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Lin J, Schäfer M, Indris S, Janek J, Kondrakov A, Brezesinski T, Strauss F. A polycationic substituted lithium argyrodite superionic solid electrolyte. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322092476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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2
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Yaron R, Bazak B, Schäfer M, Barnea N. Spectrum of light nuclei in a finite volume. Int J Clin Exp Med 2022. [DOI: 10.1103/physrevd.106.014511] [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: 11/07/2022]
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3
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Gaspar-Figueiredo S, Joliat GR, Borgstein ABJ, Van Berge Henegouwen MI, Brunel C, Demartines N, Allemann P, Schäfer M. Impact of positive resection margins (R1) on long-term survival of patients with advanced diffuse type gastric cancer. Br J Surg 2022. [DOI: 10.1093/bjs/znac188.002] [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: 11/13/2022]
Abstract
Abstract
Objective
Gastric cancer (GC) is a leading cause of cancer-related mortality worldwide. Diffuse type GC have a much worse prognosis compared to intestinal type GC. There is an ongoing debate whether microscopic involvement of the proximal margin (R1 resection) influences overall survival (OS) in advanced gastric cancer.
The aim of this study was to assess OS in patients with diffuse gastric cancers and positive lymph node involvement who underwent oncological gastrectomy with R0 and R1 resections.
Methods
All consecutive patients from two tertiary centers operated with curative intent for diffuse gastric cancer between January 2005 and December 2018 were analyzed. Patients with R2 resections or missing data were excluded. Extracted data included demographics, major comorbidities, ASA score, neo-adjuvant treatment, pre- and postoperative staging (TNM 8th edition), postoperative complication with grading according to Clavien classification, survival data and pattern of recurrence. Lymph node involvement was based on pathology.
Kaplan-Meier curves with log-rank test for comparison were used to evaluate survival between groups.
Results
A total of 94 patients with diffuse gastric cancer were included. Two patients were excluded because of R2 resection and missing data regarding pathology, leaving a cohort of 92 patients (48 male, 44 female, median age 62 years). Sixty-four patients were lymph node positive (pN+); 48 patients (75%) with R0 resection and 16 patients (25%) with R1 resection. No difference in terms of preoperative data and intraoperative characteristics was found between R0 and R1 groups. Median OS was better in the R0 group (27 months, 95% CI 17–37) compared to R1 group (7 months, 95% CI 3–11, p<0.001). Similar results were found with disease-free survival (DSF) (25 vs. 6 months, p=0.002).
On multivariable analysis, T stage and resection margin (R status) were independent factors predicting OS (T stage: HR 4.5, p<0.001, R status: HR 4.2, p<0.001) and DFS (T stage: HR 2.9, p=0.004, R status: HR 3.5, p=0.001) in the cohort of patients with lymph node involvement.
Conclusion
The present series confirmed that patients with negative surgical margins have better OS compared to patients with positive margins in case of locally advanced diffuse GC. Therefore, R0 resections should be the goal of oncological gastrectomies.
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Affiliation(s)
- S Gaspar-Figueiredo
- Department of Visceral Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - G-R Joliat
- Department of Visceral Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - A B J Borgstein
- Department of Surgery, Amsterdam University Medical Center , Amsterdam, The Netherlands
| | | | - C Brunel
- Institute of Pathology, Lausanne University Hospital , Lausanne, Switzerland
| | - N Demartines
- Department of Visceral Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - P Allemann
- Department of Visceral Surgery, Lausanne University Hospital , Lausanne, Switzerland
- Department of Surgery , Clinique de la Source, Lausanne, Switzerland
| | - M Schäfer
- Department of Visceral Surgery, Lausanne University Hospital , Lausanne, Switzerland
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Brüggenjürgen B, Braatz F, Greitemann B, Drewitz H, Ruetz A, Schäfer M, Seifert W, Steinfeldt F, Weichold C, Yao D, Stukenborg-Colsman C. Experts' Perceived Patient Burden and Outcomes of Knee-ankle-foot-orthoses (Kafos) Vs. Microprocessor-stance-and-swing-phase-controlled-knee-ankle-foot Orthoses (Mp-sscos). Can Prosthet Orthot J 2022; 5:37795. [PMID: 37614478 PMCID: PMC10443469 DOI: 10.33137/cpoj.v5i1.37795] [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: 11/24/2021] [Accepted: 02/10/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patients with neuromuscular knee-instability assisted with orthotic devices experience problems including pain, falls, mobility issues and limited engagement in daily activities. OBJECTIVES The aim of this study was to analyse current real-life burden, needs and orthotic device outcomes in patients in need for advanced orthotic knee-ankle-foot-orthoses (KAFOs). METHODOLOGY An observer-based semi-structured telephone interview with orthotic care experts in Germany was applied. Interviews were transcribed and content-analysed. Quantitative questions were analysed descriptively. FINDINGS Clinical experts from eight centres which delivered an average of 49.9 KAFOs per year and 13.3 microprocessor-stance-and-swing-phase-controlled-knee-ankle-foot orthoses (MP-SSCOs) since product availability participated. Reported underlying conditions comprised incomplete paraplegia (18%), peripheral nerve lesions (20%), poliomyelitis (41%), post-traumatic lesions (8%) and other disorders (13%). The leading observed patient burdens were "restriction of mobility" (n=6), followed by "emotional strain" (n=5) and "impaired gait pattern" (n=4). Corresponding results for potential patient benefits were seen in "improved quality-of-life" (n=8) as well as "improved gait pattern" (n=8) followed by "high reliability of the orthosis" (n=7). In total, experts reported falls occurring in 71.5% of patients at a combined annual frequency of 7.0 fall events per year when using KAFOs or stance control orthoses (SCOs). In contrast, falls were observed in only 7.2 % of MPSSCO users. CONCLUSION Advanced orthotic technology might contribute to better quality of life of patients, improved gait pattern and perceived reliability of orthosis. In terms of safety a substantial decrease in frequency of falls was observed when comparing KAFO and MP-SSCO users.
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Affiliation(s)
- B. Brüggenjürgen
- Institute for Health Services Research and Technical Orthopedics, Orthopedic Department - Medical School Hannover (MHH) at DIAKOVERE Annastift Hospital, Hannover, Germany
| | - F. Braatz
- Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie Universitätsmedizin Göttingen, Georg-August-Universität, Göttingen, Germany
| | - B. Greitemann
- RehaKlinikum Bad Rothenfelde, Klinik Münsterland, Bad Rothenfelde, Germany
| | - H. Drewitz
- Abteilung Orthetik, Otto Bock HealthCare Deutschland GmbH, Göttingen, Germany
| | - A. Ruetz
- Klinik für Konservative Orthopädie, Katholisches Klinikum Koblenz, Montabaur, Germany
| | - M. Schäfer
- Orthopädie-Technik, Pohlig GmbH, Traunstein, Germany
| | - W. Seifert
- Technische Orthopädie, Seifert Technische Orthopädie GmbH, Bad Krozingen, Germany
| | - F. Steinfeldt
- Fachklinik und Gesundheitszentrum, Johannesbad Raupennest GmbH & Co. KG, Altenberg, Germany
| | - C. Weichold
- Technische Orthopädie, Stiftung Orthopädische Universitätsklinikum, Heidelberg, Germany
| | - D. Yao
- Foot Department and Technical Orthopedics, Orthopedic Department - Medical School Hannover (MHH) at DIAKOVERE Annastift Hospital, Hannover, Germany
| | - C. Stukenborg-Colsman
- Foot Department and Technical Orthopedics, Orthopedic Department - Medical School Hannover (MHH) at DIAKOVERE Annastift Hospital, Hannover, Germany
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Hanzalova I, Schäfer M, Demartines N, Clerc D. Spigelian hernia: current approaches to surgical treatment-a review. Hernia 2021; 26:1427-1433. [PMID: 34665343 DOI: 10.1007/s10029-021-02511-8] [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: 05/08/2021] [Accepted: 09/05/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Spigelian hernias (SpH) belong to the group of eponymous abdominal wall hernias. Major reasons for diagnostic difficulties are its low incidence reaching maximum 2% of abdominal wall hernias, a specific anatomical localization with intact external oblique aponeurosis covering the hernia sac and non-constant clinical presentation. METHODS A literature review was completed to summarize current knowledge on surgical treatment options and results. RESULTS SpH presents a high incarceration risk and therefore should be operated upon even if the patient is asymptomatic. Both laparoscopic and open repair approaches are validated by current guidelines with lesser postoperative complications and shorter hospital stay in favour of minimally invasive surgery, regardless of the technique used. Overall recurrence rate is very low. CONCLUSION All diagnosed SpH should be planned for elective operation to prevent strangulated hernia and, therefore emergency surgery. Both open and laparoscopic SpH treatment can be safely performed, depending on surgeon's experience. In most cases, a mesh repair is generally advised.
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Affiliation(s)
- I Hanzalova
- Department of Visceral Surgery, Lausanne University Hospital CHUV, Bugnon 46, 1011, Lausanne, Switzerland
| | - M Schäfer
- Department of Visceral Surgery, Lausanne University Hospital CHUV, Bugnon 46, 1011, Lausanne, Switzerland.
| | - N Demartines
- Department of Visceral Surgery, Lausanne University Hospital CHUV, Bugnon 46, 1011, Lausanne, Switzerland
| | - D Clerc
- Department of Visceral Surgery, Lausanne University Hospital CHUV, Bugnon 46, 1011, Lausanne, Switzerland
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Zandirad E, Teixeira-Farinha H, Demartines N, Schäfer M, Mantziari S. Multimodal management of gastroesophageal junction adenocarcinoma: Which type of neoadjuvant treatment? Br J Surg 2021. [DOI: 10.1093/bjs/znab202.002] [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: 11/13/2022]
Abstract
Abstract
Objective
The current treatment for locally advanced gastroesophageal junction (GEJ) adenocarcinoma consists of neoadjuvant treatment (NAT) followed by surgery. Preoperative chemotherapy (CT) and radio-chemotherapy (RCT) are both valid options, but comparative data for their efficacy remain scarce. This study aimed to assess the efficacy of RCT and CT to achieve a complete pathologic response (CPR) for locally advanced GEJ adenocarcinoma. Secondary endpoints were R0 resection rates, postoperative complications, long-term survival and recurrence.
Methods
All consecutive patients with locally advanced GEJ adenocarcinoma treated with CT or RCT and oncologic resection from 2009 to 2018 were included. A CPR was defined with the Mandard tumor regression score. Standard statistical tests were used as appropriate. Overall and disease-free survival were compared with the Kaplan Meier method and log-rank test. Multivariate analysis was performed to define independent predictors of CPR, and long-term survival.
Results
Among the 94 patients (84%male, median age 62 years [IQR 9.7]), 67 (71.3%) received preoperative RCT and 27 (28.7%) CT. Patient’s characteristics and pretreatment tumor stages were comparable. Surgical approach was thoracoabdominal Lewis resection in 95.5% RCT and 81.5% CT patients (P = 0.085). CPR was more frequent in the RCT than the CT group (13.4% vs 7.4%, P = 0.009), but R0 resection rates were similar (72.1% vs 66.7%, P = 0.628). There was a trend to higher ypN0 stage in the RCT group (55.2% vs 33.3%; P = 0.057). Postoperatively, RCT patients presented more cardiovascular complications (35.8% vs 11.1%; P = 0.017), although overall morbidity was similar (68.6% vs 62.9%, P = 0.988). 5-year overall survival was comparable (61.1% RCT vs 75.7% CT, P = 0.259), as was 5-year disease-free survival (33.5% RCT vs 22.8% CT, P = 0.763). Isolated loco-regional recurrence occurred in 2.9% RCT vs 3.7% CT patients (P = 0.976). NAT type was not an independent predictor for complete pathologic response nor long-term survival in the multivariate analysis. Median follow-up was 30 months [95%CI 21.3-38.8] for all patients.
Conclusion
Patients with locally advanced GEJ adenocarcinoma demonstrated higher rates of CPR after RCT than CT, and a trend to a better lymph node sterilization, although this did not translate in a significant survival benefit or decreased recurrence rate.
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Affiliation(s)
- E Zandirad
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - H Teixeira-Farinha
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - N Demartines
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - M Schäfer
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - S Mantziari
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
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7
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St-Amour P, Mantziari S, Dromain C, Winiker M, Godat S, Schöpfer A, Demartines N, Schäfer M. Preoperative hiatal hernia in oesophageal adenocarcinoma: An impact on patient outcomes? Br J Surg 2021. [DOI: 10.1093/bjs/znab202.003] [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: 11/13/2022]
Abstract
Abstract
Objective
Uncontrolled gastroesophageal reflux and the often-associated hiatal hernia (HH) are frequently encountered in oesophageal adenocarcinoma patients. Previous data suggest unfavourable long-term oncologic outcomes in the presence of a HH, but the evidence remains scarce. The aim of this study was to assess the potential impact of preoperative HH on histologic response after neoadjuvant treatment (NAT), as well as on overall and disease-free survival.
Methods
All patients operated for an adenocarcinoma of the oesophagus or gastro-oesophageal junction (GOJ) between 2012-2018 were assessed. Baseline endoscopy and CT-scan images were retrospectively reviewed to identify the presence of a clinically significant HH (≥3cm). Response to neoadjuvant treatment (Mandard TRG grade), postoperative outcomes and survival were compared between HH and non-HH patients. Categorical variables were compared with the x2 or Fisher’s test, whereas continuous ones with the Mann-Whitney-U test. Survival analyses were performed with the Kaplan-Meier method and log-rank test.
Results
Overall, 101 patients were included (84.1% male, median age 63 years); among them, 33 (32.7%) had a HH ≥ 3cm at diagnosis of oesophageal cancer. There were no significant baseline differences in demographics and tumour stages between the two groups. NAT was used in 80.9% of non-HH versus 81.8% HH patients (P = 0.910), most often chemoradiation (57.3% in non-HH versus 63.6% in HH patients, P = 0.423). Surgical approach and postoperative complication rates were similar in all patients. Good response to NAT (TRG 1-2) was observed in 32.3% of non-HH, versus 33.3% of HH patients (P = 0.297), whereas R0 resection was achieved in 94.1% vs 90.9% of patients respectively (P = 0.551). Overall survival was comparable between HH (median 28 mo, 95%CI 22-NA) and non-HH patients (median 41mo, 95% CI 29-NA) (P = 0.605). Disease-free survival was also similar (median 18 mo, 95%CI 12-NA for HH, vs 34mo, 95%CI 14-NA for non-HH patients, P = 0.283), although HH patients experienced higher rates of distant (51.6% vs 29.2% for non-HH, P = 0.033), but not locoregional recurrence.
Conclusion
A clinically significant HH is encountered in almost a third of patients with oesophageal adenocarcinoma. However, in our study, it was not associated with a worse response to NAT, nor did it lead to a worse overall and disease-free survival.
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Affiliation(s)
- P St-Amour
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - S Mantziari
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medecine, University of Lausanne, Lausanne, Switzerland
| | - C Dromain
- Institute of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medecine, University of Lausanne, Lausanne, Switzerland
| | - M Winiker
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - S Godat
- Institute of Gastroenterology and Hepatology, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medecine, University of Lausanne, Lausanne, Switzerland
| | - A Schöpfer
- Institute of Gastroenterology and Hepatology, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medecine, University of Lausanne, Lausanne, Switzerland
| | - N Demartines
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medecine, University of Lausanne, Lausanne, Switzerland
| | - M Schäfer
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medecine, University of Lausanne, Lausanne, Switzerland
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8
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Schneider M, Labgaa I, Vrochides D, Zerbi A, Nappo G, Perinel J, Adham M, van Roessel S, Besselink M, Mieog JSD, Groen JV, Demartines N, Schäfer M, Joliat GR. External validation of three nomograms predicting survival using an international cohort of patients with resected pancreatic head ductal adenocarcinoma. Br J Surg 2021. [DOI: 10.1093/bjs/znab202.032] [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: 11/14/2022]
Abstract
Abstract
Objective
Lymph node ratio (LNR, positive lymph nodes/collected lymph nodes during surgery) was identified as an important prognostic factor of survival in resected pancreatic cancer. Several nomograms based on LNR were recently proposed to predict survival after pancreatoduodenectomy (PD). The present study aimed to externally validate 3 published nomograms using an international cohort.
Methods
Consecutive patients with ductal adenocarcinoma of the pancreatic head who underwent PD without neoadjuvant treatment from 6 tertiary centers in Europe and the USA were retrospectively collected from 2000 to 2017. Patients with metastases at diagnosis, R2 resection, missing data regarding LNR, and who died within 90 postoperative days were excluded. The 3 selected nomograms were the updated Amsterdam nomogram (including LNR, adjuvant therapy, margin status, and tumor grade), the nomogram by Pu et al. (including LNR, age, tumor grade, and T stage) and the nomogram by Li et al. (including LNR, age, tumor location, grade, size, and TNM stage). Overall survivals (OS) were calculated using Kaplan-Meier method. For the validation, calibration (Hosmer-Lemeshow test), discrimination capacity (ROC curves for 3-year OS), and clinical utility (sensitivity and specificity at the value of Youden index) were assessed.
Results
After exclusion of 95 patients with metastases, R2 resection, and who died within 90 postoperative days, 1167 patients were included. Median OS of the entire cohort was 23 months (95% confidence interval: 21-24).
For the 3 nomograms, Kaplan-Meier curves showed significant diminution of OS with increasing scores (p < 0.01 for the 3 nomograms). All nomograms showed good calibration (non significant Hosmer-Lemeshow goodness-of-fit tests). For the updated Amsterdam nomogram, the area under the ROC curve (AUROC) for 3-year OS was 0.66. Sensitivity and specificity were 73% and 50%. Regarding the nomogram by Pu et al., the AUROC was 0.67. Sensitivity and specificity were 65% and 60%. For the nomogram by Li et al., the AUROC was 0.67, while sensitivity and specificity were 56% and 71%.
Conclusion
The 3 selected nomograms were validated using an external international cohort and displayed interesting and comparable predictive values. Those nomograms may be used in clinical practice to estimate survival after PD for ductal adenocarcinoma.
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Affiliation(s)
- M Schneider
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - I Labgaa
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - D Vrochides
- Division of Hepatobiliary and Pancreatic Surgery, Carolinas Medical Center, Charlotte, North Carolina, USA
| | - A Zerbi
- Humanitas Clinical and Research Center, Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - G Nappo
- Humanitas Clinical and Research Center, Humanitas Research Hospital, Milan, Italy
| | - J Perinel
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
- Department of Digestive Surgery, Edouard Herriot Hospital, Lyon, France
| | - M Adham
- Department of Digestive Surgery, Edouard Herriot Hospital, Lyon, France
| | - S van Roessel
- Department of Surgery, Cancer Center Amsterdam, Amsterdam, Netherlands
| | - M Besselink
- Department of Surgery, Cancer Center Amsterdam, Amsterdam, Netherlands
| | - J S D Mieog
- Department of Surgery, Leiden University Medical Center, Leiden, Netherlands
| | - J V Groen
- Department of Surgery, Leiden University Medical Center, Leiden, Netherlands
| | - N Demartines
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - M Schäfer
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - G -R Joliat
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
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Elter A, Hellwich E, Dorsch S, Schäfer M, Runz A, Klüter S, Ackermann B, Brons S, Karger CP, Mann P. Development of phantom materials with independently adjustable CT- and MR-contrast at 0.35, 1.5 and 3 T. Phys Med Biol 2021; 66:045013. [PMID: 33333496 DOI: 10.1088/1361-6560/abd4b9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Quality assurance in magnetic resonance (MR)-guided radiotherapy lacks anthropomorphic phantoms that represent tissue-equivalent imaging contrast in both computed tomography (CT) and MR imaging. In this study, we developed phantom materials with individually adjustable CT value as well as [Formula: see text]- and [Formula: see text]-relaxation times in MR imaging at three different magnetic field strengths. Additionally, their experimental stopping power ratio (SPR) for carbon ions was compared with predictions based on single- and dual-energy CT. Ni-DTPA doped agarose gels were used for individual adjustment of [Formula: see text] and [Formula: see text] at [Formula: see text] and 3.0 T. The CT value was varied by adding potassium chloride (KCl). By multiple linear regression, equations for the determination of agarose, Ni-DTPA and KCl concentrations for given [Formula: see text] [Formula: see text] and CT values were derived and employed to produce nine specific soft tissue samples. Experimental [Formula: see text] [Formula: see text] and CT values of these soft tissue samples were compared with predictions and additionally, carbon ion SPR obtained by range measurements were compared with predictions based on single- and dual-energy CT. The measured CT value, [Formula: see text] and [Formula: see text] of the produced soft tissue samples agreed very well with predictions based on the derived equations with mean deviations of less than [Formula: see text] While single-energy CT overestimates the measured SPR of the soft tissue samples, the dual-energy CT-based predictions showed a mean SPR deviation of only [Formula: see text] To conclude, anthropomorphic phantom materials with independently adjustable CT values as well as [Formula: see text] and [Formula: see text] relaxation times at three different magnetic field strengths were developed. The derived equations describe the material specific relaxation times and the CT value in dependence on agarose, Ni-DTPA and KCl concentrations as well as the chemical composition of the materials based on given [Formula: see text] and CT value. Dual-energy CT allows accurate prediction of the carbon ion range in these materials.
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Affiliation(s)
- A Elter
- Department of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), INF 280, Heidelberg, Germany. National Center for Radiation Research in Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany. Faculty of Physics and Astronomy, University of Heidelberg, Heidelberg, Germany
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10
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Emmert S, van Welzen A, Masur K, Gerling T, Bekeschus S, Eschenburg C, Wahl P, Bernhardt T, Schäfer M, Semmler ML, Grabow N, Fischer T, Thiem A, Jung O, Boeckmann L. Kaltes Atmosphärendruckplasma zur Behandlung akuter und chronischer Wunden. Hautarzt 2020; 71:855-862. [DOI: 10.1007/s00105-020-04696-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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11
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Boeckmann L, Bernhardt T, Schäfer M, Semmler ML, Glatzel A, Martens MC, Ulrich M, Thiem A, Tietze J, Jung O, Panzer R, Fischer T, Emmert S. Experimentelle Forschung an der Klinik und Poliklinik für Dermatologie und Venerologie. Aktuelle Dermatologie 2020. [DOI: 10.1055/a-1147-5015] [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: 10/23/2022]
Abstract
ZusammenfassungSeit Antritt von Prof. Dr. med. Steffen Emmert als Ordinarius der Klinik und Poliklinik für Dermatologie und Venerologie im Jahr 2015 konnte das dermatologische Forschungslabor sukzessive aufgebaut und erweitert werden. Im Einklang mit dem onkologischen Schwerpunkt der Universitätsmedizin Rostock sowie dem von der Landesregierung forcierten „Gesundheitsland Mecklenburg-Vorpommern“ wird grundlagenorientierten und translationalen Projekten nachgegangen. Das vorwiegend drittmittelfinanzierte und stetig wachsende Forschungsteam bearbeitet diverse Fragestellungen in den Bereichen der Dermato-Onkologie, Plasmamedizin und seltenen Hauterkrankungen. Inzwischen auf einem soliden Fundament stehend, befindet sich der Forschungsbereich weiterhin in einem dynamischen Entwicklungsprozess. Nicht nur personell, sondern auch thematisch und methodisch wird er derzeit durch die Integration weiterer Arbeitsgruppen unter der Leitung von Ärzten aus der Klinik ergänzt und ausgebaut. Diverse Kollaborationen an der Universitätsmedizin Rostock und im Land zeugen von einem freundlichen, unterstützenden und kollegialen Umfeld, das die Integration am Standort befördert hat.
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Affiliation(s)
- L. Boeckmann
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - T. Bernhardt
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - M. Schäfer
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - M. L. Semmler
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - A. Glatzel
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - M. C. Martens
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - M. Ulrich
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - A. Thiem
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - J. Tietze
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - O. Jung
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - R. Panzer
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - T. Fischer
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
| | - S. Emmert
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock
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Frost N, Christopoulos P, Kauffmann-Guerrero D, Stratmann J, Riedel R, Schäfer M, Alt J, Guetz S, Brinkmann J, Griesinger F. 1368P Lorlatinib in pretreated ALK/ROS1-positive non-small cell lung cancer (NSCLC): Results from the German early access program. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1682] [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] Open
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13
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Groeben H, Walz MK, Nottebaum BJ, Alesina PF, Greenwald A, Schumann R, Hollmann MW, Schwarte L, Behrends M, Rössel T, Groeben C, Schäfer M, Lowery A, Hirata N, Yamakage M, Miller JA, Cherry TJ, Nelson A, Solorzano CC, Gigliotti B, Wang TS, Wietasch JKG, Friederich P, Sheppard B, Graham PH, Weingarten TN, Sprung J. International multicentre review of perioperative management and outcome for catecholamine-producing tumours. Br J Surg 2020; 107:e170-e178. [PMID: 31903598 DOI: 10.1002/bjs.11378] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 07/02/2019] [Accepted: 08/31/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Surgery for catecholamine-producing tumours can be complicated by intraoperative and postoperative haemodynamic instability. Several perioperative management strategies have emerged but none has been evaluated in randomized trials. To assess this issue, contemporary perioperative management and outcome data from 21 centres were collected. METHODS Twenty-one centres contributed outcome data from patients who had surgery for phaeochromocytoma and paraganglioma between 2000 and 2017. The data included the number of patients with and without α-receptor blockade, surgical and anaesthetic techniques, complications and perioperative mortality. RESULTS Across all centres, data were reported on 1860 patients with phaeochromocytoma or paraganglioma, of whom 343 underwent surgery without α-receptor blockade. The majority of operations (78·9 per cent) were performed using minimally invasive techniques, including 16·1 per cent adrenal cortex-sparing procedures. The cardiovascular complication rate was 5·0 per cent overall: 5·9 per cent (90 of 1517) in patients with preoperative α-receptor blockade and 0·9 per cent (3 of 343) among patients without α-receptor blockade. The mortality rate was 0·5 per cent overall (9 of 1860): 0·5 per cent (8 of 517) in pretreated and 0·3 per cent (1 of 343) in non-pretreated patients. CONCLUSION There is substantial variability in the perioperative management of catecholamine-producing tumours, yet the overall complication rate is low. Further studies are needed to better define the optimal management approach, and reappraisal of international perioperative guidelines appears desirable.
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Affiliation(s)
- H Groeben
- Department of Anaesthesiology, Critical Care Medicine and Pain Therapy, Essen, Germany
| | - M K Walz
- Department of Minimally and General Surgery, Kliniken Essen-Mitte, Essen, Germany
| | - B J Nottebaum
- Department of Anaesthesiology, Critical Care Medicine and Pain Therapy, Essen, Germany
| | - P F Alesina
- Department of Minimally and General Surgery, Kliniken Essen-Mitte, Essen, Germany
| | - A Greenwald
- Department of Anaesthesiology, Columbia University, New York
| | - R Schumann
- Department of Anaesthesiology, Tufts Medical Center, Boston, Massachusetts
| | - M W Hollmann
- Department of Anaesthesiology, Academic Medical Centre Amsterdam, Amsterdam, the Netherlands
| | - L Schwarte
- VU University Medical Centre Amsterdam, Amsterdam, the Netherlands
| | - M Behrends
- Department of Anaesthesiology and Perioperative Medicine, University of California, San Francisco, California
| | - T Rössel
- Department of Anaesthesiology and Intensive Care Medicine, Carl-Gustav Carus University Hospital Dresden, Dresden, Germany.,Department of Urology, Carl-Gustav Carus University Hospital Dresden, Dresden, Germany
| | - C Groeben
- Department of Anaesthesiology and Intensive Care Medicine, Carl-Gustav Carus University Hospital Dresden, Dresden, Germany.,Department of Urology, Carl-Gustav Carus University Hospital Dresden, Dresden, Germany
| | - M Schäfer
- Department of Anaesthesiology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - A Lowery
- Discipline of Surgery, School of Medicine, University of Ireland, Galway, Ireland
| | - N Hirata
- Department of Anaesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - M Yamakage
- Department of Anaesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - J A Miller
- Endocrine Surgery Unit, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - T J Cherry
- Endocrine Surgery Unit, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - A Nelson
- Department of Anaesthesia and Critical Care, University of Chicago Medical Center, Chicago, Illinois
| | - C C Solorzano
- Division of Surgical Oncology and Endocrine Surgery, Vanderbilt University, Nashville, Tennessee
| | - B Gigliotti
- Department of General and Endocrine Surgery, Harvard Medical School, Boston, Massachusetts
| | - T S Wang
- Division of Surgical Oncology - Endocrine Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - J K G Wietasch
- Department of Anaesthesiology, University of Groningen, Groningen, the Netherlands
| | - P Friederich
- Department of Anaesthesiology, Critical Care Medicine and Pain Therapy, Klinikum Bogenhausen, Munich, Germany
| | - B Sheppard
- Department of Surgery, Oregon Health and Science University, Portland, Oregon
| | - P H Graham
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston
| | - T N Weingarten
- Department of Anaesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - J Sprung
- Department of Anaesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Ipsen B, Hiltensberger D, Blothner K, Sahlbach H, Unseld B, Schäfer M, Anwander M, Felberbaum R. Primär systemische Therapie mit Docetaxel, Carboplatin, Trastuzumab und Pertuzumab (TCHP) als Standard beim frühen HER2neu-positiven Mammakarzinom im Interdisziplinären Brustzentrum Kempten – Allgäu (IBZK-A): Ergebnisse einer retrospektiven Analyse 2016 – 2019. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- B Ipsen
- Frauenklinik, Klinikum Kempten, Klinikverbund Allgäu
| | | | - K Blothner
- Frauenklinik, Klinikum Kempten, Klinikverbund Allgäu
| | - H Sahlbach
- Frauenklinik, Klinikum Kempten, Klinikverbund Allgäu
| | - B Unseld
- Frauenklinik, Klinikum Kempten, Klinikverbund Allgäu
| | - M Schäfer
- Frauenklinik, Klinikum Kempten, Klinikverbund Allgäu
| | - M Anwander
- Frauenklinik, Klinikum Kempten, Klinikverbund Allgäu
| | - R Felberbaum
- Frauenklinik, Klinikum Kempten, Klinikverbund Allgäu
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Keckeis J, Schäfer M, Akkaya-Kalayci T, Löffler-Stastka H. Guaranteed Equal Opportunities? The Access to Nursing Training in Central Europe for People with a Turkish Migration Background. Int J Environ Res Public Health 2020; 17:ijerph17124503. [PMID: 32585898 PMCID: PMC7345274 DOI: 10.3390/ijerph17124503] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/18/2020] [Accepted: 06/19/2020] [Indexed: 02/07/2023]
Abstract
This paper examines the reason for the small percentage of professional nurses with a Turkish migration background and investigates possibilities to increase this low amount. Our society grows older, and the number of chronic diseases increases. Furthermore, nursing professionals tend to migrate, and the retirement of the baby boomer generation will also create a lack of professional nurses in Vorarlberg, Austria. People with a Turkish migration background, who are the second largest group without Austrian citizenship in Austria, could be an important resource for the upcoming lack of qualified nurses. The nursing profession could be a secure career opportunity for these people, and therefore it is of great importance to make access to professional nursing training easier for people with a Turkish migration background. This paper describes the effects of migration on society, institutions and individuals and gives an overview of concepts related to how to deal with this situation. This qualitative study investigates the access to nursing training for people with a Turkish migration background from three different points of view-those of experts, students and nurses with a Turkish migration background, and people with a Turkish migration background who have to pass a university entrance qualification-in the form of guided interviews. The results will illustrate structural and social barriers due to complex social dynamics and also highlight possibilities to reduce those barriers. Based on the results, prospects for professional nursing are deduced on the macro, meso and micro levels, which should generate an increasing number of nurses with a Turkish migration background.
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Schäfer M. Short-term flexibility for energy grids provided by wastewater treatment plants with anaerobic sludge digestion. Water Sci Technol 2020; 81:1388-1397. [PMID: 32616691 DOI: 10.2166/wst.2019.365] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
For a sustainable development of the energy sector - in the future - an additional potential of energetic flexibility as well as storage capacities will be required to compensate for fluctuating renewable energy production. The operation of energy systems will change and flexibility in energy generation and consumption will rise to become a valuable asset. Wastewater treatment plants (WWTPs) with anaerobic sludge digestion are capable of providing that needed flexibility, not only with their energy generators but also in terms of their energy consuming aggregates on the plant. Under these circumstances a methodical approach has been developed that can be used to select, evaluate and safely implement typical aggregates on WWTPs for flexible plant operation and the provision of energetic flexibility. Relevant key figures have been developed that reconcile requirements of the purification processes with technical-physical necessities as well as the demands of the energy market. Furthermore, restrictions and control parameters have been established which complement the developed key figures to ensure effluent quality. It was demonstrated that WWTPs are able to adapt their operation mode to external and internal requirements under controlled conditions. The existing flexibility is suitable for a variety of uses, and WWTPs in general are able to participate in today's and in future energy supply products and new business models. The results show that WWTPs have a significant potential to produce renewable energy and to provide energetic flexibility, which is needed to stabilize future renewable-energy-driven energy grids.
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Affiliation(s)
- M Schäfer
- Institute of Urban Water Management, University of Kaiserslautern, D-67663 Kaiserslautern, Germany E-mail:
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17
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Kyuno D, Qian B, Groß W, Schäfer M, Ryschich E. Endothelium capture-based liver segment imaging using vascular endothelial growth factor receptor 2 in preclinical ex vivo models. BJS Open 2020; 4:332-341. [PMID: 31965760 PMCID: PMC7093791 DOI: 10.1002/bjs5.50253] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 11/08/2019] [Accepted: 11/20/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Near-infrared (NIR) imaging of liver segments provides substantial information for surgeons performing liver resection. It was hypothesized that ramucirumab, an endothelium-specific antibody approved by the Food and Drug Administration, could be used for liver segment imaging using the endothelium capture principle. METHODS The capture efficacy of anti-vascular endothelial growth factor receptor (VEGFR) 2 monoclonal antibodies (mAbs) and segment imaging were studied in a mouse model. Binding of ramucirumab in human and porcine tissues was studied using immunofluorescence staining. Isolated porcine liver perfusion was used to analyse the labelling and NIR imaging of selected liver segments. RESULTS VEGFR2 is well expressed on the endothelium of the smallest microvascular blood vessels in mouse, porcine and human liver tissues, as well as in human liver tumours. Perfusion of selected segments in the isolated liver model showed high capture of the anti-VEGFR2 (clone 522302) mAb and ramucirumab in mice and pigs respectively. NIR imaging of selected segments was achieved using isolated porcine liver perfusion with IRDye® 800CW-conjugated ramucirumab. CONCLUSION VEGFR2 is well expressed on the smallest microvascular blood vessels and can capture antibodies during single intravascular passages with high efficacy. The ex vivo imaging of a selected segment using endothelial capture of ramucirumab demonstrates the potential of this antibody for intraoperative navigation in liver surgery. Surgical relevance Imaging of liver segments provides substantial information for surgeons when performing liver resection. The antivascular endothelial growth factor receptor (VEGFR) 2 antibody ramucirumab conjugated with near-infrared dye could visualize selected liver segments using an endothelial capture-based approach in an isolated perfusion liver model. The ex vivo imaging of a selected segment using endothelial capture of ramucirumab demonstrates the potential of this anti-VEGFR2 antibody for intraoperative navigation in liver surgery.
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Affiliation(s)
- D. Kyuno
- Department of General, Visceral and Transplantation SurgeryUniversity Hospital HeidelbergHeidelbergGermany
- Department of Surgery, Surgical Oncology and ScienceSapporo Medical UniversitySapporoJapan
| | - B. Qian
- Department of General, Visceral and Transplantation SurgeryUniversity Hospital HeidelbergHeidelbergGermany
| | - W. Groß
- Department of General, Visceral and Transplantation SurgeryUniversity Hospital HeidelbergHeidelbergGermany
| | - M. Schäfer
- Department of General, Visceral and Transplantation SurgeryUniversity Hospital HeidelbergHeidelbergGermany
| | - E. Ryschich
- Department of General, Visceral and Transplantation SurgeryUniversity Hospital HeidelbergHeidelbergGermany
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18
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Pfennig A, Soltmann B, Ritter P, Bschor T, Hautzinger M, Meyer TD, Padberg F, Brieger P, Schäfer M, Correll CU, Bauer M. [A review of the update of the German S3-guideline on diagnostics and therapy of bipolar disorders 2019]. Nervenarzt 2020; 91:193-206. [PMID: 32076760 DOI: 10.1007/s00115-020-00874-4] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Since the first publication of the guideline in 2012, which included critically reviewed evidence up to 2010, several hundred articles with new evidence were published and some topics of the clinical consensus needed to be reconsidered. Therefore, it was urgently necessary to revise the guideline to bring them up to date. In this article important revisions and updates are presented and the chances and limitations of the development of the guidelines and their implementation are discussed.
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Affiliation(s)
- A Pfennig
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
| | - B Soltmann
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - P Ritter
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - T Bschor
- Abteilung für Psychiatrie, Schlosspark-Klinik Berlin, Berlin, Deutschland
| | - M Hautzinger
- Fachbereich Psychologie, Klinische Psychologie und Psychotherapie, Eberhard Karls Universität Tübingen, Tübingen, Deutschland
| | - T D Meyer
- Department of Psychiatry & Behavioral Sciences, UT Health, McGovern Medical School, Houston, TX, USA
| | - F Padberg
- Psychiatrische Klinik, Ludwig-Maximilians-Universität München, München, Deutschland
| | - P Brieger
- kbo-Isar-Amper-Klinikum, Haar (München), Deutschland
| | - M Schäfer
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik und Suchtmedizin, Kliniken Essen-Mitte und Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - C U Correll
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - M Bauer
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
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19
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Boeckmann L, Bernhardt T, Schäfer M, Semmler ML, Kordt M, Waldner AC, Wendt F, Sagwal S, Bekeschus S, Berner J, Kwiatek E, Frey A, Fischer T, Emmert S. [Current indications for plasma therapy in dermatology]. Hautarzt 2020; 71:109-113. [PMID: 31965204 DOI: 10.1007/s00105-019-04530-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 01/13/2023]
Abstract
BACKGROUND Plasma medicine is gaining increasing interest and provides a multitude of dermatological applications. Cold atmospheric pressure plasma (CAP) can be used in clinical applications without harming the treated tissue or in a tissue destructive manner. It consists of a complex mixture of biologically active agents, which can act synergistically on the treated material or tissue. OBJECTIVES A summary of the current research findings regarding dermatological applications of CAP is provided. METHODS Literature on CAP applications in dermatology has been screened and summarized. RESULTS CAP exerts antimicrobial, tissue-stimulating, blood-flow-stimulating but also pro-apoptotic effects. By exploiting these properties, CAP is successfully applied for disinfection and treatment of chronic ulcerations. Furthermore, positive effects of CAP have been shown for the treatment of tumors, actinic keratosis, scars, ichthyosis, atopic eczema as well as for alleviation of pain and itch. CONCLUSIONS While the use of CAP for disinfection and wound treatment has already moved into clinical practice, further applications such as cancer treatment are still exploratory.
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Affiliation(s)
- L Boeckmann
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock, Strempelstr. 13, 18057, Rostock, Deutschland
| | - T Bernhardt
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock, Strempelstr. 13, 18057, Rostock, Deutschland
| | - M Schäfer
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock, Strempelstr. 13, 18057, Rostock, Deutschland
| | - M Luise Semmler
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock, Strempelstr. 13, 18057, Rostock, Deutschland
| | - M Kordt
- Rudolf-Zenker-Institut für Experimentelle Chirurgie, Universitätsmedizin Rostock, Rostock, Deutschland
| | - A-C Waldner
- Arbeitsbereich Zellbiologie, Universitätsmedizin Rostock, Rostock, Deutschland
| | - F Wendt
- Institut für Pharmakologie und Toxikologie, Universitätsmedizin Rostock, Rostock, Deutschland
| | - S Sagwal
- Leibniz-Institut für Plasmaforschung und Technologie e. V., Greifswald, Deutschland
| | - S Bekeschus
- Leibniz-Institut für Plasmaforschung und Technologie e. V., Greifswald, Deutschland
| | - J Berner
- Klinik und Poliklinik für Mund-Kiefer-Gesichtschirurgie/Plastische Operationen, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - E Kwiatek
- Klinik und Poliklinik für Mund-Kiefer-Gesichtschirurgie/Plastische Operationen, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - A Frey
- Institut für Chemie, Universität Rostock, Rostock, Deutschland
| | - T Fischer
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock, Strempelstr. 13, 18057, Rostock, Deutschland
| | - S Emmert
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsmedizin Rostock, Strempelstr. 13, 18057, Rostock, Deutschland.
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Heym EC, Kampen H, Schäfer M, Walther D. Mosquito bloodmeal preferences in two zoological gardens in Germany. Med Vet Entomol 2019; 33:203-212. [PMID: 30474300 DOI: 10.1111/mve.12350] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 09/13/2018] [Accepted: 10/11/2018] [Indexed: 06/09/2023]
Abstract
Because they provide a high density and diversity of vertebrate species, small water pools and shaded environments, zoological gardens offer ideal living conditions for numerous mosquito species. Depending on their host preferences and vector competencies, these species may be able to transmit pathogens between native and non-adapted exotic blood host species, thereby causing morbidity and mortality among valuable zoo animals. To determine the extent to which native mosquito species feed on captive and wild animals, as well as on humans, in two German zoological gardens, mosquitoes were collected over two seasons by trapping and aspirating. A total of 405 blood-fed specimens belonging to 16 mosquito taxa were collected. Genetic bloodmeal analysis revealed 56 host species, mainly representing mammals of the zoo animal population, including exotic species previously not known as blood hosts of the mosquito species collected. These results indicate opportunistic feeding patterns with low host-specificity in the analysed mosquitoes, although these could be grouped, according to their bloodmeals, into 'amphibian-', 'non-human mammal-' and 'non-human mammal and human-' feeding species. As the blood-feeding preferences of vector-competent mosquito species are major determinants of vector capacity, information on the blood-feeding behaviour of mosquitoes in zoos is crucial to the success of targeted vector management.
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Affiliation(s)
- E C Heym
- Land Use and Governance, Leibniz Centre for Agricultural Landscape Research, Muencheberg, Germany
| | - H Kampen
- Institute of Infectology, Friedrich Loeffler Institut, Federal Research Institute for Animal Health, Greifswald, Germany
| | - M Schäfer
- Institute of Infectology, Friedrich Loeffler Institut, Federal Research Institute for Animal Health, Greifswald, Germany
| | - D Walther
- Land Use and Governance, Leibniz Centre for Agricultural Landscape Research, Muencheberg, Germany
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Schäfer M, Mousa SA, Shaqura M, Tafelski S. [Background and current use of adjuvants for regional anesthesia : From research to evidence-based patient treatment]. Anaesthesist 2019; 68:3-14. [PMID: 30645692 DOI: 10.1007/s00101-018-0522-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 02/07/2023]
Abstract
The discovery of the local anaesthetic effect by blocking sodium ion channels was a milestone in anaesthesia but was soon limited by sometimes life-threatening toxic effects of the local anaesthetics. By developing novel local anaesthetics and also by adding so-called adjuvants, attempts have been made to limit these life-threatening events. This article focuses on the historic background and the current state of the use of these adjuvants for regional anaesthesia. Adding epinephrine, clonidine or dexmedetomidine, but only as a single dose, results in a faster onset, longer duration of action and increased intensity of neuronal blockade of regional anaesthesia. The benefits of adding sodium bicarbonate, on the other hand, are relatively minor and, therefore, clinically negligible. Although increasing evidence in the literature suggests an improvement and prolongation of the analgesic effect after axonal administration of opioids, which can also be given continuously, systemic effects are not fully ruled out due to the increased incidence of central side effects. The partial local anaesthetic effects of opioids cannot always be distinguished from opioid receptor-specific effects. Mechanistic studies postulate a functional coupling of opioid receptors in injured rather than in intact peripheral nerves. Recent studies have identified glucocorticoid and mineralocorticoid receptors predominantly on peripheral nociceptive nerve fibers. This is consistent with numerous clinical reports of a marked prolongation of the local anaesthetic effect. In addition to the known genomic effects of steroids that occur via a change in gene expression of pain-sustaining protein structures, faster non-genomic effects are also discussed, which occur via a change in intracellular signaling pathways. In summary, new insights into mechanisms and novel results from clinical trials will help the anaesthesiologist in the decision to use adjuvants for regional anaesthesia which, however, requires to weigh the individual patient's benefits against the risks.
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Affiliation(s)
- M Schäfer
- Klinik für Anästhesiologie mit S. op. Intensivmedizin, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Deutschland.
| | - S A Mousa
- Klinik für Anästhesiologie mit S. op. Intensivmedizin, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Deutschland
| | - M Shaqura
- Klinik für Anästhesiologie mit S. op. Intensivmedizin, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Deutschland
| | - S Tafelski
- Klinik für Anästhesiologie mit S. op. Intensivmedizin, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Deutschland
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Schäfer M, Barnea N, Friedman E, Gal A, Mareš J. Calculations of η-nuclear quasi-bound states in few-body systems. EPJ Web Conf 2019. [DOI: 10.1051/epjconf/201919902022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We report on our Stochastic Variational Method (SVM) calculations ofη-nuclear quasi-bound states in s-shell nuclei as well as the very recent calculation of the p-shell nucleus6Li. TheηNpotentials used were constructed fromηNscattering amplitudes obtained within coupled-channel models that incorporateN*(1535) resonance. We found thatη6Li is bound in theηNinteraction models that yield ReaηN≥ 0.67 fm. Additional repulsion caused by the imaginary part ofηNpotentials shifts the onset ofη-nuclear binding toη4He, yielding very likely no quasi-bound state inη3He.
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Schäfer M, Ulber R. Analysis and optimization of dual-phase smartphone-based photometric systems in microliter-scaled capillaries. CHEM-ING-TECH 2018. [DOI: 10.1002/cite.201855397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- M. Schäfer
- Technische Universität Kaiserslautern; Chair of Bioprocess Engineering; Gottlieb-Daimler-Straße 49 67663 Kaiserslautern Germany
| | - R. Ulber
- Technische Universität Kaiserslautern; Chair of Bioprocess Engineering; Gottlieb-Daimler-Straße 49 67663 Kaiserslautern Germany
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Muzumdar S, Hiebert H, Haertel E, Bloch W, Werner S, Schäfer M. 1312 Nrf2 activation enhances the healing of cutaneous wounds through the activation of hair follicle stem cells. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.1329] [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: 10/17/2022]
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McHugh MJ, McGorry PD, Yuen HP, Hickie IB, Thompson A, de Haan L, Mossaheb N, Smesny S, Lin A, Markulev C, Schloegelhofer M, Wood SJ, Nieman D, Hartmann JA, Nordentoft M, Schäfer M, Amminger GP, Yung A, Nelson B. The Ultra-High-Risk for psychosis groups: Evidence to maintain the status quo. Schizophr Res 2018; 195:543-548. [PMID: 29055567 DOI: 10.1016/j.schres.2017.09.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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] [Received: 04/20/2017] [Revised: 08/31/2017] [Accepted: 09/03/2017] [Indexed: 01/12/2023]
Abstract
Individuals are considered Ultra-High-Risk (UHR) for psychosis if they meet a set of standardised criteria including presumed genetic vulnerability (Trait), or a recent history of Attenuated Psychotic Symptoms (APS) or Brief Limited Intermittent Psychotic Symptoms (BLIPS). Recent calls to revise these criteria have arisen from evidence that Trait, APS and BLIPS groups may transition to psychosis at different rates. Concurrently, it has become clear that the UHR status confers clinical risk beyond transition to psychosis. Specifically, most UHR individuals will not develop psychosis, but will experience high rates of non-psychotic disorders, persistent APS and poor long-term functional outcomes. Rather than focus on transition, the present study investigated whether UHR groups differ in their broader clinical risk profile by examining baseline clinical characteristics and long-term outcomes other than transition to psychosis. Four UHR groups were defined: Trait-only, APS-only, Trait+APS, and any BLIPS. Participants (N=702) were recruited upon entry to early intervention services and followed-up over a period of up to 13years (mean=4.53, SD=3.84). The groups evidenced similar symptom severity (SANS for negative symptoms, BPRS for positive and depression/anxiety symptoms) and psychosocial functioning (SOFAS, GAF, QLS) at baseline and follow-up as well as similar prevalence of non-psychotic disorders at follow-up. Our findings demonstrate that UHR groups evidence a similar clinical risk profile when we expand this beyond transition to psychosis, and consequently support maintaining the existing UHR criteria.
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Affiliation(s)
- M J McHugh
- Orygen, The National Centre for Excellence in Youth Mental Health, 35 Poplar Rd, Parkville, VIC, Australia.
| | - P D McGorry
- Orygen, The National Centre for Excellence in Youth Mental Health, 35 Poplar Rd, Parkville, VIC, Australia
| | - H P Yuen
- Orygen, The National Centre for Excellence in Youth Mental Health, 35 Poplar Rd, Parkville, VIC, Australia
| | - I B Hickie
- Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - A Thompson
- Division of Mental Health and Wellbeing, The University of Warwick, Coventry, UK
| | - L de Haan
- Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, The Netherlands
| | - N Mossaheb
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University Vienna, Austria
| | - S Smesny
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - A Lin
- Telethon Kids Institute, The University of Western Australia, Australia
| | - C Markulev
- Orygen, The National Centre for Excellence in Youth Mental Health, 35 Poplar Rd, Parkville, VIC, Australia
| | - M Schloegelhofer
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University Vienna, Austria; Department of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria
| | - S J Wood
- School of Psychology, University of Birmingham, Birmingham, UK; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne & Melbourne Health, Melbourne, Australia
| | - D Nieman
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - J A Hartmann
- Orygen, The National Centre for Excellence in Youth Mental Health, 35 Poplar Rd, Parkville, VIC, Australia
| | - M Nordentoft
- Mental Health Centre Copenhagen, Mental health Services Capital Region of Denmark, Denmark; Psychiatric Centre Copenhagen, University of Copenhagen, Denmark
| | - M Schäfer
- Orygen, The National Centre for Excellence in Youth Mental Health, 35 Poplar Rd, Parkville, VIC, Australia
| | - G P Amminger
- Orygen, The National Centre for Excellence in Youth Mental Health, 35 Poplar Rd, Parkville, VIC, Australia
| | - A Yung
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - B Nelson
- Orygen, The National Centre for Excellence in Youth Mental Health, 35 Poplar Rd, Parkville, VIC, Australia
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Watanabe K, Schäfer M, Cassidy C, Miyamoto S, Jone P. The Utility of Right Atrial Strain to Evaluate for Transplant Co-morbidities in Pediatric Heart Transplant Recipients. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.1024] [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: 10/17/2022] Open
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Cruz OS, Tsoutsou P, Schäfer M, Schneider R, Weber P, Guibert G, Tamburella C, Dragusanu D, Yanes B, Ozsahin M. Comparison of 3DCRT and VMAT treatment in neoadjuvant oesophageal cancer. Eur J Cancer 2018. [DOI: 10.1016/j.ejca.2018.01.101] [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: 11/28/2022]
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Abstract
This study assessed the accuracy of preoperative staging in patients undergoing oncological esophagectomy for adenocarcinoma and squamous cell carcinoma. All patients undergoing surgery for resectable esophageal cancer in a university hospital from 2005 to 2016 were identified from our institutional database. Patients with neoadjuvant treatment were excluded to avoid bias from down-staging effects. Routinely, all patients had an upper endoscopy with biopsy, a thoracoabdominal CT scan, an 18-FEG PET-CT, and endoscopic ultrasound. Preoperative staging was compared to histopathological staging of surgical specimen that was considered as gold standard. There were 51 patients with a median age of 65 years (IQR: 59.3-73 years) having 21 squamous cell carcinoma and 30 adenocarcinoma, respectively. T- and N-stages were correctly predicted in 26 (51%) and 37 patients (72%), respectively. Overall, 18 patients (35%) were preoperatively diagnosed with a correct T- and N-stage. There was no difference between adenocarcinoma and squamous cell carcinoma. Accuracy of the T-stage was not influenced by the smoking status. The N-stage was not correct in 7/22 smoking patients (32%) and 6/29 nonsmoking patients (21%).The N-stage was underestimated in smoking patients as 6/22 patients (27%) had a histologically confirmed N+ who were preoperatively classified as N0. In conclusion, only 35% of patients had a correct assessment. Separate T- and N-stage prediction was improved with 51% and 72%, respectively. Major efforts are needed for improvement.
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Affiliation(s)
- M Winiker
- Centre Hospitalier Universitaire Vaudois, Surgery, Lausanne, Switzerland
| | - S Mantziari
- Centre Hospitalier Universitaire Vaudois, Surgery, Lausanne, Switzerland
| | - S G Figueiredo
- Centre Hospitalier Universitaire Vaudois, Surgery, Lausanne, Switzerland
| | - N Demartines
- Centre Hospitalier Universitaire Vaudois, Surgery, Lausanne, Switzerland
| | - P Allemann
- Centre Hospitalier Universitaire Vaudois, Surgery, Lausanne, Switzerland
| | - M Schäfer
- Centre Hospitalier Universitaire Vaudois, Surgery, Lausanne, Switzerland
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Schäfer M. Das richtige Opioid für meinen Patienten. Anaesthesist 2017; 66:827-828. [DOI: 10.1007/s00101-017-0375-4] [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: 11/29/2022]
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Muzumdar S, Hiebert H, Haertel E, Bloch W, Werner S, Schäfer M. 668 Activation of Nrf2 promotes wound healing by expansion of hair follicle stem cell populations. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.345] [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: 11/16/2022]
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Abstract
In the future, an additional potential of control reserve as well as storage capacities will be required to compensate fluctuating renewable energy availability. The operation of energy systems will change and flexibility in energy generation and consumption will rise to a valuable asset. Wastewater treatment plants (WWTPs) are capable of providing the flexibility needed, not only with their energy generators but also in terms of their energy consuming aggregates on the plant. To meet challenges of the future in regard to energy purchase and to participate in and contribute to such a volatile energy market, WWTPs have to reveal their energetic potential as a flexible service provider. Based on the evaluated literature and a detailed analysis of aggregates on a pilot WWTP an aggregate management has been developed to shift loads and provide a procedure to identify usable aggregates, characteristic values and control parameters to ensure effluent quality. The results show that WWTPs have a significant potential to provide energetic flexibility. Even for vulnerable components such as aeration systems, load-shifting is possible with appropriate control parameters and reasonable time slots without endangering system functionality.
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Affiliation(s)
- M Schäfer
- Institute of Urban Water Management, University of Kaiserslautern, D-67663 Kaiserslautern, Germany E-mail:
| | - I Hobus
- WiW-Wupperverbandsgesellschaft für integrale Wasserwirtschaft mbH, D-42289 Wuppertal, Germany
| | - T G Schmitt
- Institute of Urban Water Management, University of Kaiserslautern, D-67663 Kaiserslautern, Germany E-mail:
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32
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Reuter E, Tafelski S, Thieme K, West C, Haase U, Beck L, Schäfer M, Spies C. [Erratum to: Treatment of fibromyalgia syndrome with gamma-hydroxybutyrate : A randomized controlled study]. Schmerz 2017; 31:407-412. [PMID: 28664244 DOI: 10.1007/s00482-017-0232-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- E Reuter
- Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Schmerzambulanz, Campus Charité Mitte und Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.
| | - S Tafelski
- Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Schmerzambulanz, Campus Charité Mitte und Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - K Thieme
- Institut für Medizinische Psychologie, Philipps-Universität Marburg, Marburg, Deutschland
| | - C West
- Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Schmerzambulanz, Campus Charité Mitte und Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - U Haase
- Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Schmerzambulanz, Campus Charité Mitte und Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - L Beck
- POLIKUM Charlottenburg, Berlin, Deutschland
| | - M Schäfer
- Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Schmerzambulanz, Campus Charité Mitte und Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - C Spies
- Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Schmerzambulanz, Campus Charité Mitte und Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
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33
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Cramer H, Schäfer M, Schöls M, Köcke J, Elsenbruch S, Lauche R, Engler H, Dobos G, Langhorst J. Randomised clinical trial: yoga vs written self-care advice for ulcerative colitis. Aliment Pharmacol Ther 2017; 45:1379-1389. [PMID: 28378342 DOI: 10.1111/apt.14062] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 02/12/2017] [Accepted: 03/06/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Perceived stress seems to be a risk factor for exacerbation of ulcerative colitis. Yoga has been shown to reduce perceived stress. AIMS To assess the efficacy and safety of yoga for improving quality of life in patients with ulcerative colitis. METHODS A total of 77 patients (75% women; 45.5 ± 11.9 years) with ulcerative colitis in clinical remission but impaired quality of life were randomly assigned to yoga (12 supervised weekly sessions of 90 min; n = 39) or written self-care advice (n = 38). Primary outcome was disease-specific quality of life (Inflammatory Bowel Disease Questionnaire). Secondary outcomes included disease activity (Rachmilewitz clinical activity index) and safety. Outcomes were assessed at weeks 12 and 24 by blinded outcome assessors. RESULTS The yoga group had significantly higher disease-specific quality of life compared to the self-care group after 12 weeks (Δ = 14.6; 95% confidence interval=2.6-26.7; P = 0.018) and after 24 weeks (Δ = 16.4; 95% confidence interval=2.5-30.3; P = 0.022). Twenty-one and 12 patients in the yoga group and in the self-care group, respectively, reached a clinical relevant increase in quality of life at week 12 (P = 0.048); and 27 and 17 patients at week 24 (P = 0.030). Disease activity was lower in the yoga group compared to the self-care group after 24 weeks (Δ = -1.2; 95% confidence interval=-0.1-[-2.3]; P = 0.029). Three and one patient in the yoga group and in the self-care group, respectively, experienced serious adverse events (P = 0.317); and seven and eight patients experienced nonserious adverse events (P = 0.731). CONCLUSIONS Yoga can be considered as a safe and effective ancillary intervention for patients with ulcerative colitis and impaired quality of life. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02043600.
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Affiliation(s)
- H Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine Essen, University of Duisburg-Essen, Essen, Germany.,Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, NSW, Australia
| | - M Schäfer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine Essen, University of Duisburg-Essen, Essen, Germany.,Department of Integrative Gastroenterology, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - M Schöls
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine Essen, University of Duisburg-Essen, Essen, Germany.,Department of Integrative Gastroenterology, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.,Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - J Köcke
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine Essen, University of Duisburg-Essen, Essen, Germany.,Department of Integrative Gastroenterology, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - S Elsenbruch
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - R Lauche
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine Essen, University of Duisburg-Essen, Essen, Germany.,Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, NSW, Australia
| | - H Engler
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - G Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine Essen, University of Duisburg-Essen, Essen, Germany
| | - J Langhorst
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine Essen, University of Duisburg-Essen, Essen, Germany.,Department of Integrative Gastroenterology, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
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Göbels K, Schäfer M, Dilmaghani D. Auswertung der EpiLag Protokolle 2014 – 2016: Ein heterogenes Bild. Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1602093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- K Göbels
- Gesundheitsamt Düsseldorf, Düsseldorf
| | - M Schäfer
- Gesundheitsamt Düsseldorf, Düsseldorf
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35
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Göbels K, Sensen F, Schäfer M, Albers P, Roßlan H, Jeziorek T. Verdacht auf Lungenpesterkrankung im Flugzeug – Erkenntnisse der IGV Übung 2016 in Düsseldorf. Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1602008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- K Göbels
- Gesundheitsamt Düsseldorf, Düsseldorf
| | - F Sensen
- Gesundheitsamt Düsseldorf, Düsseldorf
| | - M Schäfer
- Gesundheitsamt Düsseldorf, Düsseldorf
| | - P Albers
- Feuerwehr Düsseldorf, Düsseldorf
| | - H Roßlan
- Flughafen Düsseldorf, Düsseldorf
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36
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Giesel FL, Hadaschik B, Cardinale J, Radtke J, Vinsensia M, Lehnert W, Kesch C, Tolstov Y, Singer S, Grabe N, Duensing S, Schäfer M, Neels OC, Mier W, Haberkorn U, Kopka K, Kratochwil C. F-18 labelled PSMA-1007: biodistribution, radiation dosimetry and histopathological validation of tumor lesions in prostate cancer patients. Eur J Nucl Med Mol Imaging 2017; 44:678-688. [PMID: 27889802 PMCID: PMC5323462 DOI: 10.1007/s00259-016-3573-4] [Citation(s) in RCA: 366] [Impact Index Per Article: 52.3] [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: 08/02/2016] [Accepted: 11/09/2016] [Indexed: 11/24/2022]
Abstract
PURPOSE The prostate-specific membrane antigen (PSMA) targeted positron-emitting-tomography (PET) tracer 68Ga-PSMA-11 shows great promise in the detection of prostate cancer. However, 68Ga has several shortcomings as a radiolabel including short half-life and non-ideal energies, and this has motivated consideration of 18F-labelled analogs. 18F-PSMA-1007 was selected among several 18F-PSMA-ligand candidate compounds because it demonstrated high labelling yields, outstanding tumor uptake and fast, non-urinary background clearance. Here, we describe the properties of 18F-PSMA-1007 in human volunteers and patients. METHODS Radiation dosimetry of 18F-PSMA-1007 was determined in three healthy volunteers who underwent whole-body PET-scans and concomitant blood and urine sampling. Following this, ten patients with high-risk prostate cancer underwent 18F-PSMA-1007 PET/CT (1 h and 3 h p.i.) and normal organ biodistribution and tumor uptakes were examined. Eight patients underwent prostatectomy with extended pelvic lymphadenectomy. Uptake in intra-prostatic lesions and lymph node metastases were correlated with final histopathology, including PSMA immunostaining. RESULTS With an effective dose of approximately 4.4-5.5 mSv per 200-250 MBq examination, 18F-PSMA-1007 behaves similar to other PSMA-PET agents as well as to other 18F-labelled PET-tracers. In comparison to other PSMA-targeting PET-tracers, 18F-PSMA-1007 has reduced urinary clearance enabling excellent assessment of the prostate. Similar to 18F-DCFPyL and with slightly slower clearance kinetics than PSMA-11, favorable tumor-to-background ratios are observed 2-3 h after injection. In eight patients, diagnostic findings were successfully validated by histopathology. 18F-PSMA-1007 PET/CT detected 18 of 19 lymph node metastases in the pelvis, including nodes as small as 1 mm in diameter. CONCLUSION 18F-PSMA-1007 performs at least comparably to 68Ga-PSMA-11, but its longer half-life combined with its superior energy characteristics and non-urinary excretion overcomes some practical limitations of 68Ga-labelled PSMA-targeted tracers.
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Affiliation(s)
- Frederik L Giesel
- Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany.
| | - B Hadaschik
- Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
| | - J Cardinale
- Division of Radiopharmaceutical Chemistry, German Cancer Research Center (dkfz), Heidelberg, Germany
| | - J Radtke
- Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
| | - M Vinsensia
- Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany
| | | | - C Kesch
- Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
| | - Y Tolstov
- Section of Molecular Urooncology, Department of Urology, Medical Faculty Heidelberg, University Hospital Heidelberg, Heidelberg, Germany
| | - S Singer
- Section of Molecular Urooncology, Department of Urology, Medical Faculty Heidelberg, University Hospital Heidelberg, Heidelberg, Germany
| | - N Grabe
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany
- Hamamatsu Tissue Imaging and Analysis Center, University of Heidelberg, Heidelberg, Germany
| | - S Duensing
- Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
- Section of Molecular Urooncology, Department of Urology, Medical Faculty Heidelberg, University Hospital Heidelberg, Heidelberg, Germany
| | - M Schäfer
- Division of Radiopharmaceutical Chemistry, German Cancer Research Center (dkfz), Heidelberg, Germany
| | - O C Neels
- Division of Radiopharmaceutical Chemistry, German Cancer Research Center (dkfz), Heidelberg, Germany
| | - W Mier
- Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany
| | - U Haberkorn
- Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany
| | - K Kopka
- Division of Radiopharmaceutical Chemistry, German Cancer Research Center (dkfz), Heidelberg, Germany
| | - C Kratochwil
- Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany
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37
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Spies CK, Schäfer M, Ahrens C, Hahn P, Unglaub F. [Compression of the median nerve by chronic palmar dislocation of the lunate due to carpal collapse]. Unfallchirurg 2017; 120:712-714. [PMID: 28361358 DOI: 10.1007/s00113-017-0345-y] [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] [Indexed: 11/30/2022]
Abstract
Carpal tunnel syndrome is among the most frequently diagnosed forms of peripheral nerve compression. Carpal tunnel syndrome due to carpal collapse that had progressed over decades, with a palmarly dislocated lunate, is rare. Hints of past trauma to the wrist going back decades should prompt further radiological examination in case of recurrent median nerve compression. With sufficient preoperative evaluation, the causes can be accurately detected and treated. Therefore, precise and complete history-taking is mandatory. Conclusions on further diagnostics that can be drawn from the latter must be consistently implemented to enable adequate therapy.
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Affiliation(s)
- C K Spies
- Handchirurgie, Vulpius Klinik, 74906, Bad Rappenau, Deutschland.
| | - M Schäfer
- Handchirurgie, Vulpius Klinik, 74906, Bad Rappenau, Deutschland
| | - C Ahrens
- Handchirurgie, Vulpius Klinik, 74906, Bad Rappenau, Deutschland
| | - P Hahn
- Handchirurgie, Vulpius Klinik, 74906, Bad Rappenau, Deutschland
| | - F Unglaub
- Handchirurgie, Vulpius Klinik, 74906, Bad Rappenau, Deutschland.,Medizinische Fakultät Mannheim, Universität Heidelberg, Heidelberg, Deutschland
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38
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Tafelski S, Beutlhauser T, Bellin F, Reuter E, Fritzsche T, West C, Schäfer M. [Incidence of constipation in patients with outpatient opioid therapy]. Schmerz 2017; 30:158-65. [PMID: 26115741 DOI: 10.1007/s00482-015-0018-0] [Citation(s) in RCA: 2] [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] [Indexed: 12/27/2022]
Abstract
BACKGROUND Constipation is a common complication in patients with opioid therapy. Additionally, patient-related risk factors also contribute to the development of constipation and these factors have to be integrated into an individualized treatment plan. OBJECTIVE The aim of this study was to assess the incidence of constipation in patients with opioid therapy in an outpatient setting and to analyze the risk factors that contribute to the development of constipation. MATERIAL AND METHODS This retrospective cohort study was conducted in two university affiliated outpatient departments at the Charité hospital in Berlin. The trial included all consecutively treated patients with opioid therapy of at least 4 weeks duration. The study was conducted from January 2013 to August 2013. Constipation was defined according to the Rome III criteria. RESULTS Out of 1166 screened patients, altogether 171 patients were included with a median duration of opioid therapy of 5 years. The most common diagnoses were back pain, musculoskeletal pain and neuropathic pain. In 14% of the treated patients symptoms of constipation were detected and another 35% needed laxatives for symptom control resulting in an overall incidence of constipation of 49%. The remaining 51% of the patients did not use any laxatives and did not experience symptoms of constipation. Age and dosing of opioid therapy significantly increased the risk of consipation but duration of opioid therapy was not related to the incidence of constipation. DISCUSSION The incidence of constipation in this population remains high although a relevant number of patients were intermittently free of symptoms without using laxatives. An individualized therapy plan and patient education seem to be important elements to control opioid-associated constipation.
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Affiliation(s)
- S Tafelski
- Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland.
| | - T Beutlhauser
- Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland
| | - F Bellin
- Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland
| | - E Reuter
- Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland
| | - T Fritzsche
- Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland
| | - C West
- Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland
| | - M Schäfer
- Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland
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Kraxner J, Schäfer M, Röschel O, Kothleitner G, Haberfehlner G, Paller M, Grogger W. Quantitative EDXS: Influence of geometry on a four detector system. Ultramicroscopy 2017; 172:30-39. [DOI: 10.1016/j.ultramic.2016.10.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 09/26/2016] [Accepted: 10/16/2016] [Indexed: 11/29/2022]
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Cramer H, Schäfer M, Schöls M, Köcke J, Elsenbruch S, Lauche R, Egler H, Dobos G, Langhorst J, Linck G. Randomized Clinical Trial: Yoga vs. Written Self-Care Advice for Ulcerative Colitis. Deutsche Zeitschrift für Akupunktur 2017. [DOI: 10.1016/s0415-6412(17)30082-6] [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] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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41
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Werner RN, Nikkels AF, Marinović B, Schäfer M, Czarnecka-Operacz M, Agius AM, Bata-Csörgő Z, Breuer J, Girolomoni G, Gross GE, Langan S, Lapid-Gortzak R, Lesser TH, Pleyer U, Sellner J, Verjans GM, Wutzler P, Dressler C, Erdmann R, Rosumeck S, Nast A. European consensus-based (S2k) Guideline on the Management of Herpes Zoster - guided by the European Dermatology Forum (EDF) in cooperation with the European Academy of Dermatology and Venereology (EADV), Part 1: Diagnosis. J Eur Acad Dermatol Venereol 2017; 31:9-19. [PMID: 27804172 DOI: 10.1111/jdv.13995] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 09/23/2016] [Indexed: 12/15/2022]
Abstract
Herpes zoster (HZ, shingles) is a frequent medical condition which may severely impact the quality of life of affected patients. Different therapeutic approaches to treat acute HZ are available. The aim of this European project was the elaboration of a consensus-based guideline on the management of patients who present with HZ, considering different patient populations and different localizations. This interdisciplinary guideline aims at an improvement of the outcomes of the acute HZ management concerning disease duration, acute pain and quality of life of the affected patients and at a reduction of the incidence of postherpetic neuralgia and other complications. The guideline development followed a structured and predefined process, considering the quality criteria for guidelines development as suggested by the AGREE II instrument. The steering group was responsible for the planning and the organization of the guideline development process (Division of Evidence based Medicine, dEBM). The expert panel was nominated by virtue of clinical expertise and/or scientific experience and included experts from the fields of dermatology, virology/infectiology, ophthalmology, otolaryngology, neurology and anaesthesiology. Recommendations for clinical practice were formally consented during the consensus conference, explicitly considering different relevant aspects. The guideline was approved by the commissioning societies after an extensive internal and external review process. In this first part of the guideline, diagnostic means have been evaluated. The expert panel formally consented recommendations for the management of patients with (suspected) HZ, referring to the assessment of HZ patients, considering various specific clinical situations. Users of the guideline must carefully check whether the recommendations are appropriate for the context of intended application. In the setting of an international guideline, it is generally important to consider different national approaches and legal circumstances with regard to the regulatory approval, availability and reimbursement of diagnostic and therapeutic interventions.
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Affiliation(s)
- R N Werner
- Division of Evidence Based Medicine in Dermatology (dEBM), Department of Dermatology, Venereology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - A F Nikkels
- Department of Dermatology, University Medical Center of Liège, Liège, Belgium
| | - B Marinović
- Department of Dermatology and Venereology, University Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
| | - M Schäfer
- Department of Anesthesiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - M Czarnecka-Operacz
- Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
| | - A M Agius
- Department of Otorhinolaryngology, The Medical School, University of Malta, Msida, Malta
| | - Z Bata-Csörgő
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - J Breuer
- Division of Infection and Immunity, University College London, London, UK
| | - G Girolomoni
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - G E Gross
- Department of Dermatology and Venerology, Universitätsklinik Rostock, Rostock, Germany
| | - S Langan
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - R Lapid-Gortzak
- Department of Ophthalmology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - T H Lesser
- Department of Otolaryngology, University Hospital Aintree NHS Foundation Trust, Liverpool, UK
| | - U Pleyer
- Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - J Sellner
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria
| | - G M Verjans
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | - P Wutzler
- Department of Virology and Antiviral Therapy, Jena University Hospital, Jena, Germany
| | - C Dressler
- Division of Evidence Based Medicine in Dermatology (dEBM), Department of Dermatology, Venereology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - R Erdmann
- Division of Evidence Based Medicine in Dermatology (dEBM), Department of Dermatology, Venereology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - S Rosumeck
- Division of Evidence Based Medicine in Dermatology (dEBM), Department of Dermatology, Venereology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - A Nast
- Division of Evidence Based Medicine in Dermatology (dEBM), Department of Dermatology, Venereology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Häuser W, Bock F, Engeser P, Hege-Scheuing G, Hüppe M, Lindena G, Maier C, Norda H, Radbruch L, Sabatowski R, Schäfer M, Schiltenwolf M, Schuler M, Sorgatz H, Tölle T, Willweber-Strumpf A, Petzke F. [Recommendations of the updated LONTS guidelines. Long-term opioid therapy for chronic noncancer pain]. Schmerz 2016; 29:109-30. [PMID: 25616996 DOI: 10.1007/s00482-014-1463-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The regular update of the German S3 guidelines on long-term opioid therapy for chronic noncancer pain (CNCP), the"LONTS" (AWMF registration number 145/003), began in November 2013. METHODS The guidelines were developed by 26 scientific societies and two patient self-help organisations under the coordination of the Deutsche Schmerzgesellschaft (German Pain Society). A systematic literature search in the Cochrane Central Register of Controlled Trials (CENTRAL), Medline and Scopus databases (up until October 2013) was performed. Levels of evidence were assigned according to the classification system of the Oxford Centre for Evidence-Based Medicine. The strength of the recommendations was established by multistep formal procedures, in order to reach a consensus according to German Association of the Medical Scientific Societies ("Arbeitsgemeinschaft der Wissenschaftlich Medizinischen Fachgesellschaften", AWMF) regulations. The guidelines were reviewed by the Drug Commission of the German Medical Association, the Austrian Pain Society and the Swiss Association for the Study of Pain. RESULTS Opioids are one drug-based treatment option for short- (4-12 weeks), intermediate- (13-25 weeks) and long-term (≥ 26 weeks) therapy of chronic osteoarthritis, diabetic polyneuropathy, postherpetic neuralgia and low back pain. Contraindications are primary headaches, as well as functional somatic syndromes and mental disorders with the (cardinal) symptom pain. For all other clinical presentations, a short- and long-term therapy with opioid-containing analgesics should be evaluated on an individual basis. Long-term therapy with opioid-containing analgesics is associated with relevant risks (sexual disorders, increased mortality). CONCLUSION Responsible application of opioid-containing analgesics requires consideration of possible indications and contraindications, as well as regular assessment of efficacy and adverse effects. Neither an uncritical increase in opioid application, nor the global rejection of opioid-containing analgesics is justified in patients with CNCP.
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Affiliation(s)
- W Häuser
- Medizinisches Versorgungszentrum (Schmerztherapie, Palliativmedizin, Psychiatrie, Psychotherapie) Saarbrücken - St. Johann, Saarbrücken, Deutschland,
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Abstract
The strength of ceramic restorations depends on the occlusal surface roughness of the veneering porcelain, which is influenced by the final preparation. The hypothesis of the study was that roughnesses below a critical microscopic defect size—based only on fracture mechanics considerations—also affect flexural strength. The bending failure stress was evaluated on standard specimens of 4 veneer ceramics with 4 different surfaces of defined roughnesses, respectively. A linear correlation was found between roughness and failure stress. A "roughness-free" failure stress value was predicted for each tested material. This theoretical value can represent the "true" strength of the respective ceramic material. We conclude from our results that the final preparation of a ceramic restoration is critical to the strength of the material, and that ceramic veneering materials can be compared more objectively with respect to their strength by means of roughness-free strength values.
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Affiliation(s)
- H Fischer
- Department of Dental Prosthetics, Section of Dental Materials, University RWTH Aachen, Germany.
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Reuter E, Tafelski S, Thieme K, West C, Haase U, Beck L, Schäfer M, Spies C. [Treatment of fibromyalgia syndrome with gamma-hydroxybutyrate : A randomized controlled study]. Schmerz 2016; 31:149-158. [PMID: 27807735 DOI: 10.1007/s00482-016-0166-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 10/20/2022]
Abstract
BACKGROUND The etiology of fibromyalgia syndrome is not yet fully understood. Current hypotheses suggest a potential role of gamma-hydroxybutyrate (GHB) in influencing endocrinological abnormalities in patients with fibromyalgia. OBJECTIVE The aim of the study was to investigate whether low dose GHB as a growth-hormone releasing substance reduces pain intensity and improves depressive mood, physical impairment and sleep quality in outpatients with fibromyalgia. Additionally, adverse events were recorded. MATERIAL AND METHODS The pilot study was conducted in the outpatient clinic for pain at the clinic for anesthesiology and surgical intensive care of the Charité Universitätsmedizin Berlin. In the study 25 female patients with fibromyalgia according to the criteria of the American College of Rheumatology were randomized into 2 groups. Over 15 weeks patients of the intervention group received 25 mg/kg body weight oral GHB before going to bed and were compared with a placebo control group. In addition, all patients participated in operant behavioral pain treatment in a group setting. Dependent variables were pain intensity, depressive mood, physical impairment and quality of sleep. RESULTS There were no group differences in the course of pain intensity (p = 0.61), depressive mood (p = 0.16), physical impairment (p = 0.25) and quality of sleep (p = 0.44); however, all symptoms improved across the groups from pretherapy to posttherapy. Low dose GHB did not increase growth hormone blood concentrations. The number of adverse events that were reported more than two times was similar in both groups. DISCUSSION Administration of low dose GHB did not yield clinical improvements in female outpatients with fibromyalgia. General improvement in the course of treatment may have resulted from operant behavioral pain therapy. Future studies on GHB should control hypothetical risk factors for identification of non-responders.
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Affiliation(s)
- E Reuter
- Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Schmerzambulanz, Campus Charité Mitte und Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.
| | - S Tafelski
- Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Schmerzambulanz, Campus Charité Mitte und Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - K Thieme
- Institut für Medizinische Psychologie, Philipps-Universität Marburg, Marburg, Deutschland
| | - C West
- Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Schmerzambulanz, Campus Charité Mitte und Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - U Haase
- Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Schmerzambulanz, Campus Charité Mitte und Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - L Beck
- POLIKUM Charlottenburg, Berlin, Deutschland
| | - M Schäfer
- Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Schmerzambulanz, Campus Charité Mitte und Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - C Spies
- Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Schmerzambulanz, Campus Charité Mitte und Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
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Werner RN, Nikkels AF, Marinović B, Schäfer M, Czarnecka-Operacz M, Agius AM, Bata-Csörgő Z, Breuer J, Girolomoni G, Gross GE, Langan S, Lapid-Gortzak R, Lesser TH, Pleyer U, Sellner J, Verjans GM, Wutzler P, Dressler C, Erdmann R, Rosumeck S, Nast A. European consensus-based (S2k) Guideline on the Management of Herpes Zoster - guided by the European Dermatology Forum (EDF) in cooperation with the European Academy of Dermatology and Venereology (EADV), Part 2: Treatment. J Eur Acad Dermatol Venereol 2016; 31:20-29. [PMID: 27579792 DOI: 10.1111/jdv.13957] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 08/12/2016] [Indexed: 11/29/2022]
Abstract
Herpes zoster (HZ, shingles) is a frequent medical condition which may severely impact the quality of life of affected patients. Different therapeutic approaches to treat acute HZ are available. The aim of this European project was the elaboration of a consensus-based guideline on the management of patients who present with HZ, considering different patient populations and different localizations. This interdisciplinary guideline aims at an improvement of the outcomes of the acute HZ management concerning disease duration, acute pain and quality of life of the affected patients and at a reduction in the incidence of postherpetic neuralgia (PHN) and other complications. The guideline development followed a structured and pre-defined process, considering the quality criteria for guidelines development as suggested by the AGREE II instrument. The steering group was responsible for the planning and the organization of the guideline development process (Division of Evidence-Based Medicine, dEBM). The expert panel was nominated by virtue of clinical expertise and/or scientific experience and included experts from the fields of dermatology, virology/infectiology, ophthalmology, otolaryngology, neurology and anaesthesiology. Recommendations for clinical practice were formally consented during the consensus conference, explicitly considering different relevant aspects. The guideline was approved by the commissioning societies after an extensive internal and external review process. In this second part of the guideline, therapeutic interventions have been evaluated. The expert panel formally consented recommendations for the treatment of patients with HZ (antiviral medication, pain management, local therapy), considering various clinical situations. Users of the guideline must carefully check whether the recommendations are appropriate for the context of intended application. In the setting of an international guideline, it is generally important to consider different national approaches and legal circumstances with regard to the regulatory approval, availability and reimbursement of diagnostic and therapeutic interventions.
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Affiliation(s)
- R N Werner
- Department of Dermatology, Venereology and Allergology, Division of Evidence-Based Medicine in Dermatology (dEBM), Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - A F Nikkels
- Department of Dermatology, University Medical Center of Liège, Liège, Belgium
| | - B Marinović
- Department of Dermatology and Venereology, University Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
| | - M Schäfer
- Department of Anesthesiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - M Czarnecka-Operacz
- Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
| | - A M Agius
- Department of Otorhinolaryngology, The Medical School, University of Malta, Msida, Malta
| | - Z Bata-Csörgő
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - J Breuer
- Division of Infection and Immunity, University College London, London, United Kingdom
| | - G Girolomoni
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - G E Gross
- Department of Dermatology and Venerology, Universitätsklinik Rostock, Rostock, Germany
| | - S Langan
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - R Lapid-Gortzak
- Department of Ophthalmology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - T H Lesser
- Department of Otolaryngology, University Hospital Aintree NHS Foundation Trust, Liverpool, UK
| | - U Pleyer
- Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - J Sellner
- Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria
| | - G M Verjans
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | - P Wutzler
- Department of Virology and Antiviral Therapy, Jena University Hospital, Jena, Germany
| | - C Dressler
- Department of Dermatology, Venereology and Allergology, Division of Evidence-Based Medicine in Dermatology (dEBM), Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - R Erdmann
- Department of Dermatology, Venereology and Allergology, Division of Evidence-Based Medicine in Dermatology (dEBM), Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - S Rosumeck
- Department of Dermatology, Venereology and Allergology, Division of Evidence-Based Medicine in Dermatology (dEBM), Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - A Nast
- Department of Dermatology, Venereology and Allergology, Division of Evidence-Based Medicine in Dermatology (dEBM), Charité - Universitätsmedizin Berlin, Berlin, Germany
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Zwink N, Choinitzki V, Baudisch F, Hölscher A, Boemers TM, Turial S, Kurz R, Heydweiller A, Keppler K, Müller A, Bagci S, Pauly M, Brokmeier U, Leutner A, Degenhardt P, Schmiedeke E, Märzheuser S, Grasshoff-Derr S, Holland-Cunz S, Palta M, Schäfer M, Ure BM, Lacher M, Nöthen MM, Schumacher J, Jenetzky E, Reutter H. Comparison of environmental risk factors for esophageal atresia, anorectal malformations, and the combined phenotype in 263 German families. Dis Esophagus 2016; 29:1032-1042. [PMID: 26541887 DOI: 10.1111/dote.12431] [Citation(s) in RCA: 8] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Esophageal atresia with or without tracheoesophageal fistula (EA/TEF) and anorectal malformations (ARM) represent the severe ends of the fore- and hindgut malformation spectra. Previous research suggests that environmental factors are implicated in their etiology. These risk factors might indicate the influence of specific etiological mechanisms on distinct developmental processes (e.g. fore- vs. hindgut malformation). The present study compared environmental factors in patients with isolated EA/TEF, isolated ARM, and the combined phenotype during the periconceptional period and the first trimester of pregnancy in order to investigate the hypothesis that fore- and hindgut malformations involve differing environmental factors. Patients with isolated EA/TEF (n = 98), isolated ARM (n = 123), and the combined phenotype (n = 42) were included. Families were recruited within the context of two German multicenter studies of the genetic and environmental causes of EA/TEF (great consortium) and ARM (CURE-Net). Exposures of interest were ascertained using an epidemiological questionnaire. Chi-square, Fisher's exact, and Mann-Whitney U-tests were used to assess differences between the three phenotypes. Newborns with isolated EA/TEF and the combined phenotype had significantly lower birth weights than newborns with isolated ARM (P = 0.001 and P < 0.0001, respectively). Mothers of isolated EA/TEF consumed more alcohol periconceptional (80%) than mothers of isolated ARM or the combined phenotype (each 67%). Parental smoking (P = 0.003) and artificial reproductive techniques (P = 0.03) were associated with isolated ARM. Unexpectedly, maternal periconceptional multivitamin supplementation was most frequent among patients with the most severe form of disorder, i.e. the combined phenotype (19%). Significant differences in birth weight were apparent between the three phenotype groups. This might be attributable to the limited ability of EA/TEF fetuses to swallow amniotic fluid, thus depriving them of its nutritive properties. Furthermore, the present data suggest that fore- and hindgut malformations involve differing environmental factors. Maternal periconceptional multivitamin supplementation was highest among patients with the combined phenotype. This latter finding is contrary to expectation, and warrants further analysis in large prospective epidemiological studies.
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Affiliation(s)
- N Zwink
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | - V Choinitzki
- Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - F Baudisch
- Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - A Hölscher
- Department of Pediatric Surgery and Urology, University Hospital Cologne, Cologne, Germany
| | - T M Boemers
- Department of Pediatric Surgery and Urology, University Hospital Cologne, Cologne, Germany
| | - S Turial
- Department of Pediatric Surgery, University Hospital Mainz, Mainz, Germany
| | - R Kurz
- Department of Pediatric Surgery, University Hospital Bonn, Bonn, Germany
| | - A Heydweiller
- Department of Pediatric Surgery, University Hospital Bonn, Bonn, Germany
| | - K Keppler
- Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - A Müller
- Department of Neonatology and Pediatric Intensive Care, Children's Hospital, University of Bonn, Bonn, Germany
| | - S Bagci
- Department of Neonatology and Pediatric Intensive Care, Children's Hospital, University of Bonn, Bonn, Germany
| | - M Pauly
- Department of Pediatric Surgery, Asklepios Children's Hospital St. Augustin, St. Augustin, Germany
| | - U Brokmeier
- Department of Pediatric Surgery, Asklepios Children's Hospital St. Augustin, St. Augustin, Germany
| | - A Leutner
- Department of Pediatric Surgery, Medical Center Dortmund, Dortmund, Germany
| | - P Degenhardt
- Department of Pediatric Surgery, Charité University Medicine Berlin, Berlin, Germany
| | - E Schmiedeke
- Department of Pediatric Surgery and Urology, Center for Child and Youth Health, Klinikum Bremen-Mitte, Bremen, Germany
| | - S Märzheuser
- Department of Pediatric Surgery, Charité University Medicine Berlin, Berlin, Germany
| | - S Grasshoff-Derr
- Unit of Pediatric Surgery, University Hospital Wurzburg, Wurzburg, Germany
| | - S Holland-Cunz
- Department of Pediatric Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - M Palta
- Department of Pediatric Surgery, Evangelisches Krankenhaus Hamm, Hamm, Germany
| | - M Schäfer
- Department of Pediatric Surgery and Urology, Cnopf'sche Kinderklinik, Nürnberg, Germany
| | - B M Ure
- Center of Pediatric Surgery Hannover, Hannover Medical School and Bult Children's Hospital, Hannover, Germany
| | - M Lacher
- Center of Pediatric Surgery Hannover, Hannover Medical School and Bult Children's Hospital, Hannover, Germany
| | - M M Nöthen
- Institute of Human Genetics, University of Bonn, Bonn, Germany.,Department of Genomics, Life and Brain Center, University of Bonn, Bonn, Germany
| | - J Schumacher
- Institute of Human Genetics, University of Bonn, Bonn, Germany.,Department of Genomics, Life and Brain Center, University of Bonn, Bonn, Germany
| | - E Jenetzky
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany.,Department of Child and Adolescent Psychiatry and Psychotherapy, Johannes-Gutenberg University, Mainz, Germany.,Child Center Maulbronn gGmbH, Hospital for Pediatric Neurology and Social Pediatrics, Maulbronn, Germany
| | - H Reutter
- Institute of Human Genetics, University of Bonn, Bonn, Germany.,Department of Neonatology and Pediatric Intensive Care, Children's Hospital, University of Bonn, Bonn, Germany
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47
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Affiliation(s)
- L Radbruch
- Klinik für Palliativmedizin, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Deutschland. .,Deutsche Gesellschaft für Palliativmedizin, Berlin, Deutschland.
| | - M Schäfer
- Klinik für Anästhesiologie und operative Intensivmedizin, Charité - Universitätsmedizin, Campus Virchow, Berlin, Deutschland.,Deutsche Schmerzgesellschaft, Berlin, Deutschland
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48
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Schäfer M, Stehr M. Hydronephrose und Blasenentleerungsstörung. Monatsschr Kinderheilkd 2016. [DOI: 10.1007/s00112-016-0164-1] [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: 10/21/2022]
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49
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Schäfer M, Caucamán Castillo T. Modellgestützte Schätzung des relativen Risikos vermeidbarer Sterblichkeit auf Kreisebene in der Metropolregion Rhein-Ruhr unter Berücksichtigung von räumlichen Effekten und ökologischen Kovariablen. Gesundheitswesen 2016. [DOI: 10.1055/s-0036-1586676] [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: 10/21/2022]
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50
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Muzumdar S, Hiebert H, Haertel E, Bloch W, Werner S, Schäfer M. 551 Nrf2 activation enhances cutaneous wound healing by expansion of hair follicle stem cell populations. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.575] [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: 10/21/2022]
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