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German Medical Science: GMS E-journal

Dalal Varsha, Manveen Kaur, Neena Chaudhary, Fouzia Siraj
Langerhans cell histiocytosis (LCH) is a relatively rare and unique disease characterized by an abnormal proliferation of immature dendritic cells. It is predominantly seen in children with adults showing less than ten times the incidence compared to childhood. The clinical presentation and organ involvement is highly variable. Oral manifestations generally consist of mucosal ulceration associated with lesions of the underlying bone. Lesions limited to the oral mucosa are rare. We present a case of a 45-year-old male who presented with an ulcer on the hard palate showing histopathologic features of LCH...
2016: German Medical Science: GMS E-journal
Christian Georg Blumentrath, Nils Ewald, Jasmina Petridou, Uwe Werner, Barbara Hogan
The overwhelming post splenectomy infection (OPSI) in splenectomised patients is a rare but severe infection mostly caused by encapsulated bacteria. We analyse the case of a 65-year-old female patient who was presented with clinical and laboratory findings indicating gastroenteritis. Two years years before admission, the patient underwent a splenectomy for a two stage splenic rupture following resuscitation for pulmonary embolism. Immunisation of the patient was complete and timely. As a result of the unspecific clinical presentation, there was a delay in administration of antibiotics...
2016: German Medical Science: GMS E-journal
Barbara Buchberger, Laura Krabbe, Beate Lux, Jessica Tajana Mattivi
BACKGROUND: Mapping the evidence is a relatively new methodological approach and may be helpful for the development of research questions and decisions about their relevance and priority. However, the amount of data available today leads to challenges for scientists sometimes being confronted with literature searches retrieving over 30,000 results for screening. OBJECTIVES: We conducted an evidence mapping of the topic "diabetes and driving" to investigate its suitability for an evidence-based national clinical guideline...
2016: German Medical Science: GMS E-journal
Gerd Hoffmann, Mark Hartel, James B Mercer
BACKGROUND: Water-filtered infrared-A (wIRA) is a special form of heat radiation with high tissue penetration and a low thermal load to the skin surface. wIRA corresponds to the major part of the sun's heat radiation, which reaches the surface of the Earth in moderate climatic zones filtered by water and water vapour of the atmosphere. wIRA promotes healing of acute and chronic wounds both by thermal and thermic as well as by non-thermal and non-thermic cellular effects. METHODS: This publication includes a literature review with search in PubMed/Medline for "water-filtered infrared-A" and "wound"/"ulcus" or "wassergefiltertes Infrarot A" and "Wunde"/"Ulkus", respectively (publications in English and German), and additional analysis of study data...
2016: German Medical Science: GMS E-journal
Mostafa Ismail, Abd Alla Fares, Balegh Abdelhak, Jean D'Haens, Olaf Michel
OBJECTIVES: Sellar reconstruction with intrasellar packing following endoscopic resection of pituitary macroadenomas remains a subject of clinical and radiological discussion particularly, when an intraoperative cerebrospinal fluid (CSF) leakage is absent. This study was conducted to contribute our experience with sellar reconstruction after a standard endoscopic surgery of pituitary macroadenomas without intraoperative CSF leakage to the ongoing discussion between techniques with and without intrasellar packing...
2016: German Medical Science: GMS E-journal
Louis Jacob, Sevil Taskan, George Macharey, Ingeborg Sechet, Volker Ziller, Karel Kostev
OBJECTIVES: To analyze the impact of caesarean section (CS) on mode of delivery, pregnancy-induced and pregnancy-associated disorders, as well as complications in the subsequent pregnancy within German gynecological practices. METHODS: 1,801 women with CS and 1,801 matched women with vaginal delivery (VD) from the IMS Disease Analyzer database were included. The impact of previous CS on the mode of delivery and pregnancy-associated disorders as well as complications prior to or during birth in the subsequent pregnancy were analyzed...
2016: German Medical Science: GMS E-journal
E A El Okda, M M Mohamed, E B Shaheed, A R Abdel-Moemin
The influence of daily consumption of some common beverages on the development of cataract in rats was investigated. Total phenol content was determined in the beverages and an oral standardized dose of total phenols from each beverage was given to the treated rats. Weaned male albino rats were used and divided into five groups (n=7). Rats were fed Ain 93G and administered the standardized dose of instant coffee, black tea and hibiscus beverages for 30 days. On day 14 all rats were injected with a single dose of sodium selenite (Na2SeO3) 15 µmol/kg bodyweight, except the control groups NC (negative control, did not receive Na2SeO3) and PC (positive control, was already injected on day 1 of the study)...
2016: German Medical Science: GMS E-journal
Roman Rombo, Hans Weiher, Ingo G H Schmidt-Wolf
We examined the cytotoxic effects of chaetocin on clear cell renal cell carcinoma (ccRCC) cells and the possibility to combine the effects of chaetocin with the effects of cytokine-induced killer cells (CIK) assayed by MTT assay and FACS analysis. Chaetocin is a thiodioxopiperazine produced by fungi belonging to the chaetomiaceae family. In 2007, it was first reported that chaetocin shows potent and selective ex vivo anti-cancer activity by inducing reactive oxygen species. CIK cells are generated from CD3+/CD56- T lymphocytes with double negative CD4-/CD8- phenotype that are isolated from human blood...
2016: German Medical Science: GMS E-journal
Louis Jacob, Jessica Breuer, Karel Kostev
AIMS: To evaluate the prevalence of chronic diseases (CDs) among older patients in German general practices (GPs). METHODS: A total of 840,319 patients older than 65 years (359,289 male and 481,030 female) who consulted a GP between January and December 2014 were selected. Ten different CDs were considered: hypertension, lipid metabolism, diabetes, coronary heart disease, cancer, chronic obstructive pulmonary disease, heart failure, stroke, chronic kidney disease and osteoporosis...
2016: German Medical Science: GMS E-journal
Louis Jacob, Karel Kostev
BACKGROUND: Depression is recognized as the leading cause of disability in the world. Our goal was to compare treatment initiation in men and women treated in German neuropsychiatric practices after diagnosis of depression. METHODS: Patients aged between 18 and 80 first diagnosed with depression between 2010 and 2013 were identified by 223 psychiatrists in the IMS Disease Analyzer database. Patients who had received antidepressant prescriptions prior to the index date were excluded...
2016: German Medical Science: GMS E-journal
Jutta Bleidorn, Eva Hummers-Pradier, Guido Schmiemann, Birgitt Wiese, Ildikó Gágyor
BACKGROUND: Uncomplicated urinary tract infections (UTI) are common in general practice, and are usually treated with antibiotics. Recurrent UTI often pose a serious problem for affected women. Little is known about recurrent UTI and complications when uncomplicated UTI are treated without antibiotics. With ICUTI (Immediate vs. conditional antibiotic use in uncomplicated UTI, funded by BMBF No. 01KG1105) we assessed whether initial symptomatic treatment with ibuprofen could be a treatment alternative for uncomplicated UTI...
2016: German Medical Science: GMS E-journal
Arthur Hecht, Barbara Busch-Heidger, Heiner Gertzen, Heike Pfister, Birgit Ruhfus, Per-Holger Sanden, Gabriele B Schmidt
This article addresses the question of when a trial master file (TMF) can be considered sufficiently accurate and complete: What attributes does the TMF need to have so that a clinical trial can be adequately reconstructed from documented data and procedures? Clinical trial sponsors face significant challenges in assembling the TMF, especially when dealing with large, international, multicenter studies; despite all newly introduced archiving techniques it is becoming more and more difficult to ensure that the TMF is complete...
2015: German Medical Science: GMS E-journal
Sreenivasa Rao Sudulagunta, Mahesh Babu Sodalagunta, Hadi Khorram, Mona Sepehrar, Jayadevappa Gonivada, Zahra Noroozpour, Nagendra Prasad
Neuromyelitis optica (NMO or Devic's syndrome) is a rare relapsing demyelinating disease of the central nervous system (CNS) that mainly affects the spinal cord and optic nerves and shares many clinical and radiological features with multiple sclerosis. The association of NMO with other autoimmune diseases was reported, but very few reports described association with autoimmune thyroid disease. Early differentiation between NMO and multiple sclerosis is very important as the natural course and treatment regimens differ significantly...
2015: German Medical Science: GMS E-journal
Isabelle Ramirez
OBJECTIVE: The purpose of this article is to give an overview of the complexities and unexpected regulatory requirements for obtaining approval of multinational and multicentre non-interventional studies (NIS) in the European Union (EU). METHODS: The websites of national competent authorities (CAs), ethics committees (ECs) and data protection (DP) authorities were consulted to find regulations and guidance information related to the authorisation of NIS in various member states of the EU...
2015: German Medical Science: GMS E-journal
Stefanie C Hautz, Wolf E Hautz, Niklas Keller, Markus A Feufel, Claudia Spies
BACKGROUND: In Germany, a national competence based catalogue of learning objectives in medicine (NKLM) was developed by the Society for Medical Education and the Council of Medical Faculties. As many of its international counterparts the NKLM describes the qualifications of medical school graduates. The definition of such outcome frameworks indents to make medical education transparent to students, teachers and society. The NKLM aims to amend existing lists of medical topics for assessment with learnable competencies...
2015: German Medical Science: GMS E-journal
Ralf Baron, Andreas Binder, Rolf Biniek, Stephan Braune, Hartmut Buerkle, Peter Dall, Sueha Demirakca, Rahel Eckardt, Verena Eggers, Ingolf Eichler, Ingo Fietze, Stephan Freys, Andreas Fründ, Lars Garten, Bernhard Gohrbandt, Irene Harth, Wolfgang Hartl, Hans-Jürgen Heppner, Johannes Horter, Ralf Huth, Uwe Janssens, Christine Jungk, Kristin Maria Kaeuper, Paul Kessler, Stefan Kleinschmidt, Matthias Kochanek, Matthias Kumpf, Andreas Meiser, Anika Mueller, Maritta Orth, Christian Putensen, Bernd Roth, Michael Schaefer, Rainhild Schaefers, Peter Schellongowski, Monika Schindler, Reinhard Schmitt, Jens Scholz, Stefan Schroeder, Gerhard Schwarzmann, Claudia Spies, Robert Stingele, Peter Tonner, Uwe Trieschmann, Michael Tryba, Frank Wappler, Christian Waydhas, Bjoern Weiss, Guido Weisshaar
In 2010, under the guidance of the DGAI (German Society of Anaesthesiology and Intensive Care Medicine) and DIVI (German Interdisciplinary Association for Intensive Care and Emergency Medicine), twelve German medical societies published the "Evidence- and Consensus-based Guidelines on the Management of Analgesia, Sedation and Delirium in Intensive Care". Since then, several new studies and publications have considerably increased the body of evidence, including the new recommendations from the American College of Critical Care Medicine (ACCM) in conjunction with Society of Critical Care Medicine (SCCM) and American Society of Health-System Pharmacists (ASHP) from 2013...
2015: German Medical Science: GMS E-journal
Verena Weiß, Matthias Schmidt, Martin Hellmich
INTRODUCTION: For survival data the coefficient of determination cannot be used to describe how good a model fits to the data. Therefore, several measures of explained variation for survival data have been proposed in recent years. METHODS: We analyse an existing measure of explained variation with regard to minimisation aspects and demonstrate that these are not fulfilled for the measure. RESULTS: In analogy to the least squares method from linear regression analysis we develop a novel measure for categorical covariates which is based only on the Kaplan-Meier estimator...
2015: German Medical Science: GMS E-journal
Jutta Bleidorn, Sermin Bucak, Ildikó Gágyor, Eva Hummers-Pradier, Marie-Luise Dierks
BACKGROUND: Insufficient patient recruitment can impair the conduct of clinical trials substantially, not least because a significant number of eligible patients decline trial participation. Though barriers and motivational factors have been worked out for patients with cancer or chronic diseases, little is known about primary care patients' perceptions towards trial participation when visiting their family practitioner (FP) with acute uncomplicated conditions. This study aims to assess primary care patients' motivation and barriers to participate in trials, and to identify factors that optimize patient recruitment in future trials...
2015: German Medical Science: GMS E-journal
Sreenivasa Rao Sudulagunta, Mahesh Babu Sodalagunta, Mona Sepehrar, Hadi Khorram, Shiva Kumar Bangalore Raja, Shyamala Kothandapani, Zahra Noroozpour, Mohammed Aheta Sham, Nagendra Prasad, Sony Parethu Sunny, Munawar Dhanish Mohammed, Rekha Gangadharappa, Ranjitha Nidsale Sudarshan
INTRODUCTION: Guillain-Barré syndrome (GBS) is a fulminant polyradiculoneuropathy that is acute, frequently severe and autoimmune in nature. Etiology of GBS is incompletely understood, prognosis is usually good with early detection and prompt treatment. This retrospective study was done to evaluate clinical profile, epidemiological, laboratory, and electrodiagnostic features of patients with GBS and mode of management, complications and prognostic factors. METHODS: Data of 1,166 patients admitted with GBS or presented to outpatient department (previous medical records) with GBS between January 2003 and January 2014 were analyzed...
2015: German Medical Science: GMS E-journal
Sarah Schiekirka, Markus A Feufel, Christoph Herrmann-Lingen, Tobias Raupach
BACKGROUND AND OBJECTIVE: Evaluation is an integral part of education in German medical schools. According to the quality standards set by the German Society for Evaluation, evaluation tools must provide an accurate and fair appraisal of teaching quality. Thus, data collection tools must be highly reliable and valid. This review summarises the current literature on evaluation of medical education with regard to the possible dimensions of teaching quality, the psychometric properties of survey instruments and potential confounding factors...
2015: German Medical Science: GMS E-journal
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