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SAMCEP Society consensus on the treatment of upper facial lines with botulinum neurotoxin type A: A tailored approach. J Cosmet Dermatol 2023; 22:2692-2704. [PMID: 37408173 DOI: 10.1111/jocd.15768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/06/2023] [Accepted: 03/29/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND The safety and efficacy of botulinum neurotoxin type A (BoNTA) treatments are well established, but injection techniques, target muscles, and toxin doses continue to evolve, with each refinement producing improvements in treatment outcomes. The recommendations in this consensus move away from standard templates and illustrate how to tailor treatments to individual patterns and strengths of muscle activity, and patient preferences. METHODS Seventeen experts in the fields of plastic surgery, dermatology, ophthalmology, otorhinolaryngology, and neurology convened in 2022 to develop consensus-based recommendations for the use of botulinum toxin A for the treatment of horizontal forehead lines, glabellar frown lines, and crow's feet lines that reflect current clinical practice. The focus was on how to tailor injections to individual patients to optimize treatment outcomes. RESULTS For each upper face indication, consensus members describe how to perform a dynamic assessment to optimize the dose and injection technique for each patient. A tailored treatment protocol is presented for commonly observed patterns of dynamic lines. Units of Inco are defined and the precise location of injection points, illustrated with the use of anatomical images. CONCLUSION This consensus provides up-to-date recommendations on the tailored treatment of upper facial lines based on the latest research and collective clinical experience of the expert injectors. Optimal outcomes require thorough patient evaluation, both at rest and during animation, using both visual and tactile cues; detailed understanding of facial muscular anatomy and how opposing muscles interact; and use of a BoNTA with high precision to target identified zones of excess muscle activity.
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Corrigendum to "Human biomonitoring guidance values (HBM-GVs) for priority substances under the HBM4EU initiative - New values derivation for deltamethrin and cyfluthrin and overall results" [Int. J. Hyg. Environ. Health 248 (2023) 114097]. Int J Hyg Environ Health 2023; 253:114144. [PMID: 36858899 DOI: 10.1016/j.ijheh.2023.114144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
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Human biomonitoring guidance values (HBM-GVs) for priority substances under the HBM4EU initiative - New values derivation for deltamethrin and cyfluthrin and overall results. Int J Hyg Environ Health 2023; 248:114097. [PMID: 36577283 DOI: 10.1016/j.ijheh.2022.114097] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 12/27/2022]
Abstract
The European Initiative HBM4EU aimed to further establish human biomonitoring across Europe as an important tool for determining population exposure to chemicals and as part of health-related risk assessments, thus making it applicable for policy advice. Not only should analytical methods and survey design be harmonized and quality assured, but also the evaluation of human biomonitoring data. For the health-related interpretation of the data within HBM4EU, a strategy for deriving health-based human biomonitoring guidance values (HBM-GVs) for both the general population and workers was agreed on. On this basis, HBM-GVs for exposure biomarkers of 1,2-cyclohexane dicarboxylic acid diisononyl ester (DINCH), phthalates (diethyl hexyl phthalate (DEHP), di-n-butyl phthalate (DnBP), diisobutyl phthalate (DiBP), butyl benzyl phthalate (BBzP), and bis-(2-propylheptyl) phthalate (DPHP)), bisphenols A and S, pyrethroids (deltamethrin and cyfluthrin), solvents (1-methyl-2-pyrrolidone (NMP), 1-ethylpyrrolidin-2-one (NEP), N-dimethylformamide (DMF), N,N-dimethylacetamide (DMAC)), the heavy metal cadmium and the mycotoxin deoxynivalenol (DON) were developed and assigned a level of confidence. The approach to HBM-GV derivations, results, and limitations in data interpretation with special focus on the pyrethroids are presented in this paper.
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Impact du GM-CSF et des traitements ciblant la voie du GM-CSF sur les fonctions des macrophages pulmonaires humains et monocytes circulants. Rev Mal Respir 2023. [DOI: 10.1016/j.rmr.2022.11.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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ROS mediated apoptosis and cell cycle arrest in human lung adenocarcinoma cell lines by silver nanoparticles synthesized using Swietenia macrophylla seed extract. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.104084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Phytofabrication of silver and zinc oxide nanoparticles using the fruit extract of Phyllanthus emblica and its potential anti-diabetic and anti-cancer activity. PARTICULATE SCIENCE AND TECHNOLOGY 2022. [DOI: 10.1080/02726351.2022.2141668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Targeted Intraoperative Radiotherapy (TARGIT) during Breast-Conserving Surgery for Patients with Early-Stage Breast Cancer: A Phase II Prospective Trial. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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High-responsivity operation of quantum cascade detectors at 9 µm. OPTICS EXPRESS 2022; 30:40188-40195. [PMID: 36298955 DOI: 10.1364/oe.470615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 09/21/2022] [Indexed: 06/16/2023]
Abstract
Quantum cascade detectors (QCDs) are devices operating at zero external bias with a low dark-current. They show linear detection and high saturation intensities, making them suitable candidates for heterodyne detection in long-wave infrared (LWIR) free space optical communication systems. We present an approach to mitigate the performance limitation at long wavelengths, by a comparison of similar single and multi-period QCDs for optimizing their responsivity and noise behaviour. Our InGaAs/InAlAs/InP ridge QCDs are designed for operation at λ = 9.124 µm. Optical waveguide simulations support the accurate optical characterization. A detailed device analysis reveals room-temperature responsivities of 111 mA/W for the 15-period and 411 mA/W for the single-period device.
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First principles investigation on the hydrogen adsorption on planar aluminene with boron, carbon, and nitrogen as impurities. Mol Phys 2022. [DOI: 10.1080/00268976.2022.2086182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Impact of Pre-Processing Methods for the Identification of the Botanical Origin of Honey Based Upon Isotopic and Elemental Profiles. ANAL LETT 2022. [DOI: 10.1080/00032719.2022.2044347] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Fruit spirits fingerprint pointed out through artificial intelligence and FT-Raman spectroscopy. Food Control 2022. [DOI: 10.1016/j.foodcont.2021.108630] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Effect of splint on pain, function and quality of life in trapeziometacarpal osteoarthritis patients? Acta Orthop Belg 2022; 88:179-185. [PMID: 35512169 DOI: 10.52628/88.1.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Trapeziometacarpal (TM) Osteoarthritis is one of the most common osteoarthritis. It causes pain, loss of mobility and strength and affected function in daily life. Splint is one of the conservative treatments proposed to patients. The purpose of this study was to assess the effect of this conservative treatment on pain, function and quality of life at long-term. We sent 193 questionnaires to patients who received a CMC splint for their TM osteoarthritis. The CMC splint immobilizes only the TM joint and leaves free the interphalangeal joint of the thumb and the wrist. First, we comptuted how many patients had finally undergone surgical treatment. On the non-operated patients, we analyzed the pain (VAS), the function (QuickDASH score) and the quality of life (SF-12). We compared the results to literature and norms. Finally, 186 people could be included in the study ,115 we answered and 28 were operated on (24%). After 4 years (3.8±1.7 yrs) of conservative treatment, The VAS and QuickDASH scores were significantly worse comparatively to a cohort of healthy patients, trapezectomy and arthrodesis patients. The SF-12 scores were reduced from 20% comparative to norms. In conclusion, few patients had surgery after splinting as a conservative treatment. However, these non- operated patients do not provide good results.
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Assessing prospective and retrospective metacognitive accuracy following traumatic brain injury remotely across cognitive domains. Neuropsychol Rehabil 2022; 33:574-591. [PMID: 35168480 DOI: 10.1080/09602011.2022.2034650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The ability to monitor one's behaviour is frequently impaired following TBI, impacting on patients' rehabilitation. Inaccuracies in judgement or self-reflection of one's performance provides a useful marker of metacognition. However, metacognition is rarely measured during routine neuropsychology assessments and how it varies across cognitive domains is unclear. A cohort of participants consisting of 111 TBI patients [mean age = 45.32(14.15), female = 29] and 84 controls [mean age = 31.51(12.27), female = 43] was studied. Participants completed cognitive assessments via a bespoke digital platform on their smartphones. Included in the assessment were a prospective evaluation of memory and attention, and retrospective confidence judgements of task performance. Metacognitive accuracy was calculated from the difference between confidence judgement of task performance and actual performance. Prospective judgment of attention and memory was correlated with task performance in these domains for controls but not patients. TBI patients had lower task performance in processing speed, executive functioning and working memory compared to controls, maintaining high confidence, resulting in overestimation of cognitive performance compared to controls. Additional judgments of task performance complement neuropsychological assessments with little additional time-cost. These results have important theoretical and practical implications for evaluation of metacognitive impairment in TBI patients and neurorehabilitation.
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Green synthesis of silver nanoparticles using Caesalpinia bonducella leaf extract: characterization and evaluation of in vitro anti-inflammatory and anti-cancer activities. INORG NANO-MET CHEM 2022. [DOI: 10.1080/24701556.2021.2025093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Systematic Review and Meta-Analysis of Sex Specific Differences in Adverse Events After Open and Endovascular Intact Abdominal Aortic Aneurysm Repair: Consistently Worse Outcomes for Women. J Vasc Surg 2021. [DOI: 10.1016/j.jvs.2021.08.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Influence of migrant background on patient preference and expectations in breast and gynecological malignancies (NOGGO-expression V study): results of a prospective multicentre study in 606 patients in Germany. BMC Cancer 2021; 21:1018. [PMID: 34511112 PMCID: PMC8436522 DOI: 10.1186/s12885-021-08731-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 08/26/2021] [Indexed: 11/23/2022] Open
Abstract
Background An effective cross-cultural doctor-patient communication is vital for health literacy and patient compliance. Building a good relationship with medical staff is also relevant for the treatment decision-making process for cancer patients. Studies about the role of a specific migrant background regarding patient preferences and expectations are lacking. We therefore conducted a multicentre prospective survey to explore the needs and preferences of patients with a migrant background (PMB) suffering from gynecological malignancies and breast cancer to evaluate the quality of doctor-patient communication and cancer management compared to non-migrants (NM). Methods This multicentre survey recruited patients with primary or recurrence of breast, ovarian, peritoneal, or fallopian tube cancer. The patients either filled out a paper form, participated via an online survey, or were interviewed by trained staff. A 58-item questionnaire was primarily developed in German and then translated into three different languages to reach non-German-speaking patients. Results A total of 606 patients were included in the study: 54.1% (328) were interviewed directly, 9.1% (55) participated via an online survey, and 36.8% (223) used the paper print version. More than one quarter, 27.4% (166) of the participants, had a migrant background. The majority of migrants and NM were highly satisfied with the communication with their doctors. First-generation migrants (FGM) and patients with breast cancer were less often informed about participation in clinical trials (p < 0.05) and 24.5% of them suggested the help of an interpreter to improve the medical consultation. Second and third-generation migrants (SGM and TGM) experienced more fatigue and nausea than expected. Conclusions Our results allow the hypothesis that training medical staff in intercultural competence and using disease-related patient information in different languages can improve best supportive care management and quality of life in cancer patients with migrant status. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08731-6.
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Die Sicht von Müttern mit Fluchterfahrung auf die Versorgung während Schwangerschaft und Geburt – eine Mixed-Methods Studie. DAS GESUNDHEITSWESEN 2021. [DOI: 10.1055/s-0041-1732071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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PO-1115 Extreme weekly locoregional hypofractionated radiation in elderly with non-metastatic breast cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07566-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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579 The Impact of Coronavirus 2 (SARS-CoV-2) in Emergency Surgery. Our experience at the General Surgery Department in Queen Elizabeth Hospital, London. Br J Surg 2021. [PMCID: PMC8135811 DOI: 10.1093/bjs/znab134.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Background
The outbreak of the COVID-19 has had global impact on elective and emergency surgical care. So far, we possess few data to understand the effect of the CoViD-19 on emergency surgery.
Aim
To compare the total number of patients who were referred, admitted, and had an emergency operation under General Surgery (GS) between March and May 2020, to the same period between 2016-19.
Method
Retrospective analysis of prospectively collected local data from surgical take lists and operative data obtained from the hospital’s Business Intelligence Team.
Results
A 22.4% reduction was seen in the referrals per day 15.18+/-2.45 vs. 11.77 +/- 4.54 (2016-9 vs. 2020, mean+/-SD) and a 36% reduction in admissions per day 7.40 +/-1.07 vs. 4.69+/- 2.03 (2016-9 vs. 2020, mean+/-SD). A 55% reduction in the total number of emergency operations during the CoViD-19 outbreak was observed 87 (total, 2020) vs. 194+/-35.96 (mean+/-SD, 2016-19).
Conclusions
CoViD-19 had a significant impact on the number of patients presenting to GS. Interestingly, an even greater reduction in operative treatment was also observed. This may reflect reduction in theatre availability or use of a higher threshold for conservative treatment.
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Discordance entre discours et réalité : analyse nutritionnelle de 98 vidéos YouTube « une journée dans mon assiette ». NUTR CLIN METAB 2021. [DOI: 10.1016/j.nupar.2021.01.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Geburtseinleitung – ein möglicher Prädiktor zur Vorhersage einer postpartalen Hämorrhagie? Ergebnisse einer retrospektiven Fall-Kontroll-Studie. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Myometriumdefekte im Bereich der Sectionarbe – Häufigkeit und Art von assoziierten Beschwerden bei Frauen drei und sechs Monate nach Sectio. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Zum Einfluss des Akkulturationsgrades bei der Inanspruchnahme gynäkologischer Notfallambulanzen durch Migrantinnen – Ergebnisse einer prospektiven Querschnittsstudie. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Mögliche psychische Folgen eines Schwangerschaftsabbruchs für die betroffene Frau. Ergebnisse einer selektiven Literaturrecherche für die Jahre 2010 bis 2019. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Tägliche Einnahme von EGCG-angereicherten Grün-Tee-Extrakt-Kapseln durch Frauen mit asymptomatischen Uterusmyomen – Anwendungsbeobachtung über 6 Monate. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Kaposiform hemangioendothelioma with overlapping features of rapidly involuting congenital hemangioma and a delayed complication of necrotizing fasciitis. Pediatr Dermatol 2020; 37:902-906. [PMID: 32677125 DOI: 10.1111/pde.14262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 05/25/2020] [Accepted: 05/31/2020] [Indexed: 11/28/2022]
Abstract
We report the case of a male infant born at term with kaposiform hemangioendothelioma (KHE) of the right forearm and coagulopathy. Our case was unusual as it involuted leaving subcutaneous atrophy and prominent veins, which are more commonly observed in rapidly involuting congenital hemangioma. At 3 years of age, the child developed recurrent superficial thrombophlebitis localized to the area where the KHE had regressed. Subsequently, he developed necrotizing fasciitis and thrombotic veins in the same location and group A streptococcal septic shock.
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Compulsory admissions of patients with mental disorders: State of the art on ethical and legislative aspects in 40 European countries. Eur Psychiatry 2020; 63:e82. [PMID: 32829740 PMCID: PMC7576531 DOI: 10.1192/j.eurpsy.2020.79] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background. Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations that are members of the EPA to develop recommendations for improving involuntary admission processes and promote voluntary care. Methods. The survey focused on legislation of involuntary admissions and key actors involved in the admission procedure as well as most common reasons for involuntary admissions. Results. We analyzed the survey categorical data in themes, which highlight that both medical and legal actors are involved in involuntary admission procedures. Conclusions. We conclude that legal reasons for compulsory admission should be reworded in order to remove stigmatization of the patient, that raising awareness about involuntary admission procedures and patient rights with both patients and family advocacy groups is paramount, that communication about procedures should be widely available in lay-language for the general population, and that training sessions and guidance should be available for legal and medical practitioners. Finally, people working in the field need to be constantly aware about the ethical challenges surrounding compulsory admissions.
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Severe Sepsis Mimicking Primary Nonfunction Following Liver Transplantation: Normothermic Machine Perfusion Is a Potential Environment for Bacterial Overgrowth and Transmission From Donor to Recipient. A Case Report. Transplant Proc 2020; 52:2781-2785. [PMID: 32741664 DOI: 10.1016/j.transproceed.2020.06.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 06/29/2020] [Indexed: 01/07/2023]
Abstract
Primary nonfunction (PNF) in the early postoperative period following liver transplantation is fatal if not managed appropriately with early retransplantation. Severe early allograft dysfunction can mimic PNF. The identification of treatable causative factors such as sepsis, hepatic artery, or portal vein thrombosis is essential to distinguish it from PNF, and their early management may avoid the need for retransplantation. In this article, we describe a case of sepsis-induced severe liver dysfunction from a contaminated graft perfused with normothermic machine perfusion (NMP), which presented in a manner similar to PNF. The implications of graft contamination are poorly described. To our knowledge, this is the first report of bacterial contamination of a graft that underwent NMP and subsequently caused severe sepsis in the recipient. The conditions created with NMP may be optimal for certain micro-organisms to thrive. The role of the liver in the immune system is complex as it provides an essential barrier to enterically derived portal venous pathogens and produces numerous acute phase proteins that augment the systemic immune response. Additionally, the liver is also known to restrain harmful and excessive systemic immune responses such as those that occur with the sepsis syndrome. The relationship between bacterial graft contamination, sepsis, and graft dysfunction may be multidirectional.
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Prophylaxie des thromboembolies veineuses en réanimation pédiatrique : une mise au point. MEDECINE INTENSIVE REANIMATION 2020. [DOI: 10.37051/mir-00016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Objectif : Le but de ce manuscrit est de revoir la littérature actuelle sur la prévention des thromboses veineuses chezl’enfant admis en réanimation.Matériel et méthode : Revue systématique basée sur les articles trouvés dans PubMed et Embase entre janvier 1975 etmars 2018. Les mots clés suivants ont été utilisés : paediatric, children, venous thromboembolism, venous thrombosis,pulmonary embolism, thromboprophylaxis.Résultats : La thrombose veineuse est fréquente en réanimation pédiatrique et souvent sous-estimée malgré sonassociation avec une morbi-mortalité importante. La cause principale est la présence d’un cathéter veineux central.Comparativement à l’adulte, il n’existe chez l’enfant aucune évidence d’un bénéfi ce d’une prophylaxie mis à part peut-être chez l’adolescent traumatisé.Conclusions : La maladie thrombo-embolique veineuse est une préoccupation chez l’enfant gravement malade.En absence de preuves, des études sont nécessaires afi n de cibler les patients à risque et qui bénéfi cieraientd’une prophylaxie et ceux à risque de saignement chez qui l’administration d’anticoagulation pourrait êtredélétère.
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The utility of postoperative radiotherapy in intermediate-risk oral squamous cell carcinoma. Int J Oral Maxillofac Surg 2020; 50:143-150. [PMID: 32616305 DOI: 10.1016/j.ijom.2020.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/13/2020] [Accepted: 06/11/2020] [Indexed: 10/24/2022]
Abstract
The effectiveness of postoperative radiotherapy (PORT) in improving outcomes remains debatable for oral squamous cell carcinoma (OSCC) patients with pathological intermediate-risk factors (IRFs) after surgery. A retrospective analysis was conducted on 432 intermediate-risk OSCC patients defined by histological reporting of close margin (<5mm), early nodal disease (pN1), depth of invasion/tumour thickness ≥5mm, perineural invasion, and/or lymphovascular invasion. Outcomes measured were disease-free survival (DFS), disease-specific survival (DSS), and overall survival (OS). PORT was associated with an improvement in 5-year DFS on univariable analysis (80% vs 71%; P=0.044), but this did not remain significant on multivariable analysis. PORT was not associated with differences in DSS or OS. The surgical salvage rate was similar in the PORT and surgery-only groups (41% vs 47%; P=0.972). Perineural invasion was found to be an independent predictor of inferior DSS (hazard ratio (HR) 2.19), DFS (HR 1.89), and OS (HR 1.97). Significantly worse outcomes were observed for patients with ≥4 concurrent IRFs. The application of PORT was associated with lower rates of recurrence, but the benefit was less apparent on mortality. Patients with perineural invasion and multiple concurrent IRFs were found to be at greatest risk, representing a subset of intermediate-risk OSCC patients who may benefit from PORT.
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[Mental health care in French correctional facilities during the Covid-19 pandemic]. L'ENCEPHALE 2020; 46:S60-S65. [PMID: 32475693 PMCID: PMC7205690 DOI: 10.1016/j.encep.2020.05.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 05/06/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The impact of the Covid-19 pandemic on the 11 million people currently incarcerated worldwide is the subject of many concerns. Prisons and jails are filled with people suffering from many preexisting medical conditions increasing the risk of complications. Detainees' access to medical services is already limited and overcrowding poses a threat of massive contagion. Beyond the health impact of the crisis, the tightening of prison conditions worries. On March 16, 2020, in France, the lockdown measures have been accompanied by specific provisions for prisons: all facilities have suspended visitations, group activities and external interventions. Over 10,000 prisoners have been released to reduce the prison population and the risk of virus propagation. These adjustments had major consequences on the healthcare system in French prisons. The objectives of this article are to describe the reorganization of the three levels of psychiatric care for inmates in France in the context of Covid-19 pandemic and to have a look at the impact of lockdown measures and early releases on mental health of prisoners. METHODS This work is based on a survey conducted in April 2020 in France among psychiatric healthcare providers working in 42 ambulatory units for inmates and in the 9 full-time inpatient psychiatric wards exclusively for inmates called "UHSAs" (which stands for "unités hospitalières spécialement aménagées", and can be translated as "specially equipped hospital units"). A review of the international literature on mental healthcare system for inmates during the Covid-19 epidemic has also been performed. RESULTS The Covid-19 epidemic has been rather contained during the period of confinement in French prisons but the impact of confinement measures on the prison population is significant. The three levels of psychiatric care for inmates have implemented specific measures to ensure continuity of care, to support detainees during Coronavirus lockdown and to prevent an infection's spread. Among the most important are: limitation of medical consultations to serious and urgent cases, creation of "Covid units", cancellation of voluntary psychiatric hospitalizations, reinforcement of preventive hygiene measures and reshuffling of medical staff. Prolonged confinement has consequences on mental health of detainees. Currently, mental health workers are facing multiple clinical situations such as forced drug and substance withdrawal (linked to difficulties in supplying psychoactive substances), symptoms of anxiety (due to concerns for their own and their relatives' well-being) and decompensation among patients with severe psychiatric conditions. Early releases from prison may also raise some issues. People recently released from prison are identified as at high risk of death by suicide and drug overdose. The lack of time to provide the necessary link between health services within prisons and health structures outside could have serious consequences, emphasizing the well-known "revolving prison doors" effect. DISCUSSION The current lockdown measures applied in French jails and prisons point out the disparities between psychiatric care for inmates and psychiatric care for general population. Giving the high vulnerability of prison population, public health authorities should pay more attention to health care in prisons.
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Die programmierte Geburt zur Verhinderung des „weekend effects“ vor 50 Jahren. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0039-3402958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Target engagement and intracellular delivery of mono- and bivalent LDL receptor-binding peptide-cargo conjugates: Implications for the rational design of new targeted drug therapies. J Control Release 2019; 314:141-161. [PMID: 31644939 DOI: 10.1016/j.jconrel.2019.10.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/14/2019] [Accepted: 10/17/2019] [Indexed: 10/25/2022]
Abstract
Targeted delivery to specific tissues and subcellular compartments is of paramount importance to optimize therapeutic or diagnostic interventions while minimizing side-effects. Using recently identified LDL receptor (LDLR) -targeting small synthetic peptide-vectors conjugated to model cargos of different nature and size, we investigated in LDLR-expressing cells the impact of vector-cargo molecular engineering and coupling valency, as well as the cellular exposure duration on their target engagement and intracellular trafficking and delivery profiles. All vector-cargo conjugates evaluated were found to be delivered to late compartments together with the natural ligand LDL, although to varying extents and with different kinetics. Partial recycling together with the LDLR was also consistently observed. Under continuous cellular exposure, the extent of intracellular vector-cargo delivery primarily relies on their endosomal unloading potential. In this condition, the highest intracellular delivery potential was observed with a monovalent conjugate displaying a rather high LDLR dissociation rate. On the contrary, under transient cellular exposure followed by chase, low dissociation-rate bivalent conjugates revealed a higher intracellular delivery potential than the monovalent conjugate. This was shown to rely on their ability to undergo multiple endocytosis-recycling rounds, with limited release in the ligand-free medium. The absence of reciprocal competition with the natural ligand LDL on their respective intracellular trafficking was also demonstrated, which is essential in terms of potential safety liabilities. These results demonstrate that not only molecular engineering of new therapeutic conjugates of interest, but also the cellular exposure mode used during in vitro evaluations are critical to anticipate and optimize their delivery potential.
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Adequate utilisation of emergency services in Germany: a differential by migration background? Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The role of emergency services (ES) is to provide a round-the-clock acute care. In recent years, inadequate use of emergency services has been internationally thematised because of overcrowding and the cost associated. There is only limited evidence regarding the pattern of utilisation of ES by populations with a migration background.
Methods
Consecutive patients visiting three ES in Berlin from July 2017 to July 2018, and who fulfilled inclusion criteria such as being conscious, were recruited into the study. A questionnaire covered medical conditions, reasons to visit the ES, and socio-economic factors. A criterion for the adequacy of utilisation was developed using a sub-sample of patients with information provided by physicians. Differences between migrants (1st generation), their offspring (2nd generation), and non-migrants were evaluated using logistic regression.
Results
2 327 patients were included, 901 had a migration background. The utilisation was adequate if the patient was admitted to hospital and/or if all three following criterion were fulfilled: reported to have been advised by a physician to visit the ES; reported strong pain; and reported a high perceived urgency (both ≥7 on a scale from 0 to 10). Adjusting for gender, age, condition and number of recent visits to ES, 1st generation migrants had a significantly higher chance than non-migrants to have an inadequate utilisation of services (OR 1.30; 95% CI [1.01; 1.68]). For 2nd generation persons, this was not statistically significant.
Conclusions
First generation migrants have a higher chance of inadequate ES use compared to non-migrants. A similar study 20 years ago had similar findings. This implies that existing information leaflets on ES addressing specific population groups are not sufficient to improve adequacy of use. Structural changes in the healthcare system as well as improved methods of communication respecting the needs of diverse subgroups of patients need to be considered.
Key messages
Existing information leaflets on emergency services addressing specific population groups are not sufficient to improve adequacy of use. Structural changes in the healthcare system as well as improved methods of communication respecting the needs of diverse subgroups of patients need to be considered.
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Potential transfer of aquatic organisms via ballast water with a particular focus on harmful and non-indigenous species: A survey from Adriatic ports. MARINE POLLUTION BULLETIN 2019; 147:16-35. [PMID: 29454492 DOI: 10.1016/j.marpolbul.2018.02.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 12/07/2017] [Accepted: 02/02/2018] [Indexed: 06/08/2023]
Abstract
Ballast water discharges may cause negative impacts to aquatic ecosystems, human health and economic activities by the introduction of potentially harmful species. Fifty untreated ballast water tanks, ten in each port, were sampled in four Adriatic Italian ports and one Slovenian port. Salinity, temperature and fluorescence were measured on board. Faecal indicator bacteria (FIB), phyto- and zooplankton were qualitatively and quantitatively determined to identify the species assemblage arriving in ballast water. FIB exceeded the convention standard limits in 12% of the sampled tanks. Vibrio cholerae was not detected. The number of viable organisms in the size groups (minimum dimension) <50 and ≥10 μm and ≥50 μm resulted above the abundances required from the Ballast Water Management Convention in 55 and 86% of the samples, respectively. This is not surprising as unmanaged ballast waters were sampled. Some potentially toxic and non-indigenous species were observed in both phyto- and zooplankton assemblages.
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A Liver X-Receptor-Hypoxia Inducible Factor 1α Interplay Potentiates Interleukin-1B Production In Human Macrophages. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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The influence of migration on women's satisfaction during pregnancy and birth: results of a comparative prospective study with the Migrant Friendly Maternity Care Questionnaire (MFMCQ). Arch Gynecol Obstet 2019; 300:555-567. [PMID: 31267197 DOI: 10.1007/s00404-019-05227-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 06/19/2019] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Approximately 21% of Germany's inhabitants have been born abroad or are of direct descent of immigrants. A positive birth experience has an effect on a woman's mental health and her future family planning choices. While international studies showed that immigrant women are less satisfied with their birth experience, no such study has been conducted in Germany until now. METHODS At our center of tertiary care in Berlin, with approximately 50% immigrants among patients, pregnant women of at least 18 years of age were offered participation in this study. A modified version of the Migrant Friendly Maternity Care Questionnaire (MFMCQ) designed by Gagnon et al. in German, English, French, Spanish, Arabic and Turkish was used. We compared non-immigrant women to immigrant women and women with direct descent of immigrants. For certain analysis, the latter two groups were included together under the category "migration background". RESULTS During the study period, 184 non-immigrant, 214 immigrant women and 62 direct descendants of immigrants were included. The most frequent countries of origin were Syria (19%), Turkey (17%), and Lebanon (9%). We found a slight difference between groups regarding age (non-immigrants: mean 33 years versus women with any migration background: mean 31) as well as parity with more non-immigrants delivering their first child. No difference in the satisfaction with care was observed between immigrant and any migration background groups (p ≥ 0.093 in the two-sided Fisher's exact test). At least 75.8% of all participating women reported complete satisfaction with care during labor, birth and after birth. Interestingly, the level of German language proficiency did not influence the immigrant patient's satisfaction with care. CONCLUSION The study results show no difference regarding overall satisfaction with care during labor and birth despite a relevant language barrier. We are for the first time providing the MFMCQ in German and Turkish. Further future analyses on the impact of patient expectations on satisfaction with care will be conducted.
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Abnormal hemostasis in children with vascular anomalies, part I: Thrombocytopenias among different vascular anomalies. Thromb Res 2019; 196:626-634. [PMID: 31221393 DOI: 10.1016/j.thromres.2019.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 05/31/2019] [Accepted: 06/09/2019] [Indexed: 12/18/2022]
Abstract
Long before the classification of vascular anomalies from the International Society for the Study of Vascular Anomalies (ISSVA) provided a framework to differentiate vascular anomalies, otherwise known as vascular birthmarks, it was recognized that patients with such lesions can present with acute life-threatening hemostatic and/or thrombotic complications, as well as chronic long-standing bleeding or thrombotic issues. Scenarios such as a rapidly growing vascular lesion with severe acute thrombocytopenia, a visceral hemorrhagic lesion, a lesion associated with repetitive and painful superficial thrombosis, and cases of unprovoked or post-procedural fatal pulmonary embolism highlight the wide spectrum of manifestations of abnormal coagulation in patients with vascular anomalies. The separation of vascular anomalies into two distinct groups, vascular tumors and vascular malformations, was followed by the characterization that their respective coagulopathies were due to either a derangement of platelets or to a disequilibrium of the patient's coagulation/fibrinolytic process. This configuration of coagulopathies will be the foundation for this two-chapter review series. In the initial review, coagulopathies where thrombocytopenia is the main feature will be characterized, whereas the second review will focus on vascular malformations that have a coagulation disorder secondary to some degree of coagulation consumption and/or fibrinolytic pathway derangement.
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Aide échographique à la décision en pratique isolée : diagnostic différentiel d’une colique néphrétique. ANNALES FRANCAISES DE MEDECINE D URGENCE 2019. [DOI: 10.3166/afmu-2018-0114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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SP-0011 Unified Radiogenomic Prediction of Late Radiotherapy Toxicities. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30431-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Erratum to 'Frequent attendance and the concordance between PHQ screening and GP assessment in the detection of common mental disorders' [Journal of Psychosomatic Research, Vol. 110 (2018) 1-10]. J Psychosom Res 2019; 118:17. [PMID: 30782349 DOI: 10.1016/j.jpsychores.2019.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Der Einfluss von Akkulturationsstress auf die Frühgeburtenrate und perinatale Outcome bei Frauen mit und ohne Migrationshintergrund – erste Ergebnisse. Geburtshilfe Frauenheilkd 2019. [DOI: 10.1055/s-0039-1678369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Die Dysmenorrhö – Publikationen zu Ursachenklärung und Therapieansätzen in deutschsprachigen gynäkologischen Fachzeitschriften von 1850 bis 1990. Geburtshilfe Frauenheilkd 2019. [DOI: 10.1055/s-0039-1678377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Weibliche Stuprum-Betroffene: Charakteristika von 850 angezeigten und an der Charité versorgten Fällen. Geburtshilfe Frauenheilkd 2019. [DOI: 10.1055/s-0039-1678378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Die Narbengravidität – Fallserie und systematische Literaturübersicht. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Gründe für eine niedrigere Periduralanästhesierate bei Migrantinnen aus Sicht des medizinischen Personals – eine mixed-methods Analyse. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Evaluation von Biomarkern bei Myompatientinnen – Ergebnisse einer prospektiven Studie. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Der Einfluss von Migration auf die Zufriedenheit in der peripartalen Versorgung und dem Zugang zum deutschen Gesundheitssystem: Frauen mit und ohne Migrationshintergrund im Vergleich. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Zum Zusammenhang zwischen Myomgröße (> 10 cm im Vergleich zu < 10 cm) und Beschwerden: Eine retrospektive Analyse bei 3.498 Patientinnen. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Müttersterblichkeit in Berlin – medizinhistorische Betrachtung der Entwicklungen in Berlin-West 1949 bis 1981. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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