Deutsches Arzteblatt International德国医师报国际版
Deutsches Arzteblatt International(英文缩写 DTSCH ARZTEBL INT),ISSN 1866-0452,eISSN 1866-0452,中文译名:德国医师报国际版 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-11-01 至 2026-10-31，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 8.251 | Q1 |
| 2022 | 7.700 | Q1 |
| 2023 | 6.500 | Q1 |
| 2024 | 7.100 | Q1 |
| 2025 | 8.700 | Q1 |
Deutsches Arzteblatt International 最新收录文献
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1. Corneal Opacification: Diagnosis, Incidence, and Strategies for Keratoplasty.
PMID:日期:2026-11-27Corneal opacification has many causes; most commonly, diseases or injuries of the corneal endothelium lead to opacification and swelling. Corneal opacification usually manifests itself with painless loss of visual acuity and heightened sensitivity to glare. It can be treated surgically with layer-specific lamellar techniques of corneal transplantation (keratoplasty) that have become established in recent years. This narrative review is based on publications retrieved by a search in Medline, EMBASE, and the Cochrane Library for relevant clinical trials, systematic reviews, and meta-analyses of the different transplantation techniques. For endothelial diseases, which account for 55% of the nearly 9000 corneal transplantations performed in Germany every year, Descemet's membrane endothelial keratoplasty (DMEK) is associated with more rapid visual rehabilitation and a lower risk of rejection (2-3% vs.11-29%, according to a meta-analysis of 50 cohort studies) than penetrating keratoplasty (PKP). For opacification that is restricted to the stroma, deep anterior lamellar keratoplasty (DALK) has the advantage of full preservation of the recipient endothelium, so that endothelial rejection cannot occur, but it is a technically demanding procedure. In bilateral limbal stem-cell deficiency, PKP, including allogeneic limbal tissue (limbo-keratoplasty), can be effective but necessitates permanent systemic immunosuppression. Modern methods of keratoplasty enable targeted transplantation of only the affected corneal layers. As a result, postoperative complications are less common, and the transplants survive longer.
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2. Indications for Dose Adjustment of Thyroid Hormones in Older Patients.
PMID:日期:2026-11-13Thyroid dysfunction is common in older people (persons aged 65 and above). A meta-analysis of data from European countries revealed a 4.1% prevalence of undiagnosed subclinical hypothyroidism. It was found in a primary care study from the United Kingdom that approximately 10 percent of people over age 70 were under treatment for hypothyroidism. This narrative review is based on findings in relevant publications retrieved by a PubMed search and on the guidelines of the European Thyroid Association and the American Thyroid Association. Overtreatment with levothyroxine increases the risk of cardiovascular, cognitive, and skeletal complications (hazard ratio 1.37-2.02). Randomized controlled trials have not shown that treatment with levothyroxine (T4) improves presumed symptoms of hypothyroidism, body weight, or fatigue. In patients who are now taking levothyroxine, lowering the dose or stopping the drug should be considered; in older patients, the target range for thyroid-stimulating hormone (TSH) should be 4-10 mU/L. After levothyroxine is stopped, some patients remain euthyroid; in the absence of an indication, gradual tapering may be considered. Levothyroxine should not be given over the long term to patients with thyroid nodules. Subclinical hyperthyroidism in older people is associated with clinically relevant risks, particularly atrial fibrillation and bone fractures, and should therefore be treated. Its most common cause, however, is levothyroxine treatment that is either not indicated or improperly dosed. While overt hypothyroidism and hyperthyroidism must be treated at any age, the need to treat subclinical hypothyroidism should be individually assessed; subclinical hyperthyroidism, by contrast, generally warrants treatment given its associated risks. In view of the risks of inadequately treated hyperthyroidism and excessively dosed levothyroxine, physicians should regularly review the indication for treatment, the dosage, and the possibility of lowering the dose or discontinuing the drug.
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3. Antibiotic Treatment of Severe Infections with Multiresistant Bacteria.
3. 多重耐药菌所致严重感染的抗生素治疗PMID:日期:2026-11-13Approximately 10 000 people die in Germany each year because of infections with multidrug-resistant organisms (MDRO) such as carbapenem-resistant Enterobacterales (CRE), difficult-to-treat resistant Pseudomonas aeruginosa (DTR-PA), carbapenem-resistant Acinetobacter baumannii (CRAB), methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE). Such infections are a diagnostic and therapeutic challenge. This clinical practice guideline contains evidence-based recommendations for the antibiotic treatment of severe MDRO infections. This guideline is based on findings in publications retrieved by a systematic search in PubMed, Embase, and the Cochrane Library. The evidence was evaluated according to the GRADE system, and a structured nominal group process was carried out under moderation by the Association of the Scientific Medical Societies in Germany (, AWMF). In cases of suspected MDRO, the species of the pathogen and its MDRO-defining resistance should be identified and confirmed, and sensitivity to other antibiotics should be tested. In cases of severe Gram-negative MDRO infection, metallo-β-lactamases must be either detected or ruled out. Treatment tailored to the pathogen and its sensitivity pattern increases the likelihood of success and lowers selection pressure that can lead to the development of resistance. For MDRO not involving metallo-β-lactamase, the drugs of first choice are ceftazidime-avibactam, meropenem-vaborbactam, and imipenem-relebactam; for MDRO with metallo-β-lactamase or drug resistance, cefiderocol or aztreonam-avibactam may be considered. Ceftolozan-tazobactam, ceftazidime-avibactam, imipenem-relebactam, and cefiderocol are suitable for DTR-PA; ceftolozan-tazobactam is the preferred choice, while cefiderocol should be reserved for metallo-β-lactamase-producing strains. For CRAB, cefiderocol is recommended; sulbactam-durlobactam plus a carbapenem is an alternative that is not approved in Europe. MRSA bloodstream infections should be treated with intravenous daptomycin or vancomycin, and MRSA pneumonia with linezolid or vancomycin. For VRE bloodstream infections, linezolid or daptomycin at a dosage of 10-12 mg/kg is indicated. The treatment should be tailored in consideration of the site of infection, the antibiotic sensitivity profile, the resistance mechanism, and the clinical situation. New reserve antibiotics should be used selectively and in the framework of antimicrobial stewardship.
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4. The Detection of Atrial Fibrillation by Implantable Event Recorders: A Study of Patients Who Have Had a Cryptogenic Stroke.
PMID:日期:2026-11-13Arial fibrillation (AF) plays a role in approximately one-third of ischemic strokes. In embolic strokes of undetermined source (ESUS), paroxysmal atrial fibrillation often escapes detection; if detected, it could be an indication for oral anticoagulation. In the ARTESiA trial, the absolute benefit of anticoagulation was higher in patients who had already had a stroke or transient ischemic attack (TIA) than in those who had not. We retrospectively analyzed data from 233 consecutive ESUS patients at the Jena University Hospital who had received an implanted loop recorder (ILR) over the period 2021-2025. We additionally provide a narrative review on the detection rates associated with various monitoring strategies based on pertinent publications that were retrieved by a literature search. The 12-month detection rate of paroxysmal AF was 24.0% (56/233, 95% confidence interval [19.0; 29.9]). 73.2% of the initial detections were within the first 90 days. All patients in whom AF was detected were orally anticoagulated. The 12-month detection rate was higher than in the CRYSTAL-AF trial (12.4%) and the PER-DIEM trial (15.3%), but lower than was reported by Pikija et al. (31.3%). The cutoff values with the highest positive predictive value were a stroke risk analysis (SRA) index of 2 or above (38.4%) and age 75 or above (37.9%). Early, risk-adapted diagnostic testing with ILR in selected ESUS patients can detect clinically relevant AF. Advanced age and an elevated SRA index may be useful patient selection criteria. A robust number needed to treat (NNT) for the ILR strategy cannot be derived from the available one-armed registry data. The indication for ILR should be linked to its therapeutic relevance, the probability of detecting AF, and the individual hemorrhagic risk.
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5. The Quality and Perception of Preoperative Informed-Consent Discussions with Older Patients: A Questionnaire From Both the Patients' and the Physicians' Perspectives.
5. 老年患者术前知情同意讨论的质量与感知：基于患者和医生双重视角的问卷调查PMID:日期:2026-10-30Informed consent requires the provision and comprehension of adequate information, as well as autonomous decision-making by the patient. We studied whether routine preoperative informed-consent discussions fulfill these prerequisites, and to what extent patients and physicians differ in their assessments of the informed-consent process. In a single-center observational study, we asked patients aged 65 and above about the information they had been given, their comprehension of it, and their decision-making autonomy, as well as their personal preference for degree of participation and their subjective need for autonomy. Their physicians were asked to rate the informed-consent discussions that they had conducted. 111 patients and 37 physicians were questioned. Mean values given by the patients preoperatively (out of 100 points) were 84.9 points for information, 77.8 points for comprehension, and 80.2 points for autonomy. The same patients, however, rated their informedness and comprehension markedly lower when asked again after surgery (77.7 and 50.2 points, respectively). Health competence was generally low; higher values were associated with better subjective preoperative informedness (b = 1.943; R² = 0.173) and comprehension (b = 2.526; R² = 0.228; p < 0.001 for both). Physicians tended to overestimate their patients' health competence and to underestimate their need to be informed. The older patients preoperatively rated all three prerequisites for informed consent in the top fifth of a 0-100 scale but assessed the informed-consent discussion much more critically when asked again after surgery. Patients' and physicians' assessments differed as well. These findings underscore the need for structured informed-consent discussions that are better aligned with patient-relevant endpoints while also taking account of the fact that older patients often have reduced health competence.
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6. Polygenic Risk Scores: Towards Clinical Application.
PMID:日期:2026-10-30Common diseases are largely caused by the combined contributions of genetic and environmental risk factors. On the genetic side, numerous variants contribute to disease susceptibility, resulting in a substantial polygenic component of disease risk. Many such variants have already been identified. Polygenic risk scores (PRS), which aggregate the effects of these variants, enable more precise estimation of an individual's disease risk. We review the current state of bench-to-bedside translation of PRS. This review is based on publications retrieved by a selective PubMed literature search using predefined search terms relevant to PRS. Studies across a range of diseases have shown that PRS can markedly influence the assessment of disease risk, enabling the identification of individuals at high risk. The predictive value of PRS can be improved by integrating them into established clinical risk models; this is the area of application in which the implementation of PRS in clinical practice is currently most advanced. For example, studies on coronary heart disease (CHD) and on breast and pancreatic cancer have shown that integrating PRS into clinical risk models changes personalized recommendations for primary and secondary prevention. Depending on the study, this affects 24% (CHD) to 25% (breast cancer) of individuals in the respective clinical risk groups. A major limitation is that most PRS are based on data from European populations, and their predictive value may be lower in individuals of other ancestral backgrounds. Moreover, quality standards must be established to ensure that the potential of PRS can be effectively translated into routine clinical practice. As genetic data continue to grow, the predictive value of PRS is expected to increase further. PRS are therefore likely to become an integral component of risk prediction in preventive and precision medicine.
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7. Sex Differences in Suicide Mortality: Epidemiology, Modifying Factors, and Clinical Implications. A Narrative Review.
PMID:日期:2026-10-30In Western industrialized nations, the sexes differ in suicide mortality and the prevalence of diagnosed depression. Men have a higher mortality from suicide than women (figures for Germany, 2024: 18.2 vs. 6.9 per 100 000), but the 12-month prevalence of clinically diagnosed depression in women is double that in men (10-12% vs. 5-6%). This situation has been called the sex-suicide paradox. In this article, we present a structured analysis of the relevant sex-specific epidemiology and the modifying factors that account for these findings. This narrative review was created according to the SANRA recommendations on the basis of publications retrieved by a selective search in the PubMed and Cochrane Library databases and the cause-of-death statistics of the German Federal Statistical Office (2000-2026). In 2024, the suicide rate in Germany was 18.2 per 100 000 men (n = 7414) and 6.9 per 100 000 women (n = 2958). The relative risk for suicide in men is higher by a factor of 2.6 (95% CI: [2.5; 2.8]). Affective disorders are associated with ca. 90% of all suicides, although psychological autopsy studies are subject to methodological limitations, including recall bias. Men over age 85 are particularly vulnerable, with a suicide rate of 45.7 per 100 000. Modifying factors contributing to this sex disparity include the choice of more lethal means of suicide (e.g., hanging, which accounts for 50.5% of male suicides) and an often unrecognized, externalizing depression in men. It may be possible to lower mortality from suicide in men through greater sensitivity for sex-specific symptomatic presentations, greater attention to somatic risk factors in old age, and implementation of low-threshold, sex-sensitive preventive measures.
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8. Same-Day Discharge Versus Overnight Stay After Catheter Ablation: An Observational Matched-Cohort Study on Safety and Feasibility.
PMID:日期:2026-10-30Catheter ablation is an established therapy for arrhythmias. As the incidence of atrial fibrillation (AF) rises, the associated burden on the health-care system is expected to increase. Same-day discharge (SDD) may help optimize resource utilization and increase patient comfort and satisfaction. Consecutive patients undergoing SDD electrophysiology procedures were prospectively enrolled in the study and compared in a non-randomized manner with consecutive overnight stay (ONS) patients who were matched to them according to procedure type. SDD patients were evaluated on the day after the procedure. SDD Patients who were not discharged on the day of the procedure were excluded. Baseline, periprocedural, and 30-day outcomes were documented and compared. 100 patients underwent SDD electrophysiology procedures from September 2022 to March 2025. The SDD patients were younger and had a lower prevalence of coronary artery disease and chronic kidney disease than their counterparts in the ONS cohort. The most common procedure was AF ablation. Procedural complications arose in 2% (95% confidence interval: [0.6; 7.0]) vs. 6% [2.8; 12.5] in SDD and ONS patients, respectively, p =0.279. Complications up to the day of discharge, or up to the evaluation on post-procedure day 1 in the SDD group were reported in 10% [5.5; 17.4] and 17% [10.9, 25.6] of patients, respectively, p = 0.214. Complications were identified on post-procedure day 1 in 8 SDD patients, none of whom needed to be readmitted to the hospital. The numbers of emergency room consultations, unplanned outpatient visits, and rehospitalizations were similar in the two groups. In a subsequent analysis from January to May 2026, 85.8% of patients scheduled for SDD ablation were successfully discharged on the day of the procedure. In this prospective study, SDD after electrophysiology procedures was found to be a safe alternative to ONS in selected patients. None of the patients who were discharged on the same day as the procedure needed to be rehospitalized on the day after.