Dtsch Arztebl Int
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Randomized Controlled Trial Multicenter Study
The effect of specialized cancer treatment centers on treatment efficacy in Hodgkin's lymphoma.
The presumed benefits of centralization and minimum case numbers often guide health-policy decisions, but these benefits remain inadequately documented, particularly in oncology. In this study, we aim to measure the effect of the type of treatment center and/or the number of patients treated in it on the outcome of patients with Hodgkin's lymphoma. ⋯ The type of center and the minimum number of patients treated in a center have no impact on the treatment outcome of patients with Hodgkin's lymphoma in Germany. In all GHSG centers, regardless of type, the quality standards for successful treatment are apparently met on all levels of patient care.
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Foreign-body ingestion is a common event most often seen in children from 6 months to 6 years of age. In adults, foreign bodies are usually ingested accidentally together with food. This happens more commonly in persons with certain pathological changes of the gastrointestinal tract. ⋯ Most patients can be treated conservatively by observation alone, but there should be a low threshold for deciding to proceed to endoscopic retrieval. Surgery is reserved for complicated cases.
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Hallux valgus is the commonest forefoot deformity, with an estimated prevalence of 23% to 35%. It causes symptoms on the medial edge of the foot, the sole, and the small toes. Non-operative treatment may alleviate symptoms but does not correct the deformity of the big toe. Surgery is indicated if the pain persists. The correct operation must be selected from a wide variety of available techniques. ⋯ The clinical outcome of present treatments seems to be good in most cases, but large-scale randomized trials are still needed to verify the efficacy of the wide variety of operations and fixation techniques that are currently being offered.