Mobile App-based documentation of patient-reported outcomes - 3-months results from a proof-of-concept study on modern rheumatology patient management.

Background: Mobile medical applications (Apps) offer innovative solutions for patients' self-monitoring and new patient management opportunities. Prior to routine clinical application feasibility and acceptance of disease surveillance using an App that includes electronic (e) patient-reported outcome measures (PROMs) warrant evaluation. Therefore, we performed a proof-of-concept study in which rheumatoid arthritis (RA) patients used an App (RheumaLive) to document their disease.

Medical adherence in patients with systemic lupus erythematosus in Germany: predictors and reasons for non-adherence - a cross-sectional analysis of the LuLa-cohort.

Objective Adherence to medication has a major impact on treatment control and success especially in chronic diseases but often remains unrecognized. Besides clinical, socioeconomic, disease-related and treatment-related parameters, general and personal health beliefs, as well as perception of health, can affect adherence. Our aim was to investigate the adherence to lupus-specific medications in German lupus patients and to assess influencing factors including detrimental or beneficial effects of health perceptions and beliefs.

Factors associated with pain coping and catastrophising in patients with systemic lupus erythematosus: a cross-sectional study of the LuLa-cohort.

Objective: The aim of this study was to identify factors associated with pain coping and catastrophising in patients with systemic lupus erythematosus.

Methods: All patients were participants of the lupus erythematosus long-term study, which is based on patient-reported data assessed among members of the German Lupus Erythematosus Self-Help Organization. Assessments were performed by means of a questionnaire.

Radiological outcome and gait function of SCFE patients after growth arrest.

Purpose: Slipped capital femoral epiphysis (SCFE) represents the most common disorder of the hip in adolescents and a preliminary stage of degenerative joint disease. Up to now, functional outcome evaluation measured by objective instruments has been commonly neglected. The present study investigates whether the pathoanatomy of the hip joint after SCFE-analyzed on a standard X-ray-match functional results gained by three-dimensional gait analysis.

Regional deep hyperthermia for salvage treatment of children and adolescents with refractory or recurrent non-testicular malignant germ-cell tumours: an open-label, non-randomised, single-institution, phase 2 study.

Background: Although the survival of children and adolescents with malignant germ-cell tumours has improved greatly in recent years, the outcome remains poor for those with refractory or recurrent malignant germ-cell tumours. We aimed to determine whether objective tumour response could be achieved in patients with refractory or recurrent malignant germ-cell tumours with PEI-regional deep hyperthermia as salvage treatment.

Methods: Patients with refractory or recurrent non-testicular malignant germ-cell tumours after standard cisplatin-based chemotherapy were treated prospectively with PEI chemotherapy (cisplatin 40 mg/m(2), delivered intravenously on days 1 and 4; etoposide 100 mg/m(2), intravenously on days 1-4; and ifosfamide 1800 mg/m(2), intravenously on days 1-4) plus simultaneous 1-h regional deep hyperthermia (41-43°C) on days 1 and 4.

Thymoma-a clinico-pathological long-term study with emphasis on histology and adjuvant radiotherapy dose.

Introduction: To evaluate prognostic factors of thymic epithelial tumors (TETs) with particular reference to histology and the dose-response relationship of adjuvant radiotherapy.

Methods: Retrospective study with central pathological review on patients resected for TET between 1966 and 2004 at a single institution. Prognostic factors were identified using Cox regression analysis.

Computerized gait analysis in Legg-Calvé-Perthes disease--analysis of the sagittal plane.

Unlabelled: Current follow-up- and outcome-evaluations of Legg-Calvé-Perthes disease (LCPD) are based on subjective measures of function, clinical and radiological parameters. The objective of this study was to evaluate the sagittal plane kinematics and the effect on hip joint loading on the affected hip in children with LCPD.

Materials And Methods: Computerized gait analysis was performed in 49 LCPD patients aged ≥ 5 years with unilateral hip involvement.

The gait function of slipped capital femoral epiphysis in patients after growth arrest and its correlation with the clinical outcome.

Purpose: Slipped capital femoral epiphysis (SCFE) represents the preliminary stage of osteoarthritis. Reliable tools for outcome evaluation should be developed to prevent persisting defects. The functional outcome of SCFE-patients after growth arrest is analysed by instrumented 3D-gait analysis (GA).

Correlation of functional outcome and X-ray findings after Perthes disease.

Purpose: The purpose of this study was to evaluate the functional impairments during gait after Legg-Calvé-Perthes Disease (LCPD) and to correlate these data with the clinical and radiographic outcome.

Methods: In 13 individuals with LCPD in recovery or final stage (mean age 9.5 ± 3.

An ask-the-expert service on a rheumatology web site: who were the users and what did they look for?

Objective: To analyze the inquiries sent to an online ask-the-rheumatologist service in order to identify the users' needs and requirements.

Methods: The official web site of the German Competence Network Rheumatology (www.rheumanet.

[Supply of and participation in CME activities in the area served the north rhine chamber of physicians in Germany].

Introduction: the study analyses the supply and the demand for Continuing Medical Education (CME) in the area served by the "Ärztekammer Nordrhein (ÄkNo)", which is one of the biggest regional Chambers of Physicians in Germany. Both the supply of all CME events certified by the ÄkNo in 2007 (n=18,932) and the participation of physicians in CME activities - using the example of family doctors (n=850), ophthalmologists (n=122) and orthopaedists (n=38) in the university towns of Cologne, Bonn and Aachen - was analysed for the period of 2002 to 2007 (n=44,760 events).

Methods: differences between groups were tested by the nonparametric Kruskal-Wallis method; adjustment for other factors was performed using Cochran-Mantel-Haenszel tests.

The value of training in communication skills for continuing medical education.

Objective: Question arises as to what extent communication skills are considered in continuing medical education (CME).

Methods: Analysis for CME-courses in communication skills in the area of the Chamber of Physicians North Rhine (ÄkNo), Germany. Supply Arm(A): CME events (n = 19,320) certified in 2007 were evaluated.

Correlation of viral load of respiratory pathogens and co-infections with disease severity in children hospitalized for lower respiratory tract infection.

Background: The clinical significance of viral load and co-infections in children with respiratory infections is not clear.

Objective: To evaluate the correlation of viral load as well as viral and bacterial co-infections with disease severity in hospitalized children with lower respiratory tract infections (LRTIs).

Study Design: This is a prospective study conducted in children admitted for LRTIs for two seasons.

Palliative radiotherapy tailored to life expectancy in end-stage cancer patients: reality or myth?

Background: The purpose of the study was to investigate the adequacy of palliative radiation treatment in end-stage cancer patients.

Methods: Of 216 patients referred for palliative radiotherapy, 33 died within 30 days and constitute the population of the study. Symptoms, Karnofsky Performance Status (KPS), laboratory tests, and survival estimates were obtained.

[MRI bone marrow findings in 63 patients with type I Gaucher disease].

Purpose: To determine whether MR bone marrow findings in Gaucher patients may help to identify patients at high risk of developing severe Gaucher bone complications exemplified by avascular necrosis (AVN) of the femoral head.

Materials And Methods: MR images were obtained in 63 Type I Gaucher patients through a standard protocol using coronal T 1 and T 2-weighted sequences of the lower extremities. The location and extent of infiltrated marrow was established using a semi-quantitative MRI scoring method (Düsseldorf Gaucher score, DGS) and the morphological pattern of bone marrow involvement determined (whether homogeneous type A or non-homogeneous type B).

Retrospective study of neoadjuvant versus adjuvant radiochemotherapy in locally advanced noninflammatory breast cancer : survival advantage in cT2 category by neoadjuvant radiochemotherapy.

Purpose: This retrospective study compares patients treated between 1991 and 1998 with neoadjuvant radiotherapy +/- chemotherapy (RCT) or adjuvant RCT for locally advanced noninflammatory breast cancers (LABC) in terms of pathologic complete response (pCR), 10-year relapse-free (RFS), and overall survival (OS).

Patients And Methods: Preoperative RCT in 315 and adjuvant RCT in 329 cases consisted in 50 Gy (5 x 2 Gy/week) to the breast and the supra-/infraclavicular lymph nodes. 101 neoadjuvant patients received - in case of breast conservation - a 10-Gy interstitial boost with (192)Ir afterloading before and 214 neoadjuvant patients a preoperative electron boost after external-beam radiotherapy.

Changing attitudes towards online electronic health records and online patient documentation in rheumatology outpatients.

Objectives: The Internet supports interactive patient assessments, online documentation and access to online electronic health records (EHRs), but little is known about the acceptance of these features and trends in rheumatology patients. Therefore, we studied patients' attitudes and willingness to participate in online patient (self-)documentation.

Methods: We interviewed 153 consecutive outpatients with rheumatoid arthritis, systemic lupus erythematosus or spondyloarthritis using a paperbased self-administered questionnaire.

Impact of genetic polymorphisms of the renin-angiotensin system and of non-genetic factors on kidney transplant function--a single-center experience.

Renin-angiotensin-aldosterone system (RAAS) polymorphisms such as the angiotensinogen-gene-M235T-, the angiotensin-conversion enzyme (ACE)-gene I/D- and the angiotensin-II-type 1-receptor-(AT1R)-A1166C-polymorphism have been implicated in renal insufficiency and hypertension. We studied the association of these RAAS genotypes and non-genetic factors with transplant function and hypertension after renal graft transplantation (NTX). A total of 229 renal graft recipients, transplanted at a single center, were monitored up to 54 months and genotyped using polymerase chain reaction.

PSA after incidental irradiation of the nonmalignant prostate: long-term changes.

Background: Incidental irradiation of the prostate may affect serum prostate-specific antigen (PSA). However, scarce data exist on PSA changes after irradiation of noncancerous prostatic tissue. This is an update of a study on PSA after pelvic irradiation.

Diagnostic of tooth fractures with the Vistascan system.

Compared with conventional films digital radiography allows a wide range of exposure and scanner settings. The aim of this study was to investigate the diagnostic accuracy of the evaluation of tooth fractures depending on variations of exposure dose, scanner settings and surrounding tissues. Extracted human teeth were exposed separately and in a pig bone phantom before and after artificial fracture at 70 kV (Gendex Oralix DC) and three exposure settings using the Vistascan System I at three different resolution settings.

Early conversion from cyclosporine to tacrolimus increases renal graft function in chronic allograft nephropathy at BANFF stages I and II.

Switching from cyclosporine to tacrolimus without steroid pulse was suggested as a therapeutic option in chronic allograft nephropathy (CAN). Thirty-one renal transplant recipients with CAN were prospectively converted from cyclosporine to tacrolimus (group A), in parallel 31 matched cyclosporin A (CsA) patients (group B) without CAN were followed up for 30 months. In six matching patients of groups A and B inulin and para-aminohippurate (PAH)-clearances and mycophenolate were measured over a span of 3 months.

Self-assessments of patients via Tablet PC in routine patient care: comparison with standardised paper questionnaires.

Objective: We evaluated the feasibility of electronic data capture of self-administered patient questionnaires using a Tablet PC for integration in routine patient management; we also compared these data with results received from corresponding paper-pencil versions.

Methods: Standardised patient questionnaires (FFbH/HAQ, BASDAI, SF-36) were implemented in our documentation software. 153 outpatients (rheumatoid arthritis, systemic lupus erythematosus, spondyloarthritis) completed sets of questionnaires as paper-pencil and electronic versions using a Tablet PC.

C-reactive protein levels and clinical symptoms following gadolinium administration in hemodialysis patients.

Background: Until recently, gadolinium (Gd)-enhanced magnetic resonance imaging (MRI) has increasingly replaced iodinated contrast agent examinations in dialysis patients, although only limited data existed about the clinical safety of Gd contrast agents in these patients. Specific clinical adverse events (AEs), including nephrogenic systemic fibrosis, were linked to Gd exposure in dialysis patients. An inflammatory reaction or transmetallation may be involved.

Interobserver reproducibility of Gleason grading: evaluation using prostate cancer tissue microarrays.

Objectives: Due to PSA screening and increased awareness, prostate cancer (PCa) is identified earlier resulting in smaller diagnostic samples on prostate needle biopsy. Because Gleason grading plays a critical role in treatment planning, we undertook a controlled study to evaluate interobserver variability among German pathologists to grade small PCas using a series of tissue microarray (TMA) images.

Methods: We have previously demonstrated excellent agreement in Gleason grading using TMAs among expert genitourinary pathologists.

[RheumaCheck: development and evaluation of a German language screening instrument for rheumatic diseases].

Objective: Early diagnosis of inflammatory rheumatic diseases is important for patients' prognosis and outcome. The mean time delay of 1 to 5 years in Germany between the initial symptoms and the first rheumatologist contact should be reduced. Efficiency of patient questionnaires for the identification of inflammatory rheumatic diseases has been demonstrated in other countries.