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Our results support the efficacy and short-term safety of IDD as preoperative chemotherapy. IDD was less well tolerated compared to standard treatment, but improved clinical outcomes in patients with noninflammatory high-risk primary BC.

BackgroundIn a systematic review and meta-analysis we summarize the available evidence on how frequently general practitioners/family physicians (GPs) use pure placebos (e.g., placebo pills) and non-specific therapies (sometimes referred to as impure placebos; e.g., antibiotics for common cold).MethodsWe searched Medline, PubMed and SCOPUS up to July 2018 to identify cross-sectional quantitative surveys among GPs. Outcomes of primary interest were the percentages of GPs having used any placebo, pure placebos or non-specific therapies at least once in their career, at least once in the last year, at least monthly or at least weekly. Outcomes were described as proportions and pooled with random-effects meta-analysis.ResultsOf 674 publications, 16 studies from 13 countries with a total of 2.981 participating GPs (range 27 to 783) met the inclusion criteria. The percentage of GPs having used any form of placebo at least once in their career ranged from 29% to 97%, in the last year at least once from 46% to 95%, at least monthly from 15% to 89%, and at least weekly from 1% to 75%. The use of non-specific therapies by far outnumbered the use of pure placebo. For example, the proportion of GPs using pure placebos at least monthly varied between 2% and 15% compared to 53% and 89% for non-specific therapies; use at least weekly varied between 1% and 3% for pure placebos and between 16% and 75% for non-specific therapies. Besides eliciting placebos effects, many other reasons related to patient expectations, demands and medical problems were reported as reasons for applying placebo interventions.ConclusionHigh prevalence estimates of placebo use among GPs are mainly driven by the frequent use of non-specific therapies; pure placebos are used rarely. The interpretation of our quantitative findings is complicated by the diversity of definitions and survey methods.

The BiClamp procedure proved superior or similar to conventional ligation, particularly with regard to intraoperative blood loss, operating time and postoperative pain, although statistical significance was not attained for postoperative pain. Moreover, BVS was easier to use and more cost effective.

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The Control of Allergic Rhinitis and Asthma Test (CARAT10), developed by Portuguese experts, is the only questionnaire assessing asthma control under additional consideration of a frequently concurrent allergic rhinitis (AR), providing sub-scores for both diseases. Aims of this study were the translation and validation of its German version. Asthma patients both with and without AR were included at three primary care pulmologists´ practices in Southern Germany. After translation process, patients completed the CARAT10, the Asthma Control Questionnaire (ACQ), the Asthma Control Test (ACT), and the Standardised Asthma Quality of Life Questionnaire (AQLQ(S)). Item and scale characteristics as well as measures of reliability and validity of the CARAT10 were determined. A confirmatory factor analysis was conducted to test factorial validity. Data of 213 patients were analysed, 101 (47%) of them with concurrent AR. Missing responses were minimal and unsystematic. Cronbach´s α was 0.87 for the CARAT10 total score (TS) and 0.84 for each sub-score. Spearman´s correlation coefficients for the association of the CARAT10 TS with ACQ, ACT and AQLQ(S) were moderate to high and slightly higher in patients with AR. Higher correlations were found for its lower airway sub-score than the upper airway sub-score (all around 0.8 to all around 0.3). Confirmatory factor analysis confirmed the two-factorial scale structure of the CARAT10, with a two-factor model showing a better fit to the data than a one-factor model. The German version of the CARAT10 is an acceptable, reliable and valid tool. Our results suggest a recommended use in asthma patients with AR.