von Rabea Mecklenbrauck ; Nora Borchert ; Razif Gabdoulline ; Poll Piroska ; Caroline Funke ; Maximilian Brandes ; Louisa-Kristin Dallmann ; Walter Fiedler ; Jürgen Krauter ; Arne Trummer ; Bernd Hertenstein ; Martin Rudolf Müller ; Michael Lübbert ; Michael Heuser ; Andreas Voß
Michael H Freitag; Falk Hoffmann; Lars Schwettmann; Christiane Müller
Oldenburg
1 Online-Ressource (269 Seiten).
Dissertation Universität Oldenburg 2025
Hochschulschrift
Vertragsärzte sind zur Teilnahme am kassenärztlichen Bereitschaftsdienst verpflichtet, dessen Organisation zunehmend durch Ärztemangel erschwert wird. In dieser Studie wurden sieben Bereitschaftsdienstbereiche der KV Niedersachsen hinsichtlich Struktur, Inanspruchnahme und ärztlicher Wahrnehmung untersucht. Neben quantitativen Daten wurden 20 leitfadengestützte Interviews mit Ärzten durchgeführt und qualitativ ausgewertet. Die Ergebnisse zeigen große regionale Unterschiede in Organisation und Arbeitsbedingungen, z.B. hinsichtlich Diensthäufigkeit, Ausstattung und Vergütung. Kritikpunkte sind mangelnde Patientensteuerung, unzureichende Vergütung, fehlende Schnittstellen und ineffiziente Abläufe. Ärzte fordern den Einsatz von Telemedizin, nichtärztlichem Personal und begleiteten Fahrdienst. Insgesamt besteht hoher Reformbedarf zur Stärkung der ambulanten Versorgung, insbesondere in ländlichen Regionen.
Contract physicians in Germany are generally required to participate in the on-call medical service, a responsibility that is becoming increasingly challenging due to a shortage of medical professionals. This study investigates the organizational structures, service utilization, and physicians’ perceptions of seven selected on-call service areas in Lower Saxony. Quantitative data was complemented by 20 guideline-based interviews with physicians, which were analyzed using a qualitative content analysis approach. The results reveal considerable regional variation in the organization of the service and its direct impact on working conditions, such as service frequency, facilities, remuneration, and workload. Physicians identified issues such as inadequate compensation, lack of patient management, inefficient workflows, and insufficient integration of telemedicine and non-medical staff. The findings indicate a significant need for structural reforms to improve the on-call medical service and make medical practice, particularly in rural areas, more attractive.
von Maja Krech ; Amos Muench ; Daniel Teichmann ; Peter Kuzman ; Abigail Kora Suwala ; Franziska M. Ippen ; Michael Müther ; Katharina J. Weber ; Katharina Wenger-Alakmeh ; Julia Onken ; Peter Vajkoczy ; Felix Behling ; Sven-Axel May ; Georgios Ntoulias ; Joachim K. Krauss ; Oday Atallah ; Majid Esmaeilzadeh ; Wolf C. Mueller ; Frank L. Heppner ; Helena Radbruch ; Carsten Dittmayer ; Werner Stenzel ; Arend Koch ; David Capper ; David Kaul ; Werner Paulus ; Karl Plate ; Joachim P. Steinbach ; Markus Czabanka ; Rudi Beschorner ; Andreas von Deimling ; Michael Bockmayr ; Julia E. Neumann ; Sebastian Brandner ; Teresa Krieger ; Christian Hartmann ; Christian Thomas ; Leonille Schweizer
Veröffentlicht: 11. Juni 2025 ; Gesehen am 29.10.2025
DNA methylation profiling; FGFR3; Neurocytoma; Progression-free survival; Radiotherapy
Central neurocytomas (CN) are intraventricular brain tumors predominantly occurring in young adults. Although prognosis is usually favorable, tumor recurrence is common, particularly following subtotal resection (STR). Currently, the risk of progression is evaluated using atypical features and an elevated Ki67 proliferation index. However, these markers lack consistent definitions, raising the need for objective criteria. Genome-wide DNA methylation profiles were examined in 136 tumors histologically classified as CN. Clinical/histopathological characteristics were assessed in 93/90 cases, and whole-exome sequencing was conducted in 12 cases. Clinical and molecular characteristics were integrated into a survival model to predict progression-free survival (PFS). A diagnosis of CN was epigenetically confirmed in 125 of 136 cases (92%). No DNA methylation subgroups were identified, but global DNA hypomethylation emerged as a hallmark feature of CN associated with higher recurrence risk. Risk stratification based on histological features of atypia and Ki67 proliferation index was not reproducible across neuropathologists. Hypomethylation at the FGFR3 locus, accompanied by increased FGFR3 protein expression, was observed in 97% of cases. Gross total resection was associated with significantly improved PFS compared to STR, while patients undergoing STR receiving radiotherapy had a better outcome (p = 0.0001). Younger patients were identified as having a higher risk of recurrence (p = 0.026). Patient age and treatment strategy were key factors associated with survival outcomes in this cohort. These findings underscore the importance of closer follow-up for younger patients and radiotherapy for STR cases. Furthermore, FGFR3 represents a hallmark feature and potential therapeutic target, warranting further investigation.
Acta neuropathologica Berlin : Springer, 1961 149(2025), Artikel-ID 61, Seite 1-16 Online-Ressource
von Martin Poryo ; Ludwig Gortner ; Johannes Bay ; Axel R. Franz ; Harald Ehrhardt ; Lars Klein ; Judith Behnke ; Tina Frodermann ; Jutta Petzinger ; Christoph Binder ; Susanne Kirschenhofer ; Anja Stein ; Britta-Maria Hüning ; Axel Heep ; Eva Cloppenburg ; Julia Muyimbwa ; Torsten Ott ; Julia Sandkötter ; Norbert Immanuel Teig ; Susanne Wiegand ; Michael Andreas Schroth ; Andrea Kick ; Donald Wurm ; Corinna Mirjam Gebauer ; Knud Linnemann ; Jochen Kittel ; Christian Wieg ; Ursula Kiechl-Kohlendorfer ; Susanne Schmidt ; Ralf Böttger ; Wolfgang Thomas ; Francisco Hernan Brevis Nuñez ; Antje Stockmann ; Thomas A. Kriebel ; Andreas Müller ; Daniel Klotz ; Patrick Daniel Morhart ; Donatus Nohr ; Hans-Konrad Biesalski ; Eleni Z. Giannopoulou ; Susanne Hilt ; Stefan Wagenpfeil ; Nadja Haiden ; Matthew Rysavy ; Christoph Härtel ; Christian Rainer Ruckes ; Anne Ehrlich ; Sascha Meyer
von Hendrik Fokken ; Julian Waclawski ; Nadine Kattre ; Arnold Kloos ; Sebastian Müller ; Max Till Ettinger ; Tim Kacprowski ; Michael Heuser ; Michael Maetzig ; Adrian Schwarzer
