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  • 1
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA); 20100923-20100925; Bochum; DOC10gma153 /20100805/
    Publication Date: 2010-08-06
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 2
    Publication Date: 2017-01-06
    Description: Alveolar echinococcosis (AE) is the most Iethal human helminthic infection. The malignancy-like disease is rare, but morbidity and treatment costs are high. Objective of the study was to identify factors at baseline and during specific AE therapy influencing the long-term outcome of the disease.All patients with AE seen at the specialized treatment unit in Ulm between January 1992 and December 2011 were included in the analysis.The data of 312 patients were analyzed; 108 were diagnosed before 2000 (series A), 204 since 2000 (series B); 290 received specific AE treatment. Patients of series B were more often symptom-free at diagnosis (44.1% vs. 21.3%), had lower disease stages (50.0% vs. 34.2%) and more complete resections (57.7% vs. 20.0%), but higher rates of side effects and drug toxicity (54.1% vs. 40.8%). In series B, more patients remained relapse- or progression-free after 5 years (90.5% vs. 82.8%); after 10 years, the ratio of relapses converged (70.3% vs. 66.9%, p=0.0507). Relapses or progression occurred more often after incomplete surgery or long treatment pauses. The 5-year and 10-year survival rates were 96.9% and 90.6%, respectively, and 17% of the patients were cured.We observed a shift towards early diagnosis, earlier initiation of specific therapy and more complete resections after 2000. Although diagnosis and treatment of AE pose a challenge, with an individual interdisciplinary management 88.8% of the patients have a favorable outcome.
    Keywords: alveolar echinococcosis ; Echinococcus multilocularis ; antiparasitic treatment ; surgery ; classification ; risk factors ; ddc: 610
    Language: English
    Type: article
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  • 3
    Keywords: CANCER ; CELLS ; EXPRESSION ; tumor ; Germany ; CLASSIFICATION ; DIAGNOSIS ; imaging ; SYSTEM ; TOOL ; GENE ; GENE-EXPRESSION ; DIFFERENTIATION ; TISSUE ; TUMORS ; ACCURACY ; computed tomography ; DNA ; IDENTIFICATION ; gene expression ; DESIGN ; ARRAYS ; tomography ; adenocarcinoma ; ADENOCARCINOMAS ; COMPUTED-TOMOGRAPHY ; gene expression profiling ; expression profiling ; pancreatic cancer ; ultrasound ; chronic pancreatitis ; CDNA MICROARRAY ; representational difference analysis ; MASSES ; pancreas ; PANCREATIC-CANCER ; DUCTAL ADENOCARCINOMA ; ARRAY ; RAS MUTATIONS ; MASS ; EXPRESSED GENES ; FINE-NEEDLE-ASPIRATION ; MALIGNANT-TUMORS
    Abstract: Purpose: Malignant tumors of the pancreas are frequently indistinguishable from inflammatory tumors arising in the context of a chronic pancreatitis with the use of conventional imaging techniques. Thus, cytologic analysis of cells obtained by abdominal ultrasound, computed tomography, or endoscopic ultrasound-guided fine needle aspiration biopsy is required for diagnosis. However, the reliability of cytologic analyses of pancreatic fine needle aspirates remains unsatisfactory, with a diagnostic accuracy of 〈= 80%. The purpose of the current study was therefore to develop a novel diagnostic approach based on expression profiling of biopsy material using a specialized diagnostic c DNA array. Experimental Design: Previous gene expression profiling studies were reevaluated to design a 558-feature diagnostic array. Minimal amounts of residual material from pancreatic cytology samples as well as surgically resected tumor and control tissue specimens were analyzed using the diagnostic array and a newly developed statistical classification system. Results and Conclusions: Our diagnostic approach resulted in 95% accurate differentiation between ductal adenocarcinomas and nonmalignant tumors of the pancreas. The diagnostic array, in conjunction with conventional diagnostic procedures, is thus suitable to significantly improve the reliability of pancreatic cancer diagnostics and can be expected to become a valuable new tool in the routine workup of suspect masses in the pancreas
    Type of Publication: Journal article published
    PubMed ID: 16299235
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  • 4
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  Infektiologie Update 2018; 26. Jahrestagung der Paul-Ehrlich-Gesellschaft für Chemotherapie (PEG); 20181004-20181006; Wien; DOC18peg32 /20181008/
    Publication Date: 2018-10-09
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 5
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  128. Kongress der Deutschen Gesellschaft für Chirurgie; 20110503-20110506; München; DOC11dgch815 /20110520/
    Publication Date: 2011-05-20
    Keywords: ddc: 610
    Language: English
    Type: conferenceObject
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  • 6
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Epidemiologie ; Cholezystolithiasis ; Kinder ; Sonographie ; Risikofaktoren ; Key words Epidemiology ; Cholecystolithiasis ; Children ; Ultrasound ; Risk factors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Objective. To assess the prevalence of and risk factors (e. g., obesity and positive family history) for the development of cholecystolithiasis in a non-selected collective of children and adolescents. Design and participants. A series of 482 children and adolescents aged 6–18 years underwent upper abdominal diagnostic ultrasound examinations as part of a whole-community investigation (response rate: 78%) for Echinococcus multilocularis in a town in southern Germany. Results. Gallbladder stones were identified in three of 482 children, corresponding to a prevalence of 0.6%. None of the three children was overweight at the time of the examination. Additional risk factors (pronounced weight reduction and Wilson's disease) were present in one study subject. Conclusions. Findings of the present study do not confirm the significance of obesity as a risk factor for cholecystolithiasis in children and adolescents.
    Notes: Zusammenfassung Fragestellung. Ziel der Studie war es, Häufigkeit und Risikofaktoren der Cholezystolithiasis, insbesondere Adipositas und familiäre Belastung, an einem unselektierten Kollektiv von Kindern und Jugendlichen zu untersuchen. Methode und Studienkollektiv. Ein Studienkollektiv von 482 Kindern einer Gemeinde in Süddeutschland zwischen 6 und 18 Jahren wurde in einer Vollerhebung (Responserate: 78%) im Rahmen einer Screeninguntersuchung zu Echinococcus multilocularis sonographisch untersucht. Ergebnisse. Bei 3 von 482 Kindern, entsprechend einer Prävalenz von 0,6%, wurden Gallenblasensteine festgestellt. Keines der 3 Kinder war zum Zeitpunkt der Untersuchung übergewichtig. Als weitere Risikofaktoren fanden sich bei einem Studienteilnehmer eine starke Gewichtsreduktion sowie ein M. Wilson. Schlussfolgerungen. Adipositas konnte bei Kindern und Jugendlichen in der vorliegenden Studie nicht als Risikofaktor für die Cholezystolithiasis bestätigt werden.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background : Osteoporosis is a frequent complication in Crohn's disease. Although the efficacy of both sodium fluoride and aminobisphosphonates in postmenopausal osteoporosis has been investigated in long-term therapy studies, no long-term results are available regarding the effect of these agents in the management of osteoporosis in patients with Crohn's disease.Methods : Eighty-four patients with Crohn's disease and pathological bone mineral density findings were randomized to receive either vitamin D3 (1000 IU) and calcium citrate (800 mg) daily (group A) or sodium fluoride (25 mg b.d., group B) or intravenous ibandronate (1 mg every 3 months, group C) in addition to daily calcium/vitamin D substitution. On admission to the study and after 12 and 27 months, patients underwent dual-energy X-ray absorptiometry and radiological examination of the spine.Results : Sixty-eight patients completed the 1-year observation period and were available for the intention-to-treat analysis. No new vertebral fractures were diagnosed. In group A, lumbar bone density increased by 2.6% (P = 0.066, N.S.), in group B by 5.7% (P = 0.003) and in group C by 5.4% (P = 0.003). Therapy with sodium fluoride was associated with an increase in osteocalcin (N.S.), whereas administration of ibandronate was associated with a decrease in the resorption parameter, carboxy-terminal cross-linked type-I collagen telopeptide (P 〈 0.05). Both sodium fluoride and ibandronate resulted in significant decreases in the serum concentration of osteoprotegerin after 9 months (P 〈 0.001).Conclusions : The findings of the present study show that both sodium fluoride and ibandronate are effective in combination with calcium and vitamin D substitution in the management of osteopenia and osteoporosis in patients with Crohn's disease. Both agents are safe and well tolerated, and induce continuous increases in lumbar bone density.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-1440
    Keywords: Gallstones ; Serum cholesterol ; High density lipoprotein (HDL)-cholesterol ; Low density lipoprotein (LDL)-cholesterol ; triglycerides ; Nucleation time ; cholesterol saturation index ; Total lipid concentration
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The relationship between biliary lipids, cholesterol saturation index, nucleation time, and serum lipids was studied in a group of 45 gallstone patients (10 male, 35 female; age 50.1 ±14.5 years). Bile was obtained by direct fine-needle puncture of the gallbladder under local anesthesia and sonographic monitoring. No significant correlation between the serum lipids and either the cholesterol saturation index or total biliary cholesterol levels was observed. We found a positive correlation between the nucleation time and serum triglycerides content (r = 0.45, p = 0.0018) and a negative correlation between nucleation time and biliary cholesterol level (r = −0.38, p = 0.009). The fatty acids derived from the triglycerides are primarily resynthesized to phospholipids in the liver. When the supply of free fatty acids exhausts the metabolic capacity of the liver as, for example, in fat-rich diets, triglycerides accumulate in the liver cells and may possibly be excreted in the bile. Free fatty acids stimulate mucin hypersecretion in the gallbladder. This mucosal hypersecretion has been assigned a significant role in the formation of gallbladder stones. We also found a positive correlation between the total biliary bile acids and serum high density lipoprotein (HDL)-cholesterol in patients with a rapid nucleation time (r = 0.50, p = 0.0128). This supports the findings of other researchers, which suggests that HDL-cholesterol is devoted primarily to bile acid synthesis. In patients with a short nucleation time, the cholesterol saturation index, total lipid concentration, biliary cholesterol, mean age, and biliary bile acids were statistically different in comparison with patients with a prolonged nucleation time.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-1289
    Keywords: Schlüsselwörter Ultraschall, Ausbildung ; Ultraschall, Qualitätssicherung ; Facharztweiterbildung, Ultraschall ; Medizinstudium, Ultraschall
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Zum Thema Die Qualitätssicherung sowie die Verbesserung der Ausbildungssituation im Bereich der Abdomensonographie ist eine kontinuierliche und nachhaltige Herausforderung. Ziel der hier dargestellten Untersuchung war es, die Ausbildungssituation und die Qualitätssicherungsmaßnahmen an den deutschen Universitätskliniken für Ärztinnen und Ärzte in den Abteilungen für Gastroenterologie sowie das Lehrangebot für Studierende zu untersuchen. Im Rahmen einer Umfrage an den deutschen Universitätskliniken wurde nach den durchführenden Abteilungen der Abdomensonographie, Anzahl der Untersuchungen, Geräteausstattung, Ausbildungssituation, Qualitätssicherung im Bereich der Routinediagnostik und Lehrangeboten für Studierende im Bereich Ultraschall gefragt.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1573-2568
    Keywords: EPIDEMIOLOGY ; GALLSTONES ; HEREDITY ; OBESITY ; PREGNANCY ; SONOGRAPHY
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The Ulm Gallbladder Stone Study is the first ultrasound-based epidemiologic survey of cholecystolithiasis in the former West Germany. A study population of 1116 blood donors (656 men, age 38.0 ± 12.0 years; 460 women, age 34.1 ± 11.2 years) at the Central Blood Bank of the German Red Cross in Ulm was examined between April 1994 and February 1995. Based on age, subjects were assigned to one of four groups (18-30, 31-40, 41-50, and 51-65 years). Following a structured interview of each study subject, an ultrasound examination was carried out and a blood sample obtained for laboratory study. Overall, 6.0% (95% (95% CI: 4.8%-7.6%) of all study subjects (5.8% of the men and 6.3% of the women) exhibited evidence of current or past gallbladder disease (cholelithiasis or history of cholecystectomy). The prevalence of gallbladder disease correlated positively with age, reaching a maximum of 13.7% (9.5-20.0) in the 51- to 65-year-old age group, and also correlated as with body mass index (BMI). Female subjects with previous full-term pregnancies showed a higher prevalence of cholelithiasis, but this difference was not statistically significant for age-adjusted analysis. Subjects with a family history of cholelithiasis were found to suffer from gallstones in 11.5% (8.0-16.7) of cases compared with 4.6% (3.4%-6.3%) of subjects without such family history. Autopsy studies conducted in Germany have shown the prevalence of gallstones to be about 13.1% in men and 33.8% in women. Our sonographic data are relatively low in comparison. This may be due, in part, to the specific selection characteristics inherent in retrospective autopsy studies, such as age distribution and the presence of other pathologic factors associated with increased risk for cholelithiasis. The Ulm data rank in the lower third of the prevalence range reported for European sonographic studies to date. Age, positive family history, and increased BMI all correlated positively with the prevalence of gallbladder disease (P 〈 0.05). For the study population as a whole, there was no gender-specific increased risk for the development of gallstones.
    Type of Medium: Electronic Resource
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