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  • 1
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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; DOCWI60-998 /20101021/
    Publication Date: 2010-10-22
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 2
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA); 20100923-20100925; Bochum; DOC10gma197 /20100805/
    Publication Date: 2010-08-06
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 3
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  Deutscher Kongress für Orthopädie und Unfallchirurgie; 72. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 94. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 49. Tagung des Berufsverbandes der Fachärzte für Orthopädie; 20081022-20081025; Berlin; DOCPO22-193 /20081016/
    Publication Date: 2008-10-17
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 4
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    German Medical Science; Düsseldorf, Köln
    In:  German Medical Science; VOL: 2; DOC01 /20040226/
    Publication Date: 2004-02-27
    Description: Background: The present status of outpatient treatment of depression in Germany was evaluated with respect to the adherence of general practitioners (GPs) and specialists of psychiatry to clinical practice guidelines. Methods: In total, 488 depressed patients' psychopathology, diagnostic assessment, therapeutic measures and referral frequency were documented at inclusion into study by 43 general practitioners and 23 specialists of psychiatry in three regions of Germany. The investigation of change in depressive symptoms after six to eight weeks by means of self-assessment could be evaluated for 165 patients.Results: The results of diagnostic assessment demonstrated that diagnoses of depression were not always based on the diagnostic criteria for depression (ICD-10): 33% of GPs' and 17% of specialists' patients were included as depressed patients into the study despite not fulfilling the ICD-10 criteria in the standardized documentation. Therapeutic undertreatment was more often found in the group of GPs. Referrals were found not to be oriented towards guidelines. After six to eight weeks, one half of patients reported a reduction in depressed symptoms, the other half of patients reported a stagnation or even a progression. Conclusions: The study has shown that physicians in outpatient settings still fail to orient themselves towards guideline recommendations. This reflects the need for physicians to receive guideline training, with the aim of improving the quality of care for depression. A quality management intervention program consisting of guideline training and an interdisciplinary quality circle to improve depression treatment and networking was supported by the authors and is currently being evaluated.
    Description: Hintergrund: Der aktuelle Status der ambulanten Depressionsversorgung in Deutschland wurde erhoben. Methode: Insgesamt wurden bei 488 depressiven Patienten Psychopathologie, diagnostische und therapeutische Maßnahmen sowie das Überweisungsverhalten zum Zeitpunkt des Studieneinschlusses von 43 Haus- und 23 Fachärzten für Psychiatrie in drei Studienregionen Deutschlands dokumentiert. Die Veränderung der depressiven Symptomatik nach sechs bis acht Wochen im Rahmen einer Selbstbeurteilung konnte bei 165 Patienten erfasst werden. Ergebnisse: Die Ergebnisse der diagnostischen Maßnahmen zeigten, dass die individuelle Diagnosestellung nicht immer auf den diagnostischen Kriterien einer Depression (ICD-10) basierte: 33% der Hausarzt- und 17% der Facharzt-Patienten wurden als depressive Patienten in die Studie eingeschlossen, obwohl sie die ICD-10 Kriterien laut der standardisierten Dokumentation nicht erfüllten. Eine ungenügende therapeutische Versorgung wurde häufiger bei den Hausärzten gefunden. Das Überweisungsverhalten orientierte sich nicht immer an verfügbaren, aktuellen Leitlinien. Nach sechs bis acht Wochen berichtete die Hälfte der Patienten eine Symptomverbesserung, während die andere Hälfte keine Veränderung oder sogar eine Verschlechterung angab. Diskussion: Die Studie hat gezeigt, dass die Leitlinienorientierung im ambulanten Versorgungssegment optimierbar erscheint. Dies verdeutlicht einen hohen Bedarf an ärztlichen Leitlinienschulungen, um die Qualität in der ambulanten Depressionsbehandlung zu verbessern. Derzeit wird von den Autoren eine durchgeführte Qualitätsmanagement-Intervention aus Leitlinienschulung und interdisziplinären Qualitätszirkeln zur Verbesserung der Depressionsversorgung und Vernetzung evaluiert.
    Keywords: ADOLESCENT ; ADULT ; AGED ; DEPRESSIVE DISORDER/* ; DEPRESSIVE DISORDER/*diagnosis ; DEPRESSIVE DISORDER/*epidemiology ; DEPRESSIVE DISORDER/therapy ; FEMALE ; GERMANY/epidemiology ; HUMAN ; MALE ; MIDDLE AGED ; PHYSICIANS, FAMILY ; PRIMARY HEALTH CARE/* ; PRIMARY HEALTH CARE/*statistics & numerical data ; REFERRAL AND CONSULTATION/statistics & numerical data ; DIAGNOSIS, DIFFERENTIAL ; ANTIDEPRESSIVE AGENTS/therapeutic use ; HEALTH KNOWLEDGE, ATTITUDES, PRACTICE/* ; PRACTICE GUIDELINES ; ADOLESZENT ; ERWACHSENER ; ALTE MENSCHEN ; DEPRESSIVE STÖRUNG/* ; DEPRESSIVE STÖRUNG/*Diagnose ; DEPRESSIVE STÖRUNG/*Epidemiologie ; DEPRESSIVE STÖRUNG/Therapie ; WEIBLICH ; DEUTSCHLAND/Epidemiologie ; MENSCH ; MÄNNLICH ; MENSCHEN IM MITTLEREN ALTER ; HAUSÄRZTE ; MEDIZINISCHE GRUNDVERSORGUNG/* ; MEDIZINISCHE GRUNDVERSORGUNG/*Statistik & Zahlen ; ÜBERWEISUNG UND KONSULTATION/Statistik & Zahlen ; DIFFERENTIALDIAGNOSE ; ANTIDEPRESSIVA/therapeutische Anwendung ; WISSEN, EINSTELLUNG, VERHALTEN (GESUNDHEIT)/* ; KLINISCHE RICHTLINIEN ; ddc: 610
    Language: English
    Type: article
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  • 5
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2016); 20161025-20161028; Berlin; DOCWI51-1539 /20161010/
    Publication Date: 2016-10-10
    Keywords: Kypho-IORT IORT Kyphoplastie Metastasen Wirbelsäule Bestrahlung Palliativ ; ddc: 610
    Language: German
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  • 6
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2016); 20161025-20161028; Berlin; DOCWI15-1241 /20161010/
    Publication Date: 2016-10-10
    Keywords: Kypho-IORT Bestrahlung Metastasen Wirbelsäule ; ddc: 610
    Language: German
    Type: conferenceObject
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  • 7
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC); 20150607-20150610; Karlsruhe; DOCDI.11.02 /20150602/
    Publication Date: 2015-06-03
    Keywords: Glioblastoma ; molecular markers ; survival ; ddc: 610
    Language: English
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  • 8
    Keywords: tumor ; MODEL ; PERFUSION ; DIFFERENTIATION ; kidney ; DIFFUSION ; MASSES ; CELL CARCINOMA ; COEFFICIENT ; IVIM ; ADC ; TRANSPLANTED KIDNEYS
    Abstract: Purpose: Usefulness of biexponentially fitted signal attenuation at different b-values for differentiating the histological characteristics of renal tumors. Materials and methods: A total of 26 patients with 28 renal masses (histologically proven: 20 clear cell renal cell carcinomas [ccRCC], three transitional cell carcinomas, two oncocytomas, and one papillary RCC) and 30 volunteers with healthy kidneys were examined at 1.5 Tesla using an echo-planar DWI sequence. Using the IVIM model, we calculated the perfusion fraction f and the diffusion coefficient D. Furthermore, the ADC was obtained. These tumor parameters were compared to healthy renal tissue nonparametrically, and a receiver operating characteristic (ROC) analysis was performed. Results: Healthy renal parenchyma showed higher ADC and D values (p 〈 0.001) than ccRCC (ADC 1.95 +/- 0.10 [SD] mu m(2)/ms, f 18.32 +/- 2.52%, and D 1.88 +/- 0.11 mu m(2)/ms versus ADC 1.45 +/- 0.38 mu m(2)/ms, f 18.59 +/- 6.16%, and D 1.34 +/- 0.38 mu m(2)/ms). When detecting malignancies the area under the curve for D was higher than for ADC. The f values for ccRCC were higher (p 〈 0.001) than for non-ccRCC (ADC 1.52 +/- 0.47 mu m(2)/ms, f 8.44 +/- 1.24%, and D 1.30 +/- 0.18 mu m(2)/ms). Both f and D correlated with ccRCC grading. Conclusion: IVIM imaging is able to provide reliable diffusion values in the human kidney and may enhance the accuracy of tumor diagnosis. The D value was the best parameter to distinguish renal tumors from healthy renal tissue. The f value is promising for determining the histological subgroups.
    Type of Publication: Journal article published
    PubMed ID: 22104090
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  • 9
    Abstract: In patients with lung cancer (LC), malignant melanoma (MM), gastroenteropancreatic neuroendocrine tumors (GEP NETs), and prostate cancer (PCA), lymph node (LN) staging is often performed by 18F-FDG PET/CT (LC and MM), 68Ga-DOTATOC PET/CT (GEP NET), and 68Ga-labeled prostate-specific membrane antigen PET/CT (PCA) but is sometimes not accurate because of indeterminate PET findings. To better evaluate malignant LN infiltration, additional surrogate parameters, especially in cases with indeterminate PET findings, would be helpful. The purpose of this study was to evaluate whether SUVmax in the PET examination might correlate with semiautomated density measurements of LNs in the CT component of the PET/CT examination. METHODS: After approval by the institutional review board, 1,022 LNs in the PET/CT examinations of 148 patients were retrospectively analyzed (LC: 327 LNs of 40 patients; MM: 224 LNs of 33 patients; GEP NET: 217 LNs of 35 patients; and PCA: 254 LNs of 40 patients). PET/CT was performed before surgery, biopsy, chemotherapy, or internal or external radiation therapy, according to the clinical schedule; patients with prior chemotherapy or radiation therapy were excluded. SUVmax analyses were based on uptake 60 min after tracer injection, and volumetric CT histogram analyses were based on the unenhanced CT images of the PET/CT scan. RESULTS: PET findings were considered positive or negative on the basis of SUVmax in the LN compared with that in the blood pool; histologic confirmation was not available. Of the 1,022 LNs, 331 were PET-positive (3 times the SUVmax of the blood pool), 86 were PET-indeterminate (1-3 times the SUVmax of the blood pool), and 605 were PET-negative (less than the SUVmax of the blood pool). PET-positive LNs had significantly higher CT densities than PET-negative LNs, irrespective of the type of cancer. CONCLUSION: CT density measurements of LNs in patients with LC, MM, GEP NET, and PCA correlated with18F-FDG uptake, 68Ga-DOTATOC uptake, and 68Ga-PSMA uptake, respectively, and might therefore serve as an additional surrogate parameter for differentiating between malignant and benign LNs. The use of a 7.5-Hounsfield unit CT density threshold to differentiate between malignant and benign LN infiltration and 20 Hounsfield units to exclude benign LN processes might be possible in clinical routine and would be especially helpful for PET-indeterminate LNs.
    Type of Publication: Journal article published
    PubMed ID: 27660141
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  • 10
    Keywords: MR ; COEFFICIENT ; FUNCTIONAL-EVALUATION ; DOG KIDNEY
    Abstract: PURPOSE: To evaluate the effect of cold ischemia time (CIT) of renal allografts on diffusion and perfusion using intravoxel incoherent motion (IVIM) derived parameters. MATERIAL AND METHODS: A total of 37 patients with renal allografts (CIT: 27 〈15 h, 10 〉/=15 h) and 30 individuals with healthy kidneys were examined at 1.5 T using a single-shot echo-planar diffusion-weighted pulse sequence with nine b-values ranging from 0 to 800 s/mm(2). ADC, perfusion fraction f, and the diffusion coefficient D were calculated using the IVIM model. Parameters of allografts stratified by CIT were compared with healthy kidney groups using the Mann-Whitney U test for unpaired data. We computed the Spearman correlation coefficient for correlation with creatinine values. RESULTS: ADC, D, and f of transplanted kidneys were significantly lower than in the healthy controls. The long-CIT group showed significantly lower diffusion parameters compared with the short-CIT group [mean+/-SD]: ADC: 1.63+/-0.14 mum(2)/ms, f: 11.90+/-5.22%, D: 1.55+/-0.25 mum(2)/ms versus ADC: 1.79+/-0.13 mum(2)/ms, f: 16.12+/-3.43%, D: 1.73+/-0.14 mum(2)/ms, P(ADC), (f), (D)〈0.05. CONCLUSION: Our results suggest that diffusion parameters, especially the ADC, depend on the CIT of the kidney allograft. Potentially, this stands for functional changes in renal allografts. Diffusion-weighted imaging could be used for follow-up examinations. Thus, diffusion parameters may help guide therapy in patients with delayed graft function.
    Type of Publication: Journal article published
    PubMed ID: 22785337
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