Objective: Emotional distress in cancer patients often goes unnoticed in daily routine; therefore, distress screening is now recommended in many national guidelines. However, screening alone does not necessarily translate into better well-being. We examined whether stepped psychooncological care improves referral to consultation-liaison (CL) services and improves well-being.Methods: In a cluster-randomized trial, wards were randomly allocated to stepped versus standard care. Stepped care comprised screening for distress, consultation between doctor and patient about the patient's need for CL services, and provision of CL service. Primary outcomes Susanne Singer and Helge Danker contributed equally to this work. Protocol paper: Singer et al, Trials, 2014. This paper was prepared according to CONSORT 2010 checklist, extension to cluster randomized trials.

This retrospective study revealed that, of 212 patients with CRC, most had not previously undergone CRC screening in conformity with guidelines. Better patient education by physicians may improve the effectiveness of screening. Appropriate screening measures include fecal occult blood testing and colonoscopy in conformity with guidelines.

Bariatric surgery is an elective intervention, which is also performed in patients with additional risk factors, e.g. elderly patients over 65 years old, in patients suffering from relevant comorbidities and in patients with a body mass index (BMI) greater than 60 kg/m(2). To reduce the perioperative risks comorbidities require optimal adjustment. Specialized centers have reported complication rates below 1 %. Besides leakage, bleeding is the most common surgical complication in bariatric interventions. Bleeding complications occur in up to 4 % of cases but are much more common in redo surgery. For the management of bleeding, the same general rules apply as those for abdominal surgery and at the end of an operation, all bleeding must be under control. To avoid bleeding, sealing devices are widely used during tissue dissection. Stapler line bleeding is the most common form of intraoperative and postoperative bleeding. Special stapler magazines and stapler line reinforcement materials are available to minimize stapler line bleeding. Such devices result in relevant extra costs; however, they should always be generally available and used in patients with an increased risk of bleeding or an increased intraoperative tendency to bleeding.

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Adipositas ist ein weltweites Problem. Die Inzidenz von ?bergewichtigen Patienten ist in allen medizinischen Bereichen zunehmend. Das Patientenklientel mag nicht neu sein, jedoch in Anbetracht der steigenden Anzahl Adip?ser im Allgemeinen und des vermehrten Auftretens extrem ?bergewichtiger mit mehr als 200?kg K?rpergewicht im Speziellen bedarf es eines Konzepts, in dem die medizinische Versorgung f?r den Patienten und f?r das Personal entsprechend strukturiert und dadurch vereinfacht wird. Das Ziel muss sein, f?r den Patienten ein optimales Outcome zu erreichen.