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Copyright of Die Urologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Anaesthesiologie & Intensivmedizin is the property of DGAI e.V. - Deutsche Gesellschaft fur Anasthesiologie und Intensivmedizin e.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Linguistische Berichte is the property of Helmut Buske Verlag Hamburg and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIVE: This study reports the results of stereotactic radiosurgery and fractionated stereotactic radiosurgery treatment for brain metastasis in non-small cell lung cancer patients treated with modern systemic treatment methods (immunotherapy, targeted agents, and current chemotherapy agents). MATERIAL AND METHODS: This study retrospectively analyzed patients diagnosed with non-small cell lung cancer and brain metastases who underwent stereotactic radio surge ry/fr actio nated stereotactic radiosurgery in the Radiation Oncology Clinic of Ankara Bilkent City Hospital between February 21, 2019, and August 15, 2022. The study's primary endpoint was accepted as the lesions' response status after stereotactic radio surge ry/fr actio nated stereotactic radiosurgery. The secondary endpoint was accepted as the patients' intracranial progression-free survival and overall survival. RESULTS: This study included 85 patients treated for 174 lesions. Their median follow-up was 6.6 (range: 1-42) months. Their median intracranial progression-free survival after radiotherapy was 5.3 (range: 1-33) months, and their median overall survival was 6.6 (range: 1-42) months. Concurrent immunotherapy was administered to 10 (11%) patients and targeted therapy to 8 (9%). Magnetic resonance imaging indicated that 14 (6%) patients had a complete response, 62 (35.6%) had a partial response, 10 (5.7%) had stable disease, and 23 (13.2%) had progressive disease. The complete response rate was significantly higher in patients receiving targeted therapy (P < .001; odds ratio = 0.0025, 95% CI = 0.006-0.109). Intracranial recurrence was observed in 28 (32.9%) patients after stereotactic radio surge ry/fr actio nated stereotactic radiosurgery: 7 (8.2%) were inside the radiotherapy field, 13 (15.3%) were outside the radiotherapy field, and 8 (9.4%) overlapped the radiotherapy field. Intracranial progression-free survival was higher in patients receiving concomitant immunotherapy (P = .028; hazard ratio = 0.107, 95% CI = 0.015-0.783). However, overall survival was higher in patients receiving targeted therapy (P = .035; hazard ratio = 0.217, 95% CI = 0.053-0.897). CONCLUSION: Using current systemic agents with radiotherapy for brain metastasis significantly affected post-radiotherapy intracranial progression-free survival. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Chronic obstructive pulmonary disease is currently the fourth leading cause of death in the world. Pulmonary rehabilitation is recommended for chronic obstructive pulmonary disease. MATERIAL AND METHODS: This study aimed to evaluate the effects of non-invasive ventilation, supplemental oxygen, and exercise training and supplemental oxygen during exercise training during pulmonary rehabilitation practice in comparison with only exercise training on lung functions, blood gases, lactate levels, respiratory muscle pressures, dyspnea, walking distances, quality of life, and depression in patients with severe chronic obstructive pulmonary disease. The main outcome measure is exercise capacity (6-minute walk test), and the secondary end-point included quality of life. RESULTS: Thirty-five patients (mean ± SD age, 65.4 ± 6.5 years) with a mean bronchodilator forced expiratory volume in the first second of expiration of 39.4 ± 7%, undergoing an 8-week outpatient pulmonary rehabilitation, were randomized to either non-invasive ventilation, supplemental oxygen, and exercise training, supplemental oxygen during exercise training, or exercise training groups. The improvements in respiratory muscle strength were higher in non-invasive ventilation, supplemental oxygen, and exercise training patients than the moderate improvements in the exercise training group. Both non-invasive ventilation, supplemental oxygen, and exercise training and supplemental oxygen during exercise training groups showed significant increases in the 6-minute walk test and incremental shuttle walk test. However, the increase in walking distance was better in non-invasive ventilation, supplemental oxygen, and exercise training group (69.8 ± 53.2 m in 6-minute walk test and 66.6 ± 65.2 m in incremental shuttle walk test, P = .001 and P = .005, respectively) compared to supplemental oxygen during exercise training group (42.5 + 55.5 m in 6-minute walk test and 53.5 + 70.2 m in incremental shuttle walk test, P = .01 each, respectively). The total St. George's Respiratory Questionnaire score was similar in all study groups after the intervention. Symptoms of depression significantly improved only in non-invasive ventilation, supplemental oxygen, and exercise training group (-2.8 + 2.8, P = .006). CONCLUSION: Non-invasive positive-pressure ventilation (NIPPV) added to supplemental oxygen during exercise training was associated with better physiological adaptations than other modalities. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Pleural fluid pH measurement is recommended for tube thoracostomy decisions in complicated parapneumonic pleural effusions. However, pleural fluid pH may be affected by blood pH in critically ill patients with common systemic acid-base disorders. We aimed to investigate the use of pleural fluid lactate to distinguish culture-positive parapneumonic effusions from other pleural effusions. MATERIAL AND METHODS: This prospective observational study included 121 eligible patients (51 female and 70 male). All patients with pleural effusion who underwent thoracentesis were assessed. Pleural fluid lactate was measured by a blood gas analyzer. RESULTS: Of the 121 patients, 30 (24.8%) were transudate and 91 (75.2%) were exudate. Of the 91 patients with exudative pleural effusion, 61 were diagnosed as culture-negative parapneumonic, 13 as culture-positive parapneumonic, 9 as malignant, and 8 as other exudative effusion. There was a strong positive linear association between serum pH and pleural fluid pH (R = 0.77, P < .001). The post hoc tests for pleural fluid lactate revealed there was a significant difference between culture-positive parapneumonic versus culture-negative parapneumonic groups (P = .004), culture-positive parapneumonic versus transudative effusion groups (P < .001), culture-negative parapneumonic versus transudative effusion groups (P = .008) and lastly; malignant effusion versus transudative effusion groups (P = .001). Receiver operating characteristics curve analysis for culture-positive parapneumonic indicated a cutoff of 4.55 mmol/L for pleural fluid lactate to have a sensitivity of 76.9% and a specificity of 84.3% (positive predictive value: 37%, negative predictive value: 96.8%). CONCLUSION: A cutoff of 4.55 mmol/L of pleural fluid lactate can be used as a useful tool to distinguish culture-positive parapneumonic effusions from other effusions in critically ill patients. [ABSTRACT FROM AUTHOR]

Background: In the event of a mass casualty incident (MCI), the situation-related shortage of medical resources does not end when the patients are transported from the scene of the incident. Consequently, an initial triage is required in the receiving hospitals. In the first step, the aim of this study was to create a reference patient vignette set with defined triage categories. This allowed a computer-aided evaluation of the diagnostic quality of triage algorithms for MCI situations in the second step. Methods: A total of 250 case vignettes validated in practice were entered into a multistage evaluation process by initially 6 and later 36 triage experts. This algorithm—independent expert evaluation of all vignettes—served as the gold standard for analyzing the diagnostic quality of the following triage algorithms: Manchester triage system (MTS module MCI), emergency severity index (ESI), Berlin triage algorithm (BER), the prehospital algorithms PRIOR and mSTaRT, and two project algorithms from a cooperation between the Federal Office of Civil Protection and Disaster Assistance (BBK) and the Hashemite Kingdom of Jordan—intrahospital Jordanian-German project algorithm (JorD) and prehospital triage algorithm (PETRA). Each patient vignette underwent computerized triage through all specified algorithms to obtain comparative test quality outcomes. Results: Of the original 250 vignettes, a triage reference database of 210 patient vignettes was validated independently of the algorithms. These formed the gold standard for comparison of the triage algorithms analyzed. Sensitivities for intrahospital detection of patients in triage category T1 ranged from 1.0 (BER, JorD, PRIOR) to 0.57 (MCI module MTS). Specificities ranged from 0.99 (MTS and PETRA) to 0.67 (PRIOR). Considering Youden's index, BER (0.89) and JorD (0.88) had the best overall performance for detecting patients in triage category T1. Overtriage was most likely with PRIOR, and undertriage with the MCI module of MTS. Up to a decision for category T1, the algorithms require the following numbers of steps given as the median and interquartile range (IQR): ESI 1 (1–2), JorD 1 (1–4), PRIOR 3 (2–4), BER 3 (2–6), mSTaRT 3 (3–5), MTS 4 (4–5) and PETRA 6 (6–8). For the T2 and T3 categories the number of steps until a decision and the test quality of the algorithms are positively interrelated. Conclusion: In the present study, transferability of preclinical algorithm-based primary triage results to clinical algorithm-based secondary triage results was demonstrated. The highest diagnostic quality for secondary triage was provided by the Berlin triage algorithm, followed by the Jordanian-German project algorithm for hospitals, which, however, also require the most algorithm steps until a decision. [ABSTRACT FROM AUTHOR]

Introduction: According to the Master Plan 2020, science education will play a critical role in future medical curricula. Science modules have already been implemented at many locations. Other medical faculties will follow in the next few years, as legislation is expected to make recommendations of the national competence-based learning objectives curriculum for medicine (NKLM) mandatory. This article aims to present an implementation example from epidemiology and biometry as a contribution to the didactic discussions within the data sciences in medicine. Project description: We report on our experiences with a data analysis project for second-year medical students, which has been compulsory at the Faculty of Medicine and Health Sciences since 2019. The project is intended to train the scientific skills required from the subjects of epidemiology and biometry for student research projects. Emphasis is placed on responsible data handling, transparency, and reproducibility. For example, the writing of a statistical analysis plan is required prior to data access. Improved standardization of materials, optional use of the English language, and digital support will be implemented to help manage the project when student numbers increase. Discussion: The experience from five years is very positive, although a formal evaluation of the learning success is still pending. Current challenges concern staffing, additional time and supervision requirements for those students who do statistical programming with R, and improved integration into the medical curriculum. [ABSTRACT FROM AUTHOR]

Copyright of HeilberufeSCIENCE is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Zentralblatt fuer Arbeitsmedizin, Arbeitsschutz und Ergonomie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of WISTA Wirtschaft und Statistik is the property of Statistisches Bundesamt and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ergoscience is the property of Schulz-Kirchner Verlag Gmbh and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Incidence and mortality rates of cervical cancer (C53 by ICD-10) have to be corrected significantly upwards after excluding the women from the reference population whose uterus was removed surgically. The current study is based on the German Health Interview and Examination Survey for Adults (DEGS1) according to which the prevalence of hysterectomy in Germany in 2011 among women aged over 18 years was 17.4%. As per age pattern of this prevalence the incidence and mortality rates of cervical cancer are corrected. Maximal corrections can be found women of 70-79 years. In this age group the incidence rate is corrected from 13.6 to 22.5 by 65.4%, the mortality rate from 7.5 to 12.4 by 65.3%. [ABSTRACT FROM AUTHOR]

Background: Meta-analyses have a great impact on medical decision-making. Random errors are, however, often the reason for misinterpretation of interventional effects in meta-analyses.Objective: The aim of this article is to introduce authors and readers of meta-analyses to the problem of random errors. The article presents trial sequential analysis (TSA) as a suitable and user-friendly method that adjusts for the risk of random errors in meta-analyses.Material and Methods: The practical application of TSA is illustrated and exemplified using regional anesthesiology procedures versus conventional pain therapy with respect to the prevention of persistent postoperative pain after breast cancer surgery or thoracotomy. The results were compared with those from conventional meta-analytical methods.Results: Conventional meta-analytical methods showed a significant advantage for patients after breast cancer surgery as well as after thoracotomy for regional anesthesia procedures with respect to the reduction of persistent postoperative pain. By means of TSA it could be concluded for thoracotomy that the evidence of this meta-analysis was sufficient. In contrast, the TSA for breast cancer surgery showed that based on the current data set and on the basis of relevant assumptions, it is potentially a false indication of an effect. There is currently no evidence that regional anesthesia leads to a significant reduction of persistent postoperative pain.Conclusion: The TSA is a suitable tool to minimize the risk of random errors and for a more reliable assessment of the evidence for the results of a meta-analysis. [ABSTRACT FROM AUTHOR]

Copyright of Zentralblatt fuer Arbeitsmedizin, Arbeitsschutz und Ergonomie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Zentralblatt fuer Arbeitsmedizin, Arbeitsschutz und Ergonomie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Laboratory Medicine / Laboratoriums Medizin is the property of De Gruyter and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of HeilberufeSCIENCE is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Every result of a measurement is subject to error. This error is inevitably caused by inaccuracies of the devices used and by environmental influences. For correct evaluation of a measurement result, this error must be estimated as exactly as possible. In kidney stone research and urolithiasis treatment, risk indices are applied to determine a patient's health status [e.g., AP(CaOx), RS(CaOx), BRI]. These operands (indices) combine important physical and chemical parameters of a certain disease pattern in a theoretically or empirically obtained mathematical formula. The index-related total error resulting from the single errors of the individual input parameters might be calculated with the Gaussian error propagation method. This method takes into account that individually determined parameters contribute differently to the total result. Due to this, summation of the various specific errors is insufficient. Instead, they must contribute to the total error depending on their individual weight. In medical borderline cases, knowledge of the value of this error may improve diagnosis since critical observation of an acquired value helps to avoid false interpretation. Using the BONN-Risk-Index (BRI) as an example for determination of the urinary calcium oxalate crystallization risk in native urine, the method of error calculation is demonstrated in detail and the advantages of including discussion of error in method development are discussed. [ABSTRACT FROM AUTHOR]

Background: The transpulmonary thermal-dye dilution (TDD) is the clinical gold standard for measurement of intrathoracic blood volume (ITBV) and extravascular lung water (EVLW). Recently, experimental and clinical studies found that ITBV and EVLW can be derived reliably by single transpulmonary thermodilution (TD), however, dependency from various factors of lung function has been discussed.Patients and Methods: We retrospectively analyzed data from 174 critically ill patients who had undergone hemodynamic monitoring by TDD. We calculated the differences of simultaneous TD and TDD determined by ITBV or EVLW measurements. Bias and standard deviations (SD) were calculated and extended Bland-Altman regression analyses were performed. Association of the differences and the potential confounders gender, age, PEEP, p(a)O(2)/F(I)O(2) ratio and the corresponding TDD measurement were analyzed by multiple linear regression and LOWESS regression.Results: Overall results (bias+/-SD) were 1+/-58 ml/m(2) for ITBV and 0.0+/-1.4 ml/kg bw for EVLW, but TD overestimated TDD results in patients with higher ITBV and underestimated those for lower ITBV values. The deviations were small, and the dependence of ITBV could be explained completely by dependence on PEEP and age. However, low values of EVLW are overestimated by TD.Conclusion: Single transpulmonary thermodilution for estimation of ITBV or EVLW is reliable in patients with severe lung injury for normal and higher values. [ABSTRACT FROM AUTHOR]

If understanding the process that generated the data is the aim of data analysis, graphically aided analysis techniques are necessary for the development of useful statistical models. Despite this fact, graphical techniques are underused in the social sciences. Possible reasons for this neglect are discussed. A catalogue of useful graphically aided techniques and their software implementations are presented. [ABSTRACT FROM AUTHOR]

Background: Radiotherapy is a successfully proven, feasible and appropriate antineoplastic treatment for the palliation of tumor symptoms. Clinicians sometimes use the argument of the burden of advanced age and limited tolerance to withhold this modality of treatment from older patients.Patients and Methods: All cancer patients (n = 827) who presented for the first time to the Department of Radiation Oncology during 1997 were used as a base to analyze if age was a factor with regard to the feasibility and the effectiveness of palliative radiation treatment in patients with measurable tumor burden. The following treatment end-points were analyzed in 440 (53%) patients who were treated palliatively: reduction or management of pain; neurological impairment; superior vena cava syndrome; dysphagia; dyspnea; bleeding or ulceration of the tumor or metastasis as well as prevention from clinically but not yet symptomatic tumor progression, while controlling for age (< 70 years: n = 293, 70 to 75 years: n = 79, > 75 years: n = 68); treatment status (in- or out-patient), range of treatment modalities (radiation and/or chemotherapy, no cancer specific treatment). The frequency of not reaching these treatment goals is a criterium of treatment feasibility and a measure of the effect of the variables.Results: When comparing primarily palliative and non-palliative treated patients, there were similar frequencies in the defined age groups, which points to the effect of other mechanisms of selection, e.g. effect of comorbidity. In an analysis of the relevant reasons for the discontinuation of treatment in palliatively treated patients (reduction of general condition: n = 31 [7%], comorbidity: n = 1 [0%], treatment toxicity: n = 3 [1%], tumor progression: n = 15 [3%], therapy associated death: n = 11 [3%], at patients own request: n = 8 [2%]) age was not a discernible factor. Frequencies of discontinuation of treatment according to age of patients and treatment status defined as in- vs out-patient are relatively small (< 70 years: 5/85 vs 42/208; 70 to 75 years: 2/29 vs 11/50; > 75 years: 4/29 vs 13/39). There are similarities in the lower age groups and these seem to be independent from the treatment modalities used in each of the age groups.Conclusions: This presents an example of how one can analyze and present the treatment results of radiotherapy as part of quality management in a department of radiation oncology. The results confirm that it is not justified to withhold radiation therapy based on advanced age alone. [ABSTRACT FROM AUTHOR]

Purpose: To analyse the experience treating soft tissue sarcomas of the head and neck at the Massachusetts General Hospital, Boston. Detailed results have been published previously [17].Patients and Method: Between 1972 and 1993, 57 patients were treated curatively with radiation alone (n = 13) or combined surgery and pre- and/or postoperative irradiation (n = 44). Gross complete resection was achieved in 82% of patients and margins were negative in 5 patients. Doses ranged from 36.0 to 79.2 Gy (median 64.8 Gy), usually conventionally fractionated. In 16 patients protons were used. Median follow-up time was 4.3 years (range 1.1 to 16.8 years).Results: After 5 years, patients with angiosarcomas (n = 11) and patients with other tumor types (n = 46) had locoregional control rates of 24% and 69%, distant failure rates of 58% and 17%, and overall survival rates of (for overall survival) and T stage (for locoregional control) (p < 0.05). Particularly, gross completely resected T1 tumors had a locoregional control rate of 91%. Patients with locoregional recurrence were at an increased risk to die (p = 0.004 in multivariate analysis). Patients with and without direct tumor extension to neurovascular structures, bones, organs, or skin had distant failure rates of 27% and 0%, respectively (p = 0.031). In multivariate analysis, direct extension was additionally a negative prognosticator of overall survival (p = 0.034).Conclusion: 1. Angiosarcomas of the head and neck have a considerably poorer prognosis than other soft tissue sarcomas of this region. 2. Head and neck sarcomas have a higher local recurrence rate than for example soft tissue sarcomas of the extremities. Optimisation of local treatment through combination of surgery and high-dose irradiation, however, can achieve improved results, especially for prognostically favourable subgroups. 3. In addition to tumor grade and size, direct tumor extension may be a useful additional staging parameter. [ABSTRACT FROM AUTHOR]

Copyright of Zeitschrift für Soziologie is the property of De Gruyter and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Zeitschrift für Soziologie is the property of De Gruyter and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Zeitschrift für Soziologie is the property of De Gruyter and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)