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1.
Artigo em Alemão | MEDLINE | ID: mdl-37208463

RESUMO

In the view of the German government, the One Health approach is a pioneering compass for inter- and transdisciplinary thinking, networking, and action. To protect the health of humans, animals, plants, and ecosystems, it should always receive attention at all its interfaces and activities. The One Health approach has gained political importance in recent years and is being taken into account in several strategies.This article reports on the current strategies using a One Health approach. These include the German Antibiotic Resistance Strategy, the German Strategy for Adaptation to Climate Change, the global initiative Nature for Health, and the international pandemic agreement, which is currently being drafted and in which prevention also plays an important role. The issues of biodiversity loss and climate protection must be placed in a common context that takes into account the interdependencies of the health status of humans, animals, plants, and ecosystems. By involving relevant disciplines at different levels as a matter of course, we can succeed in making a joint contribution to sustainable development, as required by the United Nations' Agenda 2030. This perspective guides Germany's global engagement in global health policy toward greater stability, freedom, diversity, solidarity, and respect for human rights. Thus, a holistic approach such as One Health can contribute to achieving sustainability and strengthening democratic principles.


Assuntos
Ecossistema , Saúde Única , Humanos , Alemanha , Política de Saúde , Saúde Global
2.
Breast J ; 27(4): 363-368, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33619792

RESUMO

Subcutaneous nipple sparing mastectomies (NSM) are an important tool in modern oncoplastic surgery. Especially when an immediate implant-based reconstruction (IBR) is desired, clean margins are of the utmost importance. Central nipple biopsies during surgery serve two main purposes. Most importantly, it is hypothesized that intraoperative pathological evaluation of this biopsy may increase clean margin resection rates. In addition, a general recurrence risk reduction may occur due to the elimination of glandular and ductal components within the nipple. This analysis is a single center, multi-surgeon, retrospective, head to head analysis. Starting in March 2015, intraoperative central nipple biopsy in NSMs with IBR was introduced at the Municipal Breast Cancer Centre Cologne, Holweide, Germany. This trial retrospectively evaluates global complication rates, clean margin status and local recurrence rates for cohort 1 (NSM/no nipple biopsy, n = 103) vs. cohort 2 (NSM with nipple biopsy, n = 108) Median follow-up was 15 months. All implant-based reconstruction procedures used an epipectoral implant pocket. Cohorts were comparable. Global complication rates slightly favored the nipple biopsy cohort with respects to implant loss rate. An involved central nipple biopsy was found in 4.6% (n = 5/108) of the performed NSM procedures leading to the immediate removal of the nipple areola complex. All positive retro-areolar biopsies correlated with a positive nipple biopsy. However, in n = 1 case we found DCIS discontinual proliferation with an involved nipple biopsy, without a correlating positive retro-areolar biopsy (ie, 1 false-negative case was prevented). For the 15 month follow-up, there was no case of local recurrence within nipple areola complex for both cohorts. With this retrospective head to head analysis of 211 patients, it was shown that the central nipple biopsy correlates well with the retro-areolar biopsy. There may be a reduction in false negative rates. The procedure is safe to use and should be offered to NSM patients.


Assuntos
Neoplasias da Mama , Mamoplastia , Mastectomia Subcutânea , Biópsia , Neoplasias da Mama/cirurgia , Feminino , Alemanha , Humanos , Mastectomia , Mastectomia Subcutânea/efeitos adversos , Recidiva Local de Neoplasia , Mamilos/cirurgia , Estudos Retrospectivos
3.
J Voice ; 31(2): 255.e25-255.e30, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27397111

RESUMO

OBJECTIVES: This study examined whether prenatal exposure to either a tonal or a nontonal maternal language affects fundamental frequency (fo) properties in neonatal crying. STUDY DESIGN: This is a population prospective study. PARTICIPANTS: A total of 102 neonates within the first week of life served as the participants. METHODS: Spontaneously uttered cries (N = 6480) by Chinese (tonal language group) and German neonates (nontonal group) were quantitatively analyzed. For each cry utterance, mean fo and four characteristic variation measures (fo range, fo fluctuation, pitch sigma, and pitch sigma fluctuation) were calculated, averaged for individual neonates, and compared between groups. RESULTS: A multiple analysis of variance highlighted a significant multivariate effect for language group: Wilks λ = .76, F(6, 95) = 4.96, P < .0001, ηp2 = .24. Subsequent univariate analyses revealed significant group differences for fo variation measures, with values higher in the tonal language group. The mean fo did not differ between groups. CONCLUSIONS: Data regarding fo variation in infant cries have been suggested as providing critical insight into the maturity of neurophysiological vocal control. Our findings, alongside with auditive perception studies, further underscore the assumption of an early shaping effect of maternal speech, particularly fo-based features, on cry features of newborns. Further studies are needed to reexamine this observation and to assess its potential diagnostic relevance.


Assuntos
Acústica , Choro , Comportamento do Lactente , Periodicidade , China , Alemanha , Humanos , Recém-Nascido , Idioma , Aprendizagem , Comportamento Materno , Análise Multivariada , Estudos Prospectivos , Processamento de Sinais Assistido por Computador , Espectrografia do Som , Acústica da Fala , Fatores de Tempo , Qualidade da Voz
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