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1.
Sensors (Basel) ; 21(11)2021 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-34200346

RESUMO

Increasing temperatures and drought occurrences recently led to soil moisture depletion and increasing tree mortality. In the interest of sustainable forest management, the monitoring of forest soil properties will be of increasing importance in the future. Vis-NIR spectroscopy can be used as fast, non-destructive and cost-efficient method for soil parameter estimations. Microelectromechanical system devices (MEMS) have become available that are suitable for many application fields due to their low cost as well as their small size and weight. We investigated the performance of MEMS spectrometers in the visual and NIR range to estimate forest soil samples total C and N content of Ah and Oh horizons at the lab. The results were compared to a full-range device using PLSR and Cubist regression models at local (2.3 ha, n: Ah = 60, Oh = 50) and regional scale (State of Saxony, Germany, 184,000 km2, n: Ah = 186 and Oh = 176). For each sample, spectral reflectance was collected using MEMS spectrometer in the visual (Hamamatsu C12880MA) and NIR (NeoSpetrac SWS62231) range and using a conventional full range device (Veris Spectrophotometer). Both data sets were split into a calibration (70%) and a validation set (30%) to evaluate prediction power. Models were calibrated for Oh and Ah horizon separately for both data sets. Using the regional data, we also used a combination of both horizons. Our results show that MEMS devices are suitable for C and N prediction of forest topsoil on regional scale. On local scale, only models for the Ah horizon yielded sufficient results. We found moderate and good model results using MEMS devices for Ah horizons at local scale (R2≥ 0.71, RPIQ ≥ 2.41) using Cubist regression. At regional scale, we achieved moderate results for C and N content using data from MEMS devices in Oh (R2≥ 0.57, RPIQ ≥ 2.42) and Ah horizon (R2≥ 0.54, RPIQ ≥2.15). When combining Oh and Ah horizons, we achieved good prediction results using the MEMS sensors and Cubist (R2≥ 0.85, RPIQ ≥ 4.69). For the regional data, models using data derived by the Hamamatsu device in the visual range only were least precise. Combining visual and NIR data derived from MEMS spectrometers did in most cases improve the prediction accuracy. We directly compared our results to models based on data from a conventional full range device. Our results showed that the combination of both MEMS devices can compete with models based on full range spectrometers. MEMS approaches reached between 68% and 105% of the corresponding full ranges devices R2 values. Local models tended to be more accurate than regional approaches for the Ah horizon. Our results suggest that MEMS spectrometers are suitable for forest soil C and N content estimation. They can contribute to improved monitoring in the future as their small size and weight could make in situ measurements feasible.


Assuntos
Sistemas Microeletromecânicos , Poluentes do Solo , Florestas , Alemanha , Solo , Poluentes do Solo/análise
2.
Chin J Dent Res ; 24(2): 113-118, 2021 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-34219444

RESUMO

OBJECTIVE: To compare the efficiency of a new sonic powered irrigation system named EDDY (VDW, Munich, Germany), passive ultrasonic irrigation (PUI) and conventional needle irrigation (CNI) in root canal sealer penetration. METHODS: A total of 45 mandibular premolars were instrumented up to size 30, 0.9 taper and randomly divided into three groups (n = 15) depending on the final irrigation activation technique: EDDY, PUI or CNI. After the final irrigation procedures, the root canals were obturated with labelled sealer mixed with 0.1% rhodamine B. Transverse sections at 3, 5 and 7 mm from the root apex were examined using confocal laser scanning microscopy. The maximum depth and total area and percentage of sealer penetration were measured using ImageJ analysis software (National Institutes of Health, Bethesda, MD, USA). RESULTS: In the EDDY group, the penetration depth was higher compared to the CNI group in the apical and middle sections and compared to the PUI group in the apical section (P ˂ 0.05). The penetration area in the EDDY group was higher compared to the CNI group in all sections and compared to the PUI group in the coronal section (P ˂ 0.05). The percentage of penetration was higher in the EDDY group compared to the CNI group in all sections and compared to the PUI group in the coronal section (P ˂ 0.05). CONCLUSION: In the present study, sealer penetration was superior in the EDDY group than the CNI group in the apical section. In the middle and coronal sections, sealer penetration was similar for the EDDY and PUI groups.


Assuntos
Materiais Restauradores do Canal Radicular , Irrigantes do Canal Radicular , Alemanha , Humanos , Microscopia Confocal , Preparo de Canal Radicular , Irrigação Terapêutica
3.
BMC Health Serv Res ; 21(1): 633, 2021 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-34210298

RESUMO

BACKGROUND: Total knee arthroplasty (TKA) is performed to treat end-stage knee osteoarthritis. In Germany, a minimum volume threshold of 50 TKAs/hospital/year was implemented to ensure outcome quality. This study, embedded within a systematic review, aimed to investigate the perspectives of potential TKA patients on the hospital volume-outcome relationship for TKA (higher volumes associated with better outcomes). METHODS: A convenience sample of adults with knee problems and heterogeneous demographic characteristics participated in the study. Qualitative data were collected during a focus group prior to the systematic review (n = 5) and during telephone interviews, in which preliminary results of the systematic review were discussed (n = 16). The data were synthesised using content analysis. RESULTS: All participants (n = 21) believed that a hospital volume-outcome relationship exists for TKA while recognising that patient behaviour or the surgeon could also influence outcomes. All participants would be willing to travel longer for better outcomes. Most interviewees would choose a hospital for TKA depending on reputation, recommendations, and service quality. However, some would also choose a hospital based on the results of the systematic review that showed slightly lower mortality/revision rates at higher-volume hospitals. Half of the interviewees supported raising the minimum volume threshold even if this were to increase travel time to receive TKA. CONCLUSIONS: Potential patients believe that a hospital volume-outcome relationship exists for TKA. Hospital preference is based mainly on subjective factors, although some potential patients would consider scientific evidence when making their choice. Policy makers and physicians should consider the patient perspectives when deciding on minimum volume thresholds or recommending hospitals for TKA, respectively.


Assuntos
Artroplastia do Joelho , Osteoartrite do Joelho , Grupos Focais , Alemanha , Hospitais com Alto Volume de Atendimentos , Humanos , Osteoartrite do Joelho/cirurgia , Resultado do Tratamento
4.
J Contemp Dent Pract ; 22(3): 215-218, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-34210917

RESUMO

AIM AND OBJECTIVE: The aim and objective of this study was to evaluate and compare the cutting efficacy of two different nickel titanium rotary instruments by a novel methodology: the operative torque (torque and time needed to progress toward the apex). MATERIALS AND METHODS: Ten fresh extracted upper first premolars with two canals were instrumented with a KaVo (Biberach, Germany) and a KaVo 1:1 handpiece at 300 rpm with maximum torque set at 2 N. One canal was instrumented with ProGlider NiTi rotary instruments (Dentsply Sirona Endodontics, Ballaigues, Switzerland), with tip size of 16.02, and the other one with EgdeGlidePath rotary instrument (EdgeEndo, Albuquerque, New Mexico). Mean instrumentation time, mean torque values, and maximum torque values were evaluated for each instrument. The significance level was set at p <0.05. RESULTS: EdgeGlidePath instruments reached the working length in significantly less time with a significantly smaller amount of torque when compared to ProGlider (p >0.05). No instruments exhibited flute deformation or underwent intracanal failure. CONCLUSIONS: Operative torque is related to the capability to cut dentin and progress toward the apex: the smaller the torque values, the higher the cutting ability (and safety). Operative torque is also dependent on debris removal and irrigation techniques. Nevertheless, both operative torque and instrumentation time are clinically relevant parameters for evaluating instruments' performance (i.e., cutting ability). CLINICAL SIGNIFICANCE: Operative torque during endodontic instrumentation helps understanding the overall performance in terms of both cutting efficiency and safety.


Assuntos
Níquel , Preparo de Canal Radicular , Ligas , Ligas Dentárias , Instrumentos Odontológicos , Cavidade Pulpar , Desenho de Equipamento , Alemanha , Titânio , Torque
5.
Viruses ; 13(6)2021 06 10.
Artigo em Inglês | MEDLINE | ID: mdl-34200766

RESUMO

SARS-CoV-2 infection fatality ratios (IFR) remain controversially discussed with implications for political measures. The German county of Tirschenreuth suffered a severe SARS-CoV-2 outbreak in spring 2020, with particularly high case fatality ratio (CFR). To estimate seroprevalence, underreported infections, and IFR for the Tirschenreuth population aged ≥14 years in June/July 2020, we conducted a population-based study including home visits for the elderly, and analyzed 4203 participants for SARS-CoV-2 antibodies via three antibody tests. Latent class analysis yielded 8.6% standardized county-wide seroprevalence, a factor of underreported infections of 5.0, and 2.5% overall IFR. Seroprevalence was two-fold higher among medical workers and one third among current smokers with similar proportions of registered infections. While seroprevalence did not show an age-trend, the factor of underreported infections was 12.2 in the young versus 1.7 for ≥85-year-old. Age-specific IFRs were <0.5% below 60 years of age, 1.0% for age 60-69, and 13.2% for age 70+. Senior care homes accounted for 45% of COVID-19-related deaths, reflected by an IFR of 7.5% among individuals aged 70+ and an overall IFR of 1.4% when excluding senior care home residents from our computation. Our data underscore senior care home infections as key determinant of IFR additionally to age, insufficient targeted testing in the young, and the need for further investigations on behavioral or molecular causes of the fewer infections among current smokers.


Assuntos
Anticorpos Antivirais/sangue , COVID-19/epidemiologia , COVID-19/mortalidade , Vigilância da População/métodos , SARS-CoV-2/imunologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/sangue , COVID-19/imunologia , Feminino , Alemanha/epidemiologia , Humanos , Análise de Classes Latentes , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estações do Ano , Estudos Soroepidemiológicos , Inquéritos e Questionários , Adulto Jovem
7.
Proc Natl Acad Sci U S A ; 118(31)2021 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-34261775

RESUMO

Over the last months, cases of SARS-CoV-2 surged repeatedly in many countries but could often be controlled with nonpharmaceutical interventions including social distancing. We analyzed deidentified Global Positioning System (GPS) tracking data from 1.15 to 1.4 million cell phones in Germany per day between March and November 2020 to identify encounters between individuals and statistically evaluate contact behavior. Using graph sampling theory, we estimated the contact index (CX), a metric for number and heterogeneity of contacts. We found that CX, and not the total number of contacts, is an accurate predictor for the effective reproduction number R derived from case numbers. A high correlation between CX and R recorded more than 2 wk later allows assessment of social behavior well before changes in case numbers become detectable. By construction, the CX quantifies the role of superspreading and permits assigning risks to specific contact behavior. We provide a critical CX value beyond which R is expected to rise above 1 and propose to use that value to leverage the social-distancing interventions for the coming months.


Assuntos
COVID-19/transmissão , COVID-19/virologia , Telefone Celular , Busca de Comunicante , SARS-CoV-2/fisiologia , COVID-19/epidemiologia , Alemanha/epidemiologia , Humanos
8.
Artigo em Inglês | MEDLINE | ID: mdl-34205383

RESUMO

The COVID-19 pandemic has been a challenging period of upheaval for higher education students. This study aims to assess the factors associated with psychological stress during the COVID-19 pandemic among a sample of students in health-related fields at Munich universities in Germany. Students (n = 623) from KSH Munich and LMU Munich completed an online cross-sectional survey. Information on demographics and academic and everyday difficulties due to the COVID-19 pandemic as well as data on physical and mental health were collected. Multivariable logistic regression analyses were performed to identify factors associated with the outcome. The prevalence for higher psychological stress was 44% among the study population. Factors associated with higher psychological stress were: lower overall life satisfaction (p < 0.0001), worsened health situation (p < 0.0001), lack of social support (p = 0.0301) and social interaction (p = 0.0115), worries about financial difficulties due to loss of income (p = 0.0134), stressful thoughts about a second wave (p < 0.0001), feeling unable to positively influence the situation (p = 0.0262) and study-related effects, such as perceived study burden (p = 0.0003) and likely delay in studies (p = 0.0178)). The COVID-19 pandemic is having a significant negative impact on the mental health of students in health-related fields. Proactive efforts to support the mental health and well-being of students are needed.


Assuntos
COVID-19 , Pandemias , Estudos Transversais , Depressão , Alemanha/epidemiologia , Humanos , SARS-CoV-2 , Estresse Psicológico/epidemiologia , Estudantes , Universidades
9.
Artigo em Inglês | MEDLINE | ID: mdl-34205730

RESUMO

OBJECTIVES: We assessed the costs of dental services in statutorily insured, very old (geriatric) Germans. METHODS: A comprehensive sample of very old (≥75 years) people insured at a large Northeastern statutory insurer was followed over 6 years (2012-2017). We assessed dental services costs for: (1) examination, assessments and advice, (2) operative, (3) surgical, (4) prosthetic, (5) periodontal, (6) preventive and (7) outreach services. Association of utilization with: (1) sex, (2) age, (3) region, (4) social hardship status, (5) International Disease Classification (ICD-10) diagnoses and (6) Diagnoses Related Groups (DRGs) was explored. RESULTS: 404,610 individuals with a mean (standard deviation, SD) age 81.9 (5.4 years) were followed, 173,733 did not survive follow-up. Total mean costs were 129.61 (310.97) euro per capita; the highest costs were for prosthetic (54.40, SD 242.89 euro) and operative services (28.40, SD 68.38 euro), examination/advice (21.15, SD 28.77 euro), prevention (13.31, SD 49.79 euro), surgery (5.91, SD 23.91 euro), outreach (4.81, SD 28.56 euro) and periodontal services (1.64, SD 7.39 euro). The introduction of new fee items for outreach and preventive services between 2012 and 2017 was reflected in costs. Total costs decreased with increasing age, and this was also found for all service blocks except outreach and preventive services. Costs were higher in those with social hardship status, and in Berlin than Brandenburg and Mecklenburg-Western Pomerania. Certain general health conditions were associated with increased or decreased costs. CONCLUSIONS: Costs were associated with sex, social hardship status, place of living and general health conditions. CLINICAL SIGNIFICANCE: Dental services costs for the elderly in Germany are unequally distributed and, up to a certain age or health status, generated by invasive interventions mainly. Policy makers should incentivize preventive services earlier on and aim to distribute expenses more equally.


Assuntos
Assistência Odontológica , Custos de Cuidados de Saúde , Idoso , Idoso de 80 Anos ou mais , Berlim , Custos e Análise de Custo , Alemanha , Humanos
10.
Artigo em Inglês | MEDLINE | ID: mdl-34206207

RESUMO

Healthcare workers are at particular risk due to their occupational exposure to SARS-CoV-2. Therefore, they belong to the top priority group for vaccination. However, earlier studies show that nursing staff in particular are hesitant to be inoculated. This study presents the current picture with regard to vaccination status, willingness, vaccine preference, and reasons for or against a COVID-19 vaccination among health and welfare workers. An online survey was conducted between 4 March and 10 April 2021 among professional associations and providers of health and social services. Data sets of n = 3401 participants were analyzed. Of these, 62% stated that they had already been vaccinated at least once. A further 22% wanted to be vaccinated, while 6.6% were still hesitant and 9% refused to be vaccinated. Preference was given to predominantly mRNA-based vaccines. Altogether, there was a high vaccination rate and a great willingness to be vaccinated (>80%) across all professional groups and fields of work. Among nursing staff, the total figure was 83.5%. The percentage was highest in geriatric care at 87.5%. Contrary to findings of earlier surveys, vaccination willingness has risen in all professional groups during the course of the vaccination campaign in Germany.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Idoso , Alemanha , Humanos , SARS-CoV-2 , Vacinação
11.
Artigo em Inglês | MEDLINE | ID: mdl-34208085

RESUMO

The validity of the Montreal Cognitive Assessment (MoCA) in migrants is questionable, as sociodemographic factors and the migration process may influence performance. Our aim was to evaluate possible predictors (age, education, sex, depression, and migration) of MoCA results in Turkish migrants and Germans living in Germany. Linear regression models were conducted with a German (n = 419), a Turkish (n = 133), and an overall sample. All predictor analyses reached statistical significance. For the German sample, age, sex, education, and depression were significant predictors, whereas education was the only predictor for Turkish migrants. For the overall sample, having no migration background and higher education were significant predictors. Migration background and education had an impact on MoCA performance in a sample of German and Turkish individuals living in Germany. Thus, culture-specific normative data for the MoCA are needed, and the development of culture-sensitive cognitive screening tools is encouraged.


Assuntos
Depressão , Depressão/epidemiologia , Escolaridade , Alemanha/epidemiologia , Humanos , Modelos Lineares , Testes de Estado Mental e Demência
12.
BMC Infect Dis ; 21(1): 634, 2021 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-34215215

RESUMO

BACKGROUND: The introduction of human papillomavirus (HPV) vaccination has resulted in a remarkable decline of genital warts in women and men, but in Germany historical rates of vaccination are relatively low. We report long-term surveillance data on changes in HPV 6 and HPV 11 infection and the prevalence of genital warts in young women in the Wolfsburg HPV epidemiological study (WOLVES). METHODS: Women born in 1983/84, 1988/89, and 1993/94 participated in four cohorts between 2009/10 and 2014/15. Quadrivalent vaccination coverage and prevalence of HPV 6/11 infection and genital warts are reported for participants aged 19-22 years and 24-27 years at the time of sample collection. Statistical analyses were done to compare similarly aged participants using 2 × 2 contingency tables (Röhmel-Mansmann unconditional exact test; two-side alpha of 0.05). RESULTS: A total of 2456 women were recruited. Between 2010 and 2015, there was a statistically significant decrease in the prevalence of HPV 6 infection among women aged 24-27 years (2.1% versus 0.0%; P < 0.0001) and women aged 19-22 years (2.0% versus 0.0%; P = 0.0056). There was no significant decline in HPV 11 infection. In total, 52 of 2341 participants were diagnosed with genital warts. There was a statistically significant drop in the risk of developing genital warts in women aged 24-27 years between 2010 and 2015 (4.7% versus 1.7%, respectively; P = 0.0018). The overall risk of developing genital warts in women aged 19-27 years decreased from 3.1% in 2010 to 1.2% in 2015 (P = 0.0022). CONCLUSIONS: An increase in vaccination coverage was associated with a decreased prevalence of genital warts in young women. A protective effect greater than herd immunity alone was seen despite low vaccination rates. Quadrivalent vaccine had a protective effect on genital HPV 6 infection and an almost fully protective effect on the development of genital warts in the youngest population.


Assuntos
Condiloma Acuminado/epidemiologia , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Cobertura Vacinal/economia , Vacinação/estatística & dados numéricos , Adolescente , Adulto , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Papillomaviridae/imunologia , Infecções por Papillomavirus/economia , Infecções por Papillomavirus/virologia , Prevalência , Estudos Prospectivos , Adulto Jovem
13.
BMC Oral Health ; 21(1): 331, 2021 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-34217268

RESUMO

BACKGROUND: There is little information available regarding the decision-making process of clinicians, especially in the choice of therapy for a severely atrophic tooth gap. The aim of this research was to use case vignettes to determine the influence of possible factors on the decision making of maxillofacial and oral surgeons. METHODS: A total of 250 maxillofacial (MFS) and oral (OS) surgeons in southern Germany were surveyed for atrophic single- or multiple-tooth gap with the help of case vignettes. The influence of different determinants on the therapy decision was investigated. Two case vignettes were designed for this purpose: vignette 1 with determinants "patient age" and "endocarditis prophylaxis" and vignette 2 with determinants "anxiety" and "bisphosphonate therapy". Furthermore, the specialist designation was assessed for both. The options available to achieve a sufficient implant site were "bone split", "bone block", "augmentation with bone substitute material" and "bone resection". Therapy was either recommended or rejected based on principle. RESULTS: A total of 117 participants returned the questionnaire: 68 (58%) were OS and 49 (42%) MFS. "Patient age" and "patient anxiety" were not significantly associated with any therapy decision. However, required "endocarditis prophylaxis" led to significantly higher refusal rates for "bone split", "bone block" and "bone replacement material" and to higher rates of general refusal of a therapy. "Bisphosphonate therapy" was significantly associated with general refusal of therapy, but with no significant correlation with different therapy options. In vignette 1, OS refused therapy significantly more often than MFS, though there was no association with the specialist designation for other therapy modalities. In vignette 2, specialty was not significantly associated with the therapy decision. CONCLUSION: "Patient age" as well as "patient anxiety" appear to have no or little influence on the treatment decision for severely atrophic single- or multiple-tooth gap by specialist surgeons. Surgeons more often refuse treatment for patients with endocarditis prophylaxis and bisphosphonate therapy.


Assuntos
Substitutos Ósseos , Cirurgiões , Atrofia , Alemanha , Humanos , Cirurgiões Bucomaxilofaciais
14.
Ann Palliat Med ; 10(6): 6367-6378, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34237959

RESUMO

BACKGROUND: Patients in the intensive care unit (ICU) often have serious infections, and anti-infection treatment is vital for these patients. Procalcitonin (PCT) is often used to identify bacterial infections and monitor the effectiveness of anti-infection treatments. This study aims to analyze the current research hotspots of the application of PCT in ICU patients, and to suggest future research directions. METHODS: The Science Citation Index Expanded (SCI-EXPANDED) database in the Web of Science Core Collection (WOSCC) was used as the data source to search literature from 1995 to February 6, 2021. The search strategy was subject term = procalcitonin AND Web of Science categories = Critical Care Medicine. Using CiteSpace software, literature on the application of PCT in ICU patients was analyzed. RESULTS: A total of 1,243 papers, including 665 (53.5%) original articles, 87 (7.0%) reviews, 93 (7.5%) letters, 297 (23.9%) conference abstracts, and 101 (8.1%) other articles, were analyzed. The citation frequency was 40,442, the h-index was 96, and the average number of citations per item was 32.54. Research was mainly from the United States, Germany, France, and Spain, amongst others. The research institutions were mainly Univ Basel Hosp, Univ Pittsburgh, and Univ Hosp Geneva. Authors including Schuetz P made more contributions. Critical Care Medicine, Intensive Care Medicine, and Critical Care were important journals in this field of research. The keywords with the highest frequency were PCT, sepsis, and infection, and the more central ones were PCT, inflammation, septic shock, and C-reactive protein. The keywords with the strongest citation bursts were PCT, cytokine, and serum. CONCLUSIONS: Papers are mainly published in critical care medical journals. The countries, institutions, and authors that carry out research are relatively limited. The current hot spots are still inflammation, infection, and shock, especially the management and prognosis prediction of critically ill patients.


Assuntos
Unidades de Terapia Intensiva , Pró-Calcitonina , Bibliometria , França , Alemanha , Humanos , Espanha , Estados Unidos
15.
BMC Health Serv Res ; 21(1): 673, 2021 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-34238295

RESUMO

BACKGROUND: Hemodialysis (HD) and peritoneal dialysis (PD) are equivalent treatment alternatives for patients with end stage renal disease. In Germany, there is a legal obligation to inform every patient about all treatment alternatives and their possible harms and benefits. However, there is a low utilization of PD. Therefore, the question arises, whether HD patients perceive that they were informed about different dialysis options. We further investigate, if personal characteristics of informed and non-informed patients vary, and if both groups experienced the decision for their dialysis treatment as shared decision making (SDM). METHODS: The database was a nationwide postal survey of 590 HD patients from two statutory health insurers in Germany. Participants were asked whether they have been informed about both dialysis options. A logistic regression model examines impact factors on this information. We investigate differences in the German version of the 9-item SDM Questionnaire (SDM-Q-9) between informed and non-informed patients with a multivariate linear regression model. RESULTS: 56 % of the respondents reported they had been informed about different dialysis treatment options. Patients older than 65 had a 61 % lower chance than patients ≤ 65 for this information (p < 0.001). High educated patients had a 47 % higher chance for this information than patients with low education level (p = 0.030). Informed patients rated a higher SDM-Q-9 scores than non-informed patients (76.9 vs. 44.2; p < 0.001). Non-informed patients showed high values in those SDM-Q-9 items which had no regard to different treatment options. CONCLUSIONS: A great proportion of HD patients - mostly elderly patients and patients with a low education level - did not perceive that they were informed about different dialysis options before dialysis was initiated. The current obligation to provide information about all treatment alternatives in Germany is a first step to assure the unselected access to different treatment options. But it has not reached routine application in health care yet. Information about different treatment options can pave the way for SDM. While SDM is considered to be a valuable tool in clinical medicine, there is still room for improvement for its successful implementation when it comes to decision making on different dialysis treatment options. TRIAL REGISTRATION: The MAU-PD study (Multidimensional analysis of causes for the low prevalence of ambulatory peritoneal dialysis in Germany) is registered at the German Clinical Trials Register. DRKS-ID: DRKS00012555 Link: https://www.drks.de/drks_web/setLocale_EN.do . Date of Registration in DRKS: 2018/01/04.


Assuntos
Diálise Peritoneal , Diálise Renal , Idoso , Tomada de Decisões , Tomada de Decisão Compartilhada , Alemanha/epidemiologia , Humanos , Participação do Paciente , Estudos Retrospectivos , Inquéritos e Questionários
16.
Z Kinder Jugendpsychiatr Psychother ; 49(4): 284-294, 2021 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-34240622

RESUMO

ADHS - Disorder concepts and the beginnings of pharmacotherapy in the Federal Republic of Germany and the German Democratic Republic Abstract. After sporadic references before 1900, the concept of attention deficit/hyperactivity disorder became established in the 20th century. The hyperactive and inattentive child then became the focus of neuropediatrics in the wake of the encephalitis lethargica epidemic by clinical presentations of postencephalitic residual conditions. From these patients, physicians distilled a subgroup with an blank neurological history but impressive clinical symptoms. Child psychiatry, which emerged in the middle of the last century, studied these minimally brain-damaged patients, searching for both causes and therapies. The disorder concepts of Reinhart Lempp and Gerhard Göllnitz are significant contributions from the Federal Republic of Germany and the GDR, respectively, which provide revealing insights into the establishment of pharmacotherapy with stimulants in the 1970s.


Assuntos
Transtornos Mentais , Criança , Alemanha , Alemanha Oriental , Alemanha Ocidental , História do Século XX , Humanos
17.
Artigo em Inglês | MEDLINE | ID: mdl-34205961

RESUMO

Ongoing demographic change is leading to an increasingly older society and a rising proportion of people in need of care in the German population. Therefore, the professional group of outpatient caregivers is highly relevant. Their work is characterised not only by interacting with patients in a mobile setting but also by working in shifts. Health behaviour under these specific working conditions is crucial for ensuring long-term work ability and performance. Little is known about the health behaviour of German outpatient caregivers and its potential impact on their work. The aims of the study were (1) to examine health behavioural patterns (nutrition, exercise, smoking, regeneration) of outpatient caregivers, (2) to illuminate their personal health-promoting behaviours, and (3) to identify potential work-related factors influencing their health behaviour. Fifteen problem-centred interviews were conducted with outpatient caregivers working in Northern Germany in the period January-April 2020. Interviews were analysed by using qualitative content analysis. Outpatient caregivers reported improvable nutrition and hydration, with simultaneous high coffee consumption, low physical activity, poor regeneration (breaks and sleep quality), and good personal health-promoting behaviour (e.g., back-friendly habits), although the majority were smokers. Barriers to the implementation of health-promoting behaviours were a high perception of stress due to increased workload and time pressure, while aids to better health-promoting behaviour were described as being social support and personal resources. The respondents perceived their working conditions as potentially influencing their health behaviour. On the basis of their descriptions, various practice-relevant strategies were derived. The data explore a potential need for outpatient care services to develop interventions on behavioural and structural levels that can help create healthier working conditions for their employees so these caregivers can adopt better health behaviours.


Assuntos
Cuidadores , Pacientes Ambulatoriais , Alemanha , Comportamentos Relacionados com a Saúde , Humanos , Pesquisa Qualitativa
18.
Artigo em Inglês | MEDLINE | ID: mdl-34236956

RESUMO

A mixotrophic and acidophilic bacterial strain BGR 140T was isolated from mine tailings in the Harz Mountains near Goslar, Germany. Cells of BGR 140T were Gram-stain-positive, endospore-forming, motile and rod-shaped. BGR 140T grew aerobically at 25-55 °C (optimum 45 °C) and at pH 1.5-5.0 (optimum pH 3.0). The results of analysis of the 16S rRNA gene sequences indicated that BGR 140T was phylogenetically related to different members of the genus Sulfobacillus, and the sequence identities to Sulfobacillus acidophilus DSM 10332T, Sulfobacillus thermotolerans DSM 17362T, and Sulfobacillus benefaciens DSM 19468T were 94.8, 91.8 and 91.6 %, respectively. Its cell wall peptidoglycan is A1γ, composed of meso-diaminopimelic acid. The respiratory quinone is DMK-6. The major polar lipids were determined to be glycolipid, phospholipid and phosphatidylglycerol. The predominant fatty acid is 11-cycloheptanoyl-undecanoate. The genomic DNA G+C content is 58.2 mol%. On the basis of the results of phenotypic and genomic analyses, it is concluded that strain BGR 140T represents a novel species of the genus Sulfobacillus, for which the name Sulfobacillus harzensis sp. nov. is proposed because of its origin. Its type strain is BGR 140T (=DSM 109850T=JCM 39070T).


Assuntos
Clostridiales/classificação , Mineração , Filogenia , Técnicas de Tipagem Bacteriana , Composição de Bases , Clostridiales/isolamento & purificação , DNA Bacteriano/genética , Ácido Diaminopimélico/química , Ácidos Graxos/química , Alemanha , Peptidoglicano/química , Fosfolipídeos/química , RNA Ribossômico 16S/genética , Análise de Sequência de DNA
19.
Georgian Med News ; (314): 26-29, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34248023

RESUMO

Postoperative hypocalcemia is a common complication of thyroidectomy. This problem is most often associated with accidental devascularisation or excision of the parathyroid glands (PG). Aim was study near-infrared fluorescent imaging with intraoperative parathyroid gland indocyanine green angiography to help identify and preserve parathyroid glands during total thyroidectomy in order to avoid postoperative hypocalcemia. For period from 2017 to 2019 years, 58 patients in Odessa regional hospital were underwent total thyroidectomy. Indications for surgery were multinodular goiter (n=42), thyroid cancer (n=11) and Graves' disease (n=5). By randomization all patients were divided into two groups: in the first group, 28 patients underwent standard total thyroidectomy, in the second group 30 patients underwent near-infrared-assisted total thyroidectomy with indocyanine green (ICG) angiography. Parathyroid autofluorescence was detected using a near infrared/indocyanine green endoscopic system (Karl Storz, Germany). Serum calcium and parathyroid hormone levels were compared between the two groups of patients in 1, 7 -15 days after surgery and then 3, 6 months later. In the first group, on based of a visual assessment of the PG, autotransplantation the PG were conduct in only 4 cases (in 3 cases - one gland, in one case - 2 glands). In the second group, autotransplantation was performed in 11 patients (in 8 cases - one gland, in 2 cases - two, in one case - 3). The transient postoperative hypocalcemia was observed in 5 patients of the first group (17,86%) and in the 2 patients of second group (6,67%) on 5-10 postoperative days. In the first group 1 patient at 3 months after surgery had permanent hypocalcemia. Near-infrared fluorescent imaging with intraoperative parathyroid gland indocyanine green angiography is a safe and an easily repeatable method. This technique provides improved detecting and assessment of the perfusion of the PG. The need for autotransplantation of the PG can be determined more objectively using ICG imaging than simple visualization.


Assuntos
Verde de Indocianina , Glândulas Paratireoides , Angiografia , Alemanha , Humanos , Glândulas Paratireoides/diagnóstico por imagem , Glândulas Paratireoides/cirurgia , Hormônio Paratireóideo , Complicações Pós-Operatórias , Tireoidectomia/efeitos adversos
20.
Artigo em Inglês | MEDLINE | ID: mdl-34281045

RESUMO

BACKGROUND: Worldwide, the number of treatments in the field of sports medicine is increasing. However, the COVID-19 pandemic has changed everyday life. Many consultations had to be cancelled, postponed, or converted to a virtual format. Telemedicine in sports medicine could support physicians. This study analyzes the use and perception of telemedicine applications among physicians and patients in the field of sports medicine in Germany. METHODS: This prospective cross-sectional study was based on a survey of sports medicine physicians and patients in Germany during the COVID-19 pandemic. Descriptive statistics were calculated. RESULTS: We analyzed the responses of 729 patients and 702 sports medicine physicians. Most believed that telemedicine is useful. Both physicians and patients rated their knowledge of telemedicine as unsatisfactory. The majority of respondents said they do not currently use telemedicine but would like to do so. Patients and physicians reported that their attitude had changed positively towards telemedicine and that their usage had increased due to COVID-19. The majority in both groups agreed on implementing virtual visits in stable disease conditions. Telemedicine was considered helpful for follow-up monitoring and prevention by both groups. CONCLUSION: Telemedicine in sports medicine has seen limited use but is highly accepted among physicians and patients alike. The absence of a structured framework is an obstacle to effective implementation. Training courses should be introduced to improve the limited knowledge regarding the use of telemedicine. More research in telemedicine in sports medicine is needed. This includes large-scale randomized controlled trials, economic analyses and explorations of user preferences.


Assuntos
COVID-19 , Médicos , Medicina Esportiva , Telemedicina , Estudos Transversais , Alemanha/epidemiologia , Humanos , Pandemias , Estudos Prospectivos , SARS-CoV-2
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