Med Klin
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Randomized Controlled Trial Comparative Study Clinical Trial
[A structured treatment and educational program for patients with type 2 diabetes mellitus, insulin therapy and impaired cognitive function (DikoL)].
More than 50% of patients with type-2 diabetes mellitus and impaired cognitive function are overtaxed with some topics of established structured treatment and teaching programs for patients with insulin therapy. This leads to substantial deficits in respect of the patients' ability of diabetes self-management (insulin injections, self-monitoring) and the need for help by relatives and social workers. The consequences are an impaired quality of life and a great deal of expense in the welfare system. Since 1996, a specialized structured treatment and teaching program for patients with type-2 diabetes mellitus, insulin therapy, and impaired cognitive function (DikoL) has been developed. Main differences in comparison to established programs were less theoretical topics (no pathophysiology, no insulin action, no complicated calculation of carbohydrate pounds) and more time for practical exercise. In a randomized prospective study, the effectiveness of the DikoL program was evaluated. ⋯ Following the wishes of the majority of diabetes educators as well as diabetologists but also patients' wishes, a specially designed structured treatment and teaching program for patients with type-2 diabetes mellitus, insulin therapy, and impaired cognitive function was designed. DikoL is the first program evaluated in a randomized, prospective trial. It clearly demonstrated a bet-ter outcome for patients with impaired cognitive function in respect of diabetes self-management and satisfaction. With its implementation, patients' quality of diabetes care can be improved in a substantial manner.
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Randomized Controlled Trial Comparative Study Clinical Trial
[A new paracentesis needle for ascites and pleural effusion compared with the venous indwelling catheter. A prospective, randomized study].
Diagnostic or therapeutic paracentesis of ascites or pleural effusions is part of the daily routine on many hospital wards and in outpatient clinics. In Germany, paracentesis is usually performed with angiocaths. However, the therapeutic large volume paracentesis of ascites and paracentesis of pleural effusions with angiocaths is often cumbersome and quite often paracentesis fails, forcing the physician to repuncture. This is mainly due to the fact that angiocaths are not designed for such interventions. ⋯ The paracentesis needle was objectively superior as compared to the angiocath. It might help to avoid additional complications due to repuncture and it will increase the patients' comfort.
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Randomized Controlled Trial Clinical Trial Controlled Clinical Trial
[Iodine therapy for iodine deficiency goiter and autoimmune thyroiditis. A prospective study].
There is epidemiological and clinical evidence that iodine may induce or promote the manifestation of autoimmune thyroiditis. For this reason it is important to know if substitution of alimentary iodine deficiency or iodine treatment of endemic goitre can cause formation of thyroid antibodies. On the other hand the practical importance of this phenomenon should be evaluated. ⋯ Possible antibody reactions have no clinical importance at all. Individual cases must be observed. Low iodine doses should be preferred. Combined iodine/T4 treatment seems to have an advantage regarding immunological thyroidal reactions.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Effect of preventive selenium administration on development of ERCP-induced acute pancreatitis].
Sodium selenite may play a role in reduction of enhanced oxygen free radicals in the early phase of experimental acute pancreatitis. The aim of the study was to determine whether ERCP induced pancreatitis can be used as a human model for early acute pancreatitis and if a prophylactic antioxidant therapy with sodium selenite or a prophylactic antibiotic therapy has a beneficial effect on the clinical outcome in patients with ERCP. ⋯ A prophylactic substitution with sodium selenite or prophylactic antibiotic therapy with metronidazole/ofloxacin has no beneficial effect on the clinical outcome in patients with ERCP.
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Randomized Controlled Trial Clinical Trial
[Selenium administration in sepsis patients].
It has been hypothesized that low serum selenium concentrations, associated with low glutathione peroxidase activities in critical ill patients may contribute to decreased cleavage from free radicals and deteriorate the clinical outcome. ⋯ Selenium substitution significantly improves clinical outcome and reduces the incidence of acute renal failure.