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Nunziata F, De Felicis D, Donghi M, Bemporad E, Capone B, Palumbo G, Rotter G. Structural segregation in GSR from mercuric primers. A preliminary study. Forensic Sci Int 2024; 355:111931. [PMID: 38232575 DOI: 10.1016/j.forsciint.2024.111931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 12/27/2023] [Accepted: 01/10/2024] [Indexed: 01/19/2024]
Abstract
Since the second half of the XX century, primer mixtures based on mercury fulminate have become a rare occurrence on small ammunition markets in Western Europe and North America. As a consequence, Hg-containing gunshot residue (GSR) particles have not been as deeply investigated as residues from lead-based primer mixtures. As a matter of fact, no mention of GSR particles from mercuric primers is made by the current ASTM standard procedure for gunshot residue analysis. However, those laboratories dealing with ammunition and firearms produced in Eastern Europe or Asia still have a forensic interest in Hg-containing GSR. In this paper, a brief description of chemical composition and inner morphology of GSR particles from three different mercuric primers is reported. Regarding composition, arguments are given to promote SbSnHg residues to Characteristic of GSR particles when mercuric primers are discharged. From a morphological point of view, presence of inner nodules and other inhomogeneities were shown in GSR particles milled in a FIB/SEM. Moreover, mercury vaporization under the electron beam was observed for a particle reduced to a lamella. Mercury evanescence in GSR was interpreted in terms of mercury segregation during particle formation and higher mobility of Hg atoms in presence of defects (vacancies) in a strained lattice.
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Affiliation(s)
- Felice Nunziata
- Consiglio Nazionale delle Ricerche, Istituto di Scienze e Tecnologie per l'Energia e la Mobilità Sostenibili (STEMS), Via Marconi 4, 80125 Napoli, Italy.
| | - Daniele De Felicis
- Università degli studi Roma Tre, Dipartimento di Ingegneria Civile, Informatica e delle Tecnologie Aeronautiche, Via Vito Volterra 62, 00146 Roma, Italy
| | - Matteo Donghi
- Arma dei Carabinieri, Reparto Investigazioni Scientifiche, Parco Ducale 3, 43120 Parma, Italy
| | - Edoardo Bemporad
- Università degli studi Roma Tre, Dipartimento di Ingegneria Civile, Informatica e delle Tecnologie Aeronautiche, Via Vito Volterra 62, 00146 Roma, Italy
| | - Brenda Capone
- Università degli Studi della Campania "Luigi Vanvitelli", Dipartimento di Matematica e Fisica, Viale Lincoln 5, 81100 Caserta, Italy
| | - Giancarlo Palumbo
- Università degli Studi di Napoli "Federico II", Dipartimento di Economia, Management, Istituzioni, Laboratorio di Scienze Merceologiche, Via Vicinale Cupa Cintia 26, 80126 Napoli, Italy
| | - Gabriele Rotter
- Università degli Studi di Messina, Scuola di Specializzazione in Medicina Legale, Via Consolare Valeria 1, 98125 Messina, Italy
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Hinse M, Jerzynski L, Binting S, Kummer S, Brinkhaus B, Rotter G. German translation and validation of the complementary and alternative medicine health belief questionnaire (CHBQ). BMC Med Educ 2024; 24:99. [PMID: 38291405 PMCID: PMC10829264 DOI: 10.1186/s12909-023-04985-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 12/18/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND The Complementary and Alternative Health Belief Questionnaire (CHBQ) measures medical students' attitudes towards Complementary Medicine (CM). The aim of the study was to examine the validity and reliability of the German translation of the CHBQ. METHODS Data for the psychometric evaluation of the German translation were drawn from a study that investigated attitudes towards CM in (a sample of) medical students at Charité - Universitätsmedizin Berlin. Construct validity was determined via an exploratory factor analysis (EFA). Internal consistency was examined using Cronbach's alpha and split-half reliability. RESULTS The CHBQ was returned by 278 students, and was fully completed by 260 students (mean age 23.7 years; ± 4.3 SD), 69.2% were female). EFA revealed a single factor solution for all 10 items of the scale. All items, except one, had good item discrimination (range: 0.5-0.8), acceptable mean inter-item-correlation (0.39) and similar median correlation (0.38). Reliability was very good (α = 0.86) and further confirmed by split-half reliability (0.91). CONCLUSIONS The German version of the CHBQ is a valid and reliable instrument for measuring students' attitudes towards CM.
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Affiliation(s)
- Maximilian Hinse
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
| | - Lea Jerzynski
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Sylvia Binting
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Sonja Kummer
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Benno Brinkhaus
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Gabriele Rotter
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Department of Pediatric Oncology and Hematology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
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Della Pietra B, Porzio A, Alberico M, Rotter G, Bettin C, Feola A, Nunziata F. Semi-computational approach for assessing the damage to human soft tissues: the case of FMJRN versus HP-XTP 9 mm bullet penetration in ballistic soap. Forensic Sci Med Pathol 2023:10.1007/s12024-023-00679-2. [PMID: 37505319 DOI: 10.1007/s12024-023-00679-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2023] [Indexed: 07/29/2023]
Abstract
Ballistic soap blocks are used in wound ballistics to assess the potential damage of the ammunition employed, allowing observation of the energy transfer occurred along the wound channel. The density and viscosity of ballistic soap (also called tissue simulant) simulate, to a good degree of approximation, the effect resulting from the interaction of penetrating bullets with living human soft tissue. Ballistic soap has a "plastic reaction" to bullet penetration, and therefore, unlike ballistic gelatin, the expansion of temporary cavity remains imprinted in the tissue simulant. When the soap blocks are sectioned or divided with nondestructive instrumental techniques (e.g., Compton's scattering tomography), it's possible, therefore, to observe the temporary cavity determined by the penetration of the bullet. This study provides insight into the severity of injuries originated from two different types of bullets of the same caliber by employing ballistic soap as a tissue simulant. In addition, it provides guidance to forensic practitioners on the proper use of ballistic soap for simulating gunshot wounds. The semi-computational approach employed, based on the results obtained from the firing tests, allowed the authors to understand that there is likely a threshold value of projectile energy density, close to 1 J/mm2, beyond which its penetration into the ballistic soap ceases.
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Affiliation(s)
- Bruno Della Pietra
- Dipartimento di Medicina Sperimentale, Università degli Studi della Campania "Luigi Vanvitelli", Via Santa Maria di Costantinopoli 16, 80138, Naples, Italy
| | - Antonietta Porzio
- Dipartimento di Medicina Sperimentale, Università degli Studi della Campania "Luigi Vanvitelli", Via Santa Maria di Costantinopoli 16, 80138, Naples, Italy
| | - Mariarosaria Alberico
- Dipartimento di Medicina Sperimentale, Università degli Studi della Campania "Luigi Vanvitelli", Via Santa Maria di Costantinopoli 16, 80138, Naples, Italy
| | | | - Cristian Bettin
- Bettin Engineering, Via Ottorino Respighi 13, 35132, Padua, Italy
| | - Alessandro Feola
- Dipartimento di Medicina Sperimentale, Università degli Studi della Campania "Luigi Vanvitelli", Via Santa Maria di Costantinopoli 16, 80138, Naples, Italy
| | - Felice Nunziata
- Dipartimento di Matematica e Fisica, Università degli Studi della Campania "Luigi Vanvitelli", Viale Lincoln 5, 81100, Caserta, Italy.
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Ortiz M, Koch AK, Cramer H, Linde K, Rotter G, Teut M, Brinkhaus B, Haller H. Clinical effects of Kneipp hydrotherapy: a systematic review of randomised controlled trials. BMJ Open 2023; 13:e070951. [PMID: 37423627 DOI: 10.1136/bmjopen-2022-070951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2023] Open
Abstract
OBJECTIVE Hydrotherapy is a traditional prevention and treatment strategy. This study's aim is to systematically review all available randomised controlled trials (RCTs) investigating clinical effects of hydrotherapy according to Kneipp which is characterised by cold water applications. METHODS RCTs on disease therapy and prevention with Kneipp hydrotherapy were included. Study participants were patients and healthy volunteers of all age groups. MEDLINE (via PubMed), Scopus, Central, CAMbase, and opengrey.eu were systematically searched through April 2021 without language restrictions and updated by searching PubMed until April 6th 2023. Risk of bias was assessed using the Cochrane tool version 1.ResultsTwenty RCTs (N=4247) were included. Due to high heterogeneity of the RCTs, no meta-analysis was performed. Risk of bias was rated as unclear in most of the domains. Of 132 comparisons, 46 showed significant positive effects in favour of hydrotherapy on chronic venous insufficiency, menopausal symptoms, fever, cognition, emotional function and sickness absenteeism. However, 81 comparisons showed no differences between groups and 5 were in favour of the respective control group. Only half of the studies reported safety issues. CONCLUSION Although RCTs on Kneipp hydrotherapy seem to show positive effects in some conditions and outcomes, it remains difficult to ascertain treatment effects due to the high risk of bias and heterogeneity of most of the considered studies. Further high-quality RCTs on Kneipp hydrotherapy are urgently warranted. PROSPERO REGISTRATION NUMBER CRD42021237611.
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Affiliation(s)
- Miriam Ortiz
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin, Germany
| | - Anna Katharina Koch
- Department of Pediatrics, Division of Oncology and Hematology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Berlin, Germany
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Universitat Duisburg-Essen, Essen, Nordrhein-Westfalen, Germany
- Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
- Bosch Health Campus, Stuttgart, Germany
| | - Klaus Linde
- Institute of General Practice and Health Services Research, Technische Universität München, Munchen, Germany
| | - Gabriele Rotter
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin, Germany
| | - Michael Teut
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin, Germany
| | - Benno Brinkhaus
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin, Germany
| | - Heidemarie Haller
- Center for Integrative Medicine and Planetary Health, University of Duisburg-Essen, University Hospital, Essen, Germany
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Dornquast C, Rotter G, Schollbach L, Binting S, Scherr J, Pfab F, Brinkhaus B. Allergic diseases in German competitive athletes: results of a cross-sectional study. J Sports Med Phys Fitness 2023; 63:588-595. [PMID: 36169393 DOI: 10.23736/s0022-4707.22.13825-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Allergic diseases are common in the general population. Among the population of competitive athletes (hereafter referred to as athletes), previous studies have mostly focused on the prevalence of allergic diseases and further aspects of bronchial asthma. We aimed to examine the prevalence of allergic diseases and respective medication use in athletes in Germany. METHODS We performed a cross-sectional study in athletes from different sport disciplines between March 2012 and September 2013 in Munich, Bavaria. Allergic diseases and medication use were descriptively determined using the standardized Allergy Questionnaire for Athletes (AQUA). Allergic predisposition was defined at an AQUA Score (range 0 to 35) of at least 5. RESULTS In total, 560 athletes (mean age 20.4±6.7 years, males 73.4%, most frequent sport discipline soccer) were included in the analysis. The reported proportion of any allergic condition was 28%, and 46% of the athletes had an allergic predisposition. Sixteen percent of all athletes and 36% of athletes with an allergic predisposition reported the use of antiallergic or antiasthmatic medications. CONCLUSIONS Athletes had a high rate of allergic diseases, and almost half of them reported an allergic predisposition. Further research is needed to validate our results and investigate the impact of allergic diseases in athletes on the performance and specific aspects of their sport, such as training intensity and duration.
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Affiliation(s)
- Christina Dornquast
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Gabriele Rotter
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany -
| | - Lisa Schollbach
- Department of Prevention, Rehabilitation and Sports Medicine, Technical University of Munich, Munich, Germany
| | - Sylvia Binting
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Johannes Scherr
- Department of Prevention, Rehabilitation and Sports Medicine, Technical University of Munich, Munich, Germany
- University Center for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Florian Pfab
- Department of Prevention, Rehabilitation and Sports Medicine, Technical University of Munich, Munich, Germany
- Medzentrum Residenz, Munich, Germany
| | - Benno Brinkhaus
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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Rotter G, Binting S, Teut M, Ortiz M, Willich SN, Brinkhaus B. Characteristics of Patients Presenting at a University Outpatient Department for Complementary and Integrative Medicine. Complement Med Res 2023; 30:279-288. [PMID: 36804827 DOI: 10.1159/000529798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 02/20/2023] [Indexed: 02/22/2023]
Abstract
BACKGROUND Complementary and integrative medicine (CIM) is increasingly provided at university outpatient departments (OPDs) in Germany, but its scientific evaluation is sparse. Therefore, we aimed to investigate and evaluate feasibility, patients' characteristics and complaints at a university's CIM-OPD. METHODS A prospective evaluation included new patients without age restriction. At baseline, and after 6 and 12 months, patients filled out paper questionnaires. Patients rated their mean subjectively perceived severity of the main complaint within the last 7 days on a numerical rating scale (NRS) from 0 = no complaints to 10 = maximum complaints, their perceived resilience capacity in everyday life within the last 7 days (0 = not resilient to 10 = very resilient), and their contentment with the treatment (0 = not content to 10 = very content). Diagnoses were provided by physicians and coded according to the International Statistical Classification of Diseases and Related Health Problems, 10th revision. All data were analyzed descriptively. RESULTS During two years, 536 new patients {72.6% response, age (mean ± standard deviation [SD] and range) 49.6 ± 15.8 and 1-86 years, 75.7% female} chose to participate. The most frequent diagnosis groups were neoplasms (C00-C97, n = 143, 18.6%) and musculoskeletal diseases (M00-M99, n = 137, 17.9%). In n = 165 patients (30.8%), more than one diagnosis was provided. In a subgroup of 187 patients, who returned the questionnaire after 6 months, we compared baseline to 6-month values: severity of main complaint (mean ± SD) 5.2 ± 2.6 changed to 3.9 ± 2.6; resilience capacity 5.1 ± 2.6 to 5.6 ± 2.4. After 6 months, respondents rated their contentment with the treatment with (mean ± SD) 7.7 ± 2.6. Data after 12 months (n = 113) are comparable to data after 6 months. CONCLUSION Patients of our CIM-OPD had a broad age range, were predominantly female, and suffered mostly from oncologic-related complaints and musculoskeletal diseases. In the responding subgroup after 6 months, patients were content with the treatment. These results should be verified by further prospective evaluations. Hintergrund Komplementäre und integrative Medizin (CIM) wird in Deutschland zunehmend in Hochschulambulanzen (OPDs) angeboten, deren wissenschaftliche Evaluation ist jedoch unzureichend. Deshalb war es unser Ziel, die Durchführbarkeit einer Evaluation, die Charakteristika und die Beschwerden der Patienten und Patientinnen an einer CIM-ODP zu untersuchen. Methoden Eine prospektive Evaluation schloss neue Patienten und Patientinnen ohne Altersbeschränkung ein. Zu Baseline sowie nach sechs und 12 Monaten füllten die Patienten und Patientinnen Papierfragebögen aus. Die Patienten und Patientinnen bewerteten ihre mittlere subjektiv empfundene Schwere der Hauptbeschwerden in den letzten sieben Tagen auf einer numerischen Ratingskala (NRS) von 0 = keine Beschwerden bis 10 = maximale Beschwerden, ihre mittlere subjektiv empfundene Belastbarkeit im Alltag in den letzten sieben Tagen (0 = nicht belastbar bis 10 = sehr belastbar) und ihre Zufriedenheit mit der Behandlung (0 = nicht zufrieden bis 10 = sehr zufrieden). Die Diagnosen wurden von den Ärzten und Ärztinnen gestellt und nach der International Statistical Classification of Diseases and Related Health Problems, 10. Revision, kodiert. Die Daten wurden deskriptiv ausgewertet. Ergebnisse Im Laufe von zwei Jahren nahmen 536 neue Patienten und Patientinnen (72.6% Rücklauf, Alter (Mittelwert ± SD und Range) 49.6 ± 15.8 und 1–86 Jahre, 75.7% weiblich) teil. Die häufigsten Diagnosen waren Neoplasmen (C00-C97, n = 143, 18.6%) und Erkrankungen des Bewegungsapparates (M00-M99, n = 137, 17.9%). Bei n = 165 (30.8%) Patienten und Patientinnen wurde mehr als eine Diagnose vergeben. In einer Subgruppe von 187 Patienten und Patientinnen, die den Fragebogen nach 6 Monaten zurücksendeten, verglichen wir die Ausgangs-und 6-Monats-Werte: Schweregrad der Hauptbeschwerden (Mittelwert±SD) 5.2 ± 2.6 veränderte sich zu 3.9 ± 2.6; Belastbarkeit 5.1 ± 2.6 zu 5.6 ± 2.4. Nach sechs Monaten bewerteten die Befragten ihre Zufriedenheit mit der Behandlung mit (Mittelwert±SD) 7.7 ± 2.6. Die Daten nach 12 Monaten ( n = 113) sind mit den Daten nach 6 Monaten vergleichbar. Schlussfolgerung Die Patienten und Patientinnen unserer CIM-OPD hatten eine breite Altersspanne, überwiegend weiblich und litten zumeist unter onkologisch bedingten Beschwerden und Erkrankungen des Bewegungsapparates. Patienten und Patientinnen der nach sechs Monaten antwortenden Subgruppe waren mit der Behandlung zufrieden. Die Ergebnisse sollten durch weitere prospektive Evaluationen verifiziert werden.
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Affiliation(s)
- Gabriele Rotter
- Institute of Social Medicine, Epidemiology and Health Economics, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Sylvia Binting
- Institute of Social Medicine, Epidemiology and Health Economics, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Michael Teut
- Institute of Social Medicine, Epidemiology and Health Economics, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Miriam Ortiz
- Institute of Social Medicine, Epidemiology and Health Economics, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Stefan N Willich
- Institute of Social Medicine, Epidemiology and Health Economics, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Benno Brinkhaus
- Institute of Social Medicine, Epidemiology and Health Economics, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Rotter G, Teut M, Schleicher R, Dell'Oro M, Ortiz M, Binting S, Tissen-Diabaté T, Roll S, Michalsen A, Staab D, Wolfarth B, Brinkhaus B. Hypnotherapy, Intermittent Fasting, and Exercise Group Programs in Atopic Dermatitis: A Randomized Controlled Explorative Clinical Trial During the COVID-19 Pandemic. J Integr Complement Med 2023; 29:99-110. [PMID: 36450119 PMCID: PMC9942184 DOI: 10.1089/jicm.2022.0699] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background: Patients with atopic dermatitis (AD) frequently use healthy lifestyle behaviors, although their benefits are unclear. This study's aim was to investigate the effectiveness of hypnotherapy, fasting with diet adjustments, and exercise in AD patients. Methods: In a four-armed randomized controlled monocenter open explorative clinical trial, adult patients with mild-to-moderate severe AD underwent, over 16 weeks, a five-session hypnotherapy group program (HTP), a five-session intermittent fasting with diet adjustment group program (IFDP), a five-session exercise group program (EP), or no study intervention (control) as add-on to topical corticosteroid use if required. Endpoints included subjectively perceived itching on a visual analogue scale (VAS, 0-100 mm); disease severity by SCORing Atopic Dermatitis (SCORAD); and adverse events (AEs). Endpoints were analyzed descriptively in the Full Analysis Set (FAS). Due to the coronavirus disease 2019 (COVID-19) pandemic, relevant changes to the study protocol included online in addition to "in-presence" group interventions, closing the study arm EP and premature trial termination before randomization of 120 intended patients. Results: During the COVID-19 pandemic, study recruitment was poor. The FAS included 20 patients (17 female) with 35.0 ± 12.1 (mean ± standard deviation [SD]) years of age. At baseline, mean ± SD for HTP (n = 6), IFDP (n = 4), EP (n = 1), and control (n = 9) were VAS itching 63.2 ± 18.0, 65.0 ± 13.9, 43.0 mm, 62.1 ± 17.3; SCORAD 43.0 ± 13.6, 47.0 ± 21.0, 60.3, 39.1 ± 15.6. After 16 weeks, endpoints were VAS itching 26.0 ± 16.4, 31.7 ± 9.9, 23.0 mm, 39.3 ± 27.0; SCORAD 24.1 ± 12.2, 29.1 ± 19.1, 49.1, 25.5 ± 14.4. No serious AEs related to the interventions were observed. Conclusion: Despite very small groups, study results indicated potential beneficial changes to baseline in perceived itching intensity, disease severity, and disease-specific quality of life for HTP and IFDP. Therefore, further clinical trials should be performed investigating the effectiveness and safety of all interventions. Clinical Trial Registration: January 31, 2020 German Clinical Trials Register (DRKS): DRKS00020557, Universal Trial Number (UTN): U1111-1247-1512.
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Affiliation(s)
- Gabriele Rotter
- Department of Epidemiology and Health Economics, Institute of Social Medicine, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Address correspondence to: Gabriele Rotter, MD, MSc, Department of Epidemiology and Health Economics, Institute of Social Medicine, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin 10117, Germany
| | - Michael Teut
- Department of Epidemiology and Health Economics, Institute of Social Medicine, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Romy Schleicher
- Department of Epidemiology and Health Economics, Institute of Social Medicine, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Melanie Dell'Oro
- Department of Epidemiology and Health Economics, Institute of Social Medicine, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany
| | - Miriam Ortiz
- Department of Epidemiology and Health Economics, Institute of Social Medicine, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Sylvia Binting
- Department of Epidemiology and Health Economics, Institute of Social Medicine, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Tatjana Tissen-Diabaté
- Department of Epidemiology and Health Economics, Institute of Social Medicine, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Stephanie Roll
- Department of Epidemiology and Health Economics, Institute of Social Medicine, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Michalsen
- Department of Epidemiology and Health Economics, Institute of Social Medicine, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany
| | - Doris Staab
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Bernd Wolfarth
- Department of Sports Medicine, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Benno Brinkhaus
- Department of Epidemiology and Health Economics, Institute of Social Medicine, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
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8
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Jeitler M, Erehman A, Koppold DA, Ortiz M, Jerzynski L, Stöckigt B, Rotter G, Blakeslee S, Brinkhaus B, Michalsen A, Seifert G, Cramer H, Kandil FI, Kessler CS. Self-care and lifestyle interventions of complementary and integrative medicine during the COVID-19 pandemic-A cross-sectional study. Front Med (Lausanne) 2023; 9:1033181. [PMID: 36698795 PMCID: PMC9868272 DOI: 10.3389/fmed.2022.1033181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/05/2022] [Indexed: 01/11/2023] Open
Abstract
Background Complementary and Integrative Medicine (CIM), including self-care healthy life-style promotion strategies, is widely used in Germany. Aim of this study was to assess the use of self-care and lifestyle interventions as well as mental/emotional state experienced during the COVID-19 pandemic. Methods An exploratory cross-sectional online study was conducted with adults in Germany through an online survey. Custom-developed questions in respiratory disease-status (including COVID-19), CIM-based self-care/lifestyle interventions and dietary patterns, and mental/emotional state as well as parameters for wellbeing (World Health Organization Well-Being Index, WHO-5) and self-efficacy (General Self-Efficacy Short Scale, GSE-3) were assessed. Data was analyzed using frequency and parametric measures. Results The online survey was performed from January to March 2021 and included 1,138 participants (81.5% female; mean age: 49.2 ± 13.7 years; 54.9% holding a university degree) living in Germany, of which 62 had had a positive SARS-CoV-2 test, 4 an influenza infection and 375 participants other respiratory infections. The following individual health promotion strategies were reported: spending time in nature (90%; n = 1,024), physical activity (69.3%; n = 789), naturopathic remedies (63.1%; n = 718), plant-based diet (56.3%; n = 640), and Mind-Body interventions (54.7%; n = 623). No differences in strategies between individuals with respiratory diseases or the sample overall were found. Well-being had a mean value of 15.2 ± 5 (WHO-5) and self-efficacy 4.1 ± 0.6 (GSE-3). Nearly 8% reported a low mental/emotional state regarding the COVID-19 pandemic. Conclusion Self-care and lifestyle interventions during the COVID-19 pandemic were reported by participants who were predominantly female, middle-aged, and well-educated. Most participants showed an overall balanced mental/emotional state. Further studies should include a representative control group from the general population. Clinical trial registration clinicaltrials.gov, identifier NCT04653727.
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Affiliation(s)
- Michael Jeitler
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany,Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany,*Correspondence: Michael Jeitler,
| | - Avital Erehman
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Daniela A. Koppold
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany,Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany
| | - Miriam Ortiz
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Lea Jerzynski
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Barbara Stöckigt
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Gabriele Rotter
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Sarah Blakeslee
- Department of Paediatric Oncology/Haematology, Otto-Heubner Centre for Paediatric and Adolescent Medicine (OHC), Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Benno Brinkhaus
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Andreas Michalsen
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany,Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany
| | - Georg Seifert
- Department of Paediatric Oncology/Haematology, Otto-Heubner Centre for Paediatric and Adolescent Medicine (OHC), Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany,Departamento de Pediatria, Faculdade de Medicina, Instituto de Tratamento do Câncer Infatil (ITACI), Universidade de São Paulo, São Paulo, Brazil
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany,Institute for General Practice and Interprofessional Care, University Hospital Tuebingen, Tübingen, Germany,Bosch Health Campus, Stuttgart, Germany,National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW, Australia
| | - Farid I. Kandil
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany,Department of Paediatric Oncology/Haematology, Otto-Heubner Centre for Paediatric and Adolescent Medicine (OHC), Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Christian S. Kessler
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany,Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany
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9
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Romeo M, Gentile C, Burnett B, Rotter G, Petraglia A, Nunziata F. On the problem of data interpretation in the analysis of iron-containing GSR particles. Forensic Chem 2023. [DOI: 10.1016/j.forc.2023.100472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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10
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Jerzynski L, Rotter G, Binting S, Teut M, Tissen-Diabaté T, Jeitler M, Seifert G, Kessler C, Michalsen A, Cramer H, Stöckigt B, Brinkhaus B, Ortiz M. Health-Related Self-Care Strategies and Coping Resources During the COVID-19 Pandemic: An Online-Based Cross-Sectional Study. J Integr Complement Med 2022; 28:799-810. [PMID: 35944275 DOI: 10.1089/jicm.2022.0475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Background: Complementary medicine (CM) is often used as an opportunity for preventive health measures and supportive self-care practices. This study aimed to explore the use of self-care practices and preventive health strategies and the aspects of the experienced emotions during the COVID-19 pandemic in a population with an affinity for CM. Methods: The authors conducted an exploratory cross-sectional study using an anonymous 41-item online survey in the German language. The survey respondents were recruited among adults with an affinity for CM (e.g., as targeted through their memberships in CM associations) from September 2020 to February 2021. A selection of self-care methods, mainly from CM, was presented in the questionnaire. Numerical rating scales (NRSs), ranging from 0 = minimum to 10 = maximum, were used to measure the intensity of different emotions experienced during the pandemic. Statistical analysis was carried out descriptively. Results: A total of 1605 participants (80.6% female; mean age: 55.4 ± 12.6 [SD] years; 43.9% holding a university degree) were included. The use of self-care methods for health promotion during the pandemic was reported by 86.8% of the respondents. Respondents favored staying in nature (85.6%), healthy nutrition (85.6%), and physical activities (83.6%). More than 60% of the respondents made use of vitamin C and/or D, herbal medicines, nutritional supplements, relaxation techniques, breathing exercises, homeopathy, or meditation for health promotion. The analysis of emotional status by NRS (0-10) revealed the lowest mean ± SD (standard deviation) for "feeling lonely" (2.6 ± 2.9) and "feeling anxious" (2.8 ± 2.6), and the highest mean for "feeling connected to others" (6.2 ± 2.5) and "well-being" (5.8 ± 2.4). Conclusions: Participants used a wide variety of self-care methods and prevention strategies to promote their health during the COVID-19 pandemic and showed, overall, a balanced emotional status. Further research should include a control group representative of the general population, to investigate the possible impact of self-care strategies. Clinical Trial Registration Number: "Deutsches Register Klinischer Studien" (German Clinical Trial Register); registration number: DRKS00022909.
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Affiliation(s)
- Lea Jerzynski
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Gabriele Rotter
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Sylvia Binting
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Michael Teut
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Tatjana Tissen-Diabaté
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Michael Jeitler
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany
| | - Georg Seifert
- Department of Pediatric Oncology/Hematology, Otto-Heubner Centre for Pediatric and Adolescent Medicine (OHC), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Pediatrics, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Christian Kessler
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany
| | - Andreas Michalsen
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Barbara Stöckigt
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Benno Brinkhaus
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Miriam Ortiz
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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11
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Berghöfer A, Rotter G, Pankert J, Icke K, Roll S, King R, Willich SN. SARS-CoV-2 infections in professional orchestra and choir musicians-a prospective cohort study. Eur J Epidemiol 2022; 37:1061-1070. [PMID: 36173478 PMCID: PMC9519404 DOI: 10.1007/s10654-022-00917-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 09/13/2022] [Indexed: 11/25/2022]
Abstract
During the COVID-19 pandemic, rehearsal and concert activities of professional orchestras and choirs were severely restricted based on the assumption of particularly high infection risks associated with wind instruments and singing. Therefore, our primary objective was to determine the incidence of SARS-CoV-2 infections in orchestra and choir musicians compared to controls. We also assessed influenza, flu, upper respiratory tract infections, and course of illness. Musicians from professional orchestras and choirs and controls from 23 institutions throughout Germany were included in a prospective cohort study. Data were collected from October 2020 to June 2021 by weekly online surveys. A mixed-effects cox proportional hazards model was used to assess the effect of exposure by professional activity on SARS-CoV-2 infection. In 1,097 participants (46.7 years (SD 10.3); 46.8% female; 705 orchestra, 154 choir, and 238 control subjects) 40 SARS-CoV-2 infections occurred. Cases per person-years were 0.06 in orchestras, 0.11 in choirs, and 0.03 in controls. Hazard ratios compared to controls were 1.74 (95% CI 0.58 to 5.25, p = 0.320) for orchestra musicians and 2.97 (0.87 to 10.28, p = 0.087) for choir singers. Infection source was suspected predominantly in private contexts. Disease courses were mild to moderate. Other respiratory infections were reported in 6.1% of study weeks in orchestras, 10.1% in choirs, and 8.0% in controls. Sick leave days of total study days were 0.5, 2.1 and 1.3%, respectively. This epidemiologic study during the pandemic in professional musicians indicates no increased risk of SARS-CoV-2 infections in orchestra musicians and a trend towards increased risk in choir singers compared to controls. However, the exact routes of infection could not be validated. If appropriate hygiene concepts are adhered to, safe orchestra and choir activity appears possible in pandemic times.
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Affiliation(s)
- Anne Berghöfer
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
| | - Gabriele Rotter
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Joachim Pankert
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Katja Icke
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Stephanie Roll
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ryan King
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Stefan N Willich
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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12
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Rotter G, Teut M, Binting S, Michalsen A, Ortiz M, Brinkhaus B. Lifestyle Behaviors in Patients with Atopic Dermatitis: Results of a Cross-Sectional Study following a Randomized Controlled Trial. Complement Med Res 2022; 29:419-428. [PMID: 36122564 DOI: 10.1159/000527107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/01/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The severity of atopic dermatitis (AD) is associated with lifestyle behaviors such as exercise, relaxation techniques, and dietary or nutritional adjustments. OBJECTIVE The aim of this study was to investigate the frequency of self-initiated exercise, relaxation techniques, and dietary or nutritional adjustments and their perceived benefits in patients with AD. METHODS An exploratory cross-sectional study was performed in May 2019 with 115 AD patients who participated in a threearmed randomized controlled trial (the CAMATOP study). Data on lifestyle behaviors in the three domains of exercise, relaxation techniques, and dietary or nutritional adjustments and their perceived benefits were collected anonymously by a questionnaire and exploratively evaluated. RESULTS A total of 58 (50.4%) patients responded and were included in the analyses. Within the previous 4 months, 54 (93.1%) respondents had performed exercise, and 24 (41.4%) respondents had used a relaxation technique. A total of 44 (75.9%) respondents had adjusted their diet or nutrition intake due to AD. Exercise, relaxation techniques, and dietary or nutritional adjustments were rated as helpful by most respondents (57.4%, 87.0%, and 95.1%, respectively). Overall, 54 (93.1%) respondents adopted at least one lifestyle factor, and 13 (22.4%) adopted a lifestyle factor in all three domains. CONCLUSION In our sample, AD patients often adopted lifestyle behaviors such as exercise, relaxation techniques, diet and nutrition and perceived relaxation techniques and nutritional adjustments as helpful. Further high-quality cohort studies and prospective clinical trials should evaluate the benefits and possible risks of potentially healthy lifestyle behaviors in AD patients.
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Affiliation(s)
- Gabriele Rotter
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Michael Teut
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Sylvia Binting
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Andreas Michalsen
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany.,Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany
| | - Miriam Ortiz
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Benno Brinkhaus
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
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13
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Rotter G, Ahnert MW, Geue AV, Icke K, Binting S, Tissen-Diabaté T, Roll S, Ortiz M, Reinhold T, Kass B, Staab D, Pfab F, Willich SN, Brinkhaus B. Acupuncture and Osteopathic Medicine for Atopic Dermatitis - a Three-armed Randomized Controlled Explorative Clinical Trial. Clin Exp Dermatol 2022; 47:2166-2175. [PMID: 35875898 DOI: 10.1111/ced.15340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) patients frequently use acupuncture (ACU) and osteopathic medicine (OM), although their therapeutic benefits are unclear. OBJECTIVE To investigate the effectiveness of ACU and OM in AD patients. METHODS In a three-armed randomized controlled single-center open explorative clinical trial, adult AD patients received ACU, OM, or no study intervention (control) plus routine care. Outcomes included disease severity (SCORing Atopic Dermatitis, SCORAD), itching intensity (visual analog scale, VAS), frequency of topical corticosteroid (TCS) use within seven days, and cost-effectiveness. Endpoints were analyzed by analysis of covariance adjusted for the respective baseline value and TCS use. RESULTS Overall, 121 patients (92 female) with a mean (±SD) age of 31.4±10.5 years were randomized. After 12 weeks, the adjusted means (95% CI) for ACU, OM, and control were SCORAD 22.3 (18.3;26.3), 26.4 (22.6;30.2), 23.7 (19.9;27.5), p=0.321; VAS itching 27.9 mm (19.5;36.4), 35.0 mm (26.9;43.0), 42.3 mm (34.7;50.0), p=0.047; TCS use 2.3 (0.8;3.9), 1.9 (0.4;3.5), 4.3 (2.6;6.0), p=0.101. ACU and OM were not cost-effective compared with the control. CONCLUSION Although no differences in disease severity were found, our findings indicate that ACU might reduce itching in patients with AD. Furthermore, ACU and OM show a trend toward reducing TCS use.
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Affiliation(s)
- Gabriele Rotter
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Moritz W Ahnert
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Anne V Geue
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Katja Icke
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Sylvia Binting
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Tatjana Tissen-Diabaté
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Stephanie Roll
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Miriam Ortiz
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Thomas Reinhold
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Benjamin Kass
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Doris Staab
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Berlin, Germany
| | | | - Stefan N Willich
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Benno Brinkhaus
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
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Rotter G, Ortiz M, Binting S, Tomzik J, Reese F, Roll S, Brinkhaus B, Teut M. Mindful Walking in Patients with Chronic Low Back Pain: A Randomized Controlled Trial. Journal of Integrative and Complementary Medicine 2022; 28:474-483. [PMID: 35363058 PMCID: PMC9232228 DOI: 10.1089/jicm.2021.0361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: The objective of this study was to investigate the effectiveness of a mindful walking program (MWP) in patients with chronic low back pain (CLBP). Methods: The trial was a two-armed, randomized, controlled single-center open clinical trial. The study was performed in the Outpatient Clinic for Integrative Medicine of the Charité–Universitätsmedizin Berlin. The participants were adults aged 18–65 years with CLBP (≥3 months) and an average low back pain within the past 7 days measured on a visual analog scale (VAS, 0 = no pain, 100 = worst imaginable pain) of at least 40 mm. The patients received either eight weekly MWP sessions or no intervention (control). The primary outcome was the perceived pain intensity assessed with a VAS (0–100 mm) after 8 weeks. The secondary outcomes included back function assessed by the Hannover Functional Questionnaire Backache (FFbH-R) and perceived stress assessed by the 14-item Cohen's Perceived Stress Scale (PSS-14). The results were obtained by analysis of covariance adjusted for the respective baseline values. Results: In total, 55 patients were randomized (MWP: n = 29, 82.8% female, mean (±standard deviation) age: 52.5 ± 8.6 years, pain: 56.4 ± 14.1 mm; control: n = 26, 84.6% female, 54.8 ± 7.5 years, pain: 55.4 ± 13.1 mm). After 8 weeks, compared with the control conditions, the MWP was not associated with a statistically significant benefit for pain (VAS), adjusted mean − 9.6 [−22.3 to 3.1], p = 0.136, clinical benefits for back function (FFbH-R), adjusted mean 2.2 [−4.2 to 8.6], p = 0.493, or stress (PSS-14), adjusted mean − 1.6 [−4.8 to 1.6], p = 0.326. Conclusion: In conclusion, compared with no intervention, mindful walking did not significantly improve pain, back function, or perceived stress in patients with CLBP. Clinical Trial registration: ClinicalTrials.gov (NCT01893073).
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Affiliation(s)
- Gabriele Rotter
- Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt – Universität zu Berlin, Berlin, Germany
| | - Miriam Ortiz
- Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt – Universität zu Berlin, Berlin, Germany
| | - Sylvia Binting
- Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt – Universität zu Berlin, Berlin, Germany
| | - Juliane Tomzik
- Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt – Universität zu Berlin, Berlin, Germany
| | - Frauke Reese
- Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt – Universität zu Berlin, Berlin, Germany
| | - Stephanie Roll
- Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt – Universität zu Berlin, Berlin, Germany
| | - Benno Brinkhaus
- Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt – Universität zu Berlin, Berlin, Germany
| | - Michael Teut
- Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt – Universität zu Berlin, Berlin, Germany
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Rotter G, Pazzi M, Mattutino G. A preliminary study on the treatment of human blood soiled stubs, in presence of GSR particles. Forensic Sci Int 2022; 335:111310. [DOI: 10.1016/j.forsciint.2022.111310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/23/2022] [Accepted: 04/11/2022] [Indexed: 11/04/2022]
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Rotter G, Correzzola C, Del Ángel VF, Daminato E, Causin V. Characterisation of plastic wads: A useful approach for elucidating shooting accidents and homicides involving shotguns. Forensic Sci Int 2022; 332:111194. [PMID: 35101829 DOI: 10.1016/j.forsciint.2022.111194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 11/04/2022]
Abstract
Wads are components of shotgun cartridges used for transferring to pellets or slugs the kinetic energy produced during the combustion chain which takes place as the trigger is pulled by the shooter. The hull of the cartridge falls in the vicinities of the gun, so it is easy for a malicious shooter to cancel this particular trace from a crime scene. However, the wad is projected to an intermediate point between the shooter and the victim, it is easily lost, and so it can be useful as a trace containing information on the type of ammunition used by a shooter and possibly a convenient item for comparison with analogous objects found in the premises of a suspect. In this paper, various analytical approaches, such as thermal analysis, infrared spectroscopy and X-ray diffraction were employed in order to discriminate apparently similar commercial wads. Samples that had previously been fired and pristine samples were examined, verifying that the energy, temperature and pressure associated to the combustion of the powder in the bore does not bring about appreciable changes in the polymer structure, thus allowing to use this approach in casework.
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Affiliation(s)
| | - Claudio Correzzola
- Dipartimento di Scienze Chimiche, Università di Padova, Via Marzolo 1, Padova 35131, Italy
| | - Vanessa Fossati Del Ángel
- Ciencia Forense, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad Universitaria, Ciudad de México, México
| | - Eva Daminato
- Dipartimento di Scienze Chimiche, Università di Padova, Via Marzolo 1, Padova 35131, Italy
| | - Valerio Causin
- Dipartimento di Scienze Chimiche, Università di Padova, Via Marzolo 1, Padova 35131, Italy.
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Israel L, Rotter G, Förster-Ruhrmann U, Hummelsberger J, Nögel R, Michalsen A, Tissen-Diabaté T, Binting S, Reinhold T, Ortiz M, Brinkhaus B. Acupressure in patients with seasonal allergic rhinitis: a randomized controlled exploratory trial. Chin Med 2021; 16:137. [PMID: 34922567 PMCID: PMC8684198 DOI: 10.1186/s13020-021-00536-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 11/10/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Acupuncture has shown beneficial effects for seasonal allergic rhinitis (SAR); however, it is time and cost intensive. We investigated feasibility and effects of self-administered body acupressure as a self-care technique that stimulates acupuncture points with manual pressure in SAR patients. METHODS We conducted a two-armed randomized controlled exploratory trial to compare effects of self-administered acupressure over 4 weeks at five acupuncture points plus rescue medication (RM) with cetirizine compared to RM alone in SAR patients. Among other outcome parameters, we assessed disease-related quality of life (Rhinitis Quality of Life Questionnaire [RQLQ]), overall SAR symptoms by a visual analogue scale (VAS) and a rescue medication score (RMS) after 4 and 8 weeks. RESULTS Forty-one SAR patients (mean age 38.5 ± 10.0 years, n = 21, 51.2% women) were randomized. Compared to RM alone (n = 21), acupressure plus RM (n = 20) was associated with relevant improvements after 4 weeks, shown by the difference between groups in adjusted means of RQLQ: - 0.9 points (95% CI - 1.6 to - 0.2; p = 0.011) and VAS overall SAR symptoms: - 21.6 mm (95% CI - 36.3 to - 6.8; p = 0.005). The RMS was lower in the acupressure group than in the control group: 1.9 points (95% CI - 3.8 to - 0.1; p = 0.120). Group differences decreased slightly until week 8. The acupressure was feasible and safe. CONCLUSION Results of this exploratory study indicate that self-applied acupressure is feasible, may improve disease-specific quality of life and reduce disease-related symptoms as well as anti-allergic medication intake in SAR patients. High-quality confirmatory studies including a sham-control group are needed in the future. Trial registration DRKS-ID: DRKS00014310. Date of registration in DRKS: 2018/04/24. Investigator sponsored/initiated trial (IST/IIT): yes. Ethics approval/approval of the ethics committee: Approved (leading) Ethics Committee No. EA1/033/18, Ethik-Kommission der Charité -Universitätsmedizin Berlin. URL: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00014310.
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Affiliation(s)
- Lukas Israel
- Institute of Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Luisenstr. 57, 10117, Berlin, Germany
| | - Gabriele Rotter
- Institute of Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Luisenstr. 57, 10117, Berlin, Germany
| | - Ulrike Förster-Ruhrmann
- Department for Otolaryngology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Platz 1, 10117, Berlin, Germany
| | - Josef Hummelsberger
- Societas Medicinae Sinensis (SMS) e.V. - International Society for Chinese Medicine, Franz-Joseph-Straße 38, 80801, Munich, Germany
| | - Rainer Nögel
- Societas Medicinae Sinensis (SMS) e.V. - International Society for Chinese Medicine, Franz-Joseph-Straße 38, 80801, Munich, Germany
| | - Andreas Michalsen
- Institute of Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Luisenstr. 57, 10117, Berlin, Germany
| | - Tatjana Tissen-Diabaté
- Institute of Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Luisenstr. 57, 10117, Berlin, Germany
| | - Sylvia Binting
- Institute of Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Luisenstr. 57, 10117, Berlin, Germany
| | - Thomas Reinhold
- Institute of Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Luisenstr. 57, 10117, Berlin, Germany
| | - Miriam Ortiz
- Institute of Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Luisenstr. 57, 10117, Berlin, Germany.
| | - Benno Brinkhaus
- Institute of Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Luisenstr. 57, 10117, Berlin, Germany
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Rotter G, Binting S, Jerzynski L, Hinse M, Brinkhaus B. The attitude of medical students towards complementary medicine - results of a cross-sectional study. Eur J Integr Med 2021. [DOI: 10.1016/j.eujim.2021.101993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Fassina G, Rigato S, Fassan M, Rotter G, Sanavio M, Cecchetto G, Viel G. A case of lethal varicose vein rupture caused by massive leiomyoma. Forensic Sci Int 2021; 328:111039. [PMID: 34624735 DOI: 10.1016/j.forsciint.2021.111039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 09/26/2021] [Accepted: 09/27/2021] [Indexed: 11/30/2022]
Abstract
Varicose veins are a common and benign disease, especially affecting the lower limbs of the elderly. This pathology can exhibit several complications, which in the majority of cases do not require medical treatment; life-threatening conditions are possible but extremely rare. We present here a suspected murder case in which a woman was found dead in her home with a large amount of blood soiling the floor and the furniture of her house. Death scene investigation (DSI) with body inspection and bloodstain pattern analysis (BPA) were not exhaustive in excluding a homicide, and the prosecutor asked for a forensic autopsy. During the dissection, a uterine neoplasia, which altered the lower limb venous system, was detected, thus allowing to reconstruct the physio-pathological mechanism of the formation and rupture of the varicose vein.
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Affiliation(s)
- Giacomo Fassina
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Legal Medicine, University of Padua, Padua, Italy.
| | - Selene Rigato
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Legal Medicine, University of Padua, Padua, Italy
| | - Matteo Fassan
- Department of Medicine, Pathology, University of Padua, Padua, Italy
| | - Gabriele Rotter
- Polizia di Stato, Gabinetto Regionale di Polizia Scientifica per la Calabria, Reggio Calabria, Italy
| | - Matteo Sanavio
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Legal Medicine, University of Padua, Padua, Italy
| | - Giovanni Cecchetto
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Legal Medicine, University of Padua, Padua, Italy
| | - Guido Viel
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Legal Medicine, University of Padua, Padua, Italy
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Rotter G, Jerzynski L, Hinse M, Binting S, Brinkhaus B. The Attitude of Medical Students Toward Complementary Medicine: Results of a Cross-Sectional Study. J Altern Complement Med 2021; 27:1124-1130. [PMID: 34491826 PMCID: PMC8713257 DOI: 10.1089/acm.2021.0181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: Complementary medicine (CM) is often used by patients and offered by physicians. The attitude of medical students toward CM in Germany has been given little research attention. The aim was to assess the attitude of medical students toward CM in general and their opinion about the importance of CM university research and teaching. Methods: An exploratory cross-sectional study among medical students at the Charité—Universitätsmedizin Berlin was performed at the beginning of the summer term 2019 using an online survey. The attitude toward CM was assessed by the Complementary and Alternative Medicine Health Belief Questionnaire (CHBQ, range 10–70, neutral at 40; a higher score indicates a more positive attitude toward CM). Furthermore, students rated their own CM use and the perceived importance of CM university research and teaching (range 1–7; a higher score indicates more agreement). The study was approved by the Charité Ethics Committee (institutional review board). Results: Out of 1256 contacted students, 349 (27.8%) students (mean age 23.7 ± 4.3 years, 69.0% female) participated. The attitude toward CM based on the CHBQ was rather neutral (mean 44.2 ± 10.7) and more positive among females than males (mean 46.1 ± 10.7 vs. 40.6 ± 9.5, p < 0.001). Medical students favored CM university research (mean 5.4 ± 1.5) and mostly did not agree that CM is currently taught sufficiently at the university (mean 3.4 ± 1.7). The lifetime prevalence of student's own CM use was 48.4% of respondents (79.1% females). Conclusion: Although medical students, in this sample with a high percentage of females, reported a rather neutral attitude toward CM, the authors' findings indicate that medical students promoted research and teaching in CM. Further multicenter cross-sectional studies in German and European medical universities should be undertaken to explore students' attitudes and wishes regarding the integration of CM in university teaching, research, and patient care.
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Affiliation(s)
- Gabriele Rotter
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Epidemiology and Health Economics, Berlin, Germany
| | - Lea Jerzynski
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Epidemiology and Health Economics, Berlin, Germany
| | - Maximilian Hinse
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Epidemiology and Health Economics, Berlin, Germany
| | - Sylvia Binting
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Epidemiology and Health Economics, Berlin, Germany
| | - Benno Brinkhaus
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Epidemiology and Health Economics, Berlin, Germany
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21
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Rotter G, Binting S, Tissen-Diabaté T, Ortiz M, Brinkhaus B. Osteopathic Medicine in Four Chronic Musculoskeletal Pain Diseases: An Observational Trial with Follow-Up. Complement Med Res 2021; 29:53-66. [PMID: 34515079 DOI: 10.1159/000518311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 06/25/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND AIM Patients with chronic musculoskeletal pain diseases (CMPDs) often use osteopathic medicine (OM), although the changes in patients with pain diseases are still insufficiently investigated. This study aimed to observe changes along and after OM in addition to routine care on pain, functioning, and quality of life in patients with four CMPDs. METHODS In this observational trial with follow-up, patients suffering from chronic neck pain (CNP, n = 10), chronic low back pain (CLBP, n = 10), chronic shoulder pain (CSP, n = 10), or chronic knee pain (CKP, n = 10) received up to six OM sessions in addition to routine care. RESULTS A total of 40 patients (73% female, mean age 47.7 ± 8.3 years, mean pain intensity 59.4 ± 12.5 mm, measured by a visual analog scale [VAS] 0-100 mm) were included. After 26 weeks, there was an improvement in the VAS pain score in the whole population (mean difference to baseline -33.1 mm [95% CI -40.5 to -25.7]), as well in the patients with the four diseases: CNP (-33.7 mm [-54.7 to -12.6]), CLBP (-28.2 mm [-47.9 to -8.4]), CSP (-32.4 [-46.8 to -18.0]), and CKP (-38.1 mm [-49.1 to -27.0]). Regarding disease-specific outcomes, we found improvements in CNP, as measured by the neck disability index (scale 0-50; mean difference -3.6 [-9.0 to 1.9]), CLBP, as measured by the low back pain rating scale (scale 0-60; -3.4 [-12.5 to 5.7]), CSP, as measured by the disabilities of the arm, shoulder and hand score (scale 0-100; -13.4 [-23.1 to -3.7]), and CKP, as measured by the Western Ontario and McMaster Universities Osteoarthritis Index (scale 0-96; -13.0 [-23.5 to -2.5]). These improvements persisted through week 52. No adverse events were observed. CONCLUSION The study observed beneficial changes along and after the OM treatment in addition to routine care in patients with four different CMPDs. High-quality, multicenter randomized controlled trials are strongly needed to compare the effectiveness of OM and standard care interventions in treating CMPDs in the future. We have provided sufficient data for sample size calculations for these trials.
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Affiliation(s)
- Gabriele Rotter
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Kurt-Singer-Institute for Music Physiology and Musicians Health, Hanns Eisler School of Music Berlin, Berlin, Germany
| | - Sylvia Binting
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Tatjana Tissen-Diabaté
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Miriam Ortiz
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Benno Brinkhaus
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Brüggenjürgen B, Stricker HP, Krist L, Ortiz M, Reinhold T, Roll S, Rotter G, Weikert B, Wiese-Posselt M, Willich SN. Impact of public health interventions to curb SARS-CoV-2 spread assessed by an evidence-educated Delphi panel and tailored SEIR model. Z Gesundh Wiss 2021; 31:539-552. [PMID: 34026423 PMCID: PMC8127459 DOI: 10.1007/s10389-021-01566-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 04/14/2021] [Indexed: 01/08/2023]
Abstract
AIM To use a Delphi-panel-based assessment of the effectiveness of different non-pharmaceutical interventions (NPI) in order to retrospectively approximate and to prospectively predict the SARS-CoV-2 pandemic progression via a SEIR model (susceptible, exposed, infectious, removed). METHODS We applied an evidence-educated Delphi-panel approach to elicit the impact of NPIs on the SARS-CoV-2 transmission rate R0 in Germany. Effectiveness was defined as the product of efficacy and compliance. A discrete, deterministic SEIR model with time step of 1 day, a latency period of 1.8 days, duration of infectiousness of 5 days, and a share of the total population of 15% assumed to be protected by immunity was developed in order to estimate the impact of selected NPI measures on the course of the pandemic. The model was populated with the Delphi-panel results and varied in sensitivity analyses. RESULTS Efficacy and compliance estimates for the three most effective NPIs were as follows: test and isolate 49% (efficacy)/78% (compliance), keeping distance 42%/74%, personal protection masks (cloth masks or other face masks) 33%/79%. Applying all NPI effectiveness estimates to the SEIR model resulted in a valid replication of reported occurrence of the German SARS-CoV-2 pandemic. A combination of four NPIs at consented compliance rates might curb the CoViD-19 pandemic. CONCLUSION Employing an evidence-educated Delphi-panel approach can support SARS-CoV-2 modelling. Future curbing scenarios require a combination of NPIs. A Delphi-panel-based NPI assessment and modelling might support public health policy decision making by informing sequence and number of needed public health measures. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s10389-021-01566-2.
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Affiliation(s)
- Bernd Brüggenjürgen
- Institute for Health Services Research and Technical Orthopaedics, Orthopaedic Department of Medical School Hannover (MHH) at DIAKOVERE Annastift, Anna-von-Borries-Str. 1-7, 30625 Hannover, Germany
| | | | - Lilian Krist
- Institute for Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Miriam Ortiz
- Institute for Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Thomas Reinhold
- Institute for Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Stephanie Roll
- Institute for Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Gabriele Rotter
- Institute for Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Beate Weikert
- Institute of Hygiene and Environmental Medicine, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Miriam Wiese-Posselt
- Institute of Hygiene and Environmental Medicine, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Stefan N. Willich
- Institute for Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Rotter G, Fernholz I, Binting S, Keller T, Roll S, Kass B, Reinhold T, Willich SN, Schmidt A, Brinkhaus B. The effect of osteopathic medicine on pain in musicians with nonspecific chronic neck pain: a randomized controlled trial. Ther Adv Musculoskelet Dis 2020; 12:1759720X20979853. [PMID: 33354233 PMCID: PMC7734566 DOI: 10.1177/1759720x20979853] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 11/18/2020] [Indexed: 12/31/2022] Open
Abstract
Background: Nonspecific chronic neck pain (cNP) is common in adult violinists and violists and is often treated with osteopathic medicine (OM), although the effectiveness of this treatment has not been determined to date. This study aimed to evaluate the effectiveness and safety of OM in adult violinists and violists with cNP. Methods: In a two-armed randomized controlled single-center open trial, adult violinists and violists, including music students, with cNP (⩾12 weeks) were randomized to either five individualized OM sessions (OM group) or to no intervention (control group, CG) in the outpatient clinic for integrative medicine, Charité - Universitätsmedizin Berlin, Germany. All patients received a musicians’ medicine consultation and paracetamol on demand. The primary outcome parameter was the neck pain intensity on a visual analog scale (VAS, 0–100 mm, 0 = no pain, 100 = worst imaginable pain) after 12 weeks. Secondary outcomes included neck pain disability (Neck Disability Index, NDI, 0–100%) after 12 weeks. The last follow-up visit was after 52 weeks. Statistical analysis included analysis of covariance adjusted for respective baseline value. Results: Altogether, 62 outpatients were included [OM group (n = 28), CG (n = 34); 81% female; mean age, 41.6 ± 11.1 years; mean baseline neck pain, 55.9 ± 11.6 mm]. After 12 weeks, OM was associated with an improvement in the OM group versus the CG in neck pain on the VAS [14.6 mm (95% confidence interval 8.0; 21.2) versus 40.8 mm (34.7; 46.9), p < 0.001, Cohen’s d = 1.4], and neck pain disability as determined by the NDI [8.8% (6.7; 10.8) versus 17.2% (15.3; 19.1), p < 0.001]. Some improvements were maintained until 52 weeks of follow-up. No serious adverse events were observed. Conclusions: The results of this study suggest that OM might be effective in reducing pain intensity in adult violinists and violists with nonspecific cNP. Further studies should investigate the efficacy of OM in comparison with a sham procedure and with other effective therapy methods in high-quality multicenter trials. Trial registration: WHO Trial Registration https://apps.who.int/trialsearch/NoAccess.aspx?aspxerrorpath=/trialsearch/Trial2.aspx by German Clinical Trials Register DRKS00009258, Universal Trial Number (UTN): U1111-1173-5943.
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Affiliation(s)
- Gabriele Rotter
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Luisenstrasse 57, Berlin, 10117, Germany
| | - Isabel Fernholz
- Kurt-Singer-Institute for Music Physiology and Musicians Health, Hanns Eisler School of Music Berlin, Germany
| | - Sylvia Binting
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Theresa Keller
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Stephanie Roll
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Benjamin Kass
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Thomas Reinhold
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Stefan N Willich
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Alexander Schmidt
- Kurt-Singer-Institute for Music Physiology and Musicians Health, Hanns Eisler School of Music Berlin, Germany
| | - Benno Brinkhaus
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
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Rotter G, Schollbach L, Binting S, Dornquast C, Scherr J, Pfab F, Brinkhaus B. Use of Complementary Medicine in Competitive Sports: Results of a Cross-Sectional Study. Complement Med Res 2020; 28:139-145. [PMID: 33147595 DOI: 10.1159/000511247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 08/04/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Although complementary medicine is frequently used in Germany, there is almost no information about complementary medicine use in competitive sports. The aim was to assess the use of complementary medicine among elite athletes in Germany. PATIENTS AND METHODS A cross-sectional study among athletes was performed between March 2012 and September 2013. Athletes of both sexes who visited a sports medical outpatient clinic in Munich, Bavaria were included. Data about the use of complementary medicine were collected by means of a standardized measurement instrument, the German version of the international complementary and alternative medicine questionnaire. RESULTS Of the 334 athletes (female 25%, mean age 20.2 ± 6.6 years) who completed all 4 sections of the questionnaire, 69% reported the use of at least one type of complementary medicine within the last 12 months. 505 athletes (female 26%, mean age 20.5 ± 7.0 years) completed at least one section of the questionnaire entirely. Within 12 months, the osteopath (11%), herbal medicine (17%), vitamins/minerals (32%), and relaxation techniques (15%) were the most frequently visited/used in relation to the respective sections of the questionnaire. CONCLUSION Complementary medicine is frequently used by athletes in Germany. The efficacy, safety, and costs of complementary medicine should be investigated in clinical trials among athletes in the future.
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Affiliation(s)
- Gabriele Rotter
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany, .,Kurt-Singer-Institute for Music Physiology and Musicians' Health, Hanns Eisler School of Music Berlin, Berlin, Germany,
| | - Lisa Schollbach
- Department of Prevention, Rehabilitation and Sports Medicine, Technical University of Munich, Munich, Germany
| | - Sylvia Binting
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Christina Dornquast
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Johannes Scherr
- Department of Prevention, Rehabilitation and Sports Medicine, Technical University of Munich, Munich, Germany
| | - Florian Pfab
- Department of Prevention, Rehabilitation and Sports Medicine, Technical University of Munich, Munich, Germany.,Medzentrum Residenz, Munich, Germany
| | - Benno Brinkhaus
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Kiepe MS, Fernholz I, Schmidt T, Brinkhaus B, Schmidt A, Weikert C, Rotter G. Effects of Osteopathic Manipulative Treatment on Musicians: A Systematic Review. Med Probl Perform Art 2020; 35:110-115. [PMID: 32479587 DOI: 10.21091/mppa.2020.2017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 01/09/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Professional musicians frequently suffer from musculoskeletal complaints and disorders (MCD), which can be treated by osteopathic manipulative treatment (OMT). The aim of this systematic review was to evaluate the effectiveness and efficacy of OMT in adult musicians. METHODS A systematic literature search included the electronic databases PubMed/MEDLINE, Medpilot, EBSCOhost, BioMedCentral, OSTMED-Dr, osteopathic-research.com, PEDro, hand searches, and contact to European osteopathic academies. Interventional and observational studies published between January 1999 and January 2019, of professional or amateur musicians who were either healthy or had MCD treated by OMT, were included. The quality of the randomized controlled trials (RCTs) was assessed by the Physiotherapy Evidence Database (PEDro) Scale ranging between 0 and 10 points. RESULTS Only 5 studies were identified investigating OMT in musicians, including 1 RCT (cross-over design), 3 clinical controlled trials, and 1 case report. The internal validity of the RCT was assessed as 6 points. OMT was reported to have a positive impact on healthy singers, improving phonation time, voice quality, and voice range. It also improved the cervical range of motion in violinists. No adverse events were observed, although only the cross-over RCT reported partly an assessment of adverse events. CONCLUSIONS The evidence for OMT in adult musicians is very limited. Prospective controlled clinical trials investigating OMT in musicians are required.
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Affiliation(s)
| | | | | | | | | | | | - Gabriele Rotter
- Berlin Center for Musicians' Medicine, Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Luisenstraße 57, 10117 Berlin, Germany. Tel +49 30 450 529 007.
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Rotter G, Noeres K, Fernholz I, Willich SN, Schmidt A, Berghöfer A. Musculoskeletal disorders and complaints in professional musicians: a systematic review of prevalence, risk factors, and clinical treatment effects. Int Arch Occup Environ Health 2020; 93:149-187. [PMID: 31482285 PMCID: PMC7007903 DOI: 10.1007/s00420-019-01467-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 07/19/2019] [Indexed: 11/27/2022]
Abstract
PURPOSE Musicians' practice and performance routines reportedly lead to musculoskeletal complaints and disorders (MCD) that impact their wellbeing and performance abilities. This systematic review aims to assess the prevalence, risk factors, prevention and effectiveness of treatments for MCD in professional musicians and consider the methodological quality of the included studies. METHODS A systematic literature search was performed in December 2017 using electronic databases and supplemented by a hand search. Case-control studies, cohort studies, cross-sectional studies, interventional studies and case reports investigating the prevalence, risk factors, prevention or treatment effects of MCD in professional musicians or music students (age ≥ 16 years) were included. Quality assessments of the included studies were performed using an adapted version of the "Study Quality Assessment Tools" from the National Heart, Lung, and Blood Institute. RESULTS One case-control study, 6 cohort studies, 62 cross-sectional studies, 12 interventional studies and 28 case reports were included and assessed for methodological quality. The study designs, terminology, and outcomes were heterogeneous, as the analyses mostly did not control for major confounders, and the definition of exposure was often vague. Therefore, evidence that being a professional musician is a risk factor for MCD as well as the causal relationship between these factors remains low despite the fact that a large number of studies have been performed. CONCLUSIONS Studies with high internal and external validity regarding the prevalence, risk factors and effectiveness of the prevention or treatment of MCD in professional musicians are still missing. Further high-quality observational and interventional studies are required.
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Affiliation(s)
- Gabriele Rotter
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Luisenstrasse 57, 10117, Berlin, Germany.
- Kurt-Singer-Institute for Music Physiology and Musicians' Health, Hanns Eisler School of Music Berlin and University of the Arts Berlin, Charlottenstrasse 55, 10117, Berlin, Germany.
- Berlin Center for Musicians' Medicine, Charité - Universitätsmedizin Berlin, Luisenstrasse 13, 10117, Berlin, Germany.
| | - Katharina Noeres
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Luisenstrasse 57, 10117, Berlin, Germany
| | - Isabel Fernholz
- Kurt-Singer-Institute for Music Physiology and Musicians' Health, Hanns Eisler School of Music Berlin and University of the Arts Berlin, Charlottenstrasse 55, 10117, Berlin, Germany
- Berlin Center for Musicians' Medicine, Charité - Universitätsmedizin Berlin, Luisenstrasse 13, 10117, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Stefan N Willich
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Luisenstrasse 57, 10117, Berlin, Germany
- Berlin Center for Musicians' Medicine, Charité - Universitätsmedizin Berlin, Luisenstrasse 13, 10117, Berlin, Germany
| | - Alexander Schmidt
- Kurt-Singer-Institute for Music Physiology and Musicians' Health, Hanns Eisler School of Music Berlin and University of the Arts Berlin, Charlottenstrasse 55, 10117, Berlin, Germany
- Berlin Center for Musicians' Medicine, Charité - Universitätsmedizin Berlin, Luisenstrasse 13, 10117, Berlin, Germany
- Department of Audiology and Phoniatrics, Charité - Universitätsmedizin Berlin, Luisenstrasse 13, 10117, Berlin, Germany
| | - Anne Berghöfer
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Luisenstrasse 57, 10117, Berlin, Germany
- Berlin Center for Musicians' Medicine, Charité - Universitätsmedizin Berlin, Luisenstrasse 13, 10117, Berlin, Germany
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Cramer H, Klose P, Teut M, Rotter G, Ortiz M, Anheyer D, Linde K, Brinkhaus B. Cupping for Patients With Chronic Pain: A Systematic Review and Meta-Analysis. J Pain 2020; 21:943-956. [PMID: 31982686 DOI: 10.1016/j.jpain.2020.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 11/25/2019] [Accepted: 01/20/2020] [Indexed: 10/25/2022]
Abstract
There is a growing interest in nonpharmacological pain treatment options such as cupping. This meta-analysis aimed to assess the effectiveness and safety of cupping in chronic pain. PubMed, Cochrane Library, and Scopus were searched through November 2018 for randomized controlled trials on effects of cupping on pain intensity and disability in patients with chronic pain. Risk of bias was assessed using the Cochrane risk of bias tool. Of the 18 included trials (n =1,172), most were limited by clinical heterogeneity and risk of bias. Meta-analyses found large short-term effects of cupping on pain intensity compared to no treatment (standardized mean difference [SMD] = -1.03; 95% confidence interval [CI] = -1.41, -.65), but no significant effects compared to sham cupping (SDM = -.27; 95% CI = -.58, .05) or other active treatment (SMD = -.24; 95% CI = -.57, .09). For disability, there were medium-sized short-term effects of cupping compared to no treatment (SMD = -.66; 95% CI = -.99, -.34), and compared to other active treatments (SMD = -.52; 95% CI = -1.03, -.0028), but not compared to sham cupping (SMD = -.26; 95% CI = -.57,.05). Adverse events were more frequent among patients treated with cupping compared to no treatment; differences compared to sham cupping or other active treatment were not statistically significant. Cupping might be a treatment option for chronic pain, but the evidence is still limited by the clinical heterogeneity and risk of bias. Perspective: This article presents the results of a meta-analysis aimed to assess the effectiveness and safety of cupping with chronic pain. The results suggest that cupping might be a treatment option; however, the evidence is still limited due to methodical limitations of the included trials. High-quality trials seem warranted.
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Affiliation(s)
- Holger Cramer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Petra Klose
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Michael Teut
- Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Gabriele Rotter
- Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Miriam Ortiz
- Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Dennis Anheyer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Klaus Linde
- Institute of General Practice, Technical University of Munich, TUM Medical School, Munich, Germany
| | - Benno Brinkhaus
- Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
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Fernholz I, Mumm JLM, Plag J, Noeres K, Rotter G, Willich SN, Ströhle A, Berghöfer A, Schmidt A. Performance anxiety in professional musicians: a systematic review on prevalence, risk factors and clinical treatment effects. Psychol Med 2019; 49:2287-2306. [PMID: 31474244 DOI: 10.1017/s0033291719001910] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Music performance anxiety (MPA) is one of the most common disorders among professional musicians, nevertheless, little is known about the disease. With this systematic review, prevalence, risk factors and treatment procedures for MPA were assessed, and for the first time, quality assessments were carried out for all studies using standardized assessment tools. A systematic literature search was conducted via search algorithms in the databases MEDLINE, EMBASE, CINAHL, PsycArticles, PsycInfo and ERIC. Included were case reports, case-control, cohort, cross-sectional and intervention studies examining professional musicians with MPA. For quality assessment, adapted tools of the National Heart, Lung, and Blood Institute were used. A total of 43 studies were included (10 case reports, 21 intervention, 11 cross-sectional, one cohort study). Quality ratings ranged from -11 to 6 out of a maximum of 15/16 points for cross-sectional/cohort studies and -4 to 11 out of 18 points for intervention studies. The prevalence of MPA was between 16.5% and 60%. More women than men were affected and musicians older than 45-50 years reported less MPA than younger musicians. Regarding treatment cognitive behavioural therapy (CBT) and β-blockers were most often researched with beneficial results for CBT. However, studies with adequate control groups for CBT interventions are needed to clarify its efficacy. Studies showed methodological weaknesses, especially in the selection of participants, recording of influencing factors, blinding of interventions, randomization of participants and analysis of comorbidity. Recommendations for further research are made.
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Affiliation(s)
- I Fernholz
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Mitte, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin Center for Musicians' Medicine (BCMM), Berlin, Germany
- Kurt Singer Institute for Music Physiology and Musicians' Health, Hanns Eisler School of Music Berlin and University of the Arts Berlin, Berlin, Germany
| | - J L M Mumm
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Mitte, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin Center for Musicians' Medicine (BCMM), Berlin, Germany
| | - J Plag
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Mitte, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin Center for Musicians' Medicine (BCMM), Berlin, Germany
| | - K Noeres
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - G Rotter
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin Center for Musicians' Medicine (BCMM), Berlin, Germany
- Kurt Singer Institute for Music Physiology and Musicians' Health, Hanns Eisler School of Music Berlin and University of the Arts Berlin, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - S N Willich
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin Center for Musicians' Medicine (BCMM), Berlin, Germany
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - A Ströhle
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Mitte, Berlin, Germany
| | - A Berghöfer
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin Center for Musicians' Medicine (BCMM), Berlin, Germany
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - A Schmidt
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin Center for Musicians' Medicine (BCMM), Berlin, Germany
- Kurt Singer Institute for Music Physiology and Musicians' Health, Hanns Eisler School of Music Berlin and University of the Arts Berlin, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Clinic for Audiology and Phoniatrics, Berlin, Germany
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Teut M, Ullmann A, Ortiz M, Rotter G, Binting S, Cree M, Lotz F, Roll S, Brinkhaus B. Pulsatile dry cupping in chronic low back pain - a randomized three-armed controlled clinical trial. Altern Ther Health Med 2018; 18:115. [PMID: 29609566 PMCID: PMC5879872 DOI: 10.1186/s12906-018-2187-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 03/22/2018] [Indexed: 01/13/2023]
Abstract
Background We aimed to investigate the effectiveness of two different forms of dry pulsatile cupping in patients with chronic low back pain (cLBP) compared to medication on demand only in a three-armed randomized trial. Methods 110 cLBP patients were randomized to regular pulsatile cupping with 8 treatments plus paracetamol on demand (n = 37), minimal cupping with 8 treatments plus paracetamol on demand (n = 36) or the control group with paracetamol on demand only (n = 37). Primary outcome was the pain intensity on a visual analogue scale (VAS, 0–100 mm) after 4 weeks, secondary outcome parameter included VAS pain intensity after 12 weeks, back function as measured with the ‘Funktionsfragebogen Hannover Rücken’ (FFbH-R) and health related quality of life questionnaire Short form 36 (SF-36) after 4 and 12 weeks. Results The mean baseline-adjusted VAS after 4 weeks was 34.9 mm (95% CI: 28.7; 41.2) for pulsatile cupping, 40.4 (34.2; 46.7) for minimal cupping and 56.1 (49.8; 62.4) for control group, resulting in statistically significant differences between pulsatile cupping vs. control (21.2 (12.2; 30.1); p < 0.001) and minimal cupping vs. control (15.7 (6.9; 24.4); p = 0.001). After 12 weeks, mean adjusted VAS difference between pulsatile cupping vs. control was 15.1 ((3.1; 27.1); p = 0.014), and between minimal cupping vs. control 11.5 ((− 0.44; 23.4); p = 0.059). Differences of VAS between pulsatile cupping and minimal cupping showed no significant differences after 4 or 12 weeks. Pulsatile cupping was also better (− 5.8 (− 11.5;-0.1); p = 0.045) compared to control for back function after 4 weeks, but not after 12 weeks (− 5.4 (− 11.7;0.8); p = 0.088), pulsatile cupping also showed better improvements on SF-36 physical component scale compared to control at 4 and 12 weeks (− 5.6 (− 9.3;-2.0); p = 0.003; − 6.1 (− 9.9;-2.4); p = 0.002). For back function and quality of life minimal cupping group was not statistically different to control after 4 and 12 weeks. Paracetamol intake did not differ between the groups (cupping vs. control (7.3 (− 0.4;15.0); p = 0.063); minimal cupping vs. control (6.3 (− 2.0;14.5); p = 0.133). Conclusions Both forms of cupping were effective in cLBP without showing significant differences in direct comparison after four weeks, only pulsatile cupping showed effects compared to control after 12 weeks. Trial registration The study was registered at ClinicalTrials.gov (identifier: NCT02090686).
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Abstract
Hintergrund: Das Vorhandensein einer Hiatushernie kann das Auftreten einer gastroösophagealen Refluxerkrankung (GERD) als Komplikation bedingen. Konventionelle medizinische Therapiemaßnahmen können zu unerwünschten Ereignissen und Rezidiven führen. Bisher sind die Effekte von osteopathischen Behandlungen bei Hiatushernie und GERD nicht bekannt. Fallbericht: Eine 59-jährige Patientin mit endoskopisch diagnostizierter chronischer Gastritis, GERD und Hiatushernie beklagte einen persistierenden gastroösophagealen Reflux trotz konventionell-medizinischer konservativer Therapie. Die osteopathische Diagnostik ergab eine funktionelle Störung im Bereich des Magens und der Kardia mit einer Beteiligung zugehöriger Reflexzonen. Nach einer osteopathischen Behandlung als individuelle, befundorientierte Therapie ließen die Beschwerden erheblich nach. Die Hiatushernie war nach einer dieser Behandlung endoskopisch nicht mehr nachweisbar. Schlussfolgerungen: Dieser Fallbericht schildert die Symptomreduktion einer GERD nach osteopathischer Behandlung. In der endoskopischen Folgeuntersuchung fand sich die initial diagnostizierte Hiatushernie nicht mehr, diese Befund änderung könnte jedoch auf die unterschiedlichen Untersucher zurückgeführt werden. Prospektive kontrollierte klinische Studien sind notwendig, um den Stellenwert von osteopathischen Behandlungen bei GERD mit Hiatushernie zu untersuchen.
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Affiliation(s)
- Gabriele Rotter
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
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Pach D, Piper M, Lotz F, Reinhold T, Dombrowski M, Chang Y, Liu B, Blödt S, Rotter G, Icke K, Witt CM. Effectiveness and Cost-Effectiveness of Tuina for Chronic Neck Pain: A Randomized Controlled Trial Comparing Tuina with a No-Intervention Waiting List. J Altern Complement Med 2017; 24:231-237. [PMID: 29072931 DOI: 10.1089/acm.2017.0209] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To evaluate whether tuina is more effective and cost-effective in reducing pain compared to no intervention in patients with chronic neck pain. DESIGN Single-center randomized two-armed controlled trial. SETTING University outpatient clinic specialized in Integrative Medicine. SUBJECTS Outpatients with chronic neck pain were randomly allocated to tuina or no intervention. INTERVENTION Six tuina treatments within 3 weeks. OUTCOME MEASURES The primary outcome was the mean neck pain intensity during the previous 7 days on a visual analogue scale after 4 weeks (VAS, 0-100 mm, 0 = no pain, 100 = worst imaginable pain). Secondary outcomes included Neck Pain and Disability Scale (NPDS), Neck Disability Index (NDI), health-related quality of life (12-item quality-of-life questionnaire [SF-12]), medication intake, and cost-effectiveness after 4 and 12 weeks. Statistical analysis included analysis of covariance adjusted for baseline values and a full economic analysis from a societal perspective. RESULTS Altogether, 92 outpatients were included (46 in both groups, 87% female, mean age 45.4 [standard deviation ±9.7], and mean VAS 57.7 ± 11.5). Tuina treatment led to a clinically meaningful reduction in neck pain intensity (group differences, 4 weeks: -22.8 mm [95% confidence interval, -31.7 to -13.8]; p < 0.001 and 12 weeks: -17.9 mm [-27.1 to -8.8], p < 0.001). No serious adverse events were observed. Total costs as well as quality-adjusted life years (QALYs) did not differ significantly between the groups. When taking group differences into account independently from their statistical significance, costs per QALY gained (incremental cost-effectiveness ratio) would range within a cost-effective area from €7,566 (for costs €10.28 per session) to €39,414 (cost €35 per session). CONCLUSION An additional treatment with six tuina sessions over 3 weeks was effective, safe and relatively cost-effective for patients with chronic neck pain. A future trial should compare tuina to other best care options.
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Affiliation(s)
- Daniel Pach
- 1 Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin , and Berlin Institute of Health , Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Mike Piper
- 1 Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin , and Berlin Institute of Health , Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Fabian Lotz
- 1 Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin , and Berlin Institute of Health , Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Thomas Reinhold
- 1 Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin , and Berlin Institute of Health , Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Mirja Dombrowski
- 1 Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin , and Berlin Institute of Health , Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Yinghui Chang
- 2 First Teaching Hospital of Tianjin University of Traditional Chinese Medicine , Tianjin, China
| | - Bin Liu
- 2 First Teaching Hospital of Tianjin University of Traditional Chinese Medicine , Tianjin, China
| | - Susanne Blödt
- 1 Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin , and Berlin Institute of Health , Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Gabriele Rotter
- 1 Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin , and Berlin Institute of Health , Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Katja Icke
- 1 Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin , and Berlin Institute of Health , Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Claudia M Witt
- 1 Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin , and Berlin Institute of Health , Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany .,3 Institute for Complementary and Integrative Medicine, University of Zurich and University Hospital Zurich , Zurich, Switzerland .,4 Center for Integrative Medicine, University of Maryland School of Medicine Baltimore , MD
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Ortiz M, Schnabel K, Teut M, Rotter G, Binting S, Cree M, Lotz F, Suhr R, Brinkhaus B, Parvizi MM, Handjani F, Zarshenas MM, Moein MR, Nimrouzi M, Hatam G, Hasanzadeh J, Hamidizadeh N, Parvizi MM, Heydari M, Namazi MR, Parvizi Z, Pasalar M, Mosaffa-Jahromi M, Bagheri-Lankarani K, Afsharypuor S, Tamaddon AM, Ostovar M, Peloni G, Bolliger I, Faria RMDC, Quadri P, Sanzeni W, Zemp D, Risvoll H, Giverhaug T, Halvorsen KH, Waaseth M, Musial F, Rossi E, Baccetti S, Picchi M, Conti T, Firenzuoli F, Guido C, Bosco F, Guido C, Rossi E, Panozzo M, Picchi M, Cervino C, Nurra L, Rossi E, Picchi M, Firenzuoli F, Traversi A, Vuono K, Sabatini F, Bellandi T, Rutert B, Eggert A, Seifert G, Stritter W, Holmberg C, Längler A, Salamonsen A, Wiesener S, Schad F, Steele M, Kröz M, Matthes H, Herbstreit C, Thronicke A, Schlingensiepen I, von Schoen-Angerer T, Schneider R, Waeber L, Vagedes J, Kaczala G, Pharisa C, Wildhaber J, Huber B, Sidorov P, Sovershaeva E, Simões-Wüst AP, Nietlispach A, Mennet M, Schnelle M, von Mandach U, Wang X, Woo HL, Lee JM, Wu Y, Cho Y, Yun Y, Kim H, Jung W, Jang BH, Ziea E, Hui H, Li M, Tsui D, Lam C, Hsieh J, Chan E, Balneaves L, Burnside S, Doyle E, Dorazio S, Chan PK, Bhagra A, Chen PH, Chung VCH, Wu JCY, Lin ZX, Wong W, Wu XY, Ho RST, Wong CHL, Chan L, Ziea ETC, Elder W, Cardarelli R, Kaspar C, Kempenich R, Kopferschmitt J, Marinko Z, Damir S, Vcev A, Monezi R, Ruggerini EM, Fuchigami IM, Mazini ACM, Monezi R, Oliveira MW, Papuga P, Schloss J, Steel A, Jacobsen MDS, Monezi R, Jacobsen MR, Mangini MT, Trapani G, Di Giampietro T, Zanino L, Ciullo L, Lanaro D, Cerritelli F, Macrì F, Tsai A, Lin C, Wu TH, D’Alessandro E, Watts S, Zhang Y, Wu X, Li X, Fei Y, Liu J, Zhao N, Jia L, Yan X, Zhen F, Liu Z, Liu J, Ahn J, Yun Y, AlEidi S, Mohamed AG, Al-Beda AM, Abutalib RA, Khalil MKM, Amri H, Badekila S, Behmanesh E, Mozaffarpour S, Behmanesh E, Mozaffarpour S, Behmanesh E, Shirooye P, Meybodi RN, Mokaberinejad R, Tansaz M, Mozaffarpour S, Chung VCH, Wu XY, Wu JCY, Daneshfard B, Hosseinkhani A, Tafazoli V, Jaladat AM, Jaladat AM, Sadeghi H, Jia L, Zhao N, Yan X, Zhou L, Zhao M, Li W, Liu J, Liu Z, Jia L, Zhao N, Yan X, Zhou L, Zhao M, Li W, Liu J, Liu Z, Larsen AL, Salamonsen A, Kristoffersen AE, Hamran T, Evjen B, Stub T, Li M, Cai J, Lu T, Yin L, Wu D, Wang L, Liew SM, Liu T, Bai C, Zheng Z, Wan Y, Xu J, Wang X, Yu H, Gu X, Liu Z, Yan X, Jia L, Zhao N, Yang G, Liu J, Mozaffarpour S, Behmanesh E, Nimrouzi M, Tafazoli V, Daneshfard B, Ostrowski D, Fox K, Pasalar M, Tabatabei F, Amini F, Sathasivampillai S, Rajamanoharan P, Munday M, Heinrich M, Scherrer YM, Heinrich M, Szuter C, Amini F, Tabatabaei F, Tavakoli A, Tavakoli F, Pasalar M, rostami M, Torri MC, Szuter C, Walach H, Warner F, Majumdar A, Serasingh P, Yan X, Jia L, Zhao N, Liu Z, Liu J, Zhao N, Zhen F, Jia L, Yan X, Liu Z, Liu J, Abbing A, Ponstein A, Baars E, Croke S, Hanser S, Heckel V, Krüerke D, Simões-Wüst AP, Weiss S, Metzner S, Lee JW, Hyun MK, Masetti M, Oepen R, Gruber H, Heusser P, Pelz H, Perlitz V, Ponstein A, Abbing A, Baars E, Robinson N, Ronan P, Mian A, Madge S, Lorenc A, Agent P, Carr S, Ronan P, Robinson N, Carr S, Mian A, Lorenc A, Agent P, Madge S, Winnubst ME, Monezi R, Abolghasemi J, Heydari M, Baccetti S, Rossi E, Fedi P, Di Stefano M, Belvedere K, Baccetti S, Rossi E, Firenzuoli F, Di Stefano M, Belvedere K, Beaven K, Rose A, Florschutz G, Phil NB, Parsons H, Stewart-Brown S, Burke K, Busch M, Heyning F, Smit J, Jeekel H, de Goeij H, Guido PC, Barraza N, Balbarrey Z, Ribas A, Jimenez B, Iachino C, Quattrone F, Gaioli M, Dell’Orso M, Villanueva S, Rocha C, Macchi A, Cai J, Chen L, Wu D, Wang S, Choi E, Go N, Lee Y, Dahal G, Frauenknecht X, Gerhardt H, Galanti M, Cerda CJ, Galanti M, Galanti M, Heckersdorf DN, Jorquera H, Saldivia MLA, Jakubonienė D, McEwen B, Melo F, Fontana FM, Valle ACV, Neres MTB, Mohagheghzadeh A, Zohalinezhad ME, Njaradi O, Dunjic M, Njaradi O, Dunjic M, Ostrowski D, Fox K, Pokladnikova J, Selke-Krulichova I, Seo J, Jang H, Simões-Wüst AP, Moltó-Puigmartí C, van Dongen M, Dagnelie P, Thijs C, Tihanyi E, Hegyi G, Zhang Y, Li X, Fei Y, Liu J, Zhang Y, Liu J, Tong X. World Congress Integrative Medicine & Health 2017: part three. Altern Ther Health Med 2017. [PMCID: PMC5499100 DOI: 10.1186/s12906-017-1784-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Brinkhaus B, Falkenberg T, Haramati A, Willich SN, Briggs JP, Willcox M, Linde K, Theorell T, Wong LM, Dusek J, Wu D, Eisenberg D, Haramati A, Berger B, Kemper K, Stock-Schröer B, Sützl-Klein H, Ferreri R, Kaplan G, Matthes H, Rotter G, Schiff E, Arnon Z, Hahn E, Luberto CM, Martin D, Schwarz S, Tauschel D, Flower A, Gramminger H, Gupta HH, Gupta SN, Kerckhoff A, Kessler CS, Michalsen A, Kessler CS, Kim ES, Jang EH, Kim R, Jan SB, Mittwede M, Mohme W, Ben-Arye E, Bonucci M, Saad B, Breitkreuz T, Rossi E, Kebudi R, Daher M, Razaq S, Gafer N, Nimri O, Hablas M, Kienle GS, Samuels N, Silbermann M, Bandelin L, Lang AL, Wartner E, Holtermann C, Binstock M, Riebau R, Mujkanovic E, Cramer H, Lauche R, Michalsen A, Ward L, Cramer H, Irnich D, Stör W, Burnstock G, Schaible HG, Ots T, Langhorst J, Lauche R, Sundberg T, Falkenberg T, Amarell C, Amarell C, Anheyer M, Eckert M, Eckert M, Ogal M, Eckert M, Amarell C, Schönauer A, Reisenberger B, Brand B, Anheyer D, Dobos G, Kroez M, Martin D, Matthes H, Ammendola A, Mao JJ, Witt C, Yang Y, Dobos G, Oritz M, Horneber M, Voiß P, Reisenberger B, von Rosenstiel A, Eckert M, Ogal M, Amarell C, Anheyer M, Schad F, Schläppi M, Kröz M, Büssing A, Bar-Sela G, Matthes H, Schiff E, Ben-Arye E, Arnon Z, Avshalomov D, Attias S, Schönauer A, Haramati A, Witt C, Brinkhaus B, Cotton S, Jong M, Jong M, Scheffer C, Haramati A, Tauschel D, Edelhäuser F, AlBedah A, Lee MS, Khalil M, Ogawa K, Motoo Y, Arimitsu J, Ogawa M, Shimizu G, Stange R, Kraft K, Kuchta K, Watanabe K, Bonin D, Büssing A, Gruber H, Koch S, Gruber H, Pohlmann U, Caldwell C, Krantz B, Kortum R, Martin L, Wieland LS, Kligler B, Gould-Fogerite S, Zhang Y, Wieland LS, Riva JJ, Lumpkin M, Ratner E, Ping L, Jian P, Hamme GM, Mao X, Chouping H, Schröder S, Hummelsberger J, Wullinger M, Brodzky M, Zalpour C, Langley J, Weber W, Mudd LM, Wayne P, Witt C, Weidenhammer W, Fønnebø V, Boon H, Steel A, Bugarcic A, Rangitakatu M, Steel A, Adams J, Sibbritt D, Wardle J, Leach M, Schloss J, Dieze H, Boon H, Ijaz N, Willcox M, Heinrich M, Lewith G, Flower A, Graz B, Adam D, Grabenhenrich L, Ortiz M, Binting S, Reinhold T, Brinkhaus B, Andermo S, Sundberg T, Falkenberg T, Nordberg JH, Arman M, Bhasin M, Fan X, Libermann T, Fricchione G, Denninger J, Benson H, Berger B, Stange R, Michalsen A, Martin DD, Boers I, Vlieger A, Jong M, Brinkhaus B, Teut M, Ullmann A, Ortiz M, Rotter G, Binting S, Lotz F, Roll S, Canella C, Mikolasek M, Rostock M, Beyer J, Guckenberger M, Jenewein J, Linka E, Six C, Stoll S, Stupp R, Witt CM, Chuang E, Kligler B, McKee MD, Cramer H, Lauche R, Klose P, Lange S, Langhorst J, Dobos G, Chung VCH, Wong HLC, Wu XY, Wen GYG, Ho RST, Ching JYL, Wu JCY, Coakley A, Flanagan J, Annese C, Empoliti J, Gao Z, Liu X, Yu S, Yan X, Liang F, Hohmann CD, Steckhan N, Ostermann T, Paetow A, Hoff E, Michalsen A, Hu XY, Wu RH, Logue M, Blonde C, Lai LY, Stuart B, Flower A, Fei YT, Moore M, Liu JP, Lewith G, Hu XY, Wu RH, Logue M, Blonde C, Lai LY, Stuart B, Flower A, Fei YT, Moore M, Liu JP, Lewith G, Jeitler M, Zillgen H, Högl M, Steckhan N, Stöckigt B, Seifert G, Michalsen A, Kessler C, Khadivzadeh T, Bashtian MH, Aval SB, Esmaily H, Kim J, Kim KH, Klocke C, Joos S, Koshak A, Wie L, Koshak E, Wali S, Alamoudi O, Demerdash A, Qutub M, Pushparaj P, Heinrich M, Kruse S, Fischer I, Tremel N, Rosenecker J, Leung B, Takeda W, Liang N, Feng X, Liu JP, Cao HJ, Luberto CM, Shinday N, Philpotts L, Park E, Fricchione GL, Yeh G, Munk N, Zakeresfahani A, Foote TR, Ralston R, Boulanger K, Özbe D, Gräßel E, Luttenberger K, Pendergrass A, Pach D, Bellmann-Strobl J, Chang Y, Pasura L, Liu B, Jäger SF, Loerch R, Jin L, Brinkhaus B, Ortiz M, Reinhold T, Roll S, Binting S, Icke K, Shi X, Paul F, Witt CM, Rütz M, Lynen A, Schömitz M, Vahle M, Salomon N, Lang A, Lahat A, Kopylov U, Ben-Horin S, Har-Noi O, Avidan B, Elyakim R, Gamus D, NG S, Chang J, Wu J, Kaimiklotis J, Schumann D, Buttó L, Langhorst J, Dobos G, Haller D, Cramer H, Smith C, de Lacey S, Chapman M, Ratcliffe J, Johnson N, Lyttleton J, Boothroyd C, Fahey P, Tjaden B, van Vliet M, van Wietmarschen H, Jong M, Tröger W, Vuolanto P, Aarva P, Sorsa M, Helin K, Wenzel C, Zoderer I, Pammer P, Simon P, Tucek G, Wode K, Henriksson R, Sharp L, Stoltenberg A, Nordberg JH, Xiao-ying Y, Wang LQ, Li JG, Liang N, Wang Y, Liu JP, Balneaves L, Capler R, Bocci C, Guffi M, Paolini M, Meaglia I, Porcu P, Ivaldi GB, Dragan S, Bucuras P, Pah AM, Badalica-Petrescu M, Buleu F, Hogea-Stoichescu G, Christodorescu R, Kao L, Cho Y, Klafke N, Mahler C, von Hagens C, Uhlmann L, Bentner M, Schneeweiss A, Mueller A, Szecsenyi J, Joos S, Neri I, Ortiz M, Schnabel K, Teut M, Rotter G, Binting S, Cree M, Lotz F, Suhr R, Brinkhaus B, Rossi E, Baccetti S, Firenzuoli F, Monechi MV, Di Stefano M, Amunni G, Wong W, Chen B, Wu J, Amri H, Haramati A, Kotlyanskaya L, Anderson B, Evans R, Kligler B, Marantz P, Bradley R, Booth-LaForce C, Zwickey H, Kligler B, Brooks A, Kreitzer MJ, Lebensohn P, Goldblatt E, Esmel-Esmel N, Jiménez-Herrera M, Ijaz N, Boon H, Jocham A, Stock-Schröer B, Berberat PO, Schneider A, Linde K, Masetti M, Murakozy H, Van Vliet M, Jong M, Jong M, Agdal R, Atarzadeh F, Jaladat AM, Hoseini L, Amini F, Bai C, Liu T, Zheng Z, Wan Y, Xu J, Wang X, Yu H, Gu X, Daneshfard B, Nimrouzi M, Tafazoli V, Alorizi SME, Saghebi SA, Fattahi MR, Salehi A, Rezaeizadeh H, Zarshenas MM, Nimrouzi M, Fox K, Hughes J, Kostanjsek N, Espinosa S, Lewith G, Fisher P, Latif A, Lefeber D, Paske W, Öztürk AÖ, Öztürk G, Boers I, Tissing W, Naafs M, Busch M, Jong M, Daneshfard B, Sanaye MR, Dräger K, Fisher P, Kreitzer MJ, Evans R, Leininger B, Shafto K, Breen J, Sanaye MR, Daneshfard B, Simões-Wüst AP, Moltó-Puigmartí C, van Dongen M, Dagnelie P, Thijs C, White S, Wiesener S, Salamonsen A, Stub T, Fønnebø V, Abanades S, Blanco M, Masllorens L, Sala R, Al-Ahnoumy S, Han D, He L, Kim HY, In Choi D, Alræk T, Stub T, Kristoffersen A, von Sceidt C, Michalsen A, Bruset S, Musial F, Anheyer D, Cramer H, Lauche R, Saha FJ, Dobos G, Anheyer D, Haller H, Lauche R, Dobos G, Cramer H, Azizi H, Khadem N, Hassanzadeh M, Estiri N, Azizi H, Tavassoli F, Lotfalizadeh M, Zabihi R, Esmaily H, Azizi H, Shabestari MM, Paeizi R, Azari MA, Bahrami-Taghanaki H, Zabihi R, Azizi H, Esmaily H, Baars E, De Bruin A, Ponstein A, Baccetti S, Di Stefano M, Rossi E, Firenzuoli F, Segantini S, Monechi MV, Voller F, Barth J, Kern A, Lüthi S, Witt C, Barth J, Zieger A, Otto F, Witt C, Beccia A, Dunlap C, Courneene B, Bedregal P, Passi A, Rodríguez A, Chang M, Gutiérrez S, Beissner F, Beissner F, Preibisch C, Schweizer-Arau A, Popovici R, Meissner K, Beljanski S, Belland L, Rivera-Reyes L, Hwang U, Berger B, Sethe D, Hilgard D, Heusser P, Bishop F, Al-Abbadey M, Bradbury K, Carnes D, Dimitrov B, Fawkes C, Foster J, MacPherson H, Roberts L, Yardley L, Lewith G, Bishop F, Al-Abbadey M, Bradbury K, Carnes D, Dimitrov B, Fawkes C, Foster J, MacPherson H, Roberts L, Yardley L, Lewith G, Bishop F, Holmes M, Lewith G, Yardley L, Little P, Cooper C, Bogani P, Maggini V, Gallo E, Miceli E, Biffi S, Mengoni A, Fani R, Firenzuoli F, Brands-Guendling N, Guendling PW, Bronfort G, Evans R, Haas M, Leininger B, Schulz C, Bu X, Wang J, Fang T, Shen Z, He Y, Zhang X, Zhang Z, Wang D, Meng F, Büssing A, Baumann K, Frick E, Jacobs C, Büssing A, Grünther RA, Lötzke D, Büssing A, Jung S, Lötzke D, Recchia DR, Robens S, Ostermann T, Berger B, Stankewitz J, Kröz M, Jeitler M, Kessler C, Michalsen A, Cheon C, Jang BH, Ko SG, Huang CW, Sasaki Y, Ko Y, Cheshire A, Ridge D, Hughes J, Peters D, Panagioti M, Simon C, Lewith G, Cho HJ, Han D, Choi SJ, Jung YS, Im HB, Cooley K, Tummon-Simmons L, Cotton S, Luberto CM, Wasson R, Kraemer K, Sears R, Hueber C, Derk G, Lill JR, An R, Steinberg L, Rodriguez LD, la Fuente FGD, De la Vega M, Vargas-Román K, Fernández-Ruiz J, Cantarero-Villanueva I, Rodriguez LD, García-De la Fuente F, Jiménez-Guerrero F, Vargas-Román K, Fernández-Ruiz J, Galiano-Castillo N, Diaz-Saez G, Torres-Jimenez JI, Garcia-Gomez O, Hortal-Muñoz L, Diaz-Diez C, Dicen D, Diezel H, Adams J, Steel A, Wardle J, Diezel H, Steel A, Frawley J, Wardle J, Broom A, Adams J, Dong F, Yu H, Liu T, Ma X, Yan L, Wan Y, Zheng Z, Gu X, Dong F, Yu H, Wu L, Liu T, Ma X, Ma J, Yan L, Wan Y, Zheng Z, Zhen J, Gu X, Dubois J, Rodondi PY, Edelhäuser F, Schwartze S, Trapp B, Cysarz D. World Congress Integrative Medicine & Health 2017: Part one. Altern Ther Health Med 2017. [PMCID: PMC5498855 DOI: 10.1186/s12906-017-1782-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Teut M, Strauss C, Ortiz M, Rotter G, Reese F, Binting S, Tromzik J, Roll S, Brinkhaus B. Mindful walking in patients with chronic low back pain – A randomized controlled trial. Eur J Integr Med 2015. [DOI: 10.1016/j.eujim.2015.09.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ortiz M, Katharina S, Teut M, Rotter G, Binting S, Cree M, Lotz F, Suhr R, Brinkhaus B. Complementary and Integrative Medicine in nursing homes – Results of a prospective, exploratory, comparative, two-armed cohort study. Eur J Integr Med 2015. [DOI: 10.1016/j.eujim.2015.09.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Niemier K, Schmidt S, Engel K, Steinmetz A, Herms K, Herms K, Liefring V, Maulhardt A, Wetterling T, Kosup S, Casser R, Jäger G, Törkott S, Bieneck K, Rotter G, Marnitz U, Klein A, Jahr S, Reishauer A, Seidel W. Funktionelle Diagnostik der Bewegungssteuerung, Bewegungsstabilisation und Hypermobilität. Orthopäde 2009; 38:847-54. [DOI: 10.1007/s00132-009-1474-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Bone metastases can be the first symptom of a tumor. The case of a 65-year-old patient with a thymoma exhibiting primary metastases in the lung and bone is presented. Initially, a tumor was suspected because of an osteolytic destruction of the right proximal femur posing a high risk of fracture. Further diagnostic procedures detected a partially sclerosing mediastinal bulk and bilateral lung metastases. The histological investigation of the resected proximal femur and needle biopsy of the mediastinal bulk showed an extrathoracically metastasized polygonal cell thymoma. This metastasizing pattern is common in thymic carcinoma but very rare in thymoma. In addition to the case presentation, a review of the current literature on histological classification, therapy, and prognosis is given.
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Affiliation(s)
- G Rotter
- Klinik für Chirurgie und Chirurgische Onkologie, Universitätsklinikum Charité, Medizinische Fakultät, Humboldt-Universität, Robert-Rössle-Klinik am Max-Delbrück-Centrum für Molekulare Medizin, 13122 Berlin
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Rotter G, Ishida H. FTIR separation of nylon-6 chain conformations: Clarification of the mesomorphous and γ-crystalline phases. ACTA ACUST UNITED AC 1992. [DOI: 10.1002/polb.1992.090300508] [Citation(s) in RCA: 111] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Abstract
To better understand the role of plasmids and their importance in the endemic antibiotic resistance of Enterobacteriaceae, we began a prospective study of our combined medical intensive care/coronary care unit. An initial culture survey of the patients, ward staff, and environment was followed by a prospective sampling of 139 consecutive new admissions at the time of admission to the unit, and at regular intervals thereafter for the remainder of their stay. All cultures were planted on agar-containing gentamicin. Of the 147 patients studied, 12 (8.2%) were colonized with 20 strains of gentamicin-resistant gram-negative bacilli (GRGNB) at 29 sites. An additional four GRGNB were isolated from the environment. Of the 24 GRGNB strains, 7 (29%) Enterobacteriaceae carried plasmids shown to carry the gentamicin-resistance determinant. Plasmids were further characterized by restriction endonuclease digestion profiles of plasmid DNA purified from E. coli C600 transconjugants or transformants. A 93 kb plasmid introduced to the unit by a Serratia liquefaciens colonizing a patient transferred from another area in the hospital was identical to 93 kb plasmids carried by a C. amalonaticus and an E. aerogenes subsequently colonizing another patient on the unit. A 60 kb plasmid, first isolated from a S. marcescens colonizing a sink drain was later isolated from an E. cloacae colonizing a patient. Our results indicate that spread of specific R-plasmids may be one mechanism for dissemination of antibiotic resistance on our MICU/CCU.
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Shlaes DM, Currie CA, Rotter G, Eanes M, Floyd R. Epidemiology of gentamicin-resistant, gram-negative bacillary colonization in a spinal cord injury unit. J Clin Microbiol 1983; 18:227-35. [PMID: 6619279 PMCID: PMC270783 DOI: 10.1128/jcm.18.2.227-235.1983] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
A prospective epidemiological survey of a spinal cord injury unit for gentamicin-resistant, gram-negative bacilli was undertaken. The initial survey of the unit suggested a low level of cross-infection involving Pseudomonas aeruginosa and Providencia stuartii. However, a longitudinal study of new admissions revealed that only 13 of 52 nosocomial acquisitions could be considered to be due to cross colonization. Comparison of data on antibiotic use did not suggest selective pressure for resistant endogenous flora. Nosocomial acquisition was directly related to the length of the hospital stay. Antibiotic susceptibility testing of gentamicin-resistant, gram-negative bacilli showed only minor differences between nosocomial isolates and those present during the initial survey. Of the usual antimicrobial agents, amikacin, carbenicillin, and cefoxitin were the most active against all organisms, with the exception of Serratia spp. Of the new beta-lactams, ceftazidime and imipemide (N-formimidoyl thienamycin) were most active.
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