Dtsch Arztebl Int
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Review Meta Analysis
The effect of the WHO Surgical Safety Checklist on complication rate and communication.
In 2009, the World Health Organisation issued a worldwide recommendation for the use of its Surgical Safety Checklist in all operative procedures. In this review, we present the available data on the implementation of this checklist and its effect on perioperative morbidity and mortality and on operating-room safety culture. We also survey the experience with the checklist to date and give some recommendations for its practical implementation. ⋯ These results support the WHO's recommendation to use the Surgical Safety Checklist in all operative procedures. The checklist should be understood not merely as a list of items to be checked off, but as an instrument for the improvement of communication, teamwork, and safety culture in the operating room, and it should be implemented accordingly.
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In Germany at present, 64% of women and 59% of men who receive a diagnosis of cancer are still alive five years later. 45% of men and 57% of women with cancer are still of working age. Cancer can markedly harm their ability to work. ⋯ Most cancer patients of working age go back to work, but the percentages vary widely from one country to another, perhaps reflecting differences in social systems.
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Review Meta Analysis
Acute traumatic coagulopathy in severe injury: incidence, risk stratification, and treatment options.
Clinical observation and research findings show that acute traumatic coagulopathy (ATC) is a major factor that must be addressed in the care of severely injured patients. In this review article, we discuss the incidence and causes of ATC, the potential means of early risk stratification for it, and recommendations for its treatment. ⋯ ATC, a condition associated with increased morbidity and mortality, is seen on admission in one out of four patients with major trauma. The main causes of ATC are tissue damage, hypoperfusion, hemodilution, hypothermia, acidosis, and inflammation. It may be possible to identify patients at risk for ATC early on through the use of rapidly calculable, predictive numerical scales (McLaughlinScore, TASH, and ABC), laboratory tests, and imaging studies (FAST and CT). Acute treatment is focused on the control of bleeding and support of the coagulation system according to the current guidelines. Patients at high risk may benefit from a balanced transfusion strategy. Innovative strategies currently under study include point-of-care-guided treatment and coagulation-factor-concentrate-based treatment.
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Review Meta Analysis
The effect of overweight and nutrition on prognosis in breast cancer.
Breast cancer is the most common cancer in women. Body weight and nutrition are known to play an important role in its pathogenesis. The question thus arises whether lifestyle factors might influence the prognosis of breast cancer, potentially offering new approaches for secondary prevention. ⋯ The intervention trials yielded negative results. Nevertheless, in view of the methodological difficulties in this area of research and the overall life situation of women with breast cancer, the authors recommend a health-promoting lifestyle with avoidance of overweight and a low-fat diet rich in fruit, vegetables, and fiber.
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Review Meta Analysis
Mild cognitive impairment and dementia: the importance of modifiable risk factors.
Mild cognitive impairment (MCI), a common condition among the elderly, is defined as a deterioration of memory, attention, and cognitive function that exceeds what would be expected for the individual's age and level of education, yet does not interfere significantly with the activities of daily living. MCI may be a precursor of dementia; the rate of transition from MCI to dementia is 10% to 20% per year. The role of somatic diseases and modifiable risk factors in MCI and dementia needs further study. ⋯ Modifiable risk factors for MCI should be sought (at the very latest) in persons who already have MCI, as their optimal treatment may improve these patients' cognitive performance or keep the existing deficits from progressing.