Berufsverband Niedergelassener Gynäkologischer Onkologen

Palliative care is acrucial part of the holistic management of advanced heart failure; however, it remains unclear how palliative care is currently provided in the outpatient sector in Germany. We conducted asurvey among office-based cardiologists and general practitioners (GPs) in Germany on the current provision of palliative care for people with advanced heart failure. The survey was developed by amultiprofessional project group of the German Cardiac Society (DGK e. V.) and administered online by the National Association of Office-Based Cardiologists (BNK e.V.). Atotal of 235 individuals participated in the study. The majority of respondents reported frequently or always discussing goals of care with patients with advanced heart failure. The GPs reported significantly more often than cardiologists that they always or frequently address primary palliative care needs. None of the surveyed office-based cardiologists but 35.1% of GPs stated that they frequently or always prescribe specialized outpatient palliative care (SAPV) for patients with advanced heart failure. Over 90% of the cardiologists reported that they rarely or never continue to care for patients when they cannot come to the practice themselves. Only few office-based physicians in Germany regularly refer patients with advanced heart failure to specialized palliative care services. Primary palliative care and the involvement of SAPV are significantly more often managed by GPs than by office-based cardiologists.

Healthcare in Germany is divided into various service sectors, which differ in terms of outpatient and inpatient care as well as the legal and financial bases. The resulting breaks in consecutive patient care are to be overcome by integrating services into cross-sectoral processes (integrated care). Digitalization and the associated use of information and communication technology (ICT) play adecisive role in this. To derive implications and benefits it is necessary to classify the technical possibilities. For this purpose, eHealth is the basic generic term for all process support and direct patient applications that are based on the electronic exchange of data. Adistinction can be made between technology for process support and technology for direct application on the patient. Applications in all categories are suitable for ensuring that interfaces in the flow of information between those involved in healthcare processes are adequately managed by eHealth. Furthermore, the allocation of specialized medicine through eHealth is independent of location and sector. New possibilities for generating and using structured data for evidence development and care research are realized through eHealth and the development of existing and new care models will be promoted.

Background and aimsThe impact of mitral regurgitation (MR) in asymptomatic patients is not well defined. We aimed to determine the prevalence of MR-related complications and their association with 10-year survival in a large unselected asymptomatic MR cohort.MethodsHealth insurance claims data from Germany’s second largest health insurance fund, BARMER, which maintains longitudinal data on 8.7 million German residents, were retrospectively analyzed. All patients with an outpatient diagnosis of MR in a minimum of two quarters during a calendar year and first recorded diagnosis between 2008 and 2011 were included. Patients with any complication attributable to MR or mitral valve intervention at index were excluded. Outcomes were compared between study group and age- and sex-matched controls (i.e., without known cardiac disease). MR-related complications of interest were new congestive heart failure, new-onset atrial fibrillation, pulmonary hypertension, or cardiac decompensation.ResultsA total of 56,577 individuals (median age 68 years, 67% female) with asymptomatic MR were identified. At 10 years, MR-related complications were more frequent in the study group vs. control group (46.5% vs. 20.8%, OR 3.31, P < 0.0001). Furthermore, MR-related complications were more common in male vs. female patients with an asymptomatic MR (OR 2.65, P < 0.0001). The occurrence of at least one MR-related complication was associated with a reduced 10-year survival (OR 1.80, P < 0.0001).ConclusionsAlmost half of patients with asymptomatic MR experience complications during a 10 year follow-up which result in impaired survival. These results imply the necessity of long-term disease management program. Furthermore, decision-making process and timing for mitral valve intervention in asymptomatic patients should be reevaluated.Graphical

ist es zu verdanken, daß unser Augenmerk auf zwei Chroniken der Reichsstadt Hall gelenkt wurde, die bisher in der Literatur nicht bekannt waren. In den beiden Chronik-Editionen von Christian Kolb 1 werden sie nicht erwähnt. Kolb hatte seinerzeit zwar die im Germanischen Nationalmuseum zu Nürnberg vorhandenen Haller Chroniken erfaßt und beschrieben, aber offenbar die Bestände der bedeutenden Ansbacher Schloßbibliothek nicht auf Hallensia hin durchgesehen. Dort nämlich lagen damals die Sammlungsbestände des Historischen Vereins für Mittelfranken, zu denen die beiden besagten Chroniken heute gehören. Im gedruckten »Katalog der K. Regierungsbibliothek in Ansbach 2 ist eine der Handschriften in der Abteilung VIII. Deutsche Geschichte (d. Zur Geschichte der Einzelstaaten, Württemberg) unter Nr. 664 benannt: »Widmann. Chronik d. Stadt Hall (Schwäb.) 1553.« Das Archiv des Vereins und mit ihm die Chronikbände gelangten vor einigen Jahren als Depositum in das Staatsarchiv Nürnberg. Für die weitere Beschäftigung mit der Haller Historiographie wird es dienlich sein, Kenntnis von den bislang nicht berücksichtigten Chronikhandschriften zu haben. Deshalb sollen sie hier kurz vorgestellt werden, ohne daß ihr Verhältnis zu den bekannten Handschriften von Haller Chroniken oder Chronikauszügen näher untersucht wird. 1. MS 609 Auszug aus der Widmann-Chronik Es handelt sich um einen Folioband (20,5 x 32,5 cm) mit marmoriertem Pappeinband mit Lederecken und -rücken, auf drei Bünde gebunden. Der Band enthält VIII und 124 beschriebene Blätter, wobei die alte arabische Foliierung bei drei bereits abbricht. Das Titelblatt trägt die Aufschrift Widmann des Stifts Cornburg [verschrieben für: Comburg] Sindikus (siehe Schluß der Vorrede) Chronik der Stadt (Schwaebisch) Hall. Manuscript 1553 in einer

leider geht es weiter mit der Pandemie. Durch die Deltavariante ist weiterhin keine Normalität im Alltag zu erwarten, auch wenn aufgrund einer Impfquote von >50% die schweren Verläufe abnehmen werden, ist auch für uns COVID und insbesondere Post-COVID ein Thema im Praxisalltag. Noch ist völlig unklar, was Post-COVID genau ist, ebenso ist nicht klar, ob es kardial tatsächlich Langzeitfolgen hat. Hier liegen unterschiedliche Ergebnisse von Untersuchungen mit kernmagnetischer Resonanzspektroskopie (NMR) vor. Die Untersuchungen lassen darauf schließen, dass in den meisten Fällen die kardiale Beteiligung nach 6 Monaten folgenlos ausheilt. Ähnliches erleben wir ja auch bei anderen Viruserkrankungen wie Zytomegalie und Epstein-Barr-Virus-Erkrankungen.

Purpose Carboplatin is classified as moderate emetogenic, but shows a higher incidence of chemotherapy (CT)- induced nausea and vomiting (CINV). We present a post-hoc analysis of effectiveness, quality of life (QoL) and patient reported outcomes (PRO) of CINV prevention with NEPA, the fixed antiemetic combination of the NK1-receptor-antagonist (RA) netupitant and the 5-HT3-RA palonosetron NEPA for carboplatin-CT in the German non-interventional study AkyPRO.