Dtsch Arztebl Int
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Review Meta Analysis
Cognitive Reserve and the Risk of Postoperative Cognitive Dysfunction.
Post-operative cognitive dysfunction (POCD) occurs in 10 to 54% of older patients during the first few weeks after surgery, but little is known about risk factors predisposing to POCD. ⋯ Patients with a relatively higher level of education are at reduced risk of POCD. Risk stratification of surgical patients according to educational level may prove useful.
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Randomized Controlled Trial
Should Screening Colonoscopy Be Offered From Age 50?
The introduction of colonoscopic screening in 2002 for persons aged 55 and older was followed by a marked decline in the incidence of colon cancer in the corresponding age groups in Germany. The prevalence of colorectal neoplasia among persons aged 50 to 54 has remained unknown until now. Expert committees currently recommend colonoscopic screening for persons aged 50 and older. This option has been offered since 2014 by the AOK Baden-Württemberg and by Bosch BKK in the framework of their specialized medical care program. ⋯ These findings lend support to the demand that the offer of colonoscopic screening should be extended at least to men aged 50 and above.
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Randomized Controlled Trial
Screening for Bowel Cancer: Increasing Participation via Personal Invitation.
Participation rates in bowel cancer screening programs in Germany continue to be low. In a model project, a logistically simple procedure for inviting patients to participate was tested as a means of increasing participation. ⋯ Targeted invitations can markedly increase participation rates in cancer screening. Written invitations to undergo stool testing for blood should be accompanied by an actual test. Further trials should also include information about the number of adenomas and carcinomas detected by screening.
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In 0.5-4% of pregnancies, the prospective mother sustains a primary infection with human cytomegalovirus (HCMV). An HCMV infection of the fetus in the first or second trimester can cause complex post-encephalitic impairment of the infant brain, leading to motor and mental retardation, cerebral palsy, epilepsy, retinal defects, and progressive hearing loss. ⋯ In the absence of an active vaccine against HCMV, counseling about hygienic measures may currently be the single most effective way to prevent congenital HCMV infection. Moreover, HCMV serologic testing is recommended in the guideline of the Association of the Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, AWMF). Further randomized trials of treatment with HIG and with valaciclovir are urgently needed so that the options for the prevention and treatment of congenital HCMV infection can be assessed.
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Persons with low health literacy have difficulty dealing with the health care system and understanding health-related information. Studies from multiple countries have shown that low health literacy negatively affects health, health-related and illness-related behavior, and the utilization of health care resources. The data available till now on health literacy in Germany have been sparse. The goal of this study is to acquire representative data on the health literacy of the German population. ⋯ The low health literacy of many Germans can impair communication between doctors and patients and exacerbate existing problems in health policy. In the future, greater effort will have to be made to foster health literacy, make health-related information for patients easier to understand, and intensify research in the field of health literacy.