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  • 1
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 49, No. 3 ( 2020), p. 253-261
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Severe leukoaraiosis (LA) is an established risk factor for poor outcome after mechanical thrombectomy (MT) for large vessel occlusion stroke. There is uncertainty whether this association also applies to successfully recanalized patients with M1 segment middle cerebral artery (MCA) occlusions. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 A retrospective single-centre study of patients with successful reperfusion (thrombolysis in cerebral infarction, TICI 2b or 3) after MT for an M1 MCA occlusion was performed over a 7-year period. LA score (LAS) was assessed using the age-related white matter change scale on pre-interventional brain imaging. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 A total of 209 patients (median age 75.0 years) were included. LAS was assessed on pre-interventional imaging by computed tomography in 177 (84.7%) patients and magnetic resonance imaging in 32 (15.3%) patients. The median LAS was 1 (IQR 0–8), and severe LA consisted of the top 25 percentile, ranging from 9 to 24. Multivariable analysis demonstrated an association of severe LA (OR 0.32, 95% CI 0.12–0.88, 〈 i 〉 p 〈 /i 〉 = 0.023), higher NIHSS on admission (OR 0.89, 95% CI 0.84–0.94, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001), advanced age (OR 0.97, 95% CI 0.95–1.00, 〈 i 〉 p 〈 /i 〉 = 0.039), good leptomeningeal collaterals (OR 3.65, 95% CI 1.46–8.15, 〈 i 〉 p 〈 /i 〉 = 0.001), and TICI 3 score (OR 3.26, 95% CI 10.52–7.01) with good clinical outcome after 3 months as measured with the modified Rankin scale. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Severe LA is associated with poor clinical outcome at 3 months in acute stroke patients undergoing MT due to emergent M1 MCA occlusion.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2020
    detail.hit.zdb_id: 1482069-9
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  • 2
    In: Psychopathology, S. Karger AG, Vol. 54, No. 2 ( 2021), p. 92-97
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 A disturbed sense of self is frequently discussed as an etiological factor for delusion symptoms in psychosis. Phenomenological approaches to psychopathology posit that lacking the sense that the self is localized within one’s bodily boundaries (disembodiment) is one of the core features of the disturbed self in psychosis. The present study examines this idea by experimentally manipulating the sense of bodily boundaries. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Seventy-three patients with psychosis were randomly assigned to either a 10-min, guided self-massage in the experimental group (EG) to enhance the sense of bodily boundaries or a control group (CG), which massaged a fabric ring. Effects on an implicit measure (jumping to conclusion bias; JTC) and an explicit measure (Brief State Paranoia Checklist; BSPC) of delusion processes were assessed. The JTC measures the tendency to make a decision with little evidence available, and the BSPC explicitly measures the approval of paranoid beliefs. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Patients in the EG showed a lower JTC ( 〈 i 〉 M 〈 /i 〉 = 4.11 draws before decision) than the CG ( 〈 i 〉 M 〈 /i 〉 = 2.43; Cohen’s 〈 i 〉 d 〈 /i 〉 = 0.64). No significant difference in the BSPC was observed. 〈 b 〉 〈 i 〉 Discussion/Conclusion: 〈 /i 〉 〈 /b 〉 Our results indicate that enhancing the sense of body boundaries through a self-massage can reduce an implicit bias associated with delusional ideation and correspondingly support the idea that disembodiment might be a relevant factor in the formation of psychotic symptoms.
    Type of Medium: Online Resource
    ISSN: 0254-4962 , 1423-033X
    RVK:
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2021
    detail.hit.zdb_id: 1483565-4
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  • 3
    In: Psychopathology, S. Karger AG, Vol. 54, No. 3 ( 2021), p. 150-158
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Research on body aspects in depression primarily focuses on somatic complaints, while phenomenologists emphasize the pre-reflective bodily experience of depression as relevant for the psychopathology of it. Despite this increasing acknowledgement of the subjective body’s impact on depression, empirically, it remains rarely studied. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Relying on the psychotherapy method of 〈 i 〉 Focusing 〈 /i 〉 (Gendlin, 1982), interviews were developed, which enable participants with depression to get in contact with pre-reflective bodily experiences through turning inward, attentively observing all bodily feelings that arise, and finding symbolizations for these feelings. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 In 501 codings of the conducted interviews, the theme of passivity emerged on a continuum ranging from inhibition of drive to lack of drive. It can be split into 5 components (heaviness, emptiness, paralysis, blockage, and alienation), which were felt in the head or the whole body. Moreover, participants reported active, pressuring feelings in the chest and stomach areas, which were associated with specific emotions in some participants. 〈 b 〉 〈 i 〉 Discussion: 〈 /i 〉 〈 /b 〉 In conclusion, through focusing, participants were able to take note of their pre-reflective bodily feelings and described feelings of passivity, active, pressuring feelings, and an ambivalence between these two parts. Results support the notion that depression is associated with specific pre-reflective bodily experiences and lay a foundation for future research.
    Type of Medium: Online Resource
    ISSN: 0254-4962 , 1423-033X
    RVK:
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2021
    detail.hit.zdb_id: 1483565-4
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  • 4
    In: Breast Care, S. Karger AG, Vol. 15, No. 1 ( 2020), p. 82-95
    Abstract: The 5th International Consensus Conference for Advanced Breast Cancer (ABC5) took place on November 14–16, 2019, in Lisbon, Portugal. Its aim is to standardize the treatment of advanced breast cancer based on the available evidence and to ensure that all breast cancer patients worldwide receive adequate treatment and access to new therapies. This year, the conference focused on developments and study results in the treatment of patients with hormone receptor-positive/HER2-negative breast cancer as well as precision medicine. As in previous years, patient advocates from around the world were integrated into the ABC conference and had seats on the ABC consensus panel. In the present paper, a working group of German breast cancer experts comments on the results of the on-site ABC5 consensus votes by ABC panelists regarding their applicability for routine treatment in Germany. These comments take the recommendations of the Breast Committee of the Gynecological Oncology Working Group ( 〈 i 〉 Arbeitsgemeinschaft Gynäkologische Onkologie 〈 /i 〉 ; AGO) into account. The report and assessment presented here pertain to the preliminary results of the ABC5 consensus. The final version of the statements will be published in 〈 i 〉 Annals of Oncology 〈 /i 〉 and 〈 i 〉 The Breast 〈 /i 〉 .
    Type of Medium: Online Resource
    ISSN: 1661-3791 , 1661-3805
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2020
    detail.hit.zdb_id: 2205941-6
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  • 5
    In: Breast Care, S. Karger AG, Vol. 13, No. 1 ( 2018), p. 48-58
    Abstract: The Advanced Breast Cancer Fourth Consensus (ABC4) on diagnosis and treatment of advanced breast cancer (ABC) again took place in Lisbon, on November 2-4, 2017, and was chaired by Fatima Cardoso, MD, PhD. This year's contents focused very much on new developments in the treatment of ABC. For example, the significance of inhibition of cyclin-dependent kinases 4 and 6 (CDK4/6) in hormone receptor (HR)-positive ABC, of dual antibody blockade in human epidermal growth factor receptor 2 (HER2)-positive ABC, and of poly(ADP-ribose) polymerase (PARP) inhibition in triple-negative ABC, as well as the potential therapeutic consequences, were discussed. Other key issues were 〈 i 〉 BRCA 〈 /i 〉 -associated breast cancer, treatment of brain metastases, and personalized therapy decision-making using molecular testing (so-called ‘precision medicine'). As in past years, an important objective of the ABC conference was cooperation with representatives of patient organizations from around the world. This cooperation was further intensified during the ABC4. Following the main conference, the ‘Global Alliance' was founded, with the goal of publicizing and coordinating measures necessary worldwide from the patient advocates' standpoint. - The ABC consensus inevitably cannot accommodate country-specific needs, due to the truly global expert panel. Therefore, a working group of German breast cancer experts commented - as in the past years - on the on-site voting results by the ABC panelists upon which the final ABC4 consensus will be based, with particular consideration of the German guidelines on diagnosis and treatment of breast cancer for everyday treatment in Germany.
    Type of Medium: Online Resource
    ISSN: 1661-3791 , 1661-3805
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2018
    detail.hit.zdb_id: 2205941-6
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  • 6
    Online Resource
    Online Resource
    S. Karger AG ; 2016
    In:  Complementary Medicine Research Vol. 23, No. 2 ( 2016), p. 117-122
    In: Complementary Medicine Research, S. Karger AG, Vol. 23, No. 2 ( 2016), p. 117-122
    Abstract: Mit der Konzeption der «Evidenzbasierten Medizin» und den «Evidenzbasierten Leitlinien» soll mithilfe von Formalisierungsprozeduren die ärztliche Irrtumsanfälligkeit kalkulierbar gemacht werden. Quantifizierte objektive Aussagen über die therapeutische Wirksamkeit einer Behandlung sollen die individuelle ärztliche Beurteilung der therapeutischen Wirksamkeit überflüssig machen. Damit kommt der Befolgung von formalen Regeln die entscheidende Rolle bei der Beantwortung der Frage nach dem Wahrheitsgehalt und dem Wirklichkeitsbezug zu. Im Rahmen evidenzbasierter Leitlinien werden vorrangig die Ergebnisse randomisierter kontrollierter Studien (RCT) oder Meta-Analysen solcher Studien herangezogen. Am Beispiel der S3-Leitlinie «Malignes Melanom» wird hier eine evidenzbasierte Urteilsbildung zur Wirksamkeit einer unkonventionellen Therapie - hier mit einem Mistelpräparat - analytisch nachvollzogen. Die für die Beurteilung dieser unkonventionellen Therapie herangezogene randomisierte Studie wird genauer methodisch analysiert. Obwohl sie keine statistisch basierte Aussage zulässt, wurde eine Leitlinienempfehlung auf Basis dieser Studie abgeleitet. Es wird gezeigt, dass 1) allein die Existenz einer einzigen RCT mit hoher Evidenz gleichgesetzt wird, 2) die Ergebnisse trotz beträchtlicher Fehlinterpretationen in eine S3-Leitlinie einfließen und 3) Meinungen anstelle kritischer wissenschaftlicher Analysen verarbeitet werden. Unsere Untersuchung zeigt, dass noch so ausgefeilte epistemologische und methodologische Formalien den Arzt nicht von der Pflicht entbinden, auf Basis seiner ärztlichen Erfahrung und professionellen Kompetenz den Realitätswert der ihm zur Verfügung stehenden Information zu beurteilen.
    Type of Medium: Online Resource
    ISSN: 2504-2092 , 2504-2106
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2016
    detail.hit.zdb_id: 2888724-4
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  • 7
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 30, No. 4 ( 2010), p. 423-431
    Abstract: 〈 i 〉 Background: 〈 /i 〉 Aneurysmal subarachnoid haemorrhage (SAH) is a devastating disease with high mortality and disability. The data from large longitudinal studies on health-related quality of life (HRQoL) in patients with SAH are limited. The objective was to investigate HRQoL in patients after SAH and to identify predictors of HRQoL. 〈 i 〉 Methods: 〈 /i 〉 113 patients with aneurysmal SAH were assigned to either neurosurgery (n = 57) or endovascular coiling (n = 56). Clinical assessments (Barthel Index, modified Rankin Scale) and evaluation of HRQoL [36-Item Short-Form Survey, EuroQol (EQ5D), EQ visual analogue scale (EQ VAS)] were performed at discharge, and at 6 and 12 months of follow-up. Independent predictors of HRQoL were determined using multiple regression analysis. 〈 i 〉 Results: 〈 /i 〉 HRQoL in SAH patients was considerably reduced compared to the normal population. At discharge, 92.2% of the patients had moderate or severe problems on the EQ5D. The EQ VAS score was 57.8 ± 19.3. However, HRQoL still showed improvement from 3 months up to 1 year. At 12 months after SAH, the EQ VAS score was approximately 12–14% higher than at discharge. The independent predictors of decreased HRQoL included female gender, severe SAH, functional disability, depression, a lower level of education and the lack of a stable partnership. 〈 i 〉 Conclusions: 〈 /i 〉 The long-term HRQoL outcome after SAH is unfavourable. HRQoL outcome measures should be included in future studies to provide better evidence of the long-term outcomes after SAH. In addition, the independent determinants of HRQoL identified in this study should be considered in the healthcare programmes aimed at increasing the HRQoL in SAH survivors.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2010
    detail.hit.zdb_id: 1482069-9
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  • 8
    Online Resource
    Online Resource
    S. Karger AG ; 2000
    In:  Cellular Physiology and Biochemistry Vol. 10, No. 4 ( 2000), p. 219-228
    In: Cellular Physiology and Biochemistry, S. Karger AG, Vol. 10, No. 4 ( 2000), p. 219-228
    Type of Medium: Online Resource
    ISSN: 1015-8987 , 1421-9778
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2000
    detail.hit.zdb_id: 1482056-0
    SSG: 12
    SSG: 15,3
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  • 9
    In: Human Heredity, S. Karger AG, Vol. 56, No. 1-3 ( 2003), p. 56-62
    Abstract: 〈 i 〉 Objectives: 〈 /i 〉 The use of conventional Transmission/Disequilibrium tests in the analysis of candidate-gene association studies requires the precise and complete pre-specification of the total number of trios to be sampled to obtain sufficient power at a certain significance level (type I error risk). In most of these studies, very little information about the genetic effect size will be available beforehand and thus it will be difficult to calculate a reasonable sample size. One would therefore wish to reassess the sample size during the course of a study. 〈 i 〉 Method: 〈 /i 〉 We propose an adaptive group sequential procedure which allows for both early stopping of the study with rejection of the null hypothesis (H & #8320;) and for recalculation of the sample size based on interim effect size estimates when H & #8320; cannot be rejected. The applicability of the method which was developed by Müller and Schäfer [Biometrics 2001;57:886–891] in a clinical context is demonstrated by a numerical example. Monte Carlo simulations are performed comparing the adaptive procedure with a fixed sample and a conventional group sequential design. 〈 i 〉 Results: 〈 /i 〉 The main advantage of the adaptive procedure is its flexibility to allow for design changes in order to achieve a stabilized power characteristic while controlling the overall type I error and using the information already collected. 〈 i 〉 Conclusions: 〈 /i 〉 Given these advantages, the procedure is a promising alternative to traditional designs.
    Type of Medium: Online Resource
    ISSN: 0001-5652 , 1423-0062
    RVK:
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2003
    detail.hit.zdb_id: 1482710-4
    SSG: 12
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  • 10
    Online Resource
    Online Resource
    S. Karger AG ; 1969
    In:  Cells Tissues Organs Vol. 74, No. 1 ( 1969), p. 44-53
    In: Cells Tissues Organs, S. Karger AG, Vol. 74, No. 1 ( 1969), p. 44-53
    Type of Medium: Online Resource
    ISSN: 1422-6405 , 1422-6421
    Language: English
    Publisher: S. Karger AG
    Publication Date: 1969
    detail.hit.zdb_id: 1481840-1
    SSG: 12
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