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Schlaiss T, Singer S, Herbert SL, Diessner J, Bartmann C, Kiesel M, Janni W, Kuehn T, Flock F, Felberbaum R, Schwentner L, Leinert E, Woeckel A. Psycho-Oncological Care Provision in Highly Distressed Breast Cancer Patients. Geburtshilfe Frauenheilkd 2023; 83:702-707. [PMID: 37288248 PMCID: PMC10243917 DOI: 10.1055/a-2044-0072] [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: 11/16/2022] [Accepted: 02/19/2023] [Indexed: 06/09/2023] Open
Abstract
Objective To evaluate the proportion of breast cancer (BC) patients with distress or psychological comorbidity as well as offer and use of psychological support in subgroups of BC patients with different extents of distress. Methods 456 patients with BC were evaluated at baseline (t1) and until 5 years after diagnosis (t4) at the BRENDA certified BC centers. Logistic regression was used to analyze if patients with distress at t1 received offers and actual psychological support more often than patients without distress at t1. Regression analyses were used to examine if acute, emerging or chronic disease was associated with higher rates of offer and use of psychotherapy as well as intake of psychotropic drugs. Results In 45% of BC patients psychological affection was detected at t4. The majority of patients with moderate or severe distress at t1 (77%) received the offer for psychological service, while 71% of those received the offer for support at t4. Patients, who were psychologically affected at t1, have not been offered psychological services more often than those without, but they significantly more often used services if offered. Especially patients with acute comorbidity received significantly more often an offer for psychotherapy compared to unimpaired patients, while those patients with emerging or chronic disease did not. 14% of BC patients took psychopharmaceuticals. This mainly concerns patients with chronic comorbidity. Conclusion Psychological services were offered to and used by a fair amount of BC patients. All subgroups of BC patients should be addressed, in order to improve the comprehensive supply with psychological services.
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Affiliation(s)
- Tanja Schlaiss
- Department of Gynaecology and Obstetrics, University of Würzburg, Würzburg, Germany
| | - Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
- University Cancer Centre Mainz, Mainz, Germany
| | | | - Joachim Diessner
- Department of Gynaecology and Obstetrics, University of Würzburg, Würzburg, Germany
| | - Catharina Bartmann
- Department of Gynaecology and Obstetrics, University of Würzburg, Würzburg, Germany
| | - Matthias Kiesel
- Department of Gynaecology and Obstetrics, University of Würzburg, Würzburg, Germany
| | - Wolfgang Janni
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - Thorsten Kuehn
- Department of Gynaecology and Obstetrics, Hospital Esslingen, Esslingen, Germany
| | - Felix Flock
- Department of Gynaecology and Obstetrics, Hospital Memmingen, Memmingen, Germany
| | - Ricardo Felberbaum
- Department of Gynaecology and Obstetrics, Hospital Kempten, Kempten, Germany
| | - Lukas Schwentner
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - Elena Leinert
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - Achim Woeckel
- Department of Gynaecology and Obstetrics, University of Würzburg, Würzburg, Germany
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Herbert SL, Flock F, Felberbaum R, Janni W, Löb S, Kiesel M, Schlaiß T, Diessner J, Curtaz C, Joukhadar R, Dayan D, Schwentner L, Singer S, Wöckel A. Predictors of Decreased Quality of Life in Breast Cancer Survivors Five Years After Diagnosis. J Breast Cancer 2023; 26:26.e23. [PMID: 37272248 DOI: 10.4048/jbc.2023.26.e23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 03/16/2023] [Accepted: 04/16/2023] [Indexed: 06/06/2023] Open
Abstract
PURPOSE Due to improved therapy, early diagnosis, and growing incidence rates, the number of long-term breast cancer survivors is increasing. Survivors can still be affected by aftercare, resulting in reduced quality of life (QoL). Thus, in this study, we investigated possible predictors of decreased physical and social functioning in breast cancer survivors. METHODS In a German multicenter prospective study, we enrolled 759 female patients with breast cancer before surgery (t1), and contacted them again 5 years after surgery (t4). Data on QoL were assessed at t4 using the European Organization for Research and Treatment of Cancer QoL Core Questionnaire (EORTC QLQ-C30) and its breast cancer module EORTC QLQ-BR23. Predictors of decreased physical and social functioning were analyzed using logistic regression with odds ratios as effect estimates and 95% confidence intervals. Thresholds for the clinical importance of detrimental effects on QoL were defined according to Giesinger. RESULTS Questionnaires from 759 patients were retrieved at t1. Of these, 456 participated in the study at t4. Poor QoL 5 years after diagnosis was reported by 20%-50% of the participants. Age, mastectomy, chemotherapy, education, employment, cohabitation, psychiatric comorbidities at t1, anxiety, depression, and intensity of physical activity emerged as predictors of decreased physical and social functioning 5 years after diagnosis. CONCLUSION Relief of symptoms and improvement in the QoL should be priorities in aftercare. Detecting patients with a decreased QoL is a rising challenge. Healthcare providers should take special care of patients aged 50-59 years, patients with psychiatric comorbidities and depression, and patients who have undergone mastectomy.
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Affiliation(s)
- Saskia-Laureen Herbert
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany.
| | - Felix Flock
- Department of Gynaecology and Obstetrics, Hospital Memmingen, Memmingen, Germany
| | - Ricardo Felberbaum
- Department of Gynaecology and Obstetrics, Hospital Kempten, Kempten, Germany
| | - Wolfgang Janni
- Department of Gynaecology and Obstetrics, University Medical Centre Ulm, Ulm, Germany
| | - Sanja Löb
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany
| | - Matthias Kiesel
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany
| | - Tanja Schlaiß
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany
| | - Joachim Diessner
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany
| | - Carolin Curtaz
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany
| | - Ralf Joukhadar
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany
| | - Davut Dayan
- Department of Gynaecology and Obstetrics, University Medical Centre Ulm, Ulm, Germany
| | - Lukas Schwentner
- Department of Gynaecology and Obstetrics, University Medical Centre Ulm, Ulm, Germany
| | - Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre Mainz, Mainz, Germany
| | - Achim Wöckel
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany
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Küpker W, Felberbaum R, Bullerdiek J. Endometriose und Adenomyose. Gynäkologische Endokrinologie 2023. [DOI: 10.1007/s10304-023-00502-9] [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: 04/07/2023]
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Singer S, Janni W, Kühn T, Flock F, Felberbaum R, Schwentner L, Leinert E, Wöckel A, Schlaiß T. Awareness, offer, and use of psychosocial services by breast cancer survivors in Germany: a prospective multi-centre study. Arch Gynecol Obstet 2023; 307:945-956. [PMID: 35835919 PMCID: PMC9984346 DOI: 10.1007/s00404-022-06665-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 06/08/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE This study examined the pattern of psychosocial care in breast cancer survivors. METHODS In a prospective study with measurements before surgery, 1 month, 8 months, and 5 years thereafter, we examined the proportion of breast cancer survivors who were aware about, had been offered and received various types of psychosocial services from psychologists, social workers, doctors, self-help groups etc. The degree of helpfulness per service among users was ascertained with Likert scales. Determinants of awareness, offer and use were investigated using binary logistic regression analyses. How the services are inter-related was tested with principal component analyses. RESULTS Among 456 breast cancer survivors who participated until 5 years, psychological services were known by 91%, offered to 68%, and used by 55% of patients. Social services were known by 86%, offered to 65%, and used by 51%. Women ≥ 65 years were less likely to be informed about (odds ratio (OR) 0.2) and get offers for psychosocial services (OR 0.4 for social and 0.5 for psychological services) than women < 65 years. The services rated most helpful were social services in the hospital, psychological counselling by a consultant and psychotherapy in private practices. CONCLUSION These findings underline the importance of psychosocial support by physicians in addition to the "professional" mental health and social care providers. They also show that elderly women in need for support might be in danger of not being well-informed about the services available.
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Affiliation(s)
- Susanne Singer
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg University, Obere Zahlbacher Straße 69, 55131, Mainz, Germany.
- University Cancer Centre, Mainz, Germany.
| | - Wolfgang Janni
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - Thorsten Kühn
- Department of Gynaecology and Obstetrics, Hospital Esslingen, Memmingen, Germany
| | - Felix Flock
- Department of Gynaecology and Obstetrics, Hospital Memmingen, Memmingen, Germany
| | - Ricardo Felberbaum
- Department of Gynaecology and Obstetrics, Hospital Kempten, Kempten, Germany
| | - Lukas Schwentner
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - Elena Leinert
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - Achim Wöckel
- Department of Gynaecology and Obstetrics, University of Würzburg, Würzburg, Germany
| | - Tanja Schlaiß
- Department of Gynaecology and Obstetrics, University of Würzburg, Würzburg, Germany
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5
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Dayan D, Leinert E, Singer S, Janni W, Kühn T, Flock F, Felberbaum R, Herbert SL, Wöckel A, Schwentner L. Association of social service counseling in breast cancer patients with financial problems, role functioning and employment-results from the prospective multicenter BRENDA II study. Arch Gynecol Obstet 2023; 307:541-547. [PMID: 35604446 PMCID: PMC9918582 DOI: 10.1007/s00404-022-06604-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 04/27/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND This study examined the relationship between social service counseling (SSC) and financial and role functioning problems in primary breast cancer (BC) patients over a 5-year observation period. METHODS In the multicenter prospective study, patients were approached before surgery (t1), before initiation of adjuvant treatment (t2), after therapy completion (t3), and 5 years after surgery (t4). We examined the proportion of BC survivors who had financial and role functioning problems and the proportion who were employed at t4. We examined how frequently patients were informed about, offered, or used SSC, and we used multivariate logistic regression analyses to examine the relationship between this and financial and role functioning problem prevalence. RESULTS Of the 456 BC survivors, 33% had financial problems and 22% reported role functioning problems at t4. There was no evidence that women with increased financial problems were informed about SSC more often than those without (OR 1.1, p = 0.84) or that they used SSC more often (OR 1.3, p = 0.25). However, women with role functioning problems were informed about SSC significantly more often (OR 1.7, p = 0.02) and attended counseling significantly more often (OR 1.6, p = 0.03). Among participants aged < 65 years at t4 (n = 255), 70% were employed. Patients who had received SSC were more likely to be employed at t4 than patients who did not (OR 1.9, p = 0.04). CONCLUSION These findings underline the importance of SSC for BC patients with role functioning issues. They indicate that individuals who use SSC are more likely to be employed later on than individuals who do not.
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Affiliation(s)
- Davut Dayan
- Department of Gynecology and Obstetrics, University of Ulm, Prittwitzstr. 43, 89075, Ulm, Germany.
| | - Elena Leinert
- Department of Gynecology and Obstetrics, University of Ulm, Prittwitzstr. 43, 89075, Ulm, Germany
| | - Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Wolfgang Janni
- Department of Gynecology and Obstetrics, University of Ulm, Prittwitzstr. 43, 89075, Ulm, Germany
| | - Thorsten Kühn
- Department of Gynecology and Obstetrics, Hospital Esslingen, Esslingen, Germany
| | - Felix Flock
- Department of Gynecology and Obstetrics, Hospital Memmingen, Memmingen, Germany
| | - Ricardo Felberbaum
- Department of Gynecology and Obstetrics, Hospital Kempten, Kempten, Germany
| | | | - Achim Wöckel
- Department of Gynecology and Obstetrics, University of Würzburg, Würzburg, Germany
| | - Lukas Schwentner
- Department of Gynecology and Obstetrics, University of Ulm, Prittwitzstr. 43, 89075, Ulm, Germany
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Hierl S, Puhl A, Brössner A, Felberbaum R. Impfungen bei Kinderwunsch und Schwangerschaft. J Gynäkol Endokrinol AT 2022; 32:71-75. [PMID: 35382234 PMCID: PMC8972758 DOI: 10.1007/s41974-022-00223-0] [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] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 03/03/2022] [Indexed: 11/15/2022]
Abstract
Impfungen vor und während einer Schwangerschaft kommen eine wichtige Bedeutung zu – bei konsequenter Impfstrategie können Infektionen gänzlich verhindert werden bzw. der Krankheitsverlauf abgemildert werden und auch die Risiken für Komplikationen bei Mutter und Kind vermieden werden. Die Empfehlungen zu den Impfungen vor einer Schwangerschaft orientieren sich an den allgemeinen Impfempfehlungen. Während einer Schwangerschaft wird ausdrücklich zu zwei Impfungen geraten. Zum Einen ist dies die Impfung gegen saisonale Influenza, die die Schwangere vor der Infektion schützen soll, weil sie ein höheres Risiko für schwere Verläufe oder Komplikationen hat. Zum Anderen wird die Immunisierung gegen Pertussis empfohlen, die dem Neugeborenen während der ersten Lebensmonate Schutz bietet. Während der Stillzeit sollte ein unzureichender Impfschutz gemäß den allgemeinen Empfehlungen vervollständigt werden.
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7
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Balogh B, Brössner A, Guttenberg P, Unseld B, Felberbaum R. Endometriose Scoresysteme – Chaotische Ordnung statt ordentlicher Chaos? Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1749063] [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: 10/18/2022] Open
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8
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Dayan D, Lukac S, Janni W, Brössner A, Felberbaum R. Minimal Invasive Therapie eines Dysgerminoms in der Schwangerschaft – Fallbericht. Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1749037] [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: 10/18/2022] Open
Affiliation(s)
- D Dayan
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten, Klinikverbund Allgäu gGmbH, Kempten
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten, Klinikverbund Allgäu gGmbH, Kempten
| | - S Lukac
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten, Klinikverbund Allgäu gGmbH, Kempten
| | - W Janni
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten, Klinikverbund Allgäu gGmbH, Kempten
| | - A Brössner
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten, Klinikverbund Allgäu gGmbH, Kempten
| | - R Felberbaum
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten, Klinikverbund Allgäu gGmbH, Kempten
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9
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Herbert LS, Wöckel A, Kreienberg R, Kühn T, Flock F, Felberbaum R, Janni W, Curtaz CJ, Kiesel M, Schlaiß T, Diessner J, Salmen J, Schwentner L, Fink V, Bekes I, Leinert E, Lato K, Polasik A, Schochter F, Singer S. Inwieweit fühlen sich die Brustkrebs-Überlebenden 5 Jahre nach der Diagnose gut über die Krankheit und die Behandlung informiert? Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1749034] [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: 10/18/2022] Open
Affiliation(s)
- L S Herbert
- Frauenklinik und Poliklinik, Universitätsklinikum, Würzburg
| | - A Wöckel
- Frauenklinik und Poliklinik, Universitätsklinikum, Würzburg
| | - R Kreienberg
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm
| | - T Kühn
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Esslingen
| | | | - R Felberbaum
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten, Klinikverbund Allgäu gGmbH, Kempten
| | - W Janni
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm
| | - CJ Curtaz
- Frauenklinik und Poliklinik, Universitätsklinikum, Würzburg
| | - M Kiesel
- Frauenklinik und Poliklinik, Universitätsklinikum, Würzburg
| | - T Schlaiß
- Frauenklinik und Poliklinik, Universitätsklinikum, Würzburg
| | - J Diessner
- Frauenklinik und Poliklinik, Universitätsklinikum, Würzburg
| | - J Salmen
- Frauenklinik und Poliklinik, Universitätsklinikum, Würzburg
| | - L Schwentner
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm
| | - V Fink
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm
| | - I Bekes
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm
| | - E Leinert
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm
| | - K Lato
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm
| | - A Polasik
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm
| | - F Schochter
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm
| | - S Singer
- Institut für Medizinische Biometrie, Epidemiologie und Informatik (UMBEI); Mainz
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Römer T, Bends R, Christoffel L, Felberbaum R, Hildebrandt T, Meinhold-Heerlein I, Mueller M, Oppelt P, Renner SP, Runnebaum IB, Schiermeier S, Piriyev E, Uhl B, Toub D. The significance of transcervical ultrasound-guided radiofrequency ablation in the treatment of symptomatic fibroids: results of an expert consensus from German-speaking countries. Arch Gynecol Obstet 2022; 306:1-6. [PMID: 35316395 DOI: 10.1007/s00404-022-06516-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Uterine fibroids are one of the most common diseases in female patients, lead mainly to bleeding disorders and lower abdominal pain, and reduce the chance of having children. In recent years we have seen a trend towards more and more pharmacotherapies and minimally invasive organ-preserving treatments. One novel and innovative procedure for an organ-preserving treatment of symptomatic uterine fibroids is the transcervical ultrasound-guided radiofrequency ablation (TRFA). TRFA has been used in Germany since 2013 and later found use in other German-speaking countries as well. There have now been more than 1200 TRFA treatments performed in Germany, Austria, and Switzerland. Experts from these three countries came together for a consensus meeting to analyze the significance of the procedure in the overall concept of the treatment of symptomatic uterine fibroids.
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Affiliation(s)
- Thomas Römer
- Department of Obstetrics and Gynecology, Academic Hospital Cologne Weyertal University of Cologne, Weyertal 76, 50931, Cologne, Germany.
| | - Ralf Bends
- Department of Obstetrics and Gynecology, Academic Hospital Cologne Weyertal University of Cologne, Weyertal 76, 50931, Cologne, Germany
| | | | - Ricardo Felberbaum
- Department of Obstetrics and Gynecology, Clinic of Kempten, Academic Teaching Hospital, University of Ulm, Ulm, Germany
| | - Thomas Hildebrandt
- Department of Obstetrics and Gynecology, University Hospital Erlangen-Nuremberg, Maximilianspl. 2, 91054, Erlangen, Germany
| | - Ivo Meinhold-Heerlein
- Department of Gynecology and Obstetrics, Justus Liebig University Giessen, Giessen, Germany
| | - Michael Mueller
- University Department of Gynecology, Bern University Hospital, Bern, Switzerland
| | - Peter Oppelt
- Department for Gynecology, Obstetrics and Gynecological Endocrinology, Johannes Kepler University Linz, Linz, Austria
| | - Stefan P Renner
- Department of Obstetrics and Gynecology, Sindelfingen-Boeblingen Clinic, Boeblingen, Germany
| | - Ingo B Runnebaum
- Department of Gynecology and Reproduction Medicine, Jena University Hospital, 07747, Jena, Germany
| | - Sven Schiermeier
- Department of Obstetrics and Gynecology, University Witten-Herdecke, Marien-Hospital, Witten Marienplatz, 258452, Witten, Germany
| | - Elvin Piriyev
- Department of Obstetrics and Gynecology, Academic Hospital Cologne Weyertal University of Cologne, Weyertal 76, 50931, Cologne, Germany
- Department of Obstetrics and Gynecology, University Witten-Herdecke, Marien-Hospital, Witten Marienplatz, 258452, Witten, Germany
| | - Bernhard Uhl
- Department of Obstetrics and Gynecology, Wesel Evangelical Hospital, Wesel, Germany
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11
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Leinert E, Schwentner L, Janni W, Wöckel A, Herbert SL, Herr D, Kühn T, Flock F, Felberbaum R, Kreienberg R, Fink V, Dayan D, Ernst K, Singer S. Outcome analysis of primary breast cancer patients who declined adjuvant chemotherapy-results from the prospective multi-center BRENDA II study. Breast Cancer 2022; 29:429-436. [PMID: 35178667 PMCID: PMC9021155 DOI: 10.1007/s12282-021-01321-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 12/01/2021] [Indexed: 11/02/2022]
Abstract
BACKGROUND This study examined 5-year overall, recurrence and distant metastasis-free survival (OS, RFS, MFS) of high- and intermediate-risk breast cancer (BC) patients who declined guideline-recommended adjuvant chemotherapy (CHT). METHODS In the prospective multicenter cohort study BRENDA II, patients with primary BC were sampled over a period of four years (2009-2012). A multi-professional team (tumorboard) discussed recommendation for adjuvant CHT according to the German guideline. Potential differences in 5 year survival were analyzed using Kaplan-Meier curves and Cox regression. The hazard ratios (HR) were adjusted for age, Charlson Comorbidity Score, American Society of Anesthesiologist (ASA) physical status classification, and endocrine therapy. RESULTS A total of 759 patients were enrolled of which 688 could receive CHT according to the guidelines (n = 219 had a clear indication, in n = 304 it was possible). For 360 patients, the tumorboard advised to perform CHT, for 304 it advised against and in 24 cases, no decision was documented. Of those with a positive suggestion, 83% received CHT. Until 5 years after diagnosis, 57 patients were deceased, 41 had at least one distant metastasis and 29 a recurrence. There was no evidence for differences in OS and MFS in patients who declined CHT despite tumorboard recommendation (HR 3.5, 95% CI 0.8-15.1 for OS, HR 1.9, 95% 0.6-6.6 for MFS). Patients who received CHT had significantly better 5-year RFS compared to those who declined (HR 0.3, 95% CI 0.1-0.9, p = 0.03). There was no evidence for different survival in those who had no CHT because of comorbidity and those who declined actively, neither for OS, MFS nor RFS. CONCLUSION The prospective BRENDA II study demonstrates benefit in RFS by guideline adherence in adjuvant breast cancer treatment, indicating prospectively the value of internationally validated guidelines in breast cancer care.
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Affiliation(s)
- Elena Leinert
- Department of Gynaecology and Obstetrics, University of Ulm, Prittwitzstr. 43, 89075, Ulm, Germany.
| | - Lukas Schwentner
- Department of Gynaecology and Obstetrics, University of Ulm, Prittwitzstr. 43, 89075, Ulm, Germany
| | - Wolfgang Janni
- Department of Gynaecology and Obstetrics, University of Ulm, Prittwitzstr. 43, 89075, Ulm, Germany
| | - Achim Wöckel
- Department of Gynaecology and Obstetrics, University of Würzburg, Würzburg, Germany
| | - Saskia-L Herbert
- Department of Gynaecology and Obstetrics, University of Würzburg, Würzburg, Germany
| | - Daniel Herr
- Department of Gynaecology and Obstetrics, University of Würzburg, Würzburg, Germany
| | - Thorsten Kühn
- Department of Gynaecology and Obstetrics, Hospital Esslingen, Esslingen, Germany
| | - Felix Flock
- Department of Gynaecology and Obstetrics, Hospital Memmingen, Memmingen, Germany
| | - Ricardo Felberbaum
- Department of Gynaecology and Obstetrics, Hospital Kempten, Kempten, Germany
| | - Rolf Kreienberg
- Department of Gynaecology and Obstetrics, University of Ulm, Prittwitzstr. 43, 89075, Ulm, Germany
| | - Visnja Fink
- Department of Gynaecology and Obstetrics, University of Ulm, Prittwitzstr. 43, 89075, Ulm, Germany
| | - Davut Dayan
- Department of Gynaecology and Obstetrics, University of Ulm, Prittwitzstr. 43, 89075, Ulm, Germany
| | - Kristina Ernst
- Department of Gynaecology and Obstetrics, University of Ulm, Prittwitzstr. 43, 89075, Ulm, Germany
| | - Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
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Sitzberger C, Hansl J, Felberbaum R, Brössner A, Oberhoffer-Fritz R, Wacker-Gussmann A. Physical Activity in High-Risk Pregnancies. J Clin Med 2022; 11:jcm11030703. [PMID: 35160151 PMCID: PMC8836910 DOI: 10.3390/jcm11030703] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/07/2022] [Accepted: 01/24/2022] [Indexed: 01/11/2023] Open
Abstract
It is known that physical activity before and during pregnancy is associated with health benefits for both the mother and fetus. The WHO recommends a minimum of 150 min per week of moderate-intensity aerobic physical activity for pregnant women. However, the majority of pregnant woman seem not to be physically active in pregnancy as recommended. In addition, the WHO recommendations do not include information on physical activity (PA) for specific target groups. This might be particularly problematic in women with assisted reproduction technologies (ART) or those who have received the fetal diagnosis of congenital heart defects (CHD). The aim of our study was to elaborate on whether assisted reproduction technologies (ART) and/or the diagnosis of fetal congenital heart defects (CHD) influence the level of PA in pregnant women, and to determine if there is a difference between PA behavior before and during pregnancy. In addition, we will evaluate whether high-risk pregnant women also reach the WHO recommendations. A non-interventional, cross-sectional, monocentric study based on two standardized questionnaires on physical activity was conducted. In total, n = 158 pregnant women were included. All of the participants were recruited from the outpatient clinics of the German Heart Center, Munich, and the Klinikverbund Kempten-Oberallgäu, Germany. Pregnant women after ART (n = 18), with fetal CHD (n = 25) and with both ART and CHD (n = 8) could be included. A total of 107 pregnant women served as healthy controls. Women, after ART, showed a significantly reduced level of physical activity (p = 0.014) during pregnancy compared to women who became pregnant naturally. Additionally, less (p < 0.001) and lighter (p = 0.002) physical activity was observed in all groups during pregnancy compared to those before pregnancy. An increase in maternal age increases the likelihood of CHD (p < 0.001) and decreases the level of physical activity before pregnancy (p = 0.012). The overall level of physical activity decreased in healthy and high-risk pregnancies, and only a quarter (26.49%) of all pregnant women reached the WHO recommendations. Further research for the specific target groups is highly recommended in order to promote and increase physical activity in ART and CHD pregnancies.
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Affiliation(s)
- Christina Sitzberger
- Institute of Preventive Pediatrics, Faculty of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany; (J.H.); (R.O.-F.); (A.W.-G.)
- Correspondence:
| | - Juliane Hansl
- Institute of Preventive Pediatrics, Faculty of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany; (J.H.); (R.O.-F.); (A.W.-G.)
| | - Ricardo Felberbaum
- Klinikverbund Kempten(Allgäu), Kinderwunschzentrum, 87439 Kempten (Allgäu), Germany; (R.F.); (A.B.)
| | - Anke Brössner
- Klinikverbund Kempten(Allgäu), Kinderwunschzentrum, 87439 Kempten (Allgäu), Germany; (R.F.); (A.B.)
| | - Renate Oberhoffer-Fritz
- Institute of Preventive Pediatrics, Faculty of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany; (J.H.); (R.O.-F.); (A.W.-G.)
- German Heart Centre, Department of Paediatric Cardiology and Congenital Heart Defects, 80636 Munich, Germany
| | - Annette Wacker-Gussmann
- Institute of Preventive Pediatrics, Faculty of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany; (J.H.); (R.O.-F.); (A.W.-G.)
- German Heart Centre, Department of Paediatric Cardiology and Congenital Heart Defects, 80636 Munich, Germany
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Illig AK, Puhl A, Felberbaum R. Das Sheehan-Syndrom – eine seltene Form der Hypophysenvorderlappen-Insuffizienz. Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/a-1548-1060] [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] Open
Affiliation(s)
- Ann-Kathrin Illig
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten – Klinikverbund Allgäu, Kempten, Deutschland
| | - Alexander Puhl
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten – Klinikverbund Allgäu, Kempten
| | - Ricardo Felberbaum
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten – Klinikverbund Allgäu, Kempten
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14
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Christoffel L, Bends R, Toub D, Schiermeier S, Pschadka G, Engelhardt M, Quinn S, Hartmann M, Habiba M, Felberbaum R, Brössner A, Schippert C, Römer T. Pregnancy Outcomes After Transcervical Radiofrequency Ablation of Uterine Fibroids with the Sonata System. J Gynecol Surg 2021; 38:207-213. [PMID: 35785107 PMCID: PMC9245720 DOI: 10.1089/gyn.2021.0136] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Objective: To describe pregnancy outcomes in women who conceived after undergoing transcervical fibroid ablation (TFA) as treatment for symptomatic uterine fibroids. Materials and Methods: TFA was used to treat symptomatic uterine fibroids with radiofrequency energy, both under clinical trial protocol and commercial usage in hospitals in Europe, the United Kingdom, Mexico, and the United States. All women who reported pregnancies to their physicians after undergoing TFA with the Sonata® System and provided consent for use of their data were included. Results: There have been 36 pregnancies representing 20 deliveries among 28 women who were treated with TFA. Five women conceived more than once postablation, and four conceived as a result of assisted reproductive technology (ART). Outcomes include 8 vaginal deliveries, 12 Cesarean sections, 3 therapeutic abortions, and 8 first trimester spontaneous abortions (four occurring in a patient with a history of recurrent pregnancy loss and an immunologic disorder). Five women are currently pregnant, two of whom previously delivered after TFA. There were no 5-minute Apgar scores <7, and all neonates weighed >2500 g. All deliveries occurred at ≥37 weeks except for one delivery at 35 6/7 weeks. There were no uterine ruptures or abnormal placentation and no reports of postpartum hemorrhage or stillbirths. Ablated fibroids included transmural, submucous, and intramural myomata up to 7 cm in diameter. Conclusions: Normal pregnancy outcomes at term have occurred after TFA with the Sonata System, including in women with recurrent abortion and in those undergoing ART. There were no instances of low Apgar scores, low birthweight, stillbirth, postpartum hemorrhage, or uterine rupture (FAST-EU, NCT01226290; SONATA, NCT02228174; SAGE, NCT03 118037). (J GYNECOL SURG 38:207)
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Affiliation(s)
- Ladina Christoffel
- Chefärztin Gynäkologie/Geburtshilfe, Spital Oberengadin, Samedan, Switzerland
| | - Ralf Bends
- Evangelisches Klinikum Köln-Weyertal, Köln, Germany
| | - David Toub
- Gynesonics, Redwood City, California, USA
| | - Sven Schiermeier
- Zentrum für Frauenheilkunde und Geburtshilfe, Marien Hospital, Witten, Germany
| | | | | | - Stephen Quinn
- Department of Gynaecology, St Mary's Hospital, Imperial College Healthcare Trust, London, United Kingdom
| | | | - Marwan Habiba
- Obstetrics and Gynaecology, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | | | | | | | - Thomas Römer
- Evangelisches Klinikum Köln-Weyertal, Köln, Germany
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Abstract
Die von SARS-CoV‑2 („severe acute respiratory syndrome coronavirus 2“) ausgelöste infektiöse Atemwegserkrankung COVID-19 („coronavirus disease 2019“) weist in ihrem Verlauf und Schweregrad eine deutliche Abhängigkeit vom Geschlecht der Erkrankten auf. So ist die Inzidenzrate bei Frauen höher als bei Männern, während bei Männern schwere Verlaufsformen erheblich häufiger zu beobachten sind und die Mortalitätsrate bei ihnen signifikant höher ist. Allerdings unterscheiden sich wiederum prämenopausale und postmenopausale Frauen hinsichtlich des Verlaufs. Prämenopausale Frauen müssen seltener hospitalisiert werden und bedürfen seltener maschineller Beatmung. Postmenopausale Frauen, die eine Hormonersatztherapie erhalten, scheinen davon zu profitieren. Ergebnisse der Grundlagenforschung am Mausmodell zeigen, dass die weiblichen Sexualsteroide im Falle der Influenza den Entzündungsverlauf positiv beeinflussen bzw. im Falle von SARS-CoV‑2 die Empfänglichkeit gegenüber dem Virus herabsenken, während Androgene eine Erhöhung der Infektionsrate zur Folge haben. Dies gilt auch für Patientinnen mit polyzystischem Ovarsyndrom. Erste Ergebnisse von Therapiestudie mit Progesteron – wenngleich mit kleinen Patientenzahlen – weisen darauf hin, dass eine Therapie mit diesem Sexualsteroid sich positiv auf den Krankheitsverlauf bei betroffenen Männern auswirken kann. Allerdings zeigt auch die Verteilung der Komplikationen im Zusammenhang mit der Impfung gegen COVID-19 eine deutliche Geschlechterdifferenz, hier mit einem höheren relativen Risiko für jüngere Frauen.
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Affiliation(s)
- Ricardo Felberbaum
- Klinik für Frauenheilkunde und Geburtshilfe, Zentrum für Reproduktionsmedizin und gynäkologische Endokrinologie, Klinikum Kempten & Immenstadt, Klinikverbund Allgäu, Robert-Weixler-Str. 50, 87439 Kempten, Deutschland
| | - Wolfgang Küpker
- Zentrum für Reproduktionsmedizin und gynäkologische Endokrinologie, IVF Baden-Baden, Baden-Baden, Deutschland
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16
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Sitzberger C, Oberhoffer-Fritz R, Freiberger A, Brössner A, Engelhard J, Felberbaum R, Wacker-Gußmann A. Cardiovascular risks of children conceived by assisted reproductive technologies: a systematic review. Gynäkologische Endokrinologie 2021. [DOI: 10.1007/s10304-021-00386-7] [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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17
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Guttenberg P, Heigl F, Hettich R, Brand G, Taenzel S, Zenk S, Felberbaum R, Zahn E, Puhl AG. Therapeutische Apherese als erfolgreiches Behandlungskonzept einer Alloimmunisierung in der Schwangerschaft am Beispiel von maternalen Anti-Kell- und Anti-Duffy-Antikörpern. Geburtshilfe Frauenheilkd 2021. [DOI: 10.1055/a-1277-4079] [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: 10/22/2022] Open
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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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Sonntag B, Griesinger G, Felberbaum R. Gesundheit der Kinder nach assistierter Reproduktion. Gynäkologische Endokrinologie 2020. [DOI: 10.1007/s10304-020-00340-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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20
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Küpker W, Plathow D, Bullerdiek J, Felberbaum R. Neue Behandlungsoptionen mit GnRH-Antagonisten bei Endometriose und Uterus myomatosus. Gynäkologische Endokrinologie 2020. [DOI: 10.1007/s10304-020-00329-8] [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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21
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Felberbaum R, Küpker W, Strowitzki T, Emons G, Diedrich K. GnRH–Antagonisten 2.0. Gynäkologe 2020; 53:492-493. [PMID: 32834083 PMCID: PMC7406955 DOI: 10.1007/s00129-020-04635-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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22
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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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23
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Balogh B, Guttenberg P, Sahlbach H, Felberbaum R. Die Rolle der Roboter-assistierten Technik in der Behandlung des frühen Endometriumkarzinoms. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1714014] [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 Balogh
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten, Klinikverbund Allgäu
| | - P Guttenberg
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten, Klinikverbund Allgäu
| | - H Sahlbach
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten, Klinikverbund Allgäu
| | - R Felberbaum
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten, Klinikverbund Allgäu
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24
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Davut D, Ebner F, deGregorio A, Janni W, Felberbaum R. Sentinellymphonodektomie (SLN) mit Indocyanin-Grün (ICG) nach Hysterektomie beim frühen Endometriumkarzinom. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713970] [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)
- D Davut
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten, Klinikverbund Allgäu
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Ulm
| | - F Ebner
- Frauenklinik, Helios Amper-Klinikum Dachau
| | - A deGregorio
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Ulm
| | - W Janni
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Ulm
| | - R Felberbaum
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten, Klinikverbund Allgäu
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25
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Guttenberg P, Heigl F, Hettich R, Brand G, Taenzel S, Zenk S, Felberbaum R, Zahn E, Puhl AG. Therapeutische Apherese als erfolgreiches Behandlungskonzept einer Anti-Kell-Alloimmunisierung in der Schwangerschaft. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713995] [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)
- P Guttenberg
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikverbund Allgäu, Kempten
| | - F Heigl
- Medizinisches Versorgungszentrum, Kempten-Allgäu
| | - R Hettich
- Medizinisches Versorgungszentrum, Kempten-Allgäu
| | - G Brand
- Synlab, Medizinisches Versorgungszentrum Leverkusen, Leverkusen
| | - S Taenzel
- Synlab, Medizinisches Versorgungszentrum Leverkusen, Leverkusen
| | - S Zenk
- Synlab, Medizinisches Versorgungszentrum Augsburg, Augsburg
| | - R Felberbaum
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikverbund Allgäu, Kempten
| | - E Zahn
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikverbund Allgäu, Kempten
| | - A G Puhl
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikverbund Allgäu, Kempten
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26
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Grimm K, Brössner A, Felberbaum R. Sonographisch gesteuerte transvaginale Hochfrequenzablation symptomatischer Uterusmyome – Ergebnisse nach Anwendung des SONATA-Verfahrens am Klinikum Kempten. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1714015] [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)
- K Grimm
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten, Klinikverbund Allgäu
| | - A Brössner
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten, Klinikverbund Allgäu
| | - R Felberbaum
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten, Klinikverbund Allgäu
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27
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Bongers M, Gupta J, Garza-Leal JG, Brown M, Felberbaum R. The INTEGRITY Trial: Preservation of Uterine-Wall Integrity 12 Months After Transcervical Fibroid Ablation with the Sonata System. J Gynecol Surg 2019; 35:299-303. [PMID: 31602171 PMCID: PMC6785167 DOI: 10.1089/gyn.2019.0033] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: The aim of this research was to evaluate uterine-wall integrity 12 months after transcervical fibroid ablation (TFA) of uterine fibroids with the Sonata® system (Gynesonics Inc., Redwood City, CA). Materials and Methods: INTEGRITY is a secondary analysis of the FAST-EU clinical trial, a prospective, longitudinal, multicenter single-armed trial involving women with heavy menstrual bleeding secondary to fibroids who were treated at 7 academic and community hospitals in the United Kingdom, the Netherlands, and Mexico with transcervical, intrauterine, ultrasound-guided radiofrequency ablation (the Sonata system). TFA was performed on up to 5 fibroids per subject ranging from 1–5 cm in diameter as determined by magnetic resonance imaging (MRI). All measurements and comparisons, including uterine-wall thicknesses were derived from baseline and 12-month MRI scans by an independent core MRI center. Scans were analyzed to assess preservation of uterine-wall integrity and reviewed for uterine-wall anomalies after TFA with the Sonata system. Results: Twenty-nine patients had baseline and 12-month MRI with contrast enhancement. Minimum uterine-wall thicknesses in all visible slices were >2.5 mm in diameter. No areas on MRI indicated any loss of uterine-wall integrity, compared with baseline imaging; comparison of baseline and postablation uterine-wall thicknesses revealed no significant changes. Conclusion: Transcervical fibroid ablation with the Sonata system was associated with preservation of uterine-wall integrity in this patient cohort.
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Affiliation(s)
- Marlies Bongers
- Department of Obstetrics and Gynaecology, Grow-School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | - Janesh Gupta
- Birmingham Women's Hospital, Birmingham, United Kingdom
| | - José Gerardo Garza-Leal
- Hospital Universitario "Dr. José Eleuterio González" de Universidad Autonoma de Nuevo León, Monterrey, Mexico
| | - Matthew Brown
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA.,MedQIA, Los Angeles, CA
| | - Ricardo Felberbaum
- Department of Obstetrics and Gynecology, Klinikverbund Kempten-Oberallgäu, Kempten, Germany
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Lüftner D, Bauerfeind I, Braun M, Brucker SY, Fasching PA, Felberbaum R, Hagemann F, Haidinger R, Harbeck N, Hönig A, Huober J, Jackisch C, Kolberg HC, Kolberg-Liedtke C, Kühn T, Maass N, Reimer T, Schneeweiss A, Schumacher-Wulf E, Schütz F, Thomssen C, Untch M, Wuerstlein R, Thill M. Treatment of Early Breast Cancer Patients: Evidence, Controversies, Consensus: Focusing on Systemic Therapy - German Experts' Opinions for the 16th International St. Gallen Consensus Conference (Vienna 2019). Breast Care (Basel) 2019; 14:315-324. [PMID: 31798392 PMCID: PMC6883436 DOI: 10.1159/000502603] [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] [Received: 07/16/2019] [Accepted: 08/09/2019] [Indexed: 02/04/2023] Open
Abstract
A German working group of leading breast cancer experts have discussed the votes at the International St. Gallen Consensus Conference in Vienna for the treatment of primary breast cancer with regard to the German AGO (Ar-beitsgemeinschaft Gynäkologische Onkologie) recommendations for clinical practice in Germany. Three of the German breast cancer experts were also members of this year's St. Gallen panel. Comparing the St. Gallen recommendations with the annually updated treatment recommendations of the Gynecological Oncology Working Group (AGO Mamma 2019) and the German S3 Guideline is useful, because the recommendations of the St. Gallen panel are based on expert opinions of different countries and disciplines. The focus of this article is on systemic therapy. The motto of this year's 16th St. Gallen Consensus Conference was "Estimating the magnitude of clinical benefit." The rationale behind this motto is that, for every treatment decision, a benefit-risk assessment must be taken into consideration for each patient.
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Affiliation(s)
- Diana Lüftner
- Department of Hematology, Oncology and Tumour Immunology, Charité – Campus Benjamin Franklin, Berlin, Germany
| | - Ingo Bauerfeind
- Interdisciplinary Breast Cancer Center, Women's Hospital, Landshut Hospitals, Landshut, Germany
| | - Michael Braun
- Interdisciplinary Breast Center, Women's Hospital, Red Cross Hospital Munich, Munich, Germany
| | | | - Peter A. Fasching
- Women's Hospital at the University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Ricardo Felberbaum
- Hospital Association Kempten-Oberallgäu, Kempten Hospitals, Kempten, Germany
| | - Friederike Hagemann
- Breast Center, Women's Hospital at the Ludwig Maximillian University Munich (LMU), Munich, Germany
| | | | - Nadia Harbeck
- Breast Center, Women's Hospital at the Ludwig Maximillian University Munich (LMU), Munich, Germany
| | - Arnd Hönig
- Breast Center, Women's Hospital, Catholic Hospital Mainz, Mainz, Germany
| | - Jens Huober
- Breast Center, University Women's Hospital Ulm, Ulm, Germany
| | - Christian Jackisch
- Department of Gynecology and Obstetrics, Sana Clinic Offenbach, Offenbach, Germany
| | - Hans-Christian Kolberg
- Breast Center, Department of Gynecology and Obstetrics, Marienhospital Bottrop gGmbH, Bottrop, Germany
| | | | - Thorsten Kühn
- Department of Gynecology and Obstetrics, Esslingen Hospitals, Esslingen, Germany
| | - Nicolai Maass
- Breast Center, Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Toralf Reimer
- Breast Center, University Women's Hospital and Outpatient Clinic, Clinics Südstadt Rostock, Rostock, Germany
| | - Andreas Schneeweiss
- National Centrum for Tumor Disease (NCT), University Hospital (UKHD), and German Cancer Research Site (DKFZ), Heidelberg, Germany
| | | | - Florian Schütz
- Senology Department, Breast Center, University Hospital in Heidelberg, Heidelberg, Germany
| | - Christoph Thomssen
- University Hospital and Outpatient Department of Gynecology, Halle (Saale), Germany
| | - Michael Untch
- Department of Gynecology and Obstetrics, Interdisciplinary Breast Center, HELIOS Hospitals Berlin Buch, Berlin, Germany
| | - Rachel Wuerstlein
- Breast Center, Women's Hospital at the Ludwig Maximillian University Munich (LMU), Munich, Germany
| | - Marc Thill
- Department of Gynecology and Obstetrics, Interdisciplinary Breast Center, Agaplesion Markus Hospital, Frankfurt/M., Germany
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de Gregorio A, Nagel G, Rothenbacher D, Möller P, Rempen A, Schlicht E, Fritz S, Flock F, Felberbaum R, Friedl TWP, Thiel F, Kühn T, Kuhn P, Tzschaschel M, Janni W, Wiesmüller L, Huober J. Das BRandO Biology and Outcome (BiO)-Projekt – eine Registerstudie zum biologischen Erkrankungsprofil und klinischen Verlauf bei Mamma- und Ovarialkarzinomen (BReast and Ovarian Cancer). Geburtshilfe Frauenheilkd 2019. [DOI: 10.1055/s-0039-1693896] [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: 10/26/2022] Open
Affiliation(s)
- A de Gregorio
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinik Ulm
| | - G Nagel
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm
| | - D Rothenbacher
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm
| | - P Möller
- Institut für Pathologie, Universitätsklinik Ulm
| | - A Rempen
- Klinik für Frauenheilkunde und Geburtshilfe, Diakonieklinikum, Schwäbisch-Hall
| | - E Schlicht
- Klinik für Frauenheilkunde und Geburtshilfe, Kliniken Ostalb, Mutlangen
| | - S Fritz
- Klinik für Frauenheilkunde und Geburtshilfe, Sanaklinikum Biberach
| | - F Flock
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Memmingen
| | - R Felberbaum
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten
| | - TWP Friedl
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinik Ulm
| | - F Thiel
- Klinik für Frauenheilkunde und Geburtshilfe, Alb-Fils Klinik Göppingen
| | - T Kühn
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Esslingen
| | - P Kuhn
- Comprehensive Cancer Center Ulm, Universitätsklinik Ulm
| | - M Tzschaschel
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinik Ulm
| | - W Janni
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinik Ulm
| | - L Wiesmüller
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinik Ulm
| | - J Huober
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinik Ulm
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van der Valk E, Puhl A, Felberbaum R, Hölzl N, Zahn E. Pyoderma gangraenosum in der Schwangerschaft: Ein Fallbericht. Geburtshilfe Frauenheilkd 2019. [DOI: 10.1055/s-0039-1693870] [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: 10/26/2022] Open
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Untch M, Thomssen C, Bauerfeind I, Braun M, Brucker SY, Felberbaum R, Hagemann F, Haidinger R, Hönig A, Huober J, Jackisch C, Kolberg HC, Kolberg-Liedtke C, Kühn T, Lüftner D, Maass N, Reimer T, Schneeweiss A, Schumacher-Wulf E, Schütz F, Thill M, Wuerstlein R, Fasching PA, Harbeck N. Primary Therapy of Early Breast Cancer: Evidence, Controversies, Consensus: Spectrum of Opinion of German Specialists on the 16th St. Gallen International Breast Cancer Conference (Vienna 2019). Geburtshilfe Frauenheilkd 2019; 79:591-604. [PMID: 31217628 PMCID: PMC6570611 DOI: 10.1055/a-0897-6457] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 04/20/2019] [Accepted: 04/21/2019] [Indexed: 12/22/2022] Open
Abstract
The results of the international St. Gallen Consensus Conference for the treatment of patients with primary breast cancer were discussed this year by a working group of leading breast cancer experts in view of the therapy recommendations for everyday clinical practice in Germany. Three of the breast cancer experts are also members of this year's St. Gallen panel. The comparison of the St. Gallen recommendations with the annually updated treatment recommendations of the AGO 2019 as well as the S3 guideline is useful, since the recommendations of the St. Gallen panel represent the opinions of experts from various countries and disciplines. The recommendations of the S3 guideline and AGO are based on evidence-based research of the literature. This year's 16th St. Gallen conference featured the motto "Magnitude of clinical benefit". In addition to the evidence-based data, each therapeutic decision must also undergo a benefit/risk assessment of the patient's individual situation and be discussed with the patient.
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Affiliation(s)
- Michael Untch
- Klinik für Gynäkologie und Geburtshilfe, interdisziplinäres Brustzentrum, HELIOS Klinikum Berlin Buch, Berlin, Germany
| | - Christoph Thomssen
- Klinik und Poliklinik für Gynäkologie, Martin-Luther-Universität, Halle-Wittenberg, Halle/Saale, Germany
| | - Ingo Bauerfeind
- Interdisziplinäres Brustkrebszentrum, Frauenklinik, Klinikum Landshut, Landshut, Germany
| | - Michael Braun
- Interdisziplinäres Brustzentrum, Frauenklinik, Rotkreuzklinikum München, München, Germany
| | | | - Ricardo Felberbaum
- Interdisziplinäres Brustzentrum Kempten – Allgäu (IBZK-A), Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten, Klinikverbund Kempten-Oberallgäu, Kempten, Germany
| | | | | | - Arnd Hönig
- Brustzentrum, Frauenklinik, Katholisches Klinikum Mainz, Mainz, Germany
| | - Jens Huober
- Universitätsfrauenklinik Ulm, Brustzentrum, Ulm, Germany
| | - Christian Jackisch
- Klinik für Gynäkologie und Geburtshilfe, Sana-Klinikum Offenbach, Offenbach, Germany
| | - Hans-Christian Kolberg
- Brustzentrum, Klinik für Gynäkologie und Geburtshilfe, Marienhospital Bottrop gGmbH, Bottrop, Germany
| | | | - Thorsten Kühn
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Esslingen, Esslingen, Germany
| | - Diana Lüftner
- Medizinische Klinik mit Schwerpunkt Hämatologie, Onkologie und Tumorimmunologie, Charité Campus Benjamin Franklin, Berlin, Germany
| | - Nicolai Maass
- Brustzentrum, Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Toralf Reimer
- Brustzentrum, Universitätsfrauenklinik und Poliklinik, Klinikum Südstadt Rostock, Rostock, Germany
| | - Andreas Schneeweiss
- Sektionsleiter Gynäkologische Onkologie des Universitätsklinikum (UKHD), Fellow des Deutschen Krebsforschungszentrum (DKFZ), Nationales Centrum für Tumorerkrankungen (NCT), Universitätsklinikum Heidelberg, Heidelberg, Germany
| | | | - Florian Schütz
- Brustzentrum, Sektion Senologie, UniversitätsKlinikum Heidelberg, Heidelberg, Germany
| | - Marc Thill
- Klinik für Gynäkologie und Gynäkologische Onkologie, Agaplesion Markus Krankenhaus, Frankfurt/Main, Germany
| | - Rachel Wuerstlein
- Brustzentrum, Frauenklinik der Universität München (LMU), München, Germany
| | - Peter A. Fasching
- Frauenklinik des Universitätsklinikums Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Nadia Harbeck
- Brustzentrum, Frauenklinik der Universität München (LMU), München, Germany
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Guttenberg P, Gebhardt J, Marrocco J, Sturm A, Felberbaum R, Puhl A. Cutis marmorata teleangiectatica congenita – eine Diagnose mit Seltenheitswert. Geburtshilfe Frauenheilkd 2019. [DOI: 10.1055/a-0824-4757] [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: 10/26/2022] Open
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33
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Leinert E, Schwentner L, Blettner M, Wöckel A, Felberbaum R, Flock F, Kühn T, Denkinger MD, Janni W, Kreienberg R, Singer S. Association between cognitive impairment and guideline adherence for application of chemotherapy in older patients with breast cancer: Results from the prospective multicenter BRENDA II study. Breast J 2019; 25:386-392. [PMID: 30945393 DOI: 10.1111/tbj.13231] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 06/03/2018] [Accepted: 06/05/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND This study examined the association between cognitive impairment and guideline adherence for application of chemotherapy in older patients with breast cancer. PATIENTS AND METHODS In the prospective multicenter cohort study BRENDA II, patients aged ≥65 years with primary breast cancer were sampled over a period of 4 years (2009-2012). A multiprofessional team (tumor board) discussed recommendation for adjuvant chemotherapy according to the German S3 guideline. Cognitive impairment was screened by the clock-drawing test (CDT) prior to adjuvant treatment. RESULTS Two hundred and sixty-three patients were included in the study and CDT data were available for 193 patients. Thirty-one percent of the patients had cognitive impairment with different degree of severity. In high-risk patients (n = 61) tumor board recommendation in favor of chemotherapy was 90% and in intermediate-risk patients (n = 170) 27%. Not receiving recommendation for chemotherapy in spite of guideline recommendation was more frequent in patients with cognitive impairment (67%) vs patients without cognitive impairment (46%) with P = 0.02 (OR 2.4, 95% confidence interval (CI) 1.2-4.9). Age, education, migration background and comorbidities were not associated with chemotherapy recommendation by the tumor board among cognitively impaired patients. Once the tumor board had recommended chemotherapy, application of chemotherapy was similar in both groups of patients with or without cognitive impairment. CONCLUSION Almost one third of older patients with breast cancer are affected by cognitive impairment prior to adjuvant treatment. In these patients, cognitive impairment was associated with tumor board decision against chemotherapy in spite of a positive guideline recommendation.
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Affiliation(s)
- Elena Leinert
- Department of Gynecology and Obstetrics, University of Ulm, Ulm, Germany
| | - Lukas Schwentner
- Department of Gynecology and Obstetrics, University of Ulm, Ulm, Germany
| | - Maria Blettner
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Achim Wöckel
- Department of Gynecology and Obstetrics, University of Würzburg, Würzburg, Germany
| | - Ricardo Felberbaum
- Department of Gynecology and Obstetrics, Hospital Kempten, Kempten, Germany
| | - Felix Flock
- Department of Gynecology and Obstetrics, Hospital Memmingen, Memmingen, Germany
| | - Thorsten Kühn
- Department of Gynecology and Obstetrics, Hospital Esslingen, Esslingen, Germany
| | - Michael Dieter Denkinger
- Geriatric Research Unit, Agaplesion Bethesda Hospital, Ulm University and Geriatric Center Ulm, Ulm, Germany
| | - Wolfgang Janni
- Department of Gynecology and Obstetrics, University of Ulm, Ulm, Germany
| | - Rolf Kreienberg
- Department of Gynecology and Obstetrics, University of Ulm, Ulm, Germany
| | - Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
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de Gregorio A, Nagel G, Rothenbacher D, Möller P, Rempen A, Schlicht E, Fritz S, Flock F, Felberbaum R, Friedl TWP, Kuhn P, Tzschaschel M, Janni W, Wiesmüller L, Huober J. Das BRandO Biology and Outcome (BiO)-Projekt – eine Registerstudie zum biologischen Erkrankungsprofil und klinischen Verlauf bei Mamma- und Ovarialkarzinomen (BReast and Ovarian Cancer). Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671005] [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: 10/28/2022] Open
Affiliation(s)
| | - G Nagel
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm, Ulm, Deutschland
| | - D Rothenbacher
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm, Ulm, Deutschland
| | - P Möller
- Institut für Pathologie, Universitätsklinik Ulm, Ulm, Deutschland
| | - A Rempen
- Klinik für Frauenheilkunde und Geburtshilfe, Diakonieklinikum, Schwäbisch-Hall, Schwäbisch-Hall, Deutschland
| | - E Schlicht
- Klinik für Frauenheilkunde und Geburtshilfe, Kliniken Ostalb, Mutlangen, Deutschland
| | - S Fritz
- Klinik für Frauenheilkunde und Geburtshilfe, Sanaklinikum, Biberach, Deutschland
| | - F Flock
- Klinik für Frauenheilkunde und Geburtshilfe Memmingen, Memmingen, Deutschland
| | - R Felberbaum
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten, Kempten, Deutschland
| | - TWP Friedl
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - P Kuhn
- Comprehensive Cancer Center Ulm, Universitätsklinik Ulm, Ulm, Deutschland
| | | | - W Janni
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | | | - J Huober
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
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de Gregorio A, Rempen A, Schlicht E, Fritz S, Flock F, Kühn T, Thiel F, Felberbaum R, Kuhn P, Rothenbacher D, Albrecht S, Ernst K, Schochter F, Tzschaschel M, Friedl TWP, Möller P, Janni W, Huober J, Nagel G. Erste epidemiologische Daten zum Patientenkollektiv des BRandO Biology and Outcome (BiO)-Projekts (BReast and Ovarian Cancer). Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671006] [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: 10/28/2022] Open
Affiliation(s)
| | - A Rempen
- Klinik für Frauenheilkunde und Geburtshilfe, Diakonieklinikum, Schwäbisch-Hall, Schwäbisch-Hall, Deutschland
| | - E Schlicht
- Klinik für Frauenheilkunde und Geburtshilfe, Kliniken Ostalb, Mutlangen, Deutschland
| | - S Fritz
- Klinik für Frauenheilkunde und Geburtshilfe, Sanaklinikum, Biberach, Deutschland
| | - F Flock
- Klinik für Frauenheilkunde und Geburtshilfe Memmingen, Memmingen, Deutschland
| | - T Kühn
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Esslingen, Esslingen, Deutschland
| | - F Thiel
- Klinik am Eichert, Frauenklinik, Göppingen, Göppingen, Deutschland
| | - R Felberbaum
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten, Kempten, Deutschland
| | - P Kuhn
- Comprehensive Cancer Center Ulm, Universitätsklinik Ulm, Ulm, Deutschland
| | - D Rothenbacher
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm, Ulm, Deutschland
| | - S Albrecht
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - K Ernst
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - F Schochter
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | | | - TWP Friedl
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - P Möller
- Institut für Pathologie, Universitätsklinik Ulm, Ulm, Deutschland
| | - W Janni
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - J Huober
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - G Nagel
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm, Ulm, Deutschland
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Bühler K, Diedrich K, Felberbaum R, Schweppe KW, Thaele M. Laudatio – Zum 90. Geburtstag von Prof. Prof. h. c. Dr. Dr. h. c. mult. Bruno Lunenfeld. Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0043-105061] [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: 10/19/2022] Open
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Fehr MK, Welter J, Sell W, Jung R, Felberbaum R. Sensor-controlled scalp cooling to prevent chemotherapy-induced alopecia in female cancer patients. ACTA ACUST UNITED AC 2016; 23:e576-e582. [PMID: 28050147 DOI: 10.3747/co.23.3200] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Scalp cooling has been used since the 1970s to prevent chemotherapy-induced alopecia, one of the most common and psychologically troubling side effects of chemotherapy. Currently available scalp cooling systems demonstrate varying results in terms of effectiveness and tolerability. METHODS For the present prospective study, 55 women receiving neoadjuvant, adjuvant, or palliative chemotherapy were enrolled. The aim was to assess the effectiveness of a sensor-controlled scalp cooling system (DigniCap: Sysmex Europe GmbH, Norderstedt, Germany) to prevent chemotherapy-induced alopecia in breast or gynecologic cancer patients receiving 1 of 7 regimens. Clinical assessments, satisfaction questionnaires, and alopecia evaluations [World Health Organization (who) grading for toxicity] were completed at baseline, at each cycle, and at completion of chemotherapy. RESULTS Of the 55 patients, 78% underwent scalp cooling until completion of chemotherapy. In multivariate analysis, younger women and those receiving paclitaxel weekly or paclitaxel-carboplatin experienced less alopecia. The compound successful outcome ("no head covering" plus "who grade 0/1") was observed in all patients 50 years of age and younger receiving 4 cycles of docetaxel-cyclophosphamide or 6 cycles of paclitaxel-carboplatin. Conversely, alopecia was experienced by all women receiving triplet polychemotherapy (6 cycles of docetaxel-doxorubicin-cyclophosphamide). For women receiving sequential polychemotherapy regimens (3 cycles of fluorouracil-epirubicin-cyclophosphamide followed by 3 cycles of docetaxel or 4 cycles of doxorubicin-cyclophosphamide followed by 4 cycles of docetaxel), the subgroup 50 years of age and younger experienced a 43% success rate compared with a 10% rate for the subgroup pf older women receiving the same regimens. CONCLUSIONS The ability of scalp cooling to prevent chemotherapy-induced alopecia varies with the chemotherapy regimen and the age of the patient. Use of a compound endpoint with subjective and objective measures provides insightful and practical information when counselling patients.
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Affiliation(s)
- M K Fehr
- Department of Obstetrics and Gynecology, Cantonal Hospital Frauenfeld, Switzerland
| | - J Welter
- Department of Obstetrics and Gynecology, Cantonal Hospital Frauenfeld, Switzerland
| | - W Sell
- Department of Obstetrics and Gynecology, Cantonal Hospital Frauenfeld, Switzerland
| | - R Jung
- Department of Obstetrics and Gynecology, Cantonal Hospital Frauenfeld, Switzerland
| | - R Felberbaum
- Department of Obstetrics and Gynecology, Clinic of Kempten-Oberallgäu, Germany
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Kraft K, Mooz H, Puhl A, Graf M, Renz H, Haller M, Karch M, Felberbaum R. Tako-Tsubo cardiomyopathy after cardiopulmonary resuscitation during emergency Cesarean section in a 28 year old patient in the 31st week of pregnancy. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593213] [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: 10/20/2022] Open
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Bends R, Brössner A, Felberbaum R, Römer T. Myoma in statu nascendi nach transzervikaler Hochfrequenzablation eines transmuralen Leiomyoms des Uterus. Gynäkologische Endokrinologie 2016. [DOI: 10.1007/s10304-016-0084-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Singer S, Schwentner L, van Ewijk R, Blettner M, Wöckel A, Kühn T, Felberbaum R, Flock F, Janni W, Kreienberg R. The course of psychiatric co-morbidity in patients with breast cancer - results from the prospective multi-centre BRENDA II study. Psychooncology 2015; 25:590-6. [DOI: 10.1002/pon.3978] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 08/13/2015] [Accepted: 08/14/2015] [Indexed: 11/12/2022]
Affiliation(s)
- Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics; University Medical Centre, Johannes Gutenberg University Mainz; Mainz Germany
| | - Lukas Schwentner
- Department of Gynaecology and Obstetrics; University of Ulm; Ulm Germany
| | - Reyn van Ewijk
- Institute of Medical Biostatistics, Epidemiology and Informatics; University Medical Centre, Johannes Gutenberg University Mainz; Mainz Germany
| | - Maria Blettner
- Institute of Medical Biostatistics, Epidemiology and Informatics; University Medical Centre, Johannes Gutenberg University Mainz; Mainz Germany
| | - Achim Wöckel
- Department of Gynaecology and Obstetrics; University of Würzburg; Würzburg Germany
| | - Thorsten Kühn
- Department of Gynaecology and Obstetrics; Hospital Esslingen; Esslingen Germany
| | - Ricardo Felberbaum
- Department of Gynaecology and Obstetrics; Hospital Kempten; Kempten Germany
| | - Felix Flock
- Department of Gynaecology and Obstetrics; Hospital Memmingen; Memmingen Germany
| | - Wolfgang Janni
- Department of Gynaecology and Obstetrics; University of Ulm; Ulm Germany
| | - Rolf Kreienberg
- Department of Gynaecology and Obstetrics; University of Ulm; Ulm Germany
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Singer S, Blettner M, Kreienberg R, Janni W, Wöckel A, Kühn T, Felberbaum R, Flock F, Schwentner L. Breast Cancer Patients' Fear of Treatment: Results from the Multicenter Longitudinal Study BRENDA II. Breast Care (Basel) 2015. [PMID: 26195937 DOI: 10.1159/000381933] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [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: 02/01/2023] Open
Abstract
BACKGROUND Fear of cancer treatment can become overwhelming. It is important to understand what patients are mainly afraid of and what factors are correlated with intense fear of treatment. METHODS Patients with primary breast cancer (n = 761) completed questionnaires about fear of treatment before surgery (t1), and before (t2) and after (t3) adjuvant treatment. Psychological comorbidity was assessed using the Patient Health Questionnaire. Logistic regression identified predictors of intense fear of treatment. RESULTS Patients were most afraid of chemotherapy (mean score 3.5), and fear remained high throughout follow-up; fear of radiotherapy and of surgery was lower and decreased over time (from 2.7 to 2.2, p < 0.0001; and from 2.6 to 2.2, p < 0.0001, respectively). Patients with psychological co-morbidity (odds ratios (OR) 1.7-3.0) and those who had heard reports of negative experiences with cancer treatments from others (OR 3.8-16.2) were more likely to have intense fear of all the treatments. Patients with a previous cancer less often expressed fear of surgery (OR 0.6, 95% confidence interval 0.4-1.0). CONCLUSION Fear of treatment, especially of chemotherapy, is prevalent in many patients with primary breast cancer. Patients with psychological co-morbidity and those who have heard reports of negative experiences with cancer treatment are at higher risk of experiencing intense fear.
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Affiliation(s)
- Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg University Mainz, Germany
| | - Maria Blettner
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg University Mainz, Germany
| | - Rolf Kreienberg
- Department of Gynaecology and Obstetrics, University of Ulm, Germany
| | - Wolfgang Janni
- Department of Gynaecology and Obstetrics, University of Ulm, Germany
| | - Achim Wöckel
- Department of Gynaecology and Obstetrics, University of Würzburg, Germany
| | - Thorsten Kühn
- Department of Gynaecology and Obstetrics, Hospital Esslingen, Germany
| | | | - Felix Flock
- Department of Gynaecology and Obstetrics, Hospital Memmingen, Germany
| | - Lukas Schwentner
- Department of Gynaecology and Obstetrics, University of Ulm, Germany
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Steetskamp J, Klöckner ME, Felberbaum R, Puhl AG. Die „schwierige Einleitung“: Minprostin und Cytotec im Vergleich bei Geburtseinleitung vor Termin und bei ungünstigem Bishop-Score. Z Geburtshilfe Neonatol 2013. [DOI: 10.1055/s-0033-1361423] [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: 10/26/2022]
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Isachenko V, Mallmann P, Petrunkina AM, Rahimi G, Nawroth F, Hancke K, Felberbaum R, Genze F, Damjanoski I, Isachenko E. Comparison of in vitro- and chorioallantoic membrane (CAM)-culture systems for cryopreserved medulla-contained human ovarian tissue. PLoS One 2012; 7:e32549. [PMID: 22479331 PMCID: PMC3316540 DOI: 10.1371/journal.pone.0032549] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2011] [Accepted: 02/01/2012] [Indexed: 01/17/2023] Open
Abstract
At present, there are three ways to determine effectively the quality of the cryopreservation procedure using ovarian tissue before the re-implantation treatment: evaluation of follicles after post-thawing xenotransplantation to SCID mouse, in-vitro culture in a large volume of culture medium under constant agitation and culture on embryonic chorio-allantoic membrane within a hen's eggs. The aim of this study was to compare the two methods, culture in vitro and culture on embryonic chorioallantoic membrane (CAM) of cryopreserved human ovarian medulla-contained and medulla-free cortex. Ovarian fragments were divided into small pieces (1.5–2.0×1.0–1.2×0.8–1.5) of two types, cortex with medulla and medulla-free cortex, frozen, thawed and randomly divided into the following four groups. Group 1: medulla-free cortex cultured in vitro for 8 days in large volume of medium with mechanical agitation, Group 2: medulla-containing cortex cultured in vitro, Group 3: medulla-free cortex cultured in CAM-system for 5 days, Group 4: medulla-containing cortex cultured in CAM-system. The efficacy of the tissue culture was evaluated by the development of follicles and by intensiveness of angiogenesis in the tissue (von Willebrand factor and Desmin). For Group 1, 2, 3 and 4, respectively 85%, 85%, 87% and 84% of the follicles were morphologically normal (P>0.1). The immunohistochemical analysis showed that angiogenesis detected by von Willebrand factor was lower in groups 1 and 3 (medulla-free cortex). Neo-vascularisation (by Desmin) was observed only in ovarian tissue of Group 4 (medulla-contained cortex after CAM-culture). It appears that the presence of medulla in ovarian pieces is beneficial for post-thaw development of cryopreserved human ovarian tissue. For medical practice it is recommended for evaluation of post-warming ovarian tissue to use the CAM-system as a valuable alternative to xenotransplantation and for cryopreservation of these tissues to prepare ovarian medulla-contained strips.
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Affiliation(s)
- Vladimir Isachenko
- Department of Obstetrics and Gynecology, Cologne University, Cologne, Germany.
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Isachenko V, Isachenko E, Rahimi G, Mallmann P, Nawroth F, Hancke K, Kreienberg R, Felberbaum R. Die Chorioallantoismembran des Huhns. Gynäkologische Endokrinologie 2012. [DOI: 10.1007/s10304-011-0465-3] [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: 10/14/2022]
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Isachenko V, Nawroth F, Rahimi G, Mallmann P, Hancke K, Genze F, Schrader M, Cronauer M, Damjanoski I, Felberbaum R, Isachenko E. Die vaskularisierte Chorioallantoismembran (CAM): ein Kultursystem für kryokonserviertes menschliches Ovarialgewebe als Alternative zur Xenotransplantation. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1280271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Záchia S, Knauth D, Goldim JR, Chachamovich JR, Chachamovich E, Paz AH, Felberbaum R, Crosignani P, Tarlatzis BC, Passos EP. Assisted reproduction: what factors interfere in the professional's decisions? Are single women an issue? BMC Womens Health 2011; 11:21. [PMID: 21627812 PMCID: PMC3125239 DOI: 10.1186/1472-6874-11-21] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/22/2010] [Accepted: 05/31/2011] [Indexed: 12/02/2022]
Abstract
Background With the development of medical technology, many countries around the world have been implementing ethical guidelines and laws regarding Medically Assisted Reproduction (MAR). A physician's reproductive decisions are not solely based on technical criteria but are also influenced by society values. Therefore, the aim of this study was to analyze the factors prioritized by MAR professionals when deciding on whether to accept to perform assisted reproduction and to show any existing cultural differences. Methods Cross-sectional study involving 224 healthcare professionals working with assisted reproduction in Brazil, Italy, Germany and Greece. Instrument used for data collection: a questionnaire, followed by the description of four special MAR cases (a single woman, a lesbian couple, an HIV discordant couple and gender selection) which included case-specific questions regarding the professionals' decision on whether to perform the requested procedure as well as the following factors: socio-demographic variables, moral and legal values as well as the technical aspects which influence decision-making. Results Only the case involving a single woman who wishes to have a child (without the intention of having a partner in the future) demonstrated significant differences. Therefore, the study was driven towards the results of this case specifically. The analyses we performed demonstrated that professionals holding a Master's Degree, those younger in age, female professionals, those having worked for less time in reproduction, those in private clinics and Brazilian health professionals all had a greater tendency to perform the procedure in that case. A multivariate analysis demonstrated that the reasons for the professional's decision to perform the procedure were the woman's right to gestate and the duty of MAR professionals to help her. The professionals who decided not to perform the procedure identified the woman's marital status and the child's right to a father as the reason to withhold treatment. Conclusion The study indicates differences among countries in the evaluation of the single woman case. It also discloses the undervaluation of bioethics committees and the need for a greater participation of healthcare professionals in debates on assisted reproduction laws.
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Affiliation(s)
- Suzana Záchia
- Post-Graduate Program in Medicine, Assisted Reproduction Service, Gynecology and Obstetrics Department, Hospital de Clínicas de Porto Alegre 90035-903, Porto Alegre, Brazil.
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Gerber B, von Minckwitz G, Stehle H, Reimer T, Felberbaum R, Maass N, Fischer D, Sommer HL, Conrad B, Ortmann O, Fehm T, Rezai M, Mehta K, Loibl S. Effect of luteinizing hormone-releasing hormone agonist on ovarian function after modern adjuvant breast cancer chemotherapy: the GBG 37 ZORO study. J Clin Oncol 2011; 29:2334-41. [PMID: 21537042 DOI: 10.1200/jco.2010.32.5704] [Citation(s) in RCA: 197] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Observational studies suggested that luteinizing hormone-releasing hormone agonists (LHRHa) might prevent premature ovarian failure resulting from adjuvant chemotherapy in premenopausal patients. We aimed to test the efficacy of ovarian function preservation with the LHRHa goserelin in patients with breast cancer. PATIENTS AND METHODS In a prospective, randomized, open-label, controlled multicenter study, 60 patients younger than age 46 years with hormone-insensitive breast cancer were allocated to receive anthracycline/cyclophosphamide (with or without taxane) -based neoadjuvant chemotherapy with or without goserelin. The first goserelin injection was administered at least 2 weeks before the first chemotherapy cycle, continuing at 3.6 mg subcutaneously every 4 weeks until the end of the last cycle. The primary objective was the reappearance of normal ovarian function, defined as two consecutive menstrual periods within 21 to 35 days at 6 months after end of chemotherapy. RESULTS Fifty-three patients (88.3%) experienced temporary amenorrhea (93.3% with v 83.3% without goserelin). No significant difference was observed regarding the reappearance of menstruation at 6 months after chemotherapy (70.0% with v 56.7% without goserelin; difference of 13.3%; 95% CI, -10.85 to 37.45; P = .284). All but one evaluable patient reported regular menses at 2 years after chemotherapy. Time to restoration of menstruation was 6.8 months (95% CI, 5.2 to 8.4) with goserelin and 6.1 months (95% CI, 5.3 to 6.8) without goserelin (P = .304). Chemotherapy resulted in a decreased ovarian reserve measured by inhibin B and anti-Müllerian hormone during follow-up, supporting the other findings. CONCLUSION Premenopausal patients with breast cancer receiving goserelin simultaneously with modern neoadjuvant chemotherapy did not experience statistically significantly less amenorrhea 6 months after end of chemotherapy compared with those receiving chemotherapy alone.
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Asimakopoulos B, Demirel C, Felberbaum R, Waczek S, Nikolettos N, Köster F, Al-Hasani S, Diedrich K. Concentrations of inflammatory cytokines and the outcome in ICSI cycles. In Vivo 2010; 24:495-500. [PMID: 20668315] [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: 05/29/2023]
Abstract
UNLABELLED The aim of this study was to measure circulating and intrafollicular concentrations of three inflammatory cytokines from women undergoing ovarian stimulation in order to determine their prognostic value in the outcome of intracytoplasmic sperm injection/embryo transfer cycles. MATERIALS AND METHODS A total of 72 women following ovarian stimulation and intracytoplasmic sperm injection were included. Blood serum samples were drawn at the day of chorionic gonadotropin administration. Follicular fluids were collected at the day of oocyte retrieval. The total fractions of tumor necrosis factor alpha, interleukin (IL)-1beta and IL-6 were measured with commercially available immunoassays. RESULTS The concentrations of IL-1beta, both in serum and follicular fluids, were significantly different between ICSI cycles that resulted in pregnancy and those that failed. The concentrations of the other two cytokines did not significantly differ between successful and unsuccessful cycles. CONCLUSION The circulating and intrafollicular concentrations of IL-1beta seem to be related to the pregnancy outcome in ICSI cycles of healthy women.
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Affiliation(s)
- Byron Asimakopoulos
- IVF Unit, General University Hospital of Alexandroupolis, Democritus University of Thrace, 68100 Alexandroupolis, Greece
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