A pattern of care analysis: Prosthetic rehabilitation of head and neck cancer patients after radiotherapy

Background While some medical associations provide guidelines for the implant‐prosthetic rehabilitation of head and neck cancer patients, the circulation and implementation in the everyday routine of practicing dentists remain unknown. Purpose To analyze patterns of care for the prosthetic rehabilitation of head and neck cancer patients after radiotherapy in German speaking countries. Materials and methods An online survey consisting of 34 questions separated into three sections, (a) general inquiries, (b) treatment concepts, and (c) patient cases, was forwarded to university hospital departments for Prosthetic Dentistry and Oral and Maxillofacial Surgery, and members of different medical associations. Statistical differences between groups were analyzed using chi‐squared test (P < .05). Results From May to October 2019, 118 participants completed the survey. The majority practiced in university hospitals, had more than 5 years of work experience, and reported to be involved in <10 post radiation prosthetic rehabilitation cases per year. Rehabilitation protocols involving dental implants were implemented by oral/oral‐ and maxillofacial surgeons and prosthetic dentists, while general dentists favored implant‐free solutions. Xerostomia was recognized as a common problem for a successful prosthetic rehabilitation. The subsequent treatment choice with either fixed dental prostheses or removable dentures was divided among participants. Conclusions As treatment planning differed with regard to the participants' field of expertise and work environment, and most practitioners only handle a low number of cases, patients might benefit from centralization in larger institutes with a multidisciplinary structure. A high agreement between the practitioners' treatment concepts and the current state of research was observed. While the choice between a mucosa‐ or tooth‐supported, and an implant‐supported restoration depends on numerous individual factors, guidelines derived from longitudinal studies would enhance evidence‐based treatment in this field

Development and evaluation of a cancer-related fatigue patient education program: protocol of a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Cancer-related fatigue (CRF) and its impact on patients' quality of life has been an increasing subject of research. However, in Germany there is a lack of evidence-based interventions consistent with the multidimensional character of fatigue. The objective of this study is to develop and evaluate a self-management program for disease-free cancer patients to cope with CRF.</p> <p>Methods</p> <p>Based on evidence extracted from a literature review, a curriculum for the self-management program was elaborated. The curriculum was reviewed and validated by an interdisciplinary expert group and the training-modules will be pretested with a small number of participants and discussed in terms of feasibility and acceptance.</p> <p>To determine the efficacy of the program a randomised controlled trial will be carried out: 300 patients will be recruited from oncological practices in Bremen, Germany, and will be allocated to intervention or control group. The intervention group participates in the program, whereas the control group receives standard care and the opportunity to take part in the program after the end of the follow-up (waiting control group). Primary outcome measure is the level of fatigue, secondary outcome measures are quality of life, depression, anxiety, self-efficacy and physical activity. Data will be collected before randomisation, after intervention, and after a follow-up of 6 months.</p> <p>Discussion</p> <p>Because there are no comparable self-management programs for cancer survivors with fatigue, the development of the curriculum has been complex; therefore, the critical appraisal by the experts was an important step to validate the program and their contributions have been integrated into the curriculum. The experts appreciated the program as filling a gap in outpatient cancer care.</p> <p>If the results of the evaluation prove to be satisfactory, the outpatient care of cancer patients can be broadened and supplemented.</p> <p>Trial Registration</p> <p>ClinicalTrials NCT00552552</p

Christmas disease in a Hovawart family resembling human hemophilia B Leyden is caused by a single nucleotide deletion in a highly conserved transcription factor binding site of the F9 gene promoter.

Hemophilia B is a classical monogenic X-chromosomal recessively transmitted bleeding disorder caused by genetic variants within the coagulation factor IX gene. Although hemophilia B has been described in dogs, it has not yet been reported in the Hovawart. Here we describe the identification of a Hovawart family transmitting typical signs of an X-linked bleeding disorder. Five males were reported to suffer from recurrent hemorrhagic episodes. A blood sample of one of these males with only 2% of the normal concentration of plasma factor IX together with samples of seven relatives were provided. Next generation sequencing of the mother and grandmother revealed a single nucleotide deletion in the F9 promoter. Genotyping of the deletion in 1,298 dog specimens including 720 Hovawarts revealed that the mutant allele was only present in the aforementioned Hovawart family. The deletion is located 73 bp upstream of the F9 start codon in the conserved overlapping DNA binding sites of hepatocyte nuclear factor 4α and androgen receptor. The deletion only abolished binding of hepatocyte nuclear factor 4α, while androgen receptor binding was unaffected as demonstrated by electrophoretic mobility shift assay using human hepatocyte nuclear factor 4α and androgen receptor with double-stranded DNA probes encompassing the mutant promoter region. Luciferase reporter assays using wild type and mutated promoter fragment constructs transfected into Hep G2 cells showed a significant reduction in expression from the mutant promoter. The data provide evidence that the deletion in the Hovawart family caused a rare type of hemophilia B resembling human hemophilia B Leyden

Zum Phänomen der "follia therapeutica" der etruskisch-italischen anatomischen Votive - soziale, ökonomische und religiöse Aspekte

L'articolo riassume i progressi fatti durante gli ultimi decenni nel campo delle terrecotte anatomiche votive nel mondo etrusco e italico fra il VI e il II sec.a.C. ed esamina particolarmente aspetti di tipo sociale, economico e religioso

Greek contributions to tomb paintings in Etruria and Southern Italy: Colours, Painting techniques, Workshops and Iconography

This contributions is dealing with the manifold Greek influences in the paintings - specially tomb paintings - in Etruria and Southern Italy from the 6th to the 3rd cent. B.C

Cippi, stele, statue-stele e semata. Testimonianze in Etruria, nel mondo italico e in Magna Grecia dalla Prima Età del ferro fino all'Ellenismo. Atti del Convegno internazionale, Sutri-Villa Savorelli, 24-25 aprile 2015

Questi Atti del Convegno comprendono una introduzione e 16 contributi di autori italiani, tedeschi, francesi e austriaci. Quasi tutti articoli sono riccamente illustrati. Viene trattato per la prima volta una categoria di monumenti cioè i cippi ed altri segnacoli funerari nel mondo etrusco, italico e magnogreco durante il primo millennio a.C