Dtsch Arztebl Int
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Lung transplantation is the treatment of choice for end-stage nonmalignant lung disease. It has become a routine procedure through advances in donor lung preservation, extracorporeal membrane oxygenation, immunosuppression, intensive care medicine, and follow-up care. ⋯ Despite all the advances in lung transplantation, acute and - above all - chronic graft dysfunction still pose a major challenge for large-volume transplantation centers. Immunosuppression that is individually tailored to prevent both graft rejection and infection is important for these patients' long-term survival. Xenotransplantation and so-called lung bioengineering may become available in the future as alternatives to allotransplantation.
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Randomized Controlled Trial
App-Based Psychotherapy of Panic Disorder with Self-Guided Exposure in Virtual Reality—a Randomized, Controlled Trial.
Patients with panic disorder often suffer from temporary unavailability of care. The smartphone app Invirto (IVT) provides a digital treatment for panic disorder involving self-guided exposure in virtual reality. In this trial, we studied the efficacy of Invirto. ⋯ A digital treatment with virtual exposure can lessen anxiety, panic, and depressive symptoms and improve mental flexibility. In further studies, IVT should be compared with an active control group.
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Meta Analysis
Weaning From Tobacco with Nicotine or Varenicline in Severe and Mild Tobacco Dependence—Findings of a Meta-Analysis.
Systematic reviews have documented the beneficial effects of bupropion, cytisine, nicotine, and varenicline as aids to permanent smoking cessation. We investigated the question whether the effect of treatment depends on the severity of tobacco dependence. ⋯ The benefit of varenicline and nicotine as aids to smoking cessation is independent of the severity of tobacco dependence.
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Approximately 1.4 % of the German population aged 35 to 74 suffers from glaucoma, which is one of the more common causes of blindness. The only evidence-based treatment option at present is lowering the intraocular pressure. Modern minimally invasive surgical procedures hold out the prospect of lowering the intraocular pressure without the risk of serious complications. ⋯ There are robust data documenting the effect of iStent and Hydrus Microshunt in lowering the intraocular pressure and lessening the need for eyedrops. High-quality controlled trials are still needed to test the efficacy of other procedures.
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Practice Guideline
Clinical Practice Guideline: The Diagnosis and Treatment of Osteoporosis.
Osteoporosis is a common disease that affects approximately 6 million people in Germany alone. Osteoporotic fractures impair the quality of life and may make independent living impossible. Recommendations on the diagnosis and treatment of osteoporosis are indispensable for the effective care of this large group of patients. ⋯ Prerequisites for the optimal treatment of patients with osteoporosis include a correct diagnosis and interdisciplinary and interprofessional collaboration to determine and provide the proper treatment. 71% of persons with osteoporosis in Germany are still untreated, and this gap must be closed.