„Naturbilder“, „lebendige Gemälde“ und das „bewundernde Auge“

Unter dem Aspekt bildwissenschaftlicher Überlegungen werden die „Bilder“ Georg Gassers (1857-1931) behandelt, identifiziert und analysiert. Als Privatier zeigt Gasser in seinem Privathaus in Bozen (Südtirol) Naturalien und Ethnografika nach seinen Idealen als Künstler. An der Akademie der bildenden Künste baut er sein gestalterisches Talent aus. Die naturkundlichen Kenntnisse erwirbt er sich eigenständig. Georg Gasser arbeitet nicht wissenschaftlich, greift jedoch verschiedene wissenschaftliche Themen auf, zu denen er sich aber nicht eindeutig positioniert. Viel eher verleiht Georg Gasser seiner Position durch „Bilder“ einen hermeneutischen Rahmen. Er vermittelt Vorstellungen von gesellschaftlichem und kulturellem Zusammenleben, Bewertungen und Verständnisse von Welt. Dabei werden sein persönlicher Background, sein gesellschaftliches Umfeld und seine künstlerische Tätigkeit berücksichtigt. Durch die Kontextualisierung kann die enge Koppelung der „Bilder“ an die Person gelingen. Gasser ist Multiplator, Kommunikator und Vermittler von Wissen, der nicht nur den Besuch seiner Sammlung, die er ab 1905 im Stadtmuseum Bozen ausstellt, sondern auch seine Auftritte als Vortragender zu einem ästhetischen Erlebnis werden lässt. Das Wissen ist ganz eng mit der Art und Weise der Darbietung verwoben. Plastische Erzählweise, Metaphern und Schilderungen von Stadtansichten versetzen seine Zuhörer/innen in Erstaunen und Spannung. Die museale Darstellung gewinnt durch überlegtes Arrangement und angesagte Präsentationsformen ihren Charme. Bei all der Liebe zum Detail leidet jedoch die inhaltliche Ebene. Gasser bemüht sich nicht um den neuesten Stand der Information, sondern versucht dieses Defizit mit effektvoller Gestaltung zu kompensieren. Mit seiner Präsenz als Publikumsmagnet erwirbt er sich jedoch eine Sonderstellung in der Bozner Gesellschaft und bringt wissenschaftliches Flair in die Stadt

Cancer patients' expectations when undergoing extensive molecular diagnostics—A qualitative study

Objective: Precision cancer medicine (PCM) aims at identifying tumor-driving molecular characteristics to improve therapy. Despite early successes for some cancers, the approach faces manifold challenges. Patients undergoing extensive molecular diagnostics (MD) may hope for personal benefit, although chances are small. In order to offer suitable support to this group, health-care professionals need to gain insight into patients' experience. Thus, this study sought to explore the expectations of cancer patients undergoing MD of their tumor. Methods: In two German Comprehensive Cancer Centers, 30 patients with advanced-stage cancer who had exhausted conventional treatment and had consented to extensive, research-oriented MD (whole-genome sequencing n = 24, panel sequencing n = 6) participated in semi-structured interviews. Following thematic content analysis by Kuckartz, the interview transcripts were coded for expectations of MD participation and topics closely related. Moreover, patients completed questionnaires on their sociodemographic characteristics, medical history, and psychosocial distress. Results: Patients reported to be expecting (a) an improvement of their treatment, (b) a contribution to research, and/or (c) additional insight to their own cancer. Further, they described to feel individually appreciated and to have a reason to maintain hope for cure or recovery by participating in MD. Conclusions: Molecular diagnostics participation led patients to feel treated in a more “personalized” way, allowing them a greater sense of control in their situation of severe illness. Oncologists and psycho-oncologists need to ensure comprehensive information and empathetic support for patients undergoing extensive MD to balance their expectations and actual chances of clinical benefit

Stressors related to the COVID-19 pandemic and their association with distress, depressive, and anxiety symptoms in cancer out-patients

Patients with cancer might be particularly prone to stress caused by the COVID-19 pandemic. The aim of this study was to investigate the impact of pandemic-related stressors on oncological patients’ psychological well-being. During the second wave of the COVID-19 pandemic in Germany 122 cancer out-patients of the Comprehensive Cancer Center Munich reported on COVID-19-related stressors (information satisfaction, threat perception, and fear of disease deterioration) and answered standardized questionnaires for psychosocial distress (DT) as well as depression and anxiety symptoms (PHQ-2, GAD-2). Multiple linear regression analyses were used to identify associations of the COVID-19-related stressors with psychological symptoms, controlling for sociodemographic, psychological (self-efficacy, ASKU) and clinical (somatic symptom burden, SSS-8) variables. Initially, satisfaction with information was significantly negatively associated with all three outcome variables. Fear of disease deterioration was associated with distress and depressive symptoms. After controlling for additional variables, only satisfaction with information remained an independent determinant of anxiety (β = −0.35, p < 0.001). All three outcomes were most strongly determined by somatic symptom burden (β ≥ 0.40, p < 0.001). The results of this study tentatively suggest that physical well-being overrides the relevance of some COVID-19-related stressors for oncological patients’ psychological wellbeing. Physical symptoms are strongly tied to personal wellbeing as they are associated with suffering from cancer, which might be more central to personal wellbeing than the possibility of getting infected with SARS-CoV-2. However, satisfaction with the information received seems to be important beyond physical wellbeing, as this emerged as an independent determinant of anxiety

Off label drug use in paediatric patients : an evidence based literature study analysing liposomal amphotericin B, micafungin, ciprofloxacin, ganciclovir, tropisetron, palonosetron and diphenhydramine

Background: Clinical departments of oncology and paediatrics are the main affected by off-label drug use in children with medicines only approved for adults. Paediatric cancer patients treated with off-label drugs are at risk of unexpected drug-related adverse events, as no clear declarations for dosage, age and indication exist. By law, the prescribing physician is fully responsible for these effects. Consequently, there is a strong need for adequate, if possible evidence-based, recommendations. Methods: A literature-based data collection dealing with antiemetic and antimicrobial therapy in paediatric cancer patients was conducted. Information in terms of dosage, safety and efficacy was considered for the following drugs suggested by the paediatric division of the department of Haematology and Oncology of the University Hospital Innsbruck: liposomal amphotericin B, micafungin, ciprofloxacin, ganciclovir, tropisetron, palonosetron and dimenhydrinate. Relevant studies were identified according to a defined search strategy using literature databases like PubMed, Cochrane Library and ClinicalTrials.com. Evidence was rated for all selected publications on the basis of Jadad-Score and a classification of evidence of the different study types. The relevance of the obtained studies was measured by means of specified PICO criteria. Additionally, the bibliography of existing reviews was screened. Furthermore, study results were compared with dosage and application recommendations of the paediatric databases Kinderdosierungen.ch® and DrugDoses®. The aim was to elaborate a systematic survey including recent recommendations and experiences with respect to safety, dosage, tolerability and adverse events to facilitate the treatment of (oncologic) paediatric patients. Results: The number of adequate studies was drug dependent, but in general very low for tropisetron and dimenhydrinate. As expected for off-label use in paediatric cancer patients, the amount of studies assessed with high evidence was low. Evaluation by Jadad-Score was scarcely possible. The database DrugDoses® offered clear dosage recommendations for every single drug reviewed in this work, whereas Kinderdosierungen.ch® supplied dosage recommendations for ciprofloxacin and liposomal amphotericin B, only. Conclusion: Due to a well-functioning search strategy, adequate publications were successfully selected by online databases. The wide-ranging database DrugDoses® turned out to be useful for dosage comparison, whereas dosage-information on the platform Kinderdosierungen.ch® is much more limited, as it is specified on certain drugs. Outcomes of this review aim to support dose-selection by prescribing physicians of the Department of Haematology and Oncology of the University Hospital Innsbruck and to provide information on safety and efficacy.Anna-Theresia PichlerAbweichender Titel laut Übersetzung der Verfasserin/des VerfassersUniversity of Innsbruck, Diplomarbeit, 2017Innsbruck, Univ., Diplomarb., 2017(VLID)196059

Consistently High Frequency of Scooter Injuries in Children—Retrospective Data Analysis in a Level I Trauma Centre

The aim of this retrospective study was to present an epidemiological overview of paediatric nonelectric-scooter-related injuries, focusing on changes in injury mechanism and frequency. A retrospective, descriptive data analysis at a Level I trauma centre, including patients aged from 0 to 18 years injured by riding nonelectric scooters, was performed. The observation period ranged from January 2015 to December 2022. The total study population consisted of 983 (mean age: 7.9 ± 4.0 years) children and adolescents, with most patients being male (800/983; 81.4%). The frequency of nonelectric scooter injuries was relatively consistent over the observation period. Patients sustained mostly minor injuries (lacerations, bone contusions, sprains) (527/983; 53.6%), followed by head injuries (238/983; 24.5%), limb fractures (166/983; 16.9%) and trunk injuries (52/983; 5.3%). However, a few patients sustained severe injuries, including skull fractures (7/238; 2.9%), intracranial haematoma (4/238; 1.7%) or lacerations of abdominal organs (4/52; 7.7%). This study presented a consistently high frequency of scooter injuries in children. Children under 15 years were the most affected by scooter-related injuries. Although most injuries were minor, serious injuries occurred that should not be underestimated. Hence, we emphasise the use of protection gear and recommend raising awareness among parents and children

Information, communication, and cancer patients’ trust in the physician: what challenges do we have to face in an era of precision cancer medicine?

Purpose!#!Despite promising achievements in precision cancer medicine (PCM), participating patients are still faced with manifold uncertainties, especially regarding a potential treatment benefit of molecular diagnostics (MD). Hence, MD poses considerable challenges for patient information and communication. To meet these challenges, healthcare professionals need to gain deeper insight into patients' subjective experiences. Therefore, this qualitative study examined information aspects of MD programs in cancer patients.!##!Methods!#!In two German Comprehensive Cancer Centers, 30 cancer patients undergoing MD participated in semi-structured interviews on information transfer and information needs regarding MD. Additionally, patients provided sociodemographic and medical data and indicated their subjective level of information (visual analogue scale, VAS, 0-10).!##!Results!#!On average patients had high levels of information (mean = 7, median = 8); nevertheless 20% (n = 6) showed an information level below 5 points. Qualitative analysis revealed that patients show limited understanding of the complex background of MD and have uncertainties regarding their personal benefit. Further, patients described unmet information needs. Existential threat in awaiting the results was experienced as burdensome. To withstand the strains of their situation, patients emphasized the importance of trusting their physician.!##!Conclusion!#!The challenges in PCM consist in providing unambiguous information, especially concerning treatment benefit, and providing guidance and support. Therefore, psycho-oncology needs to develop guidelines for adequate patient communication in order to help healthcare providers and cancer patients to handle these challenges in the developing field of PCM

Attrition Rates in Multiple Myeloma Treatment under Real World Conditions—An Analysis from the Austrian Myeloma Registry (AMR)

Multiple myeloma (MM) is characterized by serial relapses, necessitating the application of sequential lines of therapy (LoT). Reports on attrition rates (ARs) vary widely. The present study analysed ARs from the Austrian Myeloma Registry. Attrition was defined as being either deceased, progressive without having received another LoT, or lack of follow-up for ≥5 years. A total of 571 patients diagnosed between January 2009 and August 2021 were included (median age: 72 years; median follow-up: 50.8 months). Some 507 patients received at least one LoT. Of the total, 43.6% underwent autologous stem cell transplantation (SCT, transplant eligible = TE)) with primarily VRd (Bortezomib/Lenalidomide/Dexamethasone) given as induction (26.5%), followed by lenalidomide maintenance in 55.7% of cases. Transplant-ineligible (NTE) patients were predominantly treated with Vd (Bortezomib/Dexamethasone, 21.6%), receiving maintenance in 27.1%. A total of 37.5% received a second LoT. ARs across one to five LoTs were 16.7–27%. Frontline induction/ SCT followed by maintenance reduced ARs associated with age and achievement of deep remission in the frontline. Deep remission prolongs follow-up and time-to-next-treatment (TTNT), while high-risk-cyctogenetics negatively affected these outcomes. Our results demonstrate considerably lower ARs for MM patients within the AMR data versus other healthcare systems. Young age and the achievement of significant remissions after optimal frontline therapy resulted in particularly low ARs. These promising results support a key role for the ease of drug access and reimbursement policies in governing long-term MM patient outcomes

Pathogen-Induced Leaf Chlorosis: Products of Chlorophyll Breakdown Found in Degreened Leaves of Phytoplasma-Infected Apple (Malus × domestica Borkh.) and Apricot (Prunus armeniaca L.) Trees Relate to the Pheophorbide <i>a</i> Oxygenase/Phyllobilin Pathway

Phytoplasmoses such as apple proliferation (AP) and European stone fruit yellows (ESFY) cause severe economic losses in fruit production. A common symptom of both phytoplasma diseases is early yellowing or leaf chlorosis. Even though chlorosis is a well-studied symptom of biotic and abiotic stresses, its biochemical pathways are hardly known. In particular, in this context, a potential role of the senescence-related pheophorbide <i>a</i> oxygenase/phyllobilin (PaO/PB) pathway is elusive, which degrades chlorophyll (Chl) to phyllobilins (PBs), most notably to colorless nonfluorescent Chl catabolites (NCCs). In this work, we identified the Chl catabolites in extracts of healthy senescent apple and apricot leaves. In extracts of apple tree leaves, a total of 12 Chl catabolites were detected, and in extracts of leaves of the apricot tree 16 Chl catabolites were found. The seven major NCC fractions in the leaves of both fruit tree species were identical and displayed known structures. All of the major Chl catabolites were also found in leaf extracts from AP- or ESFY-infected trees, providing the first evidence that the PaO/PB pathway is relevant also for pathogen-induced chlorosis. This work supports the hypothesis that Chl breakdown in senescence and phytoplasma infection proceeds via a common pathway in some members of the Rosaceae family