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  • 1
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    German Medical Science; Düsseldorf, Köln
    In:  GMS Medizinische Informatik, Biometrie und Epidemiologie; VOL: 1; DOC02 /20050407/
    Publication Date: 2005-04-08
    Description: Before general application of a primary prevention program its efficacy has to be demonstrated. For this purpose a randomized controlled trial with active or passive follow-up may be conducted. In the last 5 years, the ratio of controlled trials with passive versus those with active follow-up was 1:13. However, under certain circumstances a passive follow-up may be more appropriate and useful to overcome the drawbacks of an active follow-up, as e.g. high costs and many drop-outs. In a randomized controlled trial, a passive follow-up is based on the reporting of cases by physicians or hospitals instead of actively following up all study participants individually. The statistical evaluation can be carried out using a one-sample chi2-test. Advantages and limitations are discussed. A passive follow-up may be advantageous in situations with low incidence, large number of participants, complete ascertainment of conditions with obligatory notification or effective disease registries and should be preferred in such a context.
    Description: Vor dem Einsatz primärer Präventionsprogramme auf Bevölkerungsebene ist deren Wirksamkeit zu prüfen. Standardmäßig werden dazu randomisierte kontrollierte Studien mit aktivem oder passivem Follow-up durchgeführt. In den letzten 5 Jahren kamen auf 1 Studie mit passivem Follow-up 13 Studien mit aktivem Follow-up. Unter bestimmten Voraussetzungen kann ein passives Follow-up jedoch geeigneter und sinnvoll sein und dazu dienen die Nachteile eines aktiven Follow-ups, wie z.B. hohe Kosten und viele Drop-outs, zu vermeiden. In einer randomisierten kontrollierten Studie mit passivem Follow-up werden alle Patienten mit der interessierenden Erkrankung von den behandelnden Ärzten oder den Krankenhäusern der Region direkt an das Studiensekretariat gemeldet. Die statistische Auswertung kann mit einem 1-Stichproben-Chi2-Test erfolgen. Die Vor- und Nachteile dieses Vorgehens werden diskutiert. Ein passives Follow-up kann in Situationen mit niedriger Inzidenz, großer Anzahl von Studienteilnehmern, Gewährleistung einer vollständigen Erhebung der Krankheitsfälle durch Betrachtung einer meldepflichtigen Erkrankung und gut geführte Krankheitsregister vorteilhaft sein und sollte dann durchaus bevorzugt werden.
    Keywords: active follow-up ; passive follow-up ; study design ; randomized controlled trial ; primary prevention program ; aktives Follow-up ; passives Follow-up ; Studiendesign ; randomiserte kontrollierte Studie ; primäres Präventionsprogramm ; ddc: 610
    Language: English
    Type: article
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  • 2
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  Deutscher Kongress für Orthopädie und Unfallchirurgie; 74. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 96. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 51. Tagung des Berufsverbandes der Fachärzte für Orthopädie; 20101026-20101029; Berlin; DOCEF20-883 /20101021/
    Publication Date: 2010-10-22
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 3
    ISSN: 1435-2451
    Keywords: Peptisches Ulkus ; Komorbidität Letalität ; Ulkusoperation ; Aufenthaltsdauer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In dieser retrospektiven Studie wurden im Zeitraum zwischen dem 1.1.1984 und dem 31.12.1993 303 operativ behandelte Ulkuspatienten erfaßt. Elf potentielle Einfluβgröβen (Zeitraum der Operation, Geschlecht, Raucherverhalten, Ulkusanamnese, Einnahme ulzerogener Medikamente, Ulkuslokalisation, Magenschmerz, Anzahl der substituierten Blutkonserven, Alter der Patienten, Operationsindikation, Komorbidität) wurden hinsichtlich ihres Einflußes auf die peri- und postoperative Sterblichkeit sowie die Krankenhausverweildauer untersucht. Hohe Komorbidität (>2) und die Indikation “Notfalloperation” (gegen elektive Operation) zeigten einen negativen Einfluß hinsichtlich des Überlebens. Dem Alter kam nur eine geringe Bedeutung zu. Die postoperative Aufenthaltsdauer wurde hauptsächlich durch hohes Alter (>60 Jahre), eine hohe Anzahl (>2) substituierter Blutkonserven und einen hohen Komorbiditätsscore nach Charlson negativ beeinflußt.
    Notes: Abstract Three hundred and three consecutive patients operated on for peptic ulcer for the first time between 1 January 1984 and 31 December 1993 were evaluated in this retrospective study. Eleven variables (Period when operation took place, gender, smoking behaviour, history of former ulcers, ulcerogenic drug intake, ulcer location, epigastric pain, number of blood units substituted, patient's age, type of operation, comorbidity) were investigated regarding their influence on peri- and post-operative mortality and on the length of hospital stay after operation. We found that a high comorbidity score (>2) and the indication “emergency operation” (vs “elective operation”) had an adverse impact on survival. The importance of age was marginal. The duration of post-operative hospital stay in survivors was negatively influenced by age higher than 60 years, more than two red cell units substituted and a high comorbidity score according to Charlson.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1076
    Keywords: Key words Diabetic pregnancy  ;  Myocardial hypertrophy  ;  Glycosylated haemoglobin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Despite the current improvement of diabetes care in pregnancy, neonatal complications are still more frequent than in the general population. Even in fetuses of well controlled diabetic mothers, myocardial hypertrophy can be demonstrated although it is not related to maternal metabolic control. The objective of this study was to determine perinatal complications and the course of myocardial hypertrophy in newborns who had been prenatally monitored and to relate the findings to neonatal parameters of carbohydrate metabolism. Perinatal complications and echocardiographic evidence of myocardial hypertrophy were determined in 104 neonates of closely followed diabetic mothers. Cord blood was obtained for determination of insulin, C-peptide and glycosylated fetal haemoglobin (HbF1c). In cases of myocardial hypertrophy, the echocardiographic examinations were repeated until normalisation of the myocardial wall thickness. The most striking finding was myocardial hypertrophy in 25% of the 104 neonates, which predominantly involved the interventricular septum. This is in contrast to the prenatal symmetrical hypertrophy of the ventricular walls and may be explained by perinatal changings of ventricular geometry. There was no sign of outflow tract obstruction, and myocardial hypertrophy resolved within 6 months. Insulin and C-peptide were elevated in the majority of the newborns, whereas HbF1c was significantly decreased. Neither the maternal type of diabetes nor neonatal metabolic data were related to the somatic findings. Conclusion Myocardial hypertrophy still occurs in infants of diabetic mothers despite their good met abolic control reflected by the decreased fraction of glycosylated fetal hemoglobin which points to low fetal blood sugar levels during the last intra-uterine weeks.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-0584
    Keywords: De novo AML ; Adults ; HD-Ara-C/DNR consolidation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A total of 149 consecutive de novo AML patients aged 50 years or less (median age = 37 years) were enrolled in this prospective multicenter trial initiated in May 1985. All patients received the same induction and early consolidation therapy with daunorubicin (DNR), cytosine arabinoside (Ara-C), and etoposide (DAV). High-dose Ara-C/DNR therapy included Ara-C at 3 g/m2, in 12 doses (HD-Ara-C/DNR I) and eight doses (HD-Ara-C/DNR II), followed by DNR 30 mg/m2 for 3 days. A complete remission (CR) was achieved in 104 (70%) patients; 61 complete responders received at least one cycle with HD-Ara-C/DNR. If those patients who were transplanted in first CR (n=26), were not considered, the median relapsefree-survival (MRFS) of the remaining 78 patients was 15 months, with a probability of relapse-free survival (RFS) at 116 months of 30% (95% CI, 20–40%) after a median follow-up of 95 months. The MRFS of the HD-Ara-C/DNR consolidated patients was 25 months, with a probability of RFS at 116 months of 37% (95% CI, 24–50%). If all patients who were transplanted (n=44) were not considered, the median survival time (MST) was 18 months with a probability of being alive at 118 months of 24% (95% CI, 16–33%). MST of the HD-Ara-C/DNR consolidated patients was 58 months with a survival probability of 46% (95% CI, 31–60%) at 118 months. Prognostic factor analysis did not reveal any significant influence of age, sex, FAB subtype, white blood cell count, hemoglobin level, thrombocyte count, LDH, or response to the first induction course on RFS of the HD-Ara-C/DNR consolidated patients. In summary, HD-Ara-C/DNR consolidation can improve the long-term outcome of a subgroup of de novo AML patients. Further improvement of the outcome seems to depend on the identification of patients with an inferior outcome under that strategy who might benefit from alternative treatment strategies.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-0584
    Keywords: Key words De novo AML ; Adults ; HD-Ara-C/DNR consolidation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  A total of 149 consecutive de novo AML patients aged 50 years or less (median age = 37 years) were enrolled in this prospective multicenter trial initiated in May 1985. All patients received the same induction and early consolidation therapy with daunorubicin (DNR), cytosine arabinoside (Ara-C), and etoposide (DAV). High-dose Ara-C/DNR therapy included Ara-C at 3 g/m2, in 12 doses (HD-Ara-C/DNR I) and eight doses (HD-Ara-C/DNR II), followed by DNR 30 mg/m2 for 3 days. A complete remission (CR) was achieved in 104 (70%) patients; 61 complete responders received at least one cycle with HD-Ara-C/DNR. If those patients who were transplanted in first CR (n = 26), were not considered, the median relapse-free-survival (MRFS) of the remaining 78 patients was 15 months, with a probability of relapse-free survival (RFS) at 116 months of 30% (95% CI, 20–40%) after a median follow-up of 95 months. The MRFS of the HD-Ara-C/DNR consolidated patients was 25 months, with a probability of RFS at 116 months of 37% (95% CI, 24–50%). If all patients who were transplanted (n = 44) were not considered, the median survival time (MST) was 18 months with a probability of being alive at 118 months of 24% (95% CI, 16–33%). MST of the HD-Ara-C/DNR consolidated patients was 58 months with a survival probability of 46% (95% CI, 31–60%) at 118 months. Prognostic factor analysis did not reveal any significant influence of age, sex, FAB subtype, white blood cell count, hemoglobin level, thrombocyte count, LDH, or response to the first induction course on RFS of the HD-Ara-C/DNR consolidated patients. In summary, HD-Ara-C/DNR consolidation can improve the long-term outcome of a subgroup of de novo AML patients. Further improvement of the outcome seems to depend on the identification of patients with an inferior outcome under that strategy who might benefit from alternative treatment strategies.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 0044-2313
    Keywords: Chemistry ; Inorganic Chemistry
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Chemistry and Pharmacology
    Description / Table of Contents: Phosphazenes. LXVI. 31P-NMR Investigations. XI. Preparation of Cyclotri(phosphazene) Derivatives via the Corresponding Lithium Compound and Spreading of a 31P-NMR Spectrum by a Shift ReagentLess reactive partners such as phosphinyl chlorides do not react with the hydridocyclotri(phosphazene) I, but they react with the lithiated phosphazene II giving P-substituted products. Silyl-, stannyl-, imidophosphinyl- and thiophosphinylcyclotri(phosphazenes) have been prepared as examples. In the dimethylthiophosphinyl derivative VI the two 31P nuclei of the biphosphine grouping are nearly isochronous and their n.m.r. signals as well as those of the methyl protons are therefore degenerate. Using a shift reagent the shift difference can be increased by more than a factor of ten and the degeneracy removed.
    Notes: Mit weniger elektrophilen Partnern wie Phosphinylchloriden kann das Hydridocyclotri(phosphazen) I nicht mehr direkt, wohl aber nach Überführung in seine Lithiumverbindung II am Phosphor substituiert werden. Als Beispiele wurden Silyl-, Stannyl-, Imidophosphinyl- und Thiophosphinylcyclotri(phosphazene) dargestellt. Im Dimethylthiophosphinylderivat VI sind die beiden 31P-Kerne der Biphosphingruppierung nahezu isochron und ihre NMR-Signale und die der Methylprotonen deshalb entartet. Durch ein Shiftreagens kann ihre Verschiebungsdifferenz mehr als verzehnfacht und die Entartung damit aufgehoben werden.
    Additional Material: 3 Ill.
    Type of Medium: Electronic Resource
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  • 8
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  44. gemeinsamen Tagung der Bayerischen Urologenvereinigung und der Österreichischen Gesellschaft für Urologie und Andrologie; 20180614-20180616; Rosenheim; DOC18urobay040 /20180517/
    Publication Date: 2018-05-18
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 9
    Abstract: Only a fraction of breast cancer (BC) cases can be yet explained by mutations in genes or genomic variants discovered in linkage, genome-wide association and sequencing studies. The known genes entailing medium or high risk for BC are strongly enriched for a function in DNA double strand repair. Thus, aiming at identifying low frequency variants conferring an intermediate risk, we here investigated 17 variants (MAF: 0.01-0.1) in 10 candidate genes involved in DNA repair or cell cycle control. In an exploration cohort of 437 cases and 1189 controls, we show the variant rs3810813 in the SLX4/FANCP gene to be significantly associated with both BC (〈/=60 years; OR = 2.6(1.6-3.9), p = 1.6E-05) and decreased DNA repair capacity (〈/=60 years; beta = 37.8(17.9-57.8), p = 5.3E-4). BC association was confirmed in a verification cohort (N = 2441). Both associations were absent from cases diagnosed 〉60 years and stronger the earlier the diagnosis. By imputation we show that rs3810813 tags a haplotype with 5 additional variants with the same allele frequency (R(2) 〉 0.9), and a pattern of association very similar for both phenotypes (cases 〈60 years, p 〈 0.001, the Bonferroni threshold derived from unlinked variants in the region). In young cases (〈/=60 years) carrying the risk haplotype, micronucleus test results are predictive for BC (AUC 〉 0.9). Our findings propose a risk variant with high penetrance on the haplotype spanning SLX4/FANCP to be functionally associated to BC predisposition via decreased repair capacity and suggest this variant is carried by a fraction of these haplotypes that is enriched in early onset BC cases.
    Type of Publication: Journal article published
    PubMed ID: 29044504
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  • 10
    Keywords: DISEASE ; polymorphism ; CARTILAGE ; COX-2 GENE ; PROTECTIVE FACTOR ; ULM OSTEOARTHRITIS
    Abstract: BACKGROUND: Functional polymorphisms in genes of proinflammatory signalling cascades may contribute to the genetic risk of osteoarthritis (OA). OBJECTIVE: To examine a possible association between end-stage OA of the hip and knee joint and a known single nucleotide polymorphism (SNP) of the COX-2 gene promoter. METHODS: The SNP -765 G-C (rs20417) of the COX-2 gene promoter was genotyped by pyrosequencing in 531 (320 women/211 men) patients with OA from the Ulm Osteoarthritis Study and 400 (200 women/200 men) regional controls from the south-west of Germany. RESULTS: In the whole study population the C allele was associated with a lower risk (per allele OR 0.57; 95% CI 0.43 to 0.75, p〈0.0001) and the G allele with a higher risk for end-stage OA. Analysis of subgroups confirmed this result for primary, bilateral, hip and knee OA. CONCLUSION: The promoter polymorphism rs20417 of the COX-2 gene contributes to the genetic risk for end-stage hip and knee OA.
    Type of Publication: Journal article published
    PubMed ID: 20378913
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