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Article ; Online: Bilateral mydriasis as first manifestation of Hodgkin's lymphoma: a case report.

Baki, Enayatullah / Scheidhauer, Klemens / Schmidt-Graf, Friederike

2022 Volume 22, Issue 1, Page(s) 473

Abstract: Background: Bilateral mydriasis is usually associated with severe brain stem damage or drug-induced sympathomimetic stimulation. Herein we report it as a unique neurologic complication of Hodgkin's lymphoma.: Case presentation: A 23-year-old woman ... ...

Abstract	Background: Bilateral mydriasis is usually associated with severe brain stem damage or drug-induced sympathomimetic stimulation. Herein we report it as a unique neurologic complication of Hodgkin's lymphoma. Case presentation: A 23-year-old woman presented at our emergency department with dilated pupils unresponsive to light stimuli. MRI and CT scans showed bilaterally enlarged lymph nodes in the mediastinum and supraclavicular compressing the carotid artery on both sides. The histologic examination of lymph node biopsy specimens confirmed the diagnosis of Hodgkin's lymphoma. Conclusion: Pathologies around the carotid artery causing oculosympathetic spasm should be considered among the possible causes of a mydriasis, especially when other common causes like brain stem impairment are excluded.
Language	English
Publishing date	2022-12-12
Publishing country	England
Document type	Journal Article
ZDB-ID	2041347-6
ISSN	1471-2377 ; 1471-2377
ISSN (online)	1471-2377
ISSN	1471-2377
DOI	10.1186/s12883-022-02941-6
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Article ; Online: The role of molecular tumor boards in neuro-oncology: a nationwide survey.

Hönikl, Lisa S / Lange, Sebastian / Butenschoen, Vicki M / Delbridge, Claire / Meyer, Bernhard / Combs, Stephanie E / Illert, Anna Lena / Schmidt-Graf, Friederike

BMC cancer

2024 Volume 24, Issue 1, Page(s) 108

Abstract: Background: In neuro-oncology, the inclusion of tumor patients in the molecular tumor board has only become increasingly widespread in recent years, but so far there are no standards for indication, procedure, evaluation, therapy recommendations and ... ...

Abstract	Background: In neuro-oncology, the inclusion of tumor patients in the molecular tumor board has only become increasingly widespread in recent years, but so far there are no standards for indication, procedure, evaluation, therapy recommendations and therapy implementation of neuro-oncological patients. The present work examines the current handling of neuro-oncological patients included in molecular tumor boards in Germany. Methods: We created an online based survey with questions covering the handling of neuro-oncologic patient inclusion, annotation of genetic analyses, management of target therapies and the general role of molecular tumor boards in neuro-oncology in Germany. We contacted all members of the Neuro-Oncology working group (NOA) of the German Cancer Society (DKG) by e-mail. Results: 38 responses were collected. The majority of those who responded were specialists in neurosurgery or neurology with more than 10 years of professional experience working at a university hospital. Molecular tumor boards (MTB) regularly take place once a week and all treatment disciplines of neuro-oncology patients take part. The inclusions to the MTB are according to distinct tumors and predominantly in case of tumor recurrence. An independently MTB member mostly create the recommendations, which are regularly implemented in the tumor treatment. Recommendations are given for alteration classes 4 and 5. Problems exist mostly within the cost takeover of experimental therapies. The experimental therapies are mostly given in the department of medical oncology. Conclusions: Molecular tumor boards for neuro-oncological patients, by now, are not standardized in Germany. Similarities exists for patient inclusion and interpretation of molecular alterations; the time point of inclusion and implementation during the patient treatment differ between the various hospitals. Further studies for standardization and harmonisation are needed. In summary, most of the interviewees envision great opportunities and possibilities for molecular-based neuro-oncological therapy in the future.
MeSH term(s)	Humans ; Neoplasms/genetics ; Neoplasms/therapy ; Surveys and Questionnaires ; Medical Oncology/methods ; Hospitals, University ; Germany
Language	English
Publishing date	2024-01-19
Publishing country	England
Document type	Journal Article
ZDB-ID	2041352-X
ISSN	1471-2407 ; 1471-2407
ISSN (online)	1471-2407
ISSN	1471-2407
DOI	10.1186/s12885-024-11858-x
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Article ; Online: New concepts in neurology education: successful implementation of flipped classroom lectures.

Mosene, Katharina / Heitmann, Henrik / Pötter, Dennis / Schmidt-Graf, Friederike

Neurological research and practice

2022 Volume 4, Issue 1, Page(s) 31

Abstract: In order to inspire and attract young people to Neurology, we must offer high-quality and attractive teaching! To improve neurological education at our Medical School (Technical University of Munich), we converted the main lecture into an e-learning ... ...

Abstract	In order to inspire and attract young people to Neurology, we must offer high-quality and attractive teaching! To improve neurological education at our Medical School (Technical University of Munich), we converted the main lecture into an e-learning concept using a flipped classroom model. Students had to prepare with a video and a text as well as answering multiple choice questions before each lecture. As a further incentive, students with ≥ 80% right answers in multiple choice questions received a bonus for the final exam. During the lectures, predominantely patient cases were discussed to apply, improve and enhance the previously acquired knowledge. The realignment of the main lecture in Neurology into a flipped classroom model was very successful and was further optimized in the following semesters based on the evaluations obtained for the new concept. Moreover, this enabled us to quickly switch to remote teaching during the COVID-19 pandemic, while still offering lectures of high quality. In addition, this new teaching concept attracts students for Neurology. Furthermore, the exemplary conversion of the Neurology main lecture to a flipped classroom concept also serves as best practice and motivation to adapt other courses in our faculty and far beyond.
Language	English
Publishing date	2022-08-08
Publishing country	England
Document type	Letter
ISSN	2524-3489
ISSN (online)	2524-3489
DOI	10.1186/s42466-022-00196-7
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Article ; Online: Amino acid PET vs. RANO MRI for prediction of overall survival in patients with recurrent high grade glioma under bevacizumab therapy.

Chaban, Artem / Waschulzik, Birgit / Bernhardt, Denise / Delbridge, Claire / Schmidt-Graf, Friederike / Wagner, Arthur / Wiestler, Benedikt / Weber, Wolfgang / Yakushev, Igor

European journal of nuclear medicine and molecular imaging

2024 Volume 51, Issue 6, Page(s) 1698–1702

Abstract: Purpose: To summarize evidence on the comparative value of amino acid (AA) PET and conventional MRI for prediction of overall survival (OS) in patients with recurrent high grade glioma (rHGG) under bevacizumab therapy.: Methods: Medical databases ... ...

Abstract	Purpose: To summarize evidence on the comparative value of amino acid (AA) PET and conventional MRI for prediction of overall survival (OS) in patients with recurrent high grade glioma (rHGG) under bevacizumab therapy. Methods: Medical databases were screened for studies with individual data on OS, follow-up MRI, and PET findings in the same patient. MRI images were assessed according to the RANO criteria. A receiver operating characteristic curve analysis was used to predict OS at 9 months. Results: Five studies with a total of 72 patients were included. Median OS was significantly lower in the PET-positive than in the PET-negative group. PET findings predicted OS with a pooled sensitivity and specificity of 76% and 71%, respectively. Corresponding values for MRI were 32% and 82%. Area under the curve and sensitivity were significantly higher for PET than for MRI. Conclusion: For monitoring of patients with rHGG under bevacizumab therapy, AA-PET should be preferred over RANO MRI.
MeSH term(s)	Humans ; Bevacizumab/therapeutic use ; Glioma/diagnostic imaging ; Glioma/drug therapy ; Glioma/pathology ; Magnetic Resonance Imaging ; Positron-Emission Tomography ; Brain Neoplasms/diagnostic imaging ; Brain Neoplasms/drug therapy ; Amino Acids/therapeutic use ; Recurrence ; Female ; Neoplasm Grading ; Male ; Survival Analysis ; Middle Aged
Chemical Substances	Bevacizumab (2S9ZZM9Q9V) ; Amino Acids
Language	English
Publishing date	2024-01-17
Publishing country	Germany
Document type	Journal Article ; Comparative Study
ZDB-ID	8236-3
ISSN	1619-7089 ; 0340-6997 ; 1619-7070
ISSN (online)	1619-7089
ISSN	0340-6997 ; 1619-7070
DOI	10.1007/s00259-024-06601-4
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Article ; Online: Flipping the classroom in neurological bedside teaching: a prospective controlled study.

Heitmann, Henrik / Fischer, Elisabeth / Wagner, Philipp / Pötter, Dennis / Gartmeier, Martin / Schmidt-Graf, Friederike

BMC medical education

2023 Volume 23, Issue 1, Page(s) 164

Abstract: Background: Bedside teaching is essential to foster core clinical competences in medical education, especially in Neurology. However, bedside skills are declining and new concepts to enhance the effectiveness of bedside teaching are needed, also in view ...

Abstract	Background: Bedside teaching is essential to foster core clinical competences in medical education, especially in Neurology. However, bedside skills are declining and new concepts to enhance the effectiveness of bedside teaching are needed, also in view of limited in-person teaching possibilities in the ongoing pandemic situation. If theoretical knowledge is taught prior to in-person sessions this might allow to better focus on practical application aspects during bedside teaching. We thus aimed to answer the question to what extent such an approach can enhance the effectiveness of neurological bedside teaching. Methods: In this prospective controlled study, neurological bedside courses following a traditional and a flipped classroom (FC) approach were compared with regards to their effects on theoretical knowledge and practical skills of medical students. Evaluations were obtained from 161 students and their lecturers participating in a neurological bedside teaching course at a German university hospital between October 2020 and July 2021. Students were randomly assigned to course dates. However, the 74 students assigned to course dates from May to July 2021 completed a mandatory online preparation course prior to the bedside teaching. These students served as the interventional group (IG) and the remaining 87 students formed the control group (CG). Ratings of knowledge and skills provided by the students and their lecturers on numerical rating scales served as primary outcome measures. Moreover, the time needed to recapitulate theoretical contents during the in-person teaching session was assessed as a secondary outcome measure. Group comparisons were performed using t-statistics. Results: Theoretical knowledge upon entering the course was rated significantly higher in the IG by the students (p < 0.001) and lecturers (p = 0.003). Lecturers also rated the practical skills of students in the IG significantly higher (p < 0.001). Furthermore, significantly less time was needed to recapitulate theoretical contents during the in-person session in the IG (p = 0.03). Conclusions: Using a FC approach enhances the effectiveness of in-person neurological bedside teaching. Thus, these concepts are particularly valuable in the ongoing pandemic situation. Moreover, they might allow to reuse e-learning contents developed during the pandemic and to develop future bedside teaching concepts.
MeSH term(s)	Humans ; Prospective Studies ; Learning ; Education, Medical ; Curriculum ; Students, Medical ; Teaching
Language	English
Publishing date	2023-03-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2044473-4
ISSN	1472-6920 ; 1472-6920
ISSN (online)	1472-6920
ISSN	1472-6920
DOI	10.1186/s12909-023-04150-2
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Book ; Online ; Thesis: Retrospektive Untersuchung zur prognostischen Beurteilung von älteren Glioblastompatienten

Antoni, Stefanie Julia Verfasser] / [Schmidt-Graf, Friederike [Akademischer Betreuer] / Schmidt-Graf, Friederike [Gutachter] / Straube, Christoph [Gutachter]

2022

Author's details	Stefanie Julia Antoni ; Gutachter: Friederike Schmidt-Graf, Christoph Straube ; Betreuer: Friederike Schmidt-Graf
Keywords	Medizin, Gesundheit ; Medicine, Health
Subject code	sg610
Language	German
Publisher	Universitätsbibliothek der TU München
Publishing place	München
Document type	Book ; Online ; Thesis
Database	Digital theses on the web

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Book ; Online ; Thesis: Der Einfluss von postoperativen Infektionen auf das Überleben von Patienten mit hochgradigen Gliomen

Barbera, Luisa Verfasser] / [Schmidt-Graf, Friederike [Akademischer Betreuer] / Kirschke, Jan [Gutachter] / Schmidt-Graf, Friederike [Gutachter]

2022

Author's details	Luisa Barbera ; Gutachter: Jan Stefan Kirschke, Friederike Schmidt-Graf ; Betreuer: Friederike Schmidt-Graf
Keywords	Medizin, Gesundheit ; Medicine, Health
Subject code	sg610
Language	German
Publisher	Universitätsbibliothek der TU München
Publishing place	München
Document type	Book ; Online ; Thesis
Database	Digital theses on the web

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Article ; Online: Effectiveness of non-bedside teaching during the COVID-19 pandemic: a quasi-experimental study.

Heitmann, Henrik / Wagner, Philipp / Fischer, Elisabeth / Gartmeier, Martin / Schmidt-Graf, Friederike

BMC medical education

2022 Volume 22, Issue 1, Page(s) 73

Abstract: Background: The COVID-19 pandemic poses a huge challenge for clinical teaching due to contact restrictions and social distancing. Medical teachers have to balance potential risks and benefits of bedside teaching, especially in course formats intended to ...

Abstract	Background: The COVID-19 pandemic poses a huge challenge for clinical teaching due to contact restrictions and social distancing. Medical teachers have to balance potential risks and benefits of bedside teaching, especially in course formats intended to foster practical clinical skills. In this context, we aimed to address the question, whether presence-based teaching formats without patient involvement are suitable to teach practical skills. Methods: In this quasi-experimental study, presence-based teaching formats with and without patient contact were retrospectively compared regarding their effects on medical students' theoretical knowledge and practical skills, i.e. the performance and clinical interpretation of the neurological exam. To this end, evaluations from 102 students and their lecturers participating in a neurological bedside teaching course at a German university hospital between October 2020 and April 2021 were obtained. Students were initially randomly assigned to course dates. However, 53 students assigned to courses in November and December 2020, were not able to go bedside due to contact restrictions. These students formed the interventional group and the remaining 49 students the control group. The primary outcome measures were students' overall grading of the course (school grades, 1-6) as well as ratings of knowledge and skills provided by the students themselves and their lecturers on a numerical rating scale (0-10). Comparison between groups was performed using frequentist and Bayesian t-statistics. Results: The teaching format without patient contact received a significantly poorer overall grade by the students (p = 0.018). However, improvements in the students' self-ratings of knowledge and skills did not differ between the two formats (all p > 0.05, BF Conclusions: Teaching formats without patient contact are less well-received by the students. However, they are able to teach practical skills regarding the performance and clinical interpretation of examination techniques. Still, the evaluations obtained might not adequately capture the importance of bedside teaching in preparing future physicians for their practice. Perspectively, hybrid teaching approaches including flipped-classroom concepts hold considerable potential to enhance effectiveness of bedside teaching in the present pandemic situation and in the future.
MeSH term(s)	Bayes Theorem ; COVID-19 ; Education, Medical, Undergraduate ; Humans ; Pandemics ; Retrospective Studies ; SARS-CoV-2
Language	English
Publishing date	2022-01-31
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2044473-4
ISSN	1472-6920 ; 1472-6920
ISSN (online)	1472-6920
ISSN	1472-6920
DOI	10.1186/s12909-022-03141-z
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Article ; Online: A rare case of H3K27-altered diffuse midline glioma with multiple osseous and spinal metastases at the time of diagnosis.

Aftahy, A Kaywan / Butenschoen, Vicki M / Hoenikl, Lisa / Liesche-Starnecker, Friederike / Wiestler, Benedikt / Schmidt-Graf, Friederike / Meyer, Bernhard / Gempt, Jens

BMC neurology

2023 Volume 23, Issue 1, Page(s) 87

Abstract: Background: H3K27-altered diffuse midline gliomas are uncommon central nervous system tumors with extremely poor prognoses.: Case presentation: We report the case of a 24-year-old man patient with multiple, inter alia osseous metastases who presented ...

Abstract	Background: H3K27-altered diffuse midline gliomas are uncommon central nervous system tumors with extremely poor prognoses. Case presentation: We report the case of a 24-year-old man patient with multiple, inter alia osseous metastases who presented with back pain, hemi-hypoesthesia, and hemi-hyperhidrosis. The patient underwent combined radio-chemotherapy and demonstrated temporary improvement before deteriorating. Conclusions: H3K27-altered diffuse midline glioma presents an infrequent but crucial differential diagnosis and should be considered in cases with rapid neurological deterioration and multiple intracranial and intramedullary tumor lesions in children and young adults. Combined radio-chemotherapy delayed the neurological deterioration, but unfortunately, progression occurred three months after the diagnosis.
MeSH term(s)	Child ; Male ; Young Adult ; Humans ; Adult ; Spinal Neoplasms/complications ; Spinal Neoplasms/diagnostic imaging ; Diagnosis, Differential ; Bone and Bones ; Antineoplastic Combined Chemotherapy Protocols ; Glioma
Language	English
Publishing date	2023-02-28
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2041347-6
ISSN	1471-2377 ; 1471-2377
ISSN (online)	1471-2377
ISSN	1471-2377
DOI	10.1186/s12883-023-03135-4
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Article ; Online: Adjuvant re-irradiation vs. no early re-irradiation of resected recurrent glioblastoma: pooled comparative cohort analysis from two tertiary centers.

Straube, Christoph / Combs, Stephanie E / Bernhardt, Denise / Gempt, Jens / Meyer, Bernhard / Zimmer, Claus / Schmidt-Graf, Friederike / Vajkoczy, Peter / Grün, Arne / Ehret, Felix / Zips, Daniel / Kaul, David

Journal of neuro-oncology

2024

Abstract: Background: The optimal management strategy for recurrent glioblastoma (rGBM) remains uncertain, and the impact of re-irradiation (Re-RT) on overall survival (OS) is still a matter of debate. This study included patients who achieved gross total ... ...

Abstract	Background: The optimal management strategy for recurrent glioblastoma (rGBM) remains uncertain, and the impact of re-irradiation (Re-RT) on overall survival (OS) is still a matter of debate. This study included patients who achieved gross total resection (GTR) after a second surgery after recurrence, following the GlioCave criteria. Methods: Inclusion criteria include being 18 years or older, having histologically confirmed locally recurrent IDHwt or IDH unknown GBM, achieving MRI-proven GTR after the second surgery, having a Karnofsky performance status of at least 60% after the second surgery, having a minimum interval of 6 months between the first radiotherapy and the second surgery, and a maximum of 8 weeks from second surgery to the start of Re-RT. Results: A total of 44 patients have met the inclusion criteria. The median OS after the second surgery was 14 months. All patients underwent standard treatment after initial diagnosis, including maximum safe resection, adjuvant radiochemotherapy and adjuvant chemotherapy. Re-RT did not significantly impact OS. However, MGMT promoter methylation status and a longer interval (> 12 months) between treatments were associated with better OS. Multivariate analysis revealed the MGMT status as the only significant predictor of OS. Conclusion: Factors such as MGMT promoter methylation status and treatment interval play crucial roles in determining patient outcomes after second surgery. Personalized treatment strategies should consider these factors to optimize the management of rGBM. Prospective research is needed to define the value of re-RT after second surgery and to inform decision making in this situation.
Language	English
Publishing date	2024-03-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	604875-4
ISSN	1573-7373 ; 0167-594X
ISSN (online)	1573-7373
ISSN	0167-594X
DOI	10.1007/s11060-024-04633-2
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