Bethesda Hospital

About: Bethesda Hospital is a healthcare organization based out in Ambur, Tamil Nadu, India. It is known for research contribution in the topics: Population & Helicobacter pylori. The organization has 386 authors who have published 472 publications receiving 15193 citations.

Predictive role of HER2/neu, topoisomerase-II-alpha, and tissue inhibitor of metalloproteinases (TIMP-1) for response to adjuvant taxane-based chemotherapy in patients with intermediate-risk breast cancer: results from the WSG-AGO EC-Doc trial

Abstract: Taxane–anthracycline-based adjuvant chemotherapy is standard of care in patients with node-positive breast cancer (BC) but is also associated with severe side effects and significant costs. It is yet unclear, which biomarkers would predict benefit from taxanes and/or general chemoresistance. In this study, we investigate a large cohort of patients with intermediate-risk BC treated within the WSG EC-DOC Trial for the predictive impact of topoisomerase-II-alpha, HER2/neu, and TIMP-1. Tumor tissue was available in a representative cohort of 772 cases of the WSG EC-DOC Trial collective which compared 4xEC-4xDoc versus 6xCEF/CMF. In addition to hormone receptor status and Ki-67, HER2/neu+ and topoisomerase-II-alpha status using fluorescence in situ hybridisation (FISH) and immunohistochemistry, TIMP-1 using immunohistochemistry, and aneuploidy of chromosome 17 using FISH were evaluated and correlated with outcome and taxane benefit. There was significant superiority of EC-Doc over CEF regarding 5-year DFS (90 vs. 80 %, respectively, p = 0.006) particularly in patient subgroups defined by HR+, HER2/neu+, high proliferation (i.e., Ki-67 ≥ 20 %), patient age >50 years old and normal chromosome 17 status, high TIMP-1 and low topoisomerase-II-alpha protein expression. Significant prognostic factors in multivariate analysis were EC-Doc therapy (HR = 0.61; 95 %CI 0.38–0.986), age <50 years old (HR = 1.682; 95 %CI 1.025–2.579), centrally assessed grade 3 (HR = 4.657; 95 %CI 1.809–11.989), and high Ki-67 (HR = 2.232; 95 %CI 1.209–4.121). Interestingly, we observed a significant interaction between treatment arm (EC-Doc vs. CEF) and high topoisomerase-II-alpha protein expression (HR = 0.427; 95 %CI 0.203–0.900) in multivariate interaction analysis. Despite of univariate predictive effect of HER2/neu status among other factors only topoisomerase-II-alpha protein expression was associated with significant benefit from EC-Doc compared to CEF by multivariate interaction analysis.

Longterm treatment of rheumatoid arthritis with OM-8980. A retrospective study.

Abstract: OM-8980 is an immunomodulating drug which has been shown in double blind placebo controlled trials to be effective in the management of rheumatoid arthritis (RA). For this report, longterm information was collected from 32 patients (27 women, 5 men) with RA who had been treated for periods ranging from one to over 8 years with OM-8980 daily (median 5 years). Statistically significant reductions were observed in duration of morning stiffness, articular index, pain and erythrocyte sedimentation rate (ESR). An improvement or strong improvement in overall condition was noted in 23 patients. Adverse events were reported in only 3 patients and were minimal in nature. Our study demonstrates that OM-8980 is an effective longterm slow acting antirheumatic drug which has minimal adverse effects and should be considered to have a role to play in the management of RA.

Recommendations by the Gynecologic Endoscopy Working Group of the German Society of Obstetrics and Gynecology for the advancement of training and education in minimal-access surgery.

Abstract: Endoscopic minimal-access operative techniques have gained increasing significance in gynecology so that the most gynecological operations in health centers and clinics are now performed via an endoscopic approach: Endoscopy has proven beneficial for patients by reducing morbidity rates, reducing postoperative pain symptoms and shortening hospital stay. The German healthcare system is undergoing a process of change with increasing integration of ambulatory and inpatient care and a fundamental reform of the DRG-based hospital financing system. Economic restructuring of the healthcare system through personnel and time cutbacks in conjunction with increasing sub-specialization has clearly had a negative impact on the quality of medical training received by the next generation of young doctors. In particular, for specialist surgical areas the average training clinic has insufficient time or capacity to adequately teach surgical techniques, including minimal-access surgery. Unfortunately, this undesirable development lowers the standard of the surgical techniques required to become a specialist. The German Gynecologic Endoscopy Working Group (AGE) wish to redress this situation by offering young doctors the opportunity to participate in a structured training plan and a step-by-step guide to endoscopic minimal-access surgery. AGE will name endoscopic training centers throughout Germany—according to the pre-defined criteria—which will offer courses and the opportunity to attend lectures. Doctors may receive a certified graded qualification from the AGE to determine their knowledge and experience of endoscopy. This concept was first presented at the second “Forum operative gynecology” conference in November 2005 in Berlin. It was discussed and optimized by the AGE council and accepted at the AGE general meeting on 19 May 2005 by the executive committee, advisory board and members of the general meeting. With this concept, we wish to make a contribution to improving the training of young gynecologists and, in the long term, to lower the amount of avoidable surgical complications in gynecological endoscopy. The concept is sub-divided into a personal qualification (MIS I–III) and an institutional qualification as approved certified training centers.

The effect of a VR exercise program on falls and depression in the elderly with mild depression in the local community.

Abstract: [Purpose] The purpose of this study is to explore the effect of a VR exercise program on falls and depression in the elderly with mild depression who reside in the local community. [Subjects and Methods] This study was performed by targeting 15 elderly subjects with mild depression who resided in the local community. The targeted subjects voluntarily selected 3 VR exercise programs (each lasting 10 minutes) among 4 activities, and a resting time of 5 minutes was given for an interval after each activity. The VR exercise program was performed for total 12 weeks (36 times), 3 times a week, 45 minutes per session. [Results] After exercise, scores of static balance test (anteroposterior), Falls Efficacy Scale, and the Activities-specific Balance Confidence Scale in the test subjects were improved and depression and internal stress scores were significantly decreased after the intervention. [Conclusion] It can be concluded that the VR exercise program exerts a positive effect not only on the physical factor but also on the mental factor of the elderly subjects with mild depression who reside in the local community. It is expected that based on the VR exercise program, diversified home programs for the elderly should be developed in the future.