316 results match your criteria: "University of Heidelberg - Medical School[Affiliation]"

Massive fetomaternal hemorrhage (FMH) is a rare complication in pregnancy that may cause hydrops or can even be life-threatening for the fetus. We report on the case of a 19-year-old gravida I, para 0, who presented to our clinic at 32 weeks of gestation due to decreased fetal movements. The initial fetal heart rate tracing at admission showed a sinusoidal pattern without decelerations.

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Accounting for tastes: a German perspective on the inclusion of patient preferences in healthcare.

Pharmacoeconomics

October 2006

International Health Economics and Outcomes Research, Department of Tropical Hygiene and Public Health, University of Heidelberg - Medical School, Heidelberg, Germany.

Internationally, there has been a movement in medicine to better involve patients in decision making, whether it be at the individual or aggregate level. However, the German health sector has been slow to understand and accommodate the preferences of patients. This paper discusses the reasons why and attempts to highlight some of the consequences of not involving patients in healthcare decision making within the German context.

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Signaling during pathogen infection.

Sci STKE

May 2006

Department of Parasitology, Hygiene Institute, University of Heidelberg Medical School, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany.

Over the millennia, pathogens have coevolved with their hosts and acquired the ability to intercept, disrupt, mimic, and usurp numerous signaling pathways of those hosts. The study of host/pathogen interactions thus not only teaches us about the intricate biology of these parasitic invaders but also provides interesting insights into basic cellular processes both at the level of the individual cell and more globally throughout the organism. Host/pathogen relationships also provide insights into the evolutionary forces that shape biological diversity.

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Imaging today's infectious animalcules.

Curr Opin Microbiol

June 2006

Department of Parasitology, University of Heidelberg Medical School, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany.

The study of pathogens and their interactions with host cells has advanced hand-in-hand with developments in optical microscopy. Whereas microbiology benefits enormously from modern imaging technologies, for example, digital imaging and confocal microscopy, it also presents unique challenges. To overcome these, microbiologists are adept at customising imaging methods, and recently there have been studies using state-of-the-art quantitative imaging methods to probe host-pathogen interactions at the single-cell level.

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Background: Even today, treatment of Stage III NSCLC still poses a serious challenge. So far, surgical resection is the treatment of choice. Patients whose tumour is not resectable or who are unfit to undergo surgery are usually referred to a combined radio-chemotherapy.

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What can economics add to health technology assessment? Please not just another cost-effectiveness analysis!

Expert Rev Pharmacoecon Outcomes Res

February 2006

Group Leader, University of Heidelberg - Medical School, International Health Economics and Outcomes Research, Department of Tropical Hygiene and Public Health, Im Neuenheimer Feld 324, D-69120 Heidelberg, Germany.

Evidence based medicine is not only important for clinical practice, but national governments have embraced it through health technology assessment (HTA). HTA combines data from randomized controlled trials (RCT) and observational studies with an economic component (among other issues). HTA, however, is not taking full advantage of economics.

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Background: The prognosis of patients with liver metastases from breast cancer is commonly poor. After initial diagnosis of hepatic metastases, a median survival time of 1-20 months can be expected. The definition of prognostic factors for such patients may influence therapeutic decisions.

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A wolf dressed in sheep's clothing: perhaps quality measures are just unmeasured severity.

Appl Health Econ Health Policy

June 2006

Department of Tropical Hygiene and Public Health, University of Heidelberg Medical School, Heidelberg, Germany.

Introduction: While there has been much discussion in recent years concerning the construction of hospital quality indexes, researchers have often failed to adequately test these quality measures against testable hypotheses. Our objective is to create a quality index using a fixed-effects methodology (FE-score) and use the resulting index to explain price variation across hospitals and theoretically grounded hypotheses.

Methods: Medicare data (MEDPAR) are used for the risk adjustment of patient characteristics and the calculation of a quality score using a fixed-effects methodology for all US hospitals that provide coronary artery bypass graft (CABG).

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The outcome of various cements in combination with titanium reconstruction plates after segmental resection of the mandible.

Br J Oral Maxillofac Surg

August 2005

University of Heidelberg Medical School, Department of Oral and Cranio-Maxillofacial Surgery, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany.

We report on 82 patients who had segmental resection of the mandible and immediate reconstruction with titanium plates, which were supplemented by polymethylmethacrylate cement (n=32), glass ionomer cement (n=27), silicone (n=9), or nothing (n=14). The mean (S.D.

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Endostatin: the logic of antiangiogenic therapy.

Drug Resist Updat

October 2005

Department of Radiation Oncology, German Cancer Research Center (DKFZ), University of Heidelberg Medical School, Heidelberg, Germany.

The hypothesis that tumor growth and metastasis is angiogenesis-dependent was proposed by Judah Folkman in 1971. Its major implication is that blocking angiogenesis could be a strategy for arresting tumor growth. This hypothesis is now supported by extensive experimental evidence, and hence the angiogenic switch and microvascular endothelial cells recruited by the tumor have emerged as important targets in cancer therapy.

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It has been suggested that chemotherapy and radiotherapy could favorably be combined with antiangiogenesis in dual anticancer strategy combinations. Here we investigate the effects of a trimodal strategy consisting of all three therapy approaches administered concurrently. We found that in vitro and in vivo, the antiendothelial and antitumor effects of the triple therapy combination consisting of SU11657 (a multitargeted small molecule inhibitor of vascular endothelial growth factor and platelet-derived growth factor receptor tyrosine kinases), Pemetrexed (a multitargeted folate antimetabolite), and ionizing radiation were superior to all single and dual combinations.

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Future challenges for the economic evaluation of healthcare: patient preferences, risk attitudes and beyond.

Pharmacoeconomics

July 2005

Department of Tropical Hygiene and Public Health, University of Heidelberg-Medical School, Im Neuenheimer Feld 324, D-69120 Heidelberg, Germany.

The continued growth in the economic evaluation of healthcare over the past 25 years has led to a shortage of trained health economists globally, leading to a number of universities and/or national governments developing specialised health economics programmes to train more health economists. One of the common problems with many of these training programmes is that they only educate new health economists to the Masters level, and as such they are unable to cover the many skills needed by a successful health economist. Furthermore, government and industry interests have ensured that economic evaluation is a heavily regulated environment that gives little incentive to seek further education.

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A 12-d-old neonate suffering from group B streptococcal septic shock was treated with 24 microg/kg/h recombinant human activated protein C [rhAPC, drotrecogin alpha (activated)] for 96 h. The protein C activity increased from 5% to 53% after rhAPC infusion. The patient recovered within 14 d without any adverse effects.

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The Study Centre of the German Surgical Society--rationale and current status.

Langenbecks Arch Surg

April 2005

Study Centre of the German Surgical Society, Department of Surgery, University of Heidelberg Medical School, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.

Background: The concept of evidence-based medicine was introduced into surgery in the mid-1990s, initially focussing on the integration of best research evidence, surgeons' expertise and patients' value. The lack of relevant external evidence [randomised controlled trials (RCTs), systematic reviews] in favour of surgical procedures has led to the need for a new approach in clinical research.

Design: Development and implementation of the Study Centre of the German Surgical Society (SDGC) in order to design, perform and analyse multicentre randomised controlled trials in surgery.

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Background: A high intake of dietary flavonoids, which are abundant in fruits, vegetables, tea, and wine, is known to reduce cardiovascular mortality. The effects of flavonoids on cardiac electrophysiology, which theoretically may have both antiarrhythmic and proarrhythmic consequences, have not been studied systematically to date.

Methods And Results: We screened a broad spectrum of flavonoids for their inhibitory activity on HERG channels by using heterologous expression in Xenopus oocytes.

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Increasing evidence indicates that the expression of the endothelial adhesion molecule E-selectin is associated with progression and metastasis of breast cancer. Patients with liver metastases also show increased serum levels of the soluble form of E-selectin. It was our aim to compare serum levels of soluble E-selectin (sES) in such patients with the biology of the primary tumor and the course of the metastatic disease under therapy.

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We report on the successful treatment of a 43-year-old breast cancer patient with excessive liver metastases and chronic alcohol abuse. After first occurrence of hepatic metastases, systemic and interventional therapies were performed, and resulted in short-term partial remission. Finally, an excessive progression of the hepatic metastases was diagnosed.

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Class Ia anti-arrhythmic drug ajmaline blocks HERG potassium channels: mode of action.

Naunyn Schmiedebergs Arch Pharmacol

December 2004

Department of Cardiology, University of Heidelberg Medical School, Bergheimerstrasse 58, 69115 Heidelberg, Germany.

Ajmaline is a class Ia anti-arrhythmic drug used in several European countries and Japan as first-line treatment for ventricular tachyarrhythmia. Ajmaline has been reported to induce cardiac output (QT) prolongation and to inhibit cardiac potassium currents in guinea pig cardiomyocytes. In order to elucidate the molecular basis of these effects, we examined effects of ajmaline on human ether a-go-go related gene HERG potassium channels.

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The treatment of a jaundiced patient with hyperbilirubinaemia due to breast cancer liver metastases is still a challenging problem. The associated hepatic dysfunction often represents a limiting factor for delivering standard dose chemotherapy. We report on the successful treatment of a jaundiced patient with excessive, recurrent liver metastases from breast cancer, using a combined chemotherapy of mitomycin and 5-fluorouracil after endoscopic stenting of the common bile duct.

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Aim: The aim of this retrospective study was to investigate whether radical (segmental resection) or conservative (marginal) resection of mandibular bone influenced patients, survival.

Patients And Methods: A series of 136 patients selected for partial mandibular resection for the treatment of squamous cell carcinomas of the lower oral cavity was evaluated retrospectively. Fifty-four patients underwent marginal and 82 cases segmental resection of the mandible.

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Background And Purpose: We aimed to determine the diagnostic value of perfusion computed tomography (PCT) and CT angiography (CTA) including CTA source images (CTA-SI) in comparison with perfusion-weighted magnetic resonance imaging (MRI) (PWI) and diffusion-weighted MRI (DWI) in acute stroke <6 hours.

Methods: Noncontrast-enhanced CT, PCT, CTA, stroke MRI, including PWI and DWI, and MR angiography (MRA), were performed in patients with symptoms of acute stroke lasting <6 hours. We analyzed ischemic lesion volumes on patients' arrival as shown on NECT, PCT, CTA-SI, DWI, and PWI (Wilcoxon, Spearman, Bland-Altman) and compared them to the infarct extent as shown on day 5 NECT.

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Necrotic meningiomas are relatively rare, accounting for 1.3-3.9% of primary intracranial tumours and for 10-15% of meningiomas, but are of special clinical importance as they may resemble metastases or malignant gliomas.

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Patterns of adult and old-age mortality in rural Burkina Faso.

J Public Health Med

December 2003

Department of Tropical Hygiene and Public Health, University of Heidelberg-Medical School, Im Neuenheimer Feld 324, D-69120 Heidelberg, Germany.

Based on a demographic surveillance population from 39 villages in rural Burkina Faso, we describe mortality patterns in adults (15-59 years) and older people (> or = 60 years), and discuss seasonal trends in mortality. During the study period 1993-1998, 589 deaths in adults and 593 deaths in older people were recorded from an average adult and older people population of 13 550. The crude all-cause mortality rate per 1000 for adults was 7.

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