Dtsch Arztebl Int
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Multicenter Study
The timing of surgery for undescended testis - a retrospective multicenter analysis.
n Germany, it is recommended that the surgical treatment of an undescended testis should be carried out between the ages of 6 months and 1 year to lower the risks of subfertility and testicular carcinoma. Although this recommendation has appeared in the German guidelines from 2007 onward, orchidopexy is still frequently performed at later ages. ⋯ Most of the patients studied had surgery at a later age than recommended. Adherence to the guidelines in this respect is nonetheless relatively good in Germany compared to other countries, as studies from abroad have yielded findings that are just as bad or worse.
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The increasing implantation rates of total hip and knee prostheses have been accompanied by a corresponding rise in periprosthetic fractures (PPF), most often affecting the femur. ⋯ The treatment of periprosthetic fractures requires competence, not just in osteosynthetic techniques, but also in endoprosthesis implantation and revision. Careful preoperative planning to select the proper treatment is essential, and the necessary equipment must be on hand.
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Infants, toddlers, and children of primary-school age without any special risk factors generally have three to ten febrile respiratory infections per year. Most such infections are of viral origin and self-limiting, but viral infection is often hard to distinguish from bacterial infection. The use of a multiplex polymerase chain reaction (PCR) to detect viruses in respiratory secretions is potentially beneficial, as it might help physicians avoid giving antibiotics unnecessarily. ⋯ The detectability of viral nucleic acids is an important contribution to the diagnostic assessment of children with severe respiratory infection. For these highly sensitive diagnostic tests to be used optimally, primary viral infections must be distinguished from bacterial superinfections.