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Schweikardt, Christoph. "The Introduction of Deaconess Nurses at the German Hospital of the City of Philadelphia in the 1880s." Nursing History Review 18, no. 1 (January 2010): 29–50. http://dx.doi.org/10.1891/1062-8061.18.29.
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In 1884, seven deaconesses from Iserlohn, Germany, came to the Philadelphia German Hospital to take over nursing care and hospital administration. This article deals with the preparation and implementation of deaconess rule at the German Hospital and conflicts during the tenure of the first two Sisters Superior, Marie Krueger (1826–1887) and Wanda von Oertzen (1845–1897). Recruitment of the deaconesses took place within a network of relations between German and American motherhouses. Before their arrival in Philadelphia, the benefactor of the German Hospital, John D. Lankenau (1817–1901), had committed himself to hospital rule by the Sister Superior. A Deaconess Committee was created to deal with the opposition of the Medical Board. Introducing deaconesses to the Philadelphia German Hospital led to a major change of medical personnel and allowed the hospital to develop a new corporate identity.
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RANDHAWA, EKAMJEET, and MICHAEL STEPHEN. "EPIDEMIOLOGY OF NONTUBERCULOUS MYCOBACTERIUM FROM AN INNER-CITY PHILADELPHIA HOSPITAL IN PATIENTS WITH HIV." Chest 154, no. 4 (October 2018): 139A. http://dx.doi.org/10.1016/j.chest.2018.08.120.
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RANDHAWA, EKAMJEET, JANPREET MOKHA, and MICHAEL STEPHEN. "EPIDEMIOLOGY OF NONTUBERCULOUS MYCOBACTERIUM FROM AN INNER-CITY PHILADELPHIA HOSPITAL IN PATIENTS WITHOUT HIV." Chest 154, no. 4 (October 2018): 140A. http://dx.doi.org/10.1016/j.chest.2018.08.121.
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Ditmar, Mark F. "Requiem for a Hospital." Pediatrics 88, no. 2 (August 1, 1991): 286–89. http://dx.doi.org/10.1542/peds.88.2.286.
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The splendor falls on castle walls And snowy summits old in story: The long light shakes across the lakes, And the wild cataract leaps in glory. Blow, bugle, blow, set the wild echoes flying, Blow, bugle; answer, echoes, dying, dying, dying. —from The Splendor Falls by Alfred, Lord Tennyson This is the story of the closure of a hospital and with it a part of American pediatric history. Children's Seashore House of Atlantic City is the nation's fourth oldest pediatric hospital. After 118 years, it will close in the summer of 1990 and move to a new facility in Philadelphia. The simple brick, layer-cake structure looks very tired now, its iconic soul having been steadily removed for incorporation into the new hospital. The cornerstone animals, lions and bighorn, have been chiseled free and now guard a new outpost. So too have the plaques from the turn of the century, optimistically commemorating the establishment of endowed beds, wards, and cottages "for perpetual use" with their benefactors of simplicity and gentleness by name, such as the "Endowed Bed of St James Sunday School, 1889" and "Endowed by the Everyday Kindness Society, 1912." On this day, the workers hammer to remove the final link—an enormous marble tablet from 1919 eulogizing Dr William Bennett, the principal driving force of Children's Seashore House and also the founder of St Christopher's Hospital in Philadelphia. A mere 50 yards away, the Atlantic Ocean beats inexorably as it did at the founding in 1872, 2 years after the first planks were laid for the famous boardwalk.
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Delov, E. "The results of the examination of German and some French institutions for the mentally ill." Neurology Bulletin VIII, no. 2 (December 24, 2020): 1–75. http://dx.doi.org/10.17816/nb52841.
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The hospital for the mentally ill in Ene, which is also the clinic of Ene University, does not represent anything special. It is located in the most elevated part of the city according to Ober philosopher Weg, from where an excellent walk opens both to the city itself and to the surrounding, picturesquely spread mountains.
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Cunningham, Shayna D., Valerie Riis, Laura Line, Melissa Patti, Melissa Bucher, Celeste Durnwald, and Sindhu K. Srinivas. "Safe Start Community Health Worker Program: A Multisector Partnership to Improve Perinatal Outcomes Among Low-Income Pregnant Women With Chronic Health Conditions." American Journal of Public Health 110, no. 6 (June 2020): 836–39. http://dx.doi.org/10.2105/ajph.2020.305630.
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Safe Start is a community health worker program representing a partnership between a high-volume, inner-city, hospital-based prenatal clinic; a community-based organization; a large Medicaid insurer; and a community behavioral health organization to improve perinatal outcomes among publicly insured pregnant women with chronic health conditions in Philadelphia, Pennsylvania. As of June 2019, 291 women participated in the program. Relative to a comparison group (n = 300), Safe Start participants demonstrate improved engagement in care, reduced antenatal inpatient admissions, and shorter neonatal intensive care unit stays.
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Wnent, Jan, Stephan Seewald, Matthias Heringlake, Hans Lemke, Kirk Brauer, Rolf Lefering, Matthias Fischer, et al. "Choice of hospital after out-of-hospital cardiac arrest - a decision with far-reaching consequences: a study in a large German city." Critical Care 16, no. 5 (2012): R164. http://dx.doi.org/10.1186/cc11516.
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Burke, Andrew. "From Weimar to Winnipeg: German Expressionism and Guy Maddin." Acta Universitatis Sapientiae, Film and Media Studies 16, no. 1 (August 1, 2019): 59–79. http://dx.doi.org/10.2478/ausfm-2019-0004.
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Abstract The films of Guy Maddin, from his debut feature Tales from the Gimli Hospital (1988) to his most recent one, The Forbidden Room (2015), draw extensively on the visual vocabulary and narrative conventions of 1920s and 1930s German cinema. These cinematic revisitations, however, are no mere exercise in sentimental cinephilia or empty pastiche. What distinguishes Maddin’s compulsive returns to the era of German Expressionism is the desire to both archive and awaken the past. Careful (1992), Maddin’s mountain film, reanimates an anachronistic genre in order to craft an elegant allegory about the apprehensions and anxieties of everyday social and political life. My Winnipeg (2006) rescores the city symphony to reveal how personal history and cultural memory combine to structure the experience of the modern metropolis, whether it is Weimar Berlin or wintry Winnipeg. In this paper, I explore the influence of German Expressionism on Maddin’s work as well as argue that Maddin’s films preserve and perpetuate the energies and idiosyncrasies of Weimar cinema.
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Hackenberg, Roslind Karolina, Paul Stoll, Kristian Welle, Jasmin Scorzin, Martin Gathen, Charlotte Rommelspacher, and Koroush Kabir. "Cervical spine injuries requiring surgery in a Level I trauma centre in a major German city." Acta Neurochirurgica 164, no. 1 (October 26, 2021): 35–41. http://dx.doi.org/10.1007/s00701-021-05029-1.
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Abstract Background Cervical spine injuries (CSI) are rare in trauma patients, at about 9.2–16.5/100,000 inhabitants in Scandinavia and Canada, and the annual incidence of CSI surgeries in Norway is around 3.0/100,000 inhabitants. However, despite their rarity, the incidence of CSI has increased, thereby assuming an increasing need for surgery. Outside of Scandinavia, no data about the incidence of CSI and subsequent surgeries exist. Therefore, this study aimed to analyse CSI epidemiology and surgery in a German city with a Level I trauma centre both to understand the injury and improve needs–based planning. Methods This retrospective, monocentre study included all patients who presented with CSI from 2012–2017 at a university hospital with a Level I trauma centre in a major German city and had permanent residency within the city. Based on the assumption that the patients represented all CSI injuries in the city, as they were treated at the only available Level I trauma centre, the annual incidence of surgeries and neurologic deficits due to CSI were calculated. Results A total of 465 patients with 609 CSI were identified. Of these patients, 61 both received surgery and resided in the city (mean age, 68.1 ± 18.3 years; 26 female, 35 male). The incidence of CSI surgeries was calculated as 3.24/100,000 person years (1.75/100,000 in the upper and 1.54/100,000 in the subaxial cervical spine). Neurologic deficits occurred in 0.64/100,000 person years. The incidence of both surgeries and neurologic deficits showed no significant changes over the 6-year study period. Conclusions Compared to Scandinavia, an increasing annual incidence for CSI surgeries and neurologic deficits were found. For long-term demand planning with adaptability to demographic changes, cross-regional studies including long-term follow-up are necessary.
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Milanovic, Jasmina, Sanja Milenkovic, Momcilo Pavlovic, and Dragos Stojanovic. "The founding of Zemun Hospital." Srpski arhiv za celokupno lekarstvo 142, no. 7-8 (2014): 505–10. http://dx.doi.org/10.2298/sarh1408505m.
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This year Zemun Hospital - Clinical Hospital Center Zemun celebrates 230th anniversary of continuous work, thus becoming the oldest medical facility in Serbia. The exact date of the hospital founding has been often questioned in history. Various dates appeared in the literature, but the most frequent one was 25th of February 1784. Until now, the document which confirms this has never been published. This article represents the first official publication of the document which confirms that Zemun Hospital was indeed founded on this date. The first hospitals started emerging in Zemun when the town became a part of the Habsburg Monarchy. The first sanitary facility ever formed was the ?Kontumac? - a quarantine established in 1730. Soon after, two more confessional hospitals were opened. The Serbian (Orthodox) Hospital was founded before 1769, whereas the German (Catholic) Hospital started working in 1758. Both hospitals were financed, amongst others, by the Town Hall - the Magistrate. In order to improve efficiency of these hospitals, a decision was made to merge them into a single City Hospital. It was founded on 25th February 1784, when the General Command ordered the Magistrate of Zemun to merge the financess of all existing hospitals and initiate the construction of a new building. Although financially united, the hospitals continued working in separate buildings over a certain period of time. The final, physical merging of these hospitals was completed in 1795.
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Burke, Michael, Jennifer Willert, Sunil J. Desai, and Richard Kadota. "Pediatric Treatment Guidelines for Philadelphia Positive (Ph+) Chronic Myelogenous Leukemia (CML): What Are They in Today’s Imatinib Era?" Blood 112, no. 11 (November 16, 2008): 4399. http://dx.doi.org/10.1182/blood.v112.11.4399.4399.
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Abstract Background: The treatment of pediatric Philadelphia positive (Ph+) chronic myelogenous leukemia (CML) in the era of the tyrosine kinase inhibitors (TKI) continues to evolve with the role of allogeneic hematopoietic cell transplantation (allo-HCT) in these patients becoming more controversial. Imatinib has completely replaced allo-HCT for adult CML patients presenting in first chronic phase, reserving HCT for TKI resistant and/or advanced stage patients (accelerated phase and blast crisis). Whether treatment strategies in 2008 have changed for CML in pediatrics, from heavily allo-HCT based to TKI based medical therapy, is presently unclear. Methods: Thirty-two pediatric centers across the United States and Canada were surveyed regarding current treatment practices for CML in order to explore treatment practices in 2008. The survey targeted primary pediatric oncologists and bone marrow transplant physicians regarding their treatment approach for CML in terms of upfront therapy, utility of allo-HCT, use of TKI (including their role in the post-HCT setting) and how response to therapy was monitored. Results: Twenty-three of the thirty-two centers completed the survey to provide a completion rate of 72% (Table 1). Sixty-three percent of survey responders recommended allo-HCT, when a matched sibling donor was available, for patients with CML in first chronic phase. Regarding the use of TKI in the post-HCT setting, 9 of 27 (33%) physicians reported using imatinib as maintenance therapy post-HCT as a means to prevent relapse. All physicians reported using PCR techniques for bcr-abl of either bone marrow, peripheral blood or both to monitor treatment response with frequencies ranging from monthly to every six months. Conclusion: Treatment of pediatric CML appears variable and center dependent. This survey identified a trend toward less allo-HCT for CML in 2008 compared to years past. Despite the trend toward less HCT, the pediatric treatment consensus in 2008 for CML remains MSD allo-HCT when available. Use of imatinib was recognized by all survey responders as standard of care in upfront therapy, but the use of imatinib or other TKI in the post-HCT setting as maintenance therapy remains in question. Prospective pediatric clinical trials will be necessary to determine the optimal strategy for CML in children. Table 1. Pediatric Centers British Columbia’s Children’s Hospital Children’s Hospital of Pittsburgh Children’s Memorial Medical Center–Northwestern Cincinnati Children’s Hospital Medical Center City of Hope Columbia Presbyterian College of Phys & Surgeons Doernbecher Children’s Hospital-OHSU Duke University Medical Center Mayo Clinic Medical College of Wisconsin Nationwide Children’s Hospital Schneider Children’s Hospital St. Jude Children’s Research Hospital Stollery Children’s Hospital–Edmonton Texas Children’s Cancer Center at Baylor College of Medicine The Children’s Hospital of Philadelphia The University of Chicago Comer Children’s Hospital University of California at San Diego/Rady Children’s Hospital San Diego UCSF School of Medicine University of Florida University of Michigan–C.S. Mott Children’s Hospital University of Minnesota Children’s Hospital, Fairview Washington University–St. Louis
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Frank, M. D., L. Andrä, W. Haacke, and M. Ragaller. "Out of hospital cardiac arrest (OHCA)—What is the first rhythm: A 3-year analysis of a German city." Resuscitation 81, no. 2 (December 2010): S74. http://dx.doi.org/10.1016/j.resuscitation.2010.09.306.
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Burke, Michael, Jennifer Willert, Sunil J. Desai, and Richard Kadota. "Pediatric Treatment Guidelines for Philadelphia Positive (Ph+) Acute Lymphoblastic Leukemia (ALL): What Are They in today’s Imatinib Era?" Blood 112, no. 11 (November 16, 2008): 4393. http://dx.doi.org/10.1182/blood.v112.11.4393.4393.
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Abstract Background: The treatment of pediatric Philadelphia positive (Ph+) leukemias in the era of the tyrosine kinase inhibitors (TKI) continues to evolve with the role of allogeneic hematopoietic cell transplantation (allo-HCT) in these high-risk patients becoming more controversial. Ph+ acute lymphoblastic leukemia (ALL) prior to imatinib in both pediatric and adult patients has often involved intensive chemotherapy, including consolidative allo-HCT. Whether treatment strategies in 2008 have changed for these Ph+ leukemias in pediatrics, from heavily allo-HCT based to TKI based medical therapy, is presently unclear. Methods: Thirty-two pediatric centers across the United States and Canada were surveyed regarding current treatment practices for Ph+ ALL in order to explore treatment practices in 2008. The survey targeted primary pediatric oncologists and bone marrow transplant physicians regarding their treatment approach for Ph+ ALL in terms of upfront therapy, utility of allo-HCT, use of TKI (including their role in the post-HCT setting) and how response to therapy was monitored. Results: Twenty-three of the thirty-two centers completed the survey to provide a completion rate of 72% (Table 1). Twenty-two of the 27 physicians (81%) reported they do not classify patients by risk group according to age and presenting WBC (e.g. low-, intermediate- or high-risk) but rather use response to therapy to identify high risk patients, initially treating all Ph+ ALL patients the same. Eighty-one percent of survey responders recommended allo-HCT in first remission, when a matched sibling donor was available, for Ph+ ALL. Regarding the use of TKI in the post-HCT setting, 13 of 27 (48%) physicians reported using imatinib as maintenance therapy post-HCT as a means to prevent relapse. All physicians reported using PCR techniques for bcr-abl of either bone marrow, peripheral blood or both to monitor treatment response with frequencies ranging from monthly to every six months. Conclusion: Treatment of pediatric Ph+ ALL appears variable and center dependent. Classifying patients into low-, intermediate- or high-risk disease based on age and presenting WBC was not shown to be standard practice but rather using treatment response to identify high-risk patients. This survey identified a trend toward less allo-HCT in 2008 for Ph+ ALL compared to years past. Despite the trend toward less HCT, the treatment consensus in 2008 for pediatric Ph+ ALL remains MSD allo-HCT when available. Use of imatinib was recognized by all survey responders as standard of care in upfront therapy for Ph+ ALL, but the use of imatinib or other TKI in the post-HCT setting as maintenance therapy remains in question. Prospective pediatric clinical trials will be necessary to determine the optimal strategy for the Ph+ diseases. Table 1. Pediatric Centers British Columbia’s Children’s Hospital Children’s Hospital of Pittsburgh Children’s Memorial Medical Center–Northwestern Cincinnati Children’s Hospital Medical Center City of Hope Columbia Presbyterian College of Phys & Surgeons Doernbecher Children’s Hospital-OHSU Duke University Medical Center Mayo Clinic Medical College of Wisconsin Nationwide Children’s Hospital Schneider Children’s Hospital St. Jude Children’s Research Hospital Stollery Children’s Hospital–Edmonton Texas Children’s Cancer Center at Baylor College of Medicine The Children’s Hospital of Philadelphia The University of Chicago Comer Children’s Hospital University of California at San Diego/Rady Children’s Hospital San Diego UCSF School of Medicine University of Florida University of Michigan–C.S. Mott Children’s Hospital University of Minnesota Children’s Hospital, Fairview Washington University–St. Louis
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Jeck, Julia, Florian Jakobs, Anna Kron, Oliver A. Cornely, and Florian Kron. "Retrospective modelling of hospital bed capacities associated with the administration of remdesivir during the first wave of COVID-19 in a German metropolitan city." Journal of Antimicrobial Chemotherapy 77, no. 3 (November 25, 2021): 753–57. http://dx.doi.org/10.1093/jac/dkab432.
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Abstract Objectives Internationally, healthcare systems are confronted by an ever-increasing scarcity of medical resources due to the ongoing novel coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to investigate the impact of remdesivir on the demand of hospital bed capacities for hospitalized COVID-19 patients and to evaluate the potentially created capacities for treating additional COVID-19 patients or elective treatments at the hospital. Methods An epidemiological model was developed that utilized the population of Cologne (Germany) during the first COVID-19 wave (first hospitalized patient—30 September 2020) to compare two scenarios: no administration of remdesivir (A) and the administration of remdesivir according to the EMA label (B). The results of the Adaptive COVID-19 Treatment Trial were used to evaluate the potential impact of remdesivir on hospital capacity. Results With the first recorded patient on 2 March 2020, a total of 576 COVID-19 hospitalized patients were detected during the first wave in Cologne. Comparing both scenarios (A versus B) of the model, the administration of remdesivir increased the number of discharges from 259 to 293 (+5.8%) and fewer patients needed ICU admission [214 versus 178 (−6.3%)]. In addition, the model estimated 20 fewer deaths (scenario B). Based on a reduced length of stay, 31.4 hospital beds (57.0 versus 25.6) could have been freed by administering remdesivir to eligible patients. This would have allowed either the treatment of an additional 730 COVID-19 patients or 660 elective treatments. Conclusions In our model, remdesivir administration profoundly contributed to free hospital capacities in the metropolitan city Cologne in Germany.
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Sadeq Abdo Mohammed Al- Wesabi, Radman Ahmad Ahmad Al- Nahar, Sadeq Abdo Mohammed Al Wesabi, Radman Ahmad Ahmad Al Nahar. "Nurses' knowledge towards Intravenous cannula insertion at public and private hospitals in Sana'a City- Yemen: معرفة الممرضات بإدخال الكانيولا الوريدية في المستشفيات العامة والخاصة في مدينة صنعاء – اليمن." Journal of medical and pharmaceutical sciences 5, no. 2 (June 29, 2021): 65–57. http://dx.doi.org/10.26389/ajsrp.s110321.
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Background: the Peripheral IV cannula is one of the most frequently used medical devices in the world; to give intravenous therapy with drugs, and blood components is indispensable in today’s health care.Objective: is to assessing nurses' knowledge towards IV cannula insertion.Methods: Descriptive, hospital- based study, was conducted in Sana'a city in university of science and technology hospital, republican educational hospital, Kuwait educational hospital and Saudi German hospital from June2018 to September 2018, study covered all nurse's in hospital they were (100) nurses, the data were presented in pre- designed questionnaire firstly, then collected by direct interview by participants. Result: The results found a total of nurses have moderate knowledge about IV cannula insertion and indication of insertion (100%), also and about (63.5%) have ability to control in infection before, during and after cannula insertion, the study showed that more than half (71.7%) have good knowledge about site insertion of I.V cannula. Conclusion: The study recommended that regular program to discuss problems that faced them during cannula insertion. Such as lack of general information, not the rehabilitation of nurses scientifically, lack in training courses of nurses and not to evaluate the skills of nurses periodically. Recommendation: The nurses need to be trained, education and conducting courses how to care and maintenance of IV cannula.
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Rupa, Rosita, Tim Vladimirov, Mirza Pojskic, Christopher Nimsky, and Benjamin Voellger. "Dynamics in the Neurotrauma Catchment Area of a German University Hospital during the COVID-19 Pandemic." Healthcare 10, no. 8 (July 24, 2022): 1376. http://dx.doi.org/10.3390/healthcare10081376.
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Objective: At the beginning of 2020, the COVID-19 pandemic enforced a rapid reallocation of healthcare resources. Our neurosurgical department is located in the German county of Marburg–Biedenkopf, about 80 km from the nearest major city. We were able to maintain our previously established open-door policy after the emergence of COVID-19. Here, we report on dynamics in the catchment area for neurotrauma patients at our department during the pandemic. Methods: 763 consecutive neurotrauma cases admitted to our department between 1 January 2018 and 31 December 2021 were analyzed retrospectively. Patients’ age, gender, origin, diagnoses, and outcomes were recorded. The number of patients hospitalized with a COVID-19 infection in Germany (PHCG) were retrieved from the Robert Koch Institute (RKI). We defined calendar weeks with >1000 PHCG as high COVID-19 caseload weeks (HCLW). Chi-square and Fisher’s exact served as statistical tests. Results: In 2020 and 2021, we observed a significantly increased number of neurotrauma patients who, with primary residence outside of our district, were admitted to our hospital compared to 2018 and 2019 (p < 0.001), while there were no significant differences in in-house mortality. During HCLW, a significantly increased number of neurotrauma patients with primary residence in the densely populated southwestern margin (SWM) of the contiguous part of our catchment area were referred to us compared to the time prior to the pandemic and between HCLW (p = 0.003). In neurotrauma patients admitted from the SWM during HCLW, there was no tendency towards higher in-house mortality. Conclusion: An open-door policy may moderate the risk of involuntarily triaging neurotrauma patients during a pandemic.
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Chechulina, Anna, Jasmin Carus, Philipp Breitfeld, Christopher Gundler, Hanna Hees, Raphael Twerenbold, Stefan Blankenberg, Frank Ückert, and Sylvia Nürnberg. "Semi-Automated Mapping of German Study Data Concepts to an English Common Data Model." Applied Sciences 13, no. 14 (July 13, 2023): 8159. http://dx.doi.org/10.3390/app13148159.
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The standardization of data from medical studies and hospital information systems to a common data model such as the Observational Medical Outcomes Partnership (OMOP) model can help make large datasets available for analysis using artificial intelligence approaches. Commonly, automatic mapping without intervention from domain experts delivers poor results. Further challenges arise from the need for translation of non-English medical data. Here, we report the establishment of a mapping approach which automatically translates German data variable names into English and suggests OMOP concepts. The approach was set up using study data from the Hamburg City Health Study. It was evaluated against the current standard, refined, and tested on a separate dataset. Furthermore, different types of graphical user interfaces for the selection of suggested OMOP concepts were created and assessed. Compared to the current standard our approach performs slightly better. Its main advantage lies in the automatic processing of German phrases into English OMOP concept suggestions, operating without the need for human intervention. Challenges still lie in the adequate translation of nonstandard expressions, as well as in the resolution of abbreviations into long names.
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Mohammed, Dnya Jaza, Sana Dlawar Jalal, Ahmed Khudair Yassin, and Ali Ibrahim Mohammed. "Pattern, clinical and laboratory features from of adult acute lymphoblastic leukemia patients from Kurdistan-Iraq." Advanced Medical Journal 5, no. 2 (December 1, 2019): 55–59. http://dx.doi.org/10.56056/amj.2019.101.
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Background and objectives: Acute lymphoblastic leukemia is a heterogeneous group of neoplasm resulting from clonal proliferation and tissue infiltration by leukemic lymphoblasts. Adult acute lymphoblastic leukemia is character- ized by distinctive clinical and genetic features in comparison to childhood leukemia. This study aimed to outline the clinco-hematological features of adult Iraqi patients newly diagnosed with acute lymphoblastic leukemia in Kurdis- tan-Iraq. Methods:This study was conducted at Hiwa Cancer Hospital in Sulaimani City and Nanakali Hospital in Erbil City, Kurdistan, Iraq. A total of 109 patients of newly diagnosed acute lymphoblastic leukemia aged >15 years were included. Clinical history, physical examination, complete blood counts, with peripheral smear, bone marrow aspira- tion and immunophenotypic data (using flow cytometry) and genetic study were collected for all the enrolled cases. Results: The median age at diagnosis was 24 years with male to female ratio of 1.7:1. B- lineage was predominant at (76.1%), while T -lineage was less frequent, at 23.9%. Mean hemoglobin level was 9.1 g/dl (+2.3) with a range of (4-15.2) g/dl, white blood cells count had a range of (0.4-300) ×109/L, with a mean of 47.5 ×109/L (+62.5). The mean platelet count was 79×109/L (+83), and a range of (3-490) ×109/L. Fifty eight patients (53.2%) presented with lymphadenopathy, and seventy eight patients (71.6%) had organomegaly. Philadelphia chromosome was detected in 9.5% of cases. Fifty seven (52.3%) patients stra tified into high risk group. Conclusions: Patients from our locality have some distinct disease characters from that were reported elsewhere.
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Kleinschmidt, M., T. Floeth, and M. Greuél. "The German “netzwerk psychische gesundheit”: Establishing home treatment for patients with severe chronic mental disorders from a systemic approach." European Psychiatry 26, S2 (March 2011): 547. http://dx.doi.org/10.1016/s0924-9338(11)72254-4.
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IntroductionHome treatment models in treating severe chronic mental disorders including crisis intervention show more and more evidence to offer an excellent alternative to hospital treatment. In Germany, having higher hospitalization rates than almost any other country in Europe, it is even more necessary to evaluate such alternative option to hospital treatment.Objective/aim of studyAfter establishing a home treatment model based on Swedish, Finnish and Italian experiences in cooperation with a big German health insurance in Berlin, we present data evaluation after the first year of implementation.Methods150 Patients out of a model region in Berlin being included in the first year of the project are evaluated with respect to their socio-demographic data and diagnostic spectrum, psychopathology ratings and quality of life assessments, as well as to health economic dimensions (different financial positions of spending economic treatment resources). Using an advanced statistical method of predictive modeling, we can compare the actual hospitalization rates to the statistically predicted ones.ResultsThere are predominantly patients with psychosis (50%), depressive disorders (30%) and BPD (15%). Actual hospitalization rates are extremely low compared to the statistical prediction. Health economic balance is difficult, mainly due to high starting expenses of a treatment setting which had to be built completely new.ImplicationsThe model in the meantime is being applied to the entire city of Berlin as well as to 4 other German counties (Schleswig-Holstein, Bremen, Bayern, Niedersachsen), other regions will follow shortly.
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Kravtsov, Sergey R. "Synagogue Architecture of Latvia between Archeology and Eschatology." Arts 8, no. 3 (August 5, 2019): 99. http://dx.doi.org/10.3390/arts8030099.
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Synagogue architecture during the second half of the nineteenth century and the early part of the twentieth century was seeking novel modes of expression, and therefore the remains of ancient synagogues that were being discovered by western archeologists within the borders of the Biblical Land of Israel became a new source of inspiration. As far away as the New World, the design of contemporary synagogues was influenced by discoveries such as by the American Jewish architect, Arnold W. Brunner, who referenced the Baram Synagogue in the Galilee in his Henry S. Frank Memorial Synagogue at the Jewish Hospital in Philadelphia (1901). Less known is the fact that the archaeological discoveries in the Middle East also influenced the design of synagogues in the interwar period, in the newly-independent Baltic state of Latvia. Local architects picked up information about these archaeological finds from professional and popular editions published in German and Russian. Good examples are two synagogues along the Riga seaside, in Majori and Bulduri, and another in the inland town of Bauska. As was the case in America, the archaeological references in these Latvian examples were infused with eschatological meaning.
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Sljapic, Ziva, and Miljana Sljapic-Roganovic. "Child care in Vrsac and its development." Medical review 55, no. 9-10 (2002): 431–35. http://dx.doi.org/10.2298/mpns0210431s.
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Documents concerning history of medicine during the Turkish reign (1552-1716) are very rare. However, there is evidence of plague epidemic in 18th century and cholera epidemic in the 19th century. The first medical institutions: The German Communal Hospital, The Serbian Hospital and the Pharmacy were founded in the second half of the 18th century. In the year 1803, children were vaccinated against variola. The first Serbian book about child care ? "Cadoljub" was written by Dr. Gavrilo Pekarovic (1812-1851) during his studies of medicine in Budapest. In 1927 the city founded a dispensary for the newborn. The Polyclinic for schoolchildren was established as a part of the Health Center in 1934. After World War II, Children's Department was opened in the Health Center, later on it was turned into Mother and Child Center. At the beginning of 1955, a provisional children's ward with 18 beds was established in the former sanatorium, whereas till the end of the year it had 49 beds. In May 1965, it was moved into a new hospital building. After integration of Hospital and the Health Center into a Medical Center in 1967, a department for children was founded and it consisted of the emergency center and a hospital. Parents counseling, dispensary for children and dispensary for schoolchildren were founded in August 1971. .
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Avner, Jeffrey R., and M. Douglas Baker. "Dog Bites in Urban Children." Pediatrics 88, no. 1 (July 1, 1991): 55–57. http://dx.doi.org/10.1542/peds.88.1.55.
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As a result of a perceived increase in pit bull injuries, all children who presented to The Children's Hospital of Philadelphia during 1989 for evaluation of dog bite injuries were prospectively studied. Epidemiologic information was collected from parents, either at the time of visit or by phone on the following day. A total of 168 children were enrolled; the mean age was 8 years. Males outnumbered females 1.5:1. Most (61%) injuries occurred in or around the home and involved dogs known to the patient (77%). Types of injuries included abrasions (33%), punctures (29%), and lacerations (38%). Thirteen bites had associated complications; nine developed infection. Twelve (7%) children required admission to the hospital. More than 12 different purebreeds or crossbreeds were identified as perpetrators, including German shepherds (n = 35), pit bulls (n = 33), rottweilers (n = 9), and Dobermans (n = 7). Most (54%) animals were contained (ie, leashed, fenced, in-house) at the time of injury. Fewer (46%) were provoked prior to biting. Significantly more pit bull injuries (94% vs 43%, P < .001) were the consequence of unprovoked attacks and involved freely roaming animals (67% vs 41%, P < .01). Children aged 5 or younger were more likely to provoke animals prior to injury than were older children (69% vs 36%, P < .001). It is recommended that families with young children be the target of pet safety education and that measures be sought that would lead to early identification of a potentially dangerous dog and restrict ownership.
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Griewing, Sebastian, Michael Lingenfelder, Uwe Wagner, and Niklas Gremke. "Use Case Evaluation and Digital Workflow of Breast Cancer Care by Artificial Intelligence and Blockchain Technology Application." Healthcare 10, no. 10 (October 20, 2022): 2100. http://dx.doi.org/10.3390/healthcare10102100.
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This study aims at evaluating the use case potential of breast cancer care for artificial intelligence and blockchain technology application based on the patient data analysis at Marburg University Hospital and, thereupon, developing a digital workflow for breast cancer care. It is based on a retrospective descriptive data analysis of all in-patient breast and ovarian cancer patients admitted at the Department of Gynecology of Marburg University Hospital within the five-year observation period of 2017 to 2021. According to the German breast cancer guideline, the care workflow was visualized and, thereon, the digital concept was developed, premised on the literature foundation provided by a Boolean combination open search. Breast cancer cases display a lower average patient case complexity, fewer secondary diagnoses, and performed procedures than ovarian cancer. Moreover, 96% of all breast cancer patients originate from a city with direct geographical proximity. Estimated circumference and total catchment area of ovarian present 28.6% and 40% larger, respectively, than for breast cancer. The data support invasive breast cancer as a preferred use case for digitization. The digital workflow based on combined application of artificial intelligence as well as blockchain or distributed ledger technology demonstrates potential in tackling senological care pain points and leveraging patient data safety and sovereignty.
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Maylath, E., J. Seidel, B. Werner, and P. Schlattmann. "Geographical analysis of the risk of psychiatric hospitalization in Hamburg from 1988 – 1994." European Psychiatry 14, no. 8 (December 1999): 414–25. http://dx.doi.org/10.1016/s0924-9338(99)00226-6.
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SummaryThe analysis of the geographical distribution of hospital cases is obviously important for the purpose of planning hospital services, but it is of even greater significance in the planning of psychiatric services. This concern motivated our seven-year-long study, which examined hospitalization risks among various categories of psychiatric disorders in the major German city of Hamburg. Our database encompassed 77% (n = 64,000) of all psychiatric admissions in a total of 41 hospitals, most of which are general hospitals. In order to carry out the geographical analysis we employed a new statistical method based on a mixture distribution model. According to our findings, the strongest indications of an increased frequency were among male cases of schizophrenia, drug abuse and organic psychoses, and female cases of neurotic disorders, personality disorders, drug abuse and schizophrenia. We found that some areas are exposed to a risk of hospitalization for these diagnostic categories which is more than 50% above the reference. Contrary to other authors we did not identify an increased frequency of admission concentrated in the inner-city area for any of the diagnostic groups. The risk of hospitalization for schizophrenics was almost entirely associated with the close proximity of psychiatric units, while the risks for neuroses and personality disorders, as well as alcohol and drug abuse, appeared to be concentrated in areas of low social status. However, a statistically relevant correlation between an increased risk of hospitalization and low social status could be determined only for drug abuse and alcoholism. In the end, we did identify two areas in which there was an increased risk of hospitalization for several diagnostic groups, and this information will undoubtedly facilitate the planning of hospital and psychiatric services. The fact that our findings deviate to some extent from other authors – especially with respect to neuroses and personality disorders, but also to addiction – can be attributed to the inclusion of psychiatric cases from general hospitals in our geographic analysis.
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Vergatti, Radu Ștefan. "DIMITRIE CANTEMIR ŞI CHIRURGIA." Arhivele Olteniei 37 (December 21, 2023): 81–94. http://dx.doi.org/10.59277/ao.37.06.
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One of the most important works left by Dimitrie Cantemir, among his rich writings, was "INCREMENTORVM ET DECREMENTORVM AVLAE OTHOMANICAE SIVE ALIOTHMANICAE HISTORIAE A PRIMA GENTIS ORIGINE AD NOSTRA VSQVE TEMPORA DEDVCTATE LIBRI TRES", translated nowadays under the title "HISTORY OF THE INCREASE AND THE DECAY OF THE OTTHMAN OR ALIOTHMAN COURT (FROM THE BEGINNINGS OF THE NATION TO OUR TIME), IN THREE BOOKS". Among other information, it also contains a description of the land and the city of Avlonia - i.e. Vlora (dominated then by the Sublime Porta), as well as the Albanians from that region who had several qualities: fierce fighters, builders of aqueducts (without formal education) and healers of hernia by surgical operation. The surgery part has a special significance. In 1734 ”Incrementorum...” was translated into English by pastor Tindal, historian and translator. He used a manuscript in Latin given to him by Antioch Cantemir, son of Dimitrie Cantemir. The English text was translated into French by Fr. de Joncquieres. In 1745, a German translation appeared in the city of Hamburg, also using the English edition. In 1876, the Romanian Academy, published Iosif Hodoş first Romanian translation of the German edition. Fragments adapted from this edition were then used by Romanian researchers, including historians of medicine, such as Pompei Samarian, Dr. Vasile Sârbu. The original Latin manuscript of Dimitrie Cantemir's text was to be found not earlier than 1984 by Virgil Cândea at the Houghton Library in the USA. The Latinist Dan Sluşanschi published the manuscript and made its first translation from Latin into Romanian. The surgeon Dr. A. E. Nicolau published fragments of this translation, namely the passage regarding the surgical cure. În 2015, years after Dan Sluşanschi passing, the Romanian Academy published the text of the transcribed Latin manuscript and a translation version. In parallel, another academic and surgeon, Mircea Beuran, highlighted Cantemir's text, in a different form, exposing in the Floreasca Hospital on large, colorful, how inguinal hernia was operated in the 17th-18th centuries.
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Babić, Strahinja, Aleksandra Marjanović, Gordana Stanković-Babić, Nevena Babić, and Rade Babić. "Primarijus Dr. Milun Mitrović (1901-1978): The first children's surgeon in Niš." Medicinska rec 3, no. 3 (2022): 26–28. http://dx.doi.org/10.5937/medrec2201026b.
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Primarius Dr. Milun Mitrović (1901, Trnanje, Serbia - 1978, Niš, SFR Yugoslavia) was the first pediatric surgeon in Niš, and the fifth in Yugoslavia. He graduated from the Medical Faculty in Graz in 1928. He received the title of primarius in 1959. He won the award of the Liberation of the City of Niš for merits in the work and development of health care for the population of Niš (1960). He spoke German fluently. He worked in the Department of Pediatric Surgery at the Orthopedic Department of the General State Hospital in Belgrade until January 1, 1945, when he moved to the Surgical Department of the State Hospital in Niš, where on March 9, 1953. formed the Department of Pediatric Surgery and Orthopedics, which has two rooms and 16 beds and became the first head of this institution. The creative and visionary spirit of Primarius Dr. Milun Mitrović is reflected in the creation of the Institute for Bone and Joint Diseases of Children in Sokobanja (30 beds; October 20, 1959), the formation of the Department of Pediatric Surgery of the Serbian Medical Association (1966), the Association of Children's surgeon of Yugoslavia, formulates the magazine "Children's Surgery" (printed in Niš) and others. Primarius Dr. Milun Mitrović remained "remembered by the people of this region as a great expert, a great friend of children and a great bohemian" - according to the record of prof. Dr. Radoslav Živić in the book "Greats of Niš Medicine".
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Patel, Dhaval, Marshall Isaac Rosenberg, John Charles Leighton, and Claudia M. Dourado. "Barriers to accessing cancer care from patients’ perspective: A single cancer center experience." Journal of Clinical Oncology 42, no. 16_suppl (June 1, 2024): e13520-e13520. http://dx.doi.org/10.1200/jco.2024.42.16_suppl.e13520.
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e13520 Background: Jefferson Einstein Hospital is a safety-net hospital that serves a diverse and primarily disadvantaged community in North Philadelphia. The population in this city has 21.5% of individuals living in poverty, which is almost double the rate in Pennsylvania. According to the National Cancer Institute’s Center to Reduce Cancer Health Disparities (NCI-CRCHD), people from low socioeconomic backgrounds and specific demographics often bear a more significant disease burden than the general U.S. population. Certain population groups experience cancer disparities due to their likelihood of encountering obstacles or barriers in accessing healthcare. This study aims to identify critical barriers hindering the receipt of quality cancer care for the population served by this hospital. Methods: We identified 51 adult patients who received a new cancer diagnosis between 2022 and 2023. Barriers to accessing cancer care were defined through a literature review and expert consensus. These barriers were assessed via a survey containing fixed-choice items aimed at eliciting obstacles to accessing cancer care among newly diagnosed cancer patients undergoing treatment at the hospital. Information on these barriers was collected prospectively during survey administration and analyzed using descriptive statistics. The frequency of specific barriers within the five categories was calculated, and subjects were classified based on the presence or number of barriers. Results: A total of 51 patient surveys were evaluated. Among these surveys, 24 (47%) reported transportation issues, and 3 (6%) reported caregiving responsibilities. Ten (20%) patients encountered economic barriers, while 11 (22%) faced challenges related to their support system. Nineteen (37%) patients experienced barriers related to health literacy, and 15 (29%) specifically struggled with cancer-related health literacy. Additionally, cultural barriers were identified in 12 (24%) patients. Conclusions: Our study highlights the prevalent barriers faced by newly diagnosed cancer patients in accessing cancer care, including transportation, health literacy, financial constraints, and cultural factors. These findings underscore the importance of integrating patient perspectives into future initiatives aimed at addressing these challenges. By prioritizing patient input and enhancing patient navigation programs, we can effectively mitigate these barriers and improve access to cancer care for individuals in need. [Table: see text]
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Ramos Peñafiel, Christian Omar, Adán Germán Gallardo-Rodríguez, Daniela Pérez Sámano, Emmanuel Martinez Moreno, Álvaro Cabrera García, Carolina Balderas Delgado, Humberto Baldemar Castellanos Sinco, and Carlos Martínez Murillo. "Comparison of Two Therapeutic Approaches (Pediatric vs. Adult) for Treating Acute Lymphoblastic Leukemia. Experience of Two Centers in Mexico City." Blood 142, Supplement 1 (November 28, 2023): 5894. http://dx.doi.org/10.1182/blood-2023-185217.
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Background: Chemotherapy is the most frequently used strategy in treating adult acute lymphoblastic leukemia (ALL) in conjunction with monoclonal antibodies and tyrosine kinase inhibitors. One of the primary considerations is the type of treatment based on pediatric inspiration regimens (CALGB10403, BFM, St Jude XIII) or regimens for adult patients (HyperCVAD), with pediatric regimens being those that have improved the prognosis in the young adult population. Along with this scheme, strict monitoring through measurable residual disease (MRD) is the main dynamic prognostic factor since its positivity is associated with a greater risk of relapse. We aimed to compare the effect on the clinical prognosis of two treatment regimens based on a pediatric regimen versus an adult regimen in patients with ALL. Material and methods: A retrospective, observational, descriptive study of 5 years of follow-up was carried out in patients with ALL at the Hospital General de México and the Hospital Regional de Alta Especialidad de Ixtapaluca, classifying the treatment into two types of regimens (adult regimen vs. pediatric inspiration) evaluating the impact on survival as well as the association of different factors both to diagnosis and measurable residual disease (MRD). Results: A total of 450 patients were studied, 50.4% (n=227) were male, and 49.6% (n=223) were female. 21.1% (n=95) received a pediatric-inspired protocol (CALGB-10403), and 78.9% (n=355) received an adult protocol (Hyper-CVAD). 71.8% (n=323) were considered high risk, and 8.4% (n=38) were identified with Philadelphia positive ALL. 94.4% had a B-cell precursor phenotype ALL, and 8.7% had a nervous system infiltration at diagnosis. Overall, 60.4% integrated complete remission (n=272), with 31.3% (n=141) post-induction MRD negative. The percentage of negative MRD was higher in the pediatric protocol (38.5% vs 29.6%, p=0.000). Relapses occurred in 34% (n=153), and 21.3% (n=96) had a relapse to the central nervous system. Survival at 1000 days of follow-up was 32%, with significant differences in favor of the pediatric protocol (Log Rank 0.000) with 42% at 1000 days (Figure 1), the use of MRD as an impact tool with the prognosis (0.000) (Figure 2), the presence of a post-induction MRD+ (0.000) and high risk (Log-Rank 0.004) were the significant variables. Conclusions: The prognosis of a patient with ALL depends on the type of treatment. The prognosis is favorable when treated with a pediatric protocol. The detection of MRD by flow cytometry is the best follow-up tool, and its positivity decreases survival in adults with ALL.
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Maksimovic, Jovan. "Development of midwifery services in Vojvodina." Medical review 56, no. 7-8 (2003): 385–88. http://dx.doi.org/10.2298/mpns0308385m.
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This paper deals with the beginnings and development of midwifery services as well as schooling modalities and professional education of midwives in Vojvodina after gaining freedom from Turkish rule. Obstetrical services in the Military Border Region of Vojvodina were much better organized than in the civil, so-called 'provincial' part. In the second half of the 18th century, law regulations were brought and only midwives with certificates of universities and training courses of special midwifery schools in bigger towns could practice midwifery. At that time most trained midwives in Vojvodina were of German nationality, because Serbs knew neither German nor Hungarian and could not get education in Vienna and Budapest. A century later the situation was practically the same. Dr. Svetozar Maksimovic, Master of Obstetrics and the first director of the Maternity Hospital and a city physician in Novi Sad, was well aware that this town had no midwifery service. That is why on July 27, 1879 he submitted a suggestion for foundation of a 'Government Training Institute for Midwives and Pregnant Women'. Although this suggestion was not realized, it was the first attempt to establish a school for midwives in Novi Sad in Serbian language and was of great importance for history of medicine in Vojvodina, especially in Novi Sad. Furthermore, it points to the fact that physicians in Novi Sad, especially Dr. Svetozar Maksimovic, were informed about current medicine in the world. In the frame of public health special attention was paid to Women?s Care Services concerning especially pregnancy, delivery and puerperium. However, it was not possible to realize his vision in Vojvodina at that time, due to insufficient number of trained midwives.
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Frank, Mark, Jörg Braun, Laura Haelke, and Katja Petrowski. "Traumatic Cardiac Arrest in Polytrauma–There are Survivors: A 10-Year Analysis from a German Helicopter Base." Prehospital and Disaster Medicine 38, S1 (May 2023): s45. http://dx.doi.org/10.1017/s1049023x23001541.
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Introduction:In Germany, emergency care is provided by ambulances and rescue helicopters. Emergency physicians are part of prehospital care. The rescue helicopter in Dresden covers the city with 540.000 inhabitants and surrounding areas. The goal of the study was to evaluate cases of traumatic cardiac arrest (TCA) and to describe factors that affect the primary success of prehospital cardiopulmonary resuscitation (CPR) in trauma.Method:Data of all emergencies from the German Air Rescue (DRF-Luftrettung®) Helicopter Base Dresden were recorded on a standardized protocol and transferred to a central database (MEDAT®, HEMSDER®). Data from all patients with severe injuries, classified as polytrauma between January 2006 and December 2015 were analyzed.Results:There were a total number of 14,126 emergency cases involving the rescue Helicopter. The Helicopter was on the scene within 10.9 minutes [4-34]. Polytraumatized patients were identified in 673 cases (4.76%), the mean age was 43.73 years [2-98], and 498 patients were male (73.99%). In 444 cases, traffic accidents were responsible, in 188 cases falls from high. In 46 cases a suicide was documented. Mean ISS was 34,04 [16-75]. The main injury regions were head, extremities and chest. In 115 patients (17.08%) a TCA was observed. 43 pat. were pronounced dead initially and no treatment was initiated. 72 pat. (62.6%) received CPR. 39 of these pat. (54,17%) were also pronounced dead after treatment. 14 pat. (19.44%) were transported to hospital with ongoing CPR. 19 pat. (27.38%) reached the return of spontaneous circulation (ROSC). Male pat. reached more often ROSC.Conclusion:According to present guidelines for TCA, it is important that reversible causes of cardiac arrest in trauma pat. are to be treated. If we ensure the treatment of hypoxia, hypovolemia, tension pneumothorax and cardiac tamponade consequently, there will be a survival chance. Regular training for manual skills and simulation can be a key factor.
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Cimpeanu, Emanuela, Eve Frangopoulos, Ana M. Ventura, Edwin Chiu, Bo Lin, and Evelyn Taiwo. "Abstract P4-03-05: HER2 + Breast Cancer in Afro-Caribbean Women in New York City." Cancer Research 83, no. 5_Supplement (March 1, 2023): P4–03–05—P4–03–05. http://dx.doi.org/10.1158/1538-7445.sabcs22-p4-03-05.
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Abstract Background: Human Epidermal Growth Factor receptor 2 (HER2) protein overexpression and/or amplification positive breast cancer accounts for 14% of breast cancer cases in the United States. The use of anti-HER2 targeted therapy in combination with chemotherapy has resulted in better response rates leading to better outcomes in patients with this breast cancer subtype. Few studies directly investigate breast cancer outcomes in Afro-Caribbean women in the U.S, and fewer studies have investigated HER2 positive (HER2+) disease in this patient group. We describe the clinicopathologic characteristics and outcomes of HER2+ breast cancer in this minority patient group. Methods: This is a retrospective study conducted at Kings County Hospital (KCH), a public hospital in Brooklyn, a New York City borough with the highest population of Afro-Caribbeans in the United States, outside of Miami, Florida. Data of patients diagnosed with breast cancer from 2015-2018 was collected from the hospital’s tumor registry. Clinical and pathologic data was collected and analyzed with descriptive statistics and Chi-square testing. Results: A total of 299 women with breast cancer were screened and 18% (54) had HER2+ disease. 63% (34) of these patients were post-menopausal, with median age 56. 78% self-identified as Afro-Caribbean. 19% (11) of patients reported first- or second-degree relatives with a breast cancer diagnosis, 22% (13) reported first-degree relative with non-breast malignancy. Half of the patients younger < 45 years age reported a positive family history of any type of cancer. 74% of patients presented with Nottingham Grade 3 disease, 31% with localized disease, without lymph node involvement, 52% with regional lymph node involvement, and 17% with distant metastasis. 63% of patients were estrogen receptor (ER) positive and 37% were ER negative. Post-menopausal women presented with higher rates of lymph node involvement at 70.4% vs. 50% in pre-menopausal women (p=0.17). 41% (22) of patients received neoadjuvant chemotherapy while 31% received adjuvant therapy with standard chemotherapy and anti-HER2 targeted treatment. Of the 22 patients who received neoadjuvant treatment, 14% had complete pathologic response, 68% had partial response, and 18% had disease progression. Treatment response to neoadjuvant therapy was independent of lymph node status (90.9% in local disease vs. 85.7% in lymph node involvement, p=0.66). The median progression free survival was 48 months, overall survival at 7 years was not reached, and mortality rate was 16.7%. Conclusions: In our analysis, Afro-Caribbean patients with HER2+ breast cancer presented with high grade tumor, high incidence of regional lymph node involvement, and ER positive tumors. Noteworthy was the presence of strong family history of cancers, suggestive of familial or inherited cancers. Pathologic complete response to neoadjuvant chemotherapy was remarkably less than anticipated, and further research is warranted to study tumor biology and responses to standard HER2 systemic therapies in these patients. References: 1. https://seer.cancer.gov/statfacts/html/breast-subtypes.html 2. New York City Health and Hospitals http://www.nychealthandhospitals.org/wp-content/uploads/2016/07/chna-kings-county.pdf Kings County. 2016 Community Health Needs Assessment. Citation Format: Emanuela Cimpeanu, Eve Frangopoulos, Ana M. Ventura, Edwin Chiu, Bo Lin, Evelyn Taiwo. HER2 + Breast Cancer in Afro-Caribbean Women in New York City [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-03-05.
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Nguyen, Hoang-Quy, Hong-Duc Phan-Thi, and Thi-Hong-Van Le. "Abstract PO5-05-07: Efficacy and safety of first line CDK4/6i plus endocrine therapy for patients with HR+/HER2- metastatic breast cancer:initial real-world experience at Ho Chi Minh city oncology hospital, Viet Nam." Cancer Research 84, no. 9_Supplement (May 2, 2024): PO5–05–07—PO5–05–07. http://dx.doi.org/10.1158/1538-7445.sabcs23-po5-05-07.
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Abstract Background The cyclin-dependent kinases (CDK)4/6 inhibitors (CDK4/6i) palbociclib and ribociclib have been available in Viet Nam since 2021 for the treatment of hormone receptor-positive metastatic breast cancer (MBC). Data regarding CDK4/6i benefit in Vietnamese MBC are sparse. This study evaluated the impact of CDK4/6i in first-line HR+/HER2− MBC using real-world experience at Ho Chi Minh City Oncology Hospital. Methods A single-institution study analyzed retrospective data from 108 patients treated with palbiciclib or ribociclib with endocrine therapy in first-line in HR+/HER2– MBC patients at Ho Chi Minh city oncology hospital. Patient characteristics, PFS, treatment response, and toxicity profiles were analyzed. Results Baseline patients’ characteristics are detailed in Table 1.The median follow-up was 12.5 months (95% CI: 10.9-13.3). Best responses by the line of therapy are in Table 2. The median PFS has still not been reached. The PFS rates at 6, 12 and 18 months were 94.4%, 93.5% and 91.5%, respectively. Patients with bone-only metastasis have a better PFS than visceral metastasis (p = 0.059). Patients with recurrent disease had shorter PFS (p = 0.083) than those presenting with de novo metastasis. The most common reasons for toxicity were neutropenia (92.6%), anemia (35.2%), thrombopenia (22.2%) and the incidence of diarrhea was only 2,8%. None were related to QTc-prolongation Conclusion The real-world effectiveness and safety with CDK4/6 inhibitors in our institution HR+/HER2– MBC patients mimics that observed in the clinical trials. This finding supports the use of CDK4/6i in combination with endocrine therapy as standard of care for HR+/HER2- MBC in Viet Nam. The study also suggests the need for more study of under-represented minority populations. Further studies are ongoing to validate these findings incorporating additional cancer centers. Keywords: advanced/metastatic breast cancer, Asia, CDK4/6 inhibitors, real world Table 1. Patient Demographics and Baseline Disease Characteristics (N=108) Characteristics N (%) Age, y: Median 52 Stage Recurrent from earlier stage, stages 0–III 67 (62) De novo, newly diagnosed stage IV at enrolment 41 (38) DFI < 12 months 5 (4.6) 12-24 months 12 (11.1) > 24 months 51 (47.2) No. of metastatic sites 1 49 (45.4) 2 37 (34.3) ≥ 3 22 (20.4) Metastasis pattern Bone only 30 (27.8) Other 78 (72.2) CDK4/6i Palbociclib 35 (32.4) Ribociclib 73 (67.6) Partner ET AIs 94 (87) Fulvestrant 14 (13) Table 2. Best responses of therapy (N=108) Best responses (N,%) CR 2 (1.9) PR 29 (26.9) SD 67 (62.1) PD 10 (9.3) Total 108 (100) ORR 31 (28.8) CBR 76 (70.3) Table. Citation Format: Hoang-Quy Nguyen, Hong-Duc Phan-Thi, Thi-Hong-Van Le. Efficacy and safety of first line CDK4/6i plus endocrine therapy for patients with HR+/HER2- metastatic breast cancer:initial real-world experience at Ho Chi Minh city oncology hospital, Viet Nam [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-05-07.
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Rimmele, Martina, Jenny Wirth, Sabine Britting, Thomas Gehr, Margit Hermann, Dirk van den Heuvel, Andreas Kestler, et al. "Improvement of transitional care from hospital to home for older patients, the TIGER study: protocol of a randomised controlled trial." BMJ Open 11, no. 2 (February 2021): e037999. http://dx.doi.org/10.1136/bmjopen-2020-037999.
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IntroductionIn Germany, an efficient and feasible transition from hospital to home for older patients, ensuring continuous care across healthcare settings, has not yet been applied and evaluated. Based on the transitional care model (TCM), this study aims to reduce preventable readmissions of patients ≥75 years of age with a transitional care intervention performed by geriatric-experienced care professionals. The study investigates whether the intervention ensures continuous care during transition and stabilises the care situation of patients at home.Methods and analysesRandomised controlled clinical trial, recruiting between 25 April 2018 and 31 December 2019 in one German hospital in the city of Regensburg. The intervention group is supported by care professionals in the transition process from hospital to home for up to 12 months. Based on TCM, the intervention includes an individual care plan according to a patient’s symptoms, risks, needs and values. The plan is advanced in the domestic situation via personal visits and telephone contacts. All necessary care actions regarding, for example, mobility, residence adjustments, or nutrition, are initiated to be executed by ambulant care services, and are monitored, evaluated and adapted if necessary. In supervising the care plan, the care professionals do not administer active care services themselves but coordinate them. Patients and their caregivers are actively engaged in the care planning and execution. In contrast, the control group receives only usual discharge planning in the hospital and usual ambulatory care.The primary outcome is the all-cause readmission rate assessed using health insurance data within a follow-up of up to 12 months after hospital discharge. Secondary outcomes include care quality, mobility, nutritional and wound situation, and health-related quality of life. They are assessed at baseline, after 1 month, 3 months, 6 months, and at the end of study visit. Additionally, the economic efficiency of the intervention will be evaluated.Ethics and disseminationEthics approval for the trial was obtained from the Ethics Committee of the Friedrich-Alexander-Universität Erlangen-Nürnberg. Results will be published in peer-reviewed, open-access scientific journals and disseminated at national and international research conferences and through public presentations in the geriatric and healthcare community.Trial registrationClinicalTrials.gov identifier: NCT03513159.
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Alvarado-Muñoz, Juan, Agatha Reyes-Morales, Marco Chivalan, Silvana Torselli, Hector Valenzuela, Gozalo Yalibat, Mario Ordoñez, Rosa León, and Egly Alvarez. "Abstract P5-03-17: BRCA1/2 gene mutations in patients with high-risk breast cancer in a tertiary-level hospital in Guatemala." Cancer Research 83, no. 5_Supplement (March 1, 2023): P5–03–17—P5–03–17. http://dx.doi.org/10.1158/1538-7445.sabcs22-p5-03-17.
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Abstract Objectives, to stablish the frequency of BRCA1/2 mutation rate in high-penetrance breast cancer susceptibility population Methods Based on NCCN guidelines for testing criteria for high-penetrance breast cancer susceptibility genes genetic counseling was offered to 140 breast cancer patients in the hemato-oncology unit of Roosevelt Hospital at Guatemala City performing test with NGS and MLPA technology from 2019 to 2021. Results The overall BRCA1/2 mutation rate high-risk patients were 23% (33/140). Of the patients with mutations, 66.6% (22/33) had BRCA1 mutation, 33.3% (11/33) had BRCA2 mutation, of the mutated population the median age was 45 years. Regarding the phenotype in the mutated population, 75% were triple negative, 16% luminal and 9% with Her2 overexpression. Of the patients carrying the BRCA1 mutation, we identified the c.212+1G>A mutation in 40% of the patients, possibly a founder mutation. In the triple negative population and under 45 years of age, the percentage of patients with BRCA 1/2 mutation is 40.9 (88.8% BRCA1 and 11.1% BRCA2). Conclusions: we found a percentage of BRCA 1/2 mutations in the selected population (NCCN criteria) similar to that reported in other Latin American countries, highlighting the high percentage of BRCA mutations in women under 45 years with triple negative phenotype, previous reports have highlighted the frequency of the c.212+1G>A mutation of BRCA1 in breats cancer patient in Guatemala, in this study 40% of the BRCA1 mutations correspond to said mutation, considering it as a probable founder mutation. Citation Format: Juan Alvarado-Muñoz, Agatha Reyes-Morales, Marco Chivalan, Silvana Torselli, Hector Valenzuela, Gozalo Yalibat, Mario Ordoñez, Rosa León, Egly Alvarez. BRCA1/2 gene mutations in patients with high-risk breast cancer in a tertiary-level hospital in Guatemala [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-03-17.
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Schäffler, Henning, Dominik Dannehl, Kristina Veselinovic, Franziska Mergel, Kerstin Pfister, Brigitte Rack, Visnja Fink, et al. "Abstract PO5-16-11: Novel antibody-drug-conjugates in clinical routine: adherence, efficacy and tolerability - real-world data from German breast centers." Cancer Research 84, no. 9_Supplement (May 2, 2024): PO5–16–11—PO5–16–11. http://dx.doi.org/10.1158/1538-7445.sabcs23-po5-16-11.
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Abstract The third-generation antibody-drug conjugates, Trastuzumab-Deruxtecan (T-DXd) and Sacituzumab Govitecan (SG), have been approved for the treatment of metastatic breast carcinoma in various subtypes and therapeutic settings based on compelling Phase III study data. (DESTINY-Breast03 (T-DXd; HER2-positive), DESTINY-Breast04 (T-DXd; HER2-low), ASCENT (SG; triple-negative), and TROPiCS-02 (SG; HR+/HER2-negative). The aim of this retrospective study conducted at two major German Breast centers was to evaluate the tolerability, adherence, and efficacy of both substances in the real-world setting. All patients treated outside of clinical trials with T-DXd or SG at the Department of Gynecology and Obstetrics, Ulm University Hospital and the Department of Women’s Health, Tuebingen University Hospital between November 2020 and May 2023 were included in this retrospective analysis. Seventy-five patients were included [T-DXd: 46; SG: 29]. The mean duration of therapy was 5.4 months [T-DXd: 6.2; SG: 4.2]. The real-world cohort was more heavily pretreated than the corresponding study cohorts, with a mean of 4.2 systemic therapies in the metastatic setting prior to T-DXd therapy and 3.6 systemic therapies prior to SG therapy. The administered cumulative dose on average was 87.9% [T-DXd: 94%; SG: 79%] of the theoretical full dose or 95.3% [T-DXd: 98%; SG: 92%] when considering dose reductions that occurred. Hematotoxicities of CTC ≥ 3° occurred in 11% of patients treated with T-DXd and in 41% of patients treated with SG. Neutropenia was the predominant severe hematotoxicity (CTC≥III°) observed during SG therapy, occurring in 38% of patients. The occurrence of neutropenia during SG therapy was reduced with primary prophylactic administration of Granulocyte-Colony Stimulating Factor (GCSF), with a rate of 29% (21/29) of patients experiencing neutropenia ≥CTC-III°, compared to 63% (8/29) without primary prophylactic GCSF. Therapy-associated pneumonitis under T-DXd occurred in 5 out of the 46 included patients and was successfully treated with corticosteroids in all cases (CTC II° in 4 cases, CTC III° in 1 case). The median progression-free survival (PFS) from initial administration was 7.7 months under T-DXd [HER2-positive: 9.0; HER2-low: 6.1], and 4.8 months under SG [TNBC 4.8; HR+/HER2-negative: 2.8]. The median overall survival from initial administration was 27.1 months under T-DXd [HER2-positive: 27.1; HER2-low: not reached], and 11.9 months under SG therapy [TNBC: 11.0, HR+/HER2-negative: not reached]. This analysis provides evidence of the efficacy and tolerability of T-DXd and SG in a heterogeneous and heavily pretreated cohort in a real-world setting. However, a conclusive assessment of progression-free survival (PFS) and overall survival (OS) is not feasible yet, as a substantial number of patients are still under treatment. Updated PFS and OS data, with a specific focus on the therapy indication, will be presented at the meeting. Citation Format: Henning Schäffler, Dominik Dannehl, Kristina Veselinovic, Franziska Mergel, Kerstin Pfister, Brigitte Rack, Visnja Fink, Elena Leinert, Lea Volmer, Tobias Engler, Sara Brucker, Wolfgang Janni, Andreas Hartkopf. Novel antibody-drug-conjugates in clinical routine: adherence, efficacy and tolerability - real-world data from German breast centers [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-16-11.
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Xie, Chencheng, Jonathan M. Fenkel, Dina L. Halegoua-DeMarzio, Jesse M. Civan, Danielle M. Tholey, Steven K. Herrine, Manish Thapar, et al. "Acute Liver Failure Requiring Liver Transplantation due to Acute Hepatitis A Virus Infection." Case Reports in Transplantation 2021 (December 27, 2021): 1–4. http://dx.doi.org/10.1155/2021/5159934.
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Introduction. Hepatitis A infection (HAV) is generally characterized by an acute icteric illness or may have a subclinical self-limited course, although rarely, can result in fulminant hepatitis and death. In 2019, the City of Philadelphia declared a public health emergency due to an HAV outbreak. We are reporting a series of four cases of acute liver failure (ALF) requiring liver transplantation (LT) due to acute HAV. Methods. Chart review and case descriptions of four patients with acute HAV-related ALF who were expeditiously evaluated, listed as Status 1A, and who underwent LT between August 2019 and October 2019 at Thomas Jefferson University Hospital. Results. All four patients presented with acute hepatocellular jaundice and had a positive HAV IgM, and all other causes of ALF were excluded. All four cases met the American Association for the Study of Liver Diseases (AASLD) criteria for ALF. Three of the four cases met King’s College Criteria of poor prognosis for nonacetaminophen-induced ALF. All four patients underwent successful LT and were discharged six to twelve days postoperatively. One patient died of disseminated Aspergillus infection five months after LT, while the others have had excellent clinical outcomes shown by one-year follow-ups. All four explants had remarkably similar histological changes, revealing acute hepatitis with massive necrosis accompanied by a prominent lymphoplasmacytic inflammatory infiltrate and bile ductular proliferation. Conclusion. Although rare, patients presenting with acute HAV need close monitoring as they may rapidly progress to ALF. Early referral to a transplant center afforded timely access to LT and yielded overall good one-year survival. Widespread HAV vaccination for high-risk individuals is an essential strategy for preventing disease and curbing such future outbreaks.
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De Vasconcelos, Ana Cecilia, Candice Santos, Jurema Telles, Maria Julia Mello, and Bárbara Luz. "Abstract PO3-18-02: RISK FACTORS FOR DEATH IN ELDERLY PATIENTS WITH BREAST CANCER TREATED IN AN ONCOLOGY REFERENCE HOSPITAL IN THE CITY OF RECIFE, BRAZIL." Cancer Research 84, no. 9_Supplement (May 2, 2024): PO3–18–02—PO3–18–02. http://dx.doi.org/10.1158/1538-7445.sabcs23-po3-18-02.
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Abstract Background: Breast cancer (BC) is the most common type of cancer among women in the world and in Brazil as well. Age is the most important risk factor for the development of cancer. The treatment of BC in elderly women is particularly challenging, as physiological changes, functional deficits, comorbidities and the use of polypharmacy can alter the risk of toxicity. We conducted this trial to determine the risk factors for deaths in less than 180 days after admission in elderly cancer patients with BC treated at the Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Brazil, and correlate with specific aspects of this type of cancer, such as type of treatment and immunohistochemical profile. Methods: Prospective cohort, in women aged ≥ 60 years, diagnosed with BC, admitted to the IMIP Oncogeriatric Service. At admission, sociodemographic and clinical variables and 10 tests that make up the CGA (Comprehensive Geriatric Assessment) were evaluated, including Mini Nutritional Assessment Short Form (MNA-SF), Polypharmacy and KPS (Karnofsky Performance Status). The follow-up period was at least six months. Descriptive, bivariate analysis using the Fisher and Chi-square tests, a survival study using the Kaplan-Meier method and univariate analysis were performed, including those with p < 0.20 in the multivariate Cox proportional hazards model controlled by Age and Tumor staging. All subjects involved in the research were informed about the objectives of the study and were only included after voluntarily agreeing to participate, signing the informed consent form. Results: The study sample consisted of 326 patients diagnosed with BC in the period from January 2015 to December 2020, all female, with a mean age of 73.46 years (SD ± 7.81). Sociodemographic, clinical and treatment characteristics are described in Table 1. Of the 326 patients, 46 (14,1%) died, and of these, 21 (45,7%) had an infection and 18 (39,1%) required hospitalization. Regarding the domains of the CGA, the characteristics of patients both in the general population and those who died are described in Table 2. After multivariate analysis by Cox regression of clinical variables related to the Comprehensive Geriatric Assessment (CGA) according to death, were identified as a risk factor for death: MNA-SF < 12 (HR = 2,76, IC95%, 1,49-9,48, p =0,001), KPS ≤ 50% (HR = 4,39, IC95%, 2,03-9,48,p < 0,001). Conclusions: In order to improve the efficacy and safety of the treatment of elderly women with BC and to improve their quality of life, the instruments of CGA should be performed routinely. In this population, KPS and Mini Nutritional Assessment Short Version (MNA – SF) were identified as important predictors of early death (180 days after admission). Therefore, in elderly patients with BC who are at risk for malnutrition and have low KPS, the treatment should be analyzed with caution, as well as the evaluation for concomitant early palliative care. Table 1. Sociodemographic, clinical and treatment characteristics of elderly patients treated for BC at IMIP, Recife, 2015-2020. Table 2. Characteristics of CGA (Compreensive Geriatric Assessment) of elderly patients treated for BC at IMIP, Recife, 2015-2020. Citation Format: Ana Cecilia De Vasconcelos, Candice Santos, Jurema Telles, Maria Julia Mello, Bárbara Luz. RISK FACTORS FOR DEATH IN ELDERLY PATIENTS WITH BREAST CANCER TREATED IN AN ONCOLOGY REFERENCE HOSPITAL IN THE CITY OF RECIFE, BRAZIL [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-18-02.
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Zetts, Rachel M., Andrea Stoesz, Andrea M. Garcia, Jason N. Doctor, Jeffrey S. Gerber, Jeffrey A. Linder, and David Y. Hyun. "Primary care physicians’ attitudes and perceptions towards antibiotic resistance and outpatient antibiotic stewardship in the USA: a qualitative study." BMJ Open 10, no. 7 (July 2020): e034983. http://dx.doi.org/10.1136/bmjopen-2019-034983.
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ObjectivesAt least 30% of outpatient antibiotic prescriptions are unnecessary. Outpatient antibiotic stewardship is needed to improve prescribing and address the threat of antibiotic resistance. A better understanding of primary care physicians (PCPs) attitudes towards antibiotic prescribing and outpatient antibiotic stewardship is needed to identify barriers to stewardship implementation and help tailor stewardship strategies. The aim of this study was to assess PCPs current attitudes towards antibiotic resistance, inappropriate antibiotic prescribing and the feasibility of outpatient stewardship efforts.DesignEight focus groups with PCPs were conducted by an independent moderator using a moderator guide. Focus groups were audio recorded, transcribed and coded for major themes using deductive and inductive content analysis methods.SettingFocus groups were conducted in four US cities: Philadelphia, Birmingham, Chicago and Los Angeles.ParticipantsTwo focus groups were conducted in each city—one with family medicine and internal medicine physicians and one with paediatricians. A total of 26 family medicine/internal medicine physicians and 26 paediatricians participated.ResultsParticipants acknowledged that resistance is an important public health issue, but not as important as other pressing problems (eg, obesity, opioids). Many considered resistance to be more of a hospital issue. While participants recognised inappropriate prescribing as a problem in outpatient settings, many felt that the key drivers were non-primary care settings (eg, urgent care clinics, retail clinics) and patient demand. Participants reacted positively to stewardship efforts aimed at educating patients and clinicians. They questioned the validity of antibiotic prescribing metrics. This scepticism was due to a number of factors, including the feasibility of capturing prescribing quality, a belief that physicians will ‘game the system’ to improve their measures, and dissatisfaction and distrust of quality measurement in general.ConclusionsStakeholders will need to consider physician attitudes and beliefs about antibiotic stewardship when implementing interventions aimed at improving prescribing.
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Balabanovich, T. I., K. M. Surmach, S. N. Dziamidzik, V. V. Budrevich, and R. S. Warnakulasuriya Fernando. "Gottron’s Carcinoid Papillomatosis: Case Report." Kuban Scientific Medical Bulletin 30, no. 6 (December 22, 2023): 81–88. http://dx.doi.org/10.25207/1608-6228-2023-30-6-81-88.
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Introduction. Gottron’s papillomatosis is a rare benign type of dermatosis with pseudoepitheliomatous hyperplasia of the epidermis, first described as an independent disease by the German dermatologist H.A. Gottron. Invasive epidermal growth and hyperkeratosis reveal no signs of malignancy. Chronic venous insufficiency and lymphedema can be associated with various secondary skin lesions: the formation of ulcers, hyperkeratosis and skin papillomatosis, as well as infectious complications. Skin papillomatosis may be a manifestation of paraneoplastic syndrome, which requires a careful differential diagnosis. Timely treatment of complications in a patient with concomitant somatic pathology performed by a multidisciplinary team of specialists is necessary to improve the prognosis. Considering the relative rarity of Gottron’s papillomatosis and the lack of awareness among practicing physicians regarding the differential diagnosis of this disease, we present this clinical analysis.Description of a clinical case. Patient L., 42 years old (body mass index — 76.5 kg/m2) with chronic lymphovenous insufficiency, lymphedema, erysipelas of the right lower limb associated with unspecified skin papillomatosis, was urgently hospitalized in a health care institution “City Clinical Hospital No. 3” of Grodno (Republic of Belarus), consulted by a multidisciplinary team of clinicians including a therapist, a cardiologist, a dermatologist, an endocrinologist, an infectious disease specialist, and a surgeon. Taking into account the clinical status of the patient and the retrospective analysis of archival records of previous examinations performed on the patient in the health care institution “Grodno University Clinic”, the type of dermatosis was determined as Gottron’s papillomatosis of both lower extremities. In terms of the clinical diagnosis of the patient, complex therapy was initiated in a hospital setting, which was then continued at the outpatient stage.Conclusion. Adequate long-term treatment of morbid obesity and chronic lymphovenous insufficiency is necessary to prevent serious complications. According to the academic literature, timely diagnosis of such a rare dermatosis as Gottron’s papillomatosis, as well as the prescription of adequate therapy determine the possibility of regression in the early stages of the disease.
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Guadarrama-Orozco, Jorge Alberto, Paula Leal-Anaya, and Eva Guerrero-Santillan. "Abstract 6133: Genetic profiling landscape among gynecological and breast cancer patients in the borde city of Tijuana, Mexico: A comprehensive study." Cancer Research 84, no. 6_Supplement (March 22, 2024): 6133. http://dx.doi.org/10.1158/1538-7445.am2024-6133.
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Abstract Background: Individuals in Tijuana have been identified as having multicultural and racial diversity. In Baja, California, Mexico, the prevalence and composition of cancer-predisposing germline variants in gynecologic cancers in Tijuana patients have not been evaluated. Aim and Methods: We aimed to evaluate the prevalence of pathogenic variants (PV) using a panel of 84 cancer-predisposing genes in breast, endometrial, and ovarian cancer from the General Hospital of Tijuana during the period of October 2021-October 2023, who were contacted and invited to participate in the evaluation. Pre- and post-test genetic counseling was given, and a questionnaire on personal, gyneco-obstetric, demographic, and lifestyle variables was conducted. Peripheral blood samples were obtained from all patients, and Next-generation sequencing (NGS) was performed on the Illumina commercial platform (Illumina, SD, USA). Variants were classified according to the American College of Medical Genetics and Genomics (ACMG). Data was collected and descriptive statistics was applied to describe the characteristics of the population. Results: A total of 51 patients were included in our cohort; 98.0% (50/51) were females and 2% (1/51) were males. Among study participants (mean age ±standard deviation: 46.1 ± 10.9), 49% reported a personal history of cancer (25/51). Diagnosis of breast cancer was present in 80.3% of the patients (41/51), 9% (5/51) with ovarian cancer, and 3.9% (2/51) with endometrial cancer. Twenty-five percent of participants (13/51) harbor a PV or likely pathogenic (LP) variant distributed among four cancer-risk genes (BRCA1, BRCA2, ATM, and TP53). The distribution by gene in the patients with a PV was: BRCA1 in 61% (8/13), BRCA2 in 23% (3/13), TP53 in 8% (1/13), and ATM in 8% (1/13). Whereas 39.2% (20/51) had variants of uncertain clinical significance in genes with ambiguous or non-well-established risk association for cancer (BARD1, AXIN2, GPC3, NF2, CEBPA, MSH3, ALK, DIS3L2, CDC73, BAP1, RAD51D, NF1, MSH2, BLM, NBN, BRCA2, BARD1, RUNX1, RECQL4, EGFR, PALB2, CASR, and POLD1), and 35.2% (18/51) had negative results for both; PV and VUS. Conclusion: Our findings show a diverse pathogenic variant composition among the recruited individuals of the gynecological cancer population in Tijuana, Mexico, consistent with being a high-risk population for genetic diseases, which warrants further investigation to adequately assess the burden of hereditary cancer and implement appropriate preventative programs. Disparities in access to testing have a significant impact on affected populations, due in part to underrepresentation in surveys of regional cancer etiology and in genomic variant databases. Citation Format: Jorge Alberto Guadarrama-Orozco, Paula Leal-Anaya, Eva Guerrero-Santillan. Genetic profiling landscape among gynecological and breast cancer patients in the borde city of Tijuana, Mexico: A comprehensive study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6133.
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Parger, Anna-Maria, Daniela Muhr, Christian F. Singer, and Yen Y. Tan. "Abstract P4-12-10: Cancer worry among healthy BRCA mutation carriers in Austria: A pilot study." Cancer Research 82, no. 4_Supplement (February 15, 2022): P4–12–10—P4–12–10. http://dx.doi.org/10.1158/1538-7445.sabcs21-p4-12-10.
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Abstract Background: Breast cancer risk in BRCA mutation carriers is up to 10 times higher compared to the general population. To support these patients, it is imperative to understand the worry that these patients face when they find out that they are a pathogenic mutation carrier. The aim of this study was to assess cancer worry among healthy BRCA mutation carriers using the 8-item cancer worry instrument. As there is no German version available, the aim of the study was two-fold. One was to translate the cancer worry scale (CWS) into German, and the second was to pilot the questionnaire to compare cancer worry between BRCA mutation carriers and gender. Methods: Healthy patients who underwent genetic counselling/testing at the Medical University of Vienna/Vienna General Hospital were randomly identified from 2015-2020. The English version of the 8-item CWS was forward and backwards translated by independent interpreters. A final version was composed together with medical doctors, a breast care nurse and a psychologist. The final version was piloted to a small group of healthy BRCA mutation carriers. A total of 63 potential participants [BRCA1: N=41 (65%), BRCA2: N=22 (35%); female: N=50 (79%), male: N=13 (21%)] were identified and invited to participate in the study. An invitation pack including an invitation letter, a patient consent form and the translated instrument was sent out in January 2021. Non-responders were followed up twice by phone calls. With the feedback, a final version was put together with another independent translator and confirmed by the committee. Results: Of 63 potential participants, 35 (female: 30, 85% vs. male: 5, 14%) returned the questionnaire after 2 follow-up calls, giving a response rate of 56%. Twenty-eight individuals (80%) carry a BRCA1 mutation, while remaining 7 (20%) were BRCA2 mutation carriers. All participants were native German speakers. Their age when completing the questionnaire differ significantly between BRCA1 (median age: 40 years; range: 26-68 years) and BRCA2 (median age: 51 years; range: 30-64 years) carriers (p=0.028). Almost half of all participants work full time (46%) and have an average or high income (69% = more than 18.000 Euros/year net income). It is noteworthy, that 57% underwent prophylactic surgery, such as mastectomy, adnexectomy, salpingectomy or both, mastectomy and adnexectomy. Of 35 respondents who completed the CWS, 27 (77%) reported high cancer worry. All male responders reported high cancer worry versus 22 females. Although no significant difference. was observed between gender, it is remarkable that men worry more about the possibility of family members developing cancer than their female counterparts (60% male vs 24% female). However, no one indicated that their worry interferes with their ability to conduct daily activities. Interestingly, those with average or high income report higher cancer worry than their counterparts (p= 0.024), and those who underwent risk-reducing surgery, regardless of type of surgery, were found to have significantly less cancer worry compared to those who did not undergo risk-reducing surgery (p=0.014). There were no differences observed in cancer worry between BRCA mutation group (81% BRCA1 vs 71% BRCA2, p=0.615), employment status (p=0.064), marital status (p=0.306), education (p=0.875), or being more physically active (p=0.715). Conclusion: Our results show that although men were less motivated to participate, they worry more than their female counterparts. In addition, those who with higher income also experience higher cancer worry. To our knowledge, this is the first time CWS has been translated to German and for use in the high-risk BRCA population. Our results are hampered by small sample size and remain to be validated in a larger study. Citation Format: Anna-Maria Parger, Daniela Muhr, Christian F Singer, Yen Y Tan. Cancer worry among healthy BRCA mutation carriers in Austria: A pilot study [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-12-10.
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Batista, Bruno, Sergio Ioshii, Sergio Padilha, Jacqueline Nabhen, Tayza Ostroski, and Caroline Batista. "Abstract PO3-15-07: False-negative results of hyperexpression of HER2 receptor in breast cancer at a public tertiary hospital in Brazil." Cancer Research 84, no. 9_Supplement (May 2, 2024): PO3–15–07—PO3–15–07. http://dx.doi.org/10.1158/1538-7445.sabcs23-po3-15-07.
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Abstract Introduction: Breast cancer (BC) is the second leading cause of cancer death in women worldwide. One of the major advances in BC management was its molecular classification, especially regarding the Human Epidermal growth factor Receptor 2 (HER2). HER2 positive tumors are at greater risk of visceral metastasis and are associated with worse survival rates. Thus, the use of specific drugs to target this pathway is essential and false-negative have a high impact on patient care. HER2 status is usually accessed using immunohistochemistry (IHC), but false-negatives results occur. When IHC results are inconclusive, in-situ hybridization (ISH) testing is necessary. Objective: to determine if there is variability between the positivity rates between laboratories that performed the ISH, according to the IHQ, and to evaluate if there are false-negative results and possible prognostic impact. Methods: retrospective, observational study in a public hospital in the city of Curitiba (Brazil), followed by cross-sectional analysis of histological samples. All cases of BC that underwent HER2 assessment by IHC and ISH between January 2008 and December 2018 were included. Participants classified as HER2 negative by IHC and patients whose medical records were not available were excluded. A new analysis of all IHC slides and of cases with negative ISH was performed. Results: We identified 205 people with an average age of 53.52 (± 11.89) years. Most cases were classified as clinical stage I and II (68.3%), and the most prevalent histological features were Invasive Ductal Carcinoma (82.4%) and luminal molecular subtype (49.8%). Initial ISH testing was performed by four laboratories. There was a significant difference in HER2 positivity rates between these laboratories, even after individual reanalysis of all IHC slides. Of the 114 cases with negative ISH, it was possible to obtain histological material in 82 of them to perform a new standardized ISH. The false-negative rate for HER2 in this 82 patients was 41.46%, with 10 cases out of 24 for positive IHC (3+) and 22 out of 58 for inconclusive IHC (2+). In this paper, false-negative results did not impact in survival, most likely to differences between groups. Conclusion: our work showed different rates of positivity for HER2 among laboratories that performed confirmatory test with ISH. The performance of a second standardized ISH proved that the difference between the laboratories was due to false-negative results. There was no difference in recurrence and cancer-specific survival in this false-negative sample. Keywords: breast cancer. Biomarkers. Health technology assessment. HER2 receptor. DIfferences between laboratories reagarding HER2 false negatives –insert figrue image– Citation Format: Bruno Batista, Sergio Ioshii, Sergio Padilha, Jacqueline Nabhen, Tayza Ostroski, Caroline Batista. False-negative results of hyperexpression of HER2 receptor in breast cancer at a public tertiary hospital in Brazil [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-15-07.
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Häfner, H., A. Riecher, K. Maurer, W. Löffler, P. Munk-Jørgensen, and E. Strömgren. "How does gender influence age at first hospitalization for schizophrenia? A transnational case register study." Psychological Medicine 19, no. 4 (November 1989): 903–18. http://dx.doi.org/10.1017/s0033291700005626.
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SYNOPSISNumerous studies have reported a lower mean age at first hospitalization for schizophrenia in males than in females. For this finding not only a gender difference in age at first onset of schizophrenia, but also other factors can be responsible. With the aim of providing a comprehensive analysis of gender differences in onset, symptomatology and course of schizophrenia, we started by testing the hypothesis postulating a gender difference in mean age at first hospitalization. By using the Danish and the Mannheim psychiatric case registers we analysed all hospital admissions for schizophrenia and related diagnoses and all previous admissions for other diagnoses of the Danish population in 1976 and those of the inhabitants of the German city of Mannheim in the period of 1978–80. Artefacts were controlled for systematically. The impact of intervening variables such as selection factors as well as the influence of gender on the ascription of a diagnosis of schizophrenia for the first time were assessed. We found a mean difference of 5 to 6 years in age at first hospitalization between males and females in both countries when a broad definition of the diagnosis was used and of 4 to 5 years when a restrictive definition was applied. The higher mean age at first hospitalization among females is not attributable to artefacts, diagnostic procedures or to any essential extent to gender differences in help-seeking behaviour or occupational status. When a distinction was made between ‘single’ and ‘married’, the significant difference in age at first hospitalization between the sexes disappeared in singles. With case register data and without knowing the chronological order of marriage and onset of the disease, it remains an open question whether this finding can be explained by purely correlative associations between sex, marital status and age of onset or by causal effects.
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Soucy, Melissa, Nick Renzette, Xinming Zhuo, Prasanti Nuni, Kristi Herlth, Kevin Kelly, Gregory Omerza, and Lei Li. "Abstract 2233: Clinical validation of a methylation array-based diagnostic assay for improved classification of CNS tumors." Cancer Research 83, no. 7_Supplement (April 4, 2023): 2233. http://dx.doi.org/10.1158/1538-7445.am2023-2233.
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Abstract Current cIMPACT-NOW and WHO guidelines state that the accurate diagnosis of many central nervous system (CNS) tumors must not only incorporate traditional histological findings but also include additional molecular data derived from sequence and methylation profiling techniques. To address this clinical need, our group has adapted and clinically validated the CNS tumor classifier that was pioneered and developed by the German Cancer Research Network (DKFZ) and University Hospital Heidelberg for both adult and pediatric CNS tumors. The classifier analyzes whole genome methylation data derived from the Illumina EPIC array system with a machine learning algorithm trained on a large reference set to provide a tumor family and class (a more granular classification than family) along with calibrated scores to aid in determining confidence in the assigned classifications. Around this core algorithm, we have generated a computational and reporting pipeline to generate a mid-throughput clinical diagnostic assay. We have validated this assay using a combination of adult and pediatric CNS tumor samples and have established reliable run-level and sample-level quality control metrics with empirically defined thresholds. With these thresholds, approximately 90% of samples with a neoplastic content of 70% or greater were “classifiable”, such that a result could be returned by the CNS tumor diagnostic assay. The performance of the assay was exceptional, with a sensitivity, specificity and accuracy each greater than 98% as determined with a validation sample set of 105 specimens. Further, 4 discordant calls between the original diagnosis and the output of the new methylation-based diagnostic were identified and underwent further histopathologic review. This additional analysis led to the re-classification of 2 specimens due to molecular analysis, highlighting the clinical utility of the assay. The new assay is currently offered for clinical testing under the name JAX OncoMethyl ArrayTM and addresses a clear need in the field of CNS tumor diagnostics. Citation Format: Melissa Soucy, Nick Renzette, Xinming Zhuo, Prasanti Nuni, Kristi Herlth, Kevin Kelly, Gregory Omerza, Lei Li. Clinical validation of a methylation array-based diagnostic assay for improved classification of CNS tumors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 2233.
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van Mark, Anke, Tim Hallstein, Fabian Holzgreve, David A. Groneberg, and Daniela Ohlendorf. "How do different navigation systems affect emergency response time? A prospective simulation study." BMJ Open 14, no. 7 (July 2024): e079094. http://dx.doi.org/10.1136/bmjopen-2023-079094.
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ObjectiveThere has not been a theoretical test run in Germany that compares different navigation systems with an industry solution (MapTrip112). The aim of this study was to compare navigation systems to elucidate whether the emergency response time (ERT) was reduced and, consequently, whether the adherence to the travel time improved.DesignProspective, simulation study, cross-sectional study.SettingOffices of the Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt (60 590 Frankfurt am Main, Germany). The situation-adaptable industry navigation solution MapTrip112 was tested in its ‘Lights and Siren(s) (L&S)’ mode in comparison to the TomTom and Google Maps navigation systems. MapTrip112 was set to calculate a route that takes special emergency rights of way into account.Outcome measuresAll three navigation systems simultaneously calculated the distances and durations of fictitious routes. Three scenarios were tested: the University Hospital Frankfurt (60 596 Frankfurt am Main, Germany) and the Central Fire Station 1 (60435 Frankfurt am Main, Germany) served as the starting points for the urban routes, while the Odenwald Health Centre (64 711 Erbach, Germany) served as the starting point for rural routes. The routes’ endpoints were arbitrarily chosen locations inside the customary operational radius. The routes were selected for short and long distances as well as for different periods, including weekdays, weekends and evening rush hour (4–7 pm), in the German cities of Frankfurt am Main and Odenwaldkreis (Southern Hesse).ResultsThe time and distance were calculated for a total of 4650 trips. When comparing travel times and distances between rural and urban areas as well as between weekdays and weekends, statistically significant results were obtained (p<0.001). With time advantages ranging from 23.5 s to 300.5 s (4.75% to 50% of the travel time) on weekdays and weekends, MapTrip112 consistently outperformed both TomTom and Google Maps. For city missions, MapTrip112 achieved time gains of up to 50% over its competitors, with significant advantages during the rush hours and around specific locations such as the University Hospital Frankfurt and Fire Station 1.ConclusionMapTrip112 always achieved the fastest routes although these were not always accompanied by a shortened distance. These findings underscore MapTrip112’s superiority in providing efficient routing solutions across various scenarios. For this reason, the use of this software should be considered in practice and investigated in real-world conditions in further studies.
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Battaglia, Tracy A., Karen M. Freund, Jennifer S. Haas, and Stephenie C. Lemon. "Abstract A039: Translating research into practice: Results of a community-engaged, city-wide breast cancer patient navigation implementation study to reduce disparities." Cancer Epidemiology, Biomarkers & Prevention 32, no. 12_Supplement (December 1, 2023): A039. http://dx.doi.org/10.1158/1538-7755.disp23-a039.
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Abstract Introduction: Delays in accessing breast cancer care contribute to poor outcomes among women of color and those underinsured. Patient navigation is one of few proven interventions that overcome inequity in cancer care delivery, yet there is a need to address barriers to widespread implementation. Methods: Led by a city-wide coalition of multi-sector stakeholders, we conducted a Type 1 hybrid clinical effectiveness-implementation trial across five hospitals in Boston to test the impact of navigation on timely initiation of breast cancer treatment, while also exploring implementation outcomes including acceptability of and fidelity to an evidence-informed 11-step navigation protocol. A randomized cluster stepped wedge study design allowed for rolling out a multi-level navigation protocol iteratively in real life practices from 2019 through 2022. Hospital cancer registries sourced eligible cancer cases, while electronic medical record abstraction documented timely treatment, defined as within 60 or 90 days depending on the diagnosis. Odds ratios adjusted for time by calendar quarter and accounted for clustering by study site. Fidelity to protocol was measured using navigator documentation of interactions with patients and conducting social needs screenings. Key informant interviews and field observations were conducted to assess acceptability. Results: A total of 1,732 women with newly diagnosed breast cancer were included in the intent to treat analysis (553 historical control period, 1,179 intervention period). By study design, the majority of women were nonwhite (80%) and more than half were non-English speaking and on public health insurance. During the intervention period, 50% (n=587) had no documented evidence of receiving any contact from a navigator, 15% (n=181) had only one documented interaction with the navigator while 35% (n=407) were navigated and received social needs screens in accordance with study protocol. Compared with historical controls, navigated patients who received a social needs screen had twice the odds of receiving timely treatment (aOR 2.06, 95% CI 1.39, 3.06), those who had only one documented interaction with the navigator had 1.4 greater odds of timely treatment (aOR 1.44, 95% CI 1.08, 1.93) and those with no documented evidence of navigation were no more likely to receive timely treatment (aOR 1.42, 95% CI 0.81, 2.48. We found variability in how navigators identified patients, with significant disruption during the COVID pandemic. Navigators found navigation protocols and social needs screening acceptable, and patients reported feeling supported when asked about social needs. The study protocol formalized the navigation process within and across hospitals, yet tension for change in existing workflows and complexity in documentation served as barriers to adoption. Conclusions: Receipt of navigation is associated with more timely care among a diverse group of women at risk for poor outcomes. Despite stakeholder engagement, implementation of evidence-based breast cancer patient navigation remains suboptimal. Citation Format: Tracy A. Battaglia, Karen M. Freund, Jennifer S. Haas, Stephenie C. Lemon, Translating Research Into Practice (TRIP) Consortium. Translating research into practice: Results of a community-engaged, city-wide breast cancer patient navigation implementation study to reduce disparities [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A039.
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Otto, William, Rebekah Dumm, Yasaman Fatemi, and Sanjeev K. Swami. "664. Clinical Impact of Cell-Free DNA Metagenomics in Diagnosing Infectious Diseases in Pediatrics: A Single-Center Experience." Open Forum Infectious Diseases 8, Supplement_1 (November 1, 2021): S434. http://dx.doi.org/10.1093/ofid/ofab466.861.
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Abstract Background Metagenomic next-generation sequencing (mNGS) of plasma cell-free DNA has significant potential to improve infectious diseases diagnostics through unbiased detection of pathogens. However, the optimal patient population or clinical condition for this testing has not been determined. Methods We performed a retrospective review of all orders for plasma cell-free DNA mNGS using the Karius test (Karius, Redwood City, CA) from The Children’s Hospital of Philadelphia from 7/1/19-4/30/21. Chart review then determined if the test had a positive, negative, or no clinical impact. Results 25 mNGS tests were ordered on 24 unique patients. The majority of tests were ordered on immunocompromised patients (Table 1). Most mNGS tests were ordered after completion of routine microbiological testing (17/25, 71%). Three tests were not completed as ordered. Most completed tests (18/22, 82%) had no impact on clinical care as they confirmed the known diagnosis or were not acted upon (Figure 1). mNGS testing had a positive impact in 2 cases. For one patient with congenital heart disease presented with persistent fever and concern for endocarditis despite negative infectious workup, a negative mNGS result allowed for continued monitoring without therapy. Another patient with a lymphatics disorder had mNGS performed due to persistent clinical instability; testing was positive for Candida parapsilosis, allowing for early initiation of antifungal therapy. However, test results had a negative clinical impact in 2 other patients. In a patient with congenital heart disease and fever, identification of two organisms led to prolonged antibiotic therapy for endocarditis without resolution of symptoms. In a patient with leukemia, report of a dematiaceous mold led to further diagnostic testing, including a lumbar puncture, as well as treatment with antifungal therapy despite no clear diagnosis. Table 1 Conclusion In this study, the majority of plasma cell-free mNGS tests had no impact on clinical care. mNGS testing did positively impact care in 2 patients, but did had a negative impact on care in 2 instances, leading to further testing and unnecessary treatment. Further investigation is needed to determine the ideal population or clinical condition for testing and the ideal time of sending plasma cell-free mNGS tests. Disclosures All Authors: No reported disclosures
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Alabbody, Huda Hameed Kadhim. "Incidence of Canine Digestive System Tumours in Baghdad Province." Iraqi Journal of Veterinary Medicine 43, no. 2 (December 28, 2019): 67–76. http://dx.doi.org/10.30539/iraqijvm.v43i2.533.
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Tumours in pets occur naturally are as common in dogs as they are in humans. Tumours of the alimentary system have been reported in animals, although less frequently. Food patterns and specific diet components could have a big role in such tumour occurrence. Therefore, the aim of this study was to investigate the clinical signs and inspect the neoplasm lesions of the gastrointestinal (GI) tract grossly and histopathologically in dogs in Baghdad, Iraq, and to see whether pet diets had any tumourigenic effect. Throughout two years sixteen dogswere referred to Teaching Animal Hospital and private clinics at Baghdad city had masses in (GI) tract. Males and the large sizes breeds were more likely to be affected with GI tumours. Half of the cases aged 5-10 years and belonged to German Shepherd, while the other half involved the other breeds (i.e. Belgian Malinois, Labrador, Pointer GSP and Terrier) equally. Biopsies were taken from the tumour tissues for histological examination. Clinically, the animals presented general signs of digestive system abnormalities like difficulty defecating, bloody stool, lethargy and weight loss. Grossly, the tumours varied in their sizes from <3 cm to >5 cm in diameter, and the most frequent site of occurrence (10 out of 16 cases) was in the large intestine. Histologically, the most tumours reported were malignant, and included adenocarcinomas (6/16) followed by leiomyosarcoma (4/16), and 2/16 belonged to carcinoid tumour. However, lipoma and viral papilloma (4/16) were also registered as the benign tumours. Inconclusion,tumours of canine digestive system do exist but rare. The healthy nutrition of dog may be prevent this type of tumour when dog consume enough amount of raw meat, little of artificial food like kibble with small of some vegetables and fruits. Additionally, the information gained from dogs could be used to suspect and test the effect on humans as they have strong pathophysiology similarities
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Kartashev, I. V. "Stavropol medical institute to help the front." Гуманитарные и юридические исследования 10, no. 3 (2023): 383–89. http://dx.doi.org/10.37493/2409-1030.2023.3.3.
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Introduction. An important role in achieving the victory of the Soviet people over Nazi Germany in the Great Patriotic War was played by training institutions that the Red Army badly needed - military, engineering, medical. One of the higher educational institutions that trained doctors for the front and rear in the south of the country was the Stavropol State Medical Institute. However, information about his activities in a number of areas during this period of time was largely fragmentary. Materials and methods. The study is based on the analysis of documents and materials from the funds of the Central Archive of the Ministry of Defense of the Russian Federation and the State Archive of the Stavropol Territory, the archive and museum of the Stavropol State Medical University, the analysis of regional printed publications during the Great Patriotic War, as well as the results of previous scientific works on this issue. Based on a combination of information from various sources, the activities of the medical institute and its employees in providing assistance to the front both before the occupation of Stavropol and after its liberation from German troops are comprehensively considered. Analysis. The analysis showed that, along with the main task of training highly qualified medical workers by the university, its employees actively provided other assistance to the front. Results. In the course of the study, it was found that the specialists of the clinical departments of the university took an active part in the work of the evacuation hospitals of the city and the region, on the territory of which the largest hospital base of the Soviet troops was deployed. Research staff of the institute, among whom there were a large number of prominent scientists, participated in the development of military medical topics. Employees and students of the university were engaged in social, educational and propaganda activities, provided financial assistance to the front.
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Thill, Marc, Andrea Grafe, Peter Klare, Kerstin Luedtke-Heckenkamp, Dietmar Reichert, Pauline Wimberger, Matthias Zaiss, Katja Ziegler-Loehr, Tanja Eckl, and Andreas Schneeweiss. "Abstract P2-13-16: Dual HER2-blockade with pertuzumab (P) and trastuzumab (T) in patients with HER2-positive metastatic breast cancer (mBC) relapsing after adjuvant treatment with T. Results from a German non-interventional study (NIS) HELENA (NCT01777958)." Cancer Research 82, no. 4_Supplement (February 15, 2022): P2–13–16—P2–13–16. http://dx.doi.org/10.1158/1538-7445.sabcs21-p2-13-16.
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Abstract Background: Treatment of HER2 overexpressing mBC with the HER2 directed antibody combination of P and T became standard of care since marketing authorization of P based on the results of the randomized controlled CLEOPATRA trial (NCT 00567190). NIS HELENA was designed to document effectiveness and safety in clinical routine of first-line palliative therapy with P plus T and docetaxel (D) in patients with advanced HER2-positive BC after adjuvant therapy with T, and to determine whether the median PFS of 16.9 months (mos) reported for this subgroup in the CLEOPATRA trial can also be observed in day-to-day routine. Methods: Between 06/2013 through 07/2016, 126 patients with in-label use of P at study start (full-analysis set, FAS) in 81 German hospital-based or outpatient study sites were included into this NIS. Intense documentation period of this NIS was limited to 28 therapy cycles, and a follow-up (FU) for a maximum of 24 mos. Safety was assessed in all patients with at least one dose of P (safety set, SAF, n=132 ). QoL was assessed by FACT-B questionnaire. Main parameter of interest was mPFS. Patient Characteristics: Mean age of FAS patients was 55.1 [30.7 - 80.2] years, 81.7% (95.2%) were below 65 (75) years of age. 51.6% of the FAS patients were hormone-receptor positive (HR+), 91.3% patients of the FAS had distant, 69.8% had visceral, 45.2% liver metastases (VM). 89.7% patients of the FAS had R0-resection, including 44% breast conserving surgery, 42.9% of the FAS received neoadjuvant and 61.9% adjuvant chemo-/immunotherapy and 62.7% prior endocrine treatment. For the FAS median disease-free interval was 40.2 [6.6 - 95.9] mos. Effectiveness results: mPFS of FAS was 18.8 [15.1; 24.2] mos, longest mPFS was documented in patients with non-VM (20.5 [17.7, 27.7] mos), patients < 65 years (19.7 [15.4, 25.7] mos), and HR negative patients (19.4 [13.8, 27.7] mos). Overall response rate in the FAS was documented with 64.3% (55.6; 72.1], with best ORR in HR+ patients (69.2% [57.2, 79.1]), patients with VM (68.2%, [57.9, 77.0] and patients < 65 years (65% [55.5, 73.6]). 46 patients (36.5%) died during the study. Median OS was 55.9 mos [41.2, not reached] for the FAS. Safety: 93.9% of the SAF had an adverse event (AE), 32.6% a serious AE (SAE). AEs related to P occurred in 53.8% of SAF, SAEs related to P were documented in 13.6%. Diarrhea was the most frequently reported related (S)AE. Fatal AEs were seen in 6.1% of the SAF, in 2 patients related to P (death, central nervous system metastases and cerebral disorder). AEs leading to treatment discontinuation of any study product were observed in 20.5% of the SAF. During the intense documentation period, 11 patients had a LVEF <55%. QoL assessment using the total score index, increased slightly over time, however, based on declining patient response rates. Conclusion: Based on results from NIS HELENA, outcomes of pivotal CLEOPATRA study with respect to patients relapsing after adjuvant T pretreatment can be transferred into clinical routine. Patients derived benefit to a variable extent according to predefined subgroups. No new safety signals were detected. Citation Format: Marc Thill, Lead Auth., Andrea Grafe, Peter Klare, Kerstin Luedtke-Heckenkamp, Dietmar Reichert, Pauline Wimberger, Matthias Zaiss, Katja Ziegler-Loehr, Tanja Eckl, Andreas Schneeweiss. Dual HER2-blockade with pertuzumab (P) and trastuzumab (T) in patients with HER2-positive metastatic breast cancer (mBC) relapsing after adjuvant treatment with T. Results from a German non-interventional study (NIS) HELENA (NCT01777958) [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P2-13-16.