615 Pharmakologie, Therapeutik
Smoking remains a prominent preventable health risk in Germany, creating a need for effective cessation interventions. Digital smoking cessation interventions (DSCIs) present promising support for individuals aiming to quit, yet their utilization and acceptance are not thoroughly understood. This study analyzes usage patterns and acceptance levels of DSCIs among smokers, occasional smokers, and former smokers in Germany, focusing on user behavior, acceptance determinants, and the influence of prescription and reimbursement status. An online questionnaire based on the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) model was administered to participants. Data were collected through recruitment via social media, email lists, counseling groups, and public postings. The responses were analyzed using SPSS. The study included 173 participants (61.85% female, 37.57% male, 0.58% diverse) with an average age of 35.28 years. They reported smoking for an average of 18.21 years and attempting cessation 3.42 times. Among respondents, 41.62% had used DSCIs, predominantly former smokers (54.17%) and women (79.17%), with the “Smoke Free” app being the most utilized intervention. Although 73.05% expressed willingness to (re)use DSCIs, actual usage showed moderate acceptance levels. Significant predictors of acceptance included willingness to pay (p = 0.013), self-efficacy (p = 0.018), and physician prescription with clinical evidence (p = 0.019). The results highlight a rising demand for digital solutions focused on long-term smoking cessation, particularly among middle-aged women, emphasizing the need for a deeper understanding of acceptance drivers and model expansions to address healthcare dynamics.
This study investigates the antimicrobial potential of an indirect cold plasma method for the treatment of wounds. Indirect plasma methods differ from direct methods in that the cold plasma does not come into direct contact with the surface to be treated. The indirect plasma method described here has been implemented in the PLASMOHEAL device. The device generates an aerosol of liquid particles, which is conditioned with plasma reaction products and passed over the areas to be treated without contact. In vitro tests show a significant germ reduction of 3.4 to 4.5 log levels against various microorganisms. In vivo tests on volunteers demonstrate a reduction in E. coli contamination of 4.06 to 5.15 log levels. These results show that indirect plasma methods can achieve equivalent effects to direct methods. The highly effective, pain-free treatment at moderate costs make the indirect plasma method a promising option in modern wound care.
Objective: Rural–urban disparities in cancer care are well documented. However, research on rural–urban disparities regarding patient‐reported outcomes (PROs) is still developing. This study analyzed rural–urban disparities in patients with cancer with respect to anxiety, depression, fatigue, pain interference, and physical function.
Methods: This study was conducted at the University of Utah Huntsman Cancer Institute. We integrated data from electronic health records, Cancer Registry, and PRO questionnaires. We assessed the association between rurality status (rural vs. urban) in patients with cancer and PRO scores using multiple linear regression models and t‐tests.
Results: The cohort included 7271 patients. The mean age was 59.1 years at cancer diagnosis and 48.2% (n = 3505) were female. Across all cancer types, significant differences (Rural vs. Urban) were found for fatigue (53.6 vs. 54.1; p < 0.05) and physical function (45.5 vs. 45.1; p < 0.05). With respect to specific cancer types, there were differences in patients with oral cavity and pharynx cancer for depression (47.9 vs. 50.6; p < 0.01), fatigue (51.6 vs. 54.8; p < 0.05), pain interference (52.8 vs. 55.4; p < 0.05), and physical function (48.0 vs. 44.6; p < 0.01), colorectal cancer for fatigue (56.8 vs. 54.7; p < 0.05), pain interference (56.0 vs. 53.7; p < 0.05), and physical function (42.2 vs. 44.4; p < 0.05), uterus cancer for depression (47.5 vs. 50.5; p < 0.05) and fatigue (51.6 vs. 54.7; p < 0.05), and lung cancer for physical function (37.6 vs. 39.3; p < 0.05).
Conclusions: Across all cancer types, as well as specific cancers, this study found mostly limited rural–urban differences regarding PROs. Except for colorectal and lung/bronchus cancer, patients living in rural areas reported similar or better PRO scores for all cancer types. Results support the hypothesis that improving access can help to level rural–urban disparities regarding cancer care outcomes, because all patients were treated in the same comprehensive cancer center, had similar access to care, and had similar PRO scores.
Thecaloscopy Reduces the Risk of Recurrent Perineural (Tarlov) Cysts after Microsurgical Resection
(2024)
Sacral Tarlov cysts (TCs), often asymptomatic, can cause significant pain and severe neurological dysfunction. Conventional treatments are generally associated with high recurrence and complication rates. Specifically, the substantial recurrence rates, which can reach as high as 50%, significantly impact long-term outcomes. Recent evidence increasingly supports the hypothesis that the formation of Tarlov cysts (TCs) may be associated with inflammatory processes within the nerve root sheath, further exacerbated by elevated cerebrospinal fluid (CSF) pressure. This retrospective study explores thecaloscopy, combined with surgical techniques, as a more effective alternative. We observed a total of 78 patients, 48 of whom underwent endoscopic fenestration of the arachnoid sheath in addition to microsurgical resection of the TC. We found that the fenestration of the arachnoid sheath at the level of lumbosacral spinal nerve root entry led to a significantly decreased risk of developing recurrent TCs (5/48 vs. 9/30). Only one of the patients suffered from a persistent new bladder dysfunction after microsurgical resection. This presented technique provides a promising treatment path for the future management of TCs, offering a safe and more effective treatment option compared to previous methods. Additionally, the advantages of the thecaloscopy provide pathophysiological implications regarding the development of perineural cysts.
This case report presents the therapeutic effect of restorative neurostimulation (ReActiv8®) on chronic low back pain (CLBP) in a 44-year-old male, where the primary etiology was not lumbar disc herniation (LDH). Despite presenting with LDH at L4-L5, clinical valuations suggested lumbar microinstability and multifidus muscle dysfunction as the main contributors to his pain, without radicular symptoms. The patient had a 12-year history of CLBP, resistant to conventional treatments like physiotherapy, medications, and epidural injections. Opting for a minimally invasive approach, he underwent implantation of ReActiv8®, focusing on rehabilitating the impaired multifidus muscle. Over a 12-month therapy period, significant improvements were noted in pain levels, functionality, and quality of life, leading to a full return to work. Interestingly, follow-up imaging showed not only a substantial reduction in pain but also an unexpected resolution of the LDH at L4-L5, enhanced lumbar lordosis, and improved disc hydration, despite minor progressing Modic changes. This case underlines the potential of restorative neuro-stimulation in CLBP management, especially when the pain origin is non-discogenic. It emphasizes the importance of accurate pain source identification in CLBP treatment and suggests further research into the efficacy and applicability of neurostimulation in similar clinical scenarios.
