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Herbert SL, Wöckel A, Kreienberg R, Kühn T, Flock F, Felberbaum R, Janni W, Curtaz C, Kiesel M, Stüber T, Diessner J, Salmen J, Schwentner L, Fink V, Bekes I, Leinert E, Lato K, Polasik A, Schochter F, Singer S. To which extent do breast cancer survivors feel well informed about disease and treatment 5 years after diagnosis? Breast Cancer Res Treat 2020; 185:677-684. [PMID: 33104958 PMCID: PMC7921033 DOI: 10.1007/s10549-020-05974-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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 10/08/2020] [Indexed: 10/27/2022]
Abstract
OBJECTIVE In this study, we investigated to which extent patients feel well informed about their disease and treatment, which areas they wish more or less information and which variables are associated with a need for information about the disease, medical tests and treatment. METHODS In a German multi-centre prospective study, we enrolled 759 female breast cancer patients at the time of cancer diagnosis (baseline). Data on information were captured at 5 years after diagnosis with the European Organisation for Research and Treatment of Cancer (EORTC) Information Module (EORTC QLQ-INFO24). Good information predictors were analysed using linear regression models. RESULTS There were 456 patients who participated at the 5-year follow-up. They reported to feel well informed about medical tests (mean score 78.5) and the disease itself (69.3) but relatively poorly about other services (44.3) and about different places of care (31.3). The survivors expressed a need for more information concerning: side effects and long-term consequences of therapy, more information in general, information about aftercare, prognosis, complementary medicine, disease and therapy. Patients with higher incomes were better informed about medical tests (β 0.26, p 0.04) and worse informed with increasing levels of fear of treatment (β - 0.11, p 0.02). Information about treatment was reported to be worse by survivors > 70 years old (β -0.34, p 0.03) and by immigrants (β -0.11, p 0.02). Survivors who had received additional written information felt better informed about disease, medical tests, treatment and other services (β 0.19/0.19/0.20/0.25; each p < 0.01). CONCLUSION Health care providers have to reconsider how and what kind of information they provide. Providing written information, in addition to oral information, may improve meeting those information needs.
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Affiliation(s)
- S L Herbert
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany.
| | - A Wöckel
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany
| | - R Kreienberg
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - T Kühn
- Department of Gynaecology and Obstetrics, Hospital Esslingen, Esslingen, Germany
| | - F Flock
- Department of Gynaecology and Obstetrics, Hospital Memmingen, Memmingen, Germany
| | - R Felberbaum
- Department of Gynaecology and Obstetrics, Hospital Kempten, Kempten, Germany
| | - W Janni
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - C Curtaz
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany
| | - M Kiesel
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany
| | - T Stüber
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany
| | - J Diessner
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany
| | - J Salmen
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany
| | - L Schwentner
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - V Fink
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - I Bekes
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - E Leinert
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - K Lato
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - A Polasik
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - F Schochter
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - S Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre Mainz, Mainz, Germany
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Stoetzer C, Kistner K, Stüber T, Wirths M, Schulze V, Doll T, Foadi N, Wegner F, Ahrens J, Leffler A. Methadone is a local anaesthetic-like inhibitor of neuronal Na+ channels and blocks excitability of mouse peripheral nerves. Br J Anaesth 2014; 114:110-20. [PMID: 25012584 DOI: 10.1093/bja/aeu206] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [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: 11/14/2022] Open
Abstract
BACKGROUND Opioids enhance and prolong analgesia when applied as adjuvants to local anaesthetics (LAs). A possible molecular mechanism for this property is a direct inhibition of voltage-gated Na(+) channels which was reported for some opioids. Methadone is an effective adjuvant to LA and was recently reported to inhibit cardiac Na(+) channels. Here, we explore and compare LA properties of methadone and bupivacaine on neuronal Na(+) channels, excitability of peripheral nerves, and cell viability. METHODS Effects of methadone were explored on compound action potentials (CAP) of isolated mouse saphenous nerves. Patch clamp recordings were performed on Na(+) channels in ND7/23 cells, the α-subunits Nav1.2, Nav1.3, Nav1.7, and Nav1.8, and the hyperpolarization-activated cyclic nucleotide-gated channel 2 (HCN2). Cytotoxicity was determined using flow cytometry. RESULTS Methadone (IC50 86-119 µM) is a state-dependent and unselective blocker on Nav1.2, Nav1.3, Nav1.7, and Nav1.8 with a potency comparable with that of bupivacaine (IC50 177 µM). Both bupivacaine and methadone also inhibit C- and A-fibre CAPs in saphenous nerves in a concentration-dependent manner. Tonic block of Nav1.7 revealed a discrete stereo-selectivity with a higher potency for levomethadone than for dextromethadone. Methadone is also a weak blocker of HCN2 channels. Both methadone and bupivacaine induce a pronounced cytotoxicity at concentrations required for LA effects. CONCLUSIONS Methadone induces typical LA effects by inhibiting Na(+) channels with a potency similar to that of bupivacaine. This hitherto unknown property of methadone might contribute to its high efficacy when applied as an adjuvant to LA.
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Affiliation(s)
- C Stoetzer
- Department of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Carl-Neuberg Strasse 1, 30625 Hannover, Germany
| | - K Kistner
- Institute of Physiology and Pathophysiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - T Stüber
- Department of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Carl-Neuberg Strasse 1, 30625 Hannover, Germany
| | - M Wirths
- Department of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Carl-Neuberg Strasse 1, 30625 Hannover, Germany
| | - V Schulze
- Department of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Carl-Neuberg Strasse 1, 30625 Hannover, Germany
| | - T Doll
- Department of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Carl-Neuberg Strasse 1, 30625 Hannover, Germany
| | - N Foadi
- Department of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Carl-Neuberg Strasse 1, 30625 Hannover, Germany
| | - F Wegner
- Department of Neurology, Hannover Medical School, Carl-Neuberg Strasse 1, 30625 Hannover, Germany
| | - J Ahrens
- Department of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Carl-Neuberg Strasse 1, 30625 Hannover, Germany
| | - A Leffler
- Department of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Carl-Neuberg Strasse 1, 30625 Hannover, Germany
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Diessner J, Stüber T, Niederle B, Pawlik M, Dietl J, Honig A. XY gonadal dysgenesis--development of a germ cell tumor: case report. EUR J GYNAECOL ONCOL 2013; 34:572-574. [PMID: 24601055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Gonadal dysgenesis (GD) is a rare congenital malformation that affects about one in 3,000 births. The authors present a case of a 17-year-old woman with primary amenorrhea and poor breast development. They conducted a laparoscopic surgery and bilaterally removed hypoplastic streak gonads. Histopathology of the ovaries revealed bilateral streak gonads with gonadoblastomas and a right-sided dysgerminoma.
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Affiliation(s)
- J Diessner
- Department of Obstetrics and Gynecology, Universitäts-Frauenklinik Würzburg, Würzburg, Germany
| | - T Stüber
- Department of Obstetrics and Gynecology, Universitäts-Frauenklinik Würzburg, Würzburg, Germany
| | - B Niederle
- Department of Obstetrics and Gynecology, Universitäts-Frauenklinik Würzburg, Würzburg, Germany
| | - M Pawlik
- Department of Obstetrics and Gynecology, Universitäts-Frauenklinik Würzburg, Würzburg, Germany
| | - J Dietl
- Department of Obstetrics and Gynecology, Universitäts-Frauenklinik Würzburg, Würzburg, Germany
| | - A Honig
- Department of Obstetrics and Gynecology, Universitäts-Frauenklinik Würzburg, Würzburg, Germany
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Krockenberger M, Lafontaine B, Stein R, Hoggenmüller M, Stüber T, Dietl J. Palliativmedizin in der gynäkologischen Onkologie: Notwendigkeit oder Übertreibung? Geburtshilfe Frauenheilkd 2012. [DOI: 10.1055/s-0032-1318534] [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: 10/28/2022] Open
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