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  • 1
    Online Resource
    Online Resource
    The impact of treatment for genital cancer on quality of life and body image—results of a prospective longitudinal 10-year study
    Elsevier BV ; 2004
    In:  Gynecologic Oncology Vol. 94, No. 2 ( 2004-8), p. 398-403
    Details
    In: Gynecologic Oncology, Elsevier BV, Vol. 94, No. 2 ( 2004-8), p. 398-403
    Type of Medium: Online Resource
    ISSN: 0090-8258
    URL: Article
    DOI: 10.1016/j.ygyno.2004.04.025
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2004
    detail.hit.zdb_id: 1467974-7
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  • 2
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    Cervical Cancer Screening: Comparison of Conventional Pap Smear Test, Liquid-Based Cytology, and Human Papillomavirus Testing as Stand-alone or Cotesting Strategies
    American Association for Cancer Research (AACR) ; 2021
    In:  Cancer Epidemiology, Biomarkers & Prevention Vol. 30, No. 3 ( 2021-03-01), p. 474-484
    Details
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 30, No. 3 ( 2021-03-01), p. 474-484
    Abstract: Some countries have implemented stand-alone human papillomavirus (HPV) testing while others consider cotesting for cervical cancer screening. We compared both strategies within a population-based study. Methods: The MARZY cohort study was conducted in Germany. Randomly selected women from population registries aged ≥30 years (n = 5,275) were invited to screening with Pap smear, liquid-based cytology (LBC, ThinPrep), and HPV testing (Hybrid Capture2, HC2). Screen-positive participants [ASC-US+ or high-risk HC2 (hrHC2)] and a random 5% sample of screen-negatives were referred to colposcopy. Post hoc HPV genotyping was conducted by GP5+/6+ PCR-EIA with reverse line blotting. Sensitivity, specificity (adjusted for verification bias), and potential harms, including number of colposcopies needed to detect 1 precancerous lesion (NNC), were calculated. Results: In 2,627 screened women, cytological sensitivities (Pap, LBC: 47%) were lower than HC2 (95%) and PCR (79%) for CIN2+. Cotesting demonstrated higher sensitivities (HC2 cotesting: 99%; PCR cotesting: 84%), but at the cost of lower specificities (92%–95%) compared with HPV stand-alone (HC2: 95%; PCR: 94%) and cytology (97% or 99%). Cotesting versus HPV stand-alone showed equivalent relative sensitivity [HC2: 1.06, 95% confidence interval (CI), 1.00–1.21; PCR: 1.07, 95% CI, 1.00–1.27]. Relative specificity of Pap cotesting with either HPV test was inferior to stand-alone HPV. LBC cotesting demonstrated equivalent specificity (both tests: 0.99, 95% CI, 0.99–1.00). NNC was highest for Pap cotesting. Conclusions: Cotesting offers no benefit in detection over stand-alone HPV testing, resulting in more false positive results and colposcopy referrals. Impact: HPV stand-alone screening offers a better balance of benefits and harms than cotesting. See related commentary by Wentzensen and Clarke, p. 432
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    URL: Article
    DOI: 10.1158/1055-9965.EPI-20-1003
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2021
    detail.hit.zdb_id: 2036781-8
    detail.hit.zdb_id: 1153420-5
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  • 3
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    976Screening for cervical cancer with Human Papillomavirus testing: stand-alone is preferable over co-testing with cytology
    Oxford University Press (OUP) ; 2021
    In:  International Journal of Epidemiology Vol. 50, No. Supplement_1 ( 2021-09-01)
    Details
    In: International Journal of Epidemiology, Oxford University Press (OUP), Vol. 50, No. Supplement_1 ( 2021-09-01)
    Abstract: Cervical cancer screening can be conducted with cytology and Human Papillomavirus (HPV) testing but few studies have compared the latter directly to concomitant testing (co-testing). We compared these strategies to determine appropriate screening. Methods Within a randomised population-based cohort study conducted around Mainz, Germany, eligible women (≥30 years) were screened via Pap smear, liquid-based cytology (LBC) and HPV testing (HC2) and HPV genotyped post hoc (PCR). These tests formed three strategies: cytology (Pap or LBC) and HPV (HC2 or PCR) stand-alone and co-testing. Screen positives and 5% negative women were invited to colposcopy. Absolute and relative sensitivity, specificity, false positive rates (FPR) and number needed to colposcopy to detect one lesion (NNC) were calculated. Estimates were crude and verification bias-adjusted using stratified sampling with bootstrapped confidence intervals. Results Of 2,627 screened women, cytology stand-alone demonstrated lowest sensitivities (47%) and highest specificities (97%-99%) while HPV stand-alone demonstrated higher sensitivities (79%-95%) but lower specificities (94%-95%). Co-testing increased sensitivity (84%-99%) but not specificity (92%-95%). Relative sensitivities were similar between crude and adjusted estimates, with greater detection via HPV-based strategies. Specificity of co-testing with LBC relative to HPV stand-alone was near unity (0.99, 95% CI 0.99-1.00) but significantly lower than unity with Pap co-testing. FPR and NNC were greatest under co-testing. Conclusions HPV stand-alone screening in women over 30 years appears appropriate over co-testing as a screening strategy. Key messages Co-testing for cervical cancer does not appear to add any benefit in detection and may introduce unnecessary harms compared to HPV stand-alone screening.
    Type of Medium: Online Resource
    ISSN: 0300-5771 , 1464-3685
    URL: Article
    DOI: 10.1093/ije/dyab168.387
    RVK:
    XF 4100
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 1494592-7
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  • 4
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    Diagnosis and Therapy of Female Urinary Incontinence. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry No. 015/091, January 2022) : Part 2 with Recommendations on Interventional/Surgical Therapy of Overactive Bladder, Surgical Treatment of Stress Urinary Incontinence and Diagnosis and Therapy of Iatrogenic Urogenital Fistula
    Georg Thieme Verlag KG ; 2023
    In:  Geburtshilfe und Frauenheilkunde Vol. 83, No. 04 ( 2023-04), p. 410-436
    Details
    In: Geburtshilfe und Frauenheilkunde, Georg Thieme Verlag KG, Vol. 83, No. 04 ( 2023-04), p. 410-436
    Abstract: Ziel Im Dezember 2021 erschien die völlig überarbeitete interdisziplinäre S2k-Leitlinie für die Diagnostik, Therapie und Nachsorge der Patientinnen mit einer Harninkontinenz (AWMF-Registernummer: 015-091) und fasst erstmals die früheren Leitlinien „Belastungsinkontinenz der Frau“, „Dranginkontinenz der Frau“ und die Leitlinie „Sonographie im Rahmen der urogynäkologischen Diagnostik“ zusammen. Die Koordination erfolgte durch die Deutsche Gesellschaft für Gynäkologie und Geburtshilfe (DGGG) und der Arbeitsgemeinschaft für Urogynäkologie und plastische Beckenbodenrekonstruktion e. V. (AGUB). Methoden Diese S2k-Leitlinie wurde durch einen strukturierten Konsens von repräsentativen Mitgliedern verschiedener Professionen im Auftrag der Leitlinienkommission der DGGG, OEGGG und SGGG entwickelt. Grundlage der vorliegenden Leitlinie ist die aktuelle Leitlinienversion „Urinary Incontinence in Adults“ der European Association of Urologie (EAU), zusätzlich wurden landesspezifische Punkte für das deutsche bzw. das österreichische und das Gesundheitswesen der Schweiz berücksichtigt. Empfehlungen Die Kurzversion dieser Leitlinie beinhaltet Empfehlungen und Statements zur operativen Therapie von Patientinnen mit einer Belastungsharninkontinenz und Dranginkontinenz. Spezifische Lösungsansätze für Diagnostik und Therapie werden für die unkomplizierte und komplizierte Harninkontinenz diskutiert. Ebenso werden Diagnostik und operative Therapie der iatrogen bedingten urogenitalen Fisteln ausgewiesen.
    Type of Medium: Online Resource
    ISSN: 0016-5751 , 1438-8804
    URL: Article
    DOI: 10.1055/a-1967-1888
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2023
    detail.hit.zdb_id: 2026496-3
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  • 5
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    Online Resource
    Association of Intraventricular Fibrinolysis With Clinical Outcomes in Intracerebral Hemorrhage: An Individual Participant Data Meta-Analysis
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Stroke Vol. 53, No. 9 ( 2022-09), p. 2876-2886
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 53, No. 9 ( 2022-09), p. 2876-2886
    Abstract: In patients with intracerebral hemorrhage (ICH), the presence of intraventricular hemorrhage constitutes a promising therapeutic target. Intraventricular fibrinolysis (IVF) reduces mortality, yet impact on functional disability remains unclear. Thus, we aimed to determine the influence of IVF on functional outcomes. Methods: This individual participant data meta-analysis pooled 1501 patients from 2 randomized trials and 7 observational studies enrolled during 2004 to 2015. We compared IVF versus standard of care (including placebo) in patients treated with external ventricular drainage due to acute hydrocephalus caused by ICH with intraventricular hemorrhage. The primary outcome was functional disability evaluated by the modified Rankin Scale (mRS; range: 0–6, lower scores indicating less disability) at 6 months, dichotomized into mRS score: 0 to 3 versus mRS: 4 to 6. Secondary outcomes included ordinal-shift analysis, all-cause mortality, and intracranial adverse events. Confounding and bias were adjusted by random effects and doubly robust models to calculate odds ratios and absolute treatment effects (ATE). Results: Comparing treatment of 596 with IVF to 905 with standard of care resulted in an ATE to achieve the primary outcome of 9.3% (95% CI, 4.4–14.1). IVF treatment showed a significant shift towards improved outcome across the entire range of mRS estimates, common odds ratio, 1.75 (95% CI, 1.39–2.17), reduced mortality, odds ratio, 0.47 (95% CI, 0.35–0.64), without increased adverse events, absolute difference, 1.0% (95% CI, −2.7 to 4.8). Exploratory analyses provided that early IVF treatment (≤48 hours) after symptom onset was associated with an ATE, 15.2% (95% CI, 8.6–21.8) to achieve the primary outcome. Conclusions: As compared to standard of care, the administration of IVF in patients with acute hydrocephalus caused by intracerebral and intraventricular hemorrhage was significantly associated with improved functional outcome at 6 months. The treatment effect was linked to an early time window 〈 48 hours, specifying a target population for future trials.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.121.038455
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 1467823-8
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  • 6
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    Online Resource
    Measurement of the retinal irradiation exposure during diaphanoscopic illumination
    Walter de Gruyter GmbH ; 2020
    In:  Current Directions in Biomedical Engineering Vol. 6, No. 3 ( 2020-09-01), p. 276-279
    Details
    In: Current Directions in Biomedical Engineering, Walter de Gruyter GmbH, Vol. 6, No. 3 ( 2020-09-01), p. 276-279
    Abstract: For the visualisation of the intraocular space it is essential to illuminate the inside of the eye. One illumination approach is diaphanoscopy, in which the light of an extraocular source is transmitted through the tissue layers of the eyewall. The transmission properties of these tissues and their irradiation load depend on applied diaphanoscope contact pressure. However, excessive illumination can lead to irreversible photochemical and thermal damage to the retina. In diaphanoscopic illumination, the retina is particularly at risk due to its proximity to the light source. Therefore, the photochemical and thermal retinal hazards, resulting from direct transmitted light through the eyewall, are determined for different applied pressures of the diaphanoscope on the eye (15, 65 and 115 kPa). The study is performed on porcine eyes with different pigmentation. So, the difference in intraocular irradiance, photochemical and thermal hazards, as well as the maximal exposure time is also examined for different pigmentations. For less pigmented eyes the irradiance inside the eye, the photochemical and the thermal hazard are higher than for higher pigmented eyes. The values also become significantly higher for increasing applied pressure with the diaphanoscope but do not exceed given limits in the standard DIN EN ISO 15004-2: 2014.
    Type of Medium: Online Resource
    ISSN: 2364-5504
    URL: Article
    DOI: 10.1515/cdbme-2020-3070
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2020
    detail.hit.zdb_id: 2835398-5
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  • 7
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    Gene Expression–Based Prediction of Neoadjuvant Chemotherapy Response in Early Breast Cancer: Results of the Prospective Multicenter EXPRESSION Trial
    American Association for Cancer Research (AACR) ; 2021
    In:  Clinical Cancer Research Vol. 27, No. 8 ( 2021-04-15), p. 2148-2158
    Details
    In: Clinical Cancer Research, American Association for Cancer Research (AACR), Vol. 27, No. 8 ( 2021-04-15), p. 2148-2158
    Abstract: Expression-based classifiers to predict pathologic complete response (pCR) after neoadjuvant chemotherapy (NACT) are not routinely used in the clinic. We aimed to build and validate a classifier for pCR after NACT. Patients and Methods: We performed a prospective multicenter study (EXPRESSION) including 114 patients treated with anthracycline/taxane-based NACT. Pretreatment core needle biopsies from 91 patients were used for gene expression analysis and classifier construction, followed by validation in five external cohorts (n = 619). Results: A 20-gene classifier established in the EXPRESSION cohort using a Youden index–based cut-off point predicted pCR in the validation cohorts with an accuracy, AUC, negative predictive value (NPV), positive predictive value, sensitivity, and specificity of 0.811, 0.768, 0.829, 0.587, 0.216, and 0.962, respectively. Alternatively, aiming for a high NPV by defining the cut-off point for classification based on the complete responder with the lowest predicted probability of pCR in the EXPRESSION cohort led to an NPV of 0.960 upon external validation. With this extreme-low cut-off point, a recommendation to not treat with anthracycline/taxane-based NACT would be possible for 121 of 619 unselected patients (19.5%) and 112 of 322 patients with luminal breast cancer (34.8%). The analysis of the molecular subtypes showed that the identification of patients who do not achieve a pCR by the 20-gene classifier was particularly relevant in luminal breast cancer. Conclusions: The novel 20-gene classifier reliably identifies patients who do not achieve a pCR in about one third of luminal breast cancers in both the EXPRESSION and combined validation cohorts.
    Type of Medium: Online Resource
    ISSN: 1078-0432 , 1557-3265
    URL: Article
    DOI: 10.1158/1078-0432.CCR-20-2662
    RVK:
    XA 36791
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2021
    detail.hit.zdb_id: 1225457-5
    detail.hit.zdb_id: 2036787-9
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  • 8
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    Perihemorrhagic edema : Revisiting hematoma volume, location, and surface
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Neurology Vol. 93, No. 12 ( 2019-09-17), p. e1159-e1170
    Details
    In: Neurology, Ovid Technologies (Wolters Kluwer Health), Vol. 93, No. 12 ( 2019-09-17), p. e1159-e1170
    Abstract: To determine the influence of intracerebral hemorrhage (ICH) location and volume and hematoma surface on perihemorrhagic edema evolution. Methods Patients with ICH of the prospective Universitätsklinikum Erlangen Cohort of Patients With Spontaneous Intracerebral Hemorrhage (UKER-ICH) cohort study ( NCT03183167 ) between 2010 and 2013 were analyzed. Hematoma and edema volume during hospital stay were volumetrically assessed, and time course of edema evolution and peak edema correlated to hematoma volume, location, and surface to verify the strength of the parameters on edema evolution. Results Overall, 300 patients with supratentorial ICH were analyzed. Peak edema showed a high correlation with hematoma surface ( R 2 = 0.864, p 〈 0.001) rather than with hematoma volumes, regardless of hematoma location. Smaller hematomas with a higher ratio of hematoma surface to volume showed exponentially higher relative edema ( R 2 = 0.755, p 〈 0.001). Multivariable logistic regression analysis revealed a cutoff ICH volume of 30 mL, beyond which an increase of total mass lesion volume (combined volume of hematoma and edema) was not associated with worse functional outcome. Specifically, peak edema was associated with worse functional outcome in ICH 〈 30 mL (odds ratio [OR] 2.63, 95% confidence interval [CI] 1.68–4.12, p 〈 0.001), contrary to ICH ≥30 mL (OR 1.20, 95% CI 0.88–1.63, p = 0.247). There were no significant differences between patients with lobar and those with deep ICH after adjustment for hematoma volumes. Conclusions Peak perihemorrhagic edema, although influencing mortality, is not associated with worse functional outcomes in ICH volumes 〉 30 mL. Although hematoma volume correlates with peak edema extent, hematoma surface is the major parameter for edema evolution. The effect of edema on functional outcome is therefore more pronounced in smaller and irregularly shaped hematomas, and these patients may particularly benefit from edema-modifying therapies.
    Type of Medium: Online Resource
    ISSN: 0028-3878 , 1526-632X
    URL: Article
    DOI: 10.1212/WNL.0000000000008129
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
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  • 9
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    Increasing the willingness to stay – a novel and comprehensive member satisfaction index (MSI) model tested in a leading German tennis club
    Emerald ; 2022
    In:  The TQM Journal ( 2022-10-06)
    Details
    In: The TQM Journal, Emerald, ( 2022-10-06)
    Abstract: This study aims to address customer focus as an important component of total quality management (TQM) and explore the key drivers of member satisfaction in tennis clubs via a novel theory-based member satisfaction index (MSI) model with high explanatory and predictive power. Furthermore, the study aims to investigate the relationship between satisfaction and behavioral intentions (willingness to stay; WTS) with consideration of the mediating effect of identification with the club. Design/methodology/approach This study uses variance-based partial least squares structural equation modeling (PLS-SEM) to estimate the MSI model, which was tested in a leading tennis club in Germany ( n  = 185). Findings The results reveal that club atmosphere, club facilities and the price/quality ratio of the membership fee are the most important drivers of member satisfaction in tennis clubs. Member satisfaction has a large influence on the WTS of tennis club members. Identification with the club, when included as a mediator in the model, increases the variance explained in WTS considerably. Research limitations/implications The small sample limits the generalizability of findings, and further research is recommended. Practical implications The MSI model is a useful benchmark tool for club managers who want to quantify the satisfaction and WTS of their club members. In addition, because of the integrated formative measurement models, the PLS-SEM results show which indicators can be used to positively impact satisfaction with each of the service quality dimensions, overall member satisfaction and WTS. The most important of these results are discussed in an importance-performance map analysis. Originality/value The MSI model is a multi-attribute index model through which members' evaluations of various dimensions of service and value are derived through multivariable linear function with each dimension weighted according to its importance in one holistic model. The model shows the strong impact of satisfaction on WTS of sports club members and reveals that findings of previous research on the relationship between fan and spectator identification and loyalty are transferable to sports club members. The MSI represents a new contribution to the literature; it was applied here to tennis clubs but is also suitable for application to other sports clubs.
    Type of Medium: Online Resource
    ISSN: 1754-2731
    URL: Article
    DOI: 10.1108/TQM-10-2021-0303
    Language: English
    Publisher: Emerald
    Publication Date: 2022
    detail.hit.zdb_id: 2420151-0
    SSG: 3,2
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  • 10
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    Diagnosis and Therapy of Female Urinary Incontinence. Guideline of the DGGG, OEGGG and SGGG (S2k-Level, AWMF Registry No. 015/091, January 2022) : Part 1 with Recommendations on Diagnostics and Conservative and Medical Treatment
    Georg Thieme Verlag KG ; 2023
    In:  Geburtshilfe und Frauenheilkunde Vol. 83, No. 04 ( 2023-04), p. 377-409
    Details
    In: Geburtshilfe und Frauenheilkunde, Georg Thieme Verlag KG, Vol. 83, No. 04 ( 2023-04), p. 377-409
    Abstract: Ziel Im Dezember 2021 erschien die völlig überarbeitete interdisziplinäre S2k-Leitlinie für die Diagnostik, Therapie und Nachsorge der Patientinnen mit einer Harninkontinenz (AWMF-Registernummer: 015-091) und fasst erstmals die früheren Leitlinien „Belastungsinkontinenz der Frau“, „Dranginkontinenz der Frau“ und die Leitlinie „Sonographie im Rahmen der urogynäkologischen Diagnostik“ zusammen. Die Koordination erfolgte durch die Deutsche Gesellschaft für Gynäkologie und Geburtshilfe (DGGG) und der Arbeitsgemeinschaft für Urogynäkologie und plastische Beckenbodenrekonstruktion e. V. (AGUB). Methoden Diese S2k-Leitlinie wurde durch einen strukturierten Konsens von repräsentativen Mitgliedern verschiedener Professionen im Auftrag der Leitlinienkommission der DGGG, OEGGG und SGGG entwickelt. Grundlage der vorliegenden Leitlinie ist die aktuelle Leitlinienversion „Urinary Incontinence in Adults“ der European Association of Urologie (EAU); zusätzlich wurden landesspezifische Punkte für das deutsche bzw. das österreichische und das Gesundheitswesen der Schweiz berücksichtigt. Empfehlungen Die Kurzversion dieser Leitlinie beinhaltet Empfehlungen und Statements zur Epidemiologie, Ätiologie, Klassifikation, Symptomatik, Diagnostik und Therapie von Patientinnen mit einer Harninkontinenz. Spezifische Lösungsansätze für Diagnostik und konservative und medikamentöse Therapien werden für die unkomplizierte und komplizierte Harninkontinenz diskutiert.
    Type of Medium: Online Resource
    ISSN: 0016-5751 , 1438-8804
    URL: Article
    DOI: 10.1055/a-1967-1726
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2023
    detail.hit.zdb_id: 2026496-3
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