Days spent in acute care hospitals at the end of life of cancer patients in four Swiss cantons: a retrospective database study (SAKK 89/09).

Number of days spent in acute hospitals (DAH) at the end of life is regarded as an important care quality indicator for cancer patients. We analysed DAH during 90 days prior to death in patients from four Swiss cantons. Claims data from an insurance provider with about 20% market share and patient record review identified 2086 patients as dying of cancer. We calculated total DAH per patient. Multivariable generalised linear modelling served to evaluate potential explanatory variables. Mean DAH was 26 days. In the multivariable model, using complementary and alternative medicine (DAH = 33.9; +8.8 days compared to non-users) and canton of residence (for patient receiving anti-cancer therapy, Zürich DAH = 22.8 versus Basel DAH = 31.4; for other patients, Valais DAH = 22.7 versus Ticino DAH = 33.7) had the strongest influence. Age at death and days spent in other institutions were additional significant predictors. DAH during the last 90 days of life of cancer patients from four Swiss cantons is high compared to most other countries. Several factors influence DAH. Resulting differences are likely to have financial impact, as DAH is a major cost driver for end-of-life care. Whether they are supply- or demand-driven and whether patients would prefer fewer days in hospital remains to be established.

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 89 - Brief über die Freundschaft mit Schopenhauer

veröffentlicht in: Schopenhauer, Arthur : Arthur Schopenhauers sämtliche Werke - München : Piper - Bd. 14 : Der Briefwechsel Arthur Schopenhauers ; 1 (1799 - 1849), Nr. 20;

Na 1 Nachlass Max Horkheimer, 76 - Korrespondenzen u.a. mit Hermann Igersheimer (p. II 9, 89-222c)

1 Brief und Beilage vom Institut für sozialwissenschaftliche Forschung Darmstadt an Max Horkheimer, 1949; 82 Briefe zwischen Hermann Igersheimer und Max Horkheimer, 1941-1950; 5 Briefe zwischen Harold E. Jones von der University of California und Max Horkheimer, 1947; 1 Brief von Morris Janowitz an Max Horkheimer, 1948; 2 Briefe vom Jewish Community Center an Max Horkheimer, 1948; 7 Briefe zwischen Robert P. St.John und Max Horkheimer, 1945; 2 Briefe zwischen Erich von Kahler und Max Horkheimer, 1945; 2 Briefe und Beilage zwischen Anselm Kahn und Max Horkheimer, 04.07.1945, 19.07.1945;

Na 1 Nachlass Max Horkheimer, 302 - Korrespondenzen u.a. mit Arthur Hübscher (p. V 89, 51-199)

83 Briefe und Beilagen zwischen Arthur Hübscher und Max Horkheimer, 1963-1973; 15 Briefe und Beilagen zwischen Bundesminister a. D. Ewald Bucher und Max Horkheimer, 1966-1971; 1 Brief und Beilage von Dr. Christoph Meyer an Max Horkheimer, 1969; 6 Briefe zwischen Dr. Johann Joeden und Max Horkheimer, 1966; 5 Briefe zwischen dem Oberregierungsrat Gustav Adolf Hünniger und Max Horkheimer, 1951-1953; 2 Briefe und eine Empfehlung und ein Gutachten von Edith Hünniger an Max Horkheimer, 1952-1953;

Ms. Praed. 89 - Tabula Decretalium et Sexti

Vorbesitzer: Dominikanerkloster Frankfurt am Main

Ms.Ff.F.Stoltze 3. 89 - Brief von Johann Friedrich Gerhard an Friedrich Stoltze

Persönliche Nachrichten, Stoltze, Alexander Gwinner

Ausst. 89 - Die Leidenswerkzeuge Christi, das Heilige Grab mit Magdalena und zwei Heilige

Vorbesitzer: Augustinerkloster Mariastein bei Eichstätt; Bartholomaeusstift Frankfurt am Main;

Ms. lat. qu. 89 - Pitture in S. Calisto di Roma

Vorbesitzer: Michelangelo Gualandi;

Tumor heterogeneity dictates sensitivity to gefitinib (Iressa(TM)/ZD1839) in solid tumor models

The epidermal growth factor receptor (EGFR) and its ligands are overexpressed in many human tumors, including bladder and pancreas, correlating with a more aggressive tumor phenotype and poor patient prognosis. We initiated the present study to characterize the heterogeneity of gefitinib responsiveness in a panel of human bladder and pancreatic cancer cell lines in order to identify the biological characteristics of EGFR-dependent proliferation that could be used to prospectively identify drug-sensitive tumors. A second objective was to elucidate how to best exploit these results by utilizing gefitinib in combination therapy. To these ends, we examined the effects of the EGFR antagonist gefitinib on proliferation and apoptosis in a panel of 18 human bladder cancer cell lines and 9 human pancreatic cancer cell lines. Our data confirmed the existence of marked heterogeneity in Iressa responsiveness with less than half of the cell lines displaying significant growth inhibition by clinically relevant concentrations of the drug. Gefitinib responsiveness was found to be p27 kip1 dependent as DNA synthesis was restored following exposure to p27siRNA. Unfortunately, Iressa responsiveness was not closely linked to surface EGFR or TGF-α expression in the bladder cancer cells, however, cellular TGF-α expression correlated directly with Iressa sensitivity in the pancreatic cancer cell lines. These findings provide the potential for prospectively identifying patients with drug-sensitive tumors. ^ Further studies aimed at exploiting gefitinib-mediated cell cycle effects led us to investigate if gefitinib-mediated TRAIL sensitization correlated with increased p27kip1 accumulation. We observed that increased TRAIL sensitivity following gefitinib exposure was not dependent on p27 kip1 expression. Additional studies initiated to examine the role(s) of Akt and Erk signaling demonstrated that exposure to PI3K or MEK inhibitors significantly enhanced TRAIL-induced apoptosis at concentrations that block target phosphorylation. Furthermore, combinations of TRAIL and the PI3K or MEK inhibitors increased procaspase-8 processing above levels observed with TRAIL alone, indicating that the effects were exerted at the level of caspase-8 activation, considered the earliest step in the TRAIL pathway. ^

Petrology and geochemistry at DSDP Site 89-462

The 16 samples of Deep Sea Drilling Project (DSDP) Leg 89 basalts that we analyzed for whole rock major and trace elements and for mineralogic compositions are identical to some of the basalts recovered during Leg 61. Leg 89 samples are mostly olivine-plagioclase-clinopyroxene sparsely phyric basalts and exhibit a wide variety of textures. These basalts have lower TiO2 at a given Mg/(Mg+Fe2+)*100 than MORB (midocean ridge basalt). We recognize three major chemical types of basalts in the Nauru Basin. We believe that different degrees of partial melting, modified by fractional crystallization and possibly by magma mixing at shallow depths, can explain the chemical differences among the three groups. This petrogenetic model is consistent with the observed downhole chemical-chronostratigraphic relations of the samples. New 87Sr/86Sr and U3Nd/144Nd analyses of basalt samples from DSDP Site 462 indicate that the Nauru Basin igneous complex is within the Sr-Nd isotopic range of ocean island basalt. Thus the Nauru Basin igneous complex resembles MORB in many aspects of its chemistry, morphology, and secondary alteration patterns (Larson, Schlanger, et al., 1981), but not in its isotopic characteristics. If it were not for the unambiguous evidence that the Nauru Basin complex was erupted off-ridge, the complex could easily be interpreted as normal oceanic layer 2. For this reason, we speculate that the Nauru Basin igneous complex was produced in an oceanic riftlike environment when multiple, fast-propagating rifts were formed during the fast seafloor spreading episode in the Cretaceous.