Dtsch Arztebl Int
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The frequency of gender identity disorder is hard to determine; the number of gender reassignment operations and of court proceedings in accordance with the German Law on Transsexuality almost certainly do not fully reflect the underlying reality. There have been only a few studies on patient satisfaction with male-to-female gender reassignment surgery. ⋯ The very high rates of subjective satisfaction and the surgical outcomes indicate that gender reassignment surgery is beneficial. These findings must be interpreted with caution, however, because fewer than half of the questionnaires were returned.
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Randomized Controlled Trial Multicenter Study
The treatment of displaced intra-articular distal radius fractures in elderly patients.
From 2000 to 2012, the annual incidence of inpatient treatment for distal radius fracture in Germany rose from 65 to 86 per 100 000 persons. It is unclear whether open reduction and volar angle-stable plate osteosynthesis (ORIF), a currently advocated treatment, yields a better functional outcome or quality of life than closed reposition and casting. ⋯ The findings with respect to mobility, functionality, and quality of life at 12 months provide marginal and inconsistent evidence for the superiority of volar angle-stable plate osteosynthesis over closed reduction and casting in the treatment of intra-articular distal radius fractures. Primary nonsurgical management is also effective in suitable patients.
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The immunization rates for some diseases, including measles, were so low in Germany in recent years that endemic outbreaks occurred. A finely detailed geographic analysis of immunization rates is necessary for the identification of under-immunized areas. ⋯ High immunization rates were found across Germany for tetanus, pertussis, and poliomyelitis, although the rates in some regions were lower than they should be. Stronger informational efforts must be undertaken to improve the public acceptance of immunization against hepatitis B and measles, so that these immunization rates can rise. For measles in particular, uniform nationwide recommendations might help increase the immunization rate.
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Stroke patients should be cared for in accordance with evidence-based guidelines. The extent of implementation of guidelines for the acute care of stroke patients in Germany has been unclear to date. ⋯ The defined targets were reached for most of the quality indicators. Some indicators, however, varied widely across regional quality assurance projects. This implies that the standardization of care for stroke patients in Germany has not yet been fully achieved.