstract":"<p><strong>Background: </strong>Sexual violence against children and adolescents is widespread around the world. Current knowledge about the extent of this often concealed problem and the situational contexts in which it occurs is insufficient, not only in Germany.</p><p><strong>Methods: </strong>A representative sample of the German population aged 18 to 59 was selected for this survey with the aid of Infratest dimap (a private polling company). The participants were asked to fill in a combination of written postal and online questionnaires in a mixedmode design from January to October 2024.</p><p><strong>Results: </strong>10 000 people were contacted in writing (response rate: 30.2%). 12.7% [11.5; 13.9] stated that they were affected by sexual violence, including 20.6% of all women and 4.8% of all men. Men had more frequently experienced sexual violence in sports and leisure facilities, in a church context, and in the setting of government- provided child, youth, and family services. 37.4% [32.6; 42.2] of the affected persons had not previously reported the crime to anyone. 31.7% [30.0; 33.4] of respondents reported sexual violence via the internet and social media. The mental health of affected persons was poorer than that of unaffected persons.</p><p><strong>Conclusion: </strong>Many cases of sexual violence go unreported. The different settings in which these offenses are committed, e.g., the preponderance of male victims in institutional settings, further imply a need for differentiated protection strategies, addressing both potential victims and potential perpetrators.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":" Forthcoming","pages":"285-291"},"PeriodicalIF":6.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969266","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 Smartphone-Guided Digital Health Application for Hypertension: The Randomized Controlled HELP Trial.","authors":"Andreas Zietzer, Philip Düsing, Felix Brokamp, Sebastian Schäfer, Fabian Stieber, Karl Wilhelm, Dimitrios Zgouras, Stephan H Schirmer","doi":"10.3238/arztebl.m2025.0066","DOIUrl":"10.3238/arztebl.m2025.0066","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a significant risk factor for cardiovascular disease development. Current guidelines recommend a combination of medication and lifestyle modifications, particularly with regard to diet, exercise, blood pressure monitoring, and therapy adherence. To support this, the digital health application \"Vantis Bluthochdruck\" (Vantis app) was developed.</p><p><strong>Methods: </strong>A prospective trial in 98 patients with uncontrolled hypertension at seven German centers tested whether the Vantis app lowers systolic blood pressure. Patients were randomized 1:1 to the app or standard care, with investigators blinded to group allocation at baseline. The primary endpoint was systolic blood pressure after 13 weeks, and the secondary endpoints were therapy adherence, diastolic blood pressure, resting heart rate, body mass index, and unplanned medical visits. The study is registered under DRKS00031923.</p><p><strong>Results: </strong>The intervention group showed a significantly greater reduction in the primary endpoint, systolic blood pressure, than the control group (difference 5.5 mmHg, 95% confidence interval [1.3; 9.8]; p = 0.011). Systolic blood pressure fell from 151.4 mmHg [149.1; 153.8] to 144.3 mmHg [141.2; 147.3] in the control group and from 152.5 mmHg [149.8; 155.2] to 140.1 mmHg [136.7; 143.5] in the intervention group. Patients in the intervention group exhibited higher therapy adherence with no differences in other secondary endpoints. No app-related adverse events were reported.</p><p><strong>Conclusion: </strong>The study indicates that the tested digital health application lowers systolic blood pressure in hypertensive patients and increases guideline adherence.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":" Forthcoming","pages":"292-297"},"PeriodicalIF":6.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969263","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":"Severe Injuries in E-Scooter Accidents: An Evaluation of Data From the TraumaRegister DGU.","authors":"Frederik Hartz, Philipp Zehnder, Tobias Resch, Gregor Römmermann, Markus Schwarz, Chlodwig Kirchhoff, Peter Biberthaler, Rolf Lefering, Michael Zyskowski","doi":"10.3238/arztebl.m2025.0041","DOIUrl":"10.3238/arztebl.m2025.0041","url":null,"abstract":"<p><strong>Background: </strong>The e-scooter has become an alternative mode of transport in urban areas, and this has led to a rising number of injuries. There is a lack of comprehensive, nationwide data on severe injuries due to e-scooter accidents.</p><p><strong>Methods: </strong>From 2020 onward, e-scooter accidents have been recorded as a separate subgroup in the multicenter TraumaRegister DGU (TR-DGU) (DGU = German Trauma Society). In this study, we analyzed the data from 2020-2023 and compared them with data for bicyclists and other road users.</p><p><strong>Results: </strong>We compared data on 538 persons who were severely injured in e-scooter accidents with data on injured bicyclists and other road users. Compared to cyclists, e-scooter accident victims were more often male (78.4% versus 72.3%), younger (44.3 versus 54.5 years) and more often under the influence of alcohol (34.9% versus 15.6%). More than half of the accidents (54%) took place at night, and 83% of the e-scooter accident victims suffered a severe injury to the head or face (Abbreviated Injury Scale [AIS] ≥ 2). The most common injuries were subarachnoid hemorrhage (20.1%), skull base fracture (16.7%), and serial rib fractures (16.5%). 83.5% of these e-scooter accident victims were treated in intensive care; the average length of hospital stay was 7 days (interquartile range, 4-12 days). 26 (4.8%) of the e-scooter accident victims died.</p><p><strong>Conclusion: </strong>E-scooter accidents cause severe injuries to the head and face. Middle-aged men are most commonly affected. The victims are often under the influence of alcohol, need intensive care, and have an appreciable mortality. Measures should be taken urgently to educate e-scooter riders and improve safety.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":" Forthcoming","pages":"265-270"},"PeriodicalIF":6.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751611","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":"Pseudo-Worsening of Kidney Function.","authors":"Martin F Fromm, Michael I Sponfeldner, Frank Dörje, Katja Gessner, Pauline Dürr, Lisa Cuba, Julia Schwanfelder","doi":"10.3238/arztebl.m2025.0021","DOIUrl":"https://doi.org/10.3238/arztebl.m2025.0021","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"122 10","pages":"m1035"},"PeriodicalIF":6.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689439","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 Long-Term Tolerability of BNT162b2 in Children and Adolescents (the CoVacU18 Study).","authors":"Vivien Grieshaber, Christoph Strumann, Sarah Holzwarth, Nicole Toepfner, Wolfgang Carl Gustav von Meißner, Nikos Konstantopoulos, Martina von Poblotzki, Kai O Hensel, Matthias B Moor, Cho-Ming Chao","doi":"10.3238/arztebl.m2025.0032","DOIUrl":"10.3238/arztebl.m2025.0032","url":null,"abstract":"<p><strong>Background: </strong>The available safety data on the use of the messenger RNA-based COVID-19 vaccine BNT162b2 in persons under age 18 are limited to observation periods of up to six months.</p><p><strong>Methods: </strong>In a retrospective, cross-sectional study, we evaluated self-reported vaccine tolerability (SRVT) in eleven symptom categories among persons who were under 18 years old when they received at least one dose of the BNT162b2 vaccine in Germany on or after 1 October 2021. Data were collected online from the parents or legal guardians of the vaccinated persons. Individual participation codes enabled authenticated and pseudonymous participation in the survey. In a subgroup, the SRVT of BNT162b2 was compared with that of vaccines against other illnesses than SARS-CoV-2 (e.g., influenza).</p><p><strong>Results: </strong>Tolerability data were obtained from 3228 persons with a median age of 5.7 years; 49.6% were male. The median period of observation was 524 days. The more commonly reported undesired effects of the vaccine, mainly in older subjects, were local reactions- pain (49.7%), redness (23%)-with less common systemic symptoms including fatigue (20.1%), fever (11.4%), general feeling of illness (8.0%), and headache (6.5%). Compared to vaccines against other illnesses, BNT162b2 was more commonly associated with local and systemic symptoms (gastrointestinal, musculo - skeletal, dermatological, neurological, psychological). 41 (1.3%) of the subjects reported that their SRVT persisted for ≥90 days after vaccination with BNT162b2: these symptoms were mainly psychological (15 subjects), neurological (9 subjects), and dermatological (8 subjects). There were 45 serious adverse events; these were associated with female sex (OR = 4.70, 95% confidence interval [2.17; 10.20]) and with long-term medication use (OR = 4.06 [1.53; 10.79]).</p><p><strong>Conclusion: </strong>Vaccination with BNT162b2 was reportedly well tolerated by more than 98% of the children and adolescents who received it, although symptoms were more common than after vaccination against other illnesses than SARS-CoV-2. The participants in our study may have had a more positive attitude toward vaccination. On the other hand, a selection bias might exist for participants who experienced vaccination side effects.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":" Forthcoming","pages":"257-263"},"PeriodicalIF":6.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656375","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":"Introduction to Bayesian Statistics: Part 36 of a Series on the Evaluation of Scientific Publications.","authors":"Joachim Werner Otto Gerß, Reinhard Vonthein","doi":"10.3238/arztebl.m2025.0035","DOIUrl":"10.3238/arztebl.m2025.0035","url":null,"abstract":"<p><strong>Background: </strong>The analysis of a study with Bayesian statistics makes use of additional information to supplement the new study data. In this review, we explain the principles of the application of this method in clinical research.</p><p><strong>Methods: </strong>The concept of Bayesian statistics is introduced and explained with the aid of an illustrative example from a drug approval study. Its major aspects are discussed. The existing prior knowledge is formulated as a probability distribution of an odds ratio. Multiple scenarios are shown to demonstrate how a suitable prior distribution is determined and how it can affect the final result.</p><p><strong>Results: </strong>Bayesian statistics makes use of prior knowledge, e.g., the findings of earlier clinical trials, and combines the prior probability distribution with the findings of the current study for statistical analysis. The suitability and applicability of the prior knowledge in question must be assessed and the prior knowledge weighted accordingly, and any uncertainties must be taken into account in the analysis. The result that is derived is called the posterior distribution of the parameters of interest and is summarized in terms of point estimators and credibility intervals. In contrast to classical statistics, results of this type permit direct quantitative statements on the probability of parameter values and on the probabilities of the null and alternative hypotheses (in one-sided statistical tests).</p><p><strong>Conclusion: </strong>Combining the current study findings with prior knowledge can enable the more precise estimation of a treatment effect, or else lessen the number of subjects needed for a clinical trial. Central elements of Bayesian statistics are the selection and weighting of prior knowledge; subjective judgements must be made. Bayesian techniques require a precise description of the methods applied, meticulous study of the available literature, and experience in the mathematical representation of the results.</p>","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":" Forthcoming","pages":"271-276"},"PeriodicalIF":6.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656361","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":"Susanne Delecluse","doi":"10.3238/arztebl.m2025.0022","DOIUrl":"https://doi.org/10.3238/arztebl.m2025.0022","url":null,"abstract":"","PeriodicalId":11258,"journal":{"name":"Deutsches Arzteblatt international","volume":"122 10","pages":"m1035"},"PeriodicalIF":6.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689436","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}