1
|
Schildberg C, Kropf S, Perrakis A, Croner RS, Meyer F. [Consultations by senior physicians in general and abdominal surgery for other medical disciplines over 10 years at a tertiary center-Is a fast time-consuming processing necessary? : Spectrum of clinical findings, diagnoses and treatment decision making]. Chirurgie (Heidelb) 2023; 94:625-634. [PMID: 36991159 PMCID: PMC10310552 DOI: 10.1007/s00104-023-01855-4] [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] [Subscribe] [Scholar Register] [Accepted: 02/12/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND The challenges of an adequate, efficient and rational medical treatment and care of patients are always associated with an interprofessional activity of several specialist disciplines. AIM The spectrum of variable diagnoses and the profile of surgical decision-making with further surgical measures within the framework of senior physician consultation in general and visceral surgery for neighboring medical disciplines were analyzed on a representative patient cohort over a defined observational time period. PATIENTS AND METHODS All consecutive patients (n = 549 cases) were documented as part of a clinical systematic prospective single center observational study at a tertiary center using a computer-based patient registry over 10 years (1 October 2006-30 September 2016). The data were analyzed with respect to the spectrum of clinical findings, diagnoses, treatment decisions and the influencing factors as well as gender and age differences and time-dependent developmental trends using χ2-tests and U‑tests. RESULTS (KEY POINTS) The predominant discipline for requests for surgical consultation was cardiology (19.9%) followed by surgical disciplines (11.8%) and gastroenterology (11.3%). Disorders of wound healing (7.1%) and acute abdomen (7.1%) were predominant in the diagnostic profile. In 11.7% of the patients the indications for immediate surgery were derived, whereas in 12.9% elective surgery was recommended. The conformity rate of suspected and definitive diagnoses was only 58.4%. CONCLUSION The surgical consultation work is an important mainstay of a sufficient and especially timely clarification of surgically relevant questions in nearly all medical institutions and especially in a center. This serves i) the quality assurance of surgery in the clinical care of patients with need of additional interdisciplinary needs for surgical treatment in the daily practice of general and abdominal surgery in research on clinical care, ii) clinical marketing and monetary aspects in the sense of patient recruitment and iii) last but not least to provide emergency care of patients. Due to the high proportion of 12% of subsequent emergency operations, which were derived from requests for general and visceral surgical consultations, such requests must be processed promptly during working hours.
Collapse
Affiliation(s)
- C Schildberg
- Klinik für Allgemein und Viszeralchirurgie, Universitätsklinikum der MHB im Verbund Brandenburg an der Havel, Hochstraße 29, 14770, Brandenburg an der Havel, Deutschland.
| | - S Kropf
- Institut für Biometrie und Medizinische Informatik, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Deutschland
| | - A Perrakis
- Klinik für Allgemein‑, Viszeral‑, Gefäß- und Transplantationschirurgie, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Deutschland
| | - R S Croner
- Klinik für Allgemein‑, Viszeral‑, Gefäß- und Transplantationschirurgie, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Deutschland
| | - F Meyer
- Klinik für Allgemein‑, Viszeral‑, Gefäß- und Transplantationschirurgie, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Deutschland
| |
Collapse
|
2
|
Schmeisser A, Rauwolf T, Groscheck T, Fischbach K, Luani B, Kropf S, Tanev I, Hansen M, Meissler S, Schaefer K, Steendijk P, Braun-Dullaeus R. Predictors and prognosis of RV function in pulmonary hypertension due to heart failure with reduced ejection fraction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0754] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and aims
Failure of right ventricular (RV) function worsens outcome in pulmonary hypertension (PH). The adaptation of RV contractility to afterload, the RV-pulmonary artery (PA) coupling, is defined by the ratio of RV end-systolic to PA elastances (Ees/Ea). Using pressure volume loop (PV-L) technique we aimed to identify an Ees/Ea cutoff predictive for overall survival and to assess hemodynamic and morphologic conditions for adapted RV function in secondary PH due to Heart Failure with Reduced Ejection Fraction (HFREF).
Methods
This post hoc analysis is based on 112 patients of the prospective Magdeburger Resynchronization Responder Trial. All patients underwent right and left heart echocardiography, and a baseline PV-L and RV catheter measurement. A subgroup of patients (n=50) without a pre-implanted cardiac device underwent MRI at baseline.
Results
The analysis revealed that 0.68 is an optimal Ees/Ea cutoff (area under the curve: 0.697, p<0.001) predictive for overall survival (median follow up = 4.7 years, Ees/Ea ≥0.68 vs. <0.68, log-rank 8.9, p=0.003. In patients with PH (n=76, 68%) Multivariate Cox-regression demonstrated the independent prognostic value of RV-Ees/Ea in PH patients (HR 0.2, p<0.038). Patients without PH (n=36, 32%) and those with PH but RV-Ees/Ea ≥0.68 showed comparable RV-Ees/Ea ratios (0.88 vs. 0.9, p=0.39), RV size/function, and survival. In contrast, secondary PH with RV-PA coupling ratio Ees/Ea <0.68 corresponded extremely close to cut-off values that define RV dilatation/remodeling (RVEDV >160ml, RV-mass/volume-ratio <0.37 g/ml) and dysfunction (RVEF <38%, TAPSE <16mm, FAC <42%, and stroke-volume/end-systolic volume ratio <0.59) and is associated with a dramatically increased short and medium-term all-cause mortality. Independent predictors of prognostically unfavorable RV-PA coupling (Ees/Ea <0.68) in secondary PH were a preexistent dilated RV (end-diastolic volume >171ml, odds ratio, OR 0.96, p=0.021), high pulsatile load (PA compliance <2.3 ml/mmHg, OR 8.6, p=0.003), and advanced systolic left heart failure (left ventricular (LV) ejection fraction <30%, OR 1.23, p=0.028).
Conclusions
The RV-PA coupling ratio Ees/Ea predicts overall survival in PH due to HFREF and is mainly affected by pulsatile load, RV remodeling and LV dysfunction. Prognostically favorable coupling (RV-Ees/Ea ≥0.68) in PH was associated with preserved RV size/function and mid-term survival, comparable to HFREF without PH.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Boston Scientific
Collapse
Affiliation(s)
- A Schmeisser
- Otto-von-Guericke University of Magdeburg, Cardiology, Magdeburg, Germany
| | - T.H Rauwolf
- Otto-von-Guericke University of Magdeburg, Cardiology, Magdeburg, Germany
| | - T Groscheck
- Otto-von-Guericke University of Magdeburg, Cardiology, Magdeburg, Germany
| | - K Fischbach
- Otto-von-Guericke University of Magdeburg, Radiology, Magdeburg, Germany
| | - B Luani
- Otto-von-Guericke University of Magdeburg, Cardiology, Magdeburg, Germany
| | - S Kropf
- University of Magdeburg, Biostatistics, Magdeburg, Germany
| | - I Tanev
- Otto-von-Guericke University of Magdeburg, Cardiology, Magdeburg, Germany
| | - M Hansen
- Otto-von-Guericke University of Magdeburg, Cardiology, Magdeburg, Germany
| | - S Meissler
- Otto-von-Guericke University of Magdeburg, Cardiology, Magdeburg, Germany
| | - K Schaefer
- Otto-von-Guericke University of Magdeburg, Cardiology, Magdeburg, Germany
| | - P Steendijk
- Leiden University Medical Center, Cardiology, Leiden, Netherlands (The)
| | - R Braun-Dullaeus
- Otto-von-Guericke University of Magdeburg, Cardiology, Magdeburg, Germany
| |
Collapse
|
3
|
Schöninger L, Voigt-Zimmermann S, Kropf S, Arens C, Davaris N. [Contact endoscopy with narrow-band imaging for detection of perpendicular vascular changes in benign, dysplastic, and malignant lesions of the vocal folds]. HNO 2021; 69:712-718. [PMID: 34125236 PMCID: PMC8413161 DOI: 10.1007/s00106-021-01063-8] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Perpendicular vascular changes (PVC) are markers of tumor-induced neoangiogenesis at the vocal folds. Contact endoscopy with narrow-band imaging (CE-NBI) allows a detailed analysis of such vascular changes. OBJECTIVE This work intends to evaluate the potential of CE-NBI for diagnosis of benign, dysplastic, and malignant lesions of the vocal folds. In addition, it should be determined whether CE-NBI offers an additional benefit in detecting PVC compared to white-light endoscopy (WLE) and NBI alone. MATERIALS AND METHODS Three examiners evaluated histologically verified cases of benign, dysplastic, and malignant lesions of the larynx in WLE, NBI, and CE-NBI (n = 60). In each mode, they examined the lesion for PVC and assessed the lesion's dignity. The proportion of lesions with detected PVC, the statistical measures of performance in detecting high-grade dysplasia and carcinoma, and the interrater variability for each mode were calculated. RESULTS CE-NBI proved superior to the other investigated diagnostic methods in terms of detecting PVC and in terms of sensitivity and accuracy in the diagnosis of high-grade dysplasia and carcinoma. A clear association of such pathologies with PVC was seen. CONCLUSION CE-NBI detects PVC more frequently and reliably than the other methods investigated. The association of these vascular patterns to high-grade dysplasia and vocal fold carcinomas could be confirmed. Compared to WLE and NBI endoscopy, the diagnostic quality for detecting high-grade dysplasia and carcinoma is increased. Thus, CE-NBI can improve endoscopic differentiation between benign and malignant lesions of the vocal folds by enhancing the detection of PVC.
Collapse
Affiliation(s)
- L Schöninger
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Medizinische Fakultät, Otto-von-Guericke-Universität, Leipziger Straße 44, 39120, Magdeburg, Deutschland
| | - S Voigt-Zimmermann
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Medizinische Fakultät, Otto-von-Guericke-Universität, Leipziger Straße 44, 39120, Magdeburg, Deutschland
| | - S Kropf
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Medizinische Fakultät, Otto-von-Guericke-Universität, Leipziger Straße 44, 39120, Magdeburg, Deutschland
| | - C Arens
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Medizinische Fakultät, Otto-von-Guericke-Universität, Leipziger Straße 44, 39120, Magdeburg, Deutschland
| | - N Davaris
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Medizinische Fakultät, Otto-von-Guericke-Universität, Leipziger Straße 44, 39120, Magdeburg, Deutschland.
| |
Collapse
|
4
|
Schmeisser A, Rauwolf T, Ghanem A, Handerer J, Fischbach K, Tanev I, Groscheck T, Hansen M, Meissler S, Kropf S, Steendijk P, Braun-Dullaeus RC. P4687Relevance of TAPSE and FAC, and their relationship to PASP as echo-derived measures for RV-PA coupling in heart failure: a comparative analysis with invasive RV-pressure volume loop data. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1068] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Right ventricular (RV) to pulmonary artery (PA) coupling (C), quantified by pressure volume (PV) loop analysis, predicts RV function, and is independently associated with long term survival in systolic heart failure (HFrEF). However, the PV loop technique is invasive and complex to carry out, especially when used to do RV functional analyses. Different echo-surrogate parameters are proposed to measure RV-PA-C, such as the tricuspid annular plane systolic excursion, TAPSE/PAsystolic pressure (SP) and FAC (fractional area change)/PASP as the most promising parameters. However, up to now, no validation of these non-invasive coupling indices with the invasive gold standard method of RV-PV-loops has been done.
Methods
In 111 patients with advanced HFrEF (Post-hoc analysis of Magdeburger CRT Responder Trial, DRKS00011133), echo-derived TAPSE and FAC, and their relationship to PASP were related to the RV PV-loop-derived parameters of intrinsic RV contractility (Ees), pulmonary load (Ea), and the RV-PA-C efficiency (Ees/Ea) by linear regression analysis. Within a MRI substudy (n=49 patients) we examined the relationship of pure longitudinal contraction (MRI-TAPSE) and radial free wall to septum contraction (area change of 5 RV segments from tricuspid valve to apex in the short axis view) to the invasive RV-PA-C.
Results
The MRI analysis demonstrated that radial RV contraction (R2=0.77, p<0.001) correlated better to invasive RV-PA-C than pure longitudinal shortening (R2=0.37, p<0.001) (radial vs. longitudinal: p<0.00). Echo data for the entire patient cohort confirmed the MRI data. The FAC (R2=0.8, p<0.001) was significantly better associated with RV-PA-C than TAPSE (R2=0.57, p<0.001) (TAPSE vs FAC, p<0.001). Placing TAPSE or FAC into a quotient with PASP did not at all (TAPSE vs. TAPSE/PASP, p=0.1) or significantly attenuated (FAC vs. FAC/PASP R2=0.8 vs 0.58, p<0.001) their association to RV-PA-C. However, FAC/PASP and TAPSE/PASP correlated significantly better with global afterload (Eea), PA compliance, and pressure volume area (PVA), (p<0.001). In ROC analysis for all-cause mortality, all 4 tested parameters were prognostic relevant, however, with higher AUC values for FAC/PASP (AUC=0.74, p<0.001) and TAPSE/PASP (AUC=0.74, p<0.001) than for single TAPSE (AUC= 0.71, p=0.001) or FAC (AUC=0.7, p=0.001). Within a multivariate Cox regression analysis, only the FAC/PASP remained an independent predictor for long term survival.
Conclusion
FAC, an echo parameter that includes a predominant radial with a smaller part of longitudinal contraction, correlated significantly better to the invasively derived RV-PA-C-ratio than pure longitudinal RV shortening (TAPSE). Combining FAC or TAPSE with PASP did not improve the non-invasive RV-PA coupling information. However, it provided more comprehensive information on pulmonary vascular load and RV oxygen consumption, which seems to be translated into a higher prognostic power.
Acknowledgement/Funding
scientific grant from Boston Scientific
Collapse
Affiliation(s)
- A Schmeisser
- Otto-von-Guericke University of Magdeburg, Cardiology, Magdeburg, Germany
| | - T Rauwolf
- Otto-von-Guericke University of Magdeburg, Cardiology, Magdeburg, Germany
| | - A Ghanem
- Otto-von-Guericke University of Magdeburg, Cardiology, Magdeburg, Germany
| | - J Handerer
- Otto-von-Guericke University of Magdeburg, Cardiology, Magdeburg, Germany
| | - K Fischbach
- Otto-von-Guericke University of Magdeburg, Radiology, Magdeburg, Germany
| | - I Tanev
- Otto-von-Guericke University of Magdeburg, Cardiology, Magdeburg, Germany
| | - T Groscheck
- Otto-von-Guericke University of Magdeburg, Cardiology, Magdeburg, Germany
| | - M Hansen
- Otto-von-Guericke University of Magdeburg, Cardiology, Magdeburg, Germany
| | - S Meissler
- Otto-von-Guericke University of Magdeburg, Cardiology, Magdeburg, Germany
| | - S Kropf
- University of Magdeburg, Biostatistics, Magdeburg, Germany
| | - P Steendijk
- Leiden University Medical Center, Cardiology, Leiden, Netherlands (The)
| | - R C Braun-Dullaeus
- Otto-von-Guericke University of Magdeburg, Cardiology, Magdeburg, Germany
| |
Collapse
|
5
|
Vugts D, Adamzek K, Poot A, Vosjan M, Kropf S, Wester HJ, Van Dongen G, Windhorst A. Fully automated zirconium-89 antibody labeling and purification. Nucl Med Biol 2019. [DOI: 10.1016/s0969-8051(19)30251-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
6
|
Hess A, Wittneben A, Kropf S, Wester HJ, Ross TL, Bengel FM, Thackeray JT. 9Targeting chemokine receptor CXCR4 after myocardial infarction by PET for image-guided anti-inflammatory therapy. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez151.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Hess
- Hannover Medical School, Nuclear Medicine, Hannover, Germany
| | - A Wittneben
- Hannover Medical School, Nuclear Medicine, Hannover, Germany
| | - S Kropf
- Scintomics, Fürstenfeldbruck, Germany
| | - H J Wester
- Technical University of Munich, Munich, Germany
| | - T L Ross
- Hannover Medical School, Nuclear Medicine, Hannover, Germany
| | - F M Bengel
- Hannover Medical School, Nuclear Medicine, Hannover, Germany
| | - J T Thackeray
- Hannover Medical School, Nuclear Medicine, Hannover, Germany
| |
Collapse
|
7
|
Glasenapp A, Derlin K, Gutberlet M, Kropf S, Wester HJ, Ross TL, Bengel FM, Thackeray JT. 251Pressure overload evokes cardiac chemokine receptor CXCR4 upregulation, which predicts subsequent progression of heart failure. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez150.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Glasenapp
- Hannover Medical School, Department of Nuclearmedicine, Hannover, Germany
| | - K Derlin
- Hannover Medical School, Department of Radiology, Hannover, Germany
| | - M Gutberlet
- Hannover Medical School, Department of Radiology, Hannover, Germany
| | - S Kropf
- Scintomics GmbH, Fürstenfeldbruck, Germany
| | - H J Wester
- Technical University of Munich, Lehrstuhl für Pharmazeutische Radiochemie, Munich, Germany
| | - T L Ross
- Hannover Medical School, Department of Nuclearmedicine, Hannover, Germany
| | - F M Bengel
- Hannover Medical School, Department of Nuclearmedicine, Hannover, Germany
| | - J T Thackeray
- Hannover Medical School, Department of Nuclearmedicine, Hannover, Germany
| |
Collapse
|
8
|
Haug AR, Leisser A, Wadsak W, Mitterhauser M, Pfaff S, Kropf S, Wester HJ, Hacker M, Hartenbach M, Kiesewetter-Wiederkehr B, Raderer M, Mayerhoefer ME. Prospective non-invasive evaluation of CXCR4 expression for the diagnosis of MALT lymphoma using [ 68Ga]Ga-Pentixafor-PET/MRI. Am J Cancer Res 2019; 9:3653-3658. [PMID: 31281504 PMCID: PMC6587159 DOI: 10.7150/thno.31032] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 03/28/2019] [Indexed: 12/20/2022] Open
Abstract
MALT lymphomas express the chemokine receptor CXCR4 on a regular basis, and [68Ga]Ga-Pentixafor-PET has been shown to quantify CXCR4 expression non-invasively. We, therefore, aimed to evaluate [68Ga]Ga-Pentixafor-PET/MRI for the non-invasive assessment of MALT lymphomas. Methods: We included 36 MALT lymphoma patients, who had not undergone previous systemic or radiation therapy, in our prospective, IRB-approved, proof-of-concept study. Involved anatomic regions were the orbit (n=14), stomach (n=10), lungs (n=5), and other sites (soft-tissues n=3; adrenal gland, tonsils, parotid gland, and urinary bladder n=1, respectively). MRI sequences included an axial 2-point Dixon T1 VIBE SPAIR 3D sequence for PET attenuation correction; a coronal T2 HASTE sequence; and an axial echo-planar imaging SPAIR-based diffusion-weighted sequence (DWI) obtained during free-breathing (b-values, 50 and 800), with corresponding ADC (apparent diffusion coefficient) maps. Results: In 33/36 patients, there were MALT lymphomas with an increased uptake of [68Ga]Ga-Pentixafor; all current lymphoma manifestations showed an increased uptake and, accordingly, were positive on the PET/MRI. The remaining three patients had undergone surgery for their orbital MALT lymphomas prior to PET/MRI. Mean SUVmax was 8.6 ± 4.7, mean SUVmean was 4.7 ± 1.8, and mean SUVpeak was 8.0 ± 4.2. The mean SUVmax of the liver was 1.8, and the mean tumor-to-liver ratio was 2.9 ± 2.0. There were no significant differences in SUVmax (P=0.22), SUVmean (P=0.53), SUVpeak (P=0.29), or SUVt/l (P=0.92) between the four anatomic regions (orbit, stomach, lungs, other). The mean tumor volume was 146 ± 499. Conclusions: Our results thus indicate that [68Ga]Ga-Pentixafor-PET is feasible for the assessment of MALT lymphomas, with a good tumor-to-background ratio in terms of radiotracer uptake.
Collapse
|
9
|
Neusel C, Class D, Eckert AW, Firsching R, Göbel P, Götz D, Haase R, Jorch G, Köhn A, Kropf S, Patzer L, Schanze I, Zahl C, Rissmann A. Multicentre approach to epidemiological aspects of craniosynostosis in Germany. Br J Oral Maxillofac Surg 2018; 56:881-886. [PMID: 30360905 DOI: 10.1016/j.bjoms.2018.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 05/15/2018] [Accepted: 10/03/2018] [Indexed: 02/06/2023]
Abstract
We know of no current published data on the prevalence of craniosynostosis in Germany, so our objective in this study was to contribute to the limited knowledge of its epidemiology by assessing time trends, the frequency of prenatal diagnosis, and the timing of diagnosis and treatment. Data were collected in Saxony-Anhalt during the period 2000-17, and we designed a retrospective multicentre cohort study. The prevalence was 4.8 cases of craniosynostosis/10 000 births, and did not increase during that time. We compared the data of 91 patients with those of 273 controls. There were 75 boys and 16 girls (ratio 4.7:1). Fifty-one children had isolated craniosynostosis, consisting of 46 with a single-suture, and five with a multisuture, synostosis. Twenty-nine were associated with other congenital malformations, and 11 were syndromic. Three cases had been diagnosed prenatally, and 34 had skull deformities diagnosed immediately after birth at a mean (SD) age of 3.4 (4.7) months. The mean (SD) age at the time of first admission to hospital in one of the three surgical centres of Saxony-Anhalt was 5.9 (5.5) months, and 65 patients were operated on at a mean age of 9.1 (6.3) months. In contrast to published reports we found a prevalence of 4.8 cases of craniosynostosis/10 000 births that did not increase during the period 2000-16. Although we found a low prenatal detection rate, the diagnosis and treatment in this cohort study seemed timely.
Collapse
Affiliation(s)
- C Neusel
- Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-von-Guericke University Magdeburg, Leipziger Str. 44, Haus 39, 39120 Magdeburg, Germany.
| | - D Class
- Universitaetsklinik fuer Neurochirurgie, Leipziger Str. 44, 39120 Magdeburg, Germany.
| | - A W Eckert
- Department of Oral and Maxillofacial Surgery, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany.
| | - R Firsching
- Universitaetsklinik fuer Neurochirurgie, Leipziger Str. 44, 39120 Magdeburg, Germany.
| | - P Göbel
- Department of Paediatric Surgery and Paediatric Urology, Hospital St. Elisabeth and St. Barbara Halle (Saale), Mauerstraße 5, 06110 Halle (Saale), Germany.
| | - D Götz
- Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-von-Guericke University Magdeburg, Leipziger Str. 44, Haus 39, 39120 Magdeburg, Germany.
| | - R Haase
- Department of Neonatology and Paediatric Intensive Care, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany.
| | - G Jorch
- Department of Paediatrics, University Hospital Magdeburg, Leipziger Str. 44, Haus 10, 39120 Magdeburg, Germany.
| | - A Köhn
- Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-von-Guericke University Magdeburg, Leipziger Str. 44, Haus 39, 39120 Magdeburg, Germany.
| | - S Kropf
- Institute of Biometry and Medical Informatics, Medical Faculty Otto-von-Guericke University Magdeburg, Leipziger Str. 44, Haus 2, 39120 Magdeburg, Germany.
| | - L Patzer
- Department of Paediatrics, Hospital St. Elisabeth and St. Barbara Halle (Saale), Mauerstraße 5, 06110 Halle (Saale), Germany.
| | - I Schanze
- Institute of Human Genetics, University Hospital Magdeburg, Leipziger Str. 44, Haus 1, Haus 39, Magdeburg, 39120 Germany.
| | - C Zahl
- Department of Oral and Maxillofacial Surgery, University Hospital Magdeburg, Leipziger Str. 44, Haus 19, 39120 Magdeburg, Germany.
| | - A Rissmann
- Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty Otto-von-Guericke University Magdeburg, Leipziger Str. 44, Haus 39, 39120 Magdeburg, Germany.
| |
Collapse
|
10
|
Haase-Fielitz A, Albert C, Albert A, Bellomo R, Kropf S, Devarajan P, Westphal S, Baraki H, Kutschka I, Butter C, Haase M. P4553Urinary NGAL-guided risk assessment for adverse kidney-related events after open heart surgery. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4553] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Haase-Fielitz
- Brandenburg Heart Center, Cardiology, Bernau bei Berlin, Germany
| | | | | | - R Bellomo
- Austin Health Hospital, Melbourne, Australia
| | - S Kropf
- Otto-von-Guericke University of Magdeburg, Magdeburg, Germany
| | - P Devarajan
- Cincinnati Children's Hospital Medical Center, Cincinnati, United States of America
| | - S Westphal
- Clinical Chemistry and Pathobiochemistry, Magdeburg, Germany
| | - H Baraki
- Department of Cardiothoracic Surgery, University Göttingen, Göttingen, Germany
| | - I Kutschka
- Department of Cardiothoracic Surgery, University Göttingen, Göttingen, Germany
| | - C Butter
- Brandenburg Heart Center, Cardiology, Bernau bei Berlin, Germany
| | - M Haase
- Diaverum MVZ, Potsdam, Germany
| |
Collapse
|
11
|
Schmeisser A, Rauwolf T, Ghanem A, Fischbach K, Tanev I, Groscheck T, Kropf S, Steendijk P, Braun-Dullaeus R. P4533Homeometric adaptation to pulmonary vascular load determines right ventricular dimensions and function in patients with advanced systolic left heart disease with and without secondary pulmonary hypert. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4533] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Schmeisser
- Otto-von-Guericke University of Magdeburg, Cardiology, Magdeburg, Germany
| | - T Rauwolf
- Otto-von-Guericke University of Magdeburg, Cardiology, Magdeburg, Germany
| | - A Ghanem
- Klinikum Neindorf, Cardiology, Neindorf, Germany
| | - K Fischbach
- Otto-von-Guericke University of Magdeburg, Radiology, Magdeburg, Germany
| | - I Tanev
- Otto-von-Guericke University of Magdeburg, Cardiology, Magdeburg, Germany
| | - T Groscheck
- Otto-von-Guericke University of Magdeburg, Cardiology, Magdeburg, Germany
| | - S Kropf
- University of Magdeburg, Biostatistics, Magdeburg, Germany
| | - P Steendijk
- Leiden University Medical Center, Departement of Cardiology, Leiden, Netherlands
| | - R Braun-Dullaeus
- Otto-von-Guericke University of Magdeburg, Cardiology, Magdeburg, Germany
| |
Collapse
|
12
|
Schmeisser A, Rauwolf T, Ghanem A, Fischbach K, Tanev I, Groscheck T, Kropf S, Steendijk P, Braun-Dullaeus R. 5039The functional and prognostic impact of RV-PA coupling in advanced systolic left heart disease: A RV pressure-volume loop study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.5039] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Schmeisser
- Otto-von-Guericke University of Magdeburg, Cardiology, Magdeburg, Germany
| | - T Rauwolf
- Otto-von-Guericke University of Magdeburg, Cardiology, Magdeburg, Germany
| | - A Ghanem
- Klinikum Neindorf, Cardiology, Neindorf, Germany
| | - K Fischbach
- Otto-von-Guericke University of Magdeburg, Radiology, Magdeburg, Germany
| | - I Tanev
- Otto-von-Guericke University of Magdeburg, Cardiology, Magdeburg, Germany
| | - T Groscheck
- Otto-von-Guericke University of Magdeburg, Cardiology, Magdeburg, Germany
| | - S Kropf
- University of Magdeburg, Biostatistics, Magdeburg, Germany
| | - P Steendijk
- Leiden University Medical Center, Departement of Cardiology, Leiden, Netherlands
| | - R Braun-Dullaeus
- Otto-von-Guericke University of Magdeburg, Cardiology, Magdeburg, Germany
| |
Collapse
|
13
|
Köhler M, Hoppe S, Frommer J, Flechtner H, Kropf S, Lux A, Bartsch R, Holzner B, Krauter J, Grabietz P, Florschütz A, Hoelzer K, Jentsch-Ullrich K, Fischer T. Randomisierte klinische Studie zu einer Coping Support Intervention für Eltern von Adoleszenten und jungen Erwachsenen (AYA) mit hämatologischen Malignomen. Psychother Psychosom Med Psychol 2018. [DOI: 10.1055/s-0038-1667915] [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]
|
14
|
Pliske G, Heide S, Lucas B, Brandstädter K, Walcher F, Kropf S, Lessig R, Piatek S. [Legal medicine specialists within the framework of acute care : Analysis of legal medicine consultations in relation to the victims' statistics of the state office of criminal investigation in Saxony-Anhalt]. Unfallchirurg 2017; 121:391-396. [PMID: 28921014 DOI: 10.1007/s00113-017-0413-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND In acute medical care, there are patients who have been injured by the influence of others. The aim of this study was to analyze all cases which were presented to the Institute for Legal Medicine of the University Halle (Saale). The cases where analyzed in relation to the victims' statistics of the state office of criminal investigation in Saxony-Anhalt. MATERIALS AND METHODS The consultations of the Institute for Legal Medicine Halle-Wittenberg for 2012-2015 were evaluated with regard to the age and gender distribution, the reasons for the consultation and time until the request for consultations. These cases were statistically compared to the victims' statistics of the state office of criminal investigation in Saxony-Anhalt 2014-2015. RESULTS A total of 536 cases (55.6% male and 44.4% female patients) were evaluated. In all, 62.1% of patients were under 18 years of age; 43.5% of all consultations were requested by pediatric (surgery) clinics. The most common reasons for consultation were sexual child abuse or violence against children (50.7%). Compared to the victims' statistics, significantly more children were examined by legal medicine specialists than could have been expected (p < 0.001). In adult patients, the most common causes for consultation were acts of violence (20.4%) and domestic violence (10.1%). Among adults, significantly more women and fewer men were presented than expected (p = 0.001). CONCLUSION There were only a small number of consultations of legal medicine specialists in relation to the victims' statistics. Most of them were children and women. The temporal latency between the act of violence and the consultations was one day and more. The latency and the renunciation of the consultation of the legal medicine specialists can lead to loss of evidence.
Collapse
Affiliation(s)
- G Pliske
- Klinik für Unfallchirurgie, Otto-von-Guericke Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland.
| | - S Heide
- Institut für Rechtsmedizin, Universitätsklinikum Halle (Saale), Halle (Saale), Deutschland
| | - B Lucas
- Klinik für Unfallchirurgie, Otto-von-Guericke Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland
| | - K Brandstädter
- Institut für Rechtsmedizin, Universitätsklinikum Halle (Saale), Außenstelle Magdeburg, Magdeburg, Deutschland
| | - F Walcher
- Klinik für Unfallchirurgie, Otto-von-Guericke Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland
| | - S Kropf
- Institut für Biometrie und Medizinische Informatik, Otto-von-Guericke Universität Magdeburg, Magdeburg, Deutschland
| | - R Lessig
- Institut für Rechtsmedizin, Universitätsklinikum Halle (Saale), Halle (Saale), Deutschland
| | - S Piatek
- Klinik für Unfallchirurgie, Otto-von-Guericke Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland
| |
Collapse
|
15
|
Bergmann LCE, Darius S, Kropf S, Böckelmann I. [Measurement of contrast vision: mesopic or photopic vision? : Comparison of different methods for measuring contrast sensitivity within the framework of driving licence regulations]. Ophthalmologe 2017; 113:844-851. [PMID: 27142036 DOI: 10.1007/s00347-016-0261-5] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Since 2011 the regulations for occupational driving licences make the examination of contrast vision sensitivity obligatory; however, apart from mesopic procedures no uniform regulations are available for methods and minimum requirements. OBJECTIVE By comparing different mesopic and photopic contrast sensitivity tests this study analyzed whether these could be equivalently used and lead to the same results. MATERIAL AND METHODS Contrast vision sensitivity was determined in 150 subjects with emmetropia using five different methods, i.e. the mesopic test device Mesotest II as the reference method, Rodatest 302 and Optovist as photopic test devices and two photopic test charts (Vistech chart and Mars charts). The results of passing the tests were compared and Cohens κ was determined to quantify the conformity between the tests. RESULTS Poor agreement was found between Mesotest II and Optovist as well as between Mesotest II and the Vistech chart. There was no agreement between Rodatest 302 or Mars charts and Mesotest II; nevertheless, the contrast vision sensitivity measured with Optovist, Rodatest 302 and the Vistech chart showed good correlation (0.46 ≤ r ≤ 0.69). CONCLUSION Apart from a few limitations, the reference method Mesotest II as well as Optovist and the Vistech chart are suitable for testing contrast vision sensitivity, whereas Rodatest 302 and Mars charts cannot be recommended based on the current criteria for minimum requirements. The minimum requirements must be urgently adapted and strict regulations for measurement must be formulated. In addition, due to the poor agreement between the methods an amendment of the driving licence regulations should be considered, which requires examination of both mesopic and photopic contrast vision or alternatively mesopic contrast vision alone.
Collapse
Affiliation(s)
- L C E Bergmann
- Bereich Arbeitsmedizin, Medizinische Fakultät, Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland
| | - S Darius
- Bereich Arbeitsmedizin, Medizinische Fakultät, Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland
| | - S Kropf
- Institut für Biometrie und medizinische Informatik, Medizinische Fakultät, Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Deutschland
| | - I Böckelmann
- Bereich Arbeitsmedizin, Medizinische Fakultät, Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland.
| |
Collapse
|
16
|
Schmeisser A, Rauwolf T, Ghanem A, Groschek T, Grothues F, Fischbach K, Luani B, Smid J, Tanev I, Schaefer M, Wengler F, Kropf S, Yeritzian N, Steendijk P, Braun-Dullaeus R. P5476Right ventricular - pulmonary vascular interaction predicts left ventricular remodelling after CRT: A prospective pressure volume loop study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5476] [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: 11/12/2022] Open
|
17
|
Friebe B, Richter M, Penzlin S, Stärke C, Godenschweger F, Ricke J, Kropf S, Fischbach F, Speck O. Morphologische Bildgebung von Meniskus- und Knorpelschäden des Kniegelenkes mit Ultrahochfeld-MRT bei 7Tesla – ein Vergleich mit 3-Tesla Bildgebung mit arthroskopischer Korrelation. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- B Friebe
- Universitätsklinik Magdeburg, Radiologie und Nuklearmedizin, Magdeburg
| | - M Richter
- Universitätsklinik Magdeburg, Radiologie und Nuklearmedizin, Magdeburg
| | - S Penzlin
- Universitätsklinik Magdeburg, Radiologie und Nuklearmedizin, Magdeburg
| | - C Stärke
- Universitätsklinik Magdeburg, Orthopädie, Magdeburg
| | - F Godenschweger
- Institut für experimentelle Physik, Biomedizinische Magnetresonanz, Magdeburg
| | - J Ricke
- Universitätsklinik Magdeburg, Radiologie und Nuklearmedizin, Magdeburg
| | - S Kropf
- Universitätsklinik Magdeburg, Institut für Biometrie und medizinische Informatik, Magdeburg
| | - F Fischbach
- Universitätsklinik Magdeburg, Radiologie und Nuklearmedizin, Magdeburg
| | - O Speck
- Institut für experimentelle Physik und Leibniz Institut für Neurobiologie, Biomedizinische Magnetresonanz, Magdeburg
| |
Collapse
|
18
|
Kempa C, Berek I, Kropf S, Costa SD. Analyse des Einflusses familienpolitischer Maßnahmen auf die Geburtenentwicklung am Beispiel des Elterngeldes in Magdeburg und internationaler Vergleich mit Lyon/Frankreich. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
19
|
Petersen M, Steinert R, Jannasch O, Venerito M, Meissner C, Kropf S, Albrecht R, Lippert H, Meyer F. [Sealing of the hepatic resection area using hemostat devices does not improve results of adequate surgery]. Z Gastroenterol 2016; 54:634-41. [PMID: 27429100 DOI: 10.1055/s-0042-100284] [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] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE In hepatic resections, there has been a high quality demand. The aim of this systematic clinical, prospective, unblinded unicenter observational study with two arms in an unselected patient cohort was to investigate whether hemostat device can significantly improve outcome in resective liver surgery, in particular, in high risk patients. METHODS All consecutive patients (mean age, 60.5 [range, 17 - 96] years) who underwent hepatic resection (ntotal = 770) were prospectively documented in a computer-based registry at a university hospital (tertiary center) over a time period of 10 years and retrospectively evaluated specifically with regard to the use (-/+; in daily practice and intraoperative decision-making) of hemostat device (Tissucol(®), n = 59/Tachocomb(®), n = 202/combination, n = 55) indicated (among others) by drainage volume, inflammatory parameters and rate of specific complications (nvalidated = 541 [100 %]). RESULTS Most frequently, (a-)/typical segmental resections were used: n = 192/90 (3-segment resection, only n = 38). 1) For the assignment of patients to the two different groups (-/+ hemostat device), weight loss and type of resection were found as significant factors (trend: ASA, cirrhosis), for the amount of drainage volume, ASA, sex, Karnofsky Performance Scale and also type of resections using independent distributed statistical tests (such as χ(2), U test [Mann/Whitney]; H test [Kruskal-Willis]; correlation coefficient by Spearman) - no impact: smoking, diabetes, BMI, ethanol. 2) Not taking into account these parameters, the use of hemostat device was characterized by an increased drainage volume (negative control < Tissucol = Tachocomb < combination). 3) Using multifactorial analysis of variance, it was found even under correction by the factors with significant impact elucidated in the single test that the application of hemostat device onto the hepatic resection area resulted unexpectedly rather in an increase than a decrease of the drainage volume but 4) under accompanying more pronounced increase of the white blood cell count (leucocytosis). 5) General and specific complications such as postoperative bleeding, biliary fistula and subhepatic abscess were not further lowered in a significant manner using hemostat device. CONCLUSION Adequate surgery in the operative management of hepatic resection area cannot further be improved or optimized using hemostat device. In this context, drainage volume may not be considered a sufficient rather an orienting parameter. However, there is an inflammatory response detectable most likely indicated by a(n un-)specific effusion and increase of white blood cell count, which can be interpreted as a) being characteristic for the problematic group of patients, in whom hemostat device was decided to be useful and was finally used in daily prectice, or b) reactive inflammation to foreign material.
Collapse
Affiliation(s)
- M Petersen
- Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Germany
| | - R Steinert
- Klinik für Allgemein- und Viszeralchirurgie, St Josefs Krankenhaus, Salzkotten, Germany
| | - O Jannasch
- Klinik für Allgemein- & Viszeralchirurgie, AMEOS Klinikum, Haldensleben, Germany
| | - M Venerito
- Klinik für Gastroenterologie, Hepatologie und Infektiologie, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Germany
| | - C Meissner
- Klinik für Allgemein- und Viszeralchirurgie, Klinikum Magdeburg gGmbH, Magdeburg, Germany
| | - S Kropf
- Institut für Biometrie und Medizinische Informatik, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Germany
| | - R Albrecht
- Klinik für Viszeral- & Gefäßchirurgie, HELIOS Klinikum, Aue, Germany
| | - H Lippert
- AN-Institut für Qualitätssicherung in der Operativen Medizin, Otto-von-Guericke-Universität, Magdeburg, Germany
| | - F Meyer
- Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Germany
| |
Collapse
|
20
|
Grunwald L, Jorch G, Kropf S, Seeger S, Seliger G, Rißmann A. Die Bedeutung neurologischer, psychiatrischer und Suchterkrankungen für den Schwangerschaftsausgang: Fall-Kontroll-Studie der Geburtsjahrgänge 2010–2012. Z Geburtshilfe Neonatol 2016; 220:116-23. [DOI: 10.1055/s-0042-101870] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- L. Grunwald
- Fehlbildungsmonitoring Sachsen-Anhalt, Medizinische Fakultät der Otto-von-Guericke Universität Magdeburg, Magdeburg
| | - G. Jorch
- Universitätskinderklinik, Medizinische Fakultät, Otto-von-Guericke Universität Magdeburg, Magdeburg, Sachsen-Anhalt
| | - S. Kropf
- Institut für Biometrie und Medizinische Informatik, Medizinische Fakultät Otto-von-Guericke Universität Magdeburg, Magdeburg
| | - S. Seeger
- Klinik für Frauenheilkunde und Geburtshilfe, Perinatalzentrum, KH St. Elisabeth und St. Barbara Halle, Halle/Saale
| | - G. Seliger
- Universitätsklinik und Poliklinik für Geburtshilfe und Pränatalmedizin, Martin-Luther Universität Halle/Saale, Halle
| | - A. Rißmann
- Fehlbildungsmonitoring Sachsen-Anhalt, Medizinische Fakultät der Otto-von-Guericke Universität Magdeburg, Magdeburg
| |
Collapse
|
21
|
Schossee A, Voigt-Zimmermann S, Kropf S, Arens C. [Evaluation of a Classification Model of Horizontal Vascular Lesions of the Vocal Folds]. Laryngorhinootologie 2015; 95:245-50. [PMID: 26468674 DOI: 10.1055/s-0035-1559677] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE There exists no valid classification of beginning vascular changes of the vocal folds. We tested an own classification model of visible beginning horizontal vascular changes. MATERIAL AND METHODS 168 indirect endoscopic pictures (84 white light=WL and 84 Narrow Band Imaging=NBI) of vocal folds were presented to 3 different consultants for classification (graduation normal, slight, moderately, high-grade belonged to the vascular features ectasia, meander, convolute, frequency of the vessels, ramification, change in direction). The self-confidence was declared by the consultants with a numeric rating scale. RESULTS A classification of beginning vascular changes of the vocal folds is possible, especially of ectasia, meander, convolute, frequency of the vessels, ramification, change in direction (p<0.0001). Significantly more vascular lesions can be detected by NBI than with white light endoscopy alone (p<0.0001). There are no significant differences (p=0.3529) in self-confidence of the classification. But it differs between the consultants highly significant (p<0.0001). The inexperienced classifier shows the highest growth in the learning curve. The intrarater- and interrater-variability differs only slightly between WL and NBI. CONCLUSIONS Beginning horizontal changes of vocal fold vessels can be classified. Endoscopic NBI-pictures of the vocal folds demonstrate the beginning of vascular changes better compared to endoscopic white light pictures alone. The familiarity and expertise with the classification model and the endoscopic imaging technique affect the self-confidence of the evaluation.
Collapse
Affiliation(s)
- A Schossee
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Univ.-Klinikum der Otto-von-Guericke-Universität Magdeburg
| | - S Voigt-Zimmermann
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Univ.-Klinikum der Otto-von-Guericke-Universität Magdeburg
| | - S Kropf
- Institut für Biometrie und Medizinische Informatik, Univ.-Klinikum der Otto-von-Guericke-Universität Magdeburg
| | - C Arens
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Univ.-Klinikum der Otto-von-Guericke-Universität Magdeburg
| |
Collapse
|
22
|
Kropf S, Burger E, Radinski I, Ridwelski K, Lippert H, Altendorf-Hofmann A, Bernarding J. [Completeness and quality of baseline data and follow-up in cancer registry--an analysis on the example of colorectal cancer]. Dtsch Med Wochenschr 2015; 140:e106-13. [PMID: 26080728 DOI: 10.1055/s-0041-102171] [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: 10/23/2022]
Abstract
BACKGROUND AND AIM In Germany, data of cancer patients are recorded not only in epidemiological registers but also in clinical cancer registers. To ensure the networking of all included medical partners, quality control, and clinical research it is necessary that cancer cases are captured more or less completely. The aim of the present study was to compare the data sets of two registers. PATIENTS AND METHODS Data from patients with colorectal cancer from two large surgical clinics in Magdeburg are recorded in two registers - the Clinical Cancer Registry Magdeburg and the Institute of Quality Assurance in Operative Medicine at the Otto-von-Guericke University Magdeburg. Here we compared the data sets in order to check the completeness of data capturing and to determine factors influencing the degree of completeness. RESULTS From all patients captured in the Institute of Quality Assurance, 78.9% are found also in the clinical cancer registry. The percentage improves over the course of time, but also depends on diagnostic criteria such as the staging. There are some differences between both registries, explainable by their specific objectives. Particularly, it is demonstrated that incomplete follow-up record may bias estimates of survival rates from registries. CONCLUSION Ensuring the completeness and correctness of data is a major challenge for cancer registries. It has distinct influence on estimated quality parameters such as survival rates.
Collapse
Affiliation(s)
- S Kropf
- Institut für Biometrie und medizinische Informatik, Otto-von-Guericke-Universität, Magdeburg
| | - E Burger
- Institut für Biometrie und medizinische Informatik, Otto-von-Guericke-Universität, Magdeburg
| | - I Radinski
- Institut für Biometrie und medizinische Informatik, Otto-von-Guericke-Universität, Magdeburg
| | - K Ridwelski
- Klinik für Allgemein- und Viszeralchirurgie, Klinikum Magdeburg gGmbH, Magdeburg
| | - H Lippert
- Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Otto-von-Guericke-Universität, Magdeburg
| | - A Altendorf-Hofmann
- Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Jena
| | - J Bernarding
- Institut für Biometrie und medizinische Informatik, Otto-von-Guericke-Universität, Magdeburg
| |
Collapse
|
23
|
Schütte K, Seidensticker R, Milbradt O, Bornschein J, Kandulski A, Pech M, Kropf S, Ricke J, Malfertheiner P. Assessment and monitoring of liver function by ¹³C-aminopyrine breath test after selective transarterial chemoembolisation of hepatocellular carcinoma. Z Gastroenterol 2015; 53:21-7. [PMID: 25594703 DOI: 10.1055/s-0034-1385230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Liver function and tumor staging are essential parameters for selection of treatment modalities in patients with hepatocellular carcinoma (HCC). Transarterial chemoembolization (TACE) is associated with a risk of deterioration of liver function. In clinical routine hepatic function in patients with liver cirrhosis is assessed by the Child-Pugh-classification. Dynamic breath tests allow the assessment of the hepatic functional mass and have the potential to give more accurate information on hepatic function periinterventionally. PATIENTS AND METHODS A prospective clinical study was performed in 13 patients receiving a total of 18 TACE sessions. (13)C-aminopyrine breath test was performed the day before TACE, 2 days and 30 days after TACE and correlated with standard laboratory work-up of the patients. RESULTS Fourteen TACE sessions were performed in Child A liver cirrhosis, 4 in Child B cirrhosis. All patients presented with impaired aminopyrine metabolism at baseline. No significant changes in the (13)C aminopyrine breath test following TACE were observed. Two patients treated in Child A cirrhosis decompensated to Child B, one of them recovered. No further decompensation was observed in patients treated in Child B cirrhosis. DISCUSSION AND CONCLUSION Liver function assessment with (13)C-aminopyrine breath test and Child-Pugh-classification following TACE was discordant in a large proportion of patients. Whether a quantification of mitochondrial liver function in patients planned to undergo locoregional treatment of HCC in liver cirrhosis is helpful in the prediction of postprocedural liver decompensation needs to be addressed in larger prospective clinical trials.
Collapse
Affiliation(s)
- K Schütte
- Klinik für Gastroenterologie, Hepatologie & Infektiologie, Universitätsklinikum Magdeburg A. ö. R
| | - R Seidensticker
- Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A. ö. R
| | - O Milbradt
- Klinik für Gastroenterologie, Hepatologie & Infektiologie, Universitätsklinikum Magdeburg A. ö. R
| | - J Bornschein
- Klinik für Gastroenterologie, Hepatologie & Infektiologie, Universitätsklinikum Magdeburg A. ö. R
| | - A Kandulski
- Klinik für Gastroenterologie, Hepatologie & Infektiologie, Universitätsklinikum Magdeburg A. ö. R
| | - M Pech
- Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A. ö. R
| | - S Kropf
- Institut für Biometrie und Medizinische Informatik, Otto-von-Guericke-Universität Magdeburg
| | - J Ricke
- Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A. ö. R
| | - P Malfertheiner
- Klinik für Gastroenterologie, Hepatologie & Infektiologie, Universitätsklinikum Magdeburg A. ö. R
| |
Collapse
|
24
|
Thielitz A, Lux A, Wiede A, Kropf S, Papakonstantinou E, Gollnick H. A randomized investigator-blind parallel-group study to assess efficacy and safety of azelaic acid 15% gel vs. adapalene 0.1% gel in the treatment and maintenance treatment of female adult acne. J Eur Acad Dermatol Venereol 2014; 29:789-96. [PMID: 25399481 DOI: 10.1111/jdv.12823] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Accepted: 10/06/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND Growing numbers of post-adolescent females are suffering from treatment-resistant or relapsing adult acne forms, therefore requiring the definition of safe and effective treatment options for this burdening disease. OBJECTIVES To assess the efficacy of azelaic acid 15% gel (AzA) vs. no treatment during maintenance therapy of female adult acne and to compare its efficacy and safety vs. adapalene 0.1% gel (AD) during a 9-month period (3-month treatment and 6-month maintenance treatment). METHODS A total of 55 women between 18 and 45 years with adult acne were included in this investigator-blind trial and randomized into three groups receiving AzA gel b.i.d. for 9 months (AzA9M, n = 17) or AzA gel b.i.d. for 3 months followed by a 6-month observational phase (AzA3M, n = 19) or AD gel once daily for 9 months (AD9M, n = 19). Parameters of efficacy, safety and patient-related factors were analysed. RESULTS The reduction in lesion counts, severity and Dermatology Life Quality Index score was significant (P < 0.05) and comparable between groups during the treatment phase, while dryness and scaling were significantly lower (P < 0.05) in group AzA9M vs. AD9M. During maintenance, AzA9M was superior to AzA3M in the control of inflammatory lesions (P = 0.008) and total lesions (P = 0.014) at week 24. From week 12 to week 36, a mild relative increase in inflammatory lesions could be observed in all groups. In AzA3M, this increase exceeded that of AzA9M by 23.1% (P = 0.109), while the difference of total lesions diverged to 30.8% (P = 0.038). No significant differences could be detected between AzA9M and AD9M. Group AzA9M was non-inferior to AD9M (non-inferiority margin of 50% for the confidence limit for the relative effect) in the control of inflammatory acne lesions. CONCLUSIONS AzA15% gel is a safe and effective treatment and maintenance treatment of female adult acne with non-inferior efficacy to AD 0.1% gel in the control of inflammatory acne.
Collapse
Affiliation(s)
- A Thielitz
- Department of Dermatology and Venereology, Otto-von-Guericke University, Magdeburg, Germany
| | | | | | | | | | | |
Collapse
|
25
|
Kropf S, Meyer F, Glimm E. [Analysis of Survival Time and Other Event Times - What Does the Surgeon Need to Know?]. Zentralbl Chir 2014; 141:383-9. [PMID: 25333520 DOI: 10.1055/s-0034-1383077] [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: 10/24/2022]
Abstract
BACKGROUND Survival time is an important parameter to investigate therapeutic measures. It plays a crucial role in study concepts, data analyses as well as publications. AIM The aim of this study was to emphasise essential points, which need to be taken into account to (i) gain resilient results of survival time analysis and (ii) appropriately evaluate scientific reports. Corner Points/Main Statements: (i) The main analytical methods are Kaplan-Meier procedure to estimate survival time curves, the log rank test to compare two or more survival curves from independent samples and Cox regression for comparisons under simultaneous consideration of several influencing factors. (ii) Dependent relationships between survival and censoring probabilities may falsify these statistical procedures. (iii) For several end points, which need to be differentiated (such as death, progression etc.), and for interdependent sample elements, extended statistical procedures such as competing risk analyses or extended Cox regression models are available. CONCLUSION Survival time analysis can be considered as being extraordinarily important for evaluation of data obtained in therapeutic studies. For the academic and publishing physician, in particular, for the clinical surgeon, a basic understanding of these methodological aspects in statistics is indispensable.
Collapse
Affiliation(s)
- S Kropf
- Institut für Biometrie und Medizinische Informatik, Medizinische Fakultät der Otto-von-Guericke-Universität Magdeburg, Deutschland
| | - F Meyer
- Klinik für Allgemein-, Viszeral- & Gefäßchirurgie, Universitätsklinikum Magdeburg A. ö. R., Deutschland
| | - E Glimm
- Institut für Biometrie und Medizinische Informatik, Medizinische Fakultät der Otto-von-Guericke-Universität Magdeburg, Deutschland
| |
Collapse
|
26
|
Tammer I, Geginat G, Lange S, Kropf S, Lodes U, Schlüter D, Lippert H, Meyer F. [Antibiotic Consumption and the Development of Antibiotic Resistance in Surgical Units]. Zentralbl Chir 2014; 141:53-61. [PMID: 24777619 DOI: 10.1055/s-0033-1351087] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Antibiotic resistence is increasing worldwide. AIM A longitudinal analysis of the influence of the density of antibiotic use on the development of resistance in surgical units was undertaken. MATERIAL AND METHODS Over five years the incidence of pathogens and the resistance rates of isolates from patients of normal surgical units and those of a surgical ICU at a university hospital were examined. The resistence rates were correlated with the density of antibiotic use - calculated from the antibiotic consumption (in DDD) and the number of patient-days. RESULTS At both units, Enterobacteriaceae and Enterococci were mostly cultured. Among the Enterobacteriaceae, E. coli, Klebsiella spp., Proteus mirabilis and Enterobacter predominated. In the group of Enterococci, E. faecalis predominated at wards whereas at ICU E. faecium was the most frequent. Anaerobes ranked third at normal wards and Candida spp. at ICU. From 2007 to 2011, there was an increasing resistance against ciprofloxacin in P. mirabilis (r = 0.87; p = 0.054) and against imipenem (r = 0.86; p = 0.06) and piperacillin (r = 0.81; p = 0.09) in P. aeruginosa at normal wards. At ICU, the resistance rates of imipenem in P. aeruginosa rose (r = 0.88; p = 0.049). Resistance against ciprofloxacin in E. coli increased (r = 0.65; p = 0.23). Due to the increasing use of ciprofloxacin and meropenem at normal wards, the density of antibiotic usage rose 1.4 %/year (r = 0.94; p = 0.02). Despite the increase of meropenem use at ICU (r = 0.9; p = 0.035), the total antibiotic uptake rate remained almost constant. The antibiotic usage density was 3-fold higher at ICU than at normal wards. At normal wards, the ciprofloxacin usage correlated with the rate of resistance against ciprofloxacin in P. mirabilis P. m. At ICU, an association was detected between the uptake rate of ceftazidime and the rate of resistance against cefotaxime in the CES group. In P. aeruginosa, the use of piperacillin and the rate of resistance against piperacillin correlated. CONCLUSION The high uptake rates of fluoroquinolones and carbapenems were accompanied by increases in resistances. The resistance rates are influenced by hygiene management and microbiological diagnostics. The extensive use of carbapenems should be reassessed on both units to counter further development of antibiotic resistance.
Collapse
Affiliation(s)
- I Tammer
- Institut für Mikrobiologie, Universitätsklinikum Magdeburg A. ö. R., Magdeburg, Deutschland
| | - G Geginat
- Institut für Mikrobiologie, Universitätsklinikum Magdeburg A. ö. R., Magdeburg, Deutschland
| | - S Lange
- Zentralapotheke, Universitätsklinikum Magdeburg A. ö. R., Magdeburg, Deutschland
| | - S Kropf
- Institut für Biometrie und Medizinische Informatik, Universitätsklinikum Magdeburg A. ö. R., Magdeburg, Deutschland
| | - U Lodes
- Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Magdeburg A. ö. R., Magdeburg, Deutschland
| | - D Schlüter
- Institut für Mikrobiologie, Universitätsklinikum Magdeburg A. ö. R., Magdeburg, Deutschland
| | - H Lippert
- Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Magdeburg A. ö. R., Magdeburg, Deutschland
| | - F Meyer
- Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Magdeburg A. ö. R., Magdeburg, Deutschland
| |
Collapse
|
27
|
Friebe B, Wollrab A, Thormann M, Fischbach K, Ricke J, Grüschow M, Kropf S, Fischbach F, Speck O. Nebenwirkungen im Ultrahochfeld-MRT bei 7 Tesla im Vergleich zu einem Attrappen-Scanner. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1372768] [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: 10/25/2022]
|
28
|
Schreiber S, Abdulla S, Debska-Vielhaber G, Machts J, Feistner H, Oldag A, Görtler M, Petri S, Kollewe K, Kropf S, Heinze HJ, Dengler R, Vielhaber S. Nervensonographische Befunde bei verschiedenen Varianten der ALS. KLIN NEUROPHYSIOL 2014. [DOI: 10.1055/s-0034-1371255] [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: 10/25/2022]
|
29
|
Gall C, Federov A, Antal A, Schittkowski M, Kropf S, Mante A, Schmidt S, Sabel B. IS 5. Clinical efficacy of non-invasive transorbital alternating current stimulation in optic neuropathy: A double-blind, randomized, sham-controlled multi-center study. Clin Neurophysiol 2013. [DOI: 10.1016/j.clinph.2013.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
30
|
Gall C, Schmidt S, Antal A, Paulus W, Schittkowski M, Effert R, Kropf S, Mante A, Brandt S, Sabel B. Clinical efficacy of non-invasive transorbital alternating current stimulation in optic neuropathy: A double-blind, randomized, sham-controlled multi-center study. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.1940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
31
|
Rogits B, Jungnickel K, Löwenthal D, Kropf S, Nekolla EA, Dudeck O, Pech M, Wieners G, Ricke J. Prospective Evaluation of the radiologist’s hand dose in CT-guided interventions. ROFO-FORTSCHR RONTG 2013; 185:1081-8. [PMID: 23897530 DOI: 10.1055/s-0033-1350368] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE Assessment of radiologist's hand dose in CT-guided interventions and determination of influencing factors. MATERIALS AND METHODS The following CT-guided interventions were included: Core biopsy, drainage, periradicular therapy, and celiac plexus neurolysis. The hand dose was measured with an immediately readable dosimeter, the EDD-30 (Unfors, Sweden). The default parameters for CT fluoroscopy were 120 kV, 90 mA and a 4 mm slice thickness. All interventions were performed on a 16-slice CT unit (Aquilion 16 Toshiba, Japan). The tumor size, degree of difficulty (1 - 3), level of experience and device parameters (mAs, dose-length product, scan time) were documented. RESULTS 138 CT-guided interventions (biopsy n = 99, drainage n = 23, pain therapy n = 16) at different locations (lung n = 41, retroperitoneum n = 53, liver n = 25, spine n = 19) were included. The lesion size was 4 - 240 mm (median: 23 mm). The fluoroscopy time per intervention was 4.6 - 140.2 s (median: 24.2 s). The measured hand dose ranged from 0.001 - 3.02 mSv (median: 0.22 mSv). The median hand dose for lung puncture (n = 41) was slightly higher (median: 0.32 mSv, p = 0.01) compared to that for the liver, retroperitoneum and other. Besides physical influencing factors, the degree of difficulty (p = 0.001) and summed puncture depth (p = 0.004) correlated significantly with the hand dose. CONCLUSION The median hand dose for different CT-guided interventions was 0.22 mSv. Therefore, the annual hand dose limit would normally only be reached with about 2000 interventions.
Collapse
Affiliation(s)
- B Rogits
- Radiology and Nuclear Medicine, University Magdeburg
| | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Rogits B, Neubauer J, Friebe B, Löwenthal D, Wybranski C, Hass P, Kropf S, Pech M, Ricke J. Stichkanalmetastasen bei lokaler Ablation kolorektaler Karzinome. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
33
|
Caldron P, Gavrilova S, Kropf S. 516 – Why (not) go east? comparison of FDA inspections from cee, we and us investigational site inspections. Eur Psychiatry 2013. [DOI: 10.1016/s0924-9338(13)75820-6] [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: 11/29/2022] Open
|
34
|
Redlich A, Boxberger N, Strugala D, Frühwald MC, Leuschner I, Kropf S, Bucsky P, Vorwerk P. Systemic treatment of adrenocortical carcinoma in children: data from the German GPOH-MET 97 trial. Klin Padiatr 2012; 224:366-71. [PMID: 23143764 DOI: 10.1055/s-0032-1327579] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Adrenocortical cancer (ACC) in childhood is a rare disease with poor prognosis. Complete surgical resection, systemic chemotherapy, and mitotane therapy are important curative treatment options for patients with advanced-stage tumors. Since 1997, pediatric ACC patients in Germany have been treated according to the non-randomized, single arm study GPOH-MET-97. PATIENTS AND METHODS Data regarding disease course, treatment, and survival rates of 60 patients (age 0.24-17.8 years) with ACC treated according to the GPOH-MET-97 protocol were collected and analyzed to determine outcome, with a focus on examining the effectiveness of mitotane therapy. RESULTS Among all patients, event-free survival and overall survival were found to be 43.3% and 64.8%, respectively. Chemotherapy with VCR, IFO, ADR, CARBO, and VP16 had been provided to 34 patients (56.6%) in different settings (neoadjuvant, adjuvant, and salvage) and mitotane therapy to 32 patients (53.3%). Duration of mitotane treatment longer than 6 months and mitotane levels greater than 14 mg/l were found to be associated with significantly better survival. Local relapse was found to be associated with a worse prognosis compared to distant metastasis only. CONCLUSIONS Systemic chemotherapy and mitotane therapy are important therapeutic options in the treatment of advanced pediatric ACC patients. Neoadjuvant therapy should be considered for patients with primarily incomplete resectable or inoperable tumors, and tumor spillage is an indication for adjuvant chemo- and mitotane therapy. All pediatric ACC patients should be treated in pediatric oncological centers according to a consistent protocol in a highly interdisciplinary setting.
Collapse
Affiliation(s)
- A Redlich
- Pediatric Oncology, Otto-von-Guericke-University, Magdeburg, Germany
| | | | | | | | | | | | | | | |
Collapse
|
35
|
Tchana S, Kropf S, Robra BP. Determinanten der Inanspruchnahme medizinischer Leistungen aus Sicht der Bürger - eine regionale Befragung mit Fallvignetten. Gesundheitswesen 2012. [DOI: 10.1055/s-0032-1322112] [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: 10/27/2022]
|
36
|
Rogits B, Jungnickel K, Friebe B, Kropf S, Pech M, Wieners G, Ricke J. Komplikationrate bei komplexen CT-gestützten Interventionen. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
37
|
Rogits B, Jungnickel K, Löwenthal D, Kropf S, Dudeck O, Wieners G, Ricke J. Vergleich der Handdosis des Radiologen im Rahmen von komplexen CT-gestützten Interventionen. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
38
|
Thiele K, Smalla K, Kropf S, Rabenstein F. Detection of Acidovorax valerianellae, the causing agent of bacterial leaf spots in corn salad [Valerianella locusta (L.) Laterr.], in corn salad seeds. Lett Appl Microbiol 2012; 54:112-8. [PMID: 22098338 DOI: 10.1111/j.1472-765x.2011.03181.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM The black leaf spot disease on corn salad caused by the bacterium Acidovorax valerianellae has been observed in Europe for several years and causes economic losses in corn salad cropping. Contaminated seeds or infested soil are considered as the major infection sources. The use of healthy seed material is the only way to prevent disease outbreaks. Therefore, a sensitive diagnostic method for seed testing should be developed. METHODS AND RESULTS Using a triple antibody sandwich ELISA with a high-specific monoclonal antibody, a quick and reliable detection method for contamination of seed lots with the pathogen was developed. This method allowed to detect contaminated seed lots as well as contamination with A. valerianellae in single seeds. Furthermore, the occurrence and distribution of the pathogen could be shown in symptomatic corn salad leaves and in naturally infested seeds by transmission electron microscopy and immunogold labelling for the first time. CONCLUSION Our results confirm the seed transmission of this corn salad disease. Pathogen load and distribution vary between positively tested seed lots. SIGNIFICANCE AND IMPACT OF THE STUDY With this method, not only routine testing of seed material to eliminate contaminated seed lots from production is possible but also the control of sanitation procedures to reduce contamination.
Collapse
Affiliation(s)
- K Thiele
- Julius Kühn-Institut, Federal Research Centre for Cultivated Plants (JKI), Institute for Epidemiology and Pathogen Diagnostics, Quedlinburg and Braunschweig, Germany
| | | | | | | |
Collapse
|
39
|
Fill Malfertheiner S, Neuhaus M, Kropf S, Malfertheiner P, Costa SD. „Nur“ ein unangenehmes Brennen? – Die gastroösophageale Refluxkrankheit in der Schwangerschaft. Geburtshilfe Frauenheilkd 2009. [DOI: 10.1055/s-0029-1238944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
40
|
Wybranski C, Lüdemann L, Seidensticker M, Kropf S, Wust P, Ricke J. Bestimmung des Dosisvolumen- und Dosisgradienteneffektes auf die Schwellenwertdosis normalen Lebergewebes nach interstitieller HDR Brachytherapie. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
41
|
Krause M, Goldschmidt AJ, Berg M, Kropf S, Sachs A, Gatzioufas Z, Brückner K, Seitz B. [How does the German DRG system differentiate and reimburse vitreoretinal surgery in diabetic patients?]. Klin Monbl Augenheilkd 2008; 225:880-7. [PMID: 18951309 DOI: 10.1055/s-2008-1027614] [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: 10/21/2022]
Abstract
INTRODUCTION The German DRG system (G-DRG system) is required to assign medical cases with similar costs correctly into a particular group, each case within the group receiving the same amount of reimbursement. At the same time the system should allow all-inclusive reimbursement, not necessarily reflecting the exact costs of each case. These opposite goals and the so far limited calculation basis raise the question of how the G-DRG system actually processes and reimburses empirically collected in-hospital treatment data. PATIENTS AND METHODS In 2005, 112 patients were admitted to the University Eye Hospital, University of the Saarland. All patients had diabetic retinopathy and required at least one vitreoretinal procedure. Demographic and clinical data were collected by using the hospital information system and the coding software KODIP. For statistic evaluation, principal diagnoses, ancillary diagnoses and procedures were each reassigned to particular groups. Reimbursement was calculated based on the case data of the year 2005. Also, the case data were reassigned with respect to calculation of reimbursement for the years 2006 and 2007. The results were compared with federal G-DRG calculation data. RESULTS Mean age of the patients was 65.8 +/- 11.1 years, length of stay in-hospital was 9.3 +/- 3.2 days. In the 66 patients requiring general anaesthesia the cumulative length of stay in the operation room was 148.4 +/- 39.5 minutes, the cumulative duration of surgery was 86.3 +/- 34.1 minutes. In the 50 patients requiring local anaesthesia the cumulative length of stay in the operation room was 137.8 +/- 51.8 minutes, the cumulative duration of surgery was 81.6 +/- 43.6 minutes. The patients had 1.9 +/- 0.8 principal diagnoses, 14.4 +/- 5.8 ancillary diagnoses and 3.4 +/- 1.6 procedures. Twenty-five of 112 patients (22.3 %) were assigned to DRG C 03Z (1), 82 of 112 patients (73.2 %) were assigned to DRG C 17Z (2). Five patients were assigned to other DRG. Compared with the federal calculation data, our own data for 2005, 2006 and 2007 showed more high primary clinical complexity levels and a longer duration of in-hospital stay. For each of the three years the amount of reimbursement was equal in about two thirds of the own patients. Reimbursement was only differentiated for outliers beyond the trim point of the duration of in-hospital stay. CONCLUSIONS The demographic and clinical G-DRG data of the included patients showed substantial cost-effective inhomogeneities. These inhomogeneities were not sufficiently considered for reimbursement based upon Z-DRG. Specialised departments with higher numbers of difficult cases may be discriminated. Wrong incentives may result in the selection of "low-risk cases".
Collapse
Affiliation(s)
- M Krause
- Klinik für Augenheilkunde, Universitätsklinikum des Saarlands, Homburg/Saar.
| | | | | | | | | | | | | | | |
Collapse
|
42
|
Vogel J, Kropf S, Läuter J, Läuter H, Smith HJ, Wilke A, Wuthe H. Evaluierung der funktionellen Emphysemdiagnostik durch die Diskriminanzanalyse – Grundlagen, kritischer Vergleich zweier identischer Studien 2001 und 2004. Pneumologie 2008. [DOI: 10.1055/s-2008-1076124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
43
|
Bierwirth AR, Pels K, Caßens S, Kropf S, Keil U, Schultheiss HP, Bernarding J, Lippmann-Grob B, Brosz M, Hallauer J, Schlüter K, Geller JC. Quo vadis Diabetes? Daten aus der CoRiMa-Studie zur Situation von Patienten mit Diabetes mellitus in der primären KHK-Prävention. DIABETOL STOFFWECHS 2006. [DOI: 10.1055/s-2006-943895] [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]
|
44
|
Bierwirth AR, Pels K, Prien M, Keil U, Bernarding J, Schultheiss HP, Lippmann-Grob B, Kropf S, Brosz M, Hallauer J, Gerressen W, Geller JC. Zielwerterreichung bei Diabetes mellitus – Anspruch und Realität. Die CoRiMa-Studie – Versorgungsdaten aus der ärztlichen Routinedokumentation. DIABETOL STOFFWECHS 2006. [DOI: 10.1055/s-2006-943894] [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]
|
45
|
Braeuninger S, Chamaon K, Kropf S, Mawrin C, Wiedemann FR, Hartig R, Schoeler S, Dietzmann K, Kirches E. Short incubation with 2-methoxyestradiol kills malignant glioma cells independent of death receptor 5 upregulation. Clin Neuropathol 2005; 24:175-83. [PMID: 16033134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023] Open
Abstract
We investigated the effects of 2-methoxyestradiol (2-ME), a promising new antitumor agent, on viable cell number and nuclear morphology of malignant glioma cells (three human and one rat glioma cell lines) and analyzed the controversial role of death recepor 5 (DR5) upregulation in 2-ME induced apoptosis. Microtiter-tetrazolium (MTT) assays showed a significant reduction of viable cells after incubation with 2 microM and 20 microM 2-ME for 48 and 72 hours in all cultures. In the 20 microM concentration, there were even significant effects in the majority of shorter incubation periods. Hoechst 33258 stains showed a substantial amount of cells with nuclear fragmentation indicating a late stage of apoptosis after 20 microM 2-ME treatments of 24 hours and more. The role of the DR5-mediated extrinsic apoptotic pathway was further studied in the three human glioma cell lines; 50 ng/ml of the DR5 ligand TRAIL (tumor necrosis factor-related apoptosis-inducing ligand) and 2 microM 2-ME showed no synergism, as determined by MTT assays. Real-time PCR revealed no significantly increased amount of DR5 mRNA, suggesting that receptor upregulation does not play a major role for 2-ME-induced apoptosis in glioma cells, in contrast to data for a breast cancer cell line in the literature.
Collapse
Affiliation(s)
- S Braeuninger
- Institute of Neuropathology, Otto von Guericke University, Magdeburg, Germany
| | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Lux A, Kropf S, Gollnick H. Hautkrebsscreening – Ergebnisse einer landesweiten Kampagne durch eine Krankenkasse. Gesundheitswesen 2004. [DOI: 10.1055/s-2004-833863] [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]
|
47
|
Eszlinger M, Krohn K, Kropf S, Läuter J, Paschke R. Gene expression analysis suggests a relevance of aberrant phosphatidylinositol-3-kinase signaling in cold thyroid nodules. Exp Clin Endocrinol Diabetes 2004. [DOI: 10.1055/s-2004-819066] [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: 10/28/2022]
|
48
|
Leissner J, Ghoneim MA, Abol-Enein H, Thüroff JW, Franzaring L, Fisch M, Schulze H, Managadze G, Allhoff EP, el-Baz MA, Kastendieck H, Buhtz P, Kropf S, Hohenfellner R, Wolf HK. Extended Radical Lymphadenectomy in Patients With Urothelial Bladder Cancer:: Results of a Prospective Multicenter Study. J Urol 2004; 171:139-44. [PMID: 14665862 DOI: 10.1097/01.ju.0000102302.26806.fb] [Citation(s) in RCA: 302] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Previous studies demonstrate a positive correlation between postoperative survival and the extent of pelvic lymphadenectomies in patients with bladder cancer. However, the distribution of nodal metastases has not been examined in sufficient detail. Therefore, we conducted a comprehensive prospective analysis of lymph node metastases to obtain precise knowledge about the pattern of lymphatic tumor spread. MATERIALS AND METHODS Between 1999 and 2002 we performed 290 radical cystectomies and extended lymphadenectomies. Cranial border of the lymphadenectomy was the level of the inferior mesenteric artery, lateral border was the genitofemoral nerve and caudal border was the pelvic floor. We made every effort to excise and examine microscopically all lymph nodes from 12 well-defined anatomical locations. RESULTS Mean total number and standard deviation of lymph nodes removed was 43.1 +/- 16.1. Nodal metastases were present in 27.9% of patients. The percentage of metastases at different sites ranged from 14.1% (right obturator nodes) to 2.9% (right paracaval nodes above the aortic bifurcation). By studying cases of unilateral primary tumors or with only 1 metastasis we observed a preferred pattern of metastatic spread. However, there were many exceptions to the rule and we did not identify a well-defined sentinel lymph node. CONCLUSIONS We strongly recommend extended radical lymphadenectomy to all patients undergoing radical cystectomy for bladder cancer to remove all metastatic tumor deposits completely. The operation can be conducted in routine clinical practice and our data may serve as a guideline for future standardization and quality control of the procedure.
Collapse
Affiliation(s)
- J Leissner
- Department of Urology, Otto-von-Guericke-University, Magdeburg,
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Rawer D, Borkhardt A, Wilda M, Kropf S, Kreuder J. Influence of stochastics on quantitative PCR in the detection of minimal residual disease. Leukemia 2003; 17:2527-8; author reply 2528-31. [PMID: 14671651 DOI: 10.1038/sj.leu.2403191] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
50
|
Rawer D, Borkhardt A, Wilda M, Kropf S, Kreuder J. Reply to Arlinghaus et al (second letter). Leukemia 2003. [DOI: 10.1038/sj.leu.2403195] [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: 11/09/2022]
|