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Berlin, Germany

Buchberger B.,University of Duisburg - Essen | Follmann M.,German Cancer Society | Freyer D.,University of Duisburg - Essen | Huppertz H.,University of Duisburg - Essen | And 2 more authors.
Experimental and Clinical Endocrinology and Diabetes | Year: 2011

Aims: Assessment of the safety, efficacy and effectiveness of growth factors alone or in combination with other technologies in the treatment of DFU including medical, economical, social, ethical and juridical aspects. Methods: We systematically searched relevant data bases limited to English and German language and publications since 1990. Review and assessment of the quality of publications followed methods conforming to widely accepted standards for evidence-based medicine and health economics. Results: We identified 25 studies comparing becaplermin, rhEGF, bFGF and the metabolically active skin grafts Dermagraft and Apligraf with standard wound care (SWC) alone or extracellular wound matrix. Study duration ranged from 12 to 20 weeks and the study population comprised between 17 and 382 patients. Treatment with becaplermin, rhEGF, Dermagraft and Apligraf resulted in a higher incidence of complete wound closure and shorter time to complete wound healing with statistically significant differences. Regarding the proportion of adverse events there was no difference between treatment groups. The methodological quality of the studies was affected by significant deficiencies. Economic evaluations showed becaplermin being cost-effective. Conclusions: Add-on therapy with growth factors and active skin substitutes for treating uncomplicated DFU could be an alternative to SWC alone. For explicit recommendations further studies with stronger evidence are necessary. © Georg Thieme Verlag KG Stuttgart • New York. Source


Singer S.,University of Mainz | Singer S.,University of Leipzig | Dieng S.,OnkoZert | Wesselmann S.,German Cancer Society
Psycho-Oncology | Year: 2013

Background Over the last few years, a nationwide voluntary certification system for cancer centres has been established in Germany. To qualify for certification, cancer centres must provide psycho-oncological care to every patient who needs it. The aim of this study was to find out how many patients have been treated by a psycho-oncologist in the certified centres. Methods All cancer centres in Germany that were re-certified in 2010 provided data documenting how many patients with primary cancer received at least 30 min of psycho-oncological consultation in 2009. Results Data from n = 456 certified cancer centres were available. In the centres, a total of 36 165 patients were seen by a psycho-oncologist for at least 30 min, representing 37.3% of all patients in the centres. The highest percentage of patients who received psycho-oncological care was found in breast cancer centres (66.7%), and the lowest in prostate cancer centres (6.8%). Half of the patients (50.0%) in gynaecological cancer centres, 37.7% in colon cancer centres and 25.4% in lung cancer centres received psycho-oncological care. Conclusions Compared with non-certified centres, the proportion of patients receiving psycho-oncological care in certified cancer centres has increased. Copyright © 2012 John Wiley & Sons, Ltd. Source


Munstedt K.,Justus Liebig University | Maisch M.,Justus Liebig University | Tinneberg H.R.,Justus Liebig University | Hubner J.,German Cancer Society
Archives of Gynecology and Obstetrics | Year: 2014

Purpose: Whereas we have some information on complementary medicine in the field of oncology, little is known about complementary medicine in the field of obstetrics and gynaecology especially outside of hospitals.Methods: All office-based obstetricians and gynaecologists in the state of Hesse, Germany, were contacted and asked to fill in an assessment form regarding cooperation in the field of complementary and alternative medicine (CAM), as well as the perceived efficacy of various CAM methods for a number of pathological conditions in the field of obstetrics and gynaecology.Results: It was found that more than half of Hessian office-based obstetricians and gynaecologists had existing cooperation regarding CAM, especially with colleagues, but also midwives, pharmacists, physiotherapists, and health practitioners. The probability of cooperation was significantly inversely associated with age. It was found that the probability for advising CAM differed between various health problems. The following CAM methods were considered reasonable for the treatment of different conditions: phytotherapy for climacteric complaints and premenstrual syndrome; homoeopathy for puerperal problems; acupuncture and traditional Chinese medicine for complaints during pregnancy; and dietary supplements for the side effects of cancer therapy.Conclusions: The analysis shows that there is much cooperation in the field of CAM. Comparison between physicians’ perceived efficacy of CAM methods and objective findings shows that there is a need for the provision of valid information in the field. © 2014, Springer-Verlag Berlin Heidelberg. Source


Munstedt K.,Justus Liebig University | Vogt T.,Justus Liebig University | Hubner J.,German Cancer Society
Breast Care | Year: 2014

Background: Today there is an agreement on how patients should be counseled regarding integrative medicine in oncology. In order to better meet the patients' demands, we investigated additional beliefs and wishes related to these topics. Patients and Methods: Patients in 2 locations were asked to complete an assessment form regarding their wishes in relation to counseling on integrative medicine. Results: Based on 404 returned assessment forms, we found that most patients wished to be counseled on integrative medicine by oncologists but also wanted to be treated by them with such methods. Oncologists received the best ratings regarding credibility, oncological competence, sympathy for patients, and honesty. Only with regard to time for patients did health practitioners receive better ratings. Physical exercise, balanced diets, and psycho-oncological support were the methods mainly recommended by physicians. Health practitioners mainly recommended taking mistletoe extracts, trace elements, and immunostimulants. Conclusion: It may be hypothesized from this work that the physicians' leading role in promoting integrative medicine in the field of oncology - which contrasts with findings in other countries - is perhaps based on the patients' desire to be treated and counseled by physicians, especially oncologists. © 2014 S. Karger GmbH, Freiburg. Source


Schmidt A.,University of Cologne | Ernstmann N.,University of Cologne | Wesselmann S.,German Cancer Society | Pfaff H.,University of Cologne | And 2 more authors.
Supportive Care in Cancer | Year: 2016

Purpose: After a short hospital stay of just some days follows long-term outpatient care for breast cancer patients. The aim of the study is to describe the information needs of breast cancer outpatients and to get in touch with aspects of health literacy, as well as contact various health care workers. Methods: In a multicenter study, patients were asked about their information needs 10 weeks after surgery. The analysis on hand includes data about 1248 female patients. In addition to descriptive analyses identifying the most prevalent information needs, logistic regression analyses were calculated to identify factors associated with these. Results: The results show that information needs of breast cancer outpatients are mainly in “follow-up after acute treatment”, “coping with long-term side effects”, and “heredity of breast cancer”. In addition to sociodemographic patient characteristics, perceived helpful contacts with various health care workers as well as a satisfactory patient’s level of health literacy reduced the probability of unmet information needs. Conclusions: Breast cancer outpatients have numerous information needs. In addition to provide information at the right time regarding a specific disease phase, it is important that health professionals’ support affected breast cancer patients in coping with the new situation. © 2015, Springer-Verlag Berlin Heidelberg. Source

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