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Article ; Online: Effect of albumin infusion on oxidative albumin modification and albumin binding capacity in chronic liver failure.

Stauber, Rudolf E / Paar, Margret / Balazs, Irina / Horvath, Angela / Feldbacher, Nicole / Posch, Andreas / Rainer, Florian / Stadlbauer, Vanessa / Oettl, Karl

Basic & clinical pharmacology & toxicology

2023 Volume 134, Issue 3, Page(s) 375–384

Abstract: Oxidative albumin modification and impaired albumin binding function have been described both in chronic liver failure and for therapeutic albumin solutions. The aim of the present study was to evaluate the effect of albumin infusion on redox state and ... ...

Abstract	Oxidative albumin modification and impaired albumin binding function have been described both in chronic liver failure and for therapeutic albumin solutions. The aim of the present study was to evaluate the effect of albumin infusion on redox state and binding function of circulating albumin. We studied 20 patients with cirrhosis who routinely received albumin infusions for prevention of post-paracentesis circulatory dysfunction or treatment of hepatorenal syndrome. We measured albumin fractions by redox state of cysteine-34 and albumin binding properties using dansylsarcosine as site II ligand. Therapeutic albumin solutions showed high contents of human nonmercaptalbumin-1 and human nonmercaptalbumin-2, exceeding the respective values in our patients with decompensated cirrhosis. An initial protocol for the first nine patients sampled at baseline, 24 h and 48 h after albumin infusion revealed no significant changes of oxidized albumin species or albumin binding properties. However, a modified protocol for the remaining 11 patients sampled at baseline, <1 h after and 24 h after albumin infusion revealed short-lived changes of oxidized albumin species while no changes in albumin binding properties were observed. In conclusion, therapeutic albumin infusion transiently changed albumin redox state but did not improve binding function of circulating albumin in chronic liver failure.
MeSH term(s)	Humans ; End Stage Liver Disease/drug therapy ; Serum Albumin ; Liver Cirrhosis/drug therapy ; Liver Cirrhosis/metabolism ; Oxidative Stress ; Oxidation-Reduction
Chemical Substances	Serum Albumin
Language	English
Publishing date	2023-12-26
Publishing country	England
Document type	Journal Article
ZDB-ID	2134679-3
ISSN	1742-7843 ; 1742-7835
ISSN (online)	1742-7843
ISSN	1742-7835
DOI	10.1111/bcpt.13973
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Article ; Online: The Choosing Wisely Initiative: A critical analysis with a special focus on primary care.

Horvath, Karl / Siebenhofer, Andrea

Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen

2017 Volume 129, Page(s) 31–36

Abstract: The Choosing Wisely initiative (CWI), a campaign led by the American Board of Internal Medicine (ABIM) Foundation, promotes doctor-patient communication and reducing waste in healthcare. At present, many of the top 5 lists from the Choosing Wisely ... ...

Abstract	The Choosing Wisely initiative (CWI), a campaign led by the American Board of Internal Medicine (ABIM) Foundation, promotes doctor-patient communication and reducing waste in healthcare. At present, many of the top 5 lists from the Choosing Wisely Initiative appear to be primarily eminence-based and influenced by self-interest. The implementation of recommendations from these lists may mean taking a step backwards to the time before evidence-based medicine. On the other hand, despite all the challenges that the Choosing Wisely initiatives are currently facing, it is difficult to deny that they also hold great potential in terms of making healthcare systems more efficient and beneficial to patients. The aim of the ongoing work in Germany and Austria is to create conditions that are necessary if CW initiatives are to evolve into a model tool that will help introduce the principles of evidence-based medicine into daily practice.
MeSH term(s)	Austria ; Communication ; Evidence-Based Medicine ; Germany ; Humans ; Internal Medicine ; Physician-Patient Relations ; Primary Health Care/standards ; United States
Language	English
Publishing date	2017-11-15
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2412512-X
ISSN	2212-0289 ; 1865-9217
ISSN (online)	2212-0289
ISSN	1865-9217
DOI	10.1016/j.zefq.2017.10.015
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Article ; Online: Antikörpertests bei COVID-19 - Was uns die Ergebnisse sagen.

Horvath, Karl / Semlitsch, Thomas / Jeitler, Klaus / Krause, Robert / Siebenhofer, Andrea

Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen

2020 Volume 153, Page(s) 54–59

Abstract: Introduction: In the context of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, the detection of virus-specific antibodies (AB) will play an increasing role. The presence or absence of such antibodies can potentially lead to ... ...

Title translation	Antibody tests for COVID-19: What the results tell us.
Abstract	Introduction: In the context of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, the detection of virus-specific antibodies (AB) will play an increasing role. The presence or absence of such antibodies can potentially lead to considerations regarding immunity and infection. Issue: How reliable are inferences from positive or negative test results regarding the actual presence of SARS-CoV-2 specific antibodies? Methods: Calculation of the probability that, depending on the pretest probability (prevalence of SARS-CoV-2 infection) and test properties, antibodies are present or absent in the case of positive or negative test results. Results: Sensitivity and specificity of different SARS-CoV-2 AB test systems vary between 53 % and 94 % and between 91 % and 99.5 %, respectively. When using a test with high test quality, the positive predictive value (PPV) is 42 % and 7 9%, respectively, with a pre-test probability of 1 % to 5 %, as can currently be assumed for the general population in Austria or Germany. For persons with an increased pre-test probability of 20 %, e. g. persons from high-risk professions, the PPW is 95 %, with a pre-test probability of 80 % the PPW is almost 100 %. The negative predictive value (NPV) is at least 99.7 % for persons with a low pre-test probability of up to 5 % and 79.1 % for persons with a pre-test probability of 80 %. When using test systems with lower sensitivity and specificity, the reliability of the results decreases considerably. The PPV is 5.9 % with a pre-test probability of 1 %. Conclusions: A sufficiently high sensitivity and specificity are prerequisites for the application of antibody test systems. Positive test results are often false if the pre-test probability is low. Depending on the assumed prevalence of a SARS-CoV-2 infection, there are substantial differences in the significance of a concrete test result for the respective affected persons.
MeSH term(s)	Antibodies, Viral/isolation & purification ; Austria ; Betacoronavirus ; COVID-19 ; COVID-19 Testing ; Clinical Laboratory Techniques ; Coronavirus Infections/diagnosis ; Germany ; Humans ; Pandemics ; Pneumonia, Viral/diagnosis ; Reproducibility of Results ; SARS-CoV-2 ; Sensitivity and Specificity
Chemical Substances	Antibodies, Viral
Keywords	covid19
Language	German
Publishing date	2020-05-15
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2412512-X
ISSN	2212-0289 ; 1865-9217
ISSN (online)	2212-0289
ISSN	1865-9217
DOI	10.1016/j.zefq.2020.05.005
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Article ; Online: Long-term effects of weight-reducing diets in people with hypertension.

Semlitsch, Thomas / Krenn, Cornelia / Jeitler, Klaus / Berghold, Andrea / Horvath, Karl / Siebenhofer, Andrea

The Cochrane database of systematic reviews

2021 Volume 2, Page(s) CD008274

Abstract: Background: All major guidelines for antihypertensive therapy recommend weight loss. Dietary interventions that aim to reduce body weight might therefore be a useful intervention to reduce blood pressure and adverse cardiovascular events associated with ...

Abstract	Background: All major guidelines for antihypertensive therapy recommend weight loss. Dietary interventions that aim to reduce body weight might therefore be a useful intervention to reduce blood pressure and adverse cardiovascular events associated with hypertension. Objectives: Primary objectives To assess the long-term effects of weight-reducing diets in people with hypertension on all-cause mortality, cardiovascular morbidity, and adverse events (including total serious adverse events, withdrawal due to adverse events, and total non-serious adverse events). Secondary objectives To assess the long-term effects of weight-reducing diets in people with hypertension on change from baseline in systolic blood pressure, change from baseline in diastolic blood pressure, and body weight reduction. Search methods: For this updated review, the Cochrane Hypertension Information Specialist searched the following databases for randomised controlled trials up to April 2020: the Cochrane Hypertension Specialised Register, CENTRAL (2020, Issue 3), Ovid MEDLINE, Ovid Embase, and ClinicalTrials.gov. We also contacted authors of relevant papers about further published and unpublished work. The searches had no language restrictions. Selection criteria: We included randomised controlled trials (RCTs) of at least 24 weeks' duration that compared weight-reducing dietary interventions to no dietary intervention in adults with primary hypertension. Data collection and analysis: Two review authors independently assessed risks of bias and extracted data. Where appropriate and in the absence of significant heterogeneity between studies (P > 0.1), we pooled studies using a fixed-effect meta-analysis. In case of moderate or larger heterogeneity as measured by Higgins I Main results: This second review update did not reveal any new trials, so the number of included trials remains the same: eight RCTs involving a total of 2100 participants with high blood pressure and a mean age of 45 to 66 years. Mean treatment duration was 6 to 36 months. We judged the risks of bias as unclear or high for all but two trials. No study included mortality as a predefined outcome. One RCT evaluated the effects of dietary weight loss on a combined endpoint consisting of the necessity of reinstating antihypertensive therapy and severe cardiovascular complications. In this RCT, weight-reducing diet lowered the endpoint compared to no diet: hazard ratio 0.70 (95% confidence interval (CI) 0.57 to 0.87). None of the trials evaluated adverse events as designated in our protocol. The certainty of the evidence was low for a blood pressure reduction in participants assigned to weight-loss diets as compared to controls: systolic blood pressure: mean difference (MD) -4.5 mm Hg (95% CI -7.2 to -1.8 mm Hg) (3 studies, 731 participants), and diastolic blood pressure: MD -3.2 mm Hg (95% CI -4.8 to -1.5 mm Hg) (3 studies, 731 participants). We judged the certainty of the evidence to be high for weight reduction in dietary weight loss groups as compared to controls: MD -4.0 kg (95% CI -4.8 to -3.2) (5 trials, 880 participants). Two trials used withdrawal of antihypertensive medication as their primary outcome. Even though we did not consider this a relevant outcome for our review, the results of these RCTs strengthen the finding of a reduction of blood pressure by dietary weight-loss interventions. Authors' conclusions: In this second update, the conclusions remain unchanged, as we found no new trials. In people with primary hypertension, weight-loss diets reduced body weight and blood pressure, but the magnitude of the effects are uncertain due to the small number of participants and studies included in the analyses. Whether weight loss reduces mortality and morbidity is unknown. No useful information on adverse effects was reported in the relevant trials.
MeSH term(s)	Aged ; Antihypertensive Agents/therapeutic use ; Bias ; Blood Pressure ; Cardiovascular Diseases/prevention & control ; Diet, Reducing/adverse effects ; Humans ; Hypertension/diet therapy ; Hypertension/drug therapy ; Hypertension/mortality ; Middle Aged ; Randomized Controlled Trials as Topic ; Weight Loss
Chemical Substances	Antihypertensive Agents
Language	English
Publishing date	2021-02-08
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Systematic Review
ISSN	1469-493X
ISSN (online)	1469-493X
DOI	10.1002/14651858.CD008274.pub4
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Article ; Online: Long-term effects of weight-reducing drugs in people with hypertension.

Siebenhofer, Andrea / Winterholer, Sebastian / Jeitler, Klaus / Horvath, Karl / Berghold, Andrea / Krenn, Cornelia / Semlitsch, Thomas

The Cochrane database of systematic reviews

2021 Volume 1, Page(s) CD007654

Abstract: Background: This is the third update of this review, first published in July 2009. All major guidelines on treatment of hypertension recommend weight loss; anti-obesity drugs may be able to help in this respect.: Objectives: Primary objectives: To ... ...

Abstract	Background: This is the third update of this review, first published in July 2009. All major guidelines on treatment of hypertension recommend weight loss; anti-obesity drugs may be able to help in this respect. Objectives: Primary objectives: To assess the long-term effects of pharmacologically-induced reduction in body weight in adults with essential hypertension on all-cause mortality, cardiovascular morbidity, and adverse events (including total serious adverse events, withdrawal due to adverse events, and total non-serious adverse events).. Secondary objectives: To assess the long-term effects of pharmacologically-induced reduction in body weight in adults with essential hypertension on change from baseline in systolic and diastolic blood pressure, and on body weight reduction. Search methods: For this updated review, the Cochrane Hypertension Information Specialist searched the following databases for randomised controlled trials up to March 2020: the Cochrane Hypertension Specialised Register, CENTRAL, MEDLINE (from 1946), Embase (from 1974), the World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov. The searches had no language restrictions. We contacted authors of relevant papers about further published and unpublished work. Selection criteria: Randomised controlled trials of at least 24 weeks' duration in adults with hypertension that compared approved long-term weight-loss medications to placebo. DATA COLLECTION AND ANALYSIS: Two review authors independently selected studies, assessed risks of bias, and extracted data. Where appropriate and in the absence of significant heterogeneity between studies (P > 0.1), we pooled studies using a fixed-effect meta-analysis. When heterogeneity was present, we used the random-effects method and investigated the cause of the heterogeneity. Main results: This third update of the review added one new trial, investigating the combination of naltrexone/bupropion versus placebo. Two medications, which were included in the previous versions of this review (rimonabant and sibutramine) are no longer considered relevant for this update, since their marketing approval was withdrawn in 2010 and 2009, respectively. The number of included studies in this review update is therefore six (12,724 participants in total): four RCTs comparing orlistat to placebo, involving a total of 3132 participants with high blood pressure and a mean age of 46 to 55 years; one trial comparing phentermine/topiramate to placebo, involving 1305 participants with high blood pressure and a mean age of 53 years; and one trial comparing naltrexone/bupropion to placebo, involving 8283 participants with hypertension and a mean age of 62 years. We judged the risks of bias to be unclear for the trials investigating orlistat or naltrexone/bupropion. and low for the trial investigating phentermine/topiramate. Only the study of naltrexone/bupropion included cardiovascular mortality and morbidity as predefined outcomes. There were no differences in the rates of all-cause or cardiovascular mortality, major cardiovascular events, or serious adverse events between naltrexone/bupropion and placebo. The incidence of overall adverse events was significantly higher in participants treated with naltrexone/bupropion. For orlistat, the incidence of gastrointestinal side effects was consistently higher compared to placebo. The most frequent side effects with phentermine/topiramate were dry mouth and paraesthesia. After six to 12 months, orlistat reduced systolic blood pressure compared to placebo by mean difference (MD) -2.6 mm Hg (95% confidence interval (CI) -3.8 to -1.4 mm Hg; 4 trials, 2058 participants) and diastolic blood pressure by MD -2.0 mm Hg (95% CI -2.7 to -1.2 mm Hg; 4 trials, 2058 participants). After 13 months of follow-up, phentermine/topiramate decreased systolic blood pressure compared to placebo by -2.0 to -4.2 mm Hg (1 trial, 1030 participants) (depending on drug dosage), and diastolic blood pressure by -1.3 to -1.9 mm Hg (1 trial, 1030 participants) (depending on drug dosage). There was no difference in the change in systolic or diastolic blood pressure between naltrexone/bupropion and placebo (1 trial, 8283 participants). We identified no relevant studies investigating liraglutide or lorcaserin in people with hypertension. Authors' conclusions: In people with elevated blood pressure, orlistat, phentermine/topiramate and naltrexone/bupropion reduced body weight; the magnitude of the effect was greatest with phentermine/topiramate. In the same trials, orlistat and phentermine/topiramate, but not naltrexone/bupropion, reduced blood pressure. One RCT of naltrexone/bupropion versus placebo showed no differences in all-cause mortality or cardiovascular mortality or morbidity after two years. The European Medicines Agency refused marketing authorisation for phentermine/topiramate due to safety concerns, while for lorcaserin the application for European marketing authorisation was withdrawn due to a negative overall benefit/risk balance. In 2020 lorcaserin was also withdrawn from the US market. Two other medications (rimonabant and sibutramine) had already been withdrawn from the market in 2009 and 2010, respectively.
MeSH term(s)	Adult ; Anti-Obesity Agents/adverse effects ; Anti-Obesity Agents/therapeutic use ; Appetite Depressants/adverse effects ; Appetite Depressants/therapeutic use ; Bias ; Blood Pressure/drug effects ; Body Weight/drug effects ; Bupropion/adverse effects ; Bupropion/therapeutic use ; Diet, Reducing ; Drug Combinations ; Female ; Fructose/adverse effects ; Fructose/analogs & derivatives ; Fructose/therapeutic use ; Humans ; Hypertension/drug therapy ; Hypertension/mortality ; Lactones/adverse effects ; Lactones/therapeutic use ; Male ; Middle Aged ; Naltrexone/adverse effects ; Naltrexone/therapeutic use ; Orlistat/adverse effects ; Orlistat/therapeutic use ; Phentermine/adverse effects ; Phentermine/therapeutic use ; Piperidines/adverse effects ; Piperidines/therapeutic use ; Pyrazoles/adverse effects ; Pyrazoles/therapeutic use ; Randomized Controlled Trials as Topic ; Safety-Based Drug Withdrawals ; Time ; Topiramate/adverse effects ; Topiramate/therapeutic use
Chemical Substances	Anti-Obesity Agents ; Appetite Depressants ; Drug Combinations ; Lactones ; Naltrexone-Bupropion combination ; Piperidines ; Pyrazoles ; Bupropion (01ZG3TPX31) ; Topiramate (0H73WJJ391) ; Fructose (30237-26-4) ; Naltrexone (5S6W795CQM) ; Orlistat (95M8R751W8) ; Phentermine (C045TQL4WP)
Language	English
Publishing date	2021-01-17
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Systematic Review
ISSN	1469-493X
ISSN (online)	1469-493X
DOI	10.1002/14651858.CD007654.pub5
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Article ; Online: Antikörpertests bei COVID-19 - Was uns die Ergebnisse sagen

Horvath, Karl / Semlitsch, Thomas / Jeitler, Klaus / Krause, Robert / Siebenhofer, Andrea

Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen

2020 Volume 153-154, Page(s) 54–59

Keywords	Health Policy ; Education ; covid19
Language	German
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
ZDB-ID	2453053-0
ISSN	1865-9217
ISSN	1865-9217
DOI	10.1016/j.zefq.2020.05.005
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Conference proceedings: Gemeinsam gut entscheiden in Österreich – die neuen Top 7 der Vorsorge

Mayr, Verena / Glechner, Anna / Horvath, Karl / Gartlehner, Gerald / Siebenhofer-Kroitzsch, Andrea

2021 , Page(s) 21ebmPS–4–03

Event/congress	22. Jahrestagung des Deutschen Netzwerks Evidenzbasierte Medizin; Who cares? – EbM und Transformation im Gesundheitswesen; sine loco [digital]; Deutsches Netzwerk Evidenzbasierte Medizin e.V.; 2021
Keywords	Medizin, Gesundheit
Publishing date	2021-02-23
Publisher	German Medical Science GMS Publishing House; Düsseldorf
Document type	Conference proceedings
DOI	10.3205/21ebm075
Database	German Medical Science

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Conference proceedings: Gemeinsam gut entscheiden – Choosing Wisely Austria: Empfehlungen gegen medizinische Überversorgung in Österreich

Glechner, Anna / Mayr, Verena / Horvath, Karl / Semlitsch, Thomas / Jeitler, Klaus / Siebenhofer, Andrea / Gartlehner, Gerald / Meixner, Jana

2022 , Page(s) 22ebmVS–1–01

Event/congress	23. Jahrestagung des Deutschen Netzwerks Evidenzbasierte Medizin; Evidenzbasierte Medizin für eine bedarfsgerechte Gesundheitsversorgung; Lübeck; Deutsches Netzwerk Evidenzbasierte Medizin e.V.; 2022
Keywords	Medizin, Gesundheit
Publishing date	2022-08-30
Publisher	German Medical Science GMS Publishing House; Düsseldorf
Document type	Conference proceedings
DOI	10.3205/22ebm018
Database	German Medical Science

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Article ; Online: Written patient information materials used in general practices fail to meet acceptable quality standards.

Posch, Nicole / Horvath, Karl / Wratschko, Kerstin / Plath, Jasper / Brodnig, Richard / Siebenhofer, Andrea

BMC family practice

2020 Volume 21, Issue 1, Page(s) 23

Abstract: Background: Patient information materials and decision aids are essential tools for helping patients make informed decisions and share in decision-making. The aim of this study was to investigate the quality of the written patient information materials ... ...

Abstract	Background: Patient information materials and decision aids are essential tools for helping patients make informed decisions and share in decision-making. The aim of this study was to investigate the quality of the written patient information materials available at general practices in Styria, Austria. Methods: We asked general practitioners to send in all patient information materials available in their practices and to answer a short questionnaire. We evaluated the materials using the Ensuring Quality Information for Patients (EQIP-36) instrument. Results: A total of 387 different patient information materials were available for quality assessment. These materials achieved an average score of 39 out of 100. The score was below 50 for 78% of all materials. There was a significant lack of information on the evidence base of recommendations. Only 9 % of the materials provided full disclosure of their evidence sources. We also found that, despite the poor quality of the materials, 89% of general practitioners regularly make active use of them during consultations with patients. Conclusion: Based on international standards, the quality of patient information materials available at general practices in Styria is poor. The vast majority of the materials are not suitable as a basis for informed decisions by patients. However, most Styrian general practitioners use written patient information materials on a regular basis in their daily clinical practice. Thus, these materials not only fail to help raise the health literacy of the general population, but may actually undermine efforts to enable patients to make shared informed decisions. To increase health literacy, it is necessary to make high quality, evidence-based and easy-to-understand information material available to patients and the public. For this, it may be necessary to set up a centralized and independent clearinghouse.
MeSH term(s)	Austria ; Comprehension ; Decision Making, Shared ; Female ; General Practice ; General Practitioners ; Health Literacy ; Humans ; Male ; Pamphlets ; Patient Education as Topic/standards
Language	English
Publishing date	2020-02-01
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041495-X
ISSN	1471-2296 ; 1471-2296
ISSN (online)	1471-2296
ISSN	1471-2296
DOI	10.1186/s12875-020-1085-6
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Article: Histogram Analysis of Diffusion Weighted Imaging in Low-Grade Gliomas:

Gihr, Georg Alexander / Horvath-Rizea, Diana / Hekeler, Elena / Ganslandt, Oliver / Henkes, Hans / Hoffmann, Karl-Titus / Scherlach, Cordula / Schob, Stefan

Frontiers in oncology

2020 Volume 10, Page(s) 206

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2020-02-25
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2020.00206
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