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Daniel Deimel
Clinical social work has established itself as a health-specific profession in Germany over the past 15 years. It refers to a bio-psycho-social health understanding and is particularly focused on hard-to-reach client groups. The concept of evidence-based practice is often criticized and rejected by parts of the profession and discipline of social work. The concepts of evidence-based medicine and clinical social work are associated with positive outcomes for clinical practice and professional development.
March 15, 2018: Das Gesundheitswesen
H-H Brackmann, G C White, E Berntorp, T Andersen, C Escuriola-Ettingshausen
Development of inhibitory antibodies to infused factor VIII (FVIII) concentrates continues to be the most serious complication of haemophilia A management. Induction of immune tolerance by administering high doses of FVIII concentrate (antigen) and prothrombin complex concentrates to control bleeding was originated in the 1970s in Bonn, Germany, by Dr Hans-Hermann Brackmann, and became known as the Bonn protocol. ITI transformed the life of the index patient, who was 19 years of age when he began treatment, and dramatically improved the medical landscape for all patients with haemophilia and inhibitors...
April 2018: Haemophilia: the Official Journal of the World Federation of Hemophilia
Klaus Griesar, John Bessant, Sabine Bernschneider-Reif
The elephant is in the room-a metaphorical idiom for an obvious problem or risk that nobody wants to discuss. This abstract is not intended to be a summary, to reveal major findings, or unveil conclusions. On the contrary, it is aimed to provoke curiosity as to the question of corporate survival. Is there any recipe to be followed for companies to achieve this? The answer comes neither from the modest and traditional study rooms of philosophers nor the recent fact-based studies from the offices (and well-paid opinions) of business consultants...
March 15, 2018: Angewandte Chemie
Stefanie Kamann, Olivier Aerts, Lutz Heinemann
In the past decade, new diabetes technologies, including continuous glucose monitoring (CGM) systems, support patients with diabetes in their daily struggle with achieving a good glucose control. However, shortly after the first CGM systems appeared on the market, also the first concerns about adverse skin reactions were raised. Most patients claimed to suffer from (sometimes severe) skin irritation, or even allergy, which they related to the (acrylate-based) adhesive part of the device. For a long time the actual substance that caused these skin reactions with, for example, the Flash Glucose Monitoring system (iscCGM; Freestyle® Libre) could not be identified; however, recently Belgian and Swedish dermatologists reported that the majority of their patients that have developed a contact-allergic while using iscCGM react sensitively to a specific acrylate, that is, isobornyl acrylate (IBOA)...
March 1, 2018: Journal of Diabetes Science and Technology
Katharina Rathmann, Max Herke, Klaus Hurrelmann, Matthias Richter
OBJECTIVES: The aim of this study was to examine the associations between features of class climate and school wellbeing, based on self-rated health and reports of absence from school due to illness among adolescents in secondary schools, by using data from the German National Educational Panel Study (NEPS). METHODS: Data was obtained from the National Educational Panel Study (NEPS). The sample includes (n=7,348) seventh grade students in regular schools (Starting Cohort 3, Wave 3, 2012)...
March 14, 2018: Das Gesundheitswesen
Jennifer Kranz, Stefanie Schmidt, Cordula Lebert, Laila Schneidewind, Falitsa Mandraka, Mirjam Kunze, Sina Helbig, Winfried Vahlensieck, Kurt Naber, Guido Schmiemann, Florian M Wagenlehner
BACKGROUND: We aimed to update the 2010 evidence- and consensus-based national clinical guideline on the diagnosis and management of uncomplicated urinary tract infections (UTIs) in adult patients. Results are published in 2 parts. Part 1 covers methods, the definition of patient groups, and diagnostics. This second publication focuses on treatment of acute episodes of cystitis and pyelonephritis as well as on prophylaxis of recurrent UTIs. MATERIALS AND METHODS: An interdisciplinary group consisting of 17 representatives of 12 medical societies and a patient representative was formed...
March 14, 2018: Urologia Internationalis
Roman Johannes Gertz, Torben Lange, Johannes Tammo Kowallick, Sören Jan Backhaus, Michael Steinmetz, Wieland Staab, Shelby Kutty, Gerd Hasenfuß, Joachim Lotz, Andreas Schuster
AIM: Since cardiovascular magnetic resonance feature-tracking (CMR-FT) has been demonstrated to be of incremental clinical merit we investigated the interchangeability of global left and right ventricular strain parameters between different CMR-FT software solutions. MATERIAL AND METHODS: CMR-cine images of 10 patients without significant reduction in LVEF and RVEF and 10 patients with a significantly impaired systolic function were analyzed using two different types of FT-software (TomTec, Germany; QStrain, Netherlands)...
2018: PloS One
Antonio Ernstberger, Michael Koller, Florian Zeman, Maximilian Kerschbaum, Franz Hilber, Eva Diepold, Julika Loss, Tanja Herbst, Michael Nerlich
BACKGROUND: Trauma is a global burden of disease and one of the main causes of death worldwide. Therefore, many countries around the world have implemented a wide range of different initiatives to minimize mortality rates after trauma. One of these initiatives is the bundling of treatment expertise in trauma centers and the establishment of trauma networks. Germany has a decentralized system of trauma care medical centers. Severely injured patients ought to receive adequate treatment in both level I and level II centers...
2018: PloS One
Mehdi Shajari, Emanuel Wanner, Vladimir Rusev, Shervin Mir Mohi Sefat, Wolfgang J Mayer, Thomas Kohnen, Siegfried Priglinger, Daniel Kook
PURPOSE: To compare corneal densitometry values after Femtosecond Laser-Assisted In Situ Keratomileusis (Fs-LASIK) and Small Incision Lenticule Extraction (SMILE) using Scheimpflug Imaging. METHODS: Our retrospective clinical trial included a total of 146 eyes where 57 eyes underwent Fs-LASIK and 89 eyes underwent SMILE. Examinations with a Pentacam Scheimpflug device (Oculus, Wetzlar, Germany) were performed before surgery, 1 week, 1 month, 3 months, 6 months, and 1 year after surgery...
March 14, 2018: Current Eye Research
Wiebke Sondermann, Julia Ventzke, David Matusiewicz, Andreas Körber
BACKGROUND: Psoriatic arthritis (PsA) is an inflammatory joint disease. Despite numerous health care research studies, there is hardly any data regarding the current state of pharmaceutical care of PsA patients in Germany. STUDY POPULATION AND METHODS: Based on a systematic literature search and routine administrative data from the Rhineland/Hamburg (statutory) health insurance fund ("Allgemeine Ortskrankenkasse", AOK), the present study provides an up-to-date overview of pharmaceutical care of German PsA patients...
March 2018: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
Matthew Gaskins, Martin Dittmann, Lisa Eisert, Ricardo Niklas Werner, Corinna Dressler, Christoph Löser, Alexander Nast
BACKGROUND: A survey in 2012 revealed marked heterogeneity in the management of antithrombotic agents in dermatologic surgery in Germany. An evidence-based guideline on this topic was published for the first time in 2014. METHODS: Using the same study sample, we conducted an anonymous survey on the management of antithrombotic agents and familiarity with the guideline. We reported the results as relative frequencies and compared them with those from 2012. RESULTS: We analyzed a total of 208 questionnaires (response rate: 36...
March 2018: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
Nikolaus Ackermann, Durdica Marosevic, Stefan Hörmansdorfer, Ute Eberle, Gabriele Rieder, Bianca Treis, Anja Berger, Heribert Bischoff, Katja Bengs, Regina Konrad, Wolfgang Hautmann, Katharina Schönberger, Anne Belting, Gisela Schlenk, Gabriele Margos, Martin Hoch, Friedrich Pürner, Volker Fingerle, Bernhard Liebl, Andreas Sing
Background and aimAs a consequence of socioeconomic and political crises in many parts of the world, many European Union/European Economic Area (EU/EEA) countries have faced an increasing number of migrants. In the German federal state of Bavaria, a mandatory health screening approach is implemented, where individuals applying for asylum have to undergo a medical examination that includes serological testing for HIV and hepatitis B, screening for tuberculosis, and until September 2015, stool examination for Salmonella spp...
March 2018: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
J von Felden, J Vermehren, P Ingiliz, S Mauss, T Lutz, K G Simon, H W Busch, A Baumgarten, K Schewe, D Hueppe, C Boesecke, J K Rockstroh, M Daeumer, N Luebke, J Timm, J Schulze Zur Wiesch, C Sarrazin, S Christensen
BACKGROUND: Twelve weeks of the pangenotypic direct-acting antiviral (DAA) combination sofosbuvir/velpatasvir (SOF/VEL) was highly efficient in patients with hepatitis C virus (HCV) genotype 3 (GT3) infection in the ASTRAL-3 approval study. However, presence of resistance-associated substitutions (RASs) in the HCV nonstructural protein 5A (NS5A) was associated with lower treatment response. AIM: To assess the efficacy and safety of SOF/VEL ± ribavirin (RBV) and the impact of NS5A RASs and RBV use on treatment outcome in HCV GT3 infection in a real-world setting...
March 14, 2018: Alimentary Pharmacology & Therapeutics
Ramona Weber, Rainer Hospes, Axel Wehrend
The aim of this study was to summarize the current status of the possible causes, clinical symptoms and pathogenesis of abortion in the mare and to evaluate the frequency of varying causes of abortion in German thoroughbred breeding. An analysis of the literature using electronic libraries, journals and textbooks was performed. In addition, the results of examinations of 123 abortions of thoroughbred breeding in central Germany were evaluated. In the literature, bacterial infections are the most frequently described cause of abortion...
February 2018: Tierärztliche Praxis. Ausgabe G, Grosstiere/Nutztiere
Tetyana Leinberger, Claudia Heilmann, Stefan Sorg, Matthias Mueller, Sami Kueri, Claudia Schmoor, Matthias Siepe, Friedhelm Beyersdorf
BACKGROUND:  Median sternotomy in patients with risk factors for wound healing is associated with high rates of postoperative wound infections and sternum instability. METHODS:  A total of 338 patients with elective first median sternotomy and at least four predefined risk factors were randomized between Sternal Talon (Gebrüder Martin GmbH & Co. KG-KLS Martin Group, Tuttlingen, Germany) and wire cerclage. The primary end point was mediastinitis and/or sternal instability within 30 ± 5 days, and the secondary end points were mediastinitis and/or sternal instability within 60 ± 5 days; incidence of pneumonia during hospitalization within the first 30 (±5) days and chest pain intensity...
February 2, 2018: Thoracic and Cardiovascular Surgeon
Doreen Huppert, Dominik Straumann, Mans Magnusson, Ilmari Pyykkö, Thomas Brandt
A common European Community driving licence was established in 1980. However, there are major differences among the countries as regards medical conditions that legally affect driving ability. This article discusses various assessment guidelines for dizzy patients. These range from a total absence of specified binding requirements in Finland or regulations open to clinical interpretation in Switzerland, to inappropriately strict regulations in Germany. We focus on requirements for patients with vestibular disorders in Germany which have been in force since 2014...
March 13, 2018: Journal of Neurology
A von Braun, C Lübbert
The incidence of clostridium difficile infections (CDI) remains on a high level globally. In Germany, the number of severe or even lethal cases continues to increase. The main risk factor for the development of CDI is exposure to broad spectrum antibiotics, which disturb the physiological microbiome and therefore enable colonization with C. difficile. According to the updated US and European guidelines, orally administered vancomycin is the treatment of choice. Fidaxomicin is as effective as vancomycin but has the advantage of a lower rate of recurrence...
March 13, 2018: Der Internist
Irene Papanicolas, Liana R Woskie, Ashish K Jha
Importance: Health care spending in the United States is a major concern and is higher than in other high-income countries, but there is little evidence that efforts to reform US health care delivery have had a meaningful influence on controlling health care spending and costs. Objective: To compare potential drivers of spending, such as structural capacity and utilization, in the United States with those of 10 of the highest-income countries (United Kingdom, Canada, Germany, Australia, Japan, Sweden, France, the Netherlands, Switzerland, and Denmark) to gain insight into what the United States can learn from these nations...
March 13, 2018: JAMA: the Journal of the American Medical Association
Enrique Gómez-Barrena, Norma G Padilla-Eguiluz, Cristina Avendaño-Solá, Concepción Payares-Herrera, Ana Velasco-Iglesias, Ferran Torres, Philippe Rosset, Florian Gebhard, Nicola Baldini, Juan C Rubio-Suarez, Eduardo García-Rey, José Cordero-Ampuero, Javier Vaquero-Martin, Francisco Chana, Fernando Marco, Javier García-Coiradas, Pedro Caba-Dessoux, Pablo de la Cuadra, Philippe Hernigou, Charles-Henri Flouzat-Lachaniette, François Gouin, Didier Mainard, Jean Michel Laffosse, Miriam Kalbitz, Ingo Marzi, Norbert Südkamp, Ulrich Stöckle, Gabriela Ciapetti, Davide Maria Donati, Luigi Zagra, Ugo Pazzaglia, Guido Zarattini, Rodolfo Capanna, Fabio Catani
ORTHOUNION is a multicentre, open, comparative, three-arm, randomized clinical trial (EudraCT number 2015-000431-32) to compare the efficacy, at one and two years, of autologous human bone marrow-derived expanded mesenchymal stromal cell (hBM-MSC) treatments versus iliac crest autograft (ICA) to enhance bone healing in patients with diaphyseal and/or metaphysodiaphyseal fracture (femur, tibia, and humerus) status of atrophic or oligotrophic nonunion (more than 9 months after the acute fracture, including recalcitrant cases after failed treatments)...
2018: Stem Cells International
Johannes Vogel, Christine Kenter, Carsten Holst, Bernward Märländer
Cercospora leaf spot (CLS) epidemics in sugar beet have been increasing in recent years causing higher use of fungicides. Concomitantly, the availability of effective fungicides is at risk because of resistance development in the fungus, the lack of new active ingredients as well as restrictive approval practices. A key option for an integrated management of CLS is cultivation of resistant varieties. Because of the yield penalty in resistant varieties, acceptance in commercial practice so far has been low. The aim of our study was to characterize recent sugar beet varieties registered in Germany in terms of resistance and tolerance to CLS and their value for integrated pest management...
2018: Frontiers in Plant Science
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