In Painful Shoulder Disease, Inpatient Rehabilitation has Long Term Benefits with or without Therapeutic Nuclear Magnetic Resonance: A Randomized Controlled Clinical Trial

Introduction: The aim of the presented study was to investigate the effect of an inpatient rehabilitation stay with application of therapeutical nuclear magnetic resonance therapy (NMRT) in 150 patients with painful shoulder diseases in a controlled trial.Methods: In a double blinded placebo-controlled multicenter study during a three-week inpatient rehabilitation pain, sleep quality, shoulder function, respectively biomarkers for stress and pain by treatment series with therapeutical nuclear magnetic resonance (NMRT) applied as an additive treatment with a series of NMR on nine consecutive days (9 x 1h) was investigated.Results: Virtually all (except sleep quality) investigated parameters, mainly pain (VAS) and function (Quick Dash) improved significantly during and after the rehabilitation programme in both study groups. We found no additional effect between the group that received rehabilitation without NMRT and the group with rehabilitation programme plus active NMRT at any time of the six month follow up.&nbsp;Conclusion: In fact, a good outcome of the rehabilitation programme became obvious whereas, the NMR therapy did not result in a verifiable, additive effect. Therefore, one might consider that a possible positive effect by the NMRT on painful shoulder affections is masked by the obviously effective rehabilitation programme to treat the very complex shoulder joint.</p

Wiener klinische Wochenschrift / Management of malignant pleural mesothelioma part 1 : epidemiology, diagnosis, and staging

Malignant pleural mesothelioma is a rare malignant disease that in the majority of cases is associated with asbestos exposure. The incidence in Europe is about 20 per million inhabitants and it is increasing worldwide. Initial symptoms are shortness of breath, pleural effusion, cough, and chest pain. The typical growth pattern is along the pleural surface; however, infiltration of the lung and/or mediastinal and chest wall structures can occur in a more advanced stage. Ultimately, distant metastases outside the chest can result. Several histological subtypes of pleural mesothelioma exist, which must be differentiated from either benign diseases or metastases in the pleural space by other tumor entities. This differential diagnosis can be very difficult and a large panel of immunohistochemical markers is required to establish the exact diagnosis. The standard procedure for confirming the disease and obtaining sufficient tissue for the diagnosis is videothoracoscopy. Full thickness biopsies are required, while transthoracic needle puncture of pleural fluid or tissue is considered to be insufficient for a cytological diagnosis. Complete and detailed staging is mandatory for categorization of the disease as well as for therapeutic decision making.(VLID)348029

The impact of instructor intention for student learning and implementation of undergraduate science education reform on student perception of the learning environment

The rapid advances in technology and scientific knowledge in modern society increases the need for a workforce with an understanding of technology and critical thinking skills College graduates are entering the working world without the critical thinking skills and ability to apply the scientific knowledge gained during their undergraduate experience (Casner-Lotto & Barrington, 2006). To prepare college graduate for the careers that they will have in the future, the current way science is taught has to be reformed. When examining the impact of reformed science teaching at the undergraduate level, the question of how students perceive their learning environment arises. To address this problem, this study examined the effects that of varying levels of reformed science teaching used classroom had on students' perceptions of the learning environment. The population of this study included 103 institutions that participated in the National Aeronautics and Space Administration's NASA Opportunities for Visionary Academics (NOVA) Program. The NOVA program courses were developed by faculty teams as a part of professional development efforts for university faculty and administrators at 103 universities to work in collaborative teams to create and sustain reform in entry-level undergraduate science and mathematics courses. To determine the impact of reformed teaching on students, the National Study of Education in Undergraduate Science used surveys, interviews, and classroom observations compare the NOVA reformed courses with similar courses that had not been reformed under the NOVA program. The study sample in this dissertation includes data from 9 of those institutions and 14 faculty members. The level of reform was measured using the Reformed Teaching Observation Protocol, and students' perception of the learning environment was determined using the Constructivist Learning Environment Survey. Quantitative results were corroborated with qualitative data from interviews of both the instructors and the students. The level of reform found in the courses was found to vary along a continuum from reformed to traditional instructor orientation and this context significantly affected student perceptions of the learning environment. Results identified significant relationships between courses the level of reform implemented in the course and student perception of the learning environment. The ways in which scientific ideas were communicated impacted students' perceptions of their ability to learn science. In the courses where students were given the opportunity to develop and communicate their ideas about scientific knowledge to other students and the instructor, the students perceived the learning environment more favorably. The students in these courses were more confident in their ability to learn and understand science. They also felt more confident in their ability to use their scientific knowledge in their futures. Students in courses with little reform implanted in the classroom viewed the learning environment less favorably. They tended to feel the course content was irrelevant to their lives, and did not think they could and/or would use the course knowledge in their future care (Published By University of Alabama Libraries

Wiener klinische Wochenschrift / Management of malignant pleural mesothelioma part 3 : Data from the Austrian Mesothelioma Interest Group (AMIG) database

Background Malignant pleural mesothelioma (MPM) is a rare but aggressive tumor originating from the pleural cavity with a strong link to previous asbestos exposure. In order to determine the demographics, diagnostics, therapeutic strategies, and prognosis of MPM patients in Austria, the Austrian Mesothelioma Interest Group (AMIG) was founded in 2011. In this report the data from the AMIG MPM database collected to date are reported. Methods A prospective observational registry was initiated, including patients with histologically verified MPM diagnosed and treated at specialized centers in Austria. Patient inclusion started in January 2011 and follow-up was completed until September 2015. Results A total number of 210 patients were included. There were 167 male and 43 female patients with a mean age of 67.0 years (SD 11.3) at the time of diagnosis. Asbestos exposure was confirmed in 109 (69.4 %) patients. The histological subtype was epithelioid in 141 (67.2 %), sarcomatoid in 16 (7.6 %), biphasic in 28 (13.3 %), and MPM not otherwise specified in 25 (11.9 %) patients. Of the patients, 30 (14.3 %) received best supportive care (BSC) only, 71 (33.8 %) chemotherapy (CHT) alone, four (1.9 %) radiotherapy (RT) alone, 23 (11.9 %) CHT/RT, two (0.9 %) surgery alone, and 76 (36.2 %) curative surgery within a multimodality treatment (MMT), which was more frequently performed for patients younger than 65 years and with early-stage disease (I + II). Median overall survival (OS) was 19.1 months (95 % CI 14.723.5). The 1, 3, and 5year OS rates were 66 %, 30 %, and 23 %, respectively, and OS was significantly better in patients undergoing surgery within MMT (5-year survival 5 % vs. 40 %, p = 0.001). Conclusion Patients with earlier disease stages, younger age, good performance status, and epithelioid histology were more likely to undergo MMT including surgery, which resulted in a more favorable outcome.(VLID)348028