Treatment trends for muscle-invasive bladder cancer in Germany from 2006 to 2019.

PURPOSE: To examine national treatment trends of muscle-invasive bladder cancer (MIBC) in Germany with a special focus on radical cystectomy (RC). PATIENTS AND METHODS: Population-based data were derived from the nationwide hospital billing database of the German Federal Statistical Office and institution-related information from the reimbursement.INFO tool based on hospitals' quality reports from 2006 to 2019. Additionally, we used the German National Center for Cancer Registry data to analyze all cases of bladder cancer with stage ≥ T2 who received RC, chemotherapy, radiation therapy or a combination from 2006 to 2017. RESULTS: The annual number of RC cases in Germany increased by 28% from 5627 cases in 2006 to 7292 cases in 2019 (p = 0.001). The proportion of patients undergoing RC remained constant at about 75% in all age groups between 2006 and 2017 (p = 0.3). Relative to all performed RC, the proportion of patients > 75 years increased from 25% in 2006 to 38% in 2019 (p = 0.03). The proportion of patients receiving a combination of RC and chemotherapy increased from 9% in 2006 to 13% in 2017 (p = 0.005). In 2006, 8 of 299 urology departments (2.7%) performed more than 50 RCs per year, which increased to 17 of 360 (4.7%) in 2019. In 2019, 107 departments (29%) performed 25-49 RCs and 236 (66%) departments performed < 25 RCs. CONCLUSION: In Germany, three out of four patients with MIBC receive RC and the proportion of patients > 75 years is increasing. The combination of surgery and chemotherapy is increasingly used. With overall increasing case numbers, there is a slight tendency towards centralization.

Health anxiety status of elite athletes in COVID-19 social isolation period.

AIM: The aim of this study is to examine the health anxiety states and behaviours of athletes during the social isolation period due to COVID-19 pandemic. METHODS: 250 elite athletes participated in the study. 154 of the participants were males and 96 were females. Health Anxiety Scale was used to determine the health anxiety states of the participants in the COVID-19 pandemic process. RESULTS: Our findings revealed that athletes who were tested for COVID-19 and who thought they had symptoms of the disease had higher levels of health anxiety and athletes who reported a temporary loss in athletic performance had higher disease anxiety. CONCLUSIONS: The results of this study showed that the COVID-19 pandemic and social isolation process have some effects on athletes' health anxiety. It will be beneficial to provide psychological support in this period for athletes to have a fast return to competitions and match after the pandemic (Tab. 5, Ref. 24).

Differentiation of Salmonella typhimurium from Salmonella enteritidis and other Salmonella serotypes using random amplified polymorphic DNA analysis.

Salmonella enterica ssp. enterica serovar Typhimurium and Salmonella enterica ssp. enterica serovar Enteritidis are the major dominating serotypes of Salmonella in poultry and poultry products. Infection by Salmonella Typhimurium is an important cause of morbidity and mortality in poultry. Rapid differentiation of Salmonella Typhimurium from other Salmonella serotypes including Salmonella Enteritidis can be very crutial for public health and for epidemiologists and for the poultry industry. Ten arbitrarily designed short primers (8 to 10 bases) were used in the random amplified polymorphic DNA analysis of Salmonella Typhimurium. One of the primers, primer 3 (5'-CGT GCA CGC-3'), resulted in the amplification of a band pattern that was unique to Salmonella Typhimurium. In total, 24 strains of serotype Salmonella Typhimurium were used during the study. Eighteen of them are clinical isolates, 2 of them chicken isolates (A6, A20), 2 of them from the Pasteur Institute, 1 from Refik Saydam National Culture Collection, and 1 is a type culture strain from National Culture Type Collection. Serotype Salmonella Typhimurium strains, which were collected from several different hospitals, institutes, and culture collections, have all displayed the same amplification band by primer 3. Twenty-three strains of 16 different serotypes of salmoneallae including 11 Salmonella Enteritidis strains gave only a 300-bp amplification band or no bands, whereas an additional 700-bp amplification band was observed only in samples of Salmonella Typhimurium serotype. It is concluded that random amplified polymorphic DNA analysis with primer 3 is of potential use as a serotype-specific marker for Salmonella Typhimurium.

Effect of an early supervised rehabilitation programme compared with home-based exercise after temporomandibular joint condylar discopexy: a randomized controlled trial.

The goal of rehabilitation after temporomandibular joint (TMJ) surgery is to achieve a normal range of motion. The aim of this study was to compare the impact of a comprehensive and early supervised rehabilitation programme with home-based exercise after TMJ condylar discopexy. Patients diagnosed with disc displacement without reduction were randomized to the study and control groups. After baseline assessments, the same surgical condylar discopexy procedure was applied to both groups. Following surgery, the study group patients underwent a supervised exercise programme conducted by a physiotherapist in the outpatient clinic. This comprised 30-min sessions 3 days per week for 8 weeks in the hospital. The control group patients performed the same exercise programme at home. Maximum mouth opening (MMO), protrusion, and right and left lateral movements were measured. Based on the results, the supervised rehabilitation programme yielded significantly better outcomes for pain at rest and with activity, MMO, and protrusion compared with the home-based exercise programme. Also certain parameters of quality of life improved significantly in the study group. In conclusion, exercise therapy is the cornerstone of rehabilitation of the TMJ, and a supervised rehabilitation programme after TMJ surgery is effective in improving functional parameters.

The effect of transpedicular intracorporeal grafting in the treatment of thoracolumbar burst fractures on canal remodeling.

Short-segment posterior instrumentation for the treatment of thoracolumbar burst fractures has been reported with a high rate of failure. Transpedicular intracorporeal grafting in combination with short-segment instrumentation has been offered as an alternative to prevent failure. However, concern still remains about the potential complication of further canal narrowing or failure of remodeling with this technique. The purpose of this prospective, randomized, controlled study is to evaluate the effect of transpedicular intracorporeal grafting on spinal canal restoration and remodeling in a group of patients treated with short-segment instrumentation for thoracolumbar burst fractures. Twenty-one patients with thoracolumbar burst fractures were randomised into transpedicular grafting (TPG) (n=11) and non-transpedicular grafting (NTPG) (n=10) groups, and were prospectively followed for an average of 50 months (range 25-85 months). Groups were similar in age, type of fracture, load sharing classification and kyphotic deformity. Preoperative, postoperative and follow-up computed tomographic (CT) images through the level of pedicles were obtained, corrected for differences in magnification, and digitized. Areas of the spinal canals were measured and normalized by the estimated area at that level (average of adjacent levels). Average kyphosis was 19.7 degrees+/-6.2 degrees at presentation, was corrected to 1.9 degrees+/-4.9 degrees by operation, but was found to have deteriorated to 9.1 degrees+/-6.4 degrees at final follow-up. There were no differences between groups regarding the evolution of sagittal deformity. Spinal canal narrowing was 38.5+/-18.2% at presentation, 22.1+/-19.8% postoperatively, and it further improved to -2.5+/-16.7% at follow-up, similar for both groups. Our results demonstrate that transpedicular intracorporeal grafting in the treatment of burst fractures does not have a detectable effect on the rate of reconstruction of the canal area or on remodeling. Spinal canal remodeling was observed to occur in all patients regardless of grafting.