Abstract:
BACKGROUND:The many varieties of cystic pancreatic tumor, and especially intraductal papillary mucinous neoplasia (IPMN), have attracted increased attention recently. Their incidence may be rising, and their histopathological evaluation and classification have become more precise than before. METHODS:We discuss the current diagnostic evaluation of IPMN, along with treatment and prognostication, on the basis of the current international guideline as well as pertinent literature retrieved by a selective PubMed search. RESULTS:The preoperative diagnostic evaluation of IPMN is often problematic. In particular, it may not be possible to differentiate main-duct disease from branch-duct disease (MD-IPMN vs. BD-IPMN) before surgery--a distinction with implications for prognosis and treatment, as MD-IPMN is more often malignant. An IPMN adenoma can develop into invasive pancreatic cancer. Because firm diagnostic criteria are still lacking, it is recommended that all MD-IPMN lesions and all large BD-IPMN lesions should be resected. Partial pancreatectomy with clean margins is the treatment of choice. CONCLUSION:As IPMN seems to be a slow-growing precursor of pancreatic cancer, it is possible that its early detection and surgical treatment can lead to a cure. No conclusion about the efficacy of surveillance and follow-up programs can be drawn from the available evidence. A better understanding of the natural course of IPMN and the biology of pancreatic cancer is needed to enable further improvements in diagnosis and treatment.
journal_name
Dtsch Arztebl Intjournal_title
Deutsches Arzteblatt internationalauthors
Grützmann R,Post S,Saeger HD,Niedergethmann Mdoi
10.3238/arztebl.2011.0788subject
Has Abstractpub_date
2011-11-01 00:00:00pages
788-94issue
46issn
1866-0452journal_volume
108pub_type
杂志文章,评审abstract:BACKGROUND:Recent years have seen major changes in the diagnosis and treatment of solid intraocular tumors, mainly owing to an improved molecular biological understanding of their pathogenesis, new therapeutic approaches for the local treatment of tumors in children, and long-term follow-up observations in clinical tri...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2018.0106
更新日期:2018-02-16 00:00:00
abstract:BACKGROUND:Much new evidence on oral anticoagulation has come to light in recent years. Non-vitamin-K-dependent oral anti- coagulants (NOAC) have been developed and have been introduced into clinical practice. In this review, we present the current state of the evidence on anticoagulation for various indications with v...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2018.0776
更新日期:2018-11-16 00:00:00
abstract:BACKGROUND:Optimizing the emergency medical care chain might shorten the time to treatment of patients with ST-elevation myocardial infarction (STEMI). The initial care by a physician, and, in particular, correct ECG interpretation, are critically important factors. METHODS:From 1999 onward, data on the care of patien...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2016.0497
更新日期:2016-07-25 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:Even in industrialized countries, health care is not as safe as it should be. The term "patient safety" denotes the non-occurrence of adverse events and the presence of measures to prevent them. METHODS:The literature was selectively reviewed to obtain information on the epidemiology and causes of preventab...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2010.0092
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:One-third of all patients with epilepsy have persistent seizures despite medical treatment. If the origin of the seizures can be localized to a particular site in the brain, epilepsy surgery is a treatment option that addresses the cause of the problem. METHOD:The presurgical assessment and surgical treatme...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2014.0313
更新日期:2014-05-02 00:00:00
abstract:BACKGROUND:Clinical guidelines recommend psychosocial care as an integral part of medical treatment, but access is often limited. Technology-based approaches provide an attractive opportunity to optimize health outcomes and quality of life in people with chronic somatic diseases e.g. by means of Internet- and mobile-ba...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2018.0659
更新日期:2018-11-05 00:00:00
abstract:INTRODUCTION:Despite recent advances in their treatment, schizophrenic disorders are still among the diseases that most severely impair patients' quality of life. For this reason, centers for the early recognition of schizophrenic disorders have come into existence worldwide. In these centers, much effort is devoted to...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2008.0532
更新日期:2008-07-01 00:00:00
abstract:BACKGROUND:Multi-center observational studies in surgery can yield important findings, as long as they are appropriately designed and monitored and employ modern methods of statistical analysis. METHODS:In a multi-center quality assurance study carried out in 346 German hospitals from 2000 to 2004, data were collected...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2011.0041
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Inflammatory bowel diseases are common in Europe, with prevalences as high as 1 in 198 persons (ulcerative colitis) and 1 in 310 persons (Crohn's disease). METHODS:This review is based on pertinent articles retrieved by a search in PubMed and in German and European guidelines and Cochrane reviews of control...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,meta分析,评审
doi:10.3238/arztebl.2016.0072
更新日期:2016-02-05 00:00:00
abstract:BACKGROUND:Habitually shortened nighttime sleep is a common phenomenon in childhood and adolescence, sometimes associated with chronic sleep reduction (CSR). CSR is associated with impairments of performance ability and emotional well-being. The extent to which children and adolescents in Germany suffer from CSR is unc...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2020.0661
更新日期:2020-10-02 00:00:00
abstract:BACKGROUND:The effects of rectal surgery on patients' postoperative quality of life (QOL) and sexual function has been little studied to date. The present study aims to address this issue. METHODS:519 patients who had undergone surgery for rectal cancer from January 1997 to January 2003 were included in the study. The...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2010.0123
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:Numerous studies from around the world have shown a positive association between case numbers and the quality of medical care. The evidence to date suggests that conformity to guidelines for the treatment of patients with breast cancer is better in German hospitals that have higher case numbers. METHODS:We ...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,多中心研究
doi:10.3238/arztebl.2015.0585
更新日期:2015-08-31 00:00:00
abstract:BACKGROUND:The treatment of Hodgkin's disease (HD; also called Hodgkin's lymphoma) in children and adolescents with radiotherapy and chemotherapy leads to high survival rates but has a number of late effects. The most serious one is the development of a secondary malignant tumor, usually in the field that was irradiate...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2014.0003
更新日期:2014-01-06 00:00:00
abstract:BACKGROUND:Pulsatile tinnitus, unlike idiopathic tinnitus, usually has a specific, identifiable cause. Nonetheless, uncertainty often arises in clinical practice about the findings to be sought and the strategy for work-up. METHODS:Selective literature review and evaluation of our own series of patients. RESULTS:Puls...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2013.0451
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:About 17% of all children suffer from a mental disorder in early childhood, defined as the period up to the age of 6 years. METHODS:This review is based on publications retrieved by a selective search in PubMed and the Web of Science, as well as on the authors' clinical and scientific experience. RESULTS:I...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2015.0375
更新日期:2015-05-25 00:00:00
abstract:BACKGROUND:Because of the changing dietary habits of an aging population, hyperuricemia is frequently found in combination with other metabolic disorders. Longstanding elevation of the serum uric acid level can lead to the deposition of monosodium urate crystals, causing gout (arthritis, urate nephropathy, tophi). In G...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2009.0549
更新日期:2009-08-01 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: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:INTRODUCTION:Intermittent paradoxical closure of the vocal cords can induce major attacks of dyspnea. Such attacks, called "vocal cord dysfunction" (VCD), are an important element in the differential diagnosis of intractable bronchial asthma. METHODS:Selective review of the literature. RESULTS:The etiology of VCD is ...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2008.0699
更新日期:2008-10-01 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: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:INTRODUCTION:Magnetic resonance tomography (MRT) is the investigation of choice for diagnosing cerebral glioma, but its capacity to differentiate tumor tissue from non-specific tissue changes is limited. Positron emission tomography (PET) and single photon emission computerized tomography (SPECT) using radiolabeled ami...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2008.0055
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:The neuropsychiatric symptoms of dementia, including aggressiveness, agitation, depression, and apathy are often treated with psychotropic drugs and are a frequent reason for hospitalization, placing an economic burden on the health care system. International guidelines recommend syndrome-specific pharmacoth...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,多中心研究
doi:10.3238/arztebl.2010.0320
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:Patients with acquired brain injury who have been discharged from inpatient neurological rehabilitation often continue to suffer from limited independence, participation, and quality of life. Participation-focused outpatient treatment (in German: teilhabeorientierte ambulan. METHODS:In a randomized, control...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,随机对照试验
doi:10.3238/arztebl.2016.0634
更新日期:2016-09-23 00:00:00
abstract:BACKGROUND:A meta-analysis of studies from multiple countries has shown that the incidence of incisional hernia varies from 4% to 10% depending on the type of operation. No epidemiological surveys have been conducted so far. The worst possible complication of an incisional hernia if it is not treated surgically is inca...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,meta分析
doi:10.3238/arztebl.2018.0031
更新日期:2018-01-19 00:00:00
abstract:BACKGROUND:Women over age 65 with breast cancer are often not treated in accordance with current guidelines as far as adjuvant therapy is concerned, because of the lack of adequate scientific evidence. METHODS:This article is based on a selective review of pertinent literature retrieved by a PubMed search, as well as ...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2011.0365
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:Sepsis, the most severe manifestation of acute infection, poses a major challenge to health care systems around the world. To date, adequate data on the incidence and mortality of sepsis in Germany have been lacking. METHODS:Nationwide case-related hospital DRG statistics for the years 2007-2013 were used t...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2016.0159
更新日期:2016-03-11 00:00:00
abstract:BACKGROUND:Most meniscus lesions are of non-traumatic origin. The indications for partial meniscectomy are controversial. METHODS:We systematically searched the literature for randomized controlled trials (RCTs) comparing partial meniscectomy with non-surgical treatment. RESULTS:Of 6870 articles retrieved by the lite...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2015.0705
更新日期:2015-10-16 00:00:00
abstract:BACKGROUND:The introduction of neurological stroke units and of thrombolysis with the intravenous (IV) administration of recombinant tissue-type plasminogen activator (tPA) have markedly improved the treatment of stroke. Five randomized trials of catheter-based interventional treatment of stroke with special stents wer...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2015.0830
更新日期:2015-12-04 00:00:00