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Keywords
- Diagnostik (2)
- Früherkennung (2)
- Mammakarzinom (2)
- Nachsorge (2)
- Richtlinie (2)
- breast cancer (2)
- diagnosis (2)
- follow‑up (2)
- guideline (2)
- screening (2)
Institute
Foeckler, Francis ; Deichner, Oskar ; Ilg, Christiane ; Schmidt, Hans ; Scholz, Mathias ; Henle, Klaus
Hochwasserereignisse sind von besonderer Bedeutung, da sie die Auenlandschaft räumlich und zeitlich strukturieren und so eine große Vielfalt an Habitaten schaffen. Mollusken sind von großem Artenreichtum, der in den mitteleuropäischen Flussauen am höchsten ist. Sie sind relativ leicht zu determinieren und besitzen zudem eine geringe Mobilität und dementsprechend kleine Minimalareale. Darüber hinaus sind Ökologie und Habitatansprüche der meisten Arten gut bekannt. Dadurch eignen sich Mollusken sehr gut zur ökologischen Charakterisierung (Indikation) und zur naturschutzfachlichen Bewertung von Auenökosystemen. Obwohl in zahlreichen Studien bereits Molluskenzönosen in Auen beschrieben wurden, ist über die Reaktion von Mollusken auf Hochwasser, insbesondere Extremhochwasser, wenig bekannt, zumal kaum Daten vorliegen, die den Zustand vor und nach einem Extremereignis beschreiben. In diesem Beitrag werden die kurz- und mittelfristigen Auswirkungen des Sommerhochwassers 2002 auf Molluskengemeinschaften im Auengrünland der Mittleren Elbe beschrieben.
Ilg, Christiane ; Deichner, Oskar ; Foeckler, Francis ; Schmidt, Hans ; Henle, Klaus ; Scholz, Mathias
Mollusken eignen sich aufgrund ihrer spezifischen Eigenschaften sehr gut zur ökologischen Charakterisierung, naturschutzfachlichen Bewertung und Beweissicherung bei bevorstehenden Veränderungen innerhalb ihrer Lebensräume. Durch ihre geringe aktive Mobilität sind sie sehr stark an ihren Lebensraum gebunden. Ihre Biologie, Ökologie und Habitatansprüche sind gut bekannt. Gerade in Flussauen erreichen Mollusken sehr hohe Arten- und je nach standörtlichen Verhältnissen sehr hohe Individuenzahlen. Im Herbst 2006 sowie im Frühjahr und Herbst 2007 wurden Molluskenproben auf den Wiesen im Roßlauer Oberluch und auf zwei Referenzstandorten in der Kliekener Altaue entnommen mit dem Ziel, den Status Quo vor der Deichöffnung festzuhalten und die Entwicklung dieser Artengruppe nach der Deichrückverlegungsmaßnahme zu analysieren. Bislang liegen die Status-Quo-Ergebnisse der Herbst- und Frühjahrsaufsammlungen aus den Jahren 2006 und 2007 vor.
Dies ist der 17. Artikel in unserer Blogreihe Trouble on the Far-Right.
Um eines gleich deutlich zu machen: Über rechtsradikale Tendenzen in der Ukraine zu schreiben ist ein Drahtseilakt. Schließlich ist die Debatte in einen größeren Kontext eingebettet: Seit den Ereignissen auf dem Maidan 2014 und dem anschließenden Regime-Change erheben pro-russische Medien die sachlich schwer begründbare Beschuldigung, dass der Westen den Charakter der „faschistischen Junta in Kiew“ verkenne. Auf der anderen Seite bagatellisieren einige Publikationen die real existierenden rechten Umtriebe in der Ukraine beträchtlich. So handelt man sich schnell den Vorwurf ein, wahlweise „die faschistischen Ukrainer“ zu protegieren oder sich „den imperialistischen Russen“ anzubiedern. An dieser Stelle bleibt die notwendige Aufgabe Meinungen von Fakten zu trennen.
Die bedeutendste Kraft der parlamentarischen Rechten in der Ukraine ist die „Freiheitspartei“ Swoboda. Ihre Beteiligung an der Übergangsregierung nach den Maidan-Protesten galt einigen Beobachtern als Beweis für einen Rechtsruck in der Ukraine. Mittlerweile verfügt diese Partei nicht einmal mehr über eine parlamentarische Fraktion. Wie ist es dazu gekommen? Welche Dynamiken stehen dahinter? Ist letztendlich alles in trockenen Tüchern und die Gefahr von rechts gebannt?
Kowark, Ana ; Adam, Christian ; Ahrens, Jörg ; Bajbouj, Malek ; Bollheimer, Cornelius ; Borowski, Matthias ; Dodel, Richard ; Dolch, Michael ; Hachenberg, Thomas ; Henzler, Dietrich ; Hildebrand, Frank ; Hilgers, Ralf-Dieter ; Hoeft, Andreas ; Isfort, Susanne ; Kienbaum, Peter ; Knobe, Mathias ; Knüfermann, Pascal ; Kranke, Peter ; Laufenberg-Feldmann, Rita ; Nau, Carla ; Neuman, Mark D. ; Olotu, Cynthia ; Rex, Christopher ; Rossaint, Rolf ; Sanders, Robert D. ; Schmidt, Rene ; Schneider, Frank ; Siebert, Hartmut ; Skorning, Max ; Spies, Claudia ; Vicent, Oliver ; Wappler, Frank ; Wirtz, Dieter Christian ; Wittmann, Maria ; Zacharowski, Kai ; Zarbock, Alexander ; Coburn, Mark
Introduction: Hip fracture surgery is associated with high in-hospital and 30-day mortality rates and serious adverse patient outcomes. Evidence from randomised controlled trials regarding effectiveness of spinal versus general anaesthesia on patient-centred outcomes after hip fracture surgery is sparse.
Methods and analysis: The iHOPE study is a pragmatic national, multicentre, randomised controlled, open-label clinical trial with a two-arm parallel group design. In total, 1032 patients with hip fracture (>65 years) will be randomised in an intended 1:1 allocation ratio to receive spinal anaesthesia (n=516) or general anaesthesia (n=516). Outcome assessment will occur in a blinded manner after hospital discharge and inhospital. The primary endpoint will be assessed by telephone interview and comprises the time to the first occurring event of the binary composite outcome of all-cause mortality or new-onset serious cardiac and pulmonary complications within 30 postoperative days. In-hospital secondary endpoints, assessed via in-person interviews and medical record review, include mortality, perioperative adverse events, delirium, satisfaction, walking independently, length of hospital stay and discharge destination. Telephone interviews will be performed for long-term endpoints (all-cause mortality, independence in walking, chronic pain, ability to return home cognitive function and overall health and disability) at postoperative day 30±3, 180±45 and 365±60.
Ethics and dissemination: iHOPE has been approved by the leading Ethics Committee of the Medical Faculty of the RWTH Aachen University on 14 March 2018 (EK 022/18). Approval from all other involved local Ethical Committees was subsequently requested and obtained. Study started in April 2018 with a total recruitment period of 24 months. iHOPE will be disseminated via presentations at national and international scientific meetings or conferences and publication in peer-reviewed international scientific journals.
Trial registration number: DRKS00013644; Pre-results
Harbeck, Nadia ; Saupe, Steffen ; Jäger, Elke ; Schmidt, Marcus ; Kreienberg, Rolf ; Müller, Lothar ; Otremba, Burkhard ; Waldenmaier, Dirk ; Dorn, Julia ; Warm, Mathias ; Scholz, Michael ; Untch, Michael ; Wit, Maike de ; Barinoff, Jana ; Lück, Hans-Joachim ; Harter, Philipp ; Augustin, Doris ; Harnett, Paul ; Beckmann, Matthias Wilhelm ; Batran, Salah-Eddin al-
Purpose: The PELICAN trial evaluates for the first time efficacy and safety of pegylated liposomal doxorubicin (PLD) versus capecitabine as first-line treatment of metastatic breast cancer (MBC).
Methods: This randomized, phase III, open-label, multicenter trial enrolled first-line MBC patients who were ineligible for endocrine or trastuzumab therapy. Cumulative adjuvant anthracyclines of 360 mg/m2 doxorubicin or equivalent were allowed. Left ventricular ejection fraction of >50 % was required. Patients received PLD 50 mg/m2 every 28 days or capecitabine 1250 mg/m2 twice daily for 14 days every 21 days. The primary endpoint was time-to-disease progression (TTP).
Results: 210 patients were randomized (n = 105, PLD and n = 105, capecitabine). Adjuvant anthracyclines were given to 37 % (PLD) and 36 % (capecitabine) of patients. No significant difference was observed in TTP [HR = 1.21 (95 % confidence interval, 0.838–1.750)]. Median TTP was 6.0 months for both PLD and capecitabine. Comparing patients with or without prior anthracyclines, no significant difference in TTP was observed in the PLD arm (log-rank P = 0.64). For PLD versus capecitabine, respectively, overall survival (median, 23.3 months vs. 26.8 months) and time-to-treatment failure (median, 4.6 months vs. 3.7 months) were not statistically significantly different. Compared to PLD, patients on capecitabine experienced more serious adverse events (P = 0.015) and more cardiac events among patients who had prior anthracycline exposure (18 vs. 8 %; P = 0.31).
Conclusion: Both PLD and capecitabine are effective first-line agents for MBC.
Wöckel, Achim ; Festl, Jasmin ; Stüber, Tanja ; Brust, Katharina ; Stangl, Stephanie ; Heuschmann, Peter Ulrich ; Albert, Ute Susann ; Budach, Wilfried ; Follmann, Markus ; Janni, Wolfgang ; Kopp, Ina ; Kreienberg, Rolf ; Kühn, Thorsten ; Langer, Thomas ; Nothacker, Monika ; Scharl, Anton ; Schreer, Ingrid ; Link, Hartmut ; Engel, Jutta ; Fehm, Tanja ; Weis, Joachim ; Welt, Anja ; Steckelberg, Anke ; Feyer, Petra ; König, Klaus ; Hahne, Andrea ; Kreipe, Hans H. ; Knoefel, Wolfram Trudo ; Denkinger, Michael ; Brucker, Sara ; Lüftner, Diana ; Kubisch, Christian ; Gerlach, Christina ; Lebeau, Annette ; Siedentopf, Friederike ; Petersen, Cordula ; Bartsch, Hans Helge ; Schulz-Wendtland, Rüdiger ; Hahn, Markus ; Hanf, Volker ; Müller-Schimpfle, Markus ; Henscher, Ulla ; Roncarati, Renza ; Katalinic, Alexander ; Heitmann, Christoph ; Honegger, Christoph ; Paradies, Kerstin ; Bjelic-Radisic, Vesna ; Degenhardt, Friedrich ; Wenz, Frederik ; Rick, Oliver ; Hölzel, Dieter ; Zaiss, Matthias ; Kemper, Gudrun ; Budach, Volker ; Denkert, Carsten Michael ; Gerber, Bernd ; Tesch, Hans ; Hirsmüller, Susanne ; Sinn, Hans-Peter ; Dunst, Jürgen ; Münstedt, Karsten ; Bick, Ulrich ; Fallenberg, Eva ; Tholen, Reina ; Hung, Roswita ; Baumann, Freerk T. ; Beckmann, Matthias Wilhelm ; Blohmer, Jens-Uwe ; Fasching, Peter Andreas ; Lux, Michael Patrick ; Harbeck, Nadia ; Hadji, Peyman ; Hauner, Hans ; Heywang-Köbrunner, Sylvia H. ; Huober, Jens ; Hübner, Jutta ; Jackisch, Christian ; Loibl, Sibylle ; Lück, Hans-Jürgen ; Minckwitz, Gunter von ; Möbus, Volker ; Müller, Volkmar ; Nöthlings, Ute ; Schmidt, Marcus ; Schmutzler, Rita Katharina ; Schneeweiss, Andreas ; Schütz, Florian ; Stickeler, Elmar ; Thomssen, Christoph ; Untch, Michael ; Wesselmann, Simone ; Bücker, Arno ; Krockenberger, Mathias Heinric
Ziele: Das Ziel dieser offiziellen Leitlinie, die von der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe (DGGG) und der Deutschen Krebsgesellschaft (DKG) publiziert und koordiniert wurde, ist es, die Früherkennung, Diagnostik, Therapie und Nachsorge des Mammakarzinoms zu optimieren.
Methoden: Der Aktualisierungsprozess der S3-Leitlinie aus 2012 basierte zum einen auf der Adaptation identifizierter Quellleitlinien und zum anderen auf Evidenzübersichten, die nach Entwicklung von PICO-(Patients/Interventions/Control/Outcome-)Fragen, systematischer Recherche in Literaturdatenbanken sowie Selektion und Bewertung der gefundenen Literatur angefertigt wurden. In den interdisziplinären Arbeitsgruppen wurden auf dieser Grundlage Vorschläge für Empfehlungen und Statements erarbeitet, die im Rahmen von strukturierten Konsensusverfahren modifiziert und graduiert wurden.
Empfehlungen: Der Teil 1 dieser Kurzversion der Leitlinie zeigt Empfehlungen zur Früherkennung, Diagnostik und Nachsorge des Mammakarzinoms: Der Stellenwert des Mammografie-Screenings wird in der aktualisierten Leitlinienversion bestätigt und bildet damit die Grundlage der Früherkennung. Neben den konventionellen Methoden der Karzinomdiagnostik wird die Computertomografie (CT) zum Staging bei höherem Rückfallrisiko empfohlen. Die Nachsorgekonzepte beinhalten Untersuchungsintervalle für die körperliche Untersuchung, Ultraschall und Mammografie, während weiterführende Gerätediagnostik und Tumormarkerbestimmungen bei der metastasierten Erkrankung Anwendung finden.
Wöckel, Achim ; Festl, Jasmin ; Stüber, Tanja ; Brust, Katharina ; Stangl, Stephanie ; Heuschmann, Peter Ulrich ; Albert, Ute Susann ; Budach, Wilfried ; Follmann, Markus ; Janni, Wolfgang ; Kopp, Ina ; Kreienberg, Rolf ; Kühn, Thorsten ; Langer, Thomas ; Nothacker, Monika ; Scharl, Anton ; Schreer, Ingrid ; Link, Hartmut ; Engel, Jutta ; Fehm, Tanja ; Weis, Joachim ; Welt, Anja ; Steckelberg, Anke ; Feyer, Petra ; König, Klaus ; Hahne, Andrea ; Kreipe, Hans H. ; Knoefel, Wolfram Trudo ; Denkinger, Michael ; Brucker, Sara ; Lüftner, Diana ; Kubisch, Christian ; Gerlach, Christina ; Lebeau, Annette ; Siedentopf, Friederike ; Petersen, Cordula ; Bartsch, Hans Helge ; Schulz-Wendtland, Rüdiger ; Hahn, Markus ; Hanf, Volker ; Müller-Schimpfle, Markus ; Henscher, Ulla ; Roncarati, Renza ; Katalinic, Alexander ; Heitmann, Christoph ; Honegger, Christoph ; Paradies, Kerstin ; Bjelic-Radisic, Vesna ; Degenhardt, Friedrich ; Wenz, Frederik ; Rick, Oliver ; Hölzel, Dieter ; Zaiss, Matthias ; Kemper, Gudrun ; Budach, Volker ; Denkert, Carsten Michael ; Gerber, Bernd ; Tesch, Hans ; Hirsmüller, Susanne ; Sinn, Hans-Peter ; Dunst, Jürgen ; Münstedt, Karsten ; Bick, Ulrich ; Fallenberg, Eva ; Tholen, Reina ; Hung, Roswita ; Baumann, Freerk T. ; Beckmann, Matthias Wilhelm ; Blohmer, Jens-Uwe ; Fasching, Peter Andreas ; Lux, Michael Patrick ; Harbeck, Nadia ; Hadji, Peyman ; Hauner, Hans ; Heywang-Köbrunner, Sylvia H. ; Huober, Jens ; Hübner, Jutta ; Jackisch, Christian ; Loibl, Sibylle ; Lück, Hans-Jürgen ; Minckwitz, Gunter von ; Möbus, Volker ; Müller, Volkmar ; Nöthlings, Ute ; Schmidt, Marcus ; Schmutzler, Rita Katharina ; Schneeweiss, Andreas ; Schütz, Florian ; Stickeler, Elmar ; Thomssen, Christoph ; Untch, Michael ; Wesselmann, Simone ; Bücker, Arno ; Krockenberger, Mathias Heinric
Purpose: The aim of this official guideline coordinated and published by the German Society for Gynecology and Obstetrics (DGGG) and the German Cancer Society (DKG) was to optimize the screening, diagnosis, therapy and follow-up care of breast cancer.
Methods: The process of updating the S3 guideline dating from 2012 was based on the adaptation of identified source guidelines which were combined with reviews of evidence compiled using PICO (Patients/Interventions/Control/Outcome) questions and the results of a systematic search of literature databases and the selection and evaluation of the identified literature. The interdisciplinary working groups took the identified materials as their starting point to develop recommendations and statements which were modified and graded in a structured consensus procedure.
Recommendations: Part 1 of this short version of the guideline presents recommendations for the screening, diagnosis and follow-up care of breast cancer. The importance of mammography for screening is confirmed in this updated version of the guideline and forms the basis for all screening. In addition to the conventional methods used to diagnose breast cancer, computed tomography (CT) is recommended for staging in women with a higher risk of recurrence. The follow-up concept includes suggested intervals between physical, ultrasound and mammography examinations, additional high-tech diagnostic procedures, and the determination of tumor markers for the evaluation of metastatic disease.
Calibration of TCCON column-averaged CO₂: the first aircraft campaign over European TCCON sites
(2011)
Messerschmidt, Janina ; Geibel, Marc Christoph ; Blumenstock, Thomas ; Chen, Hilin ; Deutscher, Nicholas M. ; Engel, Andreas ; Feist, Dietrich G. ; Gerbig, Christoph ; Gisi, Michael ; Hase, Frank ; Katrynski, Krzysztof ; Kolle, Olaf ; Lavrič, Jost-Valentin ; Notholt, Justus ; Palm, Mathias ; Ramonet, Michael ; Rettinger, Markus ; Schmidt, Martina ; Sussmann, Ralf ; Toon, Geoffrey C. ; Truong, Francois ; Warneke, Thorsten ; Wennberg, Paul O. ; Wunch, Debra ; Xueref-Remy, Irene
The Total Carbon Column Observing Network (TCCON) is a ground-based network of Fourier Transform Spectrometer (FTS) sites around the globe, where the column abundances of CO2, CH4, N2O, CO and O2 are measured. CO2 is constrained with a precision better than 0.25% (1-σ). To achieve a similarly high accuracy, calibration to World Meteorological Organization (WMO) standards is required. This paper introduces the first aircraft calibration campaign of five European TCCON sites and a mobile FTS instrument. A series of WMO standards in-situ profiles were obtained over European TCCON sites via aircraft and compared with retrievals of CO2 column amounts from the TCCON instruments. The results of the campaign show that the FTS measurements are consistently biased 1.1% ± 0.2% low with respect to WMO standards, in agreement with previous TCCON calibration campaigns. The standard a priori profile for the TCCON FTS retrievals is shown to not add a bias. The same calibration factor is generated using aircraft profiles as a priori and with the TCCON standard a priori. With a calibration to WMO standards, the highly precise TCCON CO2 measurements of total column concentrations provide a suitable database for the calibration and validation of nadir-viewing satellites
Calibration of TCCON column-averaged CO₂: the first aircraft campaign over European TCCON sites
(2011)
Messerschmidt, Janina ; Geibel, Marc Christoph ; Blumenstock, Thomas ; Chen, Hilin ; Deutscher, Nicholas M. ; Engel, Andreas ; Feist, Dietrich G. ; Gerbig, Christoph ; Gisi, Michael ; Hase, Frank ; Katrynski, Krzysztof Stanislaw ; Kolle, Olaf ; Lavrič, Jost-Valentin ; Notholt, Justus ; Palm, Mathias ; Ramonet, Michael ; Rettinger, Markus ; Schmidt, Martina ; Sussmann, Ralf ; Toon, Geoffrey C. ; Truong, Francois ; Warneke, Thorsten ; Wennberg, Paul O. ; Wunch, Debra ; Xueref-Remy, Irene
The Total Carbon Column Observing Network (TCCON) is a ground-based network of Fourier Transform Spectrometer (FTS) sites around the globe, where the column abundances of CO2, CH4, N2O, CO and O2 are measured. CO2 is constrained with a precision better than 0.25 %. To achieve a similarly high accuracy, calibration to World Meteorological Organization (WMO) standards is required. This paper introduces the first aircraft calibration campaign of five European TCCON sites and a mobile FTS instrument. A series of WMO standards in-situ profiles were obtained over European TCCON sites via aircraft and compared with retrievals of CO2 column amounts from the TCCON instruments. The results of the campaign show that the FTS measurements are consistently biased 1.0 % ± 0.2 % low with respect to WMO standards, in agreement with previous TCCON calibration campaigns. The standard a priori profile for the TCCON FTS retrievals is shown to not add a bias. The same calibration factor is generated using aircraft profiles as a priori and with the TCCON standard a priori. With a calibration to WMO standards, the highly precise TCCON CO2 measurements of total column concentrations provide a suitable database for the calibration and validation of nadir-viewing satellites.