Dtsch Arztebl Int
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Randomized Controlled Trial
In-Patient Pulmonary Rehabilitation to Improve Asthma Control.
Despite the availability of effective pharmaceutical treatment options, many patients with asthma do not manage to control their illness. This randomized trial with a waiting-list control group examined whether a 3-week course of inpatient pulmonary rehabilitation (PR) improves asthma control (primary endpoint) and other secondary endpoints (e.g., quality of life, cardinal symptoms, mental stress). The subsequent observational segment of the study investigated the long-term outcome after PR. ⋯ The trial showed that a 3-week course of PR leads to clinically relevant improvement in asthma control and secondary endpoints. Patients who do not achieve control of their asthma despite outpatient treatment therefore benefit from rehabilitation.
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Randomized Controlled Trial
Non-Substance Addiction in Childhood and Adolescence.
Around 5.8% of adolescents and 2.8% of young adults have an Internet-related disorder. These figures underline the widespread concerns in our society regarding the potential dangers and risks associated with Internet and digital media use. ⋯ Internet-related disorders have not yet been conclusively conceptualized and operationalized. Further work is urgently required to refine the concepts of both the illness and and its treatment.
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Randomized Controlled Trial
Pupillometric Monitoring of Nociception in Cardiac Anesthesia.
High-dose opioids are conventionally used for cardiac anesthesia, but without monitoring of nociception. In non-cardiac surgical procedures the intra - operative dose of opioids can be individualized and reduced with pupillometric monitoring of the pupillary pain index (PPI; scale 1-9). A randomized controlled trial was carried out to explore whether pupillometry can be used for nociception monitoring in cardiac anesthesia and whether it leads to opioid reduction. ⋯ Pupillometry is appropriate for nociception monitoring in cardiac anesthesia. Thereby a considerable reduction of intraoperative opioids as well as increased intraoperative hemodynamic stability was achieved and postoperative opioid-induced hyperalgesia was prevented. The consistently low PPI scores, indicating adequate analgesia, suggest that further reduction of opioid doses is feasible.
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Randomized Controlled Trial
Computer-Assisted Orthopedic and Trauma Surgery.
There are many ways in which computer-assisted orthopedic and trauma surgery (CAOS) procedures can help surgeons to plan and execute an intervention. ⋯ Computer-assisted procedures can improve the precision of certain surgical interventions. Particularly in joint replacement and spinal surgery, the research is moving away from navigation in the direction of robotic procedures. Future studies should place greater emphasis on clinical and functional results.
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Randomized Controlled Trial
The Requirement for Closed Reduction of Dorsally Displaced Unstable Distal Radius Fractures Before Operative Treatment.
Dorsally displaced distal radius fractures are generally treated with closed reduction followed by casting. Current evidence suggests that fracture reduction is of no benefit before either conservative or surgical treatment. It has not been studied to date whether the degree of pain suffered by the patient during preoperative casting is any different if the fracture is reduced beforehand. ⋯ This trial shows that dispensing with closed reduction before casting as a preliminary to planned surgery yields no disadvantage. Thus, in the authors' view, routine reduction is not warranted.