S U M M A R YThe epidermal growth factor receptor (EGFR) is highly expressed in a variety of solid malignant tumors and its expression has been correlated with disease progression and poor survival. With the advent of targeted therapies, especially IMC-C225 (Cetuximab), a monoclonal antibody (MAb) directed against the EGFR, there is an increasing interest in immunohistochemistry (IHC)-based EGFR screening methods using paraffin-embedded tumor specimens to select cancer patients eligible for treatment with Cetuximab. With the EGFRpharmDX kit, a complete assay for demonstration of EGFR is now available. Because no information about the preservation of the EGFR under various conditions of fixation is available, we performed a prospective study on a panel of commonly used fixatives to determine optimal tissue preservation protocols. The stability of the epitope on cut tissue sections stored for a period up to 24 month was also tested using material originating from patients with head and neck cancer, non-small-cell lung carcinomas, and colorectal adenocarcinomas. Depending on the fixative used and the time of storage of cut tissue sections, a variation in the determined level of EGFR expression was demonstrated compared with the most optimal fixation procedure.

Renal cell carcinomas (RCCs) of the clear cell type are associated with alteration of the von Hippel-Lindau (VHL) tumour suppressor gene as well as subsequent stabilization and over-expression of hypoxia inducible factor (HIF), which causes up-regulation of cyclin D1. On the basis of their ability to interact with cyclin D1 we investigated a number of cell cycle proteins to shed further light on the downstream effects of HIF dysregulation. Expression of HIF1alpha, cyclin D1, cyclin-dependent kinase 4 and cyclin-dependent kinase inhibitors p16, p21 and p27 was studied by immunohistochemistry. Since NFkappaB1/RelA have been shown to bind to the cyclin D1 promoter, mRNA expression of these transcription factors was further analysed by quantitative PCR. In RCCs harbouring VHL mutations/hypermethylation, over-expression of HIF1alpha was parallelled by up-regulation of cyclin D1 and CDK4 and down-regulation of p21 and p27. Moreover, p27 expression was inversely correlated with tumour cell differentiation. Comparison of non-tumorous autologous kidney tissues revealed a significant down-regulation of NFkappaB1 mRNA expression in patients harbouring RCC with VHL mutations/hypermethylation. Our data support the notion of a link between VHL deficiency/HIF dysfunction and disturbances of cell cycle control in the tumorigenesis of VHL-negative RCC.

Background Although climbing is an increasingly popular sport, there is a lack of scientific evaluation of suitable training methods for climbers, especially with a view to prevention and rehabilitation. A specific rehabilitation program, Adjunct Compensatory Training (ACT), has recently been presented, but it has not been evaluated scientifically to date. Objective To investigate the effects of Adjunct Compensatory Training on climbing-specific overstrain syndromes of the shoulder. Methods Twenty active boulderers and climbers with an average age of 28.9 (± 7.4) years performed a guided shoulder program of six specific exercises from the ACT program over a period of four weeks. They were examined before and after the intervention. Pre- and post-interventional measurements included the Constant-Murley Score, the QuickDASH Score and the measurement of shoulder ROM (range of motion). Results The Constant-Murley Score increased from 82 (± 10.0) to 104.1 (± 8.2) at follow-up (p < 0.001). The VAS value for bouldering and climbing decreased from 5.25 (± 1.4) before to 2.4 (± 1.6) after the intervention (p < 0.001). Shoulder flexion increased from 167.5 (± 14.9) to 173.1 (± 7.7) after the intervention (p < 0.05), abduction from 172.5 (± 14.9) to 179.6 (± 5.9) (n. s.), external rotation from neutral zero position from 77.6 (± 16.8) to 86.3 ± (8.3) (p < 0.05). Feasibility and acceptance of the intervention were good. Ninety-five percent of the participants continued to exercise, and 100 percent recommended the program to others. Conclusion The ACT led to an improvement in pain, activities of daily living, range of motion and strength in boulderers and climbers with overstrain symptoms of the shoulder. It is also classified as a realistically feasible workout. The extent to which this effect will continue, and whether or not the program can prevent injuries, remains to be seen. It can only be presumed that regular exercises prevent shoulder injuries in the climbing population.

Zusammenfassung Ziel Ziel des Artikels ist es, zentrale Ergebnisse aus der landesweiten Studie zum Verbleib der Absolventen aus den 12 Modellstudiengängen in den Gesundheitsfachberufen in Nordrhein-Westfalen zu referieren. Untersuchungsziel der Studie ist es, den beruflichen Verbleib nach dem Abschluss eines berufsqualifizierenden Modellstudiums zu beschreiben und Merkmale sowie Rahmenbedingungen der beruflichen Situation darzustellen. Im Mittelpunkt des Artikels stehen Erkenntnisse zu den Merkmalen der Haupterwerbstätigkeit der Absolventen und zur Anwendung der im Studium vermittelten Kompetenzen im Berufsalltag. Methodik Insgesamt 515 Absolventen aus den Modellstudiengängen Pflege (N=244), Physiotherapie (N=97), Logopädie (N=95), Ergotherapie (N=47) und Hebammenkunde (N=32) haben sich im Frühsommer 2018 an einer Online-Querschnitt-Befragung beteiligt. In die Befragung eingeschlossen waren alle Abschlussjahrgänge zwischen Wintersemester 2013/2014 und Sommersemester 2017. Ergänzend wurden Arbeitgeber (N=109) befragt, die Absolventen aus den genannten Studiengängen eingestellt haben. Ergebnisse Die Absolventen sind v. a. im Krankenhaus und in ambulanten Therapiepraxen tätig. Acht von 10 Absolventen (84%) erbringen vornehmlich klientennahe Aufgaben. 71% dieser klientennah arbeitenden Absolventen erbringen im Vergleich zu fachschulisch ausgebildeten Personen ergänzend besondere Aufgaben. Die Absolventen schätzen sich in allen untersuchten Kompetenzdimensionen durchschnittlich als handlungssicher ein. Die Arbeitgeber nehmen in allen Kompetenzdimensionen bei den Absolventen einen „Kompetenzvorsprung“ im Vergleich zu fachschulisch Ausgebildeten wahr. Schlussfolgerungen Die Resultate der Verbleibstudie unterstützen die Empfehlung, die Studiengänge aller untersuchten Gesundheitsfachberufe berufsgesetzlich zu verankern und ihren Regelbetrieb an den Hochschulen einzuführen.

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