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Traben-Trarbach, Germany

Saghravanian N.,Mashhad University of Medical Sciences | Ghazi N.,Mashhad University of Medical Sciences | Saba M.,Private Office
Annals of Diagnostic Pathology | Year: 2013

We present a 38-year retrospective study of 165 patients with salivary gland tumors that were diagnosed from 1971 to 2009 in the Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Mashhad, Iran. The histologic diagnoses were reevaluated according to the 2005 World Health Organization classification. A total of 165 tumors were identified in 79 male and 86 female patients. The mean age was 43.41 ± 18.59 for male patients and 40.06 ± 15.91 for female patients. Although benign salivary gland tumors are usually more common than the malignant counterpart in previous studies, neoplasms showed an almost equal frequency of benign and malignant tumors in the present study. The frequency of major salivary gland tumors was 15.8%, and that of minor salivary gland tumors was 83%. The mean age of patients with major salivary gland tumors (44.30 years) was slightly higher than patients with minor ones (41.15 years). Pleomorphic adenoma was the most common histologic type of benign tumor identified, whereas mucoepidermoid was the most common malignant tumor. In contrast to some previous studies that have been reported parotid gland as the most common site for salivary tumors, in the current study, the palate was the most frequent location for salivary gland tumors and tumors have a propensity to occur at the palate than any other sites. Therefore, any lesion arising from the palate should be considered as a possible salivary gland tumor. © 2013 Elsevier Inc. Source


Hommer A.,Private Office | Hubatsch D.A.,Alcon Laboratories,Inc | Cano-Parra J.,Hospital Municipal de Badalona
Journal of Ophthalmology | Year: 2015

Purpose. To evaluate the safety and efficacy of adding brinzolamide 1%/timolol maleate 0.5% fixed combination (BTFC) to a prostaglandin analog (PGA). Methods. This was a 12-week, open-label, single-arm study of patients with open-angle glaucoma or ocular hypertension with intraocular pressure (IOP) not sufficiently controlled after ≥4 weeks of PGA monotherapy. The primary outcome was mean IOP change from baseline at week 12. Other outcomes included IOP change from baseline at week 4, percentage of patients achieving IOP ≤18 mmHg at week 12, and patient experience survey responses at week 12. Results. Forty-seven patients were enrolled and received treatment. The most commonly used PGAs were latanoprost (47%) and travoprost (32%). Mean ± SD IOP was decreased at week 12 (17.2 ± 4.1 mmHg) compared with baseline (23.1 ± 3.0 mmHg; P<0.001, paired t-test); IOP at week 4 was 17.2 ± 3.3 mmHg. At week 12, 70% of patients achieved IOP ≤18 mmHg. Patient-reported symptoms (e.g., pain and redness) were mostly unchanged from baseline. Twenty-eight adverse events (AEs) were reported; the most frequently reported AE was headache (3 events in 2 patients). Conclusion. Adjunctive BTFC + PGA therapy was effective and well tolerated. IOP decreased by 6 mmHg at weeks 4 and 12. © 2015 Anton Hommer et al. Source


Salhofer-Polanyi S.,Medical University of Vienna | Baumgartner A.,Medical University of Vienna | Kraus J.,Paracelsus Medical University | Maida E.,Private Office | And 2 more authors.
Acta Neurologica Scandinavica | Year: 2014

Background: To minimize the risk of progressive multifocal leucoencephalopathy (PML), treatment with natalizumab is often stopped after 2 years, but evidence upon rebound of disease activity is limited and controversial. Objective: To evaluate effects of natalizumab discontinuation on clinical disease activity within twelve months after cessation. Methods: We retrospectively analyzed data of 201 patients with MS who discontinued natalizumab between 2007 and 2012. Mean change scores of annualized relapse rate (ARR) and expanded disability status scale (EDSS) were calculated for detection of rebound disease activity after twelve months. Results: Natalizumab exposure did not exceed 2 years in 50.2% of patients, and the most common reasons for discontinuation were a long treatment period and concern of PML (56%). A total of 11.9% experienced a rebound phenomenon within twelve months. Mean ARR prenatalizumab was lower (P = 0.001, 95% CI -1.0-0.000) and treatment response to natalizumab poorer (P < 0.001, 95% CI 0.4-1.3) in patients with rebound compared to those without, but rebound was not associated with brief exposure to natalizumab (P = 0.159, 95% CI -9.3-1.5). 86.1% of patients switched to another therapy. Patients without rebound were found more often in the group starting an alternative treatment early (P = 0.013). Conclusion: Our data suggest that rebound of MS disease activity affects a subgroup of patients (11.9%), especially those with low disease activity before natalizumab therapy and a longer treatment gap after its withdrawal. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. Source


Audebert A.,Private Office
Journal of Endometriosis and Pelvic Pain Disorders | Year: 2014

Endometriosis may affect adolescent girls. The scientific literature on endometriosis in adolescents is limited, and many aspects are still uncertain despite a growing number of related reports. The prevalence of endometriosis in adolescents is unknown, but in selected groups of patients undergoing laparoscopy, it has been found to be higher than 50%. The physiopathology of adolescent endometriosis has not been specifically shown. However, the presence of a family history and associated genital malformations are more frequently identified in adolescents with endometriosis. The clinical presentation of the disease in adolescents has been assessed by numerous prospective and retrospective studies, and the risk factors for the development of endometriosis are well-known. The recommended diagnostic strategy is actually well-characterized, even if an early diagnosis is hardly ever made. The therapeutic management is also more consensual, but not definitive because of a lack of prospective studies evaluating either short- or long-term results and the impact on the natural history of the disease. Finally, the long-term sequelae are still a burden, and many questions are unanswered, despite new insights provided by a few recent reports evaluating the progression of the disease and its effects on subsequent fertility. Further studies are needed to better assess these issues. © 2014 Wichtig Publishing. Source


Leeners B.,University of Zurich | Gorres G.,Support Center Frauennotruf | Block E.,Private Office | Hengartner M.P.,University of Zurich
Journal of Psychosomatic Research | Year: 2016

Objective: Although childhood sexual abuse (CSA) may seriously impair childbirth experiences, few systematic evaluations on associations, mediating influences, risk and protective factors are available. As such information is mandatory to improve obstetric care, the present study aimed to provide such data. Methods: The study compared childbirth experiences from 85 women after CSA and at least one pregnancy resulting in a life birth with those from 170 control women matched for nationality, personal age and children's age. Trained specialists from support centers investigated CSA. Obstetrical data were collected from the official personal clinical record of each pregnancy (Mutterpass) and data on CSA as well as childbirth experiences were examined by questionnaires. Results: Childbirth was more often highly frightening (24.7 vs. 5.3%; p < 0.01) and a negative experience (40.7 vs. 19.6%, p < 0.01) in women with a history of CSA than in controls. Multivariate regression models support the hypothesis that at least part of this association was mediated by covariates (specifically, birth preparation classes, presence of a trusted person, participation in medical decision-making, pain relief, emergency during labor and extreme duration of labor), which represent important resources in improving obstetric care. In 41% of women with CSA, memories of traumatic experiences intruded during childbirth, whereas about 58% experienced dissociation. While dissociation may result in loss of contact with obstetric staff, it was also used to reduce labor pain. Conclusion: Childbirth following a history of CSA is associated with particular challenges. Creating a trusting environment by evaluating and integrating individual needs could ameliorate birth experiences. © 2016 Published by Elsevier Inc. Source

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