Dtsch Arztebl Int
-
Review Comparative Study
Randomized controlled trials: part 17 of a series on evaluation of scientific publications.
In clinical research, randomized controlled trials (RCTs) are the best way to study the safety and efficacy of new treatments. RCTs are used to answer patient-related questions and are required by governmental regulatory bodies as the basis for approval decisions. ⋯ RCTs cannot yield reliable data unless they are planned, conducted, analyzed, and reported in ways that are methodologically sound and appropriate to the question being asked. The quality of any RCT must be critically evaluated before its relevance to patient care can be considered.
-
110 000 to 140 000 people die in Germany each year of tobacco-related diseases. Thus, measures should be taken to lower the number of persons who start smoking, encourage smokers to stop, and keep those who have stopped from starting again, in order to achieve a sustained benefit in public health. ⋯ Smokers who decide to quit can benefit from their doctors' support. Physicians should be taught about tobacco dependency and how to treat it as part of their undergraduate medical education, residency training, and continuing medical education.
-
In Germany, lung cancer causes more deaths than any other malignant disease. Its main etiology is smoking, but other risk factors need to be considered as well. The morphological, molecular and biological phenotype is complex and should no longer be just categorized as either small-cell or non-small cell lung cancer. ⋯ The morphological and molecular classification of lung cancer is undergoing a re-evaluation which will lead to more accurate assessment of individual prognoses and to improved prediction of the response to specific treatment regimens.
-
Review Comparative Study
Bilateral endoprosthetic total hip or knee arthroplasty.
More than 300 000 joint replacement operations are performed in Germany every year, and the number is rising. In this article, we consider the question of simultaneous bilateral joint replacement at the hips or knees. Such procedures are indicated in patients suffering from bilateral, symptomatic arthrosis. ⋯ Simultaneous bilateral hip arthroplasty is safer for the patient and facilitates rehabilitation, regardless of the patient's age and ASA status (ASA, American Society of Anesthesiologists). With regard to the knees, there are two additional issues, namely the more frequent need for transfusion and somewhat higher mortality of a simultaneous bilateral procedure. Therefore, we recommend simultaneous bilateral knee arthroplasty only for patients in ASA classes 1 and 2. Simultaneous bilateral arthroplasty of either the hip or knee incurs lower costs than two separate operations.
-
Epidemic keratoconjunctivitis (EKC) is a highly contagious infection of the ocular surface. 316 cases were diagnosed in Germany in the first 8 months of 2010, corresponding to a 300% increase above the typical figures for recent years. This outbreak motivates us to present the current recommendations concerning EKC. ⋯ The first priority in the treatment of patients with definite or suspected EKC is the rigorous application of hygienic measures in medical facilities, particularly because there is still no effective drug treatment for this disease. No virostatic agent has yet been demonstrated to influence its course, either subjectively or objectively.