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1.
BMC Urol ; 23(1): 178, 2023 Nov 03.
Artículo en Inglés | MEDLINE | ID: mdl-37919726

RESUMEN

INTRODUCTION: Similar Patient-Reported Outcomes (PROs) at diagnosis for localized prostate cancer among countries may indicate that different treatments are recommended to the same profile of patients, regardless the context characteristics (health systems, medical schools, culture, preferences…). The aim of this study was to assess such comparison. METHODS: We analyzed the EPIC-26 results before the primary treatment of men diagnosed of localized prostate cancer from January 2017 onwards (revised data available up to September 2019), from a multicenter prospective international cohort including seven regions: Australia/New Zealand, Canada, Central Europe (Austria / Czech Republic / Germany), United Kingdom, Italy, Spain, and the United States. The EPIC-26 domain scores and pattern of three selected items were compared across regions (with Central Europe as reference). All comparisons were made stratifying by treatment: radical prostatectomy, external radiotherapy, brachytherapy, and active surveillance. RESULTS: The sample included a total of 13,483 men with clinically localized or locally advanced prostate cancer. PROs showed different domain patterns before treatment across countries. The sexual domain was the most impaired, and the one with the highest dispersion within countries and with the greatest medians' differences across countries. The urinary incontinence domain, together with the bowel and hormonal domains, presented the highest scores (better outcomes) for all treatment groups, and homogeneity across regions. CONCLUSIONS: Patients with localized or locally advanced prostate cancer undergoing radical prostatectomy, EBRT, brachytherapy, or active surveillance presented mainly negligible or small differences in the EPIC-26 domains before treatment across countries. The results on urinary incontinence or bowel domains, in which almost all patients presented the best possible score, may downplay the baseline data role for evaluating treatments' effects. However, the heterogeneity within countries and the magnitude of the differences found across countries in other domains, especially sexual, support the need of implementing the PRO measurement from diagnosis.


Asunto(s)
Braquiterapia , Neoplasias de la Próstata , Incontinencia Urinaria , Humanos , Masculino , Braquiterapia/efectos adversos , Medición de Resultados Informados por el Paciente , Estudios Prospectivos , Prostatectomía/métodos , Neoplasias de la Próstata/cirugía , Calidad de Vida , Sistema de Registros , Incontinencia Urinaria/etiología , Estudios Multicéntricos como Asunto
2.
Arch Gynecol Obstet ; 300(2): 383-388, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-31062148

RESUMEN

PURPOSE: In 2003, a certification system was introduced to ensure high standards of oncological care in breast cancer patients in Germany. Certified breast cancer centers (BCCs) must fulfill specific requirements including quality indicators (QI) derived from the clinical guidelines that are evaluated in annual audits. When target values for QIs are not fulfilled, centers need to give explanations. We analyzed data from BCCs for a selected indicator: the recommendation of trastuzumab for patients with early HER-2-positive invasive breast cancer. We investigated explanations given in cases when trastuzumab was not recommended to see whether this was justified. METHODS: Patient data from 274 BCCs treating 53,777 primary cases in 2015 were analyzed using descriptive statistics. RESULTS: In the 274 BCC sites, 5700 primary patients with early HER-2-positive breast cancer were treated in 2015. 128 sites (46.7%) did not reach the target value of 95% trastuzumab recommendation and thus had to give explanations. In these 128 sites, 2663 primary HER-2-positive breast cancer patients were treated, 343 (12.9%) of whom did not receive a recommendation for adjuvant trastuzumab treatment. All 128 sites delivered explanations. Overall, 450 explanations were given, allowing multiple explanations for single patients. No explanation was given for 8 of the 343 patients (2.3%). The most common given explanation was multi-/comorbidity (45.5%). CONCLUSIONS: The analysis suggests thorough decision-making when quality indicator target values for a trastuzumab recommendation were not fulfilled. Our data do not provide information on whether such decisions have an impact on treatment outcome for these patients.


Asunto(s)
Neoplasias de la Mama/tratamiento farmacológico , Quimioterapia Adyuvante/métodos , Trastuzumab/uso terapéutico , Austria , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/epidemiología , Neoplasias de la Mama/patología , Femenino , Alemania , Humanos , Italia , Suiza , Trastuzumab/farmacología , Resultado del Tratamiento
3.
Pol J Vet Sci ; 21(2): 317-323, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30450871

RESUMEN

The aim of the research was an examination of potential impact of milk yield on the intercompartmental clearance - distribution clearance as well as determination of the variability of obtained pharmacokinetic parameters by the population approach using a two-compartmental structural model. Blood perfusion has a considerable impact on physiology of the udder and kinetics of drugs that are distributed in this organ. The research was performed on healthy Holstein- Friesian and Polish Black-White cows at the age of 4-10 years. Determination of antibiotics (ampicillin, amoxicillin, cefoperazone, penicillin G prokaine, cloxacillin, cefacetril) concentration was carried out after their every intramammary administration to one quarter of the udder. A population pharmacokinetic model was created to fit milk concentration data. General milk yield of a single cow was used as a variable. A population analysis was conducted using non-linear mixed-effect modeling. The impact of milk productivity was set solely by reference to intercompartmental clearance only in case of penicillin G, cloxacillin and ampicillin. It, has been found that milk yield, depending on a drug, influenced the distribution clearance of the drug to varying degrees. It means indirectly that increased perfusion of the udder has a different impact on drug distribution from the udder to the bloodstream.


Asunto(s)
Antibacterianos , Mastitis Bovina , Leche , Animales , Antibacterianos/farmacocinética , Bovinos , Cefoperazona/farmacocinética , Femenino , Lactancia , Glándulas Mamarias Animales , Preparaciones Farmacéuticas
4.
Pol J Vet Sci ; 21(2): 281-285, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30450866

RESUMEN

Ibudilast (AV-411) is a non-selective inhibitor of cyclic nucleotide phosphodiesterase (PDE). It is currently marketed for human use in Asian countries for the treatment of asthma, cerebrovascular disorders and ocular allergies. Ibudilast has also been found to have an analgesic action for neuropathic pain at doses 5-10 times higher than those used in asthma therapy. Six healthy Labrador dogs were randomly assigned to two treatment groups using an open, single-dose, two-treatment, two-phase, cross-over design (2x2 Latin-square). Dogs in group 1 (n=3) were fasted for at least 10 hours overnight before the beginning of the experiment and 4 h following dosing while dogs in group 2 (n=3) received food ad libitum. During the first phase, each dog in group 1 and 2 received a single dose of 5 mg/kg ibudilast administered orally. After 1-week washout period the groups were rotated and the experiment was repeated. The analytical method, validated for dog plasma, was shown to be linear in the range 0.10-20 µg/mL. The limit of detection (LOD) and quantification (LOQ) were 0.03 and 0.1 µg/mL, respectively. No behavioural or health alterations were observed in the animals during or after the study. Ibudilast was detectable in plasma for up to 24 h showing a wide variability between animals. Although no statistically significant differences were observed in the present study between the fed and fasted states, examination of the raw data suggests that an effect may be present. The wide degree of variation observed in area under the curve (AUC) suggests that the investigation of population pharmacokinetic modelling is warranted.


Asunto(s)
Interacciones Alimento-Droga , Inhibidores de Fosfodiesterasa , Piridinas , Administración Oral , Animales , Área Bajo la Curva , Estudios Cruzados , Perros , Ayuno , Inhibidores de Fosfodiesterasa/farmacocinética , Piridinas/farmacocinética
6.
J Vet Pharmacol Ther ; 40(5): 552-560, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28133845

RESUMEN

The aim of this study was to perform a comparative analysis of the characteristics of cloxacillin (CLO) (MRL of withdrawal in bovine milk is 30 ng/g) after a single intramammary (IMM) dose in the dry period (DP) and lactation (LP), and to establish a high-performance liquid chromatography (HPLC) analytical method for CLO detection in milk. The research was conducted on a group of 10 cows in DP and 10 in LP. A single dose of 600 mg of CLO was administrated by the IMM route for a single quarter in DP and 500 mg for a single quarter in LP. CLO concentration was analyzed by HPLC. CLO was monitored at a wavelength of 206 nm. Pharmacokinetic calculations were performed using Phoenix® WinNonlin® 6.4 software. The calibration curve was linear over the range of 13.03-28 019.00 ng/g with the coefficient of determination R2  > 0.999. CLO withdrawal in both the LP and DP group had a biphasic nature. The total CLO elimination in the DP and LP group was reached after 36 and 6.5 days, respectively. A quantitative and confirmatory method for the determination of CLO in fresh milk has been established. We have confirmed that the withdrawal of CLO in the DP group is not a linear process and has a stepwise character.


Asunto(s)
Cloxacilina/farmacocinética , Contaminación de Alimentos/análisis , Mastitis Bovina/tratamiento farmacológico , Mastitis Bovina/metabolismo , Leche/química , Animales , Bovinos , Cromatografía Líquida de Alta Presión , Femenino , Lactancia
7.
Gesundheitswesen ; 79(3): 203-209, 2017 Mar.
Artículo en Alemán | MEDLINE | ID: mdl-27056707

RESUMEN

Multilevel Analysis (MLA) are still rarely used in Health Services Research in Germany, though hierarchical data, e. g. from patients clustered in hospitals, is often present. MLA provide the valuable opportunity to study the health care context in health care organizations and the associations between context and health care outcomes. This article's aims are to introduce this particular method of data analysis, to discuss its' benefits and its' applicability particularly for Health Services Research focusing on organizational characteristics and to provide a concise guideline for performing the analysis. First, the benefits and the necessity for MLA compared to ordinary correlation analyses in the case of hierarchical data are discussed. Furthermore, the statistical requirements and key decisions for the performance of MLA are illustrated.


Asunto(s)
Interpretación Estadística de Datos , Atención a la Salud/métodos , Investigación sobre Servicios de Salud/métodos , Modelos Estadísticos , Análisis Multinivel/métodos , Simulación por Computador , Atención a la Salud/organización & administración , Alemania , Investigación sobre Servicios de Salud/organización & administración , Administración Hospitalaria/métodos , Análisis Multinivel/organización & administración
8.
Gesundheitswesen ; 79(3): 210-218, 2017 Mar.
Artículo en Alemán | MEDLINE | ID: mdl-26619218

RESUMEN

Introduction: By linking data it is possible to merge, for example, survey data with routine data from statutory health insurance (GKV), to gain benefit from the advantages of both. As personal data is involved, it is necessary to obtain consent. Previous studies show that willingness to release this kind of data for scientific research is limited. This fact restricts the number of participants and can cause selection bias. The aim of our study was to analyze willingness to consent to the linkage of survey data with statutory health insurance data in patients with primary breast cancer. Associations between approval and socio-demographic characteristics were explored. Method: In the annual survey of patients with primary breast cancer in certified breast centers in North Rhine-Westphalia, all included patients were questioned concerning their willingness to consent to data linkage. We distinguished between patients insured by AOK Rhineland/Hamburg and all other patients: based on cooperation with AOK Rhineland/Hamburg, we obtained consent to actually link the data for all patients insured there. All other patients were questioned in terms of their insurance and their willingness to consent in general. Results: A total of 2,387 questionnaires were returned, giving a return rate of 49.3%. For the AOK Rhineland/Hamburg-insured patients, the consent rate was at 89.6%. At 75.7%, positive attitudes towards data linkage turned out to be a bit lower for patients with other insurers. Under the assumption that all non-responders disapprove data linkage, still 38.1% of patients showed a positive attitude towards data linkage. As a result of the multivariable model, insurance status (private vs. statutory) and first language turned out to be the only significant factors influencing the response. The consent of patients insured by AOK Rhineland/Hamburg is not significantly influenced by any of the measured socio-demographic factors. Conclusion: Currently, there is not much knowledge on the acceptance of data linkage in patients suffering from an acute illness. Although our results are restricted to breast cancer patients, they are able to uncover problems and chances concerning data linkage.


Asunto(s)
Neoplasias de la Mama/epidemiología , Registros Electrónicos de Salud/estadística & datos numéricos , Encuestas Epidemiológicas , Consentimiento Informado/estadística & datos numéricos , Registro Médico Coordinado/métodos , Programas Nacionales de Salud/estadística & datos numéricos , Participación del Paciente/estadística & datos numéricos , Anciano , Neoplasias de la Mama/psicología , Conjuntos de Datos como Asunto , Femenino , Alemania/epidemiología , Humanos , Consentimiento Informado/psicología , Persona de Mediana Edad , Participación del Paciente/psicología , Prevalencia
9.
Pol J Vet Sci ; 20(2): 261-268, 2017 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-28865230

RESUMEN

The aim of the study was to carry out retrospective and prospective comparative analyses of the pharmacokinetics of CEF after single intramammary (IMM) administration in cows. The prospective study (study A) was conducted on 9 dairy cows of the Polish Black-White race with clinical mastitis during the lactation period. Milk samples were collected at 2, 4, 6, 8, 10, 24, 36, 48, 72 and 84 h after single IMM administration of 250 mg of CEF to one quarter. Drug concentrations in milk samples were determined by HPLC-MS/MS technique and the results of the pharmacokinetic analysis were compared to those obtained in previous studies based on the microbiological (study B) and HPLC-UV methods (study C and D). Pharmacokinetic parameters were calculated based on adapted two-compartment model of drug distribution. One of the findings of the comparison of the analysed investigations is that the CEF kinetics determined with the microbiological method is consistent with the results obtained by the authors of this paper. Both studies yielded similar results of the key pharmacokinetic parameters related to the level of the drug distribution to tissues and elimination half-life. In the pharmacodynamic analysis, the observations in all four studies were entirely consistent and have shown lower values of T>MIC90 in healthy animals and significantly higher values in infected dairy cows. The comparison of studies A, B, C, and D revealed that the time of complete CEF wash-out of 90.90% varied and amounted to 5.7, 8.0, 2.2, and 2.2 days after administration of the drug, respectively. It was confirmed that not only the type of the analytical method but also correct sampling have a significant impact on determination of the correct value of the drug half-life after IMM administration. The comparative analysis of studies in which the milk yield was high and low allows a conclusion that this parameter in the case of CEF has no significant effect on T>MIC90.


Asunto(s)
Antibacterianos/farmacocinética , Cefoperazona/farmacocinética , Mastitis Bovina/tratamiento farmacológico , Leche/química , Animales , Antibacterianos/administración & dosificación , Antibacterianos/uso terapéutico , Área Bajo la Curva , Bovinos , Cefoperazona/administración & dosificación , Cefoperazona/uso terapéutico , Vías de Administración de Medicamentos , Residuos de Medicamentos , Femenino , Semivida , Estudios Retrospectivos
10.
Pol J Vet Sci ; 20(4): 737-742, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-29611639

RESUMEN

PURPOSE: The reduced value of resistance (R) of milk (<167Ω) or increased conductivity (EC) >6.0 mS/cm indicate the growing number of ions in milk during the initial phase of mastitis. The aim of this study is to demonstrate a linear (verified by a validation procedure) dependency between R and mean daily yield (MDY), which could be used for current monitoring and forecasting of milk yield in dairy cow herds. Although the topic has frequently been examined, a validated model for prediction of MDY based on R has still not been presented. METHODS: Data from 118 dairy cows were analyzed in the study. The validation of model dependency R↔MDY was performed by the live-one-out method (LOO). RESULTS: The minimum geometrical/arithmetical mean of R milk was observed during the 1st month of lactation and was 53.40/254.86 Ω. However, the maximum geometrical/arithmetical mean of R milk was observed during the 7th month of lactation and has 189.62/574.51 Ω. The final model was described by the curve equation MDY = -04461 × R% + 51.58 where R% - percentage share of cows in a herd whose R oscillated within the limits 49.38-154.32 Ω. CONCLUSIONS: Complete predictivity of the model within the above mentioned limits ("prognostic range") was confirmed by the results of validation of the model. The developed model enables the efficiency of a herd at specified percentage share of cows of defined milk R value to be determined.


Asunto(s)
Bovinos/fisiología , Lactancia/fisiología , Leche/química , Animales , Femenino , Modelos Biológicos
11.
Z Gastroenterol ; 54(5): 409-15, 2016 May.
Artículo en Alemán | MEDLINE | ID: mdl-27171330

RESUMEN

INTRODUCTION: Clinical trials and health services research are crucial pillars for improving patient care. This paper examines factors inhibiting and promoting the study activity and the knowledge and use of trial registries (e. g. DRKS, StudyBox) as an opportunity to learn about existing studies. MATERIAL AND METHODS: The coordinators of 274 cancer center sites certified according to the requirements of the German Cancer Society were surveyed using a standardized online questionnaire. Data were analyzed using descriptive and bivariate statistics to identify associations with characteristics of the sites (e. g. patient volume, ownership, teaching status). RESULTS: 176 sites participated in the survey (64.2 %). The central obstacle to study participa-tion from the centers' view is the low number of existing studies. General knowledge of the population about studies was considered low. Trial registries are known to almost all respondents, but are rarely used. DISCUSSION: The results of the survey suggest that comprehensive measures are needed to sustainably increase the study activity. These include, for example, better information about studies, for example through appropriate databases, and (industry-independent) research funding. One possible way to sensitize patients for studies could be the comprehensive education of the population about the purpose of studies.


Asunto(s)
Actitud del Personal de Salud , Investigación Biomédica/estadística & datos numéricos , Instituciones Oncológicas/provisión & distribución , Ensayos Clínicos como Asunto/estadística & datos numéricos , Neoplasias Colorrectales/epidemiología , Oncólogos/estadística & datos numéricos , Sistema de Registros/estadística & datos numéricos , Adulto , Anciano , Femenino , Alemania/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Proyectos de Investigación/estadística & datos numéricos , Encuestas y Cuestionarios
12.
J Vet Pharmacol Ther ; 39(6): 616-620, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-27199202

RESUMEN

Metamizole (MT) is a pyrazolone nonsteroidal anti-inflammatory drug labelled for humans and animals. The aim of this study was to assess the pharmacokinetics of its active metabolites 4-methylamino-antipyrine (MAA) and 4-amino-antipyrine (AA) in male piglets after a single intramuscular injection of MT. Eight healthy male piglets were administered MT (100 mg/kg) intramuscularly. Blood was sampled at scheduled time intervals, and drug plasma concentrations evaluated by a validated HPLC method. MAA and AA plasma concentrations were quantitatively detectable from 0.25 to 48 h and 0.50 to 72 h, respectively, in 6 of 8 and 7 of 8 animals. The average maximum concentrations of MAA and AA were of 47.59 and 4.94 mg/mL, respectively. The average half-lives were 8.57 and 13.3 h for MAA and AA, respectively. This study showed that the amount of MAA and AA produced in piglets is different to that in the animal species previously investigated. Further studies are necessary to understand whether these differences in MAA and AA plasma concentrations between animal species necessitate diverse therapeutic drug dosing.


Asunto(s)
Ampirona/farmacocinética , Dipirona/análogos & derivados , Dipirona/metabolismo , Porcinos/sangre , Ampirona/sangre , Ampirona/química , Ampirona/metabolismo , Animales , Área Bajo la Curva , Dipirona/administración & dosificación , Dipirona/sangre , Dipirona/química , Dipirona/farmacocinética , Semivida , Masculino , Estructura Molecular
13.
Pneumologie ; 69(6): 329-34, 2015 Jun.
Artículo en Alemán | MEDLINE | ID: mdl-25822008

RESUMEN

BACKGROUND: Since 2008, lung cancer centers can be certified in accordance with the criteria set out by the German Cancer Society (Deutsche Krebsgesellschaft). This paper reports on the certification program for lung cancer centers and presents data on 18 quality indicators collected during certification. METHODS: After checks for plausibility and completeness, data on quality indicators for the 2011 and 2012 patient cohorts as well as data of the treating centers were analyzed descriptively (relative/absolute frequencies, means, site medians). PATIENTS: 23,222 patients with ICD-10 diagnoses C33 und C34 from 35 (2012) and 24 operating sites (2011), respectively. RESULTS: From 2011 to 2012, both the number of certified sites and the number of patients treated increased. Fulfillment of the certification requirements is already high and improved slightly from 2011 to 2012. The implementation of indicators without target values is less advanced. CONCLUSION: Thanks to the medical and professional associations as well as the oncologic medical experts, the lung cancer certification program is evolving continuously. There has been a steady increase both in the number of patients treated and the number of lung cancer centers; certification requirements are also being increasingly fulfilled.


Asunto(s)
Instituciones Oncológicas/estadística & datos numéricos , Instituciones Oncológicas/normas , Certificación , Neoplasias Pulmonares/epidemiología , Neoplasias Pulmonares/terapia , Calidad de la Atención de Salud/estadística & datos numéricos , Alemania/epidemiología , Adhesión a Directriz/estadística & datos numéricos , Humanos , Prevalencia , Neumología , Indicadores de Calidad de la Atención de Salud/normas , Revisión de Utilización de Recursos
14.
Gesundheitswesen ; 75(10): 660-6, 2013 Oct.
Artículo en Alemán | MEDLINE | ID: mdl-23533093

RESUMEN

INTRODUCTION: Patient questionnaires are a frequently used instrument within the framework of quality management in in- and outpatient care. Often such questionnaires enable a comparison of care suppliers with the consequence that one turns out to be visibly better or poorer than another. This process, in turn, makes it necessary to check whether differences found upon evaluation of the questionnaires are not merely the result of different compositions of the questioned populations. Although frequently demanded, such adjustments are not usually made. The present article describes the choice of variables for adjustments and the statistical procedures for a relatively homogeneous sample of breast cancer patients. In addition, the utility and limitations of adjustments are discussed. METHODS: On the basis of questionnaire data from 3 840 breast cancer patients of 52 breast cancer centres in North Rhine-Westphalia collected during 2010, we examined which patient characteristics can be employed for the adjustment of satisfaction ratings and to what extent the observed values for the centres differed from the expected results. Independent variables taken into consideration were age, educational level, native language, stage, grading, ASA classification, afffected breast, type of operation, insurance status, partnership status as well as time between operation and receipt of the filled out questionnaire. RESULTS: The variance revealed by the independent variables is low. The expected values showed minimal differences which can be attributed to the high homogeneity of the patients collectives and the centres. CONCLUSION: The use of adjustments remains limited in the study population. The variance of the independent variables revealed by the adjustors is small. Finally, in our opinion, no clear recommmendation for or against case-mix adjustments can be made in patient populations such as the one examined here. Thus, even when small, effects for a more correct reporting of patient questionnaires are faced with unresolvable methodological challenges. Also of importance but an as yet only rarely discussed factor is the factual intepretation of the association of patient characteristics with a better or poorer evaluation of questionnaires. An adjustment for the respective characteristics would eliminate these findings and not make any contribution to an improvement in health care.


Asunto(s)
Algoritmos , Neoplasias de la Mama/epidemiología , Neoplasias de la Mama/terapia , Interpretación Estadística de Datos , Evaluación de Resultado en la Atención de Salud/métodos , Satisfacción del Paciente/estadística & datos numéricos , Encuestas y Cuestionarios , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Escolaridad , Femenino , Alemania/epidemiología , Humanos , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud/estadística & datos numéricos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Factores Socioeconómicos
15.
Gesundheitswesen ; 75(5): 301-6, 2013 May.
Artículo en Alemán | MEDLINE | ID: mdl-23589136

RESUMEN

This study investigates the conflict between work and private life (work-life conflict and life-work conflict) and its relationship with burnout among physicians in breast cancer centers in North Rhine-Westphalia (n=378). With regard to the construct burnout, we differentiated between the 3 subscales emotional exhaustion, depersonalisation and personal accomplishment of the Maslach burnout inventory. In a structural equation model it was seen that above all the work-life conflict is positively associated with emotional exhaustion whereas the life-work conflict has a stronger positive correlation with depersonalisation and a negative relationship with personal accomplishment. Altogether, the results emphasise the importance of a successful interaction between professional work and private life ("work-life balance") for the health of medical personnel.


Asunto(s)
Neoplasias de la Mama/psicología , Agotamiento Profesional/epidemiología , Instituciones Oncológicas/estadística & datos numéricos , Médicos/psicología , Carga de Trabajo/psicología , Lugar de Trabajo/psicología , Adulto , Anciano , Neoplasias de la Mama/epidemiología , Agotamiento Profesional/psicología , Conflicto Psicológico , Recolección de Datos , Femenino , Alemania/epidemiología , Humanos , Satisfacción en el Trabajo , Masculino , Persona de Mediana Edad , Médicos/estadística & datos numéricos , Prevalencia , Calidad de Vida/psicología , Medición de Riesgo , Carga de Trabajo/estadística & datos numéricos , Lugar de Trabajo/estadística & datos numéricos
16.
Pol J Vet Sci ; 16(4): 759-61, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-24597316

RESUMEN

This paper describes research on the levels of endogenous melatonin (MLT) in the blood serum in dogs in different seasons (March, June, September, December) and at different times of day (11:00, 12:00, 23:00, 24:00 and 1:00), using immunoassay method. Blood samples were collected in the diurnal cycle, in consecutive seasons. The conducted studies show that MLT levels undergo clear changes in both the diurnal cycle, as well as in seasonal one in this species.


Asunto(s)
Ritmo Circadiano/fisiología , Perros/sangre , Perros/fisiología , Melatonina/sangre , Estaciones del Año , Animales
17.
Urologie ; 62(6): 602-608, 2023 Jun.
Artículo en Alemán | MEDLINE | ID: mdl-36877230

RESUMEN

BACKGROUND: In the past, the IIEF­5 (International Index of Erectile Function 5 ) was predominantly used to measure erectile function in prostate cancer patients. Following international developments, the domain "sexuality" of the EPIC-26 (Expanded Prostate Cancer Index Composite 26) is increasingly used in Germany. OBJECTIVE: The aim of this work is to create a practicable comparison of the domain "sexuality" of the EPIC-26 with the IIEF­5 for treatment in Germany. This is particularly necessary for the evaluation of historical patient collectives. MATERIALS AND METHODS: For the evaluation, 2123 patients with prostate cancer confirmed by biopsy from 2014-2017 who completed both the IIEF­5 and the EPIC-26 were considered. Linear regression analyses are calculated to convert IIEF­5 sum scores to EPIC-26 sexuality domain scores. RESULTS: The correlation between IIEF­5 and the EPIC-26 domain score "sexuality" was 0.74, suggesting a high degree of content convergence between the constructs measured. While the standard error of the predicted values is relatively small, the prediction intervals are very wide. For example, for the critical IIEF­5 value of 22, the predicted value is 78.88 with a 95% prediction interval of 55.09 to 102.66. CONCLUSION: IIEF­5 and the Sexuality scale of the EPIC-26 measure a similar construct. The analysis shows that conversion of individual values is associated with great uncertainty. However, at the group level, the observed EPIC-26 "sexuality" score could be predicted quite accurately. This opens up the possibility of comparing the erectile function of cohorts of patients/test persons, even if this was collected with different measuring instruments.


Asunto(s)
Disfunción Eréctil , Neoplasias de la Próstata , Masculino , Humanos , Disfunción Eréctil/etiología , Próstata , Prostatectomía/efectos adversos , Erección Peniana , Neoplasias de la Próstata/cirugía
18.
J Cancer Res Clin Oncol ; 149(3): 1195-1209, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35380257

RESUMEN

Neoadjuvant chemotherapy (NACT) is frequently used in patients with early breast cancer. Randomized controlled trials have demonstrated similar survival after NACT or adjuvant chemotherapy (ACT). However, certain subtypes may benefit more when NACT contains regimes leading to high rates of pathologic complete response (pCR) rates. In this study we analyzed data using the OncoBox research from 94,638 patients treated in 55 breast cancer centers to describe the current clinical practice of and outcomes after NACT under routine conditions. These data were compared to patients treated with ACT. 40% of all patients received chemotherapy. The use of NACT increased over time from 5% in 2007 up to 17.3% in 2016. The proportion of patients receiving NACT varied by subtype. It was low in patients with HR-positive/HER2-negative breast cancer (5.8%). However, 31.8% of patients with triple-negative, 31.9% with HR-negative/HER2-positive, and 26.5% with HR-positive/HER2-positive breast cancer received NACT. The rates of pCR were higher in patients with HR-positive/HER2-positive, HR-negative/HER2-positive and triple-negative tumors (36, 53 and 38%) compared to HR-positive/HER2-negative tumors (12%). PCR was achieved more often in HER2-positive and triple-negative tumors over time.This is the largest study on use and effects of NACT in German breast cancer centers. It demonstrates the increased use of NACT based on recommendations in current clinical guidelines. An improvement of pCR was shown in particular in HER2-positive and triple-negative breast cancer, which is consistent with data from randomized controlled trails.


Asunto(s)
Neoplasias de la Mama , Neoplasias de la Mama Triple Negativas , Humanos , Femenino , Neoplasias de la Mama/patología , Terapia Neoadyuvante , Neoplasias de la Mama Triple Negativas/tratamiento farmacológico , Quimioterapia Adyuvante , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Receptor ErbB-2 , Resultado del Tratamiento
19.
Eur J Cancer Care (Engl) ; 21(2): 205-12, 2012 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-22070101

RESUMEN

The number of breast cancer patients who are informed about and have contact with patient self-help groups (SHGs) during their hospital stay varies across hospitals. The aim of this study is to investigate which patient and hospital characteristics contribute to these differences. Multilevel regression analysis was applied, using data on hospital characteristics and data from a patient survey, which catalogued the disease and socio-demographic characteristics of newly diagnosed breast cancer patients, and recorded if they were informed about and had contact with SHGs during their hospital stay. Data from 2639 patients from 82 hospitals were analysed. The odds of being informed about SHGs were significantly lower if patients were treated at a teaching hospital. Patients aged 40 to 59 years significantly more often reported that they were informed about SHGs than patients aged 60 to 69 years. Patients with the highest education certificates significantly more often reported that they both were informed about and have had contact with SHGs. These results suggest that in teaching hospitals, information provided to patients about SHGs is reduced. Furthermore, patients are differentially given information about SHGs and have different levels of contact with SHGs, based on their age and education.


Asunto(s)
Neoplasias de la Mama , Información de Salud al Consumidor/métodos , Hospitales/estadística & datos numéricos , Grupos de Autoayuda , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Información de Salud al Consumidor/normas , Estudios Transversales , Escolaridad , Femenino , Hospitales de Enseñanza/estadística & datos numéricos , Humanos , Persona de Mediana Edad , Oportunidad Relativa , Educación del Paciente como Asunto/estadística & datos numéricos , Análisis de Regresión , Adulto Joven
20.
J Vet Pharmacol Ther ; 33(4): 389-95, 2010 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-20646202

RESUMEN

Sulfachlorpyrazine (SCP) is currently used to treat coccidian infections in turkeys; however, there is no information available about the withdrawal period necessary for the turkey to be safe for human consumption. A high performance liquid chromatography method with ultraviolet-visible light detection was adapted and validated for the determination of SCP in turkey tissues. The procedure is based on isolation of the (SCP sodium) compound from edible turkey tissues (muscles, liver, kidneys, and fat with skin) with satisfactory recovery (72.80 +/- 1.40) and specificity. The residue depletion of SCP in turkeys was conducted after a dose of 50 mg/kg body weight/day had been administrated orally for 3 days. After treatment has been discontinued residue concentrations were detected in tissues on the 7th day. The highest SCP concentrations were measured in muscles. Based on the results presented in this study, it could be assumed that a withdrawal period of 21 days, before medicated turkeys could be slaughtered, would be sufficient to ensure consumer safety.


Asunto(s)
Antiinfecciosos/farmacocinética , Residuos de Medicamentos/análisis , Sulfanilamidas/farmacocinética , Pavos/metabolismo , Administración Oral , Animales , Antiinfecciosos/administración & dosificación , Antiinfecciosos/análisis , Cromatografía Líquida de Alta Presión/veterinaria , Residuos de Medicamentos/farmacocinética , Riñón/metabolismo , Modelos Lineales , Hígado/metabolismo , Músculos/metabolismo , Distribución Aleatoria , Piel/metabolismo , Grasa Subcutánea/metabolismo , Sulfanilamidas/administración & dosificación , Sulfanilamidas/análisis
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