Dtsch Arztebl Int
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Practice Guideline
The Diagnosis and Treatment of Peripheral Arterial Vascular Disease.
In peripheral arterial occlusive disease (PAOD), arterial stenosis or occlusion impairs perfusion in the territory of the distal portion of the aorta and the iliac and leg arteries. In Germany, the prevalence of PAOD rises with age, reaching 20% among persons over age 70. ⋯ The diagnostic assessment of PAOD is based on physical examination, measurement of the ankle-brachial index (ABI), and duplex ultrasonography. Acetylsalicylic acid and statins are indicated for patients with symptomatic PAOD. Endovascular procedures should be used if indicated. Randomized studies are needed to provide better evidence on many open questions in the treatment of PAOD.
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In 2001, calculations in models based on atomic bomb survivors indicated that children exposed to ionizing radiation by computed tomography (CT) would be expected to have an increased risk of cancer. This led to the issuance of new recommendations in Germany concerning CT in children. ⋯ In view of the risks, children should undergo CT only for the indications listed by the German Commission on Radiological Protection (Strahlenschutzkommission). Further epidemiological studies are needed for estimation of the risk associated with the use of newer CT technology.
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Data from three representative health examination surveys in Germany were analyzed to examine secular trends in the prevalence and magnitude of cardiometabolic risk factors. ⋯ The cardiometabolic risk profile of the German adult population as a whole improved over a period of 20 years. Further in-depth analyses are now planned.
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Cardiovascular disease continues to be the single most common cause of death and to account for the largest single portion of treatment costs in Germany. Reliable data on regional differences in the frequency of cardio - vascular disease are important for the planning of targeted care structures and preventive measures. ⋯ There are relevant differences among the German federal states in the lifetime prevalence of major cardiovascular disease, which are only partly accounted for by differences in age and sex distribution, socioeconomic status, and community size.