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Mannheim, Germany

Schneider S.W.,Universitatsklinikum Mannheim
Aktuelle Dermatologie | Year: 2012

It is well known that patients suffering from cancer hold a high risk of thrombosis and that teammates of the coagulation system have a high impact on tumor spreading. Therefore, tumor related thrombotic events dramatically downgrade overall survival of those patients, whereas, an anticoagulatory therapy, i.e. with low molecular heparin, attenuates tumor progression and prolongs overall survival. In this context tumor-endothelial cell interaction plays a pivotal role as tumor-induced endothelial cell activation leads to prothrombotic conditions. However, the mechanism of this interplay is not well known and will be the topic in this study. © Georg Thieme Verlag KG Stuttgart.


Schmidt H.,Westpfalz Klinikum | Hormann K.,Universitatsklinikum Mannheim | Stasche N.,Westpfalz Klinikum
Laryngo- Rhino- Otologie | Year: 2010

Tracheobronchoscopy allows endoscopic inspection and management of the tracheobronchial system. Material: The recommendation was developed in 1997 and updated in 2004 and 2009. Results: The recommendations comment on indications and contra-indications, instruments, anesthesia and complications of endoscopic tracheobronchoscopy. Discusssion: Rapid technical advances in endoscopy have led to changes in indications for different procedures, especially as pertains to rigid and flexible endoscopy. The recommendations are designed to provide guidance for ENT and affiliated specialties for choosing and processing instruments and sedation methods. © Georg Thieme Verlag KG Stuttgart - New York.


Abstract This contribution aims at tracing the development of statistical methods in medical science from the beginning in the 18 th century to modern applications in medical research. First it is outlined how conventional medical practice changed continuously during centuries in relation to the development of statistical sciences. Based on historical examples it is shown how statistical methodology contributed in overcome dogmatic thinking and to verify causal relations. Nowadays, there is a widespread consensus that medical research and its practical application is hardly possible without profound knowledge of statistical methods. The scope and risks related with an uncritical usage of statistical methods are discussed. © Georg Thieme Verlag KG Stuttgart . New York.


Hormann K.,Universitatsklinikum Mannheim | Verse T.,Asklepios Klinik Harburg
Surgery for Sleep Disordered Breathing | Year: 2010

The treatment of sleep disordered breathing has been enriched by the development of various new and largely surgical techniques. The question of which treatment best suits each individual patient has become a highly sophisticated decision. Among others, the most important factors for selecting the most appropriate treatment modality are the cruelty of the disease, the pathology found within the upper airway, and the sites of obstruction. Therefore, the second edition of this book focuses on both the surgical treatment modalities and the current concepts for treatment decisions. For each procedure, current data (including data for the entirety of 2007) were reanalyzed according to the principles of evidence-based medicine, and are presented in well-arranged tables. Indications, techniques, complications, and specific follow-up treatments in the realm of sleep medicine have been compiled in the form of a primer. New chapters concerning radiofrequency- uvulopalatoplasty and combined soft palate procedures were added. Both authors run prominent otolaryngological sleep laboratories, and perform approximately 1,500 surgical sleep medicine procedures per year. The complete surgical and sleep medicine expertise of the authors, as well as the experience of numerous international courses on sleep surgery, have been incorporated into this volume, making it an indispensable textbook for sleep medicine surgeons. © Springer-Verlag Berlin Heidelberg 2010. All rights are reserved.


Wesselmann S.,Deutsche Krebsgesellschaft e.V. | Winter A.,Deutsche Krebsgesellschaft e.V. | Ferencz J.,OnkoZert GmbH | Seufferlein T.,Universitatsklinikum Ulm | Post S.,Universitatsklinikum Mannheim
International Journal of Colorectal Disease | Year: 2014

Purpose: In order to improve the quality of treatment for cancer patients the German Cancer Society (Deutsche Krebsgesellschaft) implemented a certification system for oncological care institutions. The certified colorectal cancer centers present the structures, processes and results of their network in the framework of an auditing procedure. Methods: The current benchmarking report by the certified centers reflects the centers' reference results over a period of 3 years. The figures included in the benchmarking report reflect the areas of interdisciplinary collaboration, guideline-compliant treatment, and expertise of the main treatment partners. Results: High percentages were shown for indicators reflecting pretreatment and postoperative case presentations in multidisciplinary team meetings (91.8 % or 98.1 %), psycho-oncologic care (54.8 %) as well as social service counseling (77.1 %). Good quality of the TME rectal specimen and adequate lymph-node retrieval (12 lymph nodes at least) was achieved by 93 % or 96.6 % of the centers. Adjuvant chemotherapy (colon, Union for International Cancer Control [UICC] stage III) or neoadjuvant radiotherapy or chemoradiotherapy (rectum, UICC stages II and III) received 73.7 % or 80 % of relevant patients. Quotas of anastomotic leakage in the colon or rectum were 4.4 % or 7.6 %, whereas postoperative mortality amounted to 2.6 %. Conclusions: The present analysis of the results, together with the centers' statements and the auditors' reports, shows that most of the targets for indicator figures are being better met over the course of time. In addition, however, there is a clear potential for improvement and the centers are verifiably addressing this. A transparent presentation of the quality of care and reflection on and discussion of the results among the treatment partners in the certified network and with the auditors during the certification process may contribute to constant quality improvement in oncological care. © 2014 Springer-Verlag Berlin Heidelberg.

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