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Jantke B, Sehouli J, Rose M, Boer J, Jantke A, Dimitrova D, Woopen H, Pirmorady-Sehouli A. Role of Creative Therapies in Gynecological Oncology: Results of a Multigenerational Survey in Patients and Caregivers. Cancers (Basel) 2024; 16:599. [PMID: 38339349 PMCID: PMC10854532 DOI: 10.3390/cancers16030599] [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: 11/30/2023] [Revised: 01/12/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
INTRODUCTION Although creative therapies like painting, dancing, and writing are often used and encouraged to treat various diseases, including cancer, there are few systematic scientific studies on innovative therapies in medical care. METHODS An anonymous survey was developed for female patients, their relatives, and female medical staff on the impact of creative therapies on optimizing clinical therapy management in exclusively female trials. RESULTS Of 718 respondents, 358 were female patients, 69 were medical personnel, and 291 were in the control group. Overall, 91.2% of respondents had sought access to creative therapies, indicating strong self-motivated engagement in activities to improve health and well-being. This study also uncovered a significant preference for creative writing among patients. Furthermore, the data suggest that integrating innovative therapies into biopsychosocial anamnesis could offer valuable insights into patients' mobility, mood, and social behaviors. Despite a general hesitation to discuss leisure activities with medical professionals, many patients wanted to incorporate creative activities into their treatment plans. Moreover, group settings for innovative therapy were preferred, highlighting the need for more structured support in medical environments to facilitate these therapeutic interactions. CONCLUSIONS This study suggests creative therapies can be valuable in medical care.
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Affiliation(s)
- Bettina Jantke
- Kinderwunschärzte Berlin, Center for Sterility Treatment and Fertility Protection, 14195 Berlin, Germany
- Medical Department, Section of Psychosomatic Medicine, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Jalid Sehouli
- Department of Gynecology with Center for Oncological Surgery, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany; (J.S.)
- North-Eastern German Society of Gynecological Oncology (NOGGO), 13359 Berlin, Germany
- European Guild for Medicine and Culture (EUKMK), 10827 Berlin, Germany
| | - Matthias Rose
- Medical Department, Section of Psychosomatic Medicine, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Jolijn Boer
- Department of Gynecology with Center for Oncological Surgery, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany; (J.S.)
| | - Andreas Jantke
- Kinderwunschärzte Berlin, Center for Sterility Treatment and Fertility Protection, 14195 Berlin, Germany
| | - Desislava Dimitrova
- Department of Gynecology with Center for Oncological Surgery, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany; (J.S.)
- North-Eastern German Society of Gynecological Oncology (NOGGO), 13359 Berlin, Germany
| | - Hannah Woopen
- Department of Gynecology with Center for Oncological Surgery, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany; (J.S.)
- North-Eastern German Society of Gynecological Oncology (NOGGO), 13359 Berlin, Germany
| | - Adak Pirmorady-Sehouli
- Medical Department, Section of Psychosomatic Medicine, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany
- European Guild for Medicine and Culture (EUKMK), 10827 Berlin, Germany
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Herzog EM, Pirmorady Sehouli A, Boer J, Pietzner K, Petru E, Heinzelmann V, Roser E, Dimitrova D, Oskay-Özcelik G, Camara O, Sehouli J. How to break bad news and how to learn this skill: results from an international North-Eastern German Society for Gynecological Oncology (NOGGO) survey among physicians and medical students with 1089 participants. Int J Gynecol Cancer 2023; 33:1934-1942. [PMID: 38052472 PMCID: PMC10804030 DOI: 10.1136/ijgc-2023-004693] [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: 05/30/2023] [Accepted: 10/09/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Delivering bad news to patients is one of the most challenging tasks in medical practice. Despite its great relevance to patients, relatives, and medical staff, there is a paucity of data pertaining to training, experience, expectations, and preferences of physicians and medical students on breaking bad news. METHODS We conducted an international survey in Germany, Switzerland, and Austria using an online questionnaire among physicians and medical students. RESULTS A total of 786 physicians and 303 medical students completed the survey. Physicians stated that 32.7% deliver bad news several times a week and 45.2% several times a month. Difficulties controlling their emotions (35.1%) and remaining professional (43.4%) were the greatest challenges for physicians. Delivering bad news is associated with feelings of anxiety, both among experienced physicians (median of 3.8 out of 10.0) and medical students (median of 5.3). Conveying bad news is a burden to physicians and consequently has a substantial impact on their job satisfaction. All participants reported the need for more communication training concerning this subject. Only 49.5% of medical students and 67.3% of physicians mentioned having learned adequate communication skills. Our data demonstrate that communication training decreases the level of anxiety and increases the feeling of self-confidence towards breaking bad news. Preferred educational tools were seminars with simulation (students: 71.4%, physicians: 49.5%), observing more senior faculty (students: 57.4%, physicians: 55.1%), and supervision and feedback sessions (students: 36.3%, physicians: 45.7%). The largest barriers regarding education on communication were limited time (students: 77.0%, physicians: 74.9%) and missing awareness of supervisors (students: 60.6%, physicians: 41.1%). CONCLUSIONS Our study showed a great need for systematic training and education in breaking bad news among physicians and medical students. Hospitals, medical schools, and postgraduate training programs are strongly encouraged to fill this gap, and improve sustainable doctor-patient communication to overcome the psychological burden for physicians.
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Affiliation(s)
- Emilie M Herzog
- Department of Gynecology, Center for Oncological Surgery, Campus Virchow Klinikum, Charité University Hospital Berlin, Berlin, Germany
| | - Adak Pirmorady Sehouli
- Department of Psychosomatic Medicine, Charité University Hospital Berlin, Berlin, Germany
- European Art Guild for Medicine and Culture, Berlin, Germany
| | - Jolijn Boer
- North-Eastern German Society for Gynecological Oncology (NOGGO eV), Berlin, Germany
| | - Klaus Pietzner
- Department of Gynecology, Center for Oncological Surgery, Campus Virchow Klinikum, Charité University Hospital Berlin, Berlin, Germany
| | - Edgar Petru
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Viola Heinzelmann
- Department of Gynecology and Gynecological Oncology, University Hospital Basel, Basel, Switzerland
| | - Eva Roser
- Department of Gynecology, Center for Oncological Surgery, Campus Virchow Klinikum, Charité University Hospital Berlin, Berlin, Germany
| | - Desislava Dimitrova
- Department of Gynecology, Center for Oncological Surgery, Campus Virchow Klinikum, Charité University Hospital Berlin, Berlin, Germany
| | - Gülten Oskay-Özcelik
- North-Eastern German Society for Gynecological Oncology (NOGGO eV), Berlin, Germany
| | - Oumar Camara
- North-Eastern German Society for Gynecological Oncology (NOGGO eV), Berlin, Germany
- Department of Gynecological Oncology and Breast Centre, Helios Hospital Gotha, Gotha, Germany
| | - Jalid Sehouli
- Department of Gynecology, Center for Oncological Surgery, Campus Virchow Klinikum, Charité University Hospital Berlin, Berlin, Germany
- European Art Guild for Medicine and Culture, Berlin, Germany
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Dimitrova D, Sehouli J. [Promoting intercultural competencies in the healthcare sector through further education and training]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023; 66:1126-1129. [PMID: 37721567 PMCID: PMC10539411 DOI: 10.1007/s00103-023-03768-3] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/24/2023] [Indexed: 09/19/2023]
Abstract
Acceptance of cultural diversity and the recognition and appreciation of facets of "otherness" such as gender, age, occupational or disease-related group, religion, sociocultural background, and migration history are basic requirements for adequate communication and interaction in healthcare. The term intercultural competence is multidimensional and includes a range of qualities and skills with emotional and cognitive elements with influence on the behavioral level. In the present paper, we discuss the importance of intercultural competence for the healthcare system and which aspects of the intercultural communication are particularly relevant for culturally sensitive medical care. Additionally, we report on the implementation of an interprofessional program and continuing education concept for clinical practice: Interprofessional and Intercultural Work in Medicine, Nursing and Social Services (IPIKA).The basis of the specific approaches to improving intercultural competence should be the systematic education and training of basic communication skills. This concerns almost all curricula for the medical professions. It is important to emphasize that intercultural competence is a core and cross-sectional topic for all healthcare providers.
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Affiliation(s)
- Desislava Dimitrova
- Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie, Europäisches Kompetenzzentrum für Eierstockkrebs (EKZE), Charité Comprehensive Cancer Center (CCCC), Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland.
| | - Jalid Sehouli
- Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie, Europäisches Kompetenzzentrum für Eierstockkrebs (EKZE), Charité Comprehensive Cancer Center (CCCC), Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland
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Boyanov N, Andonov V, Shtereva K, Madzharova K, Stoynov N, Dimitrova D, Yankov I. Initial experience in target peroral endoscopic submucosal myotomy combined with septotomy for epiphrenic diverticulum. Folia Med (Plovdiv) 2023; 65:490-494. [PMID: 38351827 DOI: 10.3897/folmed.65.e83893] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 04/18/2022] [Indexed: 02/16/2024] Open
Abstract
The epiphrenic esophageal diverticulum is a rare non-malignant condition that is commonly associated with motility disorders. It would normally be treated surgically, but with the advancement of endoscopy techniques, peroral endoscopic myotomy with septotomy (D-POEM) has shown its benefits in coping with the symptoms. We present a case of a 71-year-old woman with increasing symptoms of dysphagia, weight loss and imaging data showing a large epiphrenic diverticulum. We treated her using peroral endoscopic myotomy combined with septotomy of the diverticular septum. The procedure showed excellent results with reducing the amount of contrast materials retained in it, improving the quality of life of the patient, and increasing her weight. There were minimal adverse events and no perforations or severe adverse effects occurred. D-POEM is a new and rapidly evolving procedure that is proving to be a safe and effective method of treating epiphrenic esophageal diverticulum.
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Affiliation(s)
| | | | | | | | | | | | - Ivan Yankov
- Medical University of Plovdiv, Plovdiv, Bulgaria
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Schuetz C, Gerke J, Ege M, Walter J, Kusters M, Worth A, Kanakry JA, Dimitrova D, Wolska-Kuśnierz B, Chen K, Unal E, Karakukcu M, Pashchenko O, Leiding J, Kawai T, Amrolia PJ, Berghuis D, Buechner J, Buchbinder D, Cowan MJ, Gennery AR, Güngör T, Heimall J, Miano M, Meyts I, Morris EC, Rivière J, Sharapova SO, Shaw PJ, Slatter M, Honig M, Veys P, Fischer A, Cavazzana M, Moshous D, Schulz A, Albert MH, Puck JM, Lankester AC, Notarangelo LD, Neven B. Hypomorphic RAG deficiency: impact of disease burden on survival and thymic recovery argues for early diagnosis and HSCT. Blood 2023; 141:713-724. [PMID: 36279417 PMCID: PMC10082356 DOI: 10.1182/blood.2022017667] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/19/2022] [Accepted: 10/04/2022] [Indexed: 11/20/2022] Open
Abstract
Patients with hypomorphic mutations in the RAG1 or RAG2 gene present with either Omenn syndrome or atypical combined immunodeficiency with a wide phenotypic range. Hematopoietic stem cell transplantation (HSCT) is potentially curative, but data are scarce. We report on a worldwide cohort of 60 patients with hypomorphic RAG variants who underwent HSCT, 78% of whom experienced infections (29% active at HSCT), 72% had autoimmunity, and 18% had granulomas pretransplant. These complications are frequently associated with organ damage. Eight individuals (13%) were diagnosed by newborn screening or family history. HSCT was performed at a median of 3.4 years (range 0.3-42.9 years) from matched unrelated donors, matched sibling or matched family donors, or mismatched donors in 48%, 22%, and 30% of the patients, respectively. Grafts were T-cell depleted in 15 cases (25%). Overall survival at 1 and 4 years was 77.5% and 67.5% (median follow-up of 39 months). Infection was the main cause of death. In univariable analysis, active infection, organ damage pre-HSCT, T-cell depletion of the graft, and transplant from a mismatched family donor were predictive of worse outcome, whereas organ damage and T-cell depletion remained significant in multivariable analysis (hazard ratio [HR] = 6.01, HR = 8.46, respectively). All patients diagnosed by newborn screening or family history survived. Cumulative incidences of acute and chronic graft-versus-host disease were 35% and 22%, respectively. Cumulative incidences of new-onset autoimmunity was 15%. Immune reconstitution, particularly recovery of naïve CD4+ T cells, was faster and more robust in patients transplanted before 3.5 years of age, and without organ damage. These findings support the indication for early transplantation.
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Affiliation(s)
- C. Schuetz
- Department of Paediatrics, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - J. Gerke
- Department of Paediatrics, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - M. Ege
- Dr. von Hauner Children’s Hospital at Ludwig-Maximilians-Universität, München, Germany
- Helmholtz Zentrum München, Neuherberg, Germany
| | - J. Walter
- Division of Allergy and Immunology, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL
- Division of Allergy and Immunology, Department of Medicine, Johns Hopkins All Children’s Hospital, St. Petersburg, FL
| | - M. Kusters
- Department of Immunology and Gene therapy, Great Ormond Street Hospital, NHS Foundation trust, London, United Kingdom
| | - A. Worth
- Department of Immunology and Gene therapy, Great Ormond Street Hospital, NHS Foundation trust, London, United Kingdom
| | - J. A. Kanakry
- Experimental Transplantation and Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - D. Dimitrova
- Experimental Transplantation and Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - B. Wolska-Kuśnierz
- Department of Immunology, Children's Memorial Health Institute, Warsaw, Poland
| | - K. Chen
- Division of Allergy and Immunology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT
| | - E. Unal
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Erciyes University, Kayseri, Turkey
| | - M. Karakukcu
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Erciyes University, Kayseri, Turkey
| | - O. Pashchenko
- Department of Immunology, Pirogov Russian National Research Medical University, Moscow, Russia
| | - J. Leiding
- Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Orlando Health Arnold Pamer Hospital for Children, Orlando, FL
| | - T. Kawai
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - P. J. Amrolia
- Bone Marrow Transplant Unit, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
| | - D. Berghuis
- Department of Pediatrics, Willem-Alexander Children’s Hospital, Leiden University Medical Center, Leiden, The Netherlands
| | - J. Buechner
- Department of Pediatric Hematology and Oncology, Oslo University Hospital, Oslo, Norway
| | - D. Buchbinder
- Division of Hematology, Children's Hospital of Orange County, Orange, CA
| | - M. J. Cowan
- Division of Allergy, Immunology, and Blood and Marrow Transplant, Department of Pediatrics, University of California San Francisco, San Francisco, CA
| | - A. R. Gennery
- Translational and Clinical Research Institute, Newcastle University, Paediatric Haematopoietic Stem Cell Transplant Unit, Great North Children’s Hospital, Newcastle upon Tyne, United Kingdom
| | - T. Güngör
- Department of Hematology/Oncology/Immunology, Gene-therapy, and Stem Cell Transplantation, University Children’s Hospital Zurich–Eleonore Foundation & Children’s Research Center, Zürich, Switzerland
| | - J. Heimall
- Division of Allergy and Immunology, Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA
| | - M. Miano
- IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - I. Meyts
- Department of Pediatrics, Department of Microbiology and Immunology, University Hospitals Leuven, Leuven, Belgium
| | - E. C. Morris
- UCL Institute of Immunity & Transplantation, University College London Hospitals NHS Foundation Trust, Royal Free London Hospital NHS Foundation Trust, London, United Kingdom
| | - J. Rivière
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Vall d'Hebron Research Institute, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S. O. Sharapova
- Research Department, Belarusian Research Center for Pediatric Oncology, Hematology and Immunology, Minsk, Belarus
| | - P. J. Shaw
- Blood Transplant and Cell Therapies, Children’s Hospital at Westmead, Sydney, Australia
| | - M. Slatter
- Paediatric Immunology & HSCT, Great North Children's Hospital, Newcastle upon Tyne, United Kingdom
| | - M. Honig
- Department of Pediatrics and Adolescent Medicine, Ulm University, Ulm, Germany
| | - P. Veys
- Bone Marrow Transplant Unit, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
| | - A. Fischer
- Paediatric Immunology, Department of Immunology, Haematology and Rheumatology, Necker-Enfants Malades, Paris, France
- Institut Imagine, Paris Descartes-Sorbonne Paris Cité University, Paris, France
- Collège de France, Paris, France
| | - M. Cavazzana
- Institut Imagine, Paris Descartes-Sorbonne Paris Cité University, Paris, France
- Département de Biothérapie, Hôpital Universitaire Necker-Enfants Malades, Groupe Hospitalier Paris Centre, Assistance Publique–Hopitaux de Paris, Paris, France
- Centre d’Investigation Clinique Biothérapie, Groupe hospitalier Universitaire paris centre, Assistance Publique-Hôpitaux de Paris, INSERM CIC 1416, Paris, France
| | - D. Moshous
- Paediatric Immunology, Department of Immunology, Haematology and Rheumatology, Necker-Enfants Malades, Paris, France
- Institut Imagine, Paris Descartes-Sorbonne Paris Cité University, Paris, France
| | - A. Schulz
- Department of Pediatrics and Adolescent Medicine, Ulm University, Ulm, Germany
| | - M. H. Albert
- Pediatric SCT Program, Dr. von Hauner University Children’s Hospital, Ludwig-Maximilians Universität, München, Germany
| | - J. M. Puck
- Division of Allergy, Immunology, and Blood and Marrow Transplant, Department of Pediatrics, University of California San Francisco, San Francisco, CA
| | - A. C. Lankester
- Department of Pediatrics, Willem-Alexander Children’s Hospital, Leiden University Medical Center, Leiden, The Netherlands
| | - L. D. Notarangelo
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - B. Neven
- Paediatric Immunology, Department of Immunology, Haematology and Rheumatology, Necker-Enfants Malades, Paris, France
| | - Inborn Errors Working Party (IEWP) of the European Society for Immunodeficiencies (ESID) and European Society for Blood and Marrow Transplantation (EBMT) and the Primary Immune Deficiency Treatment Consortium (PIDTC)
- Department of Paediatrics, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Dr. von Hauner Children’s Hospital at Ludwig-Maximilians-Universität, München, Germany
- Helmholtz Zentrum München, Neuherberg, Germany
- Division of Allergy and Immunology, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL
- Division of Allergy and Immunology, Department of Medicine, Johns Hopkins All Children’s Hospital, St. Petersburg, FL
- Department of Immunology and Gene therapy, Great Ormond Street Hospital, NHS Foundation trust, London, United Kingdom
- Experimental Transplantation and Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
- Department of Immunology, Children's Memorial Health Institute, Warsaw, Poland
- Division of Allergy and Immunology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Erciyes University, Kayseri, Turkey
- Department of Immunology, Pirogov Russian National Research Medical University, Moscow, Russia
- Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Orlando Health Arnold Pamer Hospital for Children, Orlando, FL
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
- Bone Marrow Transplant Unit, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
- Department of Pediatrics, Willem-Alexander Children’s Hospital, Leiden University Medical Center, Leiden, The Netherlands
- Department of Pediatric Hematology and Oncology, Oslo University Hospital, Oslo, Norway
- Division of Hematology, Children's Hospital of Orange County, Orange, CA
- Division of Allergy, Immunology, and Blood and Marrow Transplant, Department of Pediatrics, University of California San Francisco, San Francisco, CA
- Translational and Clinical Research Institute, Newcastle University, Paediatric Haematopoietic Stem Cell Transplant Unit, Great North Children’s Hospital, Newcastle upon Tyne, United Kingdom
- Department of Hematology/Oncology/Immunology, Gene-therapy, and Stem Cell Transplantation, University Children’s Hospital Zurich–Eleonore Foundation & Children’s Research Center, Zürich, Switzerland
- Division of Allergy and Immunology, Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA
- IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Pediatrics, Department of Microbiology and Immunology, University Hospitals Leuven, Leuven, Belgium
- UCL Institute of Immunity & Transplantation, University College London Hospitals NHS Foundation Trust, Royal Free London Hospital NHS Foundation Trust, London, United Kingdom
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Vall d'Hebron Research Institute, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
- Research Department, Belarusian Research Center for Pediatric Oncology, Hematology and Immunology, Minsk, Belarus
- Blood Transplant and Cell Therapies, Children’s Hospital at Westmead, Sydney, Australia
- Paediatric Immunology & HSCT, Great North Children's Hospital, Newcastle upon Tyne, United Kingdom
- Department of Pediatrics and Adolescent Medicine, Ulm University, Ulm, Germany
- Bone Marrow Transplant Unit, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
- Paediatric Immunology, Department of Immunology, Haematology and Rheumatology, Necker-Enfants Malades, Paris, France
- Institut Imagine, Paris Descartes-Sorbonne Paris Cité University, Paris, France
- Collège de France, Paris, France
- Département de Biothérapie, Hôpital Universitaire Necker-Enfants Malades, Groupe Hospitalier Paris Centre, Assistance Publique–Hopitaux de Paris, Paris, France
- Centre d’Investigation Clinique Biothérapie, Groupe hospitalier Universitaire paris centre, Assistance Publique-Hôpitaux de Paris, INSERM CIC 1416, Paris, France
- Pediatric SCT Program, Dr. von Hauner University Children’s Hospital, Ludwig-Maximilians Universität, München, Germany
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
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Demouche S, Poncin R, Grolleau C, Merandet M, Bergerat D, Majello S, Dimitrova D, Lipin S, Bouaziz J, Le Buanec H. 279 Instrument-free single-cell resolution of transcriptome in human skin. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.291] [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: 11/19/2022]
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Koch E, Torsten U, Mecke H, Richter R, Hellmeyer L, Nohe G, Müller B, Boeneß-Zaloum J, Ames K, Chen F, Beteta C, Hasenbein K, Pirmorady A, Zimmermann M, Dimitrova D, Tauber R, Sehouli J, Knieper CL, Ioana Braicu E. Patients' subjective assessment as a decisive predictor of malignancy in pelvic masses: results of a multicentric, prospective pelvic mass study. J Psychosom Obstet Gynaecol 2022; 43:273-278. [PMID: 33252280 DOI: 10.1080/0167482x.2020.1850684] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE The prognosis for ovarian cancer patients remains poor. A key to maximizing survival rates is early detection and treatment. This requires an accurate prediction of malignancy. Our study seeks to improve the accuracy of prediction by focusing on early subjective assessment of malignancy. We therefore investigated the assessment of patients themselves in comparison to the assessment of physicians. METHODS One thousand three hundred and thirty patients participated in a prospective and multicenter study in six hospitals in Berlin. Using univariate analysis and multivariate logistic regression models, we measured the accuracy of the early subjective assessment in comparison to the final histological outcome. Moreover, we investigated factors related to the assessment of patients and physicians. RESULTS The patients' assessment of malignancy is remarkably accurate. With a positive predictive value of 58%, the majority of patients correctly assessed a pelvic mass as malignant. With more information available, physicians achieved only a slightly more accurate prediction of 63%. CONCLUSIONS For the first time, our study considered subjective factors in the diagnostic process of pelvic masses. This paper demonstrates that the patients' personal assessment should be taken seriously as it can provide a significant contribution to earlier diagnosis and thus improved therapy and overall prognosis.
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Affiliation(s)
- Elisa Koch
- Department of Gynecology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Uwe Torsten
- Department for Gynecology, Vivantes Klinikum Neukölln, Berlin, Germany
| | - Herbert Mecke
- Department for Obstetrics and Gynecology, AVK Vivantes, Berlin, Germany
| | - Rolf Richter
- Department of Gynecology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Lars Hellmeyer
- Department for Obstetrics and Gynecology, Vivantes Klinikum Friedrichshain, Berlin, Germany
| | - Gerhard Nohe
- Department for Obstetrics and Gynecology, Vivantes Klinikum am Urban, Berlin, Germany
| | - Bodo Müller
- Department for Gynecology, Vivantes Klinikum Kaulsdorf, Berlin, Germany
| | - Janine Boeneß-Zaloum
- Department for Obstetrics and Gynecology, Vivantes Klinikum Friedrichshain, Berlin, Germany
| | - Kerstin Ames
- Department for Gynecology, Vivantes Klinikum Neukölln, Berlin, Germany
| | - Frank Chen
- Department for Obstetrics and Gynecology, AVK Vivantes, Berlin, Germany
| | - Carmen Beteta
- Department of Gynecology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Kati Hasenbein
- Department for Gynecology, Vivantes Humboldt-Klinikum, Berlin, Germany
| | - Adak Pirmorady
- Department of Gynecology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Mathias Zimmermann
- Central Institute of Laboratory Medicine, DRK Kliniken Berlin, Berlin, Germany
| | - Desislava Dimitrova
- Department of Gynecology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Rudolf Tauber
- Institute of Laboratory Medicine, Clinical Chemistry and Pathobiochemistry, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Jalid Sehouli
- Department of Gynecology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Catherine Linn Knieper
- Department of Gynecology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Elena Ioana Braicu
- Department of Gynecology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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8
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Taghvaei R, Dimitrova D, Karaman M, Sehouli J. Knowledge and understanding risk factors and preventive measures for osteoporosis in women: results of a survey in 502 women with and without a migration background. BMC Musculoskelet Disord 2022; 23:824. [PMID: 36042427 PMCID: PMC9429362 DOI: 10.1186/s12891-022-05773-0] [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] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 08/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Osteoporosis is a disease of the skeletal system associated with loss of bone mass and an increased risk of fractures affecting women more often than men. Identification of the knowledge about osteoporosis and its preventive methods is the backbone of any awareness program. This study investigates the knowledge with a special focus on women with and without a migration background. METHODS Data from systematic patient interviews based on a questionnaire were collected at three different sites in Berlin between February and June 2021. The survey included questions assessing migrant background, demographic characteristics, lifestyle habits including physical exercise and smoking, prevention by vitamin D intake and bone densitometry, and information on personal and family medical history. According to the responses, a scale was created to assess the level of knowledge of preventive osteoporosis measures. The ethic committee of the Charité, Medical faculty has approved this study. SPSS (version 24.0) was used for the statistical analyses. RESULTS The survey of 502 female patients revealed that 25% had low and 34% no previous knowledge of osteoporosis. Older age and a better education level correlate with a higher knowledge. Patients with gynecologic cancer are less well informed. There is a significant difference in vitamin D intake between migrant and non-migrant women (57% vs. 49%). There were no significant differences regarding the use of bone densitometry. CONCLUSION Knowledge of osteoporosis and the possibility of a bone densitometry as well as the implementation of preventive measures is low among women. Therefore, informing patients better should be a priority, with particular attention on the risks and needs of women with a migration background. Specific programs for women with and without migration background should be developed to increase the awareness of osteoporosis.
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Affiliation(s)
- Reza Taghvaei
- Department of Gynecology with Center for Oncological Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
- Orthopedic Praxis Center Berlin, Berlin, Germany
| | - Desislava Dimitrova
- Department of Gynecology with Center for Oncological Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
| | | | - Jalid Sehouli
- Department of Gynecology with Center for Oncological Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
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9
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Hudelist G, Korell M, Burkhardt M, Chvatal R, Darici E, Dimitrova D, Drahonovsky J, Haj Hamoud B, Hornung D, Krämer B, Noe G, Oppelt P, Schäfer S, Seeber B, Ulrich UA, Wenzl R, De Wilde RL, Wimberger P, Senft B, Keckstein J, Montanari E, Vaineau C, Sillem M. Rates of severe complications in patients undergoing colorectal surgery for deep endometriosis-a retrospective multicenter observational study. Acta Obstet Gynecol Scand 2022; 101:1057-1064. [PMID: 35818905 PMCID: PMC9812092 DOI: 10.1111/aogs.14418] [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: 02/22/2022] [Revised: 06/06/2022] [Accepted: 06/16/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Surgical experience and hospital procedure volumes have been associated with the risk of severe complications in expert centers for endometriosis in France. However, little is known about other certified units in Central European countries. MATERIAL AND METHODS This retrospective observational study included 937 women who underwent surgery for colorectal endometriosis between January 2018 and January 2020 in 19 participating expert centers for endometriosis. All women underwent complete excision of colorectal endometriosis by rectal shaving, discoid or segmental resection. Postoperative severe complications were defined as grades III-IV of the Clavien-Dindo classification system including anastomotic leakage, fistula, pelvic abscess and hematoma. Surgical outcomes of centers performing less than 40 (group 1), 40-59 (group 2) and ≥60 procedures (group 3) over a period of 2 years were compared. RESULTS The overall complication rate of grade III and IV complications was 5.1% (48/937), with rates of anastomotic leakage, fistula formation, abscess and hemorrhage in segmental resection, discoid resection and rectal shaving, respectively, as follows: anastomotic leakage 3.6% (14/387), 1.4% (3/222), 0.6% (2/328); fistula formation 1.6% (6/387), 0.5% (1/222), 0.9%; (3/328); abscess 0.5% (2/387), 0% (0/222) and 0.6% (2/328); hemorrhage 2.1% (8/387), 0.9% (2/222) and 1.5% (5/328). Higher overall complication rates were observed for segmental resection (30/387, 7.8%) than for discoid (6/222, 2.7%, P = 0.015) or shaving procedures (12/328, 3.7%, P = 0.089). No significant correlation was observed between the number of procedures performed and overall complication rates (rSpearman = -0.115; P = 0.639) with a high variability of complications in low-volume centers (group 1). However, an intergroup comparison revealed a significantly lower overall severe complication rate in group 3 than in group 2 (2.9% vs 6.9%; P = 0.017) without significant differences between other groups. CONCLUSIONS A high variability in complication rates does exist in centers with a low volume of activity. Major complications may decrease with an increase in the volume of activity but this effect cannot be generally applied to all institutions and settings.
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Affiliation(s)
- Gernot Hudelist
- Department of Gynecology, Center for EndometriosisHospital St. John of God; Rudolfinerhaus Private Clinic and CampusViennaAustria
| | - Matthias Korell
- Department of Obstetrics and GynecologyJohanna‐Etienne‐HospitalNeussGermany
| | - Michael Burkhardt
- Department of Obstetrics and GynecologyMedius Klinik OstfildernOstfildernGermany
| | - Radek Chvatal
- Department of Obstetrics and GynecologyZnojmo District HospitalZnojmoCzech Republic
| | - Ezgi Darici
- Brussels IVF, Center for Reproductive Medicine Universitair Ziekenhuis BrusselVrije Universiteit BrusselBrusselsBelgium
| | - Desislava Dimitrova
- Department of Obstetrics and Gynecology with Center for Oncological SurgeryCharité – Universitätsmedizin, Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of HealthBerlinGermany
| | - Jan Drahonovsky
- Department of Obstetrics and Department of GynecologyUniversity of PraguePragueCzech Republic
| | - Bashar Haj Hamoud
- Department of Obstetrics and GynecologyUniversity SaarlandHomburgGermany
| | - Daniela Hornung
- Department of Obstetrics and GynecologyVidiakliniken, Diakonissen Hospital KarlsruheKarlsruheGermany
| | - Bernhard Krämer
- Department of Obstetrics and Department of GynecologyUniversity of TübingenTübingenGermany
| | - Guenter Noe
- Department of Obstetrics and Department of GynecologyRhineland ClinicDormagenGermany
| | - Peter Oppelt
- Department of Gynecology and ObstetricsKepler Medical University of LinzLinzAustria
| | | | - Beata Seeber
- Department of Gynecologic Endocrinology and Reproductive MedicineMedical University of InnsbruckInnsbruckAustria
| | - Uwe Andreas Ulrich
- Department of Obstetrics and GynecologyMartin Luther Hospital BerlinBerlinGermany
| | - Rene Wenzl
- Department of Gynecology and ObstericsMedical University of ViennaViennaAustria
| | - Rudy Leon De Wilde
- Department of Gynecology and ObstetricsPius Hospital, Universitätsmedizin Oldenburg, Carl von Ossietzky University of OldenburgOldenburgGermany
| | - Pauline Wimberger
- Department of Obstetrics and GynecologyTechnical University DresdenDresdenGermany
| | | | | | - Eliana Montanari
- Department of Gynecology, Center for EndometriosisHospital St. John of God; Rudolfinerhaus Private Clinic and CampusViennaAustria
| | - Cloe Vaineau
- Department of Gynecology and ObstericsMedical University of Bern, InselspitalBernSwitzerland
| | - Martin Sillem
- Department of Obstetrics and GynecologyUniversity SaarlandHomburgGermany,Praxisklinik am RosengartenMannheimGermany
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10
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Slavchev B, Tonev D, Dobrev L, Geleva E, Veleva B, Protohristov H, Goutev N, Demerdjiev A, Dimitrova D. URANIUM AND 210PO RADIONUCLIDES IN DRINKING WATER IN SOUTHERN BULGARIA AND EXPECTED RADIATION DOSES. Radiat Prot Dosimetry 2022; 198:299-309. [PMID: 35368087 DOI: 10.1093/rpd/ncac039] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/09/2021] [Accepted: 02/23/2022] [Indexed: 06/14/2023]
Abstract
The activity concentrations of the naturally occurring radionuclides 238U, 234U and 210Po have been determined for the first time in drinking water from certain sources in Southern Bulgaria using nuclear and radiochemical methods. The results obtained for the water samples vary in the intervals 0.6-678 mBq l-1 for 238U, 1.4-1484 mBq l-1 for 234U, <0.3-13.6 mBq l-1 for 210Po and 1.04-10.6 for the 234U/238U ratio. The annual effective dose from 238U, 234U and 210Po ranges from 1.09 to 44.1 μSv y-1, 0.78 to 46.8 μSv y-1 and 0.77 to 62.8 μSv y-1 for infants, children and adults, respectively. The annual effective dose due to consumption of drinking water is below the individual dose criterion of 100 μSv y-1 recommended by the World Health Organization. The natural radioactivity of the water sources investigated is below the national and international limits.
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Affiliation(s)
- Bozhidar Slavchev
- Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, 72, Tsarigradsko chaussee Blvd., Sofia 1784, Bulgaria
| | - Dimitar Tonev
- Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, 72, Tsarigradsko chaussee Blvd., Sofia 1784, Bulgaria
| | - Lyuben Dobrev
- Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, 72, Tsarigradsko chaussee Blvd., Sofia 1784, Bulgaria
| | - Elena Geleva
- Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, 72, Tsarigradsko chaussee Blvd., Sofia 1784, Bulgaria
| | - Blagorodka Veleva
- Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, 72, Tsarigradsko chaussee Blvd., Sofia 1784, Bulgaria
- National Institute of Meteorology and Hydrology, 66, Tsarigradsko chaussee Blvd., Sofia 1784, Bulgaria
| | - Hristo Protohristov
- Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, 72, Tsarigradsko chaussee Blvd., Sofia 1784, Bulgaria
| | - Nikolay Goutev
- Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, 72, Tsarigradsko chaussee Blvd., Sofia 1784, Bulgaria
| | - Anguel Demerdjiev
- Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, 72, Tsarigradsko chaussee Blvd., Sofia 1784, Bulgaria
| | - Desislava Dimitrova
- Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, 72, Tsarigradsko chaussee Blvd., Sofia 1784, Bulgaria
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11
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Dimitrova D, Kästner AL, Kästner AN, Paping A, Henrich W, Braun T. Risk factors and outcomes associated with type of uterine rupture. Arch Gynecol Obstet 2022; 306:1967-1977. [PMID: 35284959 DOI: 10.1007/s00404-022-06452-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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] [Received: 03/14/2021] [Accepted: 02/10/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE To identify risk factors associated with the occurrence of complete uterine rupture (CUR) in comparison to partial uterine rupture (PUR) to further investigate to what extent a standardized definition is needed and what clinical implications can be drawn. METHODS Between 2005 and 2017 cases with CUR and PUR at Charité University Berlin, Germany were retrospectively identified. Demographic, obstetric and outcome variables were analyzed regarding the type of rupture. Binary multivariate regression analysis was conducted to identify risk factors associated with CUR. In addition, the intended route of delivery (trial of labor after cesarean delivery (TOLAC) and elective repeat cesarean delivery (ERCD)), divided according to the type of rupture, was compared. RESULTS 92 cases with uterine rupture were identified out of a total of 64.063 births (0.14%). Puerperal complications were more frequent in CUR (67.9 versus 41.1%, p = 0.021). Multiparity ≥ 3 was more frequent in CUR (31 versus 10.7%, p = 0.020). Factors increasing the risk for CUR were parity ≥ 3 (OR = 3.8, p = 0.025), previous vaginal birth (OR = 4.4, p = 0.011), TOLAC (OR = 6.5, p < 0.001) and the use of oxytocin (OR = 2.9, p = 0.036). After multivariate analysis, the only independent risk factor associated with CUR was TOLAC (OR = 7.4, p = 0.017). CONCLUSION TOLAC is the only independent risk factor for CUR. After optimized antenatal counselling TOLAC and ERCD had comparable short-term maternal and fetal outcomes in a high resource setting. A high number of previous vaginal births does not eliminate the risk of uterine rupture. A clear distinction between CUR and PUR is essential to ensure comparability among studies.
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Affiliation(s)
- D Dimitrova
- Department of Obstetrics and Department of Gynecology With Center for Oncological Surgery, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
- Department of Obstetrics, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - A L Kästner
- Department of Obstetrics, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - A N Kästner
- Department of Surgery, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - A Paping
- Department of Obstetrics, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - W Henrich
- Department of Obstetrics, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - T Braun
- Department of Obstetrics, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
- Department of Experimental Obstetrics, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
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12
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Recker F, Dohmen S, Egger EK, Stope MB, Dimitrova D, Könsgen D, Ritter M, Sehouli J, Bondio MG, Mustea A. Impact of COVID-19 on gynaecological patient care: results of patient's survey with 327 patients. Arch Gynecol Obstet 2021; 305:389-395. [PMID: 34705116 PMCID: PMC8549413 DOI: 10.1007/s00404-021-06280-8] [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: 07/18/2021] [Accepted: 10/11/2021] [Indexed: 11/12/2022]
Abstract
Purpose The pandemic SARS-CoV-2 poses new and unprecedented challenges for health care systems on a national and global level. Although the current situation has been going on for more than 1 year, there is limited data on the impact of the pandemic on general hospital and medical practice care. This survey captures the perspective of patients with gynaecological diseases of this impact. Methods Using a paper-based questionnaire, 327 patients were asked about medical care and their experiences during the pandemic at the University Hospital Bonn and the University Hospital Charité Berlin. The study was performed from the 1st June to 30th September 2020. Results A total of 327 patients participated in the study: 156 stated to have been tested for coronavirus, and 1 patient reported a positive test. 41.3% of the patients felt insecure about the current situation, 30.4% were concerned about the risk of infection during the hospital stay. The pandemic-specific measures in hospitals and medical practices unsettled 6.8% of patients. 18.1% of patients feared that their gynaecological disease would not be treated adequately due to the pandemic. 55.7% of patients reported that their confidence in their physicians has increased during the pandemic. Conclusion The results show that patients’ confidence in the healthcare system and the physicians acting significantly increased during the COVID-19 crisis. Transparent and comprehensive information policy regarding actions and restrictions within the COVID-19 crisis eases patients concerns and improves patients’ confidence in their physicians, which is crucial for a successful treatment’s outcome.
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Affiliation(s)
- F Recker
- Department for Gynecology and Gynecological Oncology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.
| | - S Dohmen
- Department for Gynecology and Gynecological Oncology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - E K Egger
- Department for Gynecology and Gynecological Oncology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - M B Stope
- Department for Gynecology and Gynecological Oncology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - D Dimitrova
- Department for Gynecology with Centre for Oncological Surgery, Campus Virchow Klinikum, Berlin, Germany
| | - D Könsgen
- Department for Gynecology and Gynecological Oncology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - M Ritter
- Department of Urology, University Hospital Bonn, Bonn, Germany
| | - J Sehouli
- Department for Gynecology with Centre for Oncological Surgery, Campus Virchow Klinikum, Berlin, Germany
| | - M Gadebusch Bondio
- Institute of Medical Humanities, University Hospital Bonn, Bonn, Germany
| | - A Mustea
- Department for Gynecology and Gynecological Oncology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
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13
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Dimitrova D. The women in situation of gaslighting – risk identification in the work environment. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.327] [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: 11/13/2022] Open
Abstract
Abstract
Background
As a contemporary form of “workplace harassment' (WH) is reported gaslighting. Preston Ni, defines it as ‘A form of constant manipulation and brainwashing…' The phenomenon is presented as mainly affecting the woman in the workplace. The aim of the study is to determine and identify the risk of subjecting a woman in the workplace in Bulgaria to this form of psychological pressure gaslighting, in favor of building a risk reduction program cause.
Methods
Empirical sociological research (ESR) among working women for period of 10 years in Sofia (around 2 million citizens), Bulgaria. An anonymous survey of 2,000 working women between the ages of 30 and 65 was conducted. The questionnaire of the respondents with only more than 5 years of work experience are included.
Results
Of the surveyed 25% are between 30-40 years, about 47% are 41-50 years, about 25% are 51-60 years and about 3% are 61-65 years. The result of the study indicates that mostly women between 41 and 50 years are subjected to psychological pressure by a man at work (about 45%), about 15% - are 51-60 years, only about 5% of women 31-40 years, and less 2% over 61. All of them are described as introverted. Mostly women with a high level of education have remained mentally resistant to gaslighting - about 35% of respondents, and less than 5% of them have shown higher creativity against the background of psychological pressure. In almost 1/3 of those subjected to prolonged mental harassment, were diagnosed for the first time, including: Hashimoto's thyroiditis (5%); arterial hypertension (about 10%); ischemic disease (about 15%). Half of them are presented with depression.
Conclusions
Gaslighting is a hidden psychological violence against a female person based on hate speech and demonstration of power. Gaslighting is defined as a real risk among women, mostly of the introverted type. Emotional plasticity based on knowledge and smart has a positive effect in situation of gaslighting.
Key messages
Gaslighting can lead to lack of confidence, clinical depression, distress and related physical illnesses. Early risk detection provides advantages for early reduction and optimization of the corporate culture of the department and the institution and in favor of building a risk reduction program.
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Affiliation(s)
- D Dimitrova
- Preventive Medicine, Faculty of Public Health, Medical University - Sofia, Sofia, Bulgaria
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14
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Dimitrova D. Workplace mobbing and organizational intelligence - healthcare risk management in a crisis. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.154] [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: 11/14/2022] Open
Abstract
Abstract
Issue
Mobbing is the old syndrome of the new age. A phenomenon of invisible systemic group pressure on a selected dissident victim and a visible harassment that sticks strongly in a crisis. A victim with a strong character, a person competent and leadership skills to a degree that exceeds another placed leader, as an expression of his fear and frustration. The presence of mobbing is always an expression of a bad organizational culture. The opportunities for risk reduction are based in the creation of a highly effective, tactical-strategic flexibility and creative program of control, mediation and modeling of the risk factors leading to mobbing.
Description of the problem
A particularly interesting scene for the manifestation of mobbing is the academic environment. The manifestation of mobbing leads to serious losses, social isolation and has health consequences on the attacked and subjected to emotional pressure member of the team. A creative scientist and charismatic teacher, a wonderful and eroded specialist does not go unnoticed by the more mediocre. Circles are formed with different scope and degrees of trust in the initiator of the mobbing, who generates and manages directly several with the role of accomplices and indirectly dozens to hundreds of cowardly and sufficiently obedient performers.
Results
Basic human rights are violated and the organizational culture of the institution is compromised through mobbing. A process of a cyclical nature in which only the victim changes. The implementation of a policy of zero tolerance for mobbing is a starting point, but it is not enough for a lasting solution to a problem with the volume and nature of a socio-economic disaster.
Lessons
Mobbing is a conflict of interest in which the better prepared fall victim to the more mediocre. Insufficiently good level of management at all levels in the institution leads to mobbing when a competent and eroded member of the team appears.
Key messages
No one is protected from mobbing in bad and destructive management. A mobbing risk reduction program is applicable to each prevention indication at each level.
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Affiliation(s)
- D Dimitrova
- Preventive Medicine, Faculty of Public Health, Medical University-Sofia, Sofia, Bulgaria
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15
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Dimitrova D, Georgieva E. Psychological assistance at disaster in Bulgaria - contemporary policies for health risk management. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.148] [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: 11/13/2022] Open
Abstract
Abstract
Issue
Health risk management (HRM) in Bulgaria is provided to citizens in emergencies, disasters, accidents and catastrophes (E&DAC). According to the legislation in the country, this is a part of the mandatory package of medical provision for the injured population (MPIP) and concerns any acute life-threatening condition (LTC). In the dynamically changing environment of E&DAC, a special form of health consequences among survivors are related to mental health (MeH).
Description of the problem
In practice, any serious E&DAC has a direct or indirect psychological impact. It can manifest itself acutely or remotely over time, puts the victims in temporary or permanent disability and is followed by serious social effects. A strategy has been proposed for inclusion in the obligatory package of MPIP in case of significant E&DAC and primary psychological assistance (PPA) for every citizen who has survived.
Results
In the country, PPАs to citizens for decades is an on-demand service provided mainly by the private sector. Within the BRC, a group has been formed to provide PPA with a modest resource capacity. The emotional citizens culture in the country is far from active demand for PPA in general and severely limited in resources and the MeH is not a priority. This system of public health care, based on withdrawal from the MeH, also exposes to increased risk of psycho-somatic and distress-provoked physical illnesses (PSDPPhI).
Lessons
Carrying out timely PPA for those in need changes the range of adverse mental effects, reducing them. Provides a better adaptive response to reduced risk of PTSD and PSDPPhI. A volume of preventive measures organized in stages over time gives a greater chance to a larger number of victims.
Key messages
The health of the nation is a complex program for controlling both the acute health problems at E&DAC and the protection of MeH. To provide modern sustainable policies for the implication of PPA in everyone who has seriously experienced E&DAC is resulted in good health practices.
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Affiliation(s)
- D Dimitrova
- Preventive Medicine, Faculty of Public Health, MU-Sofia, Sofia, Bulgaria
| | - E Georgieva
- Social Medicine, Faculty of Public Health, Sofia, Bulgaria
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Kaps C, Schwickert A, Dimitrova D, Nonnenmacher A, Siedentopf JP, Henrich W, Braun T. Online survey on uterotomy closure techniques in caesarean section. J Perinat Med 2021; 49:809-817. [PMID: 34229368 DOI: 10.1515/jpm-2021-0118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 05/19/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Uterine closure technique in caesarean section (CS) influences the rate of late complications in subsequent pregnancies. As no common recommendation on suture techniques exists, we developed a questionnaire to determine the techniques currently used and the frequencies of late complications. METHODS The online questionnaire consisted of 13 questions and was sent to 648 obstetric hospitals (level I-IV) in Germany. Number of CS, rate of vaginal birth after caesarean section (VBAC), the type of uterus suturing technique and the frequency of uterine dehiscences, ruptures and placenta accreta spectrum (PAS) were queried. The answers were anonymous, and results were evaluated descriptively. RESULTS The response rate was 24.7%. The mean CS rate was 27.3% (±6.2), the repeat CS rate 33.2% (±18.1). After CS, 46.2% (±20.2) women delivered vaginally. To close the uterotomy, 74.4% of hospitals used single layer continuous sutures, 16.3% single layer locked sutures, 3.8% interrupted sutures, 3.1% double layer continuous sutures and 2.5% used other suture techniques. The percentages of observed uterine dehiscences did not differ significantly between the different levels of care nor did the uterotomy suture techniques. CONCLUSIONS There is no uniform suturing technique in Germany. A detailed description of suture technique in surgery reports is required to evaluate complications in subsequent pregnancies. National online surveys on obstetric topics are feasible and facilitate the discussion on the need to define a standardized uterine closure technique for CS.
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Affiliation(s)
- Celine Kaps
- Department of Obstetrics and Division of 'Experimental Obstetrics', Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| | - Alexander Schwickert
- Department of Obstetrics and Division of 'Experimental Obstetrics', Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| | - Desislava Dimitrova
- Department of Obstetrics and Division of 'Experimental Obstetrics', Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| | - Andreas Nonnenmacher
- Department of Obstetrics and Division of 'Experimental Obstetrics', Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| | - Jan-Peter Siedentopf
- Department of Obstetrics and Division of 'Experimental Obstetrics', Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| | - Wolfgang Henrich
- Department of Obstetrics and Division of 'Experimental Obstetrics', Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| | - Thorsten Braun
- Department of Obstetrics and Division of 'Experimental Obstetrics', Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany.,Division of 'Experimental Obstetrics', Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
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Dimitrova D, Naghavi B, Richter R, Nasser S, Chekerov R, Braicu EI, David M, Blohmer J, Inci G, Torsten U, Oskay-Özcelik G, Blau I, Fersis N, Holzgreve A, Keil E, Keller M, Keilholz U, Sehouli J. Influence of migrant background on patient preference and expectations in breast and gynecological malignancies (NOGGO-expression V study): results of a prospective multicentre study in 606 patients in Germany. BMC Cancer 2021; 21:1018. [PMID: 34511112 PMCID: PMC8436522 DOI: 10.1186/s12885-021-08731-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [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: 01/09/2021] [Accepted: 08/26/2021] [Indexed: 11/23/2022] Open
Abstract
Background An effective cross-cultural doctor-patient communication is vital for health literacy and patient compliance. Building a good relationship with medical staff is also relevant for the treatment decision-making process for cancer patients. Studies about the role of a specific migrant background regarding patient preferences and expectations are lacking. We therefore conducted a multicentre prospective survey to explore the needs and preferences of patients with a migrant background (PMB) suffering from gynecological malignancies and breast cancer to evaluate the quality of doctor-patient communication and cancer management compared to non-migrants (NM). Methods This multicentre survey recruited patients with primary or recurrence of breast, ovarian, peritoneal, or fallopian tube cancer. The patients either filled out a paper form, participated via an online survey, or were interviewed by trained staff. A 58-item questionnaire was primarily developed in German and then translated into three different languages to reach non-German-speaking patients. Results A total of 606 patients were included in the study: 54.1% (328) were interviewed directly, 9.1% (55) participated via an online survey, and 36.8% (223) used the paper print version. More than one quarter, 27.4% (166) of the participants, had a migrant background. The majority of migrants and NM were highly satisfied with the communication with their doctors. First-generation migrants (FGM) and patients with breast cancer were less often informed about participation in clinical trials (p < 0.05) and 24.5% of them suggested the help of an interpreter to improve the medical consultation. Second and third-generation migrants (SGM and TGM) experienced more fatigue and nausea than expected. Conclusions Our results allow the hypothesis that training medical staff in intercultural competence and using disease-related patient information in different languages can improve best supportive care management and quality of life in cancer patients with migrant status. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08731-6.
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Affiliation(s)
- D Dimitrova
- Department of Gynecology with Center of Oncological Surgery, Charité University Medicine, Campus Virchow-Klinikum, Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - B Naghavi
- Charité Comprehensive Cancer Center, Charité University Medicine, Berlin, Germany
| | - R Richter
- Department of Gynecology with Center of Oncological Surgery, Charité University Medicine, Campus Virchow-Klinikum, Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - S Nasser
- Department of Gynecology with Center of Oncological Surgery, Charité University Medicine, Campus Virchow-Klinikum, Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - R Chekerov
- Department of Gynecology with Center of Oncological Surgery, Charité University Medicine, Campus Virchow-Klinikum, Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - E I Braicu
- Department of Gynecology with Center of Oncological Surgery, Charité University Medicine, Campus Virchow-Klinikum, Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - M David
- Department of Gynecology with Center of Oncological Surgery, Charité University Medicine, Campus Virchow-Klinikum, Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - J Blohmer
- Department of Gynecology and Breast Care Center, Charité University Medicine, Charité Campus Mitte, Berlin, Germany
| | - G Inci
- Department of Gynecology with Center of Oncological Surgery, Charité University Medicine, Campus Virchow-Klinikum, Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - U Torsten
- Department of Gynecology, Vivantes Klinikum Neukölln Berlin, Berlin, Germany
| | - G Oskay-Özcelik
- Gynecological Oncology Medical Practice Berlin Spandau, Berlin, Germany
| | - I Blau
- Medical Care Center Evangelisches Waldkrankenhaus am Standort Pankow, Berlin, Germany
| | - N Fersis
- Helios Klinikum Duisburg, Duisburg, Germany
| | - A Holzgreve
- Vivantes Netzwerk für Gesundheit GmbH, Berlin, Germany
| | - E Keil
- Klinik Oranienburg, Oberhavel Kliniken GmbH, Oranienburg, Germany
| | - M Keller
- North-Eastern-German Society of Gynecological Oncology, Oranienburg, Germany
| | - U Keilholz
- Charité Comprehensive Cancer Center, Charité University Medicine, Berlin, Germany
| | - J Sehouli
- Department of Gynecology with Center of Oncological Surgery, Charité University Medicine, Campus Virchow-Klinikum, Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
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18
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Dimitrova D, Armbrust R, Nasser S, Boz S, Zocholl D, Fucaraccio E, Kiechle M, Sehouli J. Results of a German survey among patients with gynecological malignancies during the COVID-19 pandemic. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e13533] [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: 11/20/2022] Open
Abstract
e13533 Background: The COVID-19 pandemic has had an immense impact on health care systems und social life. Due to limited resources, a rearrangement in medical care has been necessary in many countries. Strict rules of social distancing and postponing of medical appointments has brought major changes. At the beginning of the COVID-19 pandemic, in March 2020, several studies reflecting patient perception of cancer care modification were performed. Currently, there are still limited data on patient perception concerning changes in cancer treatment, their willingness to receive a COVID-19 vaccine, and their acceptance of social life restrictions. We initiated a multicentre prospective anonymous survey among patients with gynecological cancer to gather information about the current therapy situation and the impact of their treatment and social life. We will report the first preliminary results of 108 patients. Methods: We performed a survey among patients with gynecological cancer, who received treatment or were in follow-up at Charité Campus Virchow Klinikum between October and December 2020. The paper form questionnaire included three sections in which social background, current disease status, and patient perception of the COVID-19 implications on cancer care and social life were evaluated. Results: We included 108 patients. The median age of the participants was 59. The majority of the participants had ovarian cancer (69.4 %) and 70 % were under current cancer treatment. Almost 65 % were willing to receive a COVID-19 vaccine. More than 50 % reported anxiety and fear during the last 2 weeks. Only 16.2 % were more afraid of a COVID-19 infection than their cancer disease. Despite uncertainty of the COVID-19 pandemic, most patients fear tumour progression more than a COVID-19 infection. The cancer treatment appointments were altered in a small number of patients (9.4 %). Testing of COVID-19 was performed in 73 % of the participants. The acceptance of social measures was high; 87 % keeping social distance and over 90 % wearing a mask. Conclusions: Despite major challenges in cancer care due to the COVID-19 pandemic for the majority of the patients, the access to cancer treatment was less affected and the acceptance of prevention measures was high. Anxiety and fear was experienced by more than 50 %. The psychological effects of the COVID-19 pandemic should be further explored. The survey underscores the high need of information regarding COVID-19 and cancer.
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Affiliation(s)
- Desislava Dimitrova
- North-Eastern German Society of Gynecological Oncology (NOGGO) and Department of Gynecology with Center for Oncological Surgery, Charité–University Medicine of Berlin, Campus Virchow Klinikum, Berlin, Germany
| | - Robert Armbrust
- North-Eastern German Society of Gynecological Oncology (NOGGO) and Department of Gynecology with Center for Oncological Surgery, Charité–University Medicine of Berlin, Campus Virchow Klinikum, Berlin, Germany
| | - Sara Nasser
- North-Eastern German Society of Gynecological Oncology (NOGGO) and Department of Gynecology with Center for Oncological Surgery, Charité–University Medicine of Berlin, Campus Virchow Klinikum, Berlin, Germany
| | - Seyma Boz
- Nord-Ostdeutsche Gesellschaft für Gynäkologische Onkologie e.V., Berlin, Germany
| | - Dario Zocholl
- North-Eastern German Society of Gynecological Oncology (NOGGO) and Institute for Biometrics and Clinical Epidemiology, Charité-University Medicine Berlin, Berlin, Germany
| | - Emelina Fucaraccio
- North-Eastern German Society of Gynecological Oncology (NOGGO) and Department of Gynecology with Center for Oncological Surgery, Charité–University Medicine of Berlin, Campus Virchow Klinikum, Berlin, Germany
| | - Marion Kiechle
- Department of Obstetrics and Gynecology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Jalid Sehouli
- North-Eastern German Society of Gynecological Oncology (NOGGO) and Department of Gynecology with Center for Oncological Surgery, Charité–University Medicine of Berlin, Campus Virchow Klinikum, Berlin, Germany
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Nasser S, Fotopoulou C, Guktekin M, Dimitrova D, Morice P, Sehouli J. Patient care and clinical trials in gynecological oncology: Implications of the COVID-19 pandemic. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.5564] [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: 11/20/2022] Open
Abstract
5564 Background: This is a prospective international Survey to evaluate the impact of the COVID-19 Pandemic on the management of patients with gynecological malignancies from the multidisciplinary physicians' perspective, with particular focus on clincial infrastructures, and trial participation. Methods: The anonymous online survey consisted of 53 COVID-related questions. It was sent to all healthcare professionals in gynaecological oncology centres across Europe and the Pan-Arabian region from April 2020 to October 2020. All healthcare professionals treating women with gynecological cancers were able to participate in the survey. Results: A total of 243 answers were collected from 30 different countries. The majority (73%) of participants were gynecological oncologists from university hospitals(71%) with at least an Intensive care unit with cardiopulmonary support available at their institutions. Most institutions continued to perform elective surgeries only for oncological cases (98%). Patients had to wait on average 2 weeks longer for their surgery appointments compared to previous years(range 0-12 weeks). Cases that were prioritised for surgical intervention across all tumors (Ovarian, Endometrium, Cervical) were early stage disease (74%), primary situation (61%), and good ECOG status (63%). The radicality of surgery did not change in the majority of cases (78%) across all tumor types. During the pandemic, only 38% of clinicians stated they would start a new clinical trial. 45% stated the pandemic has negatively impacted the financial structure and support for clinical trials. 79% do not routinely screen patients included in trials for SARS CoV2. Overall, approx. 20% of clinicians did not feel well informed regarding clinical pathways for COVID-19 patients throughout the pandemic. The majority preferred regular updates and training via Webinars (75%), followed by tumorboards and interdisciplinary conferences (45%). 30% of clinicians stated that they are currently experiencing difficulties in providing adequate medical care due to staff shortage. Conclusions: Despite well-established guidelines for patient care and performing clinical trials in gynecological oncology, the COVID-19 pandemic has impacted clinical research, and financial structures. Longer waiting times for operative interventions, less support for clinical trials and concerns regarding provision of adequate medical care and triaging patients are very real. This survey underlines the necessity for building robust emergency algorithms tailored to gynecological oncology patients in the future.
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Affiliation(s)
- Sara Nasser
- North-Eastern German Society of Gynecological Oncology (NOGGO) and Department of Gynecology with Center for Oncological Surgery, Charité–University Medicine of Berlin, Campus Virchow Klinikum, Berlin, Germany
| | | | - Murat Guktekin
- Division of Gynecologic Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Desislava Dimitrova
- North-Eastern German Society of Gynecological Oncology (NOGGO) and Department of Gynecology with Center for Oncological Surgery, Charité–University Medicine of Berlin, Campus Virchow Klinikum, Berlin, Germany
| | - Philippe Morice
- Department of Surgery, Gustave Roussy Cancer Centre, Villejuif, France
| | - Jalid Sehouli
- North-Eastern German Society of Gynecological Oncology (NOGGO) and Department of Gynecology with Center for Oncological Surgery, Charité–University Medicine of Berlin, Campus Virchow Klinikum, Berlin, Germany
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20
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Yankova M, Dimitrova D, Peev T, Yordanov B. ADVANTAGES OF PRE-PROSTHETIC MASTICATORY SYSTEM PREPARATION WITH OCCLUSAL APPLIANCE. JofIMAB 2021. [DOI: 10.5272/jimab.2021272.3731] [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: 11/11/2022] Open
Abstract
The aim of this literature review is to present the main advantages of pre-prosthetic preparation of the masticatory system with occlusal appliances. The possibilities for attaining muscle relaxation at the achieved centric condyle position in the temporomandibular joints are discussed. The advantages, in terms of hard dental tissue protection, the diagnostic value and the psychoprophylactic effect, are considered. The wide-ranging benefits of the use of occlusal appliances in bruxism- and bruxomania-related craniomandibular dysfunctions are indisputable and represent a current scientific interest.
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21
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Yankova M, Peev T, Yordanov B, Dimova-Gabrovska M, Dimitrova D. STUDY OF THE KNOWLEDGE AND USE OF RESILIENT DENTURE LINING MATERIALS IN CLINICAL PRACTICE. JofIMAB 2021. [DOI: 10.5272/jimab.2021272.3668] [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: 11/11/2022] Open
Abstract
Introduction: Since the beginning of the last century until today, resilient resins have been used for the lining of partial and complete dentures with the aim to achieve more uniform distribution of masticatory pressure and to reduce the trauma of mucous membranes. The aim of this study was to investigate the knowledge and use of resilient denture lining materials (RDLMs) in clinical practice. Material and methods: The study was conducted among dental practitioners and dental technicians in 2016. A direct survey method was used, with a questionnaire containing 11 questions. Results: Over half (53.4%, n = 133) of the respondents do not use RDLMs in their practice. In the cases of retentive prosthetic field or prosthetic field with advanced atrophy, the respondents focus mainly on the surgical preparation of the prosthetic field and recommend the use of RDLMsif there are exostosis-related pain symptoms (≈41%, n = 103) or painful neurogenic points (≈ 44%, n = 105). One-third of the respondents prefer the use of long-term RDLMs, and 73% prefer to apply the indirect lining technique. Conclusion: The various types of RDLMs and their characteristics are well-known by the dental practitioners and dental technicians but rarely used, due to a number of unresolved related issues, such as ungluing of the resilient material from the denture base, appearance of an unpleasant odor, change in the color or texture of the material, etc. In our study, dental practitioners and dental technicians use RDLMsfor complete denture lining mainly in clinical cases with presented pain symptoms.
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22
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Valtcheva E, Dimitrova T, Moutafova E, Vladeva-Spasova S, Ivanova I, Stefanova R, Popova I, Slavova A, Dimitrova D, Dokova K. “The Green Sea Yard of Varna” – the innovative project in the focus of early child development. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1001] [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: 11/14/2022] Open
Abstract
Abstract
We present an innovative approach to early child development (ECD), designated as a priority for all societies. Traditional ECD services of the Bulgarian health system are predominantly medical or pedagogical provided by GPs and nurseries. This leaves space for interdisciplinary services based on the ideas of Françoise Dolto focused on child-parent relationships. The Green Sea Yard of Varna, Bulgaria, aims at providing accessible space for early socialization of children and preventive psychosocial services by experts in ECD.
The process oriented work combines: psychosocial accompaniment, social group & community work, psychoanalytic consultation with medical expertise. Specialists use direct observation, interviews, analysis of available information, hypothesis development. Questions to be answered: is there a recognized need for a space enhancing and stimulating the interaction between the three main subject in ECD child-parents-specialists; is there a need for a transitional space between the home and kindergarten enabling early child socialization; which are the most prevalent mental and behavioral problems and their earliest symptoms.
For 104 working days (December 2018-February 2020), 2 000 visits of 257 children have been performed, including 400 individual consultations of 51 children at risk. Smooth adaptation to nursery was experienced by 15,5% of children. The most prevalent problems are: insufficient to lacking parent-child verbal communication; delayed speech development; aggressive behavior towards peers.
The main lessons are: (1) There is a recognized by specialists, families and the community need for transitional spaces enabling children to experience first social encounters and concepts of social rules and norms; (2) the space stimulates both formal and informal quality communication between specialist and parents and mutual informal support between parents; (3) leading to a new view for the child as an autonomous person.
Key messages
The Green Sea Yard of Varna is the first innovative space for interdisciplinary approach to ECD, early socialization, care & prevention in our community fully applicable to other places and cultures. The project is in line with SDGs, contemporary scientific visions for the first 1000 days of a child's life and the WHO strategy for the prevention of child’s health in the family and in society.
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Affiliation(s)
- E Valtcheva
- Faculty of Public Health, The Green Sea Yard of Varna, Medical University –Varna, Varna, Bulgaria
| | - T Dimitrova
- Faculty of Public Health, The Green Sea Yard of Varna, Medical University –Varna, Varna, Bulgaria
| | - E Moutafova
- Faculty of Public Health, The Green Sea Yard of Varna, Medical University –Varna, Varna, Bulgaria
| | - S Vladeva-Spasova
- Faculty of Public Health, The Green Sea Yard of Varna, Medical University –Varna, Varna, Bulgaria
| | - I Ivanova
- Faculty of Public Health, The Green Sea Yard of Varna, Medical University –Varna, Varna, Bulgaria
| | - R Stefanova
- Faculty of Public Health, The Green Sea Yard of Varna, Medical University –Varna, Varna, Bulgaria
| | - I Popova
- Faculty of Public Health, The Green Sea Yard of Varna, Medical University –Varna, Varna, Bulgaria
| | - A Slavova
- Faculty of Public Health, The Green Sea Yard of Varna, Medical University –Varna, Varna, Bulgaria
| | - D Dimitrova
- Faculty of Public Health, The Green Sea Yard of Varna, Medical University –Varna, Varna, Bulgaria
| | - K Dokova
- Faculty of Public Health, The Green Sea Yard of Varna, Medical University –Varna, Varna, Bulgaria
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Georgieva E, Vatansever M, Velkova A, Hristov N, Pesheva P, Simeonova I, Dimitrova D, Pravchanska M. Prevalence of depression among three cohorts of medical students. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1033] [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: 11/13/2022] Open
Abstract
Abstract
Background
Medical education is often related to serious distress for students, that affects negatively their mental well-being. Depression, poor academic performance, increased alcohol consumption, suicidal thoughts, are some of the detrimental effects of diminished mental health. Studies on depression in medical students reveal a higher prevalence (1.4-73.5%) than in the general population. This study aimed to assess and compare depression prevalence and severity in three cohorts of medical students in Bulgaria and Turkey.
Methods
We conducted a cross-sectional online survey with 257 Bulgarian and 288 foreign medical students from Medical University-Sofia, Bulgaria, and with 270 Turkish medical students from Ankara in the winter semester of 2019-2020 academic year. We used the Beck depression inventory (BDI) as valid and reliable instrument to assess depression. The students were categorised according to BDI scores in three groups: with mild depression (10- 18 points); moderate depression (19-29); severe depression (30- 63). Data were analysed with program product Python 3 (v3.6.9) with Pandas v0.25.3 and Scipy v1.4.1.
Results
Depressive symptoms reported 71.5% of Turkish students, 47.1% of Bulgarian and 48.7% of foreign medical students. The depression frequency among Turkish and Bulgarian medical students was significantly different (chi2 = 35.31; p = 0,001). Mean BDI scores were similar for Bulgarian medical students (11.0) and foreign medical students, studying in Bulgaria (11.6). Turkish medical students scored highest on BDI (15.3). Severe depression was detected in 5.6% of foreign, 4.3% of Bulgarian and 6.3% of Turkish students.
Conclusions
Depression prevalence was high in all studied medical students cohorts, with Turkish cohort affected most, probably because of cultural and curriculum differences.
Key messages
Support of student’s mental health should be an integral part of the educational policies of all Medical Universities worldwide. Depression among medical students has to be prevented by comprehensive approach.
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Affiliation(s)
- E Georgieva
- Faculty Social Medicine, Department Public Health, Sofia, Bulgaria
| | | | - A Velkova
- Faculty Social Medicine, Department Public Health, Sofia, Bulgaria
| | - N Hristov
- Faculty Social Medicine, Department Public Health, Sofia, Bulgaria
| | - P Pesheva
- Faculty Social Medicine, Department Public Health, Sofia, Bulgaria
| | - I Simeonova
- Faculty Social Medicine, Department Public Health, Sofia, Bulgaria
| | - D Dimitrova
- Faculty Social Medicine, Department Public Health, Sofia, Bulgaria
| | - M Pravchanska
- Faculty Social Medicine, Department Public Health, Sofia, Bulgaria
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Dimova-Gabrovska M, Dimitrova D, Yordanov B, Yankova M, Peev T. ADVANTAGES AND DISADVANTAGES OF PAEDIATRIC CROWN PROSTHETIC TREATMENT. JofIMAB 2019. [DOI: 10.5272/jimab.2019253.2695] [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: 11/11/2022] Open
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25
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Dimova-Gabrovska M, Dimitrova D, Yordanov B, Yankova M, Peev T. QUESTIONNAIRE SURVEY OF FIXED CROWN PROSTHETIC TREATMENT IN CHILDREN. JofIMAB 2019. [DOI: 10.5272/jimab.2019253.2675] [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: 11/11/2022] Open
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26
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Dimova-Gabrovska M, Dimitrova D, Yordanov B, Apostolov N, Peev T. ULTRASOUND DIAGNOSIS OF TEMPOROMANDIBULAR JOINT IN PATIENTS WITH CRANIOMANDIBULAR DYSFUNCTIONS. JofIMAB 2019. [DOI: 10.5272/jimab.2019252.2563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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27
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Dimova-Gabrovska M, Dimitrova D, Deliverska M. A PILOT STUDY OF DIETARY INTAKE IN CHILDREN. JofIMAB 2018. [DOI: 10.5272/jimab.2018244.2254] [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: 11/11/2022] Open
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28
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Georgieva E, Dimitrova D, Georgieva L, Hristov N, Pesheva P. Demographic and social problems of aging in Bulgaria. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky214.238] [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)
| | | | | | - N Hristov
- Faculty Public Health, Sofia, Bulgaria
| | - P Pesheva
- Faculty Public Health, Sofia, Bulgaria
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Biele C, Schönborn I, Dukatz R, Dimitrova D, Henrich W. Fälle von Kindern mit hereditärer hämophagozytischer Lymphohistiozytose (HLH) in einer konsanguinen Partnerschaft. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671230] [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)
- C Biele
- Charite-Universitätsmedizin Berlin, Campus Virchow Klinikum, Klinik für Geburtsmedizin, Berlin, Deutschland
| | - I Schönborn
- Charite-Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin, Deutschland
| | - R Dukatz
- Charite-Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin, Deutschland
| | - D Dimitrova
- Charite-Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin, Deutschland
| | - W Henrich
- Charite-Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin, Deutschland
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Dimova-Gabrovska M, Dimitrova D, Mitronin VA. PROSTHETIC TREATMENT WITH CROWNS AND IMPLANTS IN CHILDREN – literature review. JofIMAB 2018. [DOI: 10.5272/jimab.2018243.2166] [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: 11/11/2022] Open
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Parashkevova A, Sehouli J, Richter R, Dimitrova D, Braicu EI, Muallem MZ. Preoperative CA-125 Value as a Predictive Factor for Postoperative Outcome in First Relapse of Platinum-sensitive Serous Ovarian Cancer. Anticancer Res 2018; 38:4865-4870. [PMID: 30061261 DOI: 10.21873/anticanres.12799] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 03/16/2018] [Revised: 04/18/2018] [Accepted: 04/30/2018] [Indexed: 11/10/2022]
Abstract
AIM The purpose of the study was to evaluate whether preoperative cancer antigen 125 (CA-125) levels predict outcome of secondary cytoreductive surgery (SCS) in patients with serous recurrent ovarian cancer and whether this could be used as a prognostic factor for progression-free (PFS) and overall (OS) survival. PATIENTS AND METHODS A cohort of 111 patients with first recurrence of platinum-sensitive serous ovarian cancer, who had undergone SCS at the Department of Gynecology and Oncological Surgery, Charité, Campus Virchow Clinic was analyzed in correlation with the preoperative CA-125 value. RESULTS The median preoperative CA-125 level was 164 U/ml. Complete tumor resection was achieved in 58.6% of the patients. PFS and OS for patients with preoperative CA-125 of less than 164.5 U/ml was significantly better than those with preoperative CA-125 ≥164.5 U/ml (p=0.025 and p<0.001, respectively). CONCLUSION Preoperative CA-125 is not a statistically significant predictive factor for complete tumor resection after SCS. Preoperative CA-125 <164.5 U/ml can predict significantly better PFS and OS for patients with first recurrence of platinum-sensitive ovarian cancer.
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Affiliation(s)
- Asya Parashkevova
- Ovarian Cancer Tumor Bank, Virchow Campus Clinic, Charité Medical University, Berlin, Germany
| | - Jalid Sehouli
- Department of Gynecology, Virchow Campus Clinic, Charité Medical University, Berlin, Germany
| | - Rolf Richter
- Department of Gynecology, Virchow Campus Clinic, Charité Medical University, Berlin, Germany
| | - Desislava Dimitrova
- Department of Gynecology, Virchow Campus Clinic, Charité Medical University, Berlin, Germany
| | - Elena Ioana Braicu
- Ovarian Cancer Tumor Bank, Virchow Campus Clinic, Charité Medical University, Berlin, Germany.,Department of Gynecology, Virchow Campus Clinic, Charité Medical University, Berlin, Germany
| | - Mustafa Zelal Muallem
- Department of Gynecology, Virchow Campus Clinic, Charité Medical University, Berlin, Germany
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Levterova B, Levterov G, Dimitrova D. Exploring the factors which affect quality of life in patients with type 2 diabetes mellitus. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.05.195] [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] Open
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Braicu E, Torsten U, Richter R, Beteta C, Boneß-Zaloume J, Dimitrova D, Koch E, Chen F, Chekerov R, Hasenbein K, Sehouli J. HE4 is the marker of choice in discriminating endometriosis from ovarian cancer in pelvic mass patients: Sub-analysis of a prospective multicentric study. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.04.547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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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Abstract
O porco dos Balcãs de Leste (EBS) é a última raça suína indígena da Bulgária que resta. É um porco “tipo banha” fenotipicamente similar ao javali com uma excelente capacidade de adaptação a condições extensivas. Atualmente (2016) a população da raça é de 1114 porcas e 48 varrascos e por essa razão o EBS é considerado como “em perigo”. Esta raça habita partes florestais do país nas encostas do leste de Stara Planina Mt. (Os Balcãs) e Strandzha Mt. Da mesma forma que o porco selvagem, o porco EBS caracteriza-se pela sua maturidade tardia – a idade ao primeiro parto ulatrapassa os 500 dias. Durante a sua vida reprodutiva esta raça local tem, em média, 5,2 ninhadas. A prolificidade varia de 6 a 8 leitões nascidos vivos e 5-6 leitões desmamados. Os animais EBS atingem um peso corporal de 100kg com cerca de 14 meses. Os valores médios caracterizadores da qualidade da carcaça aos 100kg de peso são os seguintes: carcaça – 56,7kg (determinada após a remoção da pele, cabeça, pernas pelo curvilhão e chispe e todas as vísceras), total de carne com ossos – 41,8kg (73,4% da carcaça) e gordura – 15,08kg (26,6% da carcaça).
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Dimitrova D, Tilov B, Dzhambov A. Social cohesion mediates the association between urban greenspace and mental health in youth. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx189.123] [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: 11/13/2022] Open
Affiliation(s)
- D Dimitrova
- Department of Health Management and Healthcare Economics, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - B Tilov
- Medical College, Medical University of Plovdiv, Plovdiv, Bulgaria; Department of Management, Faculty of Economics and Management, University of Agribusiness and Rural Development, Plovdiv, Bulgaria
| | - A Dzhambov
- Department of Hygiene and Ecomedicine, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
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Affiliation(s)
- P Pesheva
- Faculty of Public Health, Medical University-Sofia, Sofia, Bulgaria
| | - E Georgieva
- Faculty of Public Health, Medical University-Sofia, Sofia, Bulgaria
| | - N Hristov
- Faculty of Public Health, Medical University-Sofia, Sofia, Bulgaria
| | - V Zahariev
- Faculty of Public Health, Medical University-Sofia, Sofia, Bulgaria
| | - D Dimitrova
- Faculty of Public Health, Medical University-Sofia, Sofia, Bulgaria
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Dzhambov A, Markevych I, Tilov B, Dimitrova D. Residential greenspace modifies the effect of road traffic noise exposure on mental health in youth. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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 Dzhambov
- Department of Hygiene and Ecomedicine, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - I Markevych
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany; Institute of Epidemiology I, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg, Germany
| | - B Tilov
- Medical College, Medical University of Plovdiv, Plovdiv, Bulgaria; Department of Management, Faculty of Economics and Management, University of Agribusiness and Rural Development, Plovdiv, Bulgaria
| | - D Dimitrova
- Department of Health Management and Healthcare Economics, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
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Dimova-Gabrovska M, Dimitrova D. ULTRASOUND DIAGNOSTIC OF MUSCULUS MASSETER. JofIMAB 2017. [DOI: 10.5272/jimab.2017232.1611] [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: 11/11/2022] Open
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Dimova-Gabrovska M, Dimitrova D, Georgiev T. APPLICATION OF MRI IN THE DIAGNOSTICS OF M. MASSETER. JofIMAB 2017. [DOI: 10.5272/jimab.2017232.1607] [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: 11/11/2022] Open
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Marinova D, Slavova Y, Nachev S, Dimitrova D, Mekov E, Mihailov M, Kostadinov D, Youroukova V. Immunohistochemical characteristics of brain metastases and corresponding primary lung cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx094.004] [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: 11/14/2022] Open
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Dimitrova D, Naghavi B, Richter R, Keilholz U, Sehouli J. Zweite Interimsanalyse der multizentrischen NOGGO – Expression V – Umfrage zu den Erwartungen und Wünschen von Patientinnen mit gynäkologischen Malignomen und mit und ohne Migrationshintergrund. Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0037-1598127] [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] Open
Affiliation(s)
- D Dimitrova
- Klinik für Gynäkologie, Charité Universitätsmedizin Berlin
| | - B Naghavi
- Comprehensive Cancer Center, Charité Universitätsmedizin Berlin
| | - R Richter
- Klinik für Gynäkologie, Charité Universitätsmedizin Berlin
| | - U Keilholz
- Comprehensive Cancer Center, Charité Universitätsmedizin Berlin
| | - J Sehouli
- Klinik für Gynäkologie, Charité Universitätsmedizin Berlin
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Sehouli J, Tomè O, Dimitrova D, Camara O, Runnebaum IB, Tessen HW, Rautenberg B, Chekerov R, Muallem MZ, Lux MP, Trarbach T, Gitsch G. A phase III, open label, randomized multicenter controlled trial of oral versus intravenous treosulfan in heavily pretreated recurrent ovarian cancer: a study of the North-Eastern German Society of Gynecological Oncology (NOGGO). J Cancer Res Clin Oncol 2016; 143:541-550. [PMID: 27896440 PMCID: PMC5306340 DOI: 10.1007/s00432-016-2307-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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: 06/27/2016] [Accepted: 11/14/2016] [Indexed: 11/24/2022]
Abstract
OBJECTIVE In recurrent ovarian cancer (ROC), there is a high demand on effective therapies with a mild toxicity profile. Treosulfan is an alkylating agent approved as oral (p.o.) and intravenous (i.v.) formulation for the treatment of recurrent ovarian cancer. Data on safety and efficacy for either formulation are rare. For the first time we conducted a randomized phase III study comparing both formulations in women with ROC. METHODS Patients having received at least two previous lines of chemotherapy were randomly assigned to one of two treatment arms: treosulfan i.v. 7000 mg/m2 d1 q4w or treosulfan p.o. 600 mg/m2 d1-28 q8w. Primary endpoint was safety regarding hematological and gastrointestinal toxicity grade III/IV, secondary endpoints were other toxicities, clinical benefit rate (CBR), time to progression (TTP), overall survival (OS) and quality of life. RESULTS 250 patients were treated with treosulfan i.v. (128) or treosulfan p.o. (122). In general treosulfan therapy was well tolerated in both treatment arms. Leukopenia grade III/IV occurred significantly more frequently in the p.o. arm (3.9% i.v. arm, 14.8% p.o. arm, p = 0.002). Other toxicities were similar in both arms. CBR was comparable between arms (41.4% i.v. arm, 36.9% p.o. arm). No difference in TTP (3.7 months i.v. arm, 3.5 months p.o. arm) or OS (13.6 months i.v. arm, 10.4 months p.o. arm, p = 0.087) occurred. CONCLUSIONS Given the safety and efficacy results treosulfan is an acceptable option for heavily pretreated OC patients. Regarding the toxicity profile the i.v. application was better tolerated with less grade III and IV toxicities.
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Affiliation(s)
- Jalid Sehouli
- Gynecology and Gynecologic Oncology, Charité University Medicine Campus Virchow, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - Oliver Tomè
- Gynecologic Cancer Centre Karlsruhe, St. Vincentius Clinics, Karlsruhe, Germany
| | - Desislava Dimitrova
- Gynecology and Gynecologic Oncology, Charité University Medicine Campus Virchow, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Oumar Camara
- Centre for Gynecology, Hufeland Clinic, Bad Langensalza, Germany
| | | | | | - Beate Rautenberg
- Gynecology and Gynecologic Oncology, University Clinic, Freiburg, Germany
| | - Radoslav Chekerov
- Gynecology and Gynecologic Oncology, Charité University Medicine Campus Virchow, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Mustafa Zelal Muallem
- Gynecology and Gynecologic Oncology, Charité University Medicine Campus Virchow, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Michael Patrick Lux
- Department of OOGYN, Gyncecological University Cancer Center of Franconia, University Hospital Erlangen, CCC Erlangen-EMN, Erlangen, Germany
| | | | - Gerald Gitsch
- Gynecology and Gynecologic Oncology, University Clinic, Freiburg, Germany
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Dimitrova D. How to make Health in All Policies work – an example of Bulgaria. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw168.006] [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: 11/15/2022] Open
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Muallem MZ, Dimitrova D, Pietzner K, Richter R, Feldheiser A, Scharfe I, Schmeil I, Hösl TM, Mustea A, Wimberger P, Burges A, Kimmig R, Sehouli J. Implementation of Enhanced Recovery After Surgery (ERAS) Pathways in Gynecologic Oncology. A NOGGO-AGO* survey of 144 Gynecological Departments in Germany. Anticancer Res 2016; 36:4227-4232. [PMID: 27466536] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 06/22/2016] [Indexed: 06/06/2023]
Abstract
AIM To gather standardized information of current perioperative management of gynecological oncology patients and to evaluate up to what extent the Enhanced Recovery after Surgery (ERAS) elements are established in the clinical routine of gynecologic oncology units in Germany. MATERIALS AND METHODS We performed a multi-centric nationwide survey among 654 primary, secondary and maximal health care gynecological departments in Germany. A multiple-choice questionnaire based on the principles of ERAS was developed to gather information about perioperative management of two fictional cases in gynecological oncology. RESULTS One hundred four units (22%) have been taken the survey. Only 49.5% of surveyed hospitals claimed to be adherent to more than 70% of ERAS elements in managing perioperative period of primary cytoreductive surgery in ovarian cancer patients. 21% of these hospitals implemented more than 80% and only 8.4% implemented more than 90%. The results in border-line tumors operations did not differ from those of ovarian cancer operations. CONCLUSION The implementation of ERAS elements in gynecologic oncology in Germany is still not satisfying as only half of the departments will now be able to apply 70% of these principles. Therefore, we plan the second step of this survey in order to be able to build a consistent structured reporting platform between gynecological oncology units in Germany to facilitate the wide implementation and standardization of ERAS protocol.
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Affiliation(s)
- Mustafa Zelal Muallem
- Department of Gynecology, Campus Virchow-Klinikum, Charité Medical University, Berlin, Germany
| | - Desislava Dimitrova
- Department of Gynecology, Campus Virchow-Klinikum, Charité Medical University, Berlin, Germany Young Academy of Gynecologic Oncology (JAGO), Berlin, Germany
| | - Klaus Pietzner
- Department of Gynecology, Campus Virchow-Klinikum, Charité Medical University, Berlin, Germany Young Academy of Gynecologic Oncology (JAGO), Berlin, Germany
| | - Rolf Richter
- Department of Gynecology, Campus Virchow-Klinikum, Charité Medical University, Berlin, Germany
| | - Aarne Feldheiser
- Department of Anesthesiology and Intensive Care Medicine, Campus Charité Mitte and Campus Virchow-Klinikum, Charité Medical University, Berlin, Germany
| | - Irina Scharfe
- Department of Gynecology, Städtisches Krankenhaus Dresden-Neustadt, Dresden, Germany Young Academy of Gynecologic Oncology (JAGO), Berlin, Germany
| | - Iryna Schmeil
- Department of Gynecology, Dr. Horst-Schmidt- Klinik Wiesbaden, Wiesbaden, Germany Young Academy of Gynecologic Oncology (JAGO), Berlin, Germany
| | - Teresa Maria Hösl
- Department of Gynecology, Campus Virchow-Klinikum, Charité Medical University, Berlin, Germany
| | - Alexander Mustea
- Department of Obstetrics and Gynecology, Greifswald University Hospital, Greifswald, Germany
| | - Pauline Wimberger
- Department of Obstetrics and Gynecology, Dresden University of Technology, Dresden, Germany
| | - Alexander Burges
- Department of Obstetrics and Gynecology, Campus Grosshadern, Munich University Hospital, Munich, Germany
| | - Rainer Kimmig
- Department of Obstetrics and Gynecology, Essen University Hospital, Essen, Germany
| | - Jalid Sehouli
- Department of Gynecology, Campus Virchow-Klinikum, Charité Medical University, Berlin, Germany
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Dimitrova D, Ruscito I, Olek S, Richter R, Hellwag A, Türbachova I, Woopen H, Baron U, Braicu EI, Sehouli J. Germline mutations of BRCA1 gene exon 11 are not associated with platinum response neither with survival advantage in patients with primary ovarian cancer: understanding the clinical importance of one of the biggest human exons. A study of the Tumor Bank Ovarian Cancer (TOC) Consortium. Tumour Biol 2016; 37:12329-12337. [DOI: 10.1007/s13277-016-5109-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 06/09/2016] [Indexed: 12/15/2022] Open
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Dimitrova D, Naghavi B, Neumann K, David M, Chekerov R, Braicu EI, Torsten U, Kronenberger C, Oskay-Özcelik G, Blau I, Keilholz U, Sehouli J. Erste Ergebnisse der Expression V Studie – Berliner Umfrage zu Erwartungen und Wünsche von Patientinnen mit und ohne Migrationshintergrund und gynäkologische Malignome. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1571403] [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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Dimitrova D, Naghavi B, Neumann K, David M, Braicu EI, Chekerov R, Torsten U, Kronenberger C, Oskay-Özcelik G, Blau I, Yüksel E, Blohmer JU, Keilholz U, Sehouli J. Interimsanalyse der multizentrischen NOGGO Studie – Expression V – Umfrage zu den Erwartungen und Wünschen von Patientinnen mit gynäkologischen Malignomen und mit und ohne Migrationshintergrund. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1571369] [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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Andonova M, Urumova V, Dimitrova D, Slavov E, Dzhelebov P, Chaprazov T, Georgieva T. Acute-phase response and the effect of phytopreparation Feverfew (Tanacetum parthenium) in dogs with experimental Pseudomonas aeruginosa skin infection. BJVM 2016. [DOI: 10.15547/bjvm.873] [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: 11/12/2022] Open
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Kalachand RD, Ruscito I, Dimitrova D, Benedetti Panici P, Sehouli J, Olek S, Braicu EI, Lu L, Katsaros D, Yu H, Carey MS, Broaddus R, Lu KH, Mills GB, Harrell MI, Agnew KJ, Swisher EM, Grogan W, Stordal B, Hennessy B. Clinical characteristics and survival outcomes in BRCA1-methylated epithelial ovarian cancer (Bmeth-OC): A pooled analysis of data for 1,278 patients across five studies. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.5526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Ilary Ruscito
- Department of Gynecology and Obstetrics, Sapienza University of Rome, Rome, Italy
| | - Desislava Dimitrova
- Department of Gynecology, European Competence Center for Ovarian Cancer, Campus Virchow Klinikum, Charité Universitätsmedizin Berlin, Berlin, Germany
| | | | | | - Sven Olek
- Ivana Türbachova Laboratory for Epigenetics, Epiontis GMBH, Berlin, Germany
| | - Elena Ioana Braicu
- Charité – Universitätsmedizin Berlin, Department of Gynaecology, European Competence Center for Ovarian Cancer, Charité Campus Virchow Klinikum, Berlin, Germany
| | - Lingeng Lu
- Department of Epidemiology and Public Health, Yale Cancer Centre, Yale University School of Medicine, New Haven, CT
| | - Dionyssios Katsaros
- Dept Surgical Sciences, Gynecologic Oncology, Città della Salute, S.Anna Hospital, Torino, Italy
| | - Herbert Yu
- Epidemiology Program, University of Hawaii Cancer Centre, Honolulu, HI
| | - Mark S Carey
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Karen H. Lu
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Gordon B. Mills
- Department of Systems Biology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Kathy J Agnew
- University of Washington School of Medicine, Seattle, WA
| | | | - William Grogan
- Department of Medical Oncology, Beaumont Hospital, Dublin, Ireland
| | | | - Bryan Hennessy
- Department of Medical Oncology Beaumont Hospital, Dublin, Ireland
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