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 patients with myocardial infarction have been recorded and analyzed in the Berlin Myocardial Infarction Registry. In the First Medical Contact Study, data on initial emergency medical care were obtained on 1038 patients who had been initially treated by emergency physicians in 2012. Their pre-hospital ECGs were re-evaluated in a blinded fashion according to the criteria of the European Society of Cardiology. RESULTS:The retrospective re-evaluation of pre-hospital ECGs revealed that 756 of the 1038 patients had sustained a STEMI. The emergency physicians had correctly diagnosed STEMI in 472 patients (62.4%), and they had correctly diagnosed ventricular fibrillation in 85 patients (11.2%); in 199 patients (26.3%), the ECG interpretation was unclear. The pre-hospital ECG interpretation was significantly associated with the site of initial hospitalization and the ensuing times to treatment. In particular, the time from hospital admission to cardiac catheterization was longer in patients with an unclear initial ECG interpretation than in those with correctly diagnosed STEMI (121 [54; 705] vs. 36 [19; 60] minutes, p <0.001). After multivariate adjustment, this corresponded to a hazard ratio* of 2.67 [2.21; 3.24]. CONCLUSION:Pre-hospital ECG interpretation in patients with STEMI was a trigger factor with a major influence on the time to treatment in the hospital. The considerable percentage of pre-hospital ECGs whose interpretation was unclear implies that there is much room for improvement.
journal_name
Dtsch Arztebl Intjournal_title
Deutsches Arzteblatt internationalauthors
Stockburger M,Maier B,Fröhlich G,Rutsch W,Behrens S,Schoeller R,Theres H,Poloczek S,Plock G,Schühlen Hdoi
10.3238/arztebl.2016.0497subject
Has Abstractpub_date
2016-07-25 00:00:00pages
497-502issue
29-30issn
1866-0452pii
arztebl.2016.0497journal_volume
113pub_type
杂志文章abstract:BACKGROUND:Multiple sclerosis (MS) is the most common autoimmune disease of the central nervous system. There are at least 150 000 persons with MS in Germany. Recent years have seen the approval of new drugs against. METHODS:This article is based on pertinent literature retrieved by a selective search in PubMed as wel...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2016.0879
更新日期:2016-12-26 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: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:In peripheral arterial occlusive disease (PAOD), arterial stenosis or occlusion impairs perfusion in the territory of the distal portion of the aorta and the iliac and leg arteries. In Germany, the prevalence of PAOD rises with age, reaching 20% among persons over age 70. METHODS:This guideline was prepared...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,实务指引
doi:10.3238/arztebl.2016.0729
更新日期:2016-10-28 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:Scoliosis is a three-dimensional deviation of the spinal axis. The main diagnostic criterion is spinal curvature exceeding 10° on a plain anteroposterior X-ray image. Scoliosis is called idiopathic when no other underlying disease can be identified. METHODS:Selective literature review and recommendations of...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,meta分析,评审
doi:10.3238/arztebl.2010.0875
更新日期:2010-12-01 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:The regional prevalence of risk factors can vary over time. The Study of Health in Pomerania (SHIP) addresses prevalence trends for common risk factors in a region in northeast Germany. METHODS:A longitudinal study was carried out from 1997 to 2001 (SHIP-0, with 4308 subjects), and a second, independent ran...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2015.0185
更新日期:2015-03-13 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: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:INTRODUCTION:This study analyzes the prevalence and associated factors for smoking and passive smoking among young people. METHODS:The data are derived from a subsample of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), carried out by the Robert Koch Institute between May 2003 ...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2008.0265
更新日期:2008-04-01 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: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: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:BACKGROUND:Cirrhosis of the liver is the end stage of chronic liver disease. Among the many liver disorders that can lead to cirrhosis, some progress rapidly (years) and others more slowly (decades). In Germany, cirrhosis is often a consequence of fatty liver disease due to alcoholism or other causes, but can also be c...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2013.0085
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:Isolated non-compaction cardiomyopathy (NCCM) was first described in 1984. This disorder, a primary genetic cardiomyopathy, is now attracting increased attention. METHOD:The current state of the epidemiology, pathogenesis, pathophysiology, clinical features, diagnosis, treatment, and prognosis of NCCM are d...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2010.0206
更新日期:2010-03-01 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:Current guidelines recommend using aspirin, clopidogrel, beta-blockers, statins, and angiotensin converting enzyme (ACE) inhibitors after acute myocardial infarction (AMI). Although there is evidence that patients often stop taking these medications prematurely, long-term data reflecting the actual reality o...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2011.0856
更新日期:2011-12-01 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: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:Surgical site infections (SSI) are among the most common healthcare- associated infections. The aim of our explorative study was to determine how selected climatic factors are associated with SSI rates. METHODS:SSI rates were calculated for operative procedures included in the surgi- cal site infection surv...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2019.0529
更新日期:2019-08-05 00:00:00
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 cu...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2011.0788
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:The N-methyl-D-aspartate (NMDA) antagonist dextromethorphan has been available in pharmacies without a prescription since 1954 as an antitussive agent. There is an alarming increase in reports of its abuse. Dextromethorphan is avidly taken, mainly by young people, as a psychoactive drug. The currently availa...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2010.0537
更新日期:2010-07-01 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: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: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: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: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:BACKGROUND:Lung cancer is the leading cause of death from cancer in Germany. 90% of cases are due to the inhalation of tobacco smoke. About 40% of patients with newly diagnosed lung cancer are still smokers. A structured smoking cessation program is medically reasonable in this situation but is only rarely offered. ME...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2013.0719
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:The percentage of organ donors among the German population is very low, and the supply of organs does not meet the demand. Relatively few organ explantations are performed in Germany, compared to other countries. The central element leading up to organ explantation is the donor's consent. This can be express...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2020.0183
更新日期:2020-03-13 00:00:00