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Deitmer T, Beck CE, Becke-Jakob K, Eich C, Hackenberg S, Hoffmann TK, Koitschev A, Löhler J, Röher K, Sittel C, Welkoborsky HJ, Wienke A, Badelt G. [Statement on the lower age limit for outpatient adenotomies and tonsillotomies]. Laryngorhinootologie 2024; 103:17-24. [PMID: 38086413 DOI: 10.1055/a-2216-8474] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
Abstract
At the beginning of 2023, there have been significant changes to the regulations for outpatient surgery in Germany, which were set out in a trilateral self-administration agreement between the umbrella association of statutory health insurance companies, the German Hospital Association and the Federal Association of Statutory Health Insurance Physicians. Among other things, a catalog stated circumstances under which an operation should not be carried out on an outpatient basis or should only be carried out with doubt. This catalog explains the patient's age: up to the first year of life, inpatient performance of a service can be justified. This formulation in itself means that children from one year of age on should regularly undergo outpatient surgery.In the german scientific societies for otolaryngology, head and neck surgery as well as for anesthesiology and intensive care medicine, doubts arose as to whether this age limit could also be scientifically justified for operations in the throat such as adenotomy or tonsillotomy.A search was carried out in international guidelines and in the international literature and the statements were evaluated. The results of this literature search were discussed with representatives of the Pediatric Otorhinolaryngology Working Group (AG PädHNO) of the German Society for Otorhinolaryngology, Head and Neck Surgery (DGHNO-KHC) and the scientific working group for pediatric anesthesia (WAKKA) of the German Society for Anesthesiology and Intensive Care Medicine (DGAI) in conferences.The consensus revealed that a strict age limit of the first year of life is not appropriate for the outpatient performance of adenotomies and tonsillotomies. First of all, specifying a strict age limit is questionable because, regardless of age, a number of other medical and social factors influence the responsible performance of outpatient operations. Furthermore, the age limit of one year is not considered appropriate in view of literature, guidelines and practical experience in the international area. The assessment of the literature and the consideration of the implementation in the international area make an age limit in the range of 2-3 years seem more appropriate.This review provides the responsible doctors with a variety of insights, aspects and arguments so that they can make their decision to carry out these operations on an outpatient or inpatient basis appropriately and responsibly.
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Affiliation(s)
- T Deitmer
- Arbeitsgemeinschaft pädiatrische HNO-Heilkunde (AG PädHNO) der Deutschen Gesellschaft für HNO-Heilkunde, Kopf- und Hals-Chirurgie (DGHNO-KHC), Bonn
| | - C E Beck
- Wissenschaftlicher Arbeitskreis Kinderanästhesie (WAKKA) der Deutschen Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Klinik für Anästhesiologie und Intensivmedizin, Medizinische Hochschule Hannover, Hannover
| | - K Becke-Jakob
- Wissenschaftlicher Arbeitskreis Kinderanästhesie (WAKKA) der Deutschen Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Berufsverband Deutscher Anästhesistinnen und Anästhesisten. Klinik Hallerwiese-Cnopfsche Kinderklinik, Nürnberg
| | - C Eich
- Wissenschaftlicher Arbeitskreis Kinderanästhesie (WAKKA) der Deutschen Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Abteilung Anästhesie, Kinderintensiv- und Notfallmedizin, Kinder- und Jugendkrankenhaus Auf der Bult, Hannover
| | - S Hackenberg
- Arbeitsgemeinschaft pädiatrische HNO-Heilkunde (AG PädHNO) der Deutschen Gesellschaft für HNO-Heilkunde, Kopf- und Hals-Chirurgie (DGHNO-KHC), Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg
| | - T K Hoffmann
- Arbeitsgemeinschaft pädiatrische HNO-Heilkunde (AG PädHNO) der Deutschen Gesellschaft für HNO-Heilkunde, Kopf- und Hals-Chirurgie (DGHNO-KHC), Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Hals-Chirurgie, Universitätsklinikum Ulm
| | - A Koitschev
- Arbeitsgemeinschaft pädiatrische HNO-Heilkunde (AG PädHNO) der Deutschen Gesellschaft für HNO-Heilkunde, Kopf- und Hals-Chirurgie (DGHNO-KHC), Klinik für Hals-Nasen-Ohrenkrankheiten, Plastische Operationen, Klinikum Stuttgart
| | - J Löhler
- Deutscher Berufsverband der HNO-Ärzte, Neumünster
| | - K Röher
- Wissenschaftlicher Arbeitskreis Kinderanästhesie (WAKKA) der Deutschen Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Klinik und Poliklinik für Anästhesiologie, Universitätsklinikum Eppendorf, Hamburg
| | - C Sittel
- Arbeitsgemeinschaft pädiatrische HNO-Heilkunde (AG PädHNO) der Deutschen Gesellschaft für HNO-Heilkunde, Kopf- und Hals-Chirurgie (DGHNO-KHC), Klinik für Hals-Nasen-Ohrenkrankheiten, Plastische Operationen, Klinikum Stuttgart
| | - H J Welkoborsky
- Arbeitsgemeinschaft pädiatrische HNO-Heilkunde (AG PädHNO) der Deutschen Gesellschaft für HNO-Heilkunde, Kopf- und Hals-Chirurgie (DGHNO-KHC), Klinik für HNO-Heilkunde, Krankenhaus Nordstadt, Kliniken Region Hannover
| | - A Wienke
- Fachanwalt für Medizinrecht, Justiziar der Deutschen Gesellschaft für HNO-Heilkunde, Kopf- und Hals-Chirurgie (DGHNO-KHC), Bonn
| | - G Badelt
- Wissenschaftlicher Arbeitskreis Kinderanästhesie (WAKKA) der Deutschen Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Klinik für Anästhesie und Kinderanästhesie, Krankenhaus Barmherzige Brüder Regensburg, Klinik St. Hedwig, Regenburg
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Stöver T, Plontke SK, Guntinas-Lichius O, Welkoborsky HJ, Zahnert T, Delank KW, Deitmer T, Esser D, Dietz A, Wienke A, Loth A, Dazert S. [Structure and establishment of the German Cochlear Implant Registry]. HNO 2023; 71:767-778. [PMID: 37198274 PMCID: PMC10663275 DOI: 10.1007/s00106-023-01309-7] [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] [Accepted: 04/25/2023] [Indexed: 05/19/2023]
Abstract
Hearing rehabilitation of patients with severe hearing loss or deafness using cochlear implants (CI) is a very successful but also complex and lifelong process that requires high quality standards for structure, process, and results. Medical registries represent an ideal tool for conducting quality control relevant to care while at the same time collecting scientific data. Therefore, at the initiative of the Executive Committee of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery (DGHNO-KHC), a Germany-wide CI registry (the German Cochlear Implant Register, DCIR) was to be established. The following goals were to be achieved: 1) legal and contractual basis for the register; 2) definition of the register contents; 3) development of evaluation standards (hospital-specific and national annual reports); 4) development of a logo; 5) practical operation of the registry. After defining a catalog of services that defines the content, structure, and operation of the DCIR, a registry operator with audiological expertise was sought. After considering various offers, the registry was technically implemented in cooperation with the provider INNOFORCE (Ruggell, Liechtenstein) as registry operator. This also included the realization of an interface for data transfer from previously existing databases and development of a data protection concept for productive operation of the DCIR under the scientific leadership of the DGHNO-KHC Executive Committee. Since January 2022, it has been possible for participating hospitals to enter pseudonymized data into the DCIR. To date, 75 hospitals in Germany have contractually agreed to participate in the registry. During the first 15 months, data from over 2500 implants in over 2000 patients were registered in the DCIR. The work presented here describes the structuring, development, and successful establishment of the DCIR. Introduction of the DCIR represents an important milestone of future scientifically based quality control in CI care. The registry presented here can therefore be considered as an example for other areas of medical care and thus also sets an international standard.
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Affiliation(s)
- T Stöver
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Deutschland.
| | - S K Plontke
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsmedizin Halle, Halle (Saale), Deutschland
| | - O Guntinas-Lichius
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Jena, Jena, Deutschland
| | - H-J Welkoborsky
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Klinikum Nordstadt, Hannover, Deutschland
| | - T Zahnert
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Dresden, Dresden, Deutschland
| | - K W Delank
- Hals-Nasen-Ohren-Klinik, Klinikum Ludwigshafen, Ludwigshafen, Deutschland
| | | | | | - A Dietz
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Leipzig, Leipzig, Deutschland
| | - A Wienke
- Kanzlei WBK, Rechtsanwalt Fachanwalt Medizinrecht, Köln, Deutschland
| | - A Loth
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Deutschland
| | - S Dazert
- Universitätsklinik für Hals‑, Nasen-, und Ohrenheilkunde, St. Elisabeth Hospital, Bochum, Deutschland
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Stöver T, Plontke SK, Guntinas-Lichius O, Welkoborsky HJ, Zahnert T, Delank KW, Deitmer T, Esser D, Dietz A, Wienke A, Loth A, Dazert S. Structure and establishment of the German Cochlear Implant Registry (DCIR). HNO 2023; 71:82-92. [PMID: 37462684 PMCID: PMC10409674 DOI: 10.1007/s00106-023-01310-0] [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] [Accepted: 06/02/2023] [Indexed: 08/09/2023]
Abstract
Hearing rehabilitation of patients with severe hearing loss or deafness using cochlear implants (CI) is a very successful but also complex and lifelong process that requires high quality standards for structure, process, and results. Medical registries represent an ideal tool for conducting quality control relevant to care while at the same time collecting scientific data. Therefore, at the initiative of the Executive Committee of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery (DGHNO-KHC), a Germany-wide CI registry (the German Cochlear Implant Register, DCIR) was to be established. The following goals were to be achieved: 1) legal and contractual basis for the register; 2) definition of the register contents; 3) development of evaluation standards (hospital-specific and national annual reports); 4) development of a logo; 5) practical operation of the registry. After defining a catalog of services that defines the content, structure, and operation of the DCIR, a registry operator with audiological expertise was sought. After considering various offers, the registry was technically implemented in cooperation with the provider INNOFORCE (Ruggell, Liechtenstein) as registry operator. This also included the realization of an interface for data transfer from previously existing databases and development of a data protection concept for productive operation of the DCIR under the scientific leadership of the DGHNO-KHC Executive Committee. Since January 2022, it has been possible for participating hospitals to enter pseudonymized data into the DCIR. To date, 75 hospitals in Germany have contractually agreed to participate in the registry. During the first 15 months, data from over 2500 implants in over 2000 patients were registered in the DCIR. The work presented here describes the structuring, development, and successful establishment of the DCIR. Introduction of the DCIR represents an important milestone of future scientifically based quality control in CI care. The registry presented here can therefore be considered as an example for other areas of medical care and thus also sets an international standard.
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Affiliation(s)
- T Stöver
- Department of Otorhinolaryngology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
| | - S K Plontke
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Halle, Halle (Saale), Germany
| | - O Guntinas-Lichius
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
| | - H-J Welkoborsky
- Hospital for Otorhinolaryngology, Klinikum Nordstadt, Hanover, Germany
| | - T Zahnert
- Department of Otorhinolaryngology, Dresden University Hospital, Dresden, Germany
| | - K W Delank
- Department of Otorhinolaryngology, Ludwigshafen Hospital, Ludwigshafen, Germany
| | | | | | - A Dietz
- Department of Otorhinolaryngology, Leipzig University Hospital, Leipzig, Germany
| | - A Wienke
- Law office WBK, lawyer specialist medical law, Cologne, Germany
| | - A Loth
- Department of Otorhinolaryngology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - S Dazert
- Department of Otorhinolaryngology, University Hospital (St. Elisabeth Hospital), Bochum, Germany
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Stöver T, Plontke SK, Guntinas-Lichius O, Welkoborsky HJ, Zahnert T, Delank KW, Deitmer T, Esser D, Dietz A, Wienke A, Loth A, Dazert S. Conception and implementation of a certification system for quality control of cochlear implant treatment in Germany. HNO 2023; 71:73-81. [PMID: 37306745 PMCID: PMC10409661 DOI: 10.1007/s00106-023-01306-w] [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] [Accepted: 04/24/2023] [Indexed: 06/13/2023]
Abstract
A standardized and structured process is indispensable for optimal hearing rehabilitation with cochlear implants (CI). The Executive Committee of the German Society of Otorhinolaryngology, Head and Neck Surgery (DGHNO-KHC), initiated the conception of a certification program and a Whitepaper based on the Association of the Scientific Medical Societies in Germany (AWMF) clinical practice guideline (CPG) describing the current medical standards of CI care in Germany. The goal was to independently confirm implementation of this CPG and make this information publicly available. With the support of an independent certification organization, successful implementation of the CI-CPG by a hospital would then be verified and confirmed by awarding the "Cochlear implant-provision institution" (Cochlea-Implantat-versorgende Einrichtung, CIVE) quality certificate. A structure for implementation of a certification system was developed based on the CI-CPG. The following steps were required: 1) conception of a quality control system for certification of hospitals working in accordance with the CI-CPG; 2) development of required structures for an independent review of quality-relevant structure, process, and result parameters; 3) development of a standard procedure for independent certification of hospitals; 4) development of a certificate and a logo to demonstrate successful certification; 5) practical implementation of the certification. Following design of the certification program and the required organizational structure, the certification system was successfully launched in 2021. Applications for the quality certificate could be formally submitted from September 2021. A total of 51 off-site evaluations were performed by December 2022. In the first 16 months from introduction, 47 hospitals were successfully certified as CIVE. In this period, 20 experts were trained as auditors, who have since then carried out 18 on-site audits in hospitals. In summary, the conceptual design, structure, and practical implementation of a certification program for quality control in CI care was successfully implemented in Germany.
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Affiliation(s)
- T Stöver
- Department of Otorhinolaryngology, Frankfurt University Hospital, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
| | - S K Plontke
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Halle, Halle (Saale), Germany
| | - O Guntinas-Lichius
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
| | - H-J Welkoborsky
- Hospital for Otorhinolaryngology, Klinikum Nordstadt, Hanover, Germany
| | - T Zahnert
- Department of Otorhinolaryngology, Dresden University Hospital, Dresden, Germany
| | - K W Delank
- Department of Otorhinolaryngology, Ludwigshafen Hospital, Ludwigshafen, Germany
| | | | | | - A Dietz
- Department of Otorhinolaryngology, Leipzig University Hospital, Leipzig, Germany
| | - A Wienke
- Law office WBK, Cologne, Germany
| | - A Loth
- Department of Otorhinolaryngology, Frankfurt University Hospital, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - S Dazert
- Department of Otorhinolaryngology, University Hospital (St. Elisabeth Hospital), Bochum, Germany
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Schwyn Thöny S, Bärtschi M, Batzer M, Baselgia M, Waldner S, Steinecke M, Badorreck H, Wienke A, Jupé M. Magnetron sputter deposition of Ta 2O 5-SiO 2 quantized nanolaminates. Opt Express 2023; 31:15825-15835. [PMID: 37157674 DOI: 10.1364/oe.487892] [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] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Quantized nanolaminates are a type of optical metamaterials, which were discovered only recently. Their feasibility was demonstrated by atomic layer deposition and ion beam sputtering so far. In this paper, we will report on the successful magnetron sputter deposition of quantized nanolaminates based on Ta2O5-SiO2. We will describe the deposition process, show results and material characterization of films deposited in a very wide parameter range. Furthermore, we will show how quantized nanolaminates deposited by magnetron sputtering were used in optical interference coatings such as antireflection and mirror coatings.
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Stöver T, Plontke SK, Guntinas-Lichius O, Welkoborsky HJ, Zahnert T, Delank KW, Deitmer T, Esser D, Dietz A, Wienke A, Loth A, Dazert S. [Conception and implementation of a certification system for quality control of cochlear implant treatment in Germany. German version]. HNO 2023:10.1007/s00106-023-01305-x. [PMID: 37115246 DOI: 10.1007/s00106-023-01305-x] [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] [Accepted: 03/27/2023] [Indexed: 04/29/2023]
Abstract
A standardized and structured process is indispensable for optimal hearing rehabilitation with cochlear implants (CI). The Executive Committee of the German Society of Otorhinolaryngology, Head and Neck Surgery (DGHNO-KHC), initiated the conception of a certification system and a Whitepaper based on the Association of the Scientific Medical Societies in Germany (AWMF) clinical practice guideline (CPG) describing the current medical standards of CI care in Germany. The goal was to independently confirm implementation of this CPG and make this information publicly available. With the support of an independent certification organization, successful implementation of the CI-CPG by a hospital would then be verified and confirmed by awarding the "Cochlear implant-provision institution" (Cochlea-Implantat-versorgende Einrichtung, CIVE) quality certificate. A structure for implementation of a certification system was developed based on the CI-CPG. The following steps were required: 1) conception of a quality control system for certification of hospitals working in accordance with the CI-CPG; 2) development of required structures for an independent review of quality-relevant structure, process, and result parameters; 3) development of a standard procedure for independent certification of hospitals; 4) development of a certificate and a logo to demonstrate successful certification; 5) practical implementation of the certification. Following design of the certification system and the required organizational structure, the certification system was successfully launched in 2021. Applications for the quality certificate could be formally submitted from September 2021. A total of 51 off-site evaluations were performed by December 2022. In the first 16 months from introduction, 47 hospitals were successfully certified as CIVE. In this period, 20 experts were trained as auditors, who have since then carried out 18 on-site audits in hospitals. In summary, the conceptual design, structure, and practical implementation of a certification system for quality control in CI care was successfully implemented in Germany.
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Affiliation(s)
- T Stöver
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Deutschland.
| | - S K Plontke
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsmedizin Halle, Halle (Saale), Deutschland
| | - O Guntinas-Lichius
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Jena, Jena, Deutschland
| | - H-J Welkoborsky
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum Nordstadt, Hannover, Deutschland
| | - T Zahnert
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Dresden, Dresden, Deutschland
| | - K W Delank
- Hals-Nasen-Ohren-Klinik, Klinikum Ludwigshafen, Ludwigshafen, Deutschland
| | | | | | - A Dietz
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Leipzig, Leipzig, Deutschland
| | - A Wienke
- Kanzlei WBK, Rechtsanwalt Fachanwalt Medizinrecht, Köln, Deutschland
| | - A Loth
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Deutschland
| | - S Dazert
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum (St. Elisabeth Hospital), Bochum, Deutschland
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Radetzki F, Massarwa H, Wienke A, Delank KS, Zagrodnick J. Treatment management and outcome of polytraumatized patients in a German certified trauma center - comparing standard versus maximum care. Acta Orthop Belg 2023; 89:7-14. [PMID: 37294979 DOI: 10.52628/89.1.0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
German hospitals are classified as basic, standard and maximum care facilities within the German trauma networks. The Municipal Hospital Dessau was upgraded in 2015 as a maximum care provider. The aim of this study is to investigate whether a change in treatment management and outcome of polytraumatized patients has occurred afterwards. The study compared polytraumatized patients, treated in the Dessau Municipal Clinic as a standard care facility (DessauStandard) from 2012-2014 vs. those treated in the Dessau Municipal Clinic as a maximum care facility (DessauMax) from 2016-2017. Data of the German Trauma Register were analysed using the chi-square test, t-test and odds ratios with 95% confidence intervals.In DessauMax (238 patients; Ø 54 years, SD 22.3; ♂ 160, ♀ 78), the shock room time with 40.7 min (SD 21.4) was shorter than in DessauStandard (206 patients; Ø 56.1 years, SD 22.1; ♂ 133, ♀ 73 ) with 49 min (SD 25.1) (p=0.001). The transfer rate of 1.3% (n=3) to another hospital was lower in DessauMax (p=0.01). DessauStandard had 9 (4%) thromboembolic events and DessauMax 3 (1.3%) (p=0.7). Multiorgan failure was more common in DessauStandard, (16%) than in DessauMax (1.3%; p=0,001). DessauStandard showed a mortality of 13.1% (n=27), and DessauMax 9.2% (n=22) (p=0.22; OR=0.67, 95% CI, 0.37-1.23). The GOS in DessauMax (4.5, SD 1.2) was higher than in DessauStandard (4.1, SD 1.3) (p=0.002).The Dessau Municipal Clinic as a maximum care facility has achieved improved shock room time, fewer complications, lower mortality and an improved outcome.
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Garbe N, Schäfer C, Pilz A, Schmidt F, Raberger K, Wienke A, Keyßer G. The impact of a structured one-day seminar on disease-specific knowledge, lifestyle habits and disease impairment in ANCA-associated vasculitis. Results of a randomized, controlled study. Scand J Rheumatol 2023; 52:69-76. [PMID: 34643169 DOI: 10.1080/03009742.2021.1972534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a complex, chronic autoimmune disease, and its diagnosis triggers considerable anxiety and uncertainty for those affected. There are currently no valid data describing the impact of disease-specific patient education on the disease knowledge, subjective impairment, and changes in lifestyle habits related to AAV. METHOD We designed a one-day educational programme to serve AAV patients with information about their disease and its treatment. Patients were randomized into an intervention group and a waiting list control group. Increase in knowledge was measured with a multiple-choice test. The intervention group completed the questionnaire before, directly after, and 3 months after the seminar, while the waiting list control group was additionally tested 3 months before the seminar to rule out non-specific learning. Furthermore, we investigated the burden of the disease and the impact of our intervention on this burden. RESULTS Compared with the control group, the intervention increased the knowledge (mean ± sd score difference 2.2 ± 1.0, 95% confidence interval 0.1-4.3, p = 0.04). From the patients' point of view, their understanding of the disease had improved and the subjective impairment caused by their rheumatic disease had decreased. There was a tendency to include disease-relevant behaviour, such as nasal care or dietary recommendations, more often in everyday life. CONCLUSION A one-day seminar is suitable to increase the disease-specific knowledge of patients with AAV in a sustainable manner. In addition, our measure positively affected the disease-relevant behaviour.
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Affiliation(s)
- N Garbe
- Department of Internal Medicine II, Rheumatology, University Hospital Halle (Saale), Halle (Saale), Germany
| | - C Schäfer
- Department of Internal Medicine II, Rheumatology, University Hospital Halle (Saale), Halle (Saale), Germany
| | - A Pilz
- Department of Internal Medicine II, Rheumatology, University Hospital Halle (Saale), Halle (Saale), Germany
| | - F Schmidt
- Department of Internal Medicine II, Rheumatology, University Hospital Halle (Saale), Halle (Saale), Germany
| | - K Raberger
- Department of Pediatrics I, University Hospital Halle (Saale), Halle (Saale), Germany
| | - A Wienke
- Institute of Medical Epidemiology, Biometrics, and Informatics, Medical Faculty of the Martin-Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - G Keyßer
- Department of Internal Medicine II, Rheumatology, University Hospital Halle (Saale), Halle (Saale), Germany
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Gayatri D, Efremov L, Wienke A, Mikolajczyk R, Kantelhardt EJ. Quality of life assessment in breast cancer patients during palliative treatment in Indonesia. Eur J Public Health 2022. [PMCID: PMC9593967 DOI: 10.1093/eurpub/ckac131.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background This study aimed to prospectively assess quality of life (QOL), QOL domains, and pain severity in advanced stage breast cancer patients during palliative oncology treatment in Indonesia. Methods Advanced stage breast cancer patients > 18 years (n = 160) who began palliative oncology treatment were enrolled in the study using convenience sampling. They completed the EORTC QLQ-C15-PAL questionnaire and pain severity (Visual Analogue Scale, VAS) score at three-time points (baseline (T0), three-(T1) and six-months (T2) follow-up). The repeated measures analysis of variance (ANOVA) model was used to assess the QOL, QOL domains, and pain severity changes over time adjusted for age, place of residence, marital status, and Karnofsky Performance Status score at baseline. We classified the change over time in three qualitative groups (deterioration, improvement, or trivial/no difference). We considered it clinically relevant if patients had a 10-point difference. Results The mean age of included patients (n = 159) was 50 years. Most lived in an urban area (72.3%), had low education (71.7%), and were married (81.8%). The repeated measures ANOVA showed that the QOL score, emotional functioning, fatigue, dyspnea, appetite loss, constipation, and VAS pain score remained stable over the 6-months period. In contrast: physical functioning declined (medium to large deterioration (-19.8 (95% CI -27.2 to -12.5)) between T0 to T2), however there was an improvement in the insomnia domain (medium improvement (-13.4 (95% CI -19.9 to -6.9)) between T0 to T2). Conclusions Our findings indicated that advanced stage breast cancer patients adapted well to palliative oncology treatment over six months of observation. There was deterioration in physical functioning, but improvement in insomnia. However, more attention is needed from clinicians to achieve improvement in the overall QOL score and specific QOL domains. Key messages • Focusing on improvement overall QOL score and specific QOL domains will lead to better advanced stage breast cancer patients’ satisfaction and care. • Information is limited on palliative treatment satisfaction in low and lower middle-income countries, therefore this study has important impact on further policy considerations in Indonesia.
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Affiliation(s)
- D Gayatri
- Institute for Medical Epidemiology, Martin-Luther-University Halle-Wittenberg , Halle, Germany
- Department of Epidemiology, Faculty of Public Health, Universitas Indonesia , Depok, Indonesia
| | - L Efremov
- Institute for Medical Epidemiology, Martin-Luther-University Halle-Wittenberg , Halle, Germany
- Department of Radiation Oncology, Martin-Luther-University Halle-Wittenberg , Halle, Germany
| | - A Wienke
- Institute for Medical Epidemiology, Martin-Luther-University Halle-Wittenberg , Halle, Germany
| | - R Mikolajczyk
- Institute for Medical Epidemiology, Martin-Luther-University Halle-Wittenberg , Halle, Germany
| | - EJ Kantelhardt
- Institute for Medical Epidemiology, Martin-Luther-University Halle-Wittenberg , Halle, Germany
- Department of Gynecology, Martin-Luther-University Halle-Wittenberg , Halle, Germany
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Meyer JH, Wienke A, Surov A. CT-definierte Body Composition als prognostische Marker für Mortalität in COVID-19. Ein systematisches Review und Meta-Analyse. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1749897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- J H Meyer
- Universitätsklinikum Leipzig, Diagnostische und Interventionelle Radiologie, Leipzig
| | - A Wienke
- Medizinische Epidemiologie, Biostatistik und Informatik, Martin-Luther Universität Halle (Saale), Halle (Saale)
| | - A Surov
- Radiologie und Nuklearmedizin, Universitätsklinikum Madgeburg, Magdeburg
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11
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Meyer JH, Akritidou M, Bach GA, Bailis N, Pech M, Wienke A, Surov A. Ein neuer Score, um die 30-Tage Mortalität von Patienten mit akuter Lungenembolie vorherzusagen: The Pulmonary Embolism Mortality Score (PEMS). ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1749799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- J H Meyer
- Universitätsklinikum Leipzig, Diagnostische und Interventionelle Radiologie, Leipzig
| | - M Akritidou
- Innere Medizin, Otto-von-Guericke University Magdeburg, Magdeburg
| | - G A Bach
- Radiologie, Universitätsklinikum Halle (Saale), Halle (Saale)
| | - N Bailis
- Radiologie, Universitätsklinikum Leipzig, Leipzig
| | - M Pech
- Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg, Magdeburg
| | - A Wienke
- Medizinische Epidemiologie, Biostatistik und Informatik, Martin-Luther Universität Halle (Saale), Halle (Saale)
| | - A Surov
- Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg, Magdeburg
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12
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Wienke A. Operation verschoben – Aufklärung wiederholen? DGNeurologie 2022. [PMCID: PMC8970059 DOI: 10.1007/s42451-022-00428-9] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A. Wienke
- Wienke & Becker – Köln, Sachsenring 6, 50677 Köln, Deutschland
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Hübner L, Wienke A. [Medical guidelines are not justiciable : German Federal Administrative Court gives physicians a free hand]. HNO 2021; 69:1012-1013. [PMID: 33835211 DOI: 10.1007/s00106-021-01034-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2020] [Indexed: 11/24/2022]
Affiliation(s)
- L Hübner
- Kanzlei Wienke & Becker, Sachsenring 6, 50677, Köln, Deutschland.
| | - A Wienke
- Kanzlei Wienke & Becker, Sachsenring 6, 50677, Köln, Deutschland
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14
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Friese KV, Wienke A. [Timeliness of providing patient information on outpatient procedures]. HNO 2021; 69:925-926. [PMID: 33822266 DOI: 10.1007/s00106-021-01032-1] [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] [Accepted: 02/08/2021] [Indexed: 11/29/2022]
Affiliation(s)
- K-V Friese
- Kanzlei Wienke & Becker - Köln, Sachsenring 6, 50677, Köln, Deutschland.
| | - A Wienke
- Kanzlei Wienke & Becker - Köln, Sachsenring 6, 50677, Köln, Deutschland
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15
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Hübner L, Wienke A. [No euphemisms in the informed consent discussion : Compensation for damages after misleading information on surgical experience]. HNO 2021; 69:597-598. [PMID: 33822269 DOI: 10.1007/s00106-021-01031-2] [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] [Accepted: 07/15/2020] [Indexed: 10/21/2022]
Affiliation(s)
- L Hübner
- Wienke & Becker - Köln, Sachsenring 6, 50677, Köln, Deutschland
| | - A Wienke
- Wienke & Becker - Köln, Sachsenring 6, 50677, Köln, Deutschland.
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16
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Friese KV, Wienke A. ["If I had known …" : The hypothetical consent of the patient to medical treatment]. HNO 2021; 69:762-764. [PMID: 33822267 DOI: 10.1007/s00106-021-01033-0] [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] [Accepted: 07/17/2020] [Indexed: 11/28/2022]
Affiliation(s)
- K-V Friese
- Kanzlei Wienke & Becker, Sachsenring 6, 50677, Köln, Deutschland.
| | - A Wienke
- Kanzlei Wienke & Becker, Sachsenring 6, 50677, Köln, Deutschland
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17
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Hübner L, Wienke A. [Informed consent soon only via Skype?! : On the possibilities and limitations of telemedicine informed consent]. HNO 2021; 69:236-238. [PMID: 32458024 DOI: 10.1007/s00106-020-00883-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- L Hübner
- Kanzlei Wienke & Becker, Sachsenring 6, 50677, Köln, Deutschland
| | - A Wienke
- Kanzlei Wienke & Becker, Sachsenring 6, 50677, Köln, Deutschland.
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Hübner L, Wienke A. Patienten – allein zu Haus. HNO 2020; 68:876-880. [DOI: 10.1007/s00106-019-0726-3] [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: 10/26/2022]
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19
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Affiliation(s)
- A. Wienke
- Wienke & Becker – Köln, Sachsenring 6, 50677 Köln, Deutschland
| | - L. Hübner
- Wienke & Becker – Köln, Sachsenring 6, 50677 Köln, Deutschland
| | - G. Gahn
- Klinik für Neurologie, Städtisches Klinikum Karlsruhe gGmbH, Karlsruhe, Deutschland
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20
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Hübner L, Wienke A. Oberlandesgericht entscheidet: medizinisch-wissenschaftliche Leitlinien sind nicht justiziabel. HNO 2020; 68:613-615. [DOI: 10.1007/s00106-019-0712-9] [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: 11/30/2022]
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21
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Wienke A, Hübner L, Gahn G. Aufklärung bald nur noch via Skype?! DGNeurologie 2020. [PMCID: PMC7160816 DOI: 10.1007/s42451-020-00189-3] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- A. Wienke
- Medizinrecht, Wienke & Becker – Köln, Sachsenring 6, 50677 Köln, Deutschland
| | - L. Hübner
- Medizinrecht, Wienke & Becker – Köln, Sachsenring 6, 50677 Köln, Deutschland
| | - G. Gahn
- Klinik für Neurologie, Städtisches Klinikum Karlsruhe, Moltkestraße 90, 76133 Karlsruhe, Deutschland
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22
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Hübner L, Wienke A. Trotz Aufklärung – unwirksame Einwilligung mangels Bedenkzeit. HNO 2020; 68:280-282. [DOI: 10.1007/s00106-019-0711-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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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23
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Friese KV, Wienke A. Rechtsfragen in der Altersmedizin – ein Überblick. HNO 2020; 68:199-204. [DOI: 10.1007/s00106-019-0725-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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24
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Wienke A, Bernauer R. Studierende im Praktischen Jahr. Laryngorhinootologie 2019; 98:426-428. [DOI: 10.1055/a-0834-2214] [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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25
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Hofer V, Wrigge H, Wienke A, Hofmann G, Hilbert-Carius P. [Platelet function disorder in trauma patients, an underestimated problem? Results of a single center study]. Anaesthesist 2019; 68:368-376. [PMID: 31098664 DOI: 10.1007/s00101-019-0597-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 11/05/2018] [Revised: 03/27/2019] [Accepted: 04/03/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Plasmatic coagulation disorders in trauma patients are common and their management is subject to current guidelines. Less evidence exists for platelet function. Although it is known that several trauma-associated factors have a negative influence on platelet function, routine monitoring has not yet become established. METHODS A retrospective single center study was carried out at a German level 1 trauma center from 2010 to 2016. In all patients fulfilling the requirements for the German Trauma Society (DGU) Traumaregister® who were admitted directly from the scene of the incident, platelet function was analyzed using the Platelet Function Analyzer (PFA 100®) with adenosine diphosphate (ADP) and epinephrine as activation factors. After exclusion of patients with intake of long-term anticoagulant and antiaggregant medication, possible influencing factors of a reduced platelet function were identified. RESULTS The results from 310 patients (44.0 ± 14.7 years, 76% male, Injury Severity Score, ISS 28.4 ± 14.2 points) were available. A delayed platelet activation was found in 25.5% using ADP and 31% using epinephrine. Laboratory parameters indicated a greater blood loss. Prolonged closure times were associated with an increased transfusion rate of packed red blood cell concentrates and a higher mortality rate. Logistic regression revealed hemoglobin (Hb) and fibrinogen levels at admission to be independent predictors for a decreased platelet activation in the assay with ADP (p < 0.001, Cohen's f = 0.61) and with epinephrine (p < 0.001, f = 0.42). CONCLUSION Approximately one quarter to one third of primarily admitted trauma patients without long-term anticoagulation medication showed a delayed platelet activation in the PFA-100 test. By considering all trauma patients an even higher rate can be expected. The Hb and fibrinogen levels at admission can be helpful to estimate platelet disorders. The development of platelet assays to guide the resuscitation of individual patients seems to be absolutely necessary. The contribution of platelet disorders to trauma-induced coagulopathy is not sufficiently understood. Regarding the importance assigned to platelet transfusion or administration of desmopressin, these aspects should be the subject of further research.
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Affiliation(s)
- V Hofer
- Klinik für Anästhesiologie, Intensiv‑, Notfallmedizin und Schmerztherapie, Bergmannstrost BG-Klinikum Halle (Saale), Merseburgerstr. 165, 06112, Halle (Saale), Deutschland.,Klinik für Anästhesiologie, Universitätsklinik Regensburg, Regensburg, Deutschland
| | - H Wrigge
- Klinik für Anästhesiologie, Intensiv‑, Notfallmedizin und Schmerztherapie, Bergmannstrost BG-Klinikum Halle (Saale), Merseburgerstr. 165, 06112, Halle (Saale), Deutschland
| | - A Wienke
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - G Hofmann
- Klinik für Unfall- und Wiederherstellungschirurgie, Bergmannstrost BG-Klinikum Halle (Saale), Halle (Saale), Deutschland.,Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie Universitätsklinikum, Friedrich Schiller Universität Jena, Jena, Deutschland
| | - P Hilbert-Carius
- Klinik für Anästhesiologie, Intensiv‑, Notfallmedizin und Schmerztherapie, Bergmannstrost BG-Klinikum Halle (Saale), Merseburgerstr. 165, 06112, Halle (Saale), Deutschland.
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26
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Wienke A. Wie würden Sie entscheiden? Nuklearmedizin 2018; 57:XI-XIII. [DOI: 10.1055/s-0038-1676688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Die Patientenaufklärung ist mittlerweile auch in Arztkreisen zu einer allseits anerkannten und zentralen ärztlichen Verpflichtung geworden. Die Patientenaufklärung in Klinik und Praxis zählt neben der standardgemäßen Behandlung und der Dokumentation zu den Kardinalpflichten des ärztlichen Berufes. Auch der Gesetzgeber hat die Patientenaufklärung mit den Bestimmungen des Patientenrechtegesetzes zu einem zentralen Element der ärztlichen Behandlung erhoben. Ungeachtet dessen gibt es nach wie vor eine Vielzahl von sog. Arzthaftungsklagen, die sich auf eine Verletzung der ärztlichen Aufklärungspflicht stützen und damit in vielen Fällen Erfolg haben.
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Sailer R, Wienke A. Vorsicht bei Patientenfotos und Videodokumentation im Vortrag, bei Publikationen oder auf der Praxishomepage. Nuklearmedizin 2018; 57:IX-X. [DOI: 10.1055/s-0038-1676687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Bei medizinisch-wissenschaftlichen Vorträgen, bei ärztlichen Fort- und Weiterbildungsveranstaltungen, in Fachzeitschriften und auch in der medizinischen Forschung werden regelmäßig Abbildungen von Patienten zur Veranschaulichung von Krankheitsbildern, Behandlungsverfahren oder intraoperativer Situationen verwendet. Dies geschieht in Form der Präsentation von Röntgenbildern, intraoperativen Foto- oder Videoaufnahmen oder Bildern von Körperteilen. Auch bei der Darstellung einzelner ärztlicher Tätigkeiten oder Behandlungsverfahren ist es jedenfalls für bestimmte Eingriffe zulässig, Vorher- und Nachher-Bilder von Patienten auf der Praxishomepage zu veröffentlichen oder in der Praxis oder bei Vorträgen vorzustellen. Die Verwendung und Präsentation solcher Bilder von Patienten oder Abbildungen von Körperteilen ist gerade in der ärztlichen Ausbildung, bei Vorträgen und auch in wissenschaftlichen Publikationen geradezu an der Tagesordnung und selbstverständlich. Dennoch sollte man sich dabei im Klaren darüber sein, dass die Rechte der abgebildeten Persönlichkeiten und derjenigen, welche die Abbildungen (Fotos, Röntgenbilder etc.) hergestellt haben, nicht verletzt werden dürfen. Welche Aspekte hierbei zu beachten sind und wie man sich vor Ansprüchen Dritter auf Unterlassung und Schadensersatz am besten schützen kann, stellen wir im nachfolgenden Beitrag vor:
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Wienke A, Friese K. Rechtliche Aspekte der Digitalisierung in der Medizin. Nuklearmedizin 2018; 57:VI-VIII. [DOI: 10.1055/s-0038-1676686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Die Digitalisierung unserer Gesellschaft, unseres Handelns und unseres Denkens wird allerorten diskutiert; in Anlehnung an ein literarisch bekannt gewordenes gallisches Dorf könnte man meinen, dass sich nur wenige Unbeugsame dem digitalen Zeitalter entgegenstemmen. Auch und gerade im Gesundheitswesen ist die Digitalisierung derzeit eines der brennendsten Themen in der Gesundheitspolitik und in aktuellen Gesetzgebungsverfahren. So hat die Bundesregierung im Koalitionsvertrag vom 14.03.2018 festgehalten, dass bis 2020 ein Aktionsplan mit konkreten Maßnahmen entwickelt werden soll. Auch die aktuellen Diskussionen um die Einführung und den Nutzungsumfang der elektronischen Gesundheitskarte dominieren weiterhin in den Medien. Nicht zu vergessen ist auch die Debatte um die Lockerung des Fernbehand-lungsverbotes, für welche sich eine große Mehrheit auf dem 121. Ärztetag im Mai 2018 ausgesprochen hat. Letztlich nimmt das Thema Digitalisierung durch die damit einhergehenden datenschutzrechtlichen Fragen an Fahrt auf; wer denkt dieser Tage dabei nicht an die EU-Datenschutzgrundverordnung (DSGVO) und die Neufassung des Bundesdatenschutzgesetzes (BDSG)?
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Wienke A, Wienke M. [The right thing to do with airmiles]. HNO 2018; 67:712-714. [PMID: 30465165 DOI: 10.1007/s00106-018-0562-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- A Wienke
- Wienke & Becker - Köln, Sachsenring 6, 50677, Köln, Deutschland.
| | - M Wienke
- Wienke & Becker - Köln, Sachsenring 6, 50677, Köln, Deutschland
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30
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Friese KV, Wienke A. [Don't be frightened of the "bad wolf" : The new EU general data protection regulation in hospitals and medical practices]. HNO 2018; 67:299-303. [PMID: 30367221 DOI: 10.1007/s00106-018-0563-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- K-V Friese
- Rechtsanwälte Wienke & Becker - Köln, Sachsenring 6, 50677, Köln, Deutschland
| | - A Wienke
- Rechtsanwälte Wienke & Becker - Köln, Sachsenring 6, 50677, Köln, Deutschland.
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Wienke A. [Clarifications on the topic of data protection]. HNO 2018; 67:59-60. [PMID: 30367218 DOI: 10.1007/s00106-018-0564-8] [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]
Affiliation(s)
- A Wienke
- Wienke & Becker - Köln, Sachsenring 6, 50677, Köln, Deutschland.
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32
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Wienke A, Friese K. [Legal aspects of digitalization in the medical sector]. Laryngorhinootologie 2018; 97:713-716. [PMID: 30340229 DOI: 10.1055/a-0652-6505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Griesel M, Feuchtner J, Seraphin T, Hämmerl L, Mezger N, Korir A, Wabinga H, Thomssen C, Wienke A, Parkin DM, Kantelhardt EJ. Cervical cancer in Sub-Saharan Africa: a multinational population-based study on patterns of care. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671060] [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)
- M Griesel
- Klinik und Poliklinik für Gynäkologie, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - J Feuchtner
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - T Seraphin
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - L Hämmerl
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - N Mezger
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - A Korir
- Kenya Medical Research Institute, Nairobi Cancer Registry, Nairobi, Kenia
| | - H Wabinga
- Department of Pathology, Makerere University, Kampala, Uganda
- Kampala Cancer Registry, Makerere University, Kampala, Uganda
| | - C Thomssen
- Klinik und Poliklinik für Gynäkologie, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - A Wienke
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - DM Parkin
- African Cancer Registry Network, Oxford, Vereinigtes Königreich
- Clinical Trials Service Unit & Epidemiological Studies Unit, University of Oxford, Oxford, Vereinigtes Königreich
| | - EJ Kantelhardt
- Klinik und Poliklinik für Gynäkologie, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
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Wienke A. Neue Anforderungen zur ärztlichen Aufklärung fremdsprachiger Patienten. HNO 2018; 66:153-154. [DOI: 10.1007/s00106-017-0407-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: 11/29/2022]
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Hofmann B, Fröhlich A, Richter S, Ehrhardt M, Zitterbart C, Wienke A, Treede H, Simm A. The Preoperative Physical-health Composite Score is a Good Predictor for Postoperative Morbidity in Elective Cardiac Surgery Patients. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627855] [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]
Affiliation(s)
- B. Hofmann
- Department of Cardiac Surgery, University Hospital Halle (Saale), Mid-German Heart Center, Halle, Germany
| | - A. Fröhlich
- Department of Cardiac Surgery, University Hospital Halle (Saale), Mid-German Heart Center, Halle, Germany
| | - S. Richter
- Department of Cardiac Surgery, University Hospital Halle (Saale), Mid-German Heart Center, Halle, Germany
| | - M. Ehrhardt
- Department of Cardiac Surgery, University Hospital Halle (Saale), Mid-German Heart Center, Halle, Germany
| | - C. Zitterbart
- Department of Cardiac Surgery, University Hospital Halle (Saale), Mid-German Heart Center, Halle, Germany
| | - A. Wienke
- Department of Biostatistics and Informatics, Institute of Medical Epidemiology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - H. Treede
- Department of Cardiac Surgery, University Hospital Halle (Saale), Mid-German Heart Center, Halle, Germany
| | - A. Simm
- Department of Cardiac Surgery, University Hospital Halle (Saale), Mid-German Heart Center, Halle, Germany
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Teichgräber U, Aschenbach R, Scheinert D, Zeller T, Brechtel K, Thieme M, Blessing E, Treitl M, Lichtenberg M, von Flotow P, Vogel B, Werk M, Riambau V, Wienke A, Lehmann T, Sixt S. Erratum to: The effectiveness of the paclitaxel-coated Luminor® balloon catheter versus an uncoated balloon catheter in superficial femoral and popliteal arteries in preventing vessel restenosis or reocclusion: study protocol for a randomized controlled trial. Trials 2017; 18:193. [PMID: 28446251 PMCID: PMC5405525 DOI: 10.1186/s13063-017-1884-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 03/09/2017] [Indexed: 11/18/2022] Open
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Kuball L, Wienke A. Vorsicht bei ärztlichen Abrechnungsempfehlungen. HNO 2017; 65:771-773. [DOI: 10.1007/s00106-016-0327-3] [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: 11/27/2022]
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Simm A, Jacobs K, Navarrete Santos A, Wienke A, Treede H, Hofmann B. CARDIAC TISSUE GLYCATION AND SKIN AUTOFLUORESCENCE IN CORONARY ARTERY DISEASE PATIENTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A. Simm
- Clinic for Heart Surgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - K. Jacobs
- Clinic for Heart Surgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - A. Navarrete Santos
- Clinic for Heart Surgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - A. Wienke
- Clinic for Heart Surgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - H. Treede
- Clinic for Heart Surgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - B. Hofmann
- Clinic for Heart Surgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
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Wienke A, Hübner L. Lebensverändernde Folgen nach grob fehlerhafter Nasennebenhöhlenoperation. Laryngorhinootologie 2017; 96:244-245. [PMID: 28493253 DOI: 10.1055/s-0042-114796] [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]
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Schob S, Surov A, Hoffmann K, Wienke A, Meyer H, Fiedler E, Spielmann R. Einfluss der AQP4 Expression auf DWI Parameter in Meningeomen. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- S Schob
- Uniklinik Leipzig, Klinik und Poliklinik für diagnostische und interventionelle Radiologie, Abt. für Neuroradiologie, Leipzig
| | - A Surov
- Uniklinik Leipzig, Diagnostische und Interventionelle Radiologie, Leipzig
| | - K Hoffmann
- Uniklinik Leipzig, Abteilung für Neuroradiologie, Leipzig
| | - A Wienke
- Universität Halle-Wittenberg, Institut für Biometrie und Statistik, Halle a.d. Saale
| | - H Meyer
- Uniklinik Halle-Wittenberg, Radiologie, Halle an der Saale
| | - E Fiedler
- Uniklinik Halle-Wittenberg, Institut für Dermatologie und Dermatopathologie
| | - R Spielmann
- Uniklinik Halle-Wittenberg, Radiologie, Halle an der Saale
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Wienke A. Das neue Zweitmeinungsverfahren. Laryngorhinootologie 2017; 96:118-119. [DOI: 10.1055/s-0042-108311] [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]
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Hofmann B, Gmelin M, Metz D, Raspé C, Wienke A, Treede H, Simm A. Cardiac Surgery Score (CASUS) for Outcome Prediction in Patients Treated with Extra Corporal Life Support (ECLS). Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598924] [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: 10/20/2022]
Affiliation(s)
- B. Hofmann
- Department of Cardiac Surgery, University Hospital Halle (Saale), Halle (Saale), Germany
| | - M. Gmelin
- Department of Urology, St. Barbara Hospital, Gladbeck, Germany
| | - D. Metz
- Department of Cardiac Surgery, University Hospital Halle (Saale), Halle (Saale), Germany
| | - C. Raspé
- Department of Anesthesiology and Critical Care Medicine, University Hospital Halle (Saale), Halle (Saale), Germany
| | - A. Wienke
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - H. Treede
- Department of Cardiac Surgery, University Hospital Halle (Saale), Halle (Saale), Germany
| | - A. Simm
- Department of Cardiac Surgery, University Hospital Halle (Saale), Halle (Saale), Germany
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Kuball L, Wienke A. [The pregnant surgeon : Scope and limitations of employment prohibition according to the draft of the new Maternity Protection Act ("Mutterschutzgesetz", MuSchG‑E)]. HNO 2017; 65:617-620. [PMID: 28078401 DOI: 10.1007/s00106-016-0324-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- L Kuball
- Rechtsanwälte Wienke & Becker - Köln, Sachsenring 6, 50677, Köln, Deutschland
| | - A Wienke
- Rechtsanwälte Wienke & Becker - Köln, Sachsenring 6, 50677, Köln, Deutschland.
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Kuball L, Sailer R, Wienke A. [Chief surgeon surgery only with a chief surgeon? : Liability in cases of inadmissible representation]. HNO 2017; 65:687-688. [PMID: 28078403 DOI: 10.1007/s00106-016-0326-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- L Kuball
- Rechtsanwälte Wienke & Becker - Köln, Sachsenring 6, 50677, Köln, Deutschland
| | - R Sailer
- Rechtsanwälte Wienke & Becker - Köln, Sachsenring 6, 50677, Köln, Deutschland
| | - A Wienke
- Rechtsanwälte Wienke & Becker - Köln, Sachsenring 6, 50677, Köln, Deutschland.
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Teichgräber U, Aschenbach R, Scheinert D, Zeller T, Brechtel K, Thieme M, Blessing E, Treitl M, Lichtenberg M, von Flotow P, Vogel B, Werk M, Riambau V, Wienke A, Lehmann T, Sixt S. The effectiveness of the paclitaxel-coated Luminor® balloon catheter versus an uncoated balloon catheter in superficial femoral and popliteal arteries in preventing vessel restenosis or reocclusion: study protocol for a randomized controlled trial. Trials 2016; 17:528. [PMID: 27793175 PMCID: PMC5084407 DOI: 10.1186/s13063-016-1657-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 10/13/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this investigator-initiated trial is to evaluate the safety and efficacy of the novel Luminor® paclitaxel-coated drug-eluting balloon (DEB) catheter (iVascular, S.L.U., Barcelona, Spain) in inhibiting restenosis and in ensuring long-term vascular patency. METHODS/DESIGN This is a multicenter randomized controlled trial to evaluate the Luminor® paclitaxel-coated DEB catheter for stenotic or occlusive lesions (length ≤15 cm) in the superficial femoral artery (SFA) and the popliteal artery (PA) up to the P1 segment compared to the noncoated, plain old balloon angioplasty (POBA) catheter. In total 172 subjects will be treated with either the DEB catheter or the POBA catheter in 11 German study centers in a 1:1 randomization study design. The primary endpoint is late lumen loss (LLL) at 6 months. Secondary endpoints are patency rate, target lesion/vessel revascularization, quality of life (assessed with the Walking Impairment Questionnaire (WIQ) and the EQ-5D), change of Rutherford stage and ankle-brachial index, major and minor amputation rate at the index limb, number of dropouts and all-cause mortality. DISCUSSION EffPac represents a randomized controlled trial that will provide evidence on the effectiveness of the Luminor® paclitaxel-coated DEB catheter for the reduction of restenosis compared to the POBA catheter for the SFA and the PA. The results of EffPac will allow direct comparison to other already-completed RCTs applying paclitaxel-coated DEBs from different manufacturers with different coating technologies in the same target vessel. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02540018 , registered on 17 August 2015. Protocol version: CIP Version Final04, 11 February 2016. EUDAMED No: CIV-15-03-013204.
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Affiliation(s)
- U Teichgräber
- Universitätsklinikum Jena, Institut für Diagnostische und Interventionelle Radiologie, Am Klinikum 1, 07747, Jena, Germany.
| | - R Aschenbach
- Universitätsklinikum Jena, Institut für Diagnostische und Interventionelle Radiologie, Am Klinikum 1, 07747, Jena, Germany
| | - D Scheinert
- Universitätsklinikum Leipzig, Abteilung für Interventionelle Angiologie, Philipp-Rosenthal-Straße 27 C, 04103, Leipzig, Germany
| | - T Zeller
- Herzzentrum Bad Krozingen, Südring 15, 79189, Bad Krozingen, Germany
| | - K Brechtel
- Ihre-Radiologen Berlin Gemeinschaftspraxis für Radiologie, Budapester Straße 15-19, 13347, Berlin, Germany
| | - M Thieme
- Medinos Kliniken Sonneberg Angiologie/Kardiologie/Diabetologie, Neustadter Str. 61, 96515, Sonneberg, Germany
| | - E Blessing
- SRH Klinikum Karlsbad-Langensteinbach, Guttmannstr. 1, 76307, Karlsbad, Germany
| | - M Treitl
- Klinikum der Ludwig Maximilians Universität München - Campus Innenstadt, Institut für Klinische Radiologie, Pettenkoferstraße 8a, 80336, München, Germany
| | - M Lichtenberg
- Klinikum Arnsberg Angiologie, Stolte Ley 5, 59759, Arnsberg, Germany
| | - P von Flotow
- Westpfalz-Klinikum GmbH Standort II Kusel, Im Flur 1, 66869, Kusel, Germany
| | - B Vogel
- Ruprecht-Karls-Universität Heidelberg, Analysezentrum III/Innere Medizin III, Im Neuenheimer Feld 669, 69120, Heidelberg, Germany
| | - M Werk
- Martin-Luther-Krankenhausbetrieb GmbH, Caspar-Theyß-Straße 27-31, 14193, Berlin, Germany
| | - V Riambau
- Hospital Clínic de Barcelona, Carrer de Villarroel, 170, 08036, Barcelona, Spain
| | - A Wienke
- Martin-Luther-Universität Halle-Wittenberg, Institut für Medizinische Epidemiologie, Biometrie und Informatik, 06097, Halle (Saale), Germany
| | - T Lehmann
- Universitätsklinikum Jena, Zentrum für Klinische Studien (ZKS), Postfach, 07740, Jena, Germany
| | - S Sixt
- Angiologikum Hamburg, Wördemanns Weg 25-27, 22527, Hamburg, Germany
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Martenstein I, Wienke A. Das neue E-Health-Gesetz Was kommt auf Kliniken und niedergelassene Ärzte zu? Laryngorhinootologie 2016; 95:417-8. [DOI: 10.1055/s-0041-111138] [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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Kuball L, Wienke A. Die neue Krankenhauseinweisungs-Richtlinie. HNO 2016; 64:331-2. [DOI: 10.1007/s00106-015-0117-3] [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: 11/27/2022]
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Wienke A, Martenstein I. [After all: More than one permanent medical proxy allowed : OLG strengthens the position of private invoicing-entitled chief physicians]. HNO 2016; 64:680-2. [PMID: 27090646 DOI: 10.1007/s00106-016-0135-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- A Wienke
- Wienke & Becker - Köln, Sachsenring 6, 50677, Köln, Deutschland.
| | - I Martenstein
- Wienke & Becker - Köln, Sachsenring 6, 50677, Köln, Deutschland
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Wieczorrek G, Weber U, Wienke A, Egner E, Schröder J, Vogt A, Müller-Werdan U, Weber A, Steighardt J, Girschick C, Schlitt A. [Adherence to Phase III Cardiac Rehabilitation Programs: A Prospective, Randomized Comparison between a Conventionally Conducted Program and a Tai Chi-Based Program]. Sportverletz Sportschaden 2016; 30:95-100. [PMID: 27064493 DOI: 10.1055/s-0042-100952] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION In patients with cardiac diseases, lifestyle changes such as an increase in physical activity are recommended to prevent further cardiac events. In Germany this is possible by attending outpatient heart groups. A problem inherent in these programs is the lack of adherence since more than two thirds of patients stop attending cardiac rehabilitation programs after six months. An alternative to the conventional implementation of heart groups is Tai Chi, which was found to improve adherence to cardiac rehabilitation programs in international studies. METHODS Patients were randomly assigned to a conventional heart group or a heart group with Tai Chi exercises. At the beginning of the study, a medical history was taken and physical and instrumental tests were carried out, including an assessment of anxiety/depression (HADS questionnaire) and physical well-being (SD-12). Follow-up tests were performed every three months. RESULTS Patients were 62.6 ± 8.5 years old, the mean BMI was 28.6 ± 62 kg/m(2), and the proportion of women was 29.8 %. The groups were different in terms of age (conventional heart group: 65.0 ± 7.5; Tai Chi group: 59.9 ± 8.9 years). Therefore, age-adjusted analyses were performed in addition to the planned analyses. Regarding the primary endpoint of the study, there was no difference between the groups. After twelve months, 50 % of subjects were active in the Tai Chi group and 48 % in the conventional heart group (odds ratio 0.92, p = 0.891). After adjustment for age by logistic regression, the odds ratio was 0.47 (p = 0.285). Furthermore, both the participation period in weeks (Tai Chi group: 43.3 ± 26.0; conventional group: 45.5 ± 24.2, p = 0.766) and the participation rate (Tai Chi group: 66.8 ± 19.2 % Tai Chi, conventional group: 76.3 ± 16.5 %, p = 0.074) did not differ between the two groups. A further analysis showed a non-significant trend for improvement of anxiety, depression and physical well-being in the Tai Chi group compared with the conventional group. CONCLUSION The insight gained in international studies regarding a better adherence to Tai Chi-guided prevention programs was not transferable to heart group participants from Germany. However, there was a trend regarding a better mental condition in the Tai Chi group.
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Affiliation(s)
- G Wieczorrek
- Paracelsus-Harz-Klinik Bad Suderode, Quedlinburg
| | - U Weber
- Institut für Rehabilitationspädagogik, Philosophische Fakultät III, Erziehungswissenschaften, Martin-Luther-Universität Halle-Wittenberg
| | - A Wienke
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Universitätsklinikum Halle (Saale)
| | | | - J Schröder
- Klinik und Poliklinik für Innere Medizin III, Universitätsklinikum Halle (Saale)
| | - A Vogt
- Klinik und Poliklinik für Innere Medizin III, Universitätsklinikum Halle (Saale)
| | - U Müller-Werdan
- Klinik und Poliklinik für Innere Medizin III, Universitätsklinikum Halle (Saale)
| | - A Weber
- Institut für Gesundheits- und Pflegewissenschaft, Martin-Luther-Universität Halle-Wittenberg
| | - J Steighardt
- Koordinierungszentrum für Klinische Studien, Medizinische Fakultät der Martin-Luther-Universität Halle-Wittenberg
| | - C Girschick
- Paracelsus-Harz-Klinik Bad Suderode, Quedlinburg
| | - A Schlitt
- Paracelsus-Harz-Klinik Bad Suderode, Quedlinburg
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Wienke A, Martenstein I. Jetzt doch: Mehrere ständige ärztliche Vertreter zulässig OLG stärkt die Rechte der privatliquidationsberechtigten Chefärzte. Laryngorhinootologie 2016; 95:268-9. [DOI: 10.1055/s-0041-108210] [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]
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