Publications

228 Publications visible to you, out of a total of 228

Abstract

Not specified

Authors: Christian Kücherer, Manuel Jung, Franziska Jahn, Michael Schaaf, Kais Tahar, Barbara Paech, Alfred Winter

Date Published: 2015

Publication Type: InCollection

Abstract (Expand)

Die Methode des Benchmarkings wird mittlerweile in vielen Krankenhäusern als Instrument des strategischen Informationsmanagements genutzt. Während der letzten Jahre bildeten sich im deutschsprachigen Raum mehrere Benchmarkingcluster, innerhalb derer sich Krankenhäuser bezüglich der Kosten, Leistung und Effizienz ihrer Informationssysteme und ihres Informationsmanagements vergleichen und positionieren. Um Benchmarkingcluster hinsichtlich ihrer Merkmale unterscheiden zu können und eine Entscheidungsunterstützung für die Auswahl eines geeigneten Benchmarkingclusters zu schaffen, wird ein Klassifikationsschema entwickelt. Das Klassifikationsschema betrachtet sowohl die Rahmenbedingungen der Benchmarkingcluster sowie deren inhaltliche Ausrichtung. Es wird auf sieben im deutschsprachigen Raum und in den letzten Jahren aktive Benchmarkingcluster angewandt, um diese zu beschreiben. Derzeit überwiegt das Performance Benchmarking, wobei sich die Benchmarkingcluster hinsichtlich der Anzahl der Benchmarkingpartner und der Kooperationsformen unterscheiden. Auch werden unterschiedliche Benchmarkingobjekte betrachtet. Die Untersuchung von Kosten und Qualität von Anwendungssystemen, physischen Datenverarbeitungssystemen, Organisationsstrukturen des Informationsmanagements und IT-Service-Prozessen dominiert. Untersuchungen zum strategischen Informationsmanagement, taktischen Informationsmanagement, der IT Governance und der Qualität von Daten und datenverarbeitenden Prozessen können noch ausgebaut werden. Auf Basis des Klassifikationsschemas und der Analyse der Benchmarkingcluster werden schließlich allgemeine Empfehlungen für das Benchmarking von Krankenhausinformationssystemen abgeleitet.

Authors: Franziska Jahn, Klaus Baltschukat, Uwe Buddrus, Uwe Günther, Ansgar Kutscha, Jan-David Liebe, Volker Lowitsch, Helmut Schlegel, Alfred Winter

Date Published: 2015

Publication Type: Journal article

Abstract (Expand)

BACKGROUND: Although the growth-factor G-CSF is widely used to prevent granulotoxic side effects of cytotoxic chemotherapies, its optimal use is still unknown since treatment outcome depends on many parameters such as dosing and timing of chemotherapies, pharmaceutical derivative of G-CSF used and individual risk factors. We showed in the past that a pharmacokinetic and -dynamic model of G-CSF and human granulopoiesis can be used to predict the performance of yet untested G-CSF schedules. However, only a single chemotherapy was considered so far. RESULTS: Model assumptions proved to be feasible in explaining granulotoxicity of 10 different chemotherapeutic drugs or drug-combinations applied in 33 different schedules with and without G-CSF. Risk groups of granulotoxicity were traced back to differences in toxicity parameters. CONCLUSION: We established a comprehensive model of combined G-CSF and chemotherapy action in humans which allows us to predict and compare the outcome of alternative G-CSF schedules. We aim to apply the model in different clinical contexts to optimize and individualize G-CSF treatment.

Authors: S. Schirm, C. Engel, M. Loeffler, M. Scholz

Date Published: 24th Dec 2014

Publication Type: Not specified

Human Diseases: leukopenia

Abstract (Expand)

Type 2 diabetes mellitus (T2DM) is a risk factor of dementia. The effect of T2DM treatment quality on dementia risk, however, is unclear. 1,342 elderly individuals recruited via general practitioner registries (AgeCoDe cohort) were analyzed. This study analyzed the association between HbA1c level and the incidence of all-cause dementia (ACD) and of Alzheimer's disease dementia (referred to here as AD). HbA1c levels >/=6.5% were associated with 2.8-fold increased risk of incident ACD (p = 0.027) and for AD (p = 0.047). HbA1c levels >/=7% were associated with a five-fold increased risk of incident ACD (p = 0.001) and 4.7-fold increased risk of incident AD (p = 0.004). The T2DM diagnosis per se did not increase the risk of either ACD or AD. Higher levels of HbA1c are associated with increased risk of ACD and AD in an elderly population. T2DM diagnosis was not associated with increased risk if HbA1c levels were below 7%.

Authors: A. Ramirez, S. Wolfsgruber, C. Lange, H. Kaduszkiewicz, S. Weyerer, J. Werle, M. Pentzek, A. Fuchs, S. G. Riedel-Heller, T. Luck, E. Mosch, H. Bickel, B. Wiese, J. Prokein, H. H. Konig, C. Brettschneider, M. M. Breteler, W. Maier, F. Jessen, M. Scherer

Date Published: 20th Dec 2014

Publication Type: Not specified

Human Diseases: diabetes mellitus, dementia, Alzheimer's disease

Abstract (Expand)

Obesity is known to affect the brain's gray matter (GM) and white matter (WM) structure but the interrelationship of such changes remains unclear. Here we used T1-weighted magnetic resonance imaging (MRI) in combination with voxel-based morphometry (VBM) and diffusion-tensor imaging (DTI) with tract-based spatial statistics (TBSS) to assess the relationship between obesity-associated alterations of gray matter density (GMD) and anisotropic water diffusion in WM, respectively. In a small cohort of lean to obese women, we confirmed previous reports of obesity-associated alterations of GMD in brain regions involved in executive control (i.e., dorsolateral prefrontal cortex, DLPFC) and habit learning (i.e., dorsal striatum). Gray matter density alterations of the DLPFC were negatively correlated with radial diffusivity in the entire corpus callosum. Within the genu of the corpus callosum we found a positive correlation with axial diffusivity. In posterior region and inferior areas of the body of the corpus callosum, axial diffusivity correlated negatively with altered GMD in the dorsal striatum. These findings suggest that, in women, obesity-related alterations of GMD in brain regions involved in executive control and habit learning might relate to alterations of associated WM fiber bundles within the corpus callosum.

Authors: K. Mueller, A. Horstmann, H. E. Moller, A. Anwander, J. Lepsien, M. L. Schroeter, A. Villringer, B. Pleger

Date Published: 11th Dec 2014

Publication Type: Not specified

Human Diseases: obesity

Abstract (Expand)

Herpes simplex encephalitis (HSE) is a severe neurological disease that often leads to persistent cognitive deficits in survivors. Memory and naming impairments have been reported most, although direct association between memory and naming performance and disease-related atrophy has not yet been demonstrated in vivo for a larger sample of patients. In the present work, a voxel-based morphometry (VBM) analysis was conducted on 3T magnetic resonance imaging (MRI) of 13 HSE survivors. The gray matter density values were correlated with scores indicating verbal memory decline, as well as errors/omissions in picture naming; both were obtained through neuropsychological assessment. Analysis of individual lesion patterns revealed a considerable inter-individual variability, mainly with atrophy in the basal forebrain, adjacent frontal cortex, medial and lateral temporal cortex, insula and thalamus. The neuropsychological data analysis revealed correlation between verbal memory decline and atrophy especially in the left hippocampal region, whereas naming problems were associated with gray matter loss especially in the lateral temporal lobe, the thalamus and the left insula. These results confirm, for the first time, the assumptions of earlier studies about the considerable variability of individual lesion patterns in HSE in a whole-brain approach in vivo, and thus the anatomical validity of VBM.

Authors: S. Frisch, F. Thiel, A. Marschhauser, A. Villringer, A. Horstmann, M. L. Schroeter

Date Published: 10th Dec 2014

Publication Type: Not specified

Human Diseases: viral encephalitis

Abstract (Expand)

OBJECTIVES: This study investigates the impact of occupation-based motivational processes and social network variables on the incidence of dementia over 8 years. METHOD: Data were derived from the Leipzig Longitudinal Study of the Aged (LEILA75+), a population-based longitudinal study of individuals aged 75 years and older (n=1692 at baseline). Motivational processes were estimated based on the main occupation using the Occupational Information Network database. RESULTS: In a Cox proportional hazard model, motivational processes were not associated with the risk of dementia (hazard ratio [HR]: 0.93, 95% confidence interval [CI]: 0.74-1.16). Individuals with a higher frequency of social contact at baseline had a significantly lower risk of dementia (HR: 0.96, 95% CI: 0.91-0.99), while proximity of social contacts was not linked to the risk of dementia (HR: 1.03, 95% CI: 0.98-1.08). In individuals with low indices of motivational processes, the frequency of social contacts was associated with a lower risk of dementia (HR: 0.94, 95% CI: 0.88-1.00). On the other hand, proximity of social contacts was linked to a higher risk of dementia in individuals with high indices of motivational processes (HR: 1.09, 95% CI: 1.01-1.19). DISCUSSION: Results indicate that the frequency and proximity of social contacts have a differential impact on the risk of dementia according to lower or higher indices of motivational processes, while the impact of motivational processes on risk of dementia could not be confirmed. Future studies should carefully disentangle different aspects of social interactions and their association with motivational processes.

Authors: S. Fankhauser, S. Forstmeier, A. Maercker, M. Luppa, T. Luck, S. G. Riedel-Heller

Date Published: 29th Nov 2014

Publication Type: Not specified

Human Diseases: dementia

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