Validation of a Clinical Instrument for Measuring the Severity of Acute Bronchitis in Children - The BSS-ped.

BACKGROUND: There are no validated standardised clinical procedures for severity measurement of acute bronchitis in children. The "BSS-ped", a short version of the physician-rated assessment scale BSS (Bronchitis Severity Scale), can fill this gap, if it is valid. OBJECTIVE: To examine the scale´s validity. METHODS: Investigations were planned according to classical clinical-psychometric validity criteria including a formal competence evaluation of the scale´s authors and statistical analyses of data from 78 patients aged 1-6 and diagnosed with "acute bronchitis". Cross-validation was provided by analysis of data from 70 children with matching age, sex and diagnosis. All children were examined three times (day 0, 3-5 and 7) using the BSS-ped in addition to other clinical and psychometric monitoring procedures. RESULTS: The evidently high level of expertise of the scale's authors substantiates pronounced content validity and relevance of the BSS-ped and its items. The validity criterion, i.e. to reflect the unidimensional severity of acute bronchitis and its change using the BSS-ped score, was fulfilled. There were substantial correlations with other scales measuring the current health-related quality of life, as well as satisfaction and success of treatment. Severity change prognoses for acute bronchitis under placebo and an active substance were correct. The BSS-ped was found to be a feasible instrument because it can be repeated at short intervals (minute range) without any special technical aids or extended training. CONCLUSION: The BSS-ped is a valid procedure for measuring the severity of acute bronchitis in children.

Negative pressure wound therapy for seroma prevention and surgical incision treatment in spinal fracture care.

To evaluate the clinical use and economic aspects of negative pressure wound therapy (NPWT) after dorsal stabilisation of spinal fractures. This study is a prospective randomised evaluation of NPWT in patients with large surgical wounds after surgical stabilisation of spinal fractures by internal fixation. Patients were randomised to either standard wound dressing treatment (group A) or NPWT (group B). The wound area was examined by ultrasound to measure seroma volumes in both groups on the 5th and 10th day after surgery. Furthermore, data on economic aspects such as nursing time for wound care and material used for wound dressing were evaluated. A total of 20 patients (10 in each group) were enrolled. Throughout the whole study, mean seroma volume was significantly higher in group A than that in group B (day 5: 1·9 ml versus 0 ml; P = 0·0007; day 10: 1·6 ml versus 0·5 ml; P <0·024). Furthermore, patients of group A required more wound care time (group A: 31 ± 10 minutes; group B 13·8 ± 6 minutes; P = 0·0005) and more number of compresses (total number; group A 35 ± 15; group B 11 ± 3; P = 0·0376). NPWT reduced the development of postoperative seroma, reduced nursing time and reduced material required for wound care.

[Screening of emotional and somatic complaints in undergraduate medical students: a longitudinal study]. / Psychische und somatische Beschwerden bei Medizinstudierenden: Eine Längsschnittuntersuchung.

OBJECTIVES: 1) Do easy-to-administer screening tests for anxiety, depression, and somatic complaints detect more abnormal results in medical students than in the "normal" population? 2) Can the complaints already be recognized at the beginning of university studies? 3) Do they occur more seldom in medical students who are related to doctors? METHODS: Study with 146 of 150 enrolled medical students undergoing 2 self-rating scales during the first 3 terms: "Hospital Anxiety and Depression Scale" (HADS-D) and "Gießener Beschwerdebogen GBB" (GBB-24). RESULTS: 1) More abnormal values were measured than in the normal population. 2) The grades of anxiety, depression, and total somatic complaints, but not exhaustion, could be recognized at the start of the first term. 3) Students from medical families showed less anxieties and depressions. Nevertheless, the prevalence is remarkably high. CONCLUSIONS: HADS-D and GBB-24 are efficient aids to early detection of conspicuous emotional and somatic complaints of medical students who did not reduce their symptoms when not being treated.

Negative pressure wound therapy to prevent seromas and treat surgical incisions after total hip arthroplasty.

PURPOSE: The purpose of this study was to evaluate the use of negative pressure wound therapy (NPWT) to improve wound healing after total hip arthroplasty (THA) and its influence on the development of postoperative seromas in the wound area. MATERIALS: The study is a prospective randomised evaluation of NPWT in patients with large surgical wounds after THA, randomising patients to either a standard dressing (group A) or a NPWT (group B) over the wound area. The wound area was examined with ultrasound to measure the postoperative seromas in both groups on the fifth and tenth postoperative days. RESULTS: There were 19 patients randomised in this study. Ten days after surgery, group A (ten patients, 70.5 ± 11.01 years of age) developed seromas with an average size of 5.08 ml and group B (nine patients, 66.22 ± 17.83 years of age) 1.97 ml. The difference was significant (p = 0.021). CONCLUSION: NPWT has been used on many different types of traumatic and non traumatic wounds. This prospective, randomised study has demonstrated decreased development of postoperative seromas in the wound and improved wound healing.

Stop of loss of cognitive performance during rehabilitation after total hip arthroplasty-prospective controlled study.

Prolonged hospitalization is known to be associated with a loss of cognitive performance. Does playing video games (VGs) developed to improve cognitive properties delay this loss or even lead to an increase in cognitive performance? We performed a 10-day longitudinal study of patients who received total hip arthroplasty. We compared 16 patients (6 male) aged 66 ± 9 years (mean ± standard deviation) who played Dr. Kawashima's Brain Training: How Old Is Your Brain? (Nintendo; Redmond, Washington) on a Nintendo DS handheld console with 16 control patients (6 male) aged 69 ± 14 years. We measured cognitive performance 1 day preoperation, as well as on days 2 and 9 postoperation. With the daily exercise of a specific VG by the play group, the patients' fluid intelligence (median intelligence quotient 99-106), working memory capacity, and rate of information processing significantly improved over the course of 7 postoperative days. The cognitive performance of the control group did not increase. However, the memory spans of both groups did not systematically change. Exercise with VGs can prevent the loss of cognitive performance during prolonged hospitalization.

Clinical efficacy of kava extract WS 1490 in sleep disturbances associated with anxiety disorders. Results of a multicenter, randomized, placebo-controlled, double-blind clinical trial.

BACKGROUND: The aim of the present trial was to investigate the efficacy and safety of kava special extract WS 1490 in patients with sleep disturbances associated with anxiety, tension and restlessness states of non-psychotic origin. METHODS: In a multicenter, randomized, double-blind clinical study, 61 patients received daily doses of 200 mg WS 1490 or placebo over a period of 4 weeks. Efficacy was measured by the sleep questionnaire SF-B, the Hamilton Anxiety Scale (HAMA), the Bf-S self-rating scale of well-being and the Clinical Global Impressions (CGI) scale. RESULTS: The confirmatory analysis of the two primary efficacy variables, the differences of sleep questionnaire SF-B sub-scores 'Quality of sleep' and 'Recuperative effect after sleep' after 4 weeks of double-blind treatment compared to baseline, demonstrated statistically significant group differences in favor of kava extract WS 1490 (P=0.007 and P=0.018, respectively). Superior effects of kava extract were also present in the HAMA psychic anxiety sub-score (P=0.002). More pronounced effects with respect to the self-rating of well-being and the global clinical evaluation also indicated superior therapeutic efficacy of kava extract. Safety and tolerability were good, with no drug-related adverse events or changes in clinical or laboratory parameters. CONCLUSIONS: We conclude that sleep disturbances associated with non-psychotic anxiety disorders can be effectively and safely treated with kava extract WS 1490.

Oscillococcinum in patients with influenza-like syndromes

A controlled clinical trial was conducted to assess the effectiveness of Oscillococcinum in the treatment of patients with influenza-like syndromes. 188 patients received the test drug and 184 patients were assigned to the placebo. Data were recorded by the participating physicians at the beginning of the treatment, after 48 hours and after 7-10 days. During the...(AU)