PubMed Health⌕ Search

Biomedical subjects

H Hoyer

Publications and source records attributed to H Hoyer.

At least 19 recordsLinked to original sources
PubMed2004

Use of complementary and alternative medicine by patients with breast cancer: observations from a health-care survey.

GOALS OF THE WORK: The aim of this study was to assess the period prevalence and identify predictors of the use of complementary and alternative medicine (CAM) among women with breast cancer. PATIENTS AND METHODS: In a cross-sectional study, 263 women participating in a quality of life survey reported on CAM use. Differences between CAM users and nonusers were evaluated using logistic regression. RESULTS: About 3 years after diagnosis the period prevalence of CAM use among women with breast cancer was 36%. Younger women reported usage of CAM more often than older women. Associations between remote disease, pain and psychosocial variables were found. Involvement in self-help groups and active participation in leisure activities were associated with CAM use; this may indicate differences in the patients' ability to cope with the disease. Most patients were informed of CAM by a physician. CONCLUSIONS: Involvement in self-help groups and leisure activities were associated with CAM use, indicating differences in the patients' ability to cope. Further research is necessary to evaluate the safety of CAM and to determine the value of CAM in health care.

Adult↗
PubMed2003

A population-based study on variations in the use of adjuvant systemic therapy on postmenopausal patients with early stage breast cancer.

PURPOSE: To assess adherence to treatment recommendations regarding adjuvant systemic therapy of postmenopausal patients with early stage breast cancer. METHODS: A population-based cohort of women from Eastern Thuringia/Germany with first diagnosis of breast cancer in 1995-2000 was studied. The use of adjuvant therapy was assessed separately for patients with positive and negative nodal status fitting polytomous logistic regression models. RESULTS: Among 396 women with positive lymph nodes and 832 with negative lymph nodes, 92.9% and 87.3% received an adjuvant systemic treatment, respectively. Age, comorbidity, hormone receptor status, histological grading, and additionally, in nodal positives, the number of involved lymph nodes, were associated with treatment patterns. Age had the strongest impact on treatment decision. Older women more often received hormone- or no adjuvant therapy. However, 26.3% of the women with lymph node involvement and positive hormone receptor status received no hormone therapy, whereas 35.7% of women with negative hormone receptor status received hormone therapy. CONCLUSION: The number of patients with adjuvant systemic therapy is high in women with positive and those with negative lymph nodes, reflecting adherence to the recommendations. Better outcome could be expected if hormone therapy was used adequately in receptor positives. Further follow-up is required to monitor the outcome and changes in adherence to treatment recommendations.

Aged↗
PubMed2000

Screening for high-grade cervical intra-epithelial neoplasia and cancer by testing for high-risk HPV, routine cytology or colposcopy.

The validity of testing for high-risk types of human papillomavirus (HPV) in cervical cancer prevention programs is undetermined. We compared the performance on primary screening of HPV DNA testing, cytology and colposcopy in detecting cervical intra-epithelial neoplasia (CIN) grade 2 or 3 or cancer. A cohort of 4,761 women, median age 35 years, was screened by routine cytology, routine colposcopy and testing for high-risk HPV by a PCR-based method. Within an 8-month period, women with abnormal findings on cytology or screening colposcopy or in whom high-risk HPV types were detected were referred for colposcopy and biopsy. Women negative on all initial screening tests were followed by a second screening examination. To correct for work-up bias, the true prevalence of CIN 2 or 3 or cancer was estimated by projection from histologically verified subgroups. Cervical biopsies were taken in 364 women (7.6%), of whom 114 (2.4%) showed CIN 2 (n = 34) or CIN 3 (n = 71) or cancer (n = 9). High-risk HPV testing achieved bias-corrected performance measures of 89.4% sensitivity, 93.9% specificity, 35.8% positive predictive value and 99.6% negative predictive value. Bias-corrected rates of true- and false-positives by high-risk HPV testing compared to cytology (colposcopy) were about 4.5 (6.7) and 19.1 (7.4) times higher, respectively. The quality of routine cytology was controlled by computer-assisted review, and the observed number of true-positives more than doubled after adding automated review results. In middle-aged women, testing for high-risk HPV types, particularly when negative, may be used to increase the screening interval in programs for secondary prevention of cervical cancer.

Adult↗
PubMed1999

Influence of ovarian stimulation on the detection of human papillomavirus DNA in cervical scrapes obtained from patients undergoing assisted reproductive techniques.

OBJECTIVE: To determine whether gonadotropin stimulation influences the detection of human papillomavirus (HPV) DNA in cervical scrapes. DESIGN: Prospective, controlled study. SETTING: Tertiary care infertility clinic. PATIENT(S): Two hundred ninety-four patients enrolled in an IVF or IUI program. Two thousand two hundred sixty-two women from an ongoing screening study who were of similar age served as a control group. INTERVENTION(S): Cervical scrapes were obtained with a cytobrush before and after ovarian stimulation with gonadotropins. MAIN OUTCOME MEASURE(S): Human papillomavirus status was assessed with a general primer (GP) polymerase chain reaction (PCR) using the GP5+/GP6+ system. In GP-PCR-positive samples, high-risk HPV types were identified with a cocktail of digoxigenin-labeled oligonucleotides. Viral load was evaluated by semiquantitative analysis of the PCR products. RESULT(S): The prevalence of high-risk HPVs was 7.8% before stimulation and 6.8% after stimulation and, thus, was similar to the prevalence in controls (8.4%). Twenty-nine patients were positive for high-risk HPVs: 14 were positive before and after stimulation, 6 were negative before and positive after stimulation, and 9 were positive before and negative after stimulation. Positivity for high-risk HPVs and viral load did not correlate directly with serum estrogen levels. CONCLUSION(S): Ovarian stimulation has no significant effect on the prevalence of HPV DNA in cervical scrapes obtained from patients undergoing assisted reproductive techniques.

Adult↗
PubMed1999

Prevalence of overweight and obesity among school children in Jena (Germany).

OBJECTIVES: To examine the prevalence and changes in the prevalence of overweight and obesity among school children in Jena (Germany) in the last twenty years and to identify factors associated with childhood overweight. DESIGN: Cross-sectional surveys in 1975, 1985, 1995 and a household questionnaire in 1995. SUBJECTS: Children from schools in Jena, aged 7-14 y, participated (1975 : 1002 boys and 1000 girls; 1985 : 781 boys and 753 girls; 1995 : 989 boys and 912 girls). MEASUREMENTS: Prevalence of overweight or obesity based on the 90th or 97th age- and sex-specific percentile of the body mass index (BMI) developed for French children. In 1995 factors examined in relation to overweight included birth weight, birth length, age-class, number of children in household, occupation of the father, education of the mother and size of flat (apartment). RESULTS: In boys the prevalence of overweight increased from 10.0 to 16.3% and in girls from 11.7 to 20.7% between 1975 and 1995. The prevalence of obesity increased from 5.3 to 8.2% in boys and from 4.7 to 9.9% in girls between 1975 and 1995. However, the peak in the increase of overweight as well as of obesity lie for both sexes between 1985 and 1995. Using logistic regression, statistically significant associations with overweight were found for occupation of the father, birth weight in both sexes and additionally, for size of flat in girls. CONCLUSIONS: Overweight and obesity are increasing health problems among Jena children. Further investigations are needed to explore the influence of factors such as feeding pattern, food habits and physical activity on overweight. Special attention should be paid to the further social development in the society and to the link between low social class and overweight. Through such investigations effective preventive strategies could be developed.

Adolescent↗
PubMed1999

Multiplex polymerase chain reaction for subgenus-specific detection of human adenoviruses in clinical samples.

The polymerase chain reaction (PCR) has been used previously for the detection and typing of adenoviruses directly in clinical samples. Since under clinical conditions subgenus-specific identification is often sufficient, we extended the genus- and type-specific PCR by a subgenus-specific PCR. By sequencing several loop I4 gene regions of the hexon (major adenovirus coat protein) and comparing them to published sequences, subgenus-specific sequences were identified in this region. By using primers targeted to this region and to a conserved hexon gene region, a multiplex, nonnested PCR for the detection and subgenus-specific identification of adenoviruses could be established. The six subgenus-specific amplimers are distinguishable by agarose gel electrophoresis, and subsequent restriction analysis is not necessary. The specificity of the subgenus-specific primer pairs was tested on 23 adenovirus prototypes, representing all six subgenera, on 9 subgenus B and D intermediate strains, and on 16 subgenus C genome types. Furthermore, multiplex, subgenus-specific PCR was performed directly with 100 clinical specimens, including stool samples, ocular swabs, and throat swabs. Adenoviruses of all subgenera could be detected. Especially for clinical application, the rapid, one-step differentiation between subgenus D adenoviruses, causing the severe and highly contagious epidemic keratoconjunctivitis, and subgenus B and E adenoviruses, causing relative harmless ocular infections, is of great importance. The subgenus-specific PCR could also facilitate the primary classification of unknown virus isolates.

Adenovirus Infections, Human↗
PubMed1998

[Osteomyelitis as a complication of varicella].

Osteomyelitis is a rare complication after varicella. It should, however, be considered in any child who develops pain in a limb during or after a varicella infection. An 18 month old boy with a five day history of varicella infection was hospitalized. Movement of his right arm made him cry intensively. Blood cultures showed growth of group A beta haemolytic streptococcus. The day after admission to hospital the bone scintigrams showed increased activity in the right humeral diaphysis consistent with osteomyelitis, and penicillin therapy was started. On radiograms of the right humerus performed on the second day, no pathological changes could be shown. Radiograms after ten days showed irregular osteolytic lesions in the upper part of the humeral diaphysis. Clinically, the boy improved rapidly and could be dismissed from hospital after 17 days. Follow-up radiograms showed slowly normalized conditions, and five months after the start of symptoms, no pathological changes should be demonstrated.

Chickenpox↗
PubMed1998

Colposcopic appearance of cervical intraepithelial neoplasia is age dependent.

OBJECTIVE: We investigated to determine whether colposcopic, histologic, and virologic parameters of cervical intraepithelial neoplasia are influenced by a patient's age. STUDY DESIGN: A cohort of 967 women with a mean age of 37.1 years underwent screening for detection of cervical intraepithelial neoplasia by colposcopy, cytologic examination, and testing for high-risk human papillomaviruses with the Hybrid Capture System (Digene, Silver Springs, Md) and a general primer and type-specific primer polymerase chain reaction system. Cervicography was used for documentation and reproducible evaluation of the colposcopic appearance of the cervix. In 86% of patients with trivial colposcopic changes of doubtful significance (100/116) and 89% of patients with colposcopic changes consistent with cervical intraepithelial neoplasia (89/99), punch biopsy specimens were taken for histologic evaluation. RESULTS: In patients with trivial colposcopic changes of doubtful significance, histologically confirmed cervical intraepithelial neoplasia was almost as frequent (32%, 37/116) as in patients with colposcopic changes consistent with cervical intraepithelial neoplasia (43%, 43/99, difference not significant). The ratio between colposcopic evidence of cervical intraepithelial neoplasia and trivial colposcopic changes was 1.9 in patients <35 years old with cervical intraepithelial neoplasia, versus 0.5 in patients >/=35 years old with cervical intra-epithelial neoplasia (P =.005). Patients with trivial colposcopic changes of doubtful significance were older (median age 36 years) than were patients with colposcopic changes consistent with cervical intraepithelial neoplasia (median age 29 years, P =. 008). In patients with cervical intraepithelial neoplasia who had no or trivial colposcopic changes, the thickness of neoplastic epithelium was smaller (P =.008) and the number of cellular layers was lower (P =.01) than in patients with cervical intraepithelial neoplasia who had colposcopic changes consistent with cervical intraepithelial neoplasia. In patients <35 years old the rate of positive results for a high-risk human papillomavirus (P <.005) and the viral load (difference not significant) were higher than in women >/=35 years old. The rate of positive results for high-risk human papillomaviruses differed independently of age among patients with normal colposcopic findings, patients with trivial colposcopic changes of doubtful significance, and patients with colposcopic changes consistent with cervical intraepithelial neoplasia (P <.005). CONCLUSIONS: In women >/=35 years old cervical lesions associated with intraepithelial neoplasia are thinner and thus less colposcopically conspicuous than those in women <35 years old. Patients >/=35 years old with acetowhite cervical lesions consistent with trivial changes of doubtful significance should therefore undergo punch biopsy for histologic evaluation.

Adolescent↗
PubMed1997

Human papillomavirus distribution in cervical tissues of different morphology as determined by hybrid capture assay and PCR.

Distribution of various types of genital human Papillomavirus (HPV) in smears from histologically classified cervical lesions was determined by hybrid capture assay (HCA) and was compared with a polymerase chain reaction (PCR) system using general primers (GP) in first and type specific primers (TS) in a second step. The overall agreement of high-risk HPV by HCA and the more sensitive GP/TS PCR was 80.6% (204 of 253, kappa value 0.6). Human Papillomavirus frequency by GP/TS PCR was 14-20% higher compared with HCA (p = 0.02-0.004) independent of morphology. Only one sample was positive by HCA and negative by GP/TS PCR. A significantly higher frequency was found using HCA and GP/TS PCR in smears from histologically proven cervical intraepithelial lesions (CIN) II/III compared with CIN I, tissues with minimal changes (metaplasia, cervicitis, or lack of glycogenization), or normal morphology (61% and 81% vs 8-15% and 24-34%, p < or = 0.001). Semi-quantitative estimate of HPV DNA copies by GP-PCR coincided with estimated virus load by quantitative HCA and was significantly higher in patients with CIN II/III compared with CIN I (p < 0.001). Thus, the GP-PCR may be used to monitor the amount of HPV DNA copies in clinical samples. A direct correlation between morphologic changes and HPV detection as well as virus load was found by HCA and the more sensitive GP/TS PCR.

Adolescent↗
PubMed1996

[Logistic regression analysis of the influence of residential environment, residential hygiene and life style on the incidence and duration of acute respiratory disease in small children].

659 children aged between 1 and 2 years were examined in respect of the influence of the children's-facility, residential environment, residential hygiene, and way of life, as well as in respect of the influence of selected sociological factors on the number and duration of acute respiratory diseases (ARD). The evaluation of the results by using logistical regressions analysis came--among other things--to following factors, that correlated with a risen morbidity, respectively an extended duration of the illness (> 3 diseases in 6 months; > 20 days in 6 months). Apartments with wet walls, dark and too noisy apartments, children's-rooms with two outside walls, single window pane, outside-wall-gas-heaters, room-air-humidity too low, space for children in day-nurseries < 4 sqm, no carrying out of hardening-steps for the children, wind-influence to the open space of the children's-facility too strong, and shift-working by the mother.

Acute Disease↗
PubMed1993

The Castillo-Morales approach to orofacial pathology in Down syndrome.

Infants with Down syndrome often present with a familiar orofacial disorder which exists at birth or becomes more pronounced by the end of the first year. The primary pathology includes hypotonicity of the perioral muscles, lips, and masticatory muscles and a protruding tongue, later followed by active tongue protrusion. This results in problems with sucking, swallowing, drooling and dentition. Early intervention methods employing the combination of Castillo-Morales Manual Orofacial Therapy and his specially designed palatal plate, can improve orofacial function, facial appearance and prevent secondary conditions like pseudoprognathism, dental diseases, malocclusions, open mouth habit and pseudomacroglossia. This retrospective study examines the outcome of therapy, as prescribed by Castillo-Morales, in 39 children with Down syndrome. Normally, the average age to begin oral therapy is between six to eight months. The children were treated with the Castillo-Morales Manual Orofacial Therapy and his palatal plate for an average of 17.9 months. In this study, clinical evaluations at the beginning and the end of therapy focused only on open mouth posture and tongue protrusion. In addition, the direct stimulating effect of the palatal plate on tongue protrusion was evaluated. Significant positive results were observed in all three areas.

Child, Preschool↗
PubMed1992

[An examination of the prognostic value of biological parameters exemplified by the crucial prognosis-relevant factors of the TPI in the patient load of the Jena Clinic in 1968 to 1991. Therapy-dependent Prognosis Index].

The data of 240 patients with non-pretreated oral squamous cell carcinoma were analyzed in dependence on the tumor size (T-category), on the histologic checked lymph node status and the histopathologic grade of malignancy. There is a conformity to the results published by the DOSAK regard to the tumor size (T-category). The comparison of the survival of our patients with the estimated survival rate of the TPI shows also conformable results. Differences exist in the prognostic valuation of the lymph node status by the DOSAK. The histologic verificated lymph node status and the malignancy grade will recommend as decisionsive prognostic relevant parameters.

Aged↗
PubMed1992

[Homosexuality in childhood and adolescence].

Every second homosexual man has a presentiment of his own homosexuality during childhood. 86 percent of the homosexual men feel it till eighteen. The selfrecognition is a way full of conflicts between ignoration and acceptance; sometimes it ends in deformation of the personality or even in suicide. For well advice of homosexual children and adolescents we indicate: firstly an early sexual education in the school including information on homosexuality and secondly the academic and postgradual education of physicians, psychologists and pedagogues on natural variants of human sexuality.

Adolescent↗
PubMed1988

[Results of treatment of ovarian cancer patients at the Jena University Gynecological Clinic 1974-1983].

In a retrospective analysis 228 patients suffering from ovarian carcinoma were investigated. They had been treated at the Dept. of Gynecology of Jena from 1974 up to 1983. We determined remission rate, remission time, and 5-year survival. Conclusions of our analysis are the following: The incidence and 5-year survival of patients suffering from ovarian cancer are nearly constant during the time interval obtained in this study. Survival will be determined by 38%. Early stages (I and II) were treated only by operation while patients suffering from higher stages (III and IV) were undergone chemotherapy and/or radiotherapy. We obtained value of the remission rate and the 5-year survival rate, comparable to these reported in literature.

Combined Modality Therapy↗