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Siewert J, Teut M, Gaertner K, Binting S, Eberhardt C, Ortiz M, Grabowska W, Reinhold T, Roll S, Stoeckigt B, Willich SN, Cramer H, Brinkhaus B. Homeopathy for seasonal allergic rhinitis: rationale, design and methods of the three-armed randomized controlled HOMEOSAR trial. BMC Complement Med Ther 2022; 22:338. [PMID: 36550537 PMCID: PMC9773622 DOI: 10.1186/s12906-022-03820-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Patients with seasonal allergic rhinitis (SAR) frequently use homeopathic therapy. Although there is some evidence that homeopathy may be effective in treating symptoms of SAR, there is a lack of high-quality clinical trials. Therefore, the aim of the homeopathy for SAR (HOMEOSAR) trial is to determine the efficacy of individualized or standardized homeopathic drug treatment compared to placebo regarding rhinitis-related quality of life in patients with SAR. METHODS This randomized, placebo-controlled, double-blind, three-armed intervention study will be conducted at two university hospital outpatient clinics for complementary and integrative medicine in Berlin and in 12 office-based practices specializing in homeopathic treatment in Germany. A total of 270 patients with clinical symptoms of SAR and positive allergy test to birch and grass pollen will receive homeopathic anamnesis and subsequently be randomized into (a) standardized homeopathic drug treatment with Galphimia Glauca (potency D6), (b) individualized homeopathic drug treatment (D6), or (c) placebo. All three groups can receive on-demand rescue medication as needed. Treatment will consist of two consultations and daily intake of the study medication for 4 weeks during the pollen season. The primary outcome is the mean overall score of the Rhinitis Quality of Life Questionnaire (RQLQ) in weeks 3 and 4, analyzed using analysis of covariance (adjusted for baseline RQLQ overall score and study center). A closed testing procedure will be used to control the overall type I error comparing the 3 treatment groups. Secondary outcomes include the overall RQLQ and its seven domain scores, responder status (decrease in RQLQ overall score of at least 0.5 points compared to the baseline value), use of rescue medication, intensity of total and individual SAR symptoms based on visual analog scale, generic health-related quality of life, safety, utilization of health care resources and associated costs. In addition, a qualitative data analysis is planned. CONCLUSION The results of our study will contribute to clarifying the possible therapeutic effects of homeopathic drug treatment for patients with SAR. TRIAL REGISTRATION This study has been registered in the German Clinical Trial Registry with trial ID DRKS00018081 on June 09, 2020.
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Affiliation(s)
- J. Siewert
- grid.6363.00000 0001 2218 4662Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - M. Teut
- grid.6363.00000 0001 2218 4662Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - K. Gaertner
- grid.412581.b0000 0000 9024 6397Institute for Integrative Medicine, University of Witten/Herdecke, Herdecke, Germany
| | - S. Binting
- grid.6363.00000 0001 2218 4662Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - C. Eberhardt
- grid.7468.d0000 0001 2248 7639Pharmacy Department, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - M. Ortiz
- grid.6363.00000 0001 2218 4662Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - W. Grabowska
- grid.6363.00000 0001 2218 4662Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - T. Reinhold
- grid.6363.00000 0001 2218 4662Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - S. Roll
- grid.6363.00000 0001 2218 4662Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - B. Stoeckigt
- grid.6363.00000 0001 2218 4662Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - S. N. Willich
- grid.6363.00000 0001 2218 4662Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - H. Cramer
- grid.5718.b0000 0001 2187 5445Department of Internal and Integrative Medicine, Faculty of Medicine, Evang. Kliniken Essen-Mitte, University of Duisburg-Essen, Essen, Germany
| | - B. Brinkhaus
- grid.6363.00000 0001 2218 4662Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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Blank S, Lordick F, Bader F, Burian M, Dobritz M, Grenacher L, Becker K, Weichert W, Langer R, Sisic L, Stange A, Jäger D, Büchler M, Bruckner T, Siewert J, Ott K. Post-therapeutic response evaluation by a combination of endoscopy and CT scan in esophagogastric adenocarcinoma after chemotherapy: better than its reputation. Gastric Cancer 2015; 18:314-25. [PMID: 24722800 DOI: 10.1007/s10120-014-0367-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Accepted: 03/09/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND Neoadjuvant chemotherapy is an accepted standard of care for locally advanced esophagogastric cancer. As only a subgroup benefits, a response-based tailored treatment would be of interest. The aim of our study was the evaluation of the prognostic and predictive value of clinical response in esophagogastric adenocarcinomas. METHODS Clinical response based on a combination of endoscopy and computed tomography (CT) scan was evaluated retrospectively within a prospective database in center A and then transferred to center B. A total of 686/740 (A) and 184/210 (B) patients, staged cT3/4, cN0/1 underwent neoadjuvant chemotherapy and were then re-staged by endoscopy and CT before undergoing tumor resection. Of 184 patients, 118 (B) additionally had an interim response assessment 4-6 weeks after the start of chemotherapy. RESULTS In A, 479 patients (70%) were defined as clinical nonresponders, 207 (30%) as responders. Median survival was 38 months (nonresponders: 27 months, responders: 108 months, log-rank, p < 0.001). Clinical and histopathological response correlated significantly (p < 0.001). In multivariate analysis, clinical response was an independent prognostic factor (HR for death 1.4, 95% CI 1.0-1.8, p = 0.032). In B, 140 patients (76%) were nonresponders and 44 (24%) responded. Median survival was 33 months, (nonresponders: 27 months, responders: not reached, p = 0.003). Interim clinical response evaluation (118 patients) also had prognostic impact (p = 0.008). Interim, preoperative clinical response and histopathological response correlated strongly (p < 0.001). CONCLUSION Preoperative clinical response was an independent prognostic factor in center A, while in center B its prognostic value could only be confirmed in univariate analysis. The accordance with histopathological response was good in both centers, and interim clinical response evaluation showed comparable results to preoperative evaluation.
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Affiliation(s)
- Susanne Blank
- Department of Surgery, University Hospital of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany,
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Feussner H, Siewert J. Kommentar. Dtsch Med Wochenschr 2009. [DOI: 10.1055/s-0029-1233758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Ott K, Lordick F, Feith M, Bartels H, Fink U, Stein HJ, Molls M, Biemer E, Siewert J. Cervical squamous cell carcinoma of the esophagus-a unique series of limited resection and free jejunal graft interposition after neoadjuvant RCTx in 94 patients. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.4572] [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
4572 Background: The treatment of cervical squamous cell carcinoma (SCC) is discussed controversial. A limited resection of the cervical esophagus and reconstruction with a free jejenunal graft interposition using a microsurgical technique has been evaluated in our department. Methods: From 1986–2006 94 patients with the initial staging uT2–4, N any cM0 (75 male, 19 female; age 56+9.6, range: 19–74 years) with cervical SCC of the esophagus were treated with limited esophageal resection and reconstructed with a free jejunal autograft in combination after neoadjuvant RCTx within phase II studies. The median follow up is 23 months (0.1–120). Results: Laryngectomie had to be performed in 13 patients (14%). Recurrent nerve palsy on one side was found in 15/77 (19.5%) and on both sides in 13/77 (17%). Complications occurred in 70 (75%) of the patients, 47% of the patients had more than one complication. Reoperations were necessary in 29 patients (31%). The 30-day mortality was 2/94 (2.1%). Median survival is 29.9 months (1-, 3 and 5-year survival rates: 81%, 43%, 41%). 27/94 (29%) patients showed complete tumor regression (ypT0) after RCTx. Prognostic factors are complete tumor regression (p=0.007), ypT-(p=0.006), the R-category (p=0.018), but not the ypN-category (p=0.06). Neither the occurrence of complications (p=0.57) nor reoperation (p=.89) are associated with survival. The complete resection rate was 76 % (71/94). Median survival is 34.3 months, median recurrence free survival is 21.4 months for the R0 resected patients. 30/71 (42%) had a recurrence (locoregional in 27% (19/71), distant metastases in 10% (7/71) and a combination of both in 6% (4/71). Conclusions: Limited resection of the esophagus and reconstruction by a free jejunal graft after neoadjuvant RCTx is highly sophisticated and complex. Despite a high complication and reoperation rate the results are excellent with a low mortality and a good prognosis. This approach seems to be appropriate for cervical SCC in oncological centers with an infrastructure providing interdisciplinary management. Comparable data for cervical SCC of the esophagus without the inclusion of hypopharyx carcinoma do not exist in literature so far. No significant financial relationships to disclose.
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Affiliation(s)
- K. Ott
- Klinikum rechts der Isar, D- 81675 Munich, Germany
| | - F. Lordick
- Klinikum rechts der Isar, D- 81675 Munich, Germany
| | - M. Feith
- Klinikum rechts der Isar, D- 81675 Munich, Germany
| | - H. Bartels
- Klinikum rechts der Isar, D- 81675 Munich, Germany
| | - U. Fink
- Klinikum rechts der Isar, D- 81675 Munich, Germany
| | - H. J. Stein
- Klinikum rechts der Isar, D- 81675 Munich, Germany
| | - M. Molls
- Klinikum rechts der Isar, D- 81675 Munich, Germany
| | - E. Biemer
- Klinikum rechts der Isar, D- 81675 Munich, Germany
| | - J. Siewert
- Klinikum rechts der Isar, D- 81675 Munich, Germany
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Brücher BL, Wieder H, Busch R, Becker K, Lordick F, Molls M, Siewert J, Schwaiger M. Possible individualized therapy by early assessment of response during neoadjuvant radiochemotherapy in esophageal squamous cell carcinoma patients by 18-FDG-PET. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.4060] [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
4060 Background: Response evaluation by positron emission tomography with the glucose analog [18F]-fluorodeoxyglucose (FDG-PET) has been used in patients with esophageal squamous cell carcinoma (ESCC) after neoadjuvant radiochemotherapy (RTx/CTx). This prospective study was undertaken to compare FDG-PET assessment of tumor response during RTx/CTx with histopathology in patients with ESCC, and to correlate the findings with survival. Methods: Patients (n=61) with histologically proven intrathoracic ESCC (cT3, cN0/+, cM0) underwent preoperative, simultaneous RTx/CTx followed by esophagectomy between 1996 and 2005. The patients underwent FDG-PET prior to and 2 weeks after the begin of RTx/CTx (20Gray). Histopathological response was quantified as the percentage of residual tumor cells. The threshold pre-therapy-to-during-therapy decrease in standardized uptake value by FDG-PET used to define metabolic responders (ΔSUVR) was -30%. Results: Receiving-operator-curve analysis (ROC) for determination of metabolic response revealed an area-under-curve (AUC) of 7140 (p=0.005) with a sensitivity of 76%, specificity (70%), a positive predictive value of 81% and a negative predictive value of 64% (p<0.0001). Responder by FDG-PET during the neoadjuvant treatment (p=0.016) as well as Histopathology (p<0.0001) showed substantially better survival compared to nonresponders. Conclusions: Changes in tumor metabolic activity by FDG-PET during neoadjuvant RTx/CTx allows an accurate determination of response due to the multimodal approach in patients with ESCC. This stratification may lead to a change of the neoadjuvant into a definitive therapy concept in nonresponders (individualized tumor therapy). [Table: see text]
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Affiliation(s)
- B. L. Brücher
- Technical University, Munich, Germany; Technical University of Munich, Munich, Germany
| | - H. Wieder
- Technical University, Munich, Germany; Technical University of Munich, Munich, Germany
| | - R. Busch
- Technical University, Munich, Germany; Technical University of Munich, Munich, Germany
| | - K. Becker
- Technical University, Munich, Germany; Technical University of Munich, Munich, Germany
| | - F. Lordick
- Technical University, Munich, Germany; Technical University of Munich, Munich, Germany
| | - M. Molls
- Technical University, Munich, Germany; Technical University of Munich, Munich, Germany
| | - J. Siewert
- Technical University, Munich, Germany; Technical University of Munich, Munich, Germany
| | - M. Schwaiger
- Technical University, Munich, Germany; Technical University of Munich, Munich, Germany
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Hanazono K, Natsugoe S, Stein H, Aikou T, Hoefler H, Siewert J. Distribution of p53 mutations in esophageal and gastric carcinomas and the relationship with p53 expression. Oncol Rep 2006. [DOI: 10.3892/or.15.4.821] [Citation(s) in RCA: 3] [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: 11/06/2022] Open
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Keller G, Vogelsang H, Becker I, Plaschke S, Ott K, Suriano G, Mateus A, Seruca R, Biedermann K, Döring C, Siewert J, Höfler H. Germline mutations in the E-cadherin and TP53 genes, but not in HPP1 or RUNX3 are associated with genetic predisposition for gastric cancer. Pathol Res Pract 2004. [DOI: 10.1016/s0344-0338(04)80712-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
We analyze possible implementations of quantum algorithms in a system of (macroscopic) Josephson charge qubits. System layout and parameters to realize the Deutsch algorithm with up to three qubits are provided. Special attention is paid to the necessity of entangled states in the various implementations. Further, we demonstrate explicitly that the gates to implement the Bernstein-Vazirani algorithm can be realized by using a system of uncoupled qubits.
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Affiliation(s)
- J Siewert
- Dipartimento di Metodologie Fisiche e Chimiche (DMFCI), Università di Catania, viale A. Doria 6, I-95125 Catania, Italy
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Affiliation(s)
- A H Hölscher
- Department of Visceral and Vascular Surgery, University of Cologne, Germany
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Siewert J, Schön G. Charge transport in voltage-biased superconducting single-electron transistors. Phys Rev B Condens Matter 1996; 54:7421-7424. [PMID: 9984366 DOI: 10.1103/physrevb.54.7421] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Grandt D, Siewert J, Sieburg B, al Tai O, Schimiczek M, Goebell H, Layer P, Eysselein VE, Reeve JR, Müller MK. Peptide YY inhibits exocrine pancreatic secretion in isolated perfused rat pancreas by Y1 receptors. Pancreas 1995; 10:180-6. [PMID: 7536329 DOI: 10.1097/00006676-199503000-00012] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Peptide YY (PYY) inhibits exocrine pancreatic secretion in several species. Two receptors, Y1 and Y2, are known to mediate PYY actions. While PYY 1-36 binds equally to both receptor subtypes, a second endogenous form of PYY, PYY 3-36, selectively activates Y2 receptors. The importance of Y receptor subtypes for inhibition of exocrine pancreatic secretion by PYY is unknown. We studied the effects of PYY 1-36 on cholecystokinin octapeptide (CCK-8)-stimulated amylase secretion in an isolated perfused rat pancreas model. To characterize functionally the receptors involved we determined the effects of a Y1-selective agonist, [Pro34]PYY; a Y2 selective agonist, PYY 3-36; and neuropeptide Y (NPY) in this model. PYY 1-36 significantly inhibited stimulated amylase secretion in the denervated rat pancreas. [Pro34]PYY and NPY both inhibited exocrine pancreatic secretion as potently as PYY 1-36. Contrary to that, the Y2 selective agonist, PYY 3-36, was inactive. We conclude that PYY inhibits exocrine pancreatic secretion in this extrinsically denervated rat pancreas model by Y1 receptors.
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Affiliation(s)
- D Grandt
- Department of Gastroenterology, University of Essen, Germany
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Bauernschmitt R, Siewert J, Nazarov YV, Odintsov AA. Josephson effect in low-capacitance superconductor-normal-metal-superconductor systems. Phys Rev B Condens Matter 1994; 49:4076-4081. [PMID: 10011305 DOI: 10.1103/physrevb.49.4076] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Flach S, Siewert J. Fast and slow dynamics in the one-dimensional Phi 4 lattice model: A molecular-dynamics study. Phys Rev B Condens Matter 1993; 47:14910-14922. [PMID: 10005866 DOI: 10.1103/physrevb.47.14910] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Heidecke CD, Araujo JL, Kupiec-Weglinski JW, Abbud-Filho M, Araneda D, Stadler J, Siewert J, Strom TB, Tilney NL. Lack of evidence for an active role for natural killer cells in acute rejection of organ allografts. Transplantation 1985; 40:441-4. [PMID: 3901444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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