Abstract:
BACKGROUND:The German Federal Law on Radiation Control contains no special provisions for X-ray studies in children and adolescents, even though exposure to ionizing radiation must be kept especially low in young persons, because their tissues are highly radiosensitive. Children, who have many years left to live, are more likely than adults to develop radiation-induced cancer; also, as future parents, they are at risk for passing on radiation-induced genetic defects to the next generation. Whenever possible, radiological studies on children and adolescents should be of a type that does not involve ionizing radiation, such as ultrasonography or magnetic resonance imaging. Pediatric conventional X-rays and computerized tomography (CT) require special examining techniques and protocols that are adapted to the patient's age and to the indication for the study. METHODS:We selectively review the literature on pediatric dose reduction and discuss our own investigations on the subject as well. RESULTS:The essential technical prerequisites for lowering the dose of ionizing radiation in conventional X-ray studies include the proper setting of tube voltage, the use of tube filters, suitable patient positioning and fixation, variable use of a scattered-radiation grid, and a modern storage-plate system. In CT studies, the use of age- and indication-adapted protocols can lower radiation exposure by as much as 95%. CONCLUSION:There are now many ways to lower the exposure of children and adolescents to ionizing radiation without sacrificing diagnostic reliability. The main factors in lowering exposure are proper attention to clinical indications, the use of special X-ray protocols, the use of alternative imaging studies without ionizing radiation wherever possible, and the expertise of the examiner.
journal_name
Dtsch Arztebl Intjournal_title
Deutsches Arzteblatt internationalauthors
Alzen G,Benz-Bohm Gdoi
10.3238/arztebl.2011.0407subject
Has Abstractpub_date
2011-06-01 00:00:00pages
407-14issue
24issn
1866-0452journal_volume
108pub_type
杂志文章abstract:BACKGROUND:Dermatologists, paediatricians, and general practitioners are often consulted by worried parents for the evaluation of a cutaneous tumor. METHODS:Selective literature review. RESULTS:Only 1-2% of skin tumors excised in children turn out to be malignant when examined histologically. Warning signs of maligna...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2011.0347
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:As of 1 April 2007, pharmacists in Germany filling prescriptions covered by the statutory health insurance system (Gesetzliche Krankenversicherung, GKV) are required, whenever possible, to dispense a preparation that contains the same active substance and for which a rebate contract is in effect. The physici...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2009.0783
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Because the course of Legg-Calvé-Perthes disease (LCPD) is highly variable, its appropriate diagnostic evaluation and treatment are still debated. METHODS:The authors selectively review the literature, present their own study findings, and discuss the guidelines of the German Society for Orthopedics and Ort...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2009.0517
更新日期:2009-07-01 00:00:00
abstract:INTRODUCTION:Autopsy studies of persons who died of cancer have shown the lungs to be the sole site of metastasis in about 20% of cases. The resection of pulmonary metastases is indicated for palliative purposes if they contain a large volume of necrotic tumor, infiltrate the thoracic wall to produce pain, or cause hem...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2012.0645
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Pilonidal disease is an acute or chronic infection in the subcutaneous fatty tissue, mainly in the natal cleft. Its incidence in Germany in 2012 was 48 cases per 100 000 persons per year. METHODS:This review is based on pertinent publications retrieved by a selective literature search. RESULTS:The numerous...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2019.0012
更新日期:2019-01-07 00:00:00
abstract:BACKGROUND:Adverse drug events (ADE) are a common cause of hospital admission as well as a common complication of inpatient care. The current reporting systems in Germany are of only limited use for the identification of ADE. The aim of this study is to examine the potential usefulness of ICD-10 coded diagnoses in rout...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2010.0023
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:For prospective parents at risk of transmitting a monogenic disease, polar body analysis is an option for pre-conception genetic diagnosis. In Germany, polar body analysis is currently performed in only two centers (Lübeck and Regensburg). METHODS:The authors present a clinical series of 9 couples at risk f...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2009.0533
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Urinary tract infections (UTI) are among the leading reasons for treatment in adult primary care medicine, accounting for a considerable percentage of antibiotic prescriptions. Because this problem is so common and so significant in routine clinical practice, a high level of diagnostic accuracy is essential....
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2010.0361
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:Screening colonoscopy can lower the incidence of colorectal cancer (CRC), yet participation rates are low even in groups at high risk. The goal of this study was to double the rate of participation in screening colonoscopy among persons at familial risk and then to determine the frequency of neoplasia in thi...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.3238/arztebl.2018.0715
更新日期:2018-10-26 00:00:00
abstract:BACKGROUND:Many patients in German hospitals complain of inadequate treatment of their postoperative pain. Hospital-related structural and procedural variables may affect pain perception and patient satisfaction. We studied the association of individual variables with outcome quality. METHODS:Data from the years 2011 ...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2017.0161
更新日期:2017-03-10 00:00:00
abstract:BACKGROUND:Familial hypercholesterolemia (FH) is a congenital disorder of lipid metabolism characterized by a marked elevation of the plasma concentration of LDL (low-density lipoprotein) cholesterol beginning in childhood and by the early onset of coronary heart disease. It is among the commonest genetic disorders, wi...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2014.0523
更新日期:2014-08-04 00:00:00
abstract:BACKGROUND:Lung transplantation is the final treatment option in the end stage of certain lung diseases, once all possible conservative treatments have been exhausted. Depending on the indication for which lung transplantation is performed, it can improve the patient's quality of life (e.g., in emphysema) and/ or prolo...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,meta分析,评审
doi:10.3238/arztebl.2014.0107
更新日期:2014-02-14 00:00:00
abstract:BACKGROUND:Atraumatic necrosis of the femoral head is a common cause of hip arthrosis in middle age. In Germany, it affects 5000-7000 patients per year, corresponding to an incidence of 0.01%. Though rarer than primary hip arthrosis, it is still of major clinical and socio-economic significance. Patients with this prob...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,meta分析,评审
doi:10.3238/arztebl.2016.0031
更新日期:2016-01-22 00:00:00
abstract:INTRODUCTION:Crohn's disease and ulcerative colitis are chronic inflammatory diseases resulting from an inappropriate immune response, in genetically susceptible individuals, to microbial antigens of commensal microorganisms. This inappropriate response is promoted by certain environmental factors. Both diseases manife...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2009.0123
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:Some hematological malignancies arise in persons with a hereditary predisposition. The hereditary nature of these diseases often goes unrecognized, particularly when symptoms begin in adulthood. METHODS:This review is based on pertinent publications retrieved by a selective search in PubMed. RESULTS:Many r...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2018.0848
更新日期:2018-12-14 00:00:00
abstract:BACKGROUND:A number of studies have revealed higher postoperative mortality after operations that were performed toward the end of the week. It is not yet known whether a day-of-the-week effect exists after visceral surgical procedures for cancer in Germany. METHODS:Data on resections of carcinomas of the colon, rectu...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2020.0521
更新日期:2020-08-03 00:00:00
abstract:INTRODUCTION:The range of indications for vitreoretinal surgery has widened in recent years, and intraocular gas application is frequently performed as part of retinal surgery, with the aim of achieving long-acting tamponade. METHODS:Selective literature review. RESULTS:An intraocular gas bubble containing perfluorop...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2008.0108
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:The prevalence of abdominal aortic aneurysms (AAA) with a maximal diameter of 3 cm or more is age-dependent; among persons over age 65, it lies between 4% and 8% in men and between 0.5% and 1.5% in women. About 10% of all AAAs have a maximum diameter of 5 cm or more. The prognosis of ruptured AAA (rAAA) is d...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,meta分析,评审
doi:10.3238/arztebl.2009.0657
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:When gunshot and blast injuries affect only a single person, first aid can always be delivered in conformity with the relevant guidelines. In contrast, when there is a dynamic casualty situation affecting many persons, such as after a terrorist attack, treatment may need to be focused on immediately life-thr...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2017.0237
更新日期:2017-04-07 00:00:00
abstract:BACKGROUND:25% of all women report involuntary loss of urine, and 7% may require treatment. METHODS:This review is based on a selection of pertinent literature, including guidelines and Cochrane reviews. RESULTS:The assessment of pelvic floor dysfunction in women begins with a basic evaluation that is followed by spe...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2015.0564
更新日期:2015-08-17 00:00:00
abstract:INTRODUCTION:The trauma registry of the German Society of Trauma Surgery is a multicentric prospective record of the treatment of severely injured patients. METHODS:The present study examines the effect of a quality management system on key processes and outcomes, in hospitals included in the trauma registry. The stud...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2008.0225
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Hoarseness (dysphonia) is the reason for about 1% of all consultations in primary care. It has many causes, ranging from self-limited laryngitis to malignant tumors of the vocal cords. METHODS:This review is based on literature retrieved by a selective search in PubMed employing the terms "hoarseness," "hoa...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2015.0329
更新日期:2015-05-08 00:00:00
abstract:BACKGROUND:An estimated 200 to 500 patients develop life-threatening acute liver failure (ALF) in Germany each year. Only sparse data are currently available on the epidemiology and causes of this condition and on potential treatments for it. This article summarizes our current knowledge of the causes, clinical course,...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2011.0714
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Direct (non-vitamin-K-dependent) oral anticoagulants (DOAC) are given as an alternative to vitamin K antagonists (VKA) to prevent stroke and embolic disease in patients with atrial fibrillation that is not due to pathology of the heart valves. Fatal hemorrhage is rarer when DOACs are given (nonvalvular atria...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2016.0575
更新日期:2016-09-05 00:00:00
abstract:BACKGROUND:High-altitude travel, for mountain climbing, trekking, or sightseeing, has become very popular. Therefore, the awareness of its dangers has increased, and many prospective travelers seek medical advice before setting forth on their trip. METHODS:We selectively searched the literature for relevant original a...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2011.0839
更新日期:2011-12-01 00:00:00
abstract:INTRODUCTION:The purpose of this article is to present the results of microsurgical clipping or endovascular coil obliteration of unruptured intracranial aneurysms (UIA), in a single cerebrovascular center with regard to successful obliteration and periprocedural complications. METHODS:Data concerning patients with UI...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2008.0449
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:The histomorphological changes of lung damage in severe coronavirus disease 2019 (COVID-19) have not yet been adequately characterized. In this article, we describe the sequence of pathological changes in COVID-19 and discuss the implications for approaches to treatment. METHODS:Standardized autopsies were ...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2020.0500
更新日期:2020-07-20 00:00:00
abstract:BACKGROUND:When reading reports of medical research findings, one is usually confronted with p-values. Publications typically contain not just one p-value, but an abundance of them, mostly accompanied by the word "significant." This article is intended to help readers understand the problem of multiple p-values and how...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2010.0050
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Abdominal and thoracic aortic aneurysms are diagnosed in 40 and 10 to 15 out of 100 000 persons per year, respectively. Fenestrated (fEVAR) and branched (bEVAR) stent grafts have been developed for abdominal juxtarenal and thoracoabdominal aneurysms. We discuss the patency and complication rates of fEVAR and...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,meta分析,评审
doi:10.3238/arztebl.2015.0816
更新日期:2015-11-27 00:00:00
abstract:BACKGROUND:Despite sparse documentation of their long-term therapeutic effects and side effects, antipsychotic drugs have come to be prescribed more frequently for children and adolescents in recent years, both in the USA and in Europe. No current data are available about antipsychotic prescriptions for this age group ...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2014.0025
更新日期:2014-01-17 00:00:00