Dtsch Arztebl Int
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There is current debate on the appropriate type and extent of medical testing for amateur and hobby athletes before they engage in sports. In particular, views diverge on the value of an ECG at rest. ⋯ In accordance with the current European recommendations, and in consideration of the risks of athletic activity, we recommend that all persons participating in sports should undergo a pre-participation examination that includes an ECG at rest. Although primary-prevention campaigns advise physically inactive persons to get regular exercise, prospective studies are still lacking as a basis for recommendations in this group.
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Screening colonoscopy has been offered in Germany since the end of 2002. Our aim was to estimate numbers of colorectal cancers prevented or detected early by screening colonoscopy in 2003-2010. ⋯ Despite limited participation, the German screening colonoscopy program makes a major contribution to prevention and early detection of colorectal cancer.
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The Pain-Free Hospital Project was initiated in 2003 with the aim of improving pain management throughout Germany. We assessed the current state of pain management in German hospitals. ⋯ Severe postoperative pain is still too common among hospitalized patients, particularly pain that is induced by movement. Patients being treated on non-surgical wards also often suffer severe pain needlessly. Pain management seems to be worse for non-surgical patients (cancer patients excepted) than for surgical patients: waiting times for medication are longer, and ineffective medications are given more often. On the other hand, a number of hospitals provide positive examples of the potential effectiveness of pain management for both surgical and non-surgical patients.
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Review Comparative Study
The role of vitamin D in cancer prevention: does UV protection conflict with the need to raise low levels of vitamin D?
Vitamin D is essential for life. Part of the body's supply of vitamin D is ingested in food, but UV induced vitamin D synthesis in the body plays an even more important role. UV irradiation is a cause for the currently rising incidence of skin cancer in many countries; on the other hand, Vitamin D might be protective against some cancers. In this paper we summarize the current data on vitamin D and cancer and on the vitamin D status of populations in Europe and discuss whether current recommendations on UV protection require changes. ⋯ More research is needed into the possible protective effects of vitamin D against cancer. Brief, daily UV exposure stimulates vitamin D production and causes negligible skin damage. Raising the vitamin D level even further by extended solar UV exposure or irradiation in a solarium is inadvisable because of the risk of skin cancer. Oral vitamin D supplementation can be considered as an alternative, particularly for persons at high risk, such as the elderly and members of certain ethnic groups.
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Multiple pregnancies have become more common in the industrialized world because of rising maternal ages and advances in reproductive medicine. ⋯ The care of women with multiple pregnancies requires the collaboration of specialists in prenatal medicine, obstetrics, and neonatology as well as a properly functioning integration of outpatient and inpatient care.