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Stumpfe FM, Schneider MO, Antoniadis S, Mayr A, Fleckenstein T, Staerk C, Kehl S, Hermanek P, Böhm J, Scharl A, Beckmann MW, Hein A. Lack of evidence for effects of lockdowns on stillbirth rates during the SARS-CoV-2 pandemic in Bavaria: analysis of the Bavarian perinatal survey from 2010 to 2020. Arch Gynecol Obstet 2023; 308:1457-1462. [PMID: 36348075 PMCID: PMC9643984 DOI: 10.1007/s00404-022-06838-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 10/25/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Internationally, potential effects of national SARS-CoV-2-related lockdowns on stillbirth rates have been reported, but data for Germany, including risk factors for fetal pregnancy outcome, are lacking. The aim of this study is to compare the stillbirth rates during the two first lockdown periods in 2020 with previous years from 2010 to 2019 in a large Bavarian cohort. METHODS This study is a secondary analysis of the Bavarian perinatal data from 2010 to 2020, including 349,245 births. Univariate and multivariable regression analyses were performed to investigate the effect of two Bavarian lockdowns on the stillbirth rate in 2020 compared to the corresponding periods from 2010 to 2019. RESULTS During the first lockdown, the stillbirth rate was significantly higher compared to the reference period (4.04 vs. 3.03 stillbirths per 1000 births; P = 0.03). After adjustment for seasonal and long-term trends, this effect can no longer be observed (P = 0.2). During the second lockdown, the stillbirth rate did not differ in univariate (3.46 vs. 2.93 stillbirths per 1000 births; P = 0.22) as well as in multivariable analyses (P = 0.68), compared to the years 2010 to 2019. CONCLUSION After adjustment for known long-term effects, in this study we did not find evidence that the two Bavarian lockdowns had an effect on the rate of stillbirths.
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Affiliation(s)
- Florian Matthias Stumpfe
- Department of Obstetrics and Gynecology, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital of Erlangen, Universitätsstraße 21-23, 91054, Erlangen, Germany.
| | - Michael Oliver Schneider
- Department of Obstetrics and Gynecology, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital of Erlangen, Universitätsstraße 21-23, 91054, Erlangen, Germany
| | - Sophia Antoniadis
- Department of Obstetrics and Gynecology, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital of Erlangen, Universitätsstraße 21-23, 91054, Erlangen, Germany
| | - Andreas Mayr
- Department of Medical Biometry, Informatics and Epidemiology, Faculty of Medicine, University of Bonn, Bonn, Germany
| | - Tobias Fleckenstein
- Department of Medical Biometry, Informatics and Epidemiology, Faculty of Medicine, University of Bonn, Bonn, Germany
| | - Christian Staerk
- Department of Medical Biometry, Informatics and Epidemiology, Faculty of Medicine, University of Bonn, Bonn, Germany
| | - Sven Kehl
- Department of Obstetrics and Gynecology, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital of Erlangen, Universitätsstraße 21-23, 91054, Erlangen, Germany
| | - Peter Hermanek
- Department of Methods and Perinatology, BAQ, Bavarian Institute for Quality Assurance, Munich, Germany
| | - Julian Böhm
- Department of Methods and Perinatology, BAQ, Bavarian Institute for Quality Assurance, Munich, Germany
| | | | - Matthias Wilhelm Beckmann
- Department of Obstetrics and Gynecology, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital of Erlangen, Universitätsstraße 21-23, 91054, Erlangen, Germany
| | - Alexander Hein
- Department of Obstetrics and Gynecology, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital of Erlangen, Universitätsstraße 21-23, 91054, Erlangen, Germany
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Stumpfe FM, Mayr A, Schneider MO, Kehl S, Stübs F, Antoniadis S, Titzmann A, Pontones CA, Bayer CM, Beckmann MW, Faschingbauer F. Cerebroplacental versus Umbilicocerebral Ratio-Analyzing the Predictive Value Regarding Adverse Perinatal Outcomes in Low- and High-Risk Fetuses at Term. Medicina (Kaunas) 2023; 59:1385. [PMID: 37629674 PMCID: PMC10456565 DOI: 10.3390/medicina59081385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/25/2023] [Accepted: 07/27/2023] [Indexed: 08/27/2023]
Abstract
Background and Objectives: The aim of this study was to investigate the prediction of adverse perinatal outcomes using the cerebroplacental (CPR) and umbilicocerebral (UCR) ratios in different cohorts of singleton pregnancies. Materials and Methods: In this retrospective cohort study, we established our own Multiple of Median (MoM) for CPR and UCR. The predictive value for both ratios was studied in the following outcome parameters: emergency cesarean delivery, operative intervention (OI), OI due to fetal distress, 5-min Apgar < 7, admission to neonatal intensive care unit, and composite adverse perinatal outcome. The performance of the ratios was assessed in the following cohorts: total cohort (delivery ≥ 37 + 0 weeks gestation, all birth weight centiles), low-risk cohort (delivery ≥ 37 + 0 weeks gestation, birth weight ≥ 10. centile), prolonged pregnancy cohort (delivery ≥ 41 + 0 weeks gestation, birth weight ≥ 10. centile) and small-for-gestational-age fetuses (delivery ≥ 37 + 0 weeks gestation, birth weight < 10. centile). The underlying reference values for MoM were estimated using quantile regression depending on gestational age. Prediction performance was evaluated using logistic regression models assessing the corresponding Brier score, combining discriminatory power and calibration. Results: Overall, 3326 cases were included. Across all cohorts, in the case of a significant association between a studied outcome parameter and CPR, there was an association with UCR, respectively. The Brier score showed only minimal differences for both ratios. Conclusions: Our study provides further evidence regarding predictive values of CPR and UCR. The results of our study suggest that reversal of CPR to UCR does not improve the prediction of adverse perinatal outcomes.
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Affiliation(s)
- Florian M. Stumpfe
- Department of Obstetrics and Gynecology, University Hospital of Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (F.M.S.)
| | - Andreas Mayr
- Department of Medical Biometry, Informatics and Epidemiology, Faculty of Medicine, University of Bonn, 53127 Bonn, Germany
| | - Michael O. Schneider
- Department of Obstetrics and Gynecology, University Hospital of Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (F.M.S.)
| | - Sven Kehl
- Department of Obstetrics and Gynecology, University Hospital of Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (F.M.S.)
| | - Frederik Stübs
- Department of Obstetrics and Gynecology, University Hospital of Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (F.M.S.)
| | - Sophia Antoniadis
- Department of Obstetrics and Gynecology, University Hospital of Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (F.M.S.)
| | - Adriana Titzmann
- Department of Obstetrics and Gynecology, University Hospital of Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (F.M.S.)
| | - Constanza A. Pontones
- Department of Obstetrics and Gynecology, University Hospital of Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (F.M.S.)
| | | | - Matthias W. Beckmann
- Department of Obstetrics and Gynecology, University Hospital of Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (F.M.S.)
| | - Florian Faschingbauer
- Department of Obstetrics and Gynecology, University Hospital of Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (F.M.S.)
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Alfer J, Fattahi A, Bleisinger N, Antoniadis S, Krieg J, Dittrich R, Beckmann MW, Hartmann A, Popovici RM, Tremellen K. Individual dynamics of uterine natural killer cells in natural and stimulated cycles monitored using a new endometrial dating method. Am J Reprod Immunol 2022; 88:e13620. [PMID: 36148557 PMCID: PMC9787954 DOI: 10.1111/aji.13620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 08/14/2022] [Accepted: 09/06/2022] [Indexed: 12/30/2022] Open
Abstract
PROBLEM It is important to evaluate the dynamics of uterine natural killer (uNK) cells in hormone replacement therapy (HRT) cycles, given their potential role in implantation and the common usage of HRT cycles with in vitro fertilization (IVF). METHOD OF STUDY A total of 132 subfertile patients were evaluated during the secretory phase of either natural ovulation (OV) or HRT cycles, with two biopsies taken on approximately days 5 and 10 after ovulation/progesterone administration in a single menstrual cycle. Immunohistochemical Personal Endometrial Maturation Analysis (PEMA) was used to better quantify secretory-phase endometrial development, in combination with subsequent evaluation of uNK cell density. RESULTS uNK cell density increased rapidly from the early to mid-secretory phase, with mean uNK densities of 113 and 117 per mm2 in first biopsies and 315 and 387 per mm2 in second biopsies for OV and HRT cycles, respectively. After reassessment of endometrial development with PEMA, the first and second biopsies in HRT and OV cycles were histologically dated to developmental ranges between days 15-20 (first biopsy) and days 19-25 (second biopsy). CONCLUSION Subfertile women showed variable endometrial development in PEMA assessment, with uNK cell density correlating with the dating results. Overall, comparable levels of uNK cell density were observed in OV and HRT cycles. Importantly, uNK cell density depends on the histological maturation stage, with similar low coefficients of determination. This observation suggests that aberrant uNK cell results more likely reflect displaced endometrial maturation, rather than an intrinsic anomaly in uNK cell trafficking.
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Affiliation(s)
- Joachim Alfer
- Department of PathologyErlangen University HospitalFriedrich‐Alexander University of Erlangen–NürnbergErlangenGermany,Kaufbeuren‐Ravensburg Institute of PathologyRavensburgGermany
| | - Amir Fattahi
- Department of Reproductive BiologySchool of Advanced Medical SciencesTabriz University of Medical SciencesTabrizIran,Department of Obstetrics and GynecologyErlangen University HospitalFriedrich‐Alexander University of Erlangen–NürnbergGermany
| | - Nathalie Bleisinger
- Department of Obstetrics and GynecologyErlangen University HospitalFriedrich‐Alexander University of Erlangen–NürnbergGermany
| | - Sophia Antoniadis
- Department of Obstetrics and GynecologyErlangen University HospitalFriedrich‐Alexander University of Erlangen–NürnbergGermany
| | | | - Ralf Dittrich
- Department of Obstetrics and GynecologyErlangen University HospitalFriedrich‐Alexander University of Erlangen–NürnbergGermany
| | - Matthias W. Beckmann
- Department of Obstetrics and GynecologyErlangen University HospitalFriedrich‐Alexander University of Erlangen–NürnbergGermany
| | - Arndt Hartmann
- Department of PathologyErlangen University HospitalFriedrich‐Alexander University of Erlangen–NürnbergErlangenGermany
| | | | - Kelton Tremellen
- Department of ObstetricsGynaecology and Reproductive MedicineFlinders UniversitySouth AustraliaAustralia
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Huebner H, Lubrich H, Blum S, Antoniadis S, Lermann J, Ekici A, Fasching PA, Beckmann MW, Ruebner M, Burghaus S. Comparison of methods for isolation and quantification of circulating cell-free DNA from patients with endometriosis. Reprod Biomed Online 2021; 43:788-798. [PMID: 34493460 DOI: 10.1016/j.rbmo.2021.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 07/13/2021] [Accepted: 08/03/2021] [Indexed: 10/20/2022]
Abstract
RESEARCH QUESTION Which is the optimal extraction method for isolating and quantifying circulating cell-free DNA (ccfDNA) from patients with endometriosis? Endometriosis is a common benign disease, associated with pain, infertility and reduced quality of life. Endometriosis is also a known risk factor for various cancers. Robust biomarkers for early detection and prediction of prognosis, however, are lacking. CcfDNA is an easy to obtain biomarker associated with prognosis of cancer patients and enables non-invasive analysis of somatic mutations. Recently, elevated levels of ccfDNA were detected in patients with endometriosis. DESIGN Two different ccfDNA extraction methods were compared: Maxwell RSC ccfDNA plasma kit (Maxwell) and QiAamp minElute ccfDNA mini kit (QIAamp). The ccfDNA and circulating mitochondrial DNA (mtDNA) quantities from 34 patients diagnosed with endometriosis were analysed. Fluorometric measurement and quantitative reverse transcription polymerase chain reaction (qRT-PCR) of short and long ALU and mtDNA fragments were used to quantiy ccfDNA. RESULTS The yield of ccfDNA isolated with the Maxwell method was significantly higher compared with the QIAamp method (P < 0.0001). Integrity of ccfDNA was significantly higher in the QIAamp isolate (P < 0.0001). Recovered mtDNA was not significantly different between both extraction methods used. CONCLUSIONS The choice of extraction method can significantly influence the ccfDNA output and integrity. Both methods, however, enabled isolation of sufficient ccfDNA for further downstream applications. With this approach, isolation of ccfDNA could enable the non-invasive detection and analysis of somatic mutation within endometriosis tissue.
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Affiliation(s)
- Hanna Huebner
- Department of Gynecology and Obstetrics, Erlangen University Hospital, University Endometriosis Center for Franconia, Friedrich-Alexander University Erlangen-Nürnberg, Germany
| | - Hannah Lubrich
- Department of Gynecology and Obstetrics, Erlangen University Hospital, University Endometriosis Center for Franconia, Friedrich-Alexander University Erlangen-Nürnberg, Germany
| | - Simon Blum
- Department of Gynecology and Obstetrics, Erlangen University Hospital, University Endometriosis Center for Franconia, Friedrich-Alexander University Erlangen-Nürnberg, Germany
| | - Sophia Antoniadis
- Department of Gynecology and Obstetrics, Erlangen University Hospital, University Endometriosis Center for Franconia, Friedrich-Alexander University Erlangen-Nürnberg, Germany
| | - Johannes Lermann
- Department of Obstetrics and Gynecology, Klinikum Klagenfurt am Wörthersee, Austria
| | - Arif Ekici
- Institute of Human Genetics, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nürnberg, Erlangen, Germany
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Erlangen University Hospital, University Endometriosis Center for Franconia, Friedrich-Alexander University Erlangen-Nürnberg, Germany
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Erlangen University Hospital, University Endometriosis Center for Franconia, Friedrich-Alexander University Erlangen-Nürnberg, Germany
| | - Matthias Ruebner
- Department of Gynecology and Obstetrics, Erlangen University Hospital, University Endometriosis Center for Franconia, Friedrich-Alexander University Erlangen-Nürnberg, Germany
| | - Stefanie Burghaus
- Department of Gynecology and Obstetrics, Erlangen University Hospital, University Endometriosis Center for Franconia, Friedrich-Alexander University Erlangen-Nürnberg, Germany.
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Theuser AK, Hack CC, Fasching PA, Antoniadis S, Grasruck K, Wasner S, Knoll S, Sievers H, Beckmann MW, Thiel FC. Patterns and Trends of Herbal Medicine Use among Patients with Gynecologic Cancer. Geburtshilfe Frauenheilkd 2021; 81:699-707. [PMID: 34168382 PMCID: PMC8216777 DOI: 10.1055/a-1487-6284] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 04/20/2021] [Indexed: 11/03/2022] Open
Abstract
Background More and more information about complementary and integrative medicine is becoming available, especially among cancer patients. However, little is known about the use of herbal medicine by patients with gynecologic cancers. This study aimed to assess the use of herbal products by gynecologic cancer patients compared with healthy controls. Methods This cross-sectional study was conducted at the Department for Gynecology and Obstetrics of Erlangen University Hospital and included 201 patients with gynecologic cancer and 212 healthy controls. Use of herbal medicines was evaluated using a standardized questionnaire. Medical information on cancer patients was collected from hospital records. Group comparisons were done using a logistic regression model. Risk ratios were assessed using a Poisson regression model. Results Gynecologic cancer patients used herbal medicine significantly less often than healthy persons. 69% of gynecologic cancer patients and 81% of healthy participants reported using herbal products. 40% of cancer patients and 56% of healthy persons reported using plants for medicinal purposes. Motives of cancer patients for using herbal medicine included treatment of cancer-related symptoms. The major source of information for both groups was family and friends. Conclusions Although herbal medicine was used less by patients with gynecologic cancer, herbal products were used by both cancer patients and healthy individuals. To provide cancer patients with optimal therapy, oncologists should be informed about the herbal products used by their patients as this will allow them to take their patients' self-medication with herbal medicine into account. Counseling by oncologists on the use of herbal medicine should be encouraged.
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Affiliation(s)
| | - Carolin C Hack
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen - European Metropolitan Area Nuremberg (CCC ER-EMN), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen - European Metropolitan Area Nuremberg (CCC ER-EMN), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sophia Antoniadis
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen - European Metropolitan Area Nuremberg (CCC ER-EMN), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Katharina Grasruck
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen - European Metropolitan Area Nuremberg (CCC ER-EMN), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sonja Wasner
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen - European Metropolitan Area Nuremberg (CCC ER-EMN), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Stefanie Knoll
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen - European Metropolitan Area Nuremberg (CCC ER-EMN), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | | | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen - European Metropolitan Area Nuremberg (CCC ER-EMN), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Falk C Thiel
- Department of Gynecology and Obstetrics, Alb Fils Kliniken, Klinik am Eichert, Göppingen, Germany
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Jud SM, Cupisti S, Frobenius W, Winkler A, Schultheis F, Antoniadis S, Beckmann MW, Heindl F. Correction to: Introducing multiple-choice questions to promote learning for medical students: effect on exam performance in obstetrics and gynecology. Arch Gynecol Obstet 2021; 304:1627. [PMID: 34155541 PMCID: PMC8553671 DOI: 10.1007/s00404-021-06112-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Sebastian M Jud
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany.
| | - Susanne Cupisti
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Wolfgang Frobenius
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Andrea Winkler
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Franziska Schultheis
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Sophia Antoniadis
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Felix Heindl
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany
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Theuser AK, Antoniadis S, Langemann H, Wasner S, Grasruck K, Dietzel-Drentwett S, Fasching PA, Beckmann MW, Hack CC. Active Participation, Mind-Body Stabilization, and Coping Strategies with Integrative Medicine in Breast Cancer Patients. Integr Cancer Ther 2021; 20:1534735421990108. [PMID: 33645304 PMCID: PMC7924003 DOI: 10.1177/1534735421990108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE Increasing numbers of breast cancer survivors have led to a growing demand for integrative medicine. When patients have completed treatments associated with severe side effects, attention turns to reducing psychological symptoms, coping behavior, and self-care. The aim of this study was to assess patient-reported benefits in relation to active participation, mind-body stabilization, and coping strategies in breast cancer patients receiving integrative medicine. METHODS In a cross-sectional study, health counseling and treatment provided by a standardized integrative medicine consultancy service at the University Breast Center of Franconia were evaluated in 75 breast cancer patients over a 15-month period. At the baseline, the patients answered a questionnaire on their medical history, symptoms, and the treatment goals they were hoping to achieve with integrative medicine. Patient-reported outcomes relative to active participation, mind-body stabilization, and coping strategies were analyzed. RESULTS A large majority of the patients had previous experience with integrative medicine (91%). Most reported that they achieved their treatment goals with integrative medicine. Ninety-one percent achieved active participation in cancer treatment, 90% mind-body stabilization, and 79% improvement in coping strategies. Besides active participation, which was greatest in patients with stable disease, the success of integrative therapy was independent of age, concomitant diseases, previous integrative medicine experience, treatment state, and systemic cancer therapy. CONCLUSION Breast cancer patients benefit from the counseling and treatment provided with integrative medicine in mind-body stabilization and coping with cancer. Active participation in cancer treatment is important for the patients. Integrative treatment services should form part of routine patient care.
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Affiliation(s)
- Anna-Katharin Theuser
- Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Sophia Antoniadis
- Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Hanna Langemann
- Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Sonja Wasner
- Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Katharina Grasruck
- Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | | | - Peter A Fasching
- Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Matthias W Beckmann
- Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Carolin C Hack
- Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
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Jud SM, Cupisti S, Frobenius W, Winkler A, Schultheis F, Antoniadis S, Beckmann MW, Heindl F. Introducing multiple-choice questions to promote learning for medical students: effect on exam performance in obstetrics and gynecology. Arch Gynecol Obstet 2020; 302:1401-1406. [PMID: 32865608 PMCID: PMC8172403 DOI: 10.1007/s00404-020-05758-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 08/24/2020] [Indexed: 11/30/2022]
Abstract
Purpose Testing is required in medical education. The large number of exams that students face requires effective learning strategies. Various methods of improving knowledge retention and recall have been discussed, two of the most widely evaluated of which are test-enhanced learning and pause procedures. This study investigated the effect of voluntary multiple-choice questions on students’ performance. Methods In a prospective study from April 2013 to March 2015, 721 students were randomly assigned to receive supplementary online material only (control group) or additional multiple-choice questions (investigative group) accompanying lectures. Their performance in the final exam was evaluated. Results A total of 675 students were ultimately included, with 299 randomly assigned to the investigative group and 376 to the control group. Students in the investigative group scored significantly better in relation to grades and points (2.11 vs. 2.49; 33 vs 31.31; p < 0.05). The effect declined over time. Conclusion This is the first study of the use of voluntary multiple-choice questions to improve medical students’ performance. The results support test-enhanced learning and the feasibility of implementing multiple-choice questions in lectures.
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Affiliation(s)
- Sebastian M Jud
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany.
| | - Susanne Cupisti
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Wolfgang Frobenius
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Andrea Winkler
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Franziska Schultheis
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Sophia Antoniadis
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Felix Heindl
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Universitätsstrasse 21-23, 91054, Erlangen, Germany
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Antoniadis S, Burghaus S, Becker K, Beckmann M, Hack C. Einfluss von achtsamkeitsbasierter Stressreduktion (mindfulness based stress reduction) auf Patientinnen mit Endometriose im Rahmen einer randomisierten Kohortenstudie. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718066] [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: 10/23/2022] Open
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10
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Hildebrandt T, Lotz L, Blum S, Fahlbusch C, Heusinger K, Cupisti S, Dittrich R, Beckmann MW, Antoniadis S. Ergebnisse der Stimulationsbehandlung durch pulsatile GnRH-Substitution unter Verwendung eines innovativen, patientenkontrollierten Systems (LutrePulse®). Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718228] [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: 10/23/2022] Open
Affiliation(s)
| | - L Lotz
- Frauenklinik Universität Erlangen
| | - S Blum
- Frauenklinik Universität Erlangen
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11
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Blum S, Fasching P, Hildebrandt T, Lermann J, Heindl F, Born T, Lubrich H, Antoniadis S, Becker K, Fahlbusch C, Heusinger K, Burghaus S, Beckmann M, Hein A. Epidemiologische Faktoren bei verschiedenen klinischen Formen der Endometriose – eine Fall-Fall-Untersuchung. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717165] [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: 10/23/2022] Open
Affiliation(s)
- S Blum
- Frauenklinik des Universitätsklinikums Erlangen
| | - P Fasching
- Frauenklinik des Universitätsklinikums Erlangen
| | | | - J Lermann
- Frauenklinik des Universitätsklinikums Erlangen
| | - F Heindl
- Frauenklinik des Universitätsklinikums Erlangen
| | - T Born
- Frauenklinik des Universitätsklinikums Erlangen
| | - H Lubrich
- Frauenklinik des Universitätsklinikums Erlangen
| | | | - K Becker
- Frauenklinik des Universitätsklinikums Erlangen
| | - C Fahlbusch
- Frauenklinik des Universitätsklinikums Erlangen
| | - K Heusinger
- Frauenklinik des Universitätsklinikums Erlangen
| | - S Burghaus
- Frauenklinik des Universitätsklinikums Erlangen
| | - M Beckmann
- Frauenklinik des Universitätsklinikums Erlangen
| | - A Hein
- Frauenklinik des Universitätsklinikums Erlangen
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12
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Blum S, Fasching PA, Hildebrandt T, Lermann J, Heindl F, Born T, Lubrich H, Antoniadis S, Becker K, Fahlbusch C, Heusinger K, Burghaus S, Beckmann MW, Hein A. Epidemiologische Faktoren bei verschiedenen klinischen Formen der Endometriose – eine Fall-Fall-Untersuchung. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1714020] [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: 10/23/2022] Open
Affiliation(s)
- S Blum
- Frauenklinik des Universitätsklinikums Erlangen-Nürnberg, Erlangen
| | - P A Fasching
- Frauenklinik des Universitätsklinikums Erlangen-Nürnberg, Erlangen
| | - T Hildebrandt
- Frauenklinik des Universitätsklinikums Erlangen-Nürnberg, Erlangen
| | - J Lermann
- Frauenklinik des Universitätsklinikums Erlangen-Nürnberg, Erlangen
| | - F Heindl
- Frauenklinik des Universitätsklinikums Erlangen-Nürnberg, Erlangen
| | - T Born
- Frauenklinik des Universitätsklinikums Erlangen-Nürnberg, Erlangen
| | - H Lubrich
- Frauenklinik des Universitätsklinikums Erlangen-Nürnberg, Erlangen
| | - S Antoniadis
- Frauenklinik des Universitätsklinikums Erlangen-Nürnberg, Erlangen
| | - K Becker
- Frauenklinik des Universitätsklinikums Erlangen-Nürnberg, Erlangen
| | - C Fahlbusch
- Frauenklinik des Universitätsklinikums Erlangen-Nürnberg, Erlangen
| | - K Heusinger
- Frauenklinik des Universitätsklinikums Erlangen-Nürnberg, Erlangen
| | - S Burghaus
- Frauenklinik des Universitätsklinikums Erlangen-Nürnberg, Erlangen
| | - M W Beckmann
- Frauenklinik des Universitätsklinikums Erlangen-Nürnberg, Erlangen
| | - A Hein
- Frauenklinik des Universitätsklinikums Erlangen-Nürnberg, Erlangen
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13
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Blum S, Fasching PA, Hildebrandt T, Lermann J, Heindl F, Born T, Lubrich H, Antoniadis S, Becker K, Tchartchian G, Bojahr B, Jentschke M, Fehmd T, Janni W, Hartung CP, Füger T, Renner SP, Germeyer A, Oppelt P, Enzelsberger SH, Fleisch M, Hepp P, Lange J, Fahlbusch C, Heusinger K, Burghaus S, Beckmann MW, Hein A. Das internationale Endometriose-Evaluationsprogramm (IEEP) – eine Studie für Kliniker, Forscher und Patientinnen. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1714019] [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: 10/23/2022] Open
Affiliation(s)
- S Blum
- Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg
| | - P A Fasching
- Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg
| | - T Hildebrandt
- Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg
| | - J Lermann
- Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg
| | - F Heindl
- Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg
| | - T Born
- Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg
| | - H Lubrich
- Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg
| | - S Antoniadis
- Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg
| | - K Becker
- Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg
| | - G Tchartchian
- Zertifiziertes Endometriosezentrum der Klinik für MIC, Berlin
| | - B Bojahr
- Zertifiziertes Endometriosezentrum der Klinik für MIC, Berlin
| | - M Jentschke
- Klinik für Frauenheilkunde und Geburtshilfe, Medizinische Hochschule, Hannover
| | - T Fehmd
- Universitäts-Frauenklinik Düsseldorf, Düsseldorf
| | - W Janni
- Frauenheilkunde und Geburtshilfe, Universitätsklinikum Ulm, Ulm
| | | | - T Füger
- MIC-Zentrum Frauenklinik Dr. Geisenhofer, München
| | - S P Renner
- Frauenklinik, Kliniken Böblingen, Klinikum Sindelfingen-Böblingen, Böblingen
| | - A Germeyer
- Universitäts-Frauenklinik Heidelberg, Heidelberg
| | - P Oppelt
- Universitätsklinik für Gynäkologie, Geburtshilfe & Gyn. Endokrinologie, Kepler Universitätsklinikum, Linz, Österreich
| | - S-H Enzelsberger
- Universitätsklinik für Gynäkologie, Geburtshilfe & Gyn. Endokrinologie, Kepler Universitätsklinikum, Linz, Österreich
| | - M Fleisch
- Landesfrauenklinik, Helios Universitätsklinikum, Wuppertal
| | - P Hepp
- Landesfrauenklinik, Helios Universitätsklinikum, Wuppertal
| | - J Lange
- Agaplesion Markus Krankenaus, Endometriosezentrum, Frankfurt/Main
| | - C Fahlbusch
- Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg
| | - K Heusinger
- Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg
| | - S Burghaus
- Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg
| | - M W Beckmann
- Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg
| | - A Hein
- Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg
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Jud SM, Cupisti S, Frobenius W, Benn S, Winkler A, Antoniadis S, Beckmann MW, Heindl F. Logbooks alone are not enough: initial experience with implementing a logbook for medical students in a clinical internship in gynecology and obstetrics. Eur J Med Res 2020; 25:15. [PMID: 32384922 PMCID: PMC7206670 DOI: 10.1186/s40001-020-00413-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 04/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Logbooks are being increasingly widely used as a means of improving medical education and further training. They will in all probability continue to be mandatory in the Practical Year (PJ) in Germany even after the upcoming amendment of the Medical Licensing Regulations (ÄAppO). However, there are different approaches to their design and use, and these are also currently undergoing considerable change. This study for the first time examines and discusses the influence of logbooks on students' evaluation of a gynecology internship. METHODS The study was based on a well-established two-part 1-week internship course, with initially unstructured morning classes on wards and duty areas, along with precisely planned afternoon classes with skills training by peer teachers and seminars supervised by duty-exempted physicians. The postgraduate lecturers were prepared for the introduction of the logbook in a special course, and the aim was to optimize morning classes by introducing learning objectives adapted to the respective locations. The effects over 38 weeks of practical training were examined in evaluations by 235 prospectively group-randomized students with and without logbooks (n = 166 and n = 66, respectively; three datasets were not evaluable). RESULTS In the cohort comparison, the logbook group responded significantly more positively toward the internship at the start of the course (P = 0.046). In the final evaluation, however, medical supervision during the entire internship was rated significantly more poorly (P = 0.007). The logbook cohort also considered that guidance based on learning objectives was significantly worse, as was the extent to which wards and duty areas were prepared for the students (P = 0.001 and P = 0.029). CONCLUSIONS Introducing a logbook to optimize clinical teaching in internships may raise expectations that cannot always be met. In addition to adapting the learning objectives to a general framework that is less favorable in comparison with the Practical Year, the least that is required appears to be simultaneous and continuous mentoring of the lecturers, as well as an increase in staffing resources.
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Affiliation(s)
- Sebastian M Jud
- Department of Gynecology, Erlangen University Hospital, Universitätsstrasse 21-23, 91054, Erlangen, Germany.
| | - Susanne Cupisti
- Department of Gynecology, Erlangen University Hospital, Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Wolfgang Frobenius
- Department of Gynecology, Erlangen University Hospital, Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Sigrid Benn
- Department of Gynecology, Erlangen University Hospital, Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Andrea Winkler
- Department of Gynecology, Erlangen University Hospital, Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Sophia Antoniadis
- Department of Gynecology, Erlangen University Hospital, Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Matthias W Beckmann
- Department of Gynecology, Erlangen University Hospital, Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Felix Heindl
- Department of Gynecology, Erlangen University Hospital, Universitätsstrasse 21-23, 91054, Erlangen, Germany
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15
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Lotz L, Barbosa PR, Knorr C, Hofbeck L, Hoffmann I, Beckmann MW, Antoniadis S, Dittrich R. The safety and satisfaction of ovarian tissue cryopreservation in prepubertal and adolescent girls. Reprod Biomed Online 2020; 40:547-554. [PMID: 32199797 DOI: 10.1016/j.rbmo.2020.01.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 01/12/2020] [Accepted: 01/14/2020] [Indexed: 01/18/2023]
Abstract
RESEARCH QUESTION Is ovarian tissue cryopreservation (OTC) for fertility preservation in prepubertal and adolescent girls safe, and who would benefit most from the procedure? DESIGN Survey and retrospective study including patients who had OTC under the age of 18 years in a single centre for fertility preservation. Serum anti-Müllerian hormone levels were measured as a marker for detection of diminished ovarian reserve. RESULTS Fifty-three from 102 women participated in the survey (12 deceased, 19 declined, 17 unreachable, 1 palliative). The average age at OTC was 14.8 ± 2.3 (range: 6-17) years and at survey 21.9 ± 4.3 (range: 16-33) years. Ovarian tissue retrieval (laparoscopy: n = 45, laparotomy: n = 8) was without complications in 52 cases. In 23 (53.5%) of the 43 women who were post-menarchal at OTC, transient amenorrhoea occurred. At survey, 15 women reported a regular menstrual cycle, 25 used oral contraceptives, 9 women reported hormone replacement therapy due to primary ovary insufficiency and 4 had amenorrhoea. Two patients reported the birth of a healthy child after IVF, while 51 patients are still childless, mostly due to their young age (mean: 21.2 years). To date, one patient has had transplantation of the ovarian tissue (17 years at cryopreservation). Forty-nine of the interviewees would again decide on OTC, while three argued against it on the basis of the previous financial cost; one woman was unsure. CONCLUSIONS Children with cancer may be at risk for gonadal insufficiency. OTC is practically the only technique that can be offered to young girls. The procedure is safe and well accepted.
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Affiliation(s)
- Laura Lotz
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen D-91054, Germany.
| | - Patricia Reis Barbosa
- Department of Pediatric Surgery and Pediatric Orthopedics, Hospital St Hedwig, Hospital Barmherzige Brüder Regensburg, Krankenhaus Barmherzige Brüder, Regensburg, Germany
| | - Christian Knorr
- Department of Pediatric Surgery and Pediatric Orthopedics, Hospital St Hedwig, Hospital Barmherzige Brüder Regensburg, Krankenhaus Barmherzige Brüder, Regensburg, Germany
| | - Louisa Hofbeck
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen D-91054, Germany
| | - Inge Hoffmann
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen D-91054, Germany
| | - Matthias W Beckmann
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen D-91054, Germany
| | - Sophia Antoniadis
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen D-91054, Germany
| | - Ralf Dittrich
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen D-91054, Germany
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16
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Burghaus S, Hildebrandt T, Fahlbusch C, Heusinger K, Antoniadis S, Lermann J, Hackl J, Häberle L, Renner SP, Fasching PA, Beckmann MW, Blum S. Standards Used by a Clinical and Scientific Endometriosis Center for the Diagnosis and Therapy of Patients with Endometriosis. Geburtshilfe Frauenheilkd 2019; 79:487-497. [PMID: 31148849 PMCID: PMC6529229 DOI: 10.1055/a-0813-4411] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 08/26/2018] [Revised: 10/30/2018] [Accepted: 12/04/2018] [Indexed: 12/22/2022] Open
Abstract
Endometriosis is one of the most common benign gynecological diseases. The extremely heterogeneous complex of symptoms complicates the diagnosis and treatment of this disease. In most patients, there is a latency period of several years between the first occurrence of symptoms and the definitive diagnosis. This paper aims (1) to evaluate standards for the diagnosis and treatment of patients with (symptoms suspicious for) endometriosis in terms of feasibility, and (2) to assess the potential use of data collected by a certified clinical and scientific endometriosis center to answer scientific questions. Standards for outpatient consultations were developed for a special endometriosis outpatient clinic. Between January 2014 and December 2017, a total of 1715 outpatients with a suspicion of endometriosis presented to this special endometriosis outpatient clinic; the diagnosis and treatment of patients was carried out in accordance with the developed standards. Data of this patient cohort obtained from patient records created during outpatient consultations and from a questionnaire recorded in an Oracle-based database was analyzed. The patient cohort was also compared with another patient cohort who had attended different outpatient clinics and had been diagnosed intraoperatively with endometriosis. 41.8% of patients examined during special outpatient consultations had surgery for suspicion or recurrence of endometriosis. Endometriosis was confirmed in 81.5% of cases. Pain symptoms were the main indication for surgery in 70.1% of cases compared to 45.1% of cases in the comparison group. The structured approach used in the special endometriosis outpatient clinic is a key aspect of the care provided by the certified clinical and scientific endometriosis center. It ensures that patients are diagnosed and treated in accordance with guideline recommendations, that diagnosis and treatment comply with certification requirements, and that the collected data can be used to answer scientific questions.
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Affiliation(s)
- Stefanie Burghaus
- Frauenklinik, Universitätsklinikum Erlangen, Universitäts-Endometriosezentrum Franken (UEF), Erlangen, Germany
| | - Thomas Hildebrandt
- Frauenklinik, Universitätsklinikum Erlangen, Universitäts-Endometriosezentrum Franken (UEF), Erlangen, Germany
| | - Christine Fahlbusch
- Frauenklinik, Universitätsklinikum Erlangen, Universitäts-Endometriosezentrum Franken (UEF), Erlangen, Germany
| | - Katharina Heusinger
- Frauenklinik, Universitätsklinikum Erlangen, Universitäts-Endometriosezentrum Franken (UEF), Erlangen, Germany
| | - Sophia Antoniadis
- Frauenklinik, Universitätsklinikum Erlangen, Universitäts-Endometriosezentrum Franken (UEF), Erlangen, Germany
| | - Johannes Lermann
- Klinik für Gynäkologie und Geburtshilfe, Klinikum Bayreuth, Bayreuth, Germany
| | - Janina Hackl
- Frauenklinik, Universitätsklinikum Erlangen, Universitäts-Endometriosezentrum Franken (UEF), Erlangen, Germany
| | - Lothar Häberle
- Abteilung für Biostatistik, Frauenklinik, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Stefan P Renner
- Frauenklinik, Klinikum Sindelfingen-Böblingen, Böblingen, Germany
| | - Peter A Fasching
- Frauenklinik, Universitätsklinikum Erlangen, Universitäts-Endometriosezentrum Franken (UEF), Erlangen, Germany
| | - Matthias W Beckmann
- Frauenklinik, Universitätsklinikum Erlangen, Universitäts-Endometriosezentrum Franken (UEF), Erlangen, Germany
| | - Simon Blum
- Frauenklinik, Universitätsklinikum Erlangen, Universitäts-Endometriosezentrum Franken (UEF), Erlangen, Germany
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Hack CC, Antoniadis S, Beckmann MW, Brandl AL, Fasching PA, Hackl J, Langemann H, Katja S, Weber N, Theuser AK. Supportive Infusions in Integrative Breast and Gynecological Oncology - Report on Patients' Satisfaction and Self-reported Effects and Side Effects. Geburtshilfe Frauenheilkd 2018; 78:1129-1137. [PMID: 30498280 PMCID: PMC6255728 DOI: 10.1055/a-0754-2923] [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: 07/30/2018] [Revised: 09/14/2018] [Accepted: 10/05/2018] [Indexed: 11/30/2022] Open
Abstract
Background
During cancer therapy, many patients suffer from malnutrition or vitamin deficiency. Treatment for nutrition-related deficiencies should therefore include nutritional therapy and possibly oral or intravenous substitution of micronutrients. Little information exists on multinutrient infusion therapies. The aim of this study was to develop standardized infusion protocols for integrative medicine infusions with micronutrients (IMed infusions) and to report on side effects of the treatment and patientsʼ satisfaction with it.
Methods
For the IMed consultancy service, four special formulas for intravenous use were developed in cooperation with the pharmacy at Erlangen University Hospital. A retrospective cross-sectional study was conducted between October 2015 and January 2018 in which 45 patients with gynecological or breast cancer (BC) and IMed infusion therapy were included. Follow-up data were obtained from 20 patients using a standardized questionnaire on IMed infusions.
Results
A total of 280 IMed infusions were administered in the study period. The majority of the patients received an IMed regeneration infusion (78%). The majority of the patients had BC and were receiving chemotherapy. Most patients reported a high or very high level of satisfaction with the organization (60%), general treatment (65%) and counseling (85%). Subjective improvement in their disease-related and therapy-induced symptoms, such as fatigue, polyneuropathy and physical efficiency, was reported by 70% of the patients, while 75% reported a subjective increase in quality of life. Side effects were rare and minor.
Conclusions
Therapy with IMed infusions in women with BC or gynecological cancer requires the same standards set for drug therapy. Although vitamins represent dietary supplements, appropriate assessment of the patientʼs medical history is needed and patients must receive appropriate information. For this purpose, standardized processes, as in the context of an IMed consultancy service, are helpful.
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Affiliation(s)
- Carolin C Hack
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen - European Metropolitan Area Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Sophia Antoniadis
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen - European Metropolitan Area Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen - European Metropolitan Area Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Anna Lisa Brandl
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen - European Metropolitan Area Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen - European Metropolitan Area Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Janina Hackl
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen - European Metropolitan Area Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Hanna Langemann
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen - European Metropolitan Area Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Stock Katja
- Department of Pharmacy, Erlangen University Hospital, Erlangen, Germany
| | - Natalie Weber
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen - European Metropolitan Area Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Anna-Katharin Theuser
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen - European Metropolitan Area Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
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18
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Banys-Paluchowski M, Antoniadis S, Hein A, Fehm T, Arnold N, Fasching P. Veranstaltungsbericht: 10. Wissenschaftliches Symposium der AGO-TraFo. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/a-0750-0971] [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] Open
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19
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Antoniadis S, Häberle L, Rübner M, Büchner K, Blum S, Ekici A, Hartmann A, Hein A, Reis A, Beckmann MW, Renner SP, Fasching PA, Burghaus S. Genetic risk factors for endometriosis, endometrial and ovarian cancer in a German Case-Control Study. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1670971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- S Antoniadis
- Universitätsfrauenklinik Erlangen, Erlangen, Deutschland
| | - L Häberle
- Universitätsfrauenklinik Erlangen, Biostatistik, Erlangen, Deutschland
| | - M Rübner
- Universitätsfrauenklinik Erlangen, Erlangen, Deutschland
| | - K Büchner
- Universitätsfrauenklinik Erlangen, Erlangen, Deutschland
| | - S Blum
- Universitätsfrauenklinik Erlangen, Erlangen, Deutschland
| | - A Ekici
- Universität Erlangen Institut für Humangenetik, Humangenetik, Erlangen, Deutschland
| | - A Hartmann
- Universität Erlangen, Pathologie, Erlangen, Deutschland
| | - A Hein
- Universitätsfrauenklinik Erlangen, Erlangen, Deutschland
| | - A Reis
- Universität Erlangen Institut für Humangenetik, Humangenetik, Erlangen, Deutschland
| | - MW Beckmann
- Universitätsfrauenklinik Erlangen, Erlangen, Deutschland
| | - SP Renner
- Frauenklinik Böblingen, Böblingen, Deutschland
| | - PA Fasching
- Universitätsfrauenklinik Erlangen, Erlangen, Deutschland
| | - S Burghaus
- Universitätsfrauenklinik Erlangen, Erlangen, Deutschland
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Hack CC, Antoniadis S, Hackl J, Langemann H, Schwitulla J, Fasching PA, Beckmann MW, Theuser AK. Correction to: Breast cancer patients’ satisfaction with individual therapy goals and treatment in a standardized integrative medicine consultancy service. Arch Gynecol Obstet 2018; 298:157-158. [DOI: 10.1007/s00404-018-4785-6] [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] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Hack CC, Antoniadis S, Hackl J, Langemann H, Schwitulla J, Fasching PA, Beckmann MW, Theuser AK. Breast cancer patients’ satisfaction with individual therapy goals and treatment in a standardized integrative medicine consultancy service. Arch Gynecol Obstet 2018; 298:147-156. [DOI: 10.1007/s00404-018-4779-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 04/19/2018] [Indexed: 12/23/2022]
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Antoniadis S, Clifford R, Chagla L. Five-year local recurrence for breast cancer; the presentation of our local data. Int J Surg 2016. [DOI: 10.1016/j.ijsu.2016.08.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Iatrakis G, Tsionis C, Antoniadis S, Kourounis G. Effect on endometrium of combined oestrogen-progestogen replacement therapy of 1 mg 17beta-estradiol and 0.5 mg norethisterone acetate. CLIN EXP OBSTET GYN 2004; 31:50-2. [PMID: 14998189] [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: 04/29/2023]
Abstract
The purpose of the study was to determine the effects of low-dose hormone replacement therapy (HRT) on ultrasound thickness of the endometrium and on endometrial histology in postmenopausal women. Two hundred and fifty-four postmenopausal women were included in the study; 124 completed three years of treatment with continuous HRT containing 1 mg oestradiol and 0.5 mg norethisterone acetate daily, and 130 women did not take HRT during the same time (control group). Ultrasound scan showed that the mean thickness of the endometrium was similar between the groups under investigation at the end of the study. Ninety-one percent of the women in the HRT group and 78% in the control group had an atrophic or unassessable endometrium and no cases of endometrial hyperplasia or malignancy were detected in either group at endometrial biopsy at the end of the study. It seems that low-dose continuous HRT of moderate duration is not associated with either endometrial hyperplasia or malignancy.
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Affiliation(s)
- G Iatrakis
- Technological Educational Institution of Athens, Greece
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Dacou-Voutetakis C, Klontza D, Lagos P, Tzonou A, Katsarou E, Antoniadis S, Papazisis G, Papadopoulos G, Matsaniotis N. Age of pubertal stages including menarche in Greek girls. Ann Hum Biol 1983; 10:557-63. [PMID: 6651213 DOI: 10.1080/03014468300006781] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The age at the different stages of pubertal development, including menarche, was assessed by the status quo method in 1366 middle-class girls living in Athens. The initial pubertal event in the average Athenian girl was the appearance of pubic hair along the labiae (P10:8.85, P50:10.47), followed shortly by breast budding (P10:9.39, P50:10.62), and later on by axillary hair growth (P10:10.55, P50:11.63). The age at menarche was 12.58 +/- 0.07 years. It seems tht Athenian girls of 1979 have one of the earliest ages of menarche reported. Recollected age data on menarche when compared to previous data from the Greek population show a decrease of 0.46 years/decade from 1935 to 1964 and no appreciable change from 1964 to 1979. Although these data are not absolutely comparable from the methodological point of view, they may indicate that the trend in menarcheal age in Athens is levelling off.
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