Search results for "Germany"
showing 10 items of 1172 documents
Management of Pulmonary Embolism: Results from the German Chest Pain Unit Registry.
2020
<b><i>Introduction:</i></b> Since 2008, specialized chest pain units (CPUs) were implemented across Germany ensuring structured diagnostics in acute chest pain. This study aims to analyze the management of pulmonary embolism (PE) patients in such certified CPUs. <b><i>Methods:</i></b> Data were retrieved from 13,902 patients enrolled in the German CPU registry and analyzed for the diagnosis of PE including patient characteristics, critical time intervals, diagnostic workup, treatment, and prognosis. PE patients were compared to the overall CPU patient cohort. Only patients with a complete 3-month follow-up were included. <b><i>Resu…
First German Guideline on Diagnostics and Therapy of Clinically Non-Functioning Pituitary Tumors
2021
AbstractAlthough non-functioning pituitary tumors are frequent, diagnostic and therapeutic concepts are not well standardized. We here present the first German multidisciplinary guideline on this topic. The single most important message is to manage the patients by a multidisciplinary team (consisting at least of an endocrinologist, a neurosurgeon, and a (neuro-) radiologist). The initial diagnostic work-up comprises a detailed characterization of both biochemical (focusing on hormonal excess or deficiency states) and morphological aspects (with magnetic resonance imaging of the sellar region). An ophthalmological examination is only needed in presence of symptoms or large tumors affecting …
Depression in the nursing home: a cluster-randomized stepped-wedge study to probe the effectiveness of a novel case management approach to improve tr…
2019
Abstract Background Depression is the second most common psychiatric illness in old people. Up to 30% of nursing home residents suffer from minor or major depression. Although depressive disorders in old age can be improved and even cured with adequate therapy, they often go unnoticed in nursing home residents and remain untreated. This highlights a striking deficit in health care and might results not only in lower quality of life among those concerned but also in poor physical functioning, premature mortality and increased hospitalization rates. Methods The aim of the interdisciplinary research project DAVOS is to implement an innovative and stepped structural case management program to i…
The spectrum of allergic (cross-)sensitivity in clinical patch testing with 'para amino' compounds
2002
Background: Allergic contact sensitization to ‘para amino’ compounds is frequent and the spectrum of cross-reactivity between members of this chemical group is variable. Methods: A retrospective analysis of clinical patch test data obtained with a special test series in the centres of the Information Network of Departments of Dermatology (IVDK) between 1995 and 1999. Results: In the 638 patients tested with the above test panel positive reactions were observed most often to p-aminoazobenzene (16.2%), p-phenylenediamine (14.1%), p-toluylenediamine (10.0%), followed by 4,4′-diaminodiphenylmethane (8.5%), Disperse Orange 3 (8.4%) and p-aminophenol (3.1%). Among the 544 patients tested with p-p…
Economic evaluation of caspofungin vs liposomal amphotericin B for empirical therapy of suspected systemic fungal infection in the German hospital se…
2007
As antifungal agents are frequently used in hematology and oncology, economic data on the empirical therapy of suspected systemic fungal infection are pivotal. Data were analyzed according to: (1) the rate of nephrotoxicity related to treatment with caspofungin in comparison to liposomal amphotericin B (L-AmB) from a randomized clinical trial, (2) the effect of nephrotoxicity on length of hospital stay from a European observational study, and (3) an example of total bottom-up cost in a department of hematology in Germany. All estimates include 95% confidence intervals (CI) using two-stage Monte Carlo simulation on binominal and Gaussian random variables from separate studies with comparable…
Impact of vCJD on blood supply.
2007
Variant Creutzfeldt-Jakob disease (vCJD) is an at present inevitably lethal neurodegenerative disease which can only be diagnosed definitely post mortem. The majority of the approximately 200 victims to date have resided in the UK where most contaminated beef materials entered the food chain. Three cases in the UK demonstrated that vCJD can be transmitted by blood transfusion. Since BSE and vCJD have spread to several countries outside the UK, it appears advisable that specific risk assessments be carried out in different countries and geographic areas. This review explains the approach adopted by Germany in assessing the risk and considering precautionary measures. A fundamental premise is…
Standard treatment of female patients with breast cancer decreases substantially for women aged 70 years and older: a German clinical cohort study
2010
Standard treatment of patients with breast cancer decreases with age and older persons are mostly excluded from clinical trials. We hypothesized that non-adherence to treatment guidelines occurs for women agedor =70 years and changes overall survival (OAS) and disease-free survival (DFS).We enrolled 1922 women agedor =50 years with histologically confirmed invasive breast cancer treated at the University of Ulm from 1992 to 2005. Adherence to guidelines and effects on OAS and DFS for women agedor =70 years was compared with that for younger women (50-69 years).Women70 years less often received recommended breast-conserving therapy (70-79 years: 74%-83%;79 years: 54%) than women agedor =69 y…
Psycho‐oncological care of melanoma patients in certified skin cancer centers
2017
Background The establishment und certification of skin cancer centers (SCCs) in compliance with requirements issued by the German Cancer Society play a key role for quality-assured treatment of skin cancer patients. These requirements also call for the implementation of a qualified psycho-oncology program. When planning the present study, we assumed site-specific differences in the way such programs were implemented at various SCCs. Methods In 2014, we conducted a cross-sectional survey of all SCCs certified at the time (n = 43), in which these institutions were asked to provide information on the structural and process quality of their psycho-oncology programs. Results Overall, 81.4 % of c…
Minimal Reporting Standards for Active Middle Ear Hearing Implants.
2017
There is currently no standardized method for reporting audiological, surgical and subjective outcome measures in clinical trials with active middle ear implants (AMEIs). It is often difficult to compare studies due to data incompatibility and to perform meta-analyses across different centres is almost impossible. A committee of ENT and audiological experts from Germany, Austria and Switzerland decided to address this issue by developing new minimal standards for reporting the outcomes of AMEI clinical trials. The consensus presented here aims to provide a recommendation to enable better inter-study comparability.
Management of incomplete regional anaesthesia in Germany: results of a nation-wide survey.
2007
Background: Regional anaesthesia (RA) provides well-defined benefits with known attendant risks. However, incomplete blockade may introduce unanticipated risks depending on the compensatory measures employed. Until now, no data were available characterizing the pattern of response of German anaesthesiologists in this situation. This study analyses interventions in response to incomplete RA in a nation-wide setting. Methods: A questionnaire was sent to every German anaesthesia department (n= 1381). Questions focused on interventions coping with an incomplete RA and differentiated between a pre- and a peri-surgical setting and measures to face pain outside the surgical field. If systemic su…