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排序方式: 共有174条查询结果,搜索用时 15 毫秒
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Schmitz Jan Jansen Stefanie Meyer Moritz Hinkelbein Jochen 《Notfall & Rettungsmedizin》2022,25(4):285-293
Notfall + Rettungsmedizin - Tauchunfälle sind vergleichsweise selten und stellen (Erst‑)Helfer vor besondere Herausforderungen. Sie müssen schnell und kompetent behandelt werden, da... 相似文献
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Die Anaesthesiologie - 相似文献
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Die Anaesthesiologie - Erratum zu: Anaesthesist 2018 https://doi.org/10.1007/s00101-018-0466-x In dem ursprünglich publizierten Artikel wurde im Namen des Autors T.K. Becker das... 相似文献
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V. Suárez D. C. Schroeder K. Rücker J. Hinkelbein A. Böhmer A. Koryllos J. Volland A. Wafaisade 《Notfall & Rettungsmedizin》2018,21(8):690-694
This article presents the case of a patient with haemorrhagic shock due to self-inflicted stab wounds to the chest and upper abdomen during a suicide attempt. Prehospital packing with chitosan gauze resulted in hemostasis and stabilisation of the patient during transport to the hospital. For uncontrolled bleeding from penetrating trauma the use of hemostyptic agents is an important option. The authors believe that hemostyptic agents should be introduced into clinical praxis of emergency medical services (EMS) and their use should be trained by EMS personnel. 相似文献
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Gunnar Lohm Dirk Bottke Basil Jamil Kurt Miller Konrad Neumann Detlef Bartkowiak Wolfgang Hinkelbein Thomas Wiegel 《World journal of urology》2013,31(2):423-428
Purpose
Salvage radiotherapy (SRT) is applied routinely in patients with a biochemical relapse after radical prostatectomy (RP). Although the detection threshold for relapse after RP has steadily been lowered, only about 30 % of the SRT patients achieve a durable response. We have previously shown the association between a PSA decrease below detectable levels after SRT and biochemical progression-free survival (BPFS). After recalculating our data according to a more recent definition of biochemical failure after SRT, we now show the significance of the post-RP PSA nadir.Materials and methods
Among 159 prostate cancer patients without hormonal treatment after RP, SRT was given to 72 patients with persistently detectable PSA after RP and to 87 whose PSA increased out of an undetectable range. The median pre-SRT PSA was 0.29 ng/ml for the former group and 0.34 ng/ml for the latter group. A radiation dose of 66.6 Gy was applied to the prostate bed.Results
The overall median follow-up time was 41.7 months. The probability for BPFS after this period was 52.8 % in 72 patients with persistently detectable PSA after RP and 65.4 % in 87 patients who had a post-RP PSA nadir below detection limit. Univariate and multivariate analyses showed no significant difference in BPFS of both patient groups (p > 0.05).Conclusion
Our findings suggest that SRT is a viable treatment option for patients with persistently detectable PSA, giving similar results as in patients whose PSA increases out of an undetectable range after RP. 相似文献9.
Dirk Bottke Reinhard Golz Stephan Störkel Axel Hinke Alessandra Siegmann Lothar Hertle Kurt Miller Wolfgang Hinkelbein Thomas Wiegel 《European urology》2013
Background
In a randomised trial, radical prostatectomy (RP) followed by adjuvant radiotherapy (aRT) was compared with RP alone in patients with pT3 pN0 prostate cancer with or without positive margin at local pathology (German Cancer Society trial numbers ARO 96-02/AUO AP 09/95).Objective
A pathology review was performed on 85% of RP specimens of patients to investigate the influence of pathology review on the analysis.Design, setting, and participants
Patients post-RP (n = 385) were randomised before achieving an undetectable prostate-specific antigen (PSA) level to either wait and see (n = 192) or 60 Gy aRT (n = 193). Of 307 patients with undetectable PSA after RP, 262 had pathology review. These results were included prospectively into the analysis.Outcome measurements and statistical analysis
Agreement between local and review pathology was measured by the total percentage of agreement and by simple kappa statistics. The prognostic reliability for the different parameters was analysed by Cox regression model. Event-free rates were determined by Kaplan-Meier analysis with a median follow-up of 40 mo for the wait-and-see arm and 38.5 mo for the aRT arm.Results and limitations
There was fair concordance between pathology review and local pathologists for seminal vesicle invasion (pT3c: 91%; κ = 0.76), surgical margin status (84%; κ = 0.65), and for extraprostatic extension (pT3a/b: 75%; κ = 0.74). Agreement was much less for Gleason score (47%; κ = 0.42), whereby the review pathology resulted in a shift to Gleason score 7. In contrast to the analysis of progression-free survival with local pathology, the multivariate analysis including review pathology revealed PSMs and Gleason score >6 as significant prognostic factors.Conclusions
Phase 3 studies of postoperative treatment of prostate cancer should be accomplished in the future with a pathology review. In daily practice, a second opinion by a pathologist experienced in urogenital pathology would be desirable, in particular, for high-risk patients after RP. 相似文献10.