Dtsch Arztebl Int
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Review Meta Analysis
Early orthogeriatric treatment of trauma in the elderly: a systematic review and metaanalysis.
More than 125,000 hip fractures occur in Germany every year, with a one-year mortality of about 25%. To improve treatment outcomes, models of cooperation between trauma surgery and geriatrics have been developed. Their benefit has not yet been unequivocally demonstrated. ⋯ Only a few randomized controlled trials of early orthogeriatric treatment have been performed, and these trials are of limited quality. Due to low case numbers, a benefit from interdisciplinary orthogeriatric treatment could not clearly be demonstrated. Further trials are needed.
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Generalized anxiety disorder (GAD) is a common and serious disease with a lifetime prevalence of 4.3% to 5.9%. It is underdiagnosed in primary care. ⋯ The treatment of GAD with CBT and drugs is evidence-based and has a good chance of improving the manifestations of the disorder.
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Tinnitus is defined as the perception of sound in the absence of a corresponding external acoustic stimulus. It is a common problem that markedly impairs the quality of life of about 1% of the general population. ⋯ There are many ways to treat chronic tinnitus, and new treatments are now being developed. As tinnitus has many causes and can be associated with many different comorbid disturbances, multidisciplinary diagnostic evaluation and treatment are important. For many tinnitus patients, long-term therapeutic success depends on the maintenance of a therapeutic relationship with the treating physician, so that the physician and the patient can work together to give careful consideration to each newly proposed diagnostic test or treatment step.
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The prevalence of dissociative seizures is between 2 and 33 sufferers per 100,000 persons. 70% of sufferers are women. Dissociative seizures markedly impair quality of life. Their close superficial resemblance to epileptic seizures makes them hard to diagnose. ⋯ When the diagnosis of dissociative seizures has been made, psychotherapy is indicated, possibly in combination with psychoactive medication, in the setting of long-term treatment provided in collaboration by the neurologist, psychiatrist, psychotherapist, and family physician. Further randomized trials are needed to determine which treatments are best for which subgroups of patients.
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Multicenter Study
Delays in starting morning operating lists: an analysis of more than 20,000 cases in 22 German hospitals.
Delays in the start of the first operation of the day often lead to conflicts among the involved physicians and nurses. Data on such delays have already been published for individual hospitals, but robust comparative data from a large number of institutions have not been available till now. ⋯ The processes for the first operation of the day are not optimally structured in the hospitals whose cases were analyzed in this study. Delayed starts were common.