4 research outputs found
Supplementary Material for: A Comparison of Schemas, Schema Modes and Childhood Traumas in Obsessive-Compulsive Disorder, Chronic Pain Disorder and Eating Disorders
<b><i>Background:</i></b> In this study, we investigated early maladaptive schemas (EMS), schema modes and childhood traumas in patients suffering from obsessive-compulsive disorder (OCD) in contrast to patients with other Axis I disorders. Based on cognitive theories on OCD, our main research question was whether schemas belonging to the domain of ‘impaired autonomy and performance' are more prevalent in OCD than in both eating disorders (ED) and chronic pain disorder (CPD). <b><i>Sampling and Methods:</i></b> EMS, schema modes and traumatic childhood experiences were measured in 60 patients with OCD, 41 with ED, 40 with CPD and 142 healthy controls. To analyze differences between the groups, MANCOVAs were conducted followed by deviation contrasts. Depression level, age and gender were considered as possible covariates. <b><i>Results:</i></b> OCD patients scored higher on 4 EMS, 2 of which belong to the domain ‘impaired autonomy and performance'. ED patients had higher scores in the EMS ‘emotional inhibition' and CPD patients on the Childhood Trauma Questionnaire subscale ‘physical neglect'. <b><i>Conclusions:</i></b> These results suggest that there might be typical schema patterns associated with OCD and ED. We can also conclude that a higher prevalence of traumatic experiences does not necessarily coincide with more EMS and schema modes
Supplementary Material for: An empirical survey on the adaption of neoadjuvant chemotherapy in bladder cancer
Objective:
To determine the adaption of neoadjuvant chemotherapy (NAC) in patients with muscle-invasive bladder cancer (MIBC) in Germany, Austria and Switzerland and especially underlying reasons for potential low adherence to guidelines.
Methods:
We conducted a non-validated survey amongst 336 urologic departments in Germany, Austria and Switzerland. RedCap questionnaires were electronically distributed and included 23 items concerning the general NAC administration standards and guideline compliance in patient counselling regarding actual treatment.
Results:
Return rate of the questionnaire was 19.1% (63/336). Although 45 departments (71.4%) claim to perform NAC as standard-of-care, only 49% of eligible patients actually receive NAC. An advanced disease stage (≥cT3) and a high tumor-volume were mentioned to support application of NAC, whereas 35% of responders worry a deterioration of patients' preoperative status due to NAC. Furthermore, 26.7% of respondents are concerned about the low extent of survival benefit.
Conclusion:
Application of NAC in eligible MIBC-patients in Germany, Austria and Switzerland remains low. Although the majority of urologic departments discusses NAC and acknowledges the need for intensified treatment in advanced disease stages, not all eligible patients will actually receive NAC before radical cystectomy
Supplementary Material for: ERBB2 Expression as Potential Risk-Stratification for Early Cystectomy in Patients with pT1 Bladder Cancer and Concomitant Carcinoma in situ
<strong><em>Background/Aims/Objectives:</em></strong> It is difficult to identify patients with a non-muscle-invasive bladder cancer (NMIBC) at stage pT1 with concomitant carcinoma in situ (Cis) who will benefit from an early cystectomy. <b><i>Methods:</i></b> We retrospectively analyzed clinical data and formalin-fixed paraffin-embedded tissues of patients with NMIBC. Messenger ribonucleic acid (mRNA) expression of progesterone receptor (PGR), estrogen receptor (ESR1), ERBB2, and marker of proliferation Ki-67 (MKI67) was measured by single-step reverse transcription quantitative real-time polymerase chain reaction using RNA-specific TaqMan assays. Relative gene expression was determined by the normalization of 2 reference genes (CALM2, B2M) using the 40 ΔΔCT method and relative gene expression was correlated to the histopathological stage and oncological outcome. <b><i>Results:</i></b> Of 302 patients with pT1 NMIBC in the initial transurethral resection of the bladder, 65 had a concomitant Cis. Elevated ERBB2 expression (>40.1) significantly correlated with progress in patients with and without concomitant Cis (<i>p</i> = 0.020 and <i>p</i> = 0.049, respectively). For the subgroup of pT1 with concomitant Cis, elevated ERBB2 expression significantly discriminated between a high-risk group of 55% progression-free survival (PFS) and a low-risk group of 90% PFS after a 5-year follow-up (<i>p</i> = 0.020). Cox-regression analysis revealed ERBB2 expression as the only independent prognostic factor for PFS (<i>p</i> = 0.0037). <b><i>Conclusions:</i></b> High mRNA expression of ERBB2 can identify patients with pT1 NMIBC with concomitant Cis, who have a high risk of progression and might benefit from an early cystectomy
Supplementary Material for: What Kind of Patients Receive Inpatient and Day-Hospital Treatment in Departments of Psychosomatic Medicine and Psychotherapy in Germany?
Introduction: Germany is one of the few countries with a medical specialty of psychosomatic medicine and psychotherapy and many treatment resources of this kind. Objective: This observational study describes the psychosomatic treatment programs as well as a large sample of day-hospital and inpatients in great detail using structured diagnostic interviews. Methods: Mental disorders were diagnosed according to ICD-10 and DSM-IV by means of Mini-DIPS and SCID-II. In addition to the case records, a modified version of the CSSRI was employed to collect demographic data and service use. The PHQ-D was used to assess depression, anxiety, and somatization. Results: 2,094 patients from 19 departments participated in the study after giving informed consent. The sample consisted of a high proportion of “complex patients” with high comorbidity of mental and somatic diseases, severe psychopathology, and considerable social and occupational dysfunction including more than 50 days of sick leave per year in half of the sample. The most frequent diagnoses were depression, somatoform and anxiety disorders, eating disorders, personality disorders, and somato-psychic conditions. Conclusions: Inpatient and day-hospital treatment in German university departments of psychosomatic medicine and psychotherapy is an intensive multimodal treatment for complex patients with high comorbidity and social as well as occupational dysfunction