Dtsch Arztebl Int
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Review Meta Analysis
Midclavicular fracture: not just a trivial injury: current treatment options.
Conservative treatment was long recommended for midclavicular fractures because of the excellent results that were reported in the 1960's and 70's. Recently, however, the rucksack bandage has received competition from surgical treatment. The spectrum of operations ranges from classic plate osteosynthesis to intramedullary techniques and angle-stable implants. ⋯ In any case of midclavicular fracture, the type of fracture should be precisely analyzed and an individual treatment strategy should be developed in view of the patient's particular situation. Current studies show with a high level of evidence (level 1) that patients with dislocated fractures benefit from surgery.
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There is current debate on the appropriate type and extent of medical testing for amateur and hobby athletes before they engage in sports. In particular, views diverge on the value of an ECG at rest. ⋯ In accordance with the current European recommendations, and in consideration of the risks of athletic activity, we recommend that all persons participating in sports should undergo a pre-participation examination that includes an ECG at rest. Although primary-prevention campaigns advise physically inactive persons to get regular exercise, prospective studies are still lacking as a basis for recommendations in this group.
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Screening colonoscopy has been offered in Germany since the end of 2002. Our aim was to estimate numbers of colorectal cancers prevented or detected early by screening colonoscopy in 2003-2010. ⋯ Despite limited participation, the German screening colonoscopy program makes a major contribution to prevention and early detection of colorectal cancer.
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The German-language recommendations for the management of postoperative nausea and vomiting (PONV) have been revised by an expert committee. Major aspects of this revision are presented here in the form of an evidence-based review article. ⋯ PONV lowers patient satisfaction but is treatable. The effective, evidence-based measures of preventing and treating it should be implemented in routine practice.