196,840 research outputs found
Sicherheit und Monitoring der patientenkontrollierten intravenösen Analgesie. Anwendungspraxis in deutschen Krankenhäusern
No full textResponse of the Uterus Commission of AGO to the Comment of M. Kolben, C. Dannecker and R. Kurzl
No full text
Innovations in Cervical and Endometrial Cancer
No full textThe S2k guideline "Diagnostics and Therapy for Cervical Cancer" published in 2008 is currently being revised to the S3 level. Current developments in epidemiology, surgical therapy, radio-chemotherapy and drug therapy will be presented. The S2k guideline "Diagnostics and Therapy for Endometrial Cancer" will also be up-dated this year. The revised recommendations on early diagnosis and diagnostics, therapy for precursors, surgical therapy, adjuvant therapy and therapy for recurrences and metastases will be presented
Current practice of acute pain management in children - a national follow-up survey in Germany
No full textOBJECTIVES
This study aimed to summarize the current standard practices for acute pain management in children in Germany and the implementation of these procedures. The last survey on acute pain management in children was performed in 1999, highlighting the need for an up to date review.
METHODS
A questionnaire was mailed to German departments of anesthesiology (n = 885), asking for structures and processes of acute pain management in children. Results were compared between hospitals with and without an acute pain service and with and without a pediatric department.
RESULTS
Of the 407 responding hospitals (response rate of 46%), 342 treated children younger than 14 years. These were considered for analysis. Of the 342 hospitals, 42% contained either a general pediatric department or a department of pediatric surgery, and the majority of the responding hospitals had an acute pain service (83%). Pain intensities were measured at least once per shift in 40% of the institutions, and at least once or twice a day in 27%. Of the institutions, 31% did not document pain scores regularly, without any difference between hospitals with or without a pediatric department. Standard operating procedures for acute pain management existed in 68% of the hospitals, with large differences in content and length. Opioids were administered to children in 85% of the hospitals. Nonopioid analgesics were the first choice baseline analgesics in most hospitals. Peripheral regional and epidural analgesia were performed in children in 18% and 8% of the hospitals, respectively (21%/16% with a paediatric department, 16%/1% without; P < 0.001).
CONCLUSION
Current practice of pediatric pain management varied widely and the recommendations of guidelines, like regular pain management, were frequently not met. However, improvements could be observed since 1999, for example, an increase in regular pain measurements (4% vs 67%). Furthermore, pain management in hospitals running a pediatric department had a higher degree of organization, and more sophisticated analgesic techniques
Inactivation of GPR30 reduces growth of triple-negative breast cancer cells: possible application in targeted therapy
No full textTriple-negative breast cancers lack estrogen receptor alpha (ER alpha), progesterone receptor, and do not overexpress human epidermal growth factor receptor 2 (Her-2). They are neither susceptible to endocrine therapy nor to a therapy using the anti-Her-2 antibody, trastuzumab. Therefore, an efficient targeted therapy is warranted. Triple-negative breast tumors frequently express membrane bound estrogen receptor G-protein coupled receptor (GPR30). As proof of principle, we analyzed the consequences of a knock-down of GPR30 expression on the growth regulation of triple-negative breast cancer cell lines. Cells of triple-negative breast cancer cell lines were transfected with siRNA against GPR30 or control siRNA, and cell growth was stimulated either with 10(-9) M 17 beta-estradiol or 10(-6) M 4-hydroxytamoxifen. Cell proliferation was measured using Alamar blue staining. Activation of c-Src and epidermal growth factor (EGF)-receptor was assessed using western blot. Expression of c-fos was quantified by reverse transcription polymerase chain reaction. Seven days after transfection with siRNA, GPR30 mRNA in triple-negative breast cancer cell lines MDA-MB-435 and HCC1806 was reduced by 74 and 90%, respectively. 10(-8) M 17 beta-estradiol enhanced proliferation of MDA-MB-435 to 129.6 +/- A 5.4% of control (p < 0.05) and HCC1806 to 156.9 +/- A 15.4% of control (p < 0.05), respectively. 10(-6) M 4-hydroxytamoxifen increased cell number of MDA-MB-435 to 121.0 +/- A 6.9% of control (p < 0.05) and HCC1806 to 124.5 +/- A 12.1% of control (n.s.), respectively. This increased proliferation by the two estrogenic compounds was completely prevented by knock-down of GPR30 expression in both cell lines. In control cells, activity of Src kinase was increased 3-fold by estradiol and 3.8-fold using 4-hydroxytamoxifen. Transactivation of the EGF-receptor was similarly increased in both cell lines by 17 beta-estradiol and 4-hydroxytamoxifen. Both compounds increased c-fos expression 1.5- and 3.1-fold, respectively. Knock-down of GPR30 expression completely abolished activation of all these signaling pathways responsible for enhanced proliferation. A pharmacological inhibition of GPR30 by specific small molecular inhibitors might prove to be an appropriate targeted therapy of triple-negative breast cancer in the future
Placenta percreta in week 10 of pregnancy with consecutive hysterectomy: Case report
No full textPlacenta percreta in early pregnancy is rare and has been documented in only a few cases. We report on a patient with abdominal pain in week 10 of pregnancy. Sonography revealed a defective embryonic development and the absence of a border line between trophoblast and myometrium, as well as invasive growth in the region of isthmocervical transition, so curettage was performed. Heavy bleeding at this stage made a hysterectomy necessary. Histological examination revealed a placenta percreta. Because of possible complications, the therapy of choice for a placenta percreta. is a hysterectomy, as was performed in this case
Global, local and graphical person-fit analysis using person response functions
No full textPerson-fit statistics test whether the likelihood of a respondent’s complete vector of item scores on a test is low given the hypothesized item response theory model. This binary information may be insufficient for diagnosing the cause of a misfitting item-score vector. The authors propose a comprehensive methodology for person-fit analysis in the context of nonparametric item response theory. The methodology (a) includes H. Van der Flier’s (1982) global person-fit statistic U3 to make the binary decision about fit or misfit of a person’s item-score vector, (b) uses kernel smoothing (J. O. Ramsay, 1991) to estimate the person-response function for the misfitting item-score vectors, and (c) evaluates unexpected trends in the person-response function using a new local person-fit statistic (W. H. M. Emons, 2003). An empirical data example shows how to use the methodology for practical person-fit analysis
Early onset vulvar Lichen sclerosus in premenopausal women and oral contraceptives
No full textObjective: For vulvar Lichen sclerosus (LS) immunological factors, genetic predisposition, and decreased 5 alpha-reductase activity have been discussed as aetiological factors. During the last decade an increase of LS in young women has been suspected. Aim of this study was to evaluate data of premenopausal women with early onset LS to find potential risk factors focussing on the use of oral contraceptives. Study design: We retrospectively analyzed the data of 40 premenopausal patients with early onset LS regarding use of oral contraceptives (OCPs), and first occurrence of LS. To compare these data in a case-control study we analyzed a matched control group of 110 healthy women. Results: All our LS patients were using OCPs compared to 73 women (66.4%) in the control group. OCPs with anti-androgenic activity (chlormadinone acetate, cyproterone acetate, dienogest, and drospirenone) were used by 28 (70%) of the LS patients and by 35 (47.9%) of the 73 women using OCPs in the control group. Thus, the odds ratio for early onset LS for women using anti-androgenic OCPs was 2.53 (95% CI: 1.12-5.75). Conclusion: Our data suggest that disturbance of the androgen dependent growth of the vulvar skin by OCPs and especially by OCPs with anti-androgenic properties might trigger the early onset of LS in a subgroup of susceptible young women. (c) 2007 Elsevier Ireland Ltd. All rights reserved
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