@article{MehnertKochSchulzetal.2012,
  author    = {Mehnert, Anja and Koch, Uwe and Schulz, Holger and Wegscheider, Karl and Weis, Joachim and Faller, Hermann and Keller, Monika and Br{\"a}hler, Elmar and H{\"a}rter, Martin},
  title     = {Prevalence of mental disorders, psychosocial distress and need for psychosocial support in cancer patients - study protocol of an epidemiological multi-center study},
  volume    = {12},
  number    = {70},
  doi       = {10.1186/1471-244X-12-70},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-153296},
  year      = {2012},
  abstract  = {Background Empirical studies investigating the prevalence of mental disorders and psychological distress in cancer patients have gained increasing importance during recent years, particularly with the objective to develop and implement psychosocial interventions within the cancer care system. Primary purpose of this epidemiological cross-sectional multi-center study is to detect the 4-week-, 12-month-, and lifetime prevalence rates of comorbid mental disorders and to further assess psychological distress and psychosocial support needs in cancer patients across all major tumor entities within the in- and outpatient oncological health care and rehabilitation settings in Germany. Methods/Design In this multicenter, epidemiological cross-sectional study, cancer patients across all major tumor entities will be enrolled from acute care hospitals, outpatient cancer care facilities, and rehabilitation centers in five major study centers in Germany: Freiburg, Hamburg, Heidelberg, Leipzig and W{\"u}rzburg. A proportional stratified random sample based on the nationwide incidence of all cancer diagnoses in Germany is used. Patients are consecutively recruited in all centers. On the basis of a depression screener (PHQ-9) 50\% of the participants that score below the cutoff point of 9 and all patients scoring above are assessed using the Composite International Diagnostic Interview for Oncology (CIDI-O). In addition, all patients complete validated questionnaires measuring emotional distress, information and psychosocial support needs as well as quality of life. Discussion Epidemiological data on the prevalence of mental disorders and distress provide detailed and valid information for the estimation of the demands for the type and extent of psychosocial support interventions. The data will provide information about specific demographic, functional, cancer- and treatment-related risk factors for mental comorbidity and psychosocial distress, specific supportive care needs and use of psychosocial support offers.},
  language  = {en}
}
@phdthesis{Schulz2007,
  author    = {Schulz, Martin},
  title     = {Einsatz des ITW W{\"u}rzburg unter besonderer Beachtung der Beatmung},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-25784},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2007},
  abstract  = {Es wurden die Eins{\"a}tze des ITW W{\"u}rzburg des Jahres 2005 anhand der vorhandenen Intensivtransportprotokolle ausgewertet. Ziel der Arbeit war eine quantitative und qualitative Bestandsaufnahme des Interhospitalverkehrs unter besonderer Beachtung des Beatmungsmanagements. Insgesamt wurden 249 reine ITW-Eins{\"a}tze im Jahr 2005 gefahren, von denen 243 durch ein vorhandenes Intensivtransportprotokoll dokumentiert waren. Die Dokumentation des Intensivtransportprotokolls war recht different. Zum einen hing die Qualit{\"a}t der Dokumentation vom transportbegleiteten Arzt ab und zum anderen wiesen einzelne Bereiche des Protokolls eine schlechtere Dokumentation auf als andere. Insgesamt waren Scores oder Angaben, die verschl{\"u}sselt einzutragen waren durchweg schlechter dokumentiert. Außerdem wurden viele Angaben im {\"U}bernahmestatus nicht dokumentiert, da diese oft schon im Verlaufsprotokoll protokolliert waren, was allerdings die digitale Erfassung erschwerte. Aufgrund dieser Beobachtungen entstand der Eindruck, dass hier ein Bedarf zur Vereinfachung des Protokolls besteht. Die Einsatzfrequenz war mit 0,68 Eins{\"a}tzen pro Tag relativ gering, was mit dem großen Einsatzbereich und der geringen Einwohner-, und Krankenhausdichte zusammenh{\"a}ngt. Der ITW W{\"u}rzburg wurde vorwiegend w{\"a}hrend der regul{\"a}ren Vorbehaltszeiten genutzt. Nur ein geringer Anteil (<10\%) der Eins{\"a}tze fanden außerhalb dieser Zeiten statt. Die Gesamteinsatzdauer im Median betrug 3 Std. 30 Min. pro ITW-Einsatz. Der l{\"a}ngste Einsatzabschnitt war dabei die Nachbereitungszeit mit 1 Std. 15 Min. im Median. Sie beinhaltete sowohl die Wiederherstellung der Einsatzbereitschaft des Fahrzeugs, sowie die R{\"u}ckfahrt zum Standort und Pausen. Der k{\"u}rzeste Einsatzabschnitt war die Behandlungszeit vor Ort mit 30 Minuten im Median. Dabei fiel auf, dass zentripetale Transporte signifikant l{\"a}ngere Behandlungszeiten vor Ort erforderten als zentrifugale Transporte. Nur 67,5\% der Eins{\"a}tze erreichten den Patienten innerhalb einer Stunde. Um eine Eintreffzeit von einer Stunde zu realisieren, w{\"a}ren mindestens zwei weitere ITW-Standorte in Schweinfurt und Aschaffenburg n{\"o}tig. Dies erscheint aber vor dem Hintergrund der Auslastung des ITW W{\"u}rzburgs, der geringen Zahl an Sofort-transporten und der Kosten nicht ad{\"a}quat. Drei Viertel aller Transporte waren Ferntransporte, mit einer durchschnittlichen Entfernung der Zielklinik von 72 Km. Hier erscheint der Standort W{\"u}rzburg hinsichtlich der guten Verkehrsanbindung als zentraler Standort des ITWs sinnvoll. Zentripetale und zentrifugale Transporte waren ann{\"a}hernd gleich vertreten. Das Patientenkollektiv des ITW W{\"u}rzburg entsprach dem auf Intensivstationen. Knapp dreiviertel der Patienten war {\"u}ber 50 Jahre alt. Insgesamt {\"u}berwog der Anteil der m{\"a}nnlichen Patienten. Am h{\"a}ufigsten wurden Patienten mit intrakraniellen Blutungen, zerebralen Isch{\"a}mien und Sch{\"a}delhirntraumen transportiert. Dieser Gruppe folgten Patienten mit akutem Koronarsyndrom und Patienten mit Sepsis. {\"U}ber die H{\"a}lfte, der mit dem ITW W{\"u}rzburg transportierten Patienten, waren beatmungspflichtig. Dabei fiel auf, dass unabh{\"a}ngig von der Transportart, die Zahl der BIPAP beatmeten Patienten zunahm. Am st{\"a}rksten war dieser Anstieg bei den zentrifugalen Transporten. Der PEEP wurde bei zentripetalen Transporten signifikant {\"o}fters erh{\"o}ht als bei zentrifugalen oder zentri-zentralen Transporten, was wie schon die Behandlungszeit vor Ort, auf eine intensivere Therapie schließen l{\"a}sst. Die Strukturqualit{\"a}t des ITW W{\"u}rzburgs in Form von Ausstattung und Personal wird den geforderten Standards gerecht. Gerade vor dem Hintergrund des Patientenkollektivs kommt der Ausstattung des ITWs und der Qualifikation des Personals eine entscheidende Bedeutung zu. Bestehende Standards d{\"u}rfen im Hinblick auf eine ad{\"a}quate Versorgung der Patienten nicht unterschritten werden. Verbesserungsbedarf besteht lediglich hinsichtlich der Prozessqualit{\"a}t. Dies gilt insbesondere f{\"u}r die Dokumentation, die entsprechenden Dokumentationswerkzeuge und die Auslastung des ITW W{\"u}rzburgs. Hinsichtlich der Dokumentation ist eine m{\"o}glichst zeitnahe elektronische Doku-mentation w{\"u}nschenswert mit Ausbau der im Rahmen dieser Arbeit erstellten Datenbank. Was die Auslastung des ITW betrifft, so ist sicherlich noch Potential vorhanden, das es auszusch{\"o}pfen gilt. Hier ist eine bessere Informationspolitik {\"u}ber die Vorteile und Einsatzm{\"o}glichkeiten des ITWs von N{\"o}ten. Das Beatmungsmanagement zeigte eine Intensivierung der Beatmung vor allem bei zentripetalen Transporten, was die Bedeutung des ITWs als Teil der Intensiv-medizinischen Versorgung unterstreicht.},
  subject      = {Notfallmedizin},
  language  = {de}
}
@article{SemmlerSacconiBachetal.2014,
  author    = {Semmler, Anna-Lena and Sacconi, Sabrina and Bach, J. Elisa and Liebe, Claus and B{\"u}rmann, Jan and Kley, Rudolf A. and Ferbert, Andreas and Anderheiden, Roland and Van den Bergh, Peter and Martin, Jean-Jacques and De Jonghe, Peter and Neuen-Jacob, Eva and M{\"u}ller, Oliver and Deschauer, Marcus and Bergmann, Markus and Schr{\"o}der, J. Michael and Vorgerd, Matthias and Schulz, J{\"o}rg B. and Weis, Joachim and Kress, Wolfram and Claeys, Kristl G.},
  title     = {Unusual multisystemic involvement and a novel BAG3 mutation revealed by NGS screening in a large cohort of myofibrillar myopathies},
  series = {Orphanet Journal of Rare Diseases},
  volume    = {9},
  journal   = {Orphanet Journal of Rare Diseases},
  number    = {121},
  issn      = {1750-1172},
  doi       = {10.1186/s13023-014-0121-9},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-115623},
  year      = {2014},
  abstract  = {Background: Myofibrillar myopathies (MFM) are a group of phenotypically and genetically heterogeneous neuromuscular disorders, which are characterized by protein aggregations in muscle fibres and can be associated with multisystemic involvement. Methods: We screened a large cohort of 38 index patients with MFM for mutations in the nine thus far known causative genes using Sanger and next generation sequencing (NGS). We studied the clinical and histopathological characteristics in 38 index patients and five additional relatives (n = 43) and particularly focused on the associated multisystemic symptoms. Results: We identified 14 heterozygous mutations (diagnostic yield of 37\%), among them the novel p. Pro209Gln mutation in the BAG3 gene, which was associated with onset in adulthood, a mild phenotype and an axonal sensorimotor polyneuropathy, in the absence of giant axons at the nerve biopsy. We revealed several novel clinical phenotypes and unusual multisystemic presentations with previously described mutations: hearing impairment with a FLNC mutation, dysphonia with a mutation in DES and the first patient with a FLNC mutation presenting respiratory insufficiency as the initial symptom. Moreover, we described for the first time respiratory insufficiency occurring in a patient with the p. Gly154Ser mutation in CRYAB. Interestingly, we detected a polyneuropathy in 28\% of the MFM patients, including a BAG3 and a MYOT case, and hearing impairment in 13\%, including one patient with a FLNC mutation and two with mutations in the DES gene. In four index patients with a mutation in one of the MFM genes, typical histological findings were only identified at the ultrastructural level (29\%). Conclusions: We conclude that extraskeletal symptoms frequently occur in MFM, particularly cardiac and respiratory involvement, polyneuropathy and/or deafness. BAG3 mutations should be considered even in cases with a mild phenotype or an adult onset. We identified a genetic defect in one of the known genes in less than half of the MFM patients, indicating that more causative genes are still to be found. Next generation sequencing techniques should be helpful in achieving this aim.},
  language  = {en}
}
@article{BaeuerleinRiedelBakeretal.2013,
  author    = {B{\"a}uerlein, Carina A. and Riedel, Simone S. and Baker, Jeanette and Brede, Christian and Jord{\´a}n Garrote, Ana-Laura and Chopra, Martin and Ritz, Miriam and Beilhack, Georg F. and Schulz, Stephan and Zeiser, Robert and Schlegel, Paul G. and Einsele, Hermann and Negrin, Robert S. and Beilhack, Andreas},
  title     = {A diagnostic window for the treatment of acute graft-versus-host disease prior to visible clinical symptoms in a murine model},
  series = {BMC Medicine},
  journal   = {BMC Medicine},
  doi       = {10.1186/1741-7015-11-134},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-96797},
  year      = {2013},
  abstract  = {Background Acute graft-versus-host disease (aGVHD) poses a major limitation for broader therapeutic application of allogeneic hematopoietic cell transplantation (allo-HCT). Early diagnosis of aGVHD remains difficult and is based on clinical symptoms and histopathological evaluation of tissue biopsies. Thus, current aGVHD diagnosis is limited to patients with established disease manifestation. Therefore, for improved disease prevention it is important to develop predictive assays to identify patients at risk of developing aGVHD. Here we address whether insights into the timing of the aGVHD initiation and effector phases could allow for the detection of migrating alloreactive T cells before clinical aGVHD onset to permit for efficient therapeutic intervention. Methods Murine major histocompatibility complex (MHC) mismatched and minor histocompatibility antigen (miHAg) mismatched allo-HCT models were employed to assess the spatiotemporal distribution of donor T cells with flow cytometry and in vivo bioluminescence imaging (BLI). Daily flow cytometry analysis of peripheral blood mononuclear cells allowed us to identify migrating alloreactive T cells based on homing receptor expression profiles. Results We identified a time period of 2 weeks of massive alloreactive donor T cell migration in the blood after miHAg mismatch allo-HCT before clinical aGVHD symptoms appeared. Alloreactive T cells upregulated α4β7 integrin and P-selectin ligand during this migration phase. Consequently, targeted preemptive treatment with rapamycin, starting at the earliest detection time of alloreactive donor T cells in the peripheral blood, prevented lethal aGVHD. Conclusions Based on this data we propose a critical time frame prior to the onset of aGVHD symptoms to identify alloreactive T cells in the peripheral blood for timely and effective therapeutic intervention.},
  language  = {en}
}
@article{EsserMehnert‐TheuerkaufFriedrichetal.2020,
  author    = {Esser, Peter and Mehnert-Theuerkauf, Anja and Friedrich, Michael and Johansen, Christoffer and Br{\"a}hler, Elmar and Faller, Hermann and H{\"a}rter, Martin and Koch, Uwe and Schulz, Holger and Wegscheider, Karl and Weis, Joachim and Kuba, Katharina and Hinz, Andreas and Hartung, Tim},
  title     = {Risk and associated factors of depression and anxiety in men with prostate cancer: Results from a German multicenter study},
  series = {Psycho-Oncology},
  volume    = {29},
  journal   = {Psycho-Oncology},
  number    = {10},
  doi       = {10.1002/pon.5471},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-218277},
  pages     = {1604 -- 1612},
  year      = {2020},
  abstract  = {Objective In order to optimize psycho-oncological care, studies that quantify the extent of distress and identify certain risk groups are needed. Among patients with prostate cancer (PCa), findings on depression and anxiety are limited. Methods We analyzed data of PCa patients selected from a German multi-center study. Depression and anxiety were assessed with the PHQ-9 and the GAD-7 (cut-off ≥7). We provided physical symptom burden, calculated absolute and relative risk (AR and RR) of depression and anxiety across patient subsets and between patients and the general population (GP) and tested age as a moderator within the relationship of disease-specific symptoms with depression and anxiety. Results Among 636 participants, the majority reported disease-specific problems (sexuality: 60\%; urination: 52\%). AR for depression and anxiety was 23\% and 22\%, respectively. Significant RR were small, with higher risks of distress in patients who are younger (eg, RR\(_{depression}\) = 1.15; 95\%-CI: 1.06-1.26), treated with chemotherapy (RR\(_{depression}\)n = 1.46; 95\%-CI: 1.09-1.96) or having metastases (RR\(_{depression}\) = 1.30; 95\%-CI: 1.02-1.65). Risk of distress was slightly elevated compared to GP (eg, RR\(_{depression}\) = 1.13; 95\%-CI: 1.07-1.19). Age moderated the relationship between symptoms and anxiety (B\(_{urination}\) = -0.10, P = .02; B\(_{sexuality}\) = -0.11, P = .01). Conclusions Younger patients, those with metastases or treatment with chemotherapy seem to be at elevated risk for distress and should be closely monitored. Many patients suffer from disease-specific symptom burden, by which younger patients seem to be particularly distressed. Support of coping mechanisms associated with disease-specific symptom burden seems warranted.},
  language  = {en}
}
@article{FeldheimKesslerFeldheimetal.2022,
  author    = {Feldheim, Jonas and Kessler, Almuth F. and Feldheim, Julia J. and Schulz, Ellina and Wend, David and Lazaridis, Lazaros and Kleinschnitz, Christoph and Glas, Martin and Ernestus, Ralf-Ingo and Brandner, Sebastian and Monoranu, Camelia M. and L{\"o}hr, Mario and Hagemann, Carsten},
  title     = {Effects of long-term temozolomide treatment on glioblastoma and astrocytoma WHO grade 4 stem-like cells},
  series = {International Journal of Molecular Sciences},
  volume    = {23},
  journal   = {International Journal of Molecular Sciences},
  number    = {9},
  issn      = {1422-0067},
  doi       = {10.3390/ijms23095238},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-284417},
  year      = {2022},
  abstract  = {Glioblastoma leads to a fatal course within two years in more than two thirds of patients. An essential cornerstone of therapy is chemotherapy with temozolomide (TMZ). The effect of TMZ is counteracted by the cellular repair enzyme O\(^6\)-methylguanine-DNA methyltransferase (MGMT). The MGMT promoter methylation, the main regulator of MGMT expression, can change from primary tumor to recurrence, and TMZ may play a significant role in this process. To identify the potential mechanisms involved, three primary stem-like cell lines (one astrocytoma with the mutation of the isocitrate dehydrogenase (IDH), CNS WHO grade 4 (HGA)), and two glioblastoma (IDH-wildtype, CNS WHO grade 4) were treated with TMZ. The MGMT promoter methylation, migration, proliferation, and TMZ-response of the tumor cells were examined at different time points. The strong effects of TMZ treatment on the MGMT methylated cells were observed. Furthermore, TMZ led to a loss of the MGMT promoter hypermethylation and induced migratory rather than proliferative behavior. Cells with the unmethylated MGMT promoter showed more aggressive behavior after treatment, while HGA cells reacted heterogenously. Our study provides further evidence to consider the potential adverse effects of TMZ chemotherapy and a rationale for investigating potential relationships between TMZ treatment and change in the MGMT promoter methylation during relapse.},
  language  = {en}
}
@article{BonigKuciKucietal.2019,
  author    = {Bonig, Halvard and Ku{\c{c}}i, Zyrafete and Ku{\c{c}}i, Selim and Bakhtiar, Shahrzad and Basu, Oliver and Bug, Gesine and Dennis, Mike and Greil, Johann and Barta, Aniko and K{\´a}llay, Kriszti{\´a}n M. and Lang, Peter and Lucchini, Giovanna and Pol, Raj and Schulz, Ansgar and Sykora, Karl-Walter and Teichert von Luettichau, Irene and Herter-Sprie, Grit and Ashab Uddin, Mohammad and Jenkin, Phil and Alsultan, Abdulrahman and Buechner, Jochen and Stein, Jerry and Kelemen, Agnes and Jarisch, Andrea and Soerensen, Jan and Salzmann-Manrique, Emilia and Hutter, Martin and Sch{\"a}fer, Richard and Seifried, Erhard and Paneesha, Shankara and Novitzky-Basso, Igor and Gefen, Aharon and Nevo, Neta and Beutel, Gernot and Schlegel, Paul-Gerhardt and Klingebiel, Thomas and Bader, Peter},
  title     = {Children and adults with Refractory acute Graft-versus-Host Disease respond to treatment with the Mesenchymal Stromal cell preparation "MSC-FFM"—Outcome report of 92 patients},
  series = {Cells},
  volume    = {8},
  journal   = {Cells},
  number    = {12},
  issn      = {2073-4409},
  doi       = {10.3390/cells8121577},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-193878},
  pages     = {1577},
  year      = {2019},
  abstract  = {(1) Background: Refractory acute graft-versus-host disease (R-aGvHD) remains a leading cause of death after allogeneic stem cell transplantation. Survival rates of 15\% after four years are currently achieved; deaths are only in part due to aGvHD itself, but mostly due to adverse effects of R-aGvHD treatment with immunosuppressive agents as these predispose patients to opportunistic infections and loss of graft-versus-leukemia surveillance resulting in relapse. Mesenchymal stromal cells (MSC) from different tissues and those generated by various protocols have been proposed as a remedy for R-aGvHD but the enthusiasm raised by initial reports has not been ubiquitously reproduced. (2) Methods: We previously reported on a unique MSC product, which was generated from pooled bone marrow mononuclear cells of multiple third-party donors. The products showed dose-to-dose equipotency and greater immunosuppressive capacity than individually expanded MSCs from the same donors. This product, MSC-FFM, has entered clinical routine in Germany where it is licensed with a national hospital exemption authorization. We previously reported satisfying initial clinical outcomes, which we are now updating. The data were collected in our post-approval pharmacovigilance program, i.e., this is not a clinical study and the data is high-level and non-monitored. (3) Results: Follow-up for 92 recipients of MSC-FFM was reported, 88 with GvHD ≥°III, one-third only steroid-refractory and two-thirds therapy resistant (refractory to steroids plus ≥2 additional lines of treatment). A median of three doses of MSC-FFM was administered without apparent toxicity. Overall response rates were 82\% and 81\% at the first and last evaluation, respectively. At six months, the estimated overall survival was 64\%, while the cumulative incidence of death from underlying disease was 3\%. (4) Conclusions: MSC-FFM promises to be a safe and efficient treatment for severe R-aGvHD.},
  language  = {en}
}
@article{KerwagenRiemerWachteretal.2023,
  author    = {Kerwagen, Fabian and Riemer, Uwe and Wachter, Rolf and von Haehling, Stephan and Abdin, Amr and B{\"o}hm, Michael and Schulz, Martin and St{\"o}rk, Stefan},
  title     = {Impact of the COVID-19 pandemic on implementation of novel guideline-directed medical therapies for heart failure in Germany: a nationwide retrospective analysis},
  series = {The Lancet Regional Health - Europe},
  volume    = {35},
  journal   = {The Lancet Regional Health - Europe},
  issn      = {2666-7762},
  doi       = {10.1016/j.lanepe.2023.100778},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-350510},
  year      = {2023},
  abstract  = {Background Guideline-directed medical therapy (GDMT) is the cornerstone in the treatment of patients with heart failure and reduced ejection fraction (HFrEF) and novel substances such as sacubitril/valsartan (S/V) and sodium-glucose co-transporter-2 inhibitors (SGLT2i) have demonstrated marked clinical benefits. We investigated their implementation into real-world HF care in Germany before, during, and after the COVID-19 pandemic period. Methods The IQVIA LRx data set is based on ∼80\% of 73 million people covered by the German statutory health insurance. Prescriptions of S/V were used as a proxy for HFrEF. Time trends were analysed between Q1/2016 and Q2/2023 for prescriptions for S/V alone and in combination therapy with SGLT2i. Findings The number of patients treated with S/V increased from 5260 in Q1/2016 to 351,262 in Q2/2023. The share of patients with combination therapy grew from 0.6\% (29 of 5260) to 14.2\% (31,128 of 219,762) in Q2/2021, and then showed a steep surge up to 54.8\% (192,429 of 351,262) in Q2/2023, coinciding with the release of the European Society of Cardiology (ESC) guidelines for HF in Q3/2021. Women and patients aged >80 years were treated less often with combined therapy than men and younger patients. With the start of the COVID-19 pandemic, the number of patients with new S/V prescriptions dropped by 17.5\% within one quarter, i.e., from 26,855 in Q1/2020 to 22,145 in Q2/2020, and returned to pre-pandemic levels only in Q1/2021. Interpretation The COVID-19 pandemic was associated with a 12-month deceleration of S/V uptake in Germany. Following the release of the ESC HF guidelines, the combined prescription of S/V and SGLT2i was readily adopted. Further efforts are needed to fully implement GDMT and strengthen the resilience of healthcare systems during public health crises.},
  language  = {en}
}