Publications by authors named "Hardt J"

Purpose: This study examines the impact of enhanced recovery after surgery (ERAS®) on patient recovery after elective colorectal surgery. The innovative PostopQRS™ tool was used for the analysis of patient recovery.

Methods: This single-center study compares three cohorts: two retrospective cohorts before (A) and after (B) ERAS® implementation and a prospective cohort post-ERAS® implementation (C) using PostopQRS™.

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Background And Objectives: The watch-and-wait (WW) strategy in patients after complete clinical response (cCR) following chemoradiotherapy for locally advanced rectal cancer (LARC) offers the option of organ preservation. The aim of this study was to assess the oncological outcomes of WW patients treated and followed up in a German referral cancer center.

Methods: In this retrospective study, we analyzed the clinical records of consecutive patients with LARC who underwent neoadjuvant radiotherapy/chemoradiotherapy at our institution between January 2020 and December 2023 and received non-operative management after cCR.

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Objectives: Gaming is a global phenomenon often associated with impaired health and sleep patterns. Although the research activities are growing, the evidence to date is rare due to the various gaming titles and inconsistent study designs. Thus, this study aimed to examine the impact of excessive gaming in the evening on subjective as well as objective sleep parameters by focusing on specific game titles and assessing several evenings/nights using a mixed-methods approach.

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Article Synopsis
  • The field of meta-analysis for diagnostic test accuracy studies is evolving, focusing on methods to analyze multiple thresholds of sensitivity and specificity.
  • A case study highlighted the application of various methods for meta-analyzing diagnostic test studies, but no comprehensive simulation has compared these methods systematically.
  • This article presents a simulation study that evaluates three frequentist approaches for analyzing ROC curves, finding that Hoyer et al.'s method performed the best in most scenarios and is suggested for practical use.
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Purpose: Despite mobilization is highly recommended in the ERAS colorectal guideline, studies suggest that more than half of patients don't reach the daily goal of 360 min out of bed. However, data used to quantify mobilization are predominantly based on self-assessments, for which the accuracy is uncertain. This study aims to accurately measure postoperative mobilization in ERAS-patients by validated motion data from body sensors.

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  • The study looks at how early palliative care can help improve the quality of life for patients with metastatic renal cell carcinoma (mRCC) who experience severe symptoms, a crucial aspect not previously examined in depth.
  • Patients with mRCC were admitted to a palliative care unit, and their symptoms were tracked before, during, and after treatment, revealing that many suffered from pain, dyspnea, fatigue, and the need for assistance.
  • Results showed that multidisciplinary palliative care significantly reduced symptom scores and pain levels, indicating the effectiveness of integrating palliative care early in treatment for mRCC patients.
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Background: Immunotherapeutic approaches, including immune checkpoint inhibitor (ICI) therapy, are increasingly recognized for their potential. Despite notable successes, patient responses to these treatments vary significantly. The absence of reliable predictive and prognostic biomarkers hampers the ability to foresee outcomes.

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Background & Aims: Exploration whether Motivational Interviewing (MI) could be learned and implemented with ease within a surgical in-hospital setting and whether participation in the intervention led to significantly higher compliance with ERAS®-recommended protein intake goals. The individual healing process of many patients is delayed because they fail to cover their calorie requirement, which could be counteracted by a patient-centered conversational intervention that is new in perioperative practice.

Methods: This patient-blinded pilot-RCT included 60 patients (≥18 years) following the certified ERAS® bowel protocol for colorectal surgery between March and August 2022.

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Purpose: Remote ischemic preconditioning (RIPC) reportedly reduces ischemia‒reperfusion injury (IRI) in various organ systems. In addition to tension and technical factors, ischemia is a common cause of anastomotic leakage (AL) after rectal resection. The aim of this pilot study was to investigate the potentially protective effect of RIPC on anastomotic healing and to determine the effect size to facilitate the development of a subsequent confirmatory trial.

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Recently, a new and promising approach for range verification was proposed. This method requires the use of two different ion species. Due to their equal magnetic rigidity, fully ionized carbon and helium ions can be simultaneously accelerated in accelerators like synchrotrons.

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Purpose: Early mobilization is an essential component of the Enhanced Recovery after Surgery (ERAS®)-pathway. However, a large percentage of patients fail to achieve the ERAS® recommended goal (360 min out of bed from post-operative day 1/POD1). Motivational Interviewing (MI) is an evidence-based type of patient-centered consultation to promote intrinsic motivation.

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Established methods of age estimation are based on correlating defined maturation stages of bony structures with tables representing the observed range of biological ages in the majority of cases. In this retrospective monocentric study in southwestern Germany, common age estimation methodology was assessed in n = 198 subjects at the age of 25 or younger by analyzing the influence of age, quadratic age, biological sex and age-sex interaction on the ossification stages of the medial epiphysis fugue. Three readers (ICC ≥ 0.

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Background: Remote ischemic preconditioning reduces ischemia-reperfusion injury in patients undergoing hepatectomy. Moreover, there is evidence that the protective effects of remote ischemic preconditioning may be more pronounced in pre-damaged livers. The objective of this trial was to investigate the extent to which remote ischemic preconditioning can attenuate ischemia-reperfusion injury after hepatectomy and Pringle maneuver in patients with chronic liver disease.

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Issue Addressed: Co-designed and culturally tailored preventive initiatives delivered in childhood have high potential to close the cross-cultural gap in health outcomes of priority populations. Māori and Pacific Islander people living in Australia exhibit a higher prevalence of overweight and obesity and higher rates of multimorbidity, including heart disease, cancer and diabetes.

Methods: This mixed-methods, pilot implementation and evaluation study, aimed to evaluate the implementation of a community-based, co-designed and culturally tailored childhood obesity prevention program, using quantitative (pre-post anthropometric measurement, pre-post health behaviour questionnaire) and qualitative (semi-structured interview) methods.

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  • TENS is a pain relief method but can cause electromagnetic interference (EMI), previously seen as risky for patients with implantable cardioverter-defibrillators (ICDs) due to outdated technology.
  • A study involving 107 patients with modern ICDs tested the safety of TENS, monitoring for EMI during different stimulation modes.
  • Results showed that while some EMI occurred (15.9% of patients), it was mostly minor, indicating TENS could be safely used under medical supervision for ICD patients if precautions are taken.
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: The objective of this study was to evaluate the accuracy of forensic age estimation in a German population by combining clavicle and wisdom teeth assessments based on cone beam computed tomography (CT) data. The study aimed to determine the reliability of this approach in predicting biological age. A total of 161 CT data sets from 120 males and 41 females with known exact ages were evaluated by three raters.

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Purpose: Postoperative wound complications are common in patients undergoing resection of lower extremity soft tissue tumors. Postoperative drainage therapy ensures adequate wound healing but may delay or complicate it. The aim of this study is to evaluate the incidence of postoperative wound complications and delayed or prolonged drainage treatment and to propose a standardized definition and severity grading of complex postoperative courses.

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Purpose: The effectiveness of modern perioperative treatment concepts has been demonstrated in several studies and meta-analyses. Despite good evidence, limited implementation of the fast track (FT) concept is still a widespread concern. To assess the status quo in Austrian and German hospitals, a survey on the implementation of FT measures was conducted among members of the German Society of General and Visceralsurgery (DGAV), the German Society of Coloproctology (DGK) and the Austrian Society of Surgery (OEGCH) to analyze where there is potential for improvement.

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About 20 % of children in Germany grow up with a single mother - this is often associated with multiple strain for the mothers and may have adverse effects on the child-parent relationship. In two retrospective internet surveys (wave 1 born in 1960s, wave 2 born in 1990s) perceived maternal love and role reversal were assessed in children of single mothers and children grown up in two parent families. In both waves high values of maternal love were reported.

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Background: Chronic recurrent angioedema without wheals (CRA) with normal C1 inhibitor (C1-INH) that is unresponsive to antihistamines may involve patients with recurrent angioedema of unknown cause (ie, so-called non-histaminergic idiopathic angioedema) as well as patients with hereditary angioedema with normal C1-INH (HAEnCI) when HAEnCI occurs in only one family member.

Objective: To identify patients with one of type of HAEnCI in a group of patients with CRA with normal C1-INH that was unresponsive to antihistamines.

Methods: A total of 132 patients with CRA and normal C1-INH that was unresponsive to antihistamines underwent mutational and clinical analysis.

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The INTERPOL standard for the identification of unknown individuals includes the established primary characteristics of fingerprint, DNA, and teeth. Exposure to noxious agents such as fire and water often severely limits the availability of usable material such as fingerprints. In addition to teeth, the protected oral cavity also houses palatal fold pairs, which are the subject of this study to demonstrate individuality and consequently support identification.

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  • Surgical procedures such as adenotonsillectomy are common in children, and understanding perioperative complications is crucial for safety and documentation.
  • The study involved a retrospective evaluation of 402 children, revealing 124 complications (93 mild, 31 severe) categorized using the Dindo-Clavien system.
  • Significant associations with complications included factors like long-term medication, additional diagnoses, and surgical duration, with severe complications linked to premature birth and ASA scores, highlighting the need for careful monitoring in at-risk groups.
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  • The study aimed to demonstrate that magnetic resonance (MR) imaging could serve as a reliable indicator for treatment effectiveness and survival after yttrium-90 transarterial radioembolization (TARE) in patients with colorectal liver metastases (CRLMs).
  • A total of 50 patients were analyzed, comparing different imaging criteria (vRECIST vs. qEASL) and their impact on survival rates; results showed qEASL was more effective than vRECIST for predicting outcomes.
  • While the median survival was about 337 days, factors like high tumor burden decreased survival odds, and baseline clinical data were not able to predict the MR response to TARE treatment.
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Objectives Dental age determination relies on the presence of wisdom teeth, which can be assigned to specific age ranges according to their stage of development. The purpose of this study is to highlight the applicability of the Demirjian staging of layman compared to expert, as well as the inclusion of all four wisdom teeth in the overall assessment, in order to emphasize and critically highlight a precise age estimation in clinical practice, especially in the case of agenesis or the presence of less than all four wisdom teeth. Material and Methods: In this study, dental age determination is performed and compared by a trained layperson and an expert using 385 orthopantomograms.

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Even though surgery has remained a key component within multi-disciplinary cancer care, the expectations have changed. Instead of serving as a modality to free a patient of a mass at all means and at the risk of high morbidity, modern cancer surgery is expected to provide adequate tumor clearance with lowest invasiveness. This review summarizes the evidence on quality assurance in surgical oncology and gives a comprehensive overview of quality improvement tools.

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