Swiss medical weekly
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Swiss medical weekly · Oct 2010
Randomized Controlled Trial Multicenter Study Comparative StudyShort versus conventional term glucocorticoid therapy in acute exacerbation of chronic obstructive pulmonary disease - the "REDUCE" trial.
International guidelines advocate a 10 to 14-day course of systemic glucocorticoid therapy in the management of COPD exacerbations. The optimal duration of therapy is unknown and glucocorticoids have serious adverse effects. The aim of this trial is to demonstrate non-inferiority of a five-day compared to a 14-day course of systemic glucocorticoids with respect to COPD outcome, thereby significantly reducing steroid exposure and side effects in patients with COPD exacerbations. ⋯ If the strategy of significantly reducing cumulative exposure to glucocorticoids while taking advantage of their beneficial short-term effects proves to be successful, it will warrant a change in common glucocorticoid prescription practice, thereby improving the management of COPD.
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Swiss medical weekly · Jan 2010
Randomized Controlled Trial Comparative StudyFunctional multidisciplinary rehabilitation versus outpatient physiotherapy for non specific low back pain: randomized controlled trial.
In recent decades the treatment of non-specific low back pain has turned to active modalities, some of which were based on cognitive-behavioural principles. Non-randomised studies clearly favour functional multidisciplinary rehabilitation over outpatient physiotherapy. However, systematic reviews and meta-analysis provide contradictory evidence regarding the effects on return to work and functional status. The aim of the present randomised study was to compare long-term functional and work status after 3-week functional multidisciplinary rehabilitation or 18 supervised outpatient physiotherapy sessions. ⋯ Functional multidisciplinary rehabilitation was better than outpatient physiotherapy in improving functional and work status. From an economic point of view, these results should be backed up by a cost-effectiveness study.
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Swiss medical weekly · May 2009
Randomized Controlled Trial Comparative StudyRandomised comparison of complications from three different permanent central venous access systems.
We present a prospective randomised trial comparing complications from three different permanent central venous access systems (PCVAS). ⋯ The polyurethane catheters that ruptured more often had a larger diameter and a thicker wall than the other polyurethane catheters, and were probably subjected to greater shearing between the clavicle and the first rib. Silicone catheters, although thicker and of larger diameter than the two other catheters, seemed more resistant to shearing.
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Swiss medical weekly · Oct 2008
Randomized Controlled TrialThe efficacy of non-pharmacological methods of pain management in school-age children receiving venepuncture in a paediatric department: a randomized controlled trial of audiovisual distraction and routine psychological intervention.
Non-pharmacologic analgesia has been demonstrated to alleviate pain and distress in invasive procedures. Nevertheless, the practice has not been adopted widely in paediatric departments because nurses are often too busy to perform a time consuming procedure. ⋯ Audiovisual distraction was demonstrated to be effective in reducing self-reported pain, improving patient cooperation and increasing success rate in venepuncture procedures and was as successful as routine psychological intervention. It is highly recommended as an effective, labour saving and easy to administer analgesia and should be used to help prevent pain from venepuncture in school age children.
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Swiss medical weekly · Apr 2006
Randomized Controlled TrialPrevalence and influence of diagnostic tests for acute respiratory tract infections in primary care.
General practitioners (GPs) use diagnostic tests to help distinguish between viral and bacterial acute respiratory tract infections (ARTI). We investigated the prevalence of these tests, and how tests are associated with diagnosis, treatment and patient satisfaction. ⋯ Nearly half of these patients with ARTI received a diagnostic test. Older patients, those with higher education and those in more discomfort were more likely to get tests. A positive test was strongly associated with antibiotic treatment.