Academic literature on the topic 'Vivantes (Hospital : Berlin, Germany)'

Background: National and international guidelines for the diagnosis and treatment of cancer associated venous thromboembolism (CAT) recommend anticoagulation treatment for 3 to 6 months and a re-evaluation for resumption depending on the individual risk of every patient. In CAT low molecular weight heparin (LMWH) was estimated to be the most effective and safest treatment option in 2015. However, it remains unclear how cancer patients with VTE were (treated in clinical daily care in Germany. In former register trials, the specific characteristics of individual cancer patients were insufficiently characterized and inadequately discussed. Special aspects of daily care are lacking in most publications. Methods: The GECAT register was set up for Berlin´s two main hospital companies Charité-Universitaetsmedizin Berlin and Vivantes, (both covering about 50 % of the hospital beds in Berlin) to document prospectively patients with a newly diagnosed VTE . Patients with the diagnosis of cancer within 2 years prior to the VTE got basis documentation by a physician after informed consent. A follow up of these patients was scheduled after 3 and 6 months per telephone interview. Points of interest were: kind and location of the VTE event, diagnostic procedures, drug and dosage of initial and follow-up anti-coagulation treatment, relapse of VTE or bleeding complications, serious adverse events, mortality, and date and reason for determination of anticoagulation. Primary objective was to evaluate the treatment reality of patients with cancer associated VTE in clinical daily practice. Results: Between May 2015 and May 2017, 382 patients (pts) with active cancer within the last 2 years and newly diagnosed VTE gave consent to this register trial. 193 (50.5%) were female, median age was 65 years (range 19-89). For 133 pts (34.8%), VTE was the primary reason for admission at hospital, 34.3% were referred by their oncologist, 13,6% by their general practitioner, 15,5% by other treating physicians and 36.6% directly via the emergency department. 182 pts (47.6%) had pulmonary embolism, 268 pts (70.2%) had venous thrombosis and 18,6%71 pts (18.6%) had both. The most common cancer sites were lung (n=57, 14,9%), gynecological (n=44, 11,5%), colorectal (n=40, 10,5%) and pancreatic cancer (n=33 8,6%); 204 pts (56%) with solid tumors presented with stage IV diseases; 60 pts (15.7%) had hematological malignancies. 279 pts (73%) received anticancer treatments at the time of diagnosis of VTE. 148 (38.7%) pts died in the 6 months study period (20 pts died in hospital after admission, 90 pts within the first 3 months and 38 pts within the 6 months follow up). Initially, the majority of pts (n=350; 91.6%) was treated with LMWH. After discharge from hospital 78.7% remained on LMWH and 12.7% were treated with direct oral anticoagulants (DOACs). After 3 months 64.9% of pts received LMWH and 26.1% DOACs; after 6 months 48.4% LMWH and 44% DOACs. Responsible for the anticoagulation treatment decisions was mostly the oncologist (58%), followed by the general practitioner (26.3%) and other physicians (15,7%) . During the initial hospital stay, 2.6% of pts had a bleeding complication and 0.8% were diagnosed with a progress of VTE. At 6 months follow up, 6.4% reported bleeding complications and 2.4% recurrent VTE. Conclusion: The GECAT register trial gives new and clinically relevant information about the clinical daily care practice of cancer patients with newly diagnosed VTE in Berlin, Germany. The treating oncologist is in most cases responsible for the treatment. Disclosures Sinn: LEO: Research Funding; Bayer Healthcare AG: Research Funding; Servier: Honoraria, Research Funding; Astra Zeneca: Honoraria, Research Funding; Amgen: Honoraria; Sanofi: Honoraria. Scholz:Celgene: Consultancy; GILEAD: Consultancy, Speakers Bureau; Roche: Consultancy; Janssen-Cilag: Consultancy; Hexal: Consultancy; Novartis: Consultancy; Pfizer: Speakers Bureau; Takeda: Consultancy; Daiichi Sankio: Consultancy. Klamroth:Bayer, Biomarin, CSL Behring, Novo Nordisk, Octapharma, Pfizer, Roche, SOBI, Takeda: Consultancy; Bayer, Novo Nordisk, SOBI: Research Funding.

Public education campaigns are recommended to increase awareness for stroke. The effect of a public advertising and education campaign in an urban region in Germany was assessed and compared with a control region. We hypothesized that such a campaign would increase the number of patients being admitted by emergency medical services (EMS). A multimedia campaign and targeted education of health care professionals and the public was employed in Berlin during six consecutive months to disseminate knowledge about stroke symptoms and appropriate actions to take. Data on time to hospital admission and details on transport were retrieved from registries for the episode before, during, and after the campaign. To test the effect of the campaign, it was compared with another urban region in Germany (Ruhr-Area), where no campaign had been conducted. Between January 2010 and February 2011, 9,166 patients with stroke or transient ischemic attack (TIA) were documented in Berlin and 9,994 in the Ruhr-Area. In both regions, following the campaign period, patients were more often admitted to hospital within the first 2 hr after onset (Berlin: odds ratio [OR] = 1.16, 95% confidence interval [CI] = [1.02, 1.32]; Ruhr-Area: OR = 1.18, 95% CI = [1.05, 1.34]). Patients were more likely being admitted via EMS after the campaign (Berlin: OR = 1.71, 95% CI = [1.50, 1.94]; Ruhr-Area: OR = 1.34, 95% CI = [1.17, 1.53]). The results suggest that an increased uptake of EMS triggered shorter time to hospital admission. A reduction in delay to hospitalization and an increased uptake of EMS were observed over the study period for both regions. No effect of the campaign was identified.

The experts taking part in the Workshop were: E. Rodríguez-Farré ( Coordinator); G.N. Fracchia, (Secretary); M. Adolphe, École des Hautes Études, Paris, France); P.H. Bach (University of East London, UK); M. Baeder (Hoechst Ltd, Hattersheira, Germany); R. Bass (BGA, Berlin, Germany); H.G. Baumgarten (Frei Universität, Berlin, Germany); H. Bazin (DGXII, CEC, Brussels, Belgium); P. Bentley (Ciba-Geigy, Basle, Switzerland); A. Boobis (Royal Postgraduate Medical School, London, UK); J. Castell (Hospital La Fé, Valencia, Spain); J.P. Contzen (DGXII, CEC, Brussels, Belgium); A. Cordier (Sandoz Pharma Ltd, Basle, Switzerland); J. Diezi (Université de Lausanne, Switzerland); L. Dubertret (INSERM U-312, Creteil, France); P.M. Fasella (DGXII, CEC, Brussels, Belgium); J.H. Fentem (FRAME, Nottingham, UK); A. Guillouzo (INSERM U-49, Rennes, France); I. Kimber (Zeneca, Macclesfield, UK); T. Krieg (Universität zu Koln, Germany); A. Mantovani (Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy); K. Miller (BIBRA, Carshalton, UK); J.P. Morin (INSERM U-295, Rouen, France); D. Paul (Fraunhofer Institut für Toxikologie und Aerosolforschung, Hannover, Germany); P.W.J. Peters (Riijkinstituut voor Volksgezondheid en Milieuhygiene, Bilthoven, The Netherlands); J. Picard (Faculté des Sciences, Louvain la Neuve, Belgium); D. Poggiolini (Ministry of Health, Rome, Italy); C.M. Regan (University College, Dublin, Ireland); C.A. Reinhardt (SIAT, Zurich, Switzerland); B. Robaire (McGill University, Montreal, Canada); M. Roberfroid (Université Catholique de Louvain, Brussels, Belgium); V. Rogiers (Vrije Universiteit Brussels, Belgium); J. Rueff (Istituto de Higiene e Medicina Tropical, Lisbon, Portugal); H. Spielmann (ZEBET, Berlin, Germany); H. Stolte (Medizinische Hochschule, Hannover, Germany); J. van Noordwijk (European Pharmacopeia Commission, Bosch en Duin, The Netherlands); E. Walum (University of Stockholm, Sweden); D.C. Williams (Trinity College, Dublin, Ireland); and M. Yaniv (Institut Pasteur, Paris, France), and their contributions are gratefully acknowledged.

AbstractPurpose:Ethnic minority groups show elevated suicide attempt rates across Europe. Evidence suggests a similar trend for women of Turkish origin in Germany, yet data on suicidal behaviour in minorities in Germany is scarce. The objective was to examine rates of suicidal behaviour, underlying motives, and to explore the effectiveness of an intervention program.Methods:From 05/2009–09/2011, data on all suicide attempts among women of Turkish origin who presented at a hospital-based emergency unit in Berlin, Germany, were collected. A multi-modal intervention was conducted in 2010 and the effects of age, generation and the intervention on suicide attempt rates were examined.Results:At the start, the highest rate was found in women aged 18–24 years with 225.4 (95% CI = 208.8–242.0)/100,000. Adjustment disorder was the most prevalent diagnosis with 49.7% (n = 79), being more common in second-generation women (P = .004). Further analyses suggested an effect of the intervention in the youngest age group (trend change of ß = –1.25; P = .017).Conclusion:Our findings suggest a particularly high rate of suicide attempts by 18–24-year-old, second-generation women of Turkish origin in Berlin. Furthermore, our results suggest a trend change in suicide attempts in women aged 18–24 years related to a population-based intervention program.

Professor Angela Märten speaks to Rachel Jenkins, Commissioning Editor Angela Märten earned her PhD at Humboldt University of Berlin, Germany, in 2000, after working for several years as an oncology nurse. Upon completion of her PhD, she assumed responsibility for Phase I trials and translational research for the University Hospital of Bonn, Germany. In 2002, the University Hospital of Bonn appointed her as Assistant Professor for Experimental Haematology and Oncology. In 2003, she accepted a new position at the University of Heidelberg, Germany, heading the Immunotherapeutic Group and the Oncology Trial Department. The University of Heidelberg appointed her as Associate Professor in 2006 while she completed her Master of Sciences in Clinical Research in 2008. Professor Märten has been principal investigator of several clinical trials and has published more than 100 papers, with a particular focus on pancreatic carcinoma and lung cancer. She joined Boehringer Ingelheim in 2009, where she built up the German Medical Affairs Oncology team, before joining the Global Afatinib team in 2013. She is currently Global Senior Medical Advisor, Therapeutic Area of Oncology at Boehringer Ingelheim.

Questions: There are no current health care studies from Germany regarding the “morning-after pill”. This paper will use routine data to analyse details regarding the usersʼ profiles, reasons for using it and the utilisation of hospital outpatient facilities. Patient Collective and Methods: Retrospective analysis of all triage sheets in the emergency department of the Virchow Hospital Campus/Charité University Hospital, Berlin, over a four-year period from 2007 to 2010 that were coded with the ICD diagnosis Z30 (= contraception advice) and statistical processing of the associated administrative data. Results: 860 triage sheets were included in the analysis. The emergency department is used most frequently for the prescription of the “morning-after pill” at the weekend. The average age of the users was 25.1 years. The most common reason cited for needing emergency contraception was unprotected sexual intercourse, with the second-most common being “condom failure”. Around half of the women attended the department within 12 hours of having unprotected sex. Less than 2 % (n = 14) of all women decided against a prescription of emergency contraceptive after counselling. Conclusions: The user profile and reasons for using emergency oral contraception correlate largely with the information contained in international literature. Although the “morning-after pill” is probably prescribed mainly in general practices in Germany, and despite the availability of new drugs with a permitted post-exposure interval of up to 120 hours after unprotected sex, there appears to still be a high demand for counselling and prescriptions of the “morning-after pill” in the context of the emergency department.

Comparing two public medical affairs which involved disciplinary proceedings and libel actions, one from Bavaria and one from Prussia, this article analyzes the dynamics behind legal conflicts over doctors’ professional ethics in Imperial Germany. In both the case of Dr Maurice Hutzler, who com mitted suicide after conflicts with senior colleagues at the Gisela Children’s Hospital and a sentence of the court of honour of the Munich Medical District Society, and the Berlin “patient trade” affair, in which the medical professors Ernst von Leyden, Hermann Senator, Karl Anton Ewald and Carl Posner were accused of having made payments to middlemen for bringing them lucrative private patients, notions of personal and professional honour played a central role. The Munich case highlighted shortcomings of the Bavarian medical court of honour system, which was less developed than its Prussian counterpart. The analysis of the two cases suggests that the ethics of medical practice in early twentieth-century Germany should be viewed as part of a culture of honour.

IntroductionHome treatment models in treating severe chronic mental disorders including crisis intervention show more and more evidence to offer an excellent alternative to hospital treatment. In Germany, having higher hospitalization rates than almost any other country in Europe, it is even more necessary to evaluate such alternative option to hospital treatment.Objective/aim of studyAfter establishing a home treatment model based on Swedish, Finnish and Italian experiences in cooperation with a big German health insurance in Berlin, we present data evaluation after the first year of implementation.Methods150 Patients out of a model region in Berlin being included in the first year of the project are evaluated with respect to their socio-demographic data and diagnostic spectrum, psychopathology ratings and quality of life assessments, as well as to health economic dimensions (different financial positions of spending economic treatment resources). Using an advanced statistical method of predictive modeling, we can compare the actual hospitalization rates to the statistically predicted ones.ResultsThere are predominantly patients with psychosis (50%), depressive disorders (30%) and BPD (15%). Actual hospitalization rates are extremely low compared to the statistical prediction. Health economic balance is difficult, mainly due to high starting expenses of a treatment setting which had to be built completely new.ImplicationsThe model in the meantime is being applied to the entire city of Berlin as well as to 4 other German counties (Schleswig-Holstein, Bremen, Bayern, Niedersachsen), other regions will follow shortly.