Deutsches Arzteblatt International

Temporary Discontinuation and Restarting of Oral Anticoagulants for Neurological and Cardiac Indications
Kellert L, Sinner MF, Höllig A, Nolte CH and Linnemann B
Approximately 1 million people in Germany are under treatment with an oral anticoagulant (OAC) for the primary or secondary prophylaxis of arterial and venous thromboembolic disease. Each year, 12-20% of them undergo an invasive procedure or operation. The temporary discontinuation and restarting of OAC for comorbid conditions, complications, and invasive procedures should be designed both to reduce thromboembolic events and to avoid hemorrhagic complications.
Preoperative Immunotherapy in Oncology
Hofheinz RD, Lorenzen S, Sebastian M, Bölükbas S, Fichtner-Feigl S and Loibl S
Immune checkpoint inhibitors (ICI) are in standard use for the treatment of many kinds of metastatic tumor. Their use before surgery to prolong event-free and overall survival (EFS, OS) has been studied in recent years.
Colonoscopy Versus Fecal Occult Blood Test Versus No Screening: A Comparative Analysis of Long-Term Effects
Sergeev D, Heisser T, Hoffmeister M and Brenner H
Colorectal cancer (CRC) remains a leading cause of cancer-related death. Many of these deaths could be prevented by screening. The German screening program was updated in April 2025, enabling men and women aged 50 and above to choose between fecal immunochemical testing (FIT) once every two years or up to 2 screening colonoscopies (CS) at an interval of 10 years apart. In this study, we compare the expected long-term outcomes for these strategies as well as for a combination of the two, assuming that full use is made of the tests that are offered.
Metamizole: Indications and Risks
Cascorbi I and Baron R
Metamizole is the most commonly prescribed analgesic drug in Germany, with 280 million daily doses prescribed per year. It is generally considered safe, yet it is controversial and not approved for use in many countries because of the very rare, but potentially lethal risk of agranulocytosis.
Transcatheter Aortic Valve Implantation: Selection, Early Mortality, and Complications. A Multicenter Evaluation of More Than 33 000 Implantations (2013–2023)
Wrobel JM, Abdel-Wahab M, Shamekhi J, Voran JC, Frank D, Hannen L, Adam M, Kim WK, Wienemann H, Guthoff H, Finke K, Schröder J, Nickenig G, Schofer N, Baldus S, Rudolph TK and Mauri V
Transcatheter aortic valve implantation (TAVI) has become the standard treatment of persons aged 75 and above with severe aortic valvular stenosis. In this study, we analyzed temporal trends in risk profiles and treatment results from 2013 to 2023.
The Medical Determination of Fitness for Detention in Police Custody
Heide S, Dettmeyer R, Michels G, Berg A, Lange J and Rothschild MA
In Germany, police custody is used to prevent danger. An arrested person's medical fitness for detention must be assessed by a physician if it is in doubt. The frequency of such examinations among arrested persons in Germany ranges from 5.5% to 66.0%. There are currently no binding guidelines for the assessment of fitness for detention.
Arterial Hypertension: The Incidence of Diagnosed Hypertension, 24-Hour Blood Pressure Measurement and Pharmacotherapy. An Analysis of Routine Health Insurance Data
Reitzle L, Maier B, Hoebel J, Pawlowska-Phelan D, Ludwig M and Neuhauser H
Arterial hypertension is a major risk factor for morbidity and mortality in Germany. No current data are available on trends in the incidence of hypertension.
Treating Venous Leg Ulcers in Primary Care: The Cluster-Randomized Ulcus Cruris Care Trial
Fleischhauer T, Sander N, Feisst M, Awounvo S, Weller L, Poss-Doering R, Laux G, Altiner A, Müller-Bühl U, Szecsenyi J and Senft JD
Venous leg ulcers (VLUs) markedly restrict patients' everyday activities and impair their quality of life. Compression is the most important treatment measure but is often not consistently implemented in practice. The aim of the Ulcus Cruris Care (UCC) project was to develop a primary care approach for the systematic support of evidence-based, patient-centered treatment.
Heat Exposure and the Risk of Emergency Hospitalization in Germany: Stratified Analyses by Age, Sex, and Diagnostic Group
Kriit HK, Herrmann A, Norris R, Rocklöv J and De Allegri M
Climate change has increased the frequency and intensity of periods of extreme heat, which are associated with elevated mortality. Little is known about the association of emergency hospital admissions with particular risk groups.
Moyamoya Disease: Pathophysiology, Diagnosis, and Treatment
Mertens R, Siebert E, Endres M, Nikolaus M, Danyel M and Vajkoczy P
Moyamoya disease is a cerebrovascular angiopathy that can lead to ischemic and hemorrhagic stroke in both children and adults. Approximately 6 - 10% of all strokes and transient ischemic attacks in childhood are attributable to Moyamoya disease. It is characterized by bilateral stenosis of the intracranial internal carotid arteries, with the formation of collateral vessels. Recent advances in the understanding of genetic causes, pathophysiological mechanisms, and imaging techniques have substantially changed the management of the disease over the past decades.
Clinical Practice Guideline: Colorectal Cancer—Diagnosis, Treatment, Prevention, and Long-Term Follow-Up Care
Ebert MP, Reichermeier S, Klug L, Lynen Jansen P and Pox C
Approximately 24 000 people die of colorectal cancer (CRC) in Germany each year. New developments in prevention, diagnosis, and treatment are improving long-term outcomes. These measures have been incorporated in the updated guideline and are presented here along with the findings of other new randomized controlled trials (RCTs).
Support for Patient-Centered Cardiovascular Risk Counseling With Two Components of the DECADE Intervention: Findings of a Multiregional, Cluster-Randomized Controlled Trial
Tinsel I, Schmoor C, Börger M, Kamp M, Hardt H, Rakebrandt A, Kloppe T, Gräfe W, Kutter S, Riemenschneider H and Maun A
Health-conscious behavior can help prevent cardiovascular diseases. The DECADE intervention ("decision aid, action planning, and follow-up support for patients to reduce the 10-year risk of cardiovascular diseases") is designed to support primary care physicians in cardiovascular risk counseling. We studied the effects of two of its components.
Life Without Health Insurance: Causes, Living Situations, and Medical Care—a Qualitative Study
Heinrichs F, Weckbecker K, Münster E and Kersting C
Internal Medicine Emergencies During the Munich Oktoberfest, 2013–2022
Schlichtiger J, Bogner-Flatz V, Hinzmann D and Brunner S
The Frequency of Inquiries About Suspected Poisoning With Botanical Drugs
Wendt S, Linden D, Prasa D and Franke H
Robot-Assisted Broad Consent Collection: Initial Experience in Practice
Simon JJ, Feder SC, Meyer K, Friederich HC and Hartmann M
Gastric Pneumatosis Due to Immunochemotherapy for Lung Cancer
Töllner W, Walldorf J and Blank V
Calcinosis Cutis in Triple Overlap Syndrome
Ilic M and Schreyer AG
The Survival of Extremely Premature Neonates in Perinatal Care Centers of Different Care Levels: An Analysis from the German Federal States of Thuringia and Saxony
Heimann Y, Giró-Paños Z, Schleußner E and Zöllkau J
The Administrative Prevalence of In- and Outpatient Cruciate Ligament Surgery in Germany
Szymski D, Krutsch W, Weber J, Knapp G, Huber L, Walter N, Heiss C, Alt V and Rupp M
Acute Anuric Kidney Injury Due to Subtotal Renal Artery Occlusion
Hudowenz O, Graßhoff L and Sieren MM