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Bad Wildungen, Germany

Patschan D.,Universitatsmedizin Gottingen | Jehle P.M.,Martin Luther University of Halle Wittenberg | Van Ophoven A.,Klinik fur Neuro Urologie | Hansen H.-C.,Klinik fur Neurologie und Psychiatrie | And 3 more authors.
Nieren- und Hochdruckkrankheiten | Year: 2014

The acid base equilibrium is one of the most strictly regulated systems of the human body - even the slightest deviation of blood pH may lead to critical medical situations with a potentially fatal outcome. However, it is more and more recognized that it is the unspectacular, sub-acute acidosis that has a substantial impact on the course of chronic diseases. One major reason for this development is the sustaining nephroprotective effect of the most important buffer, bicarbonate, in patients with chronic kidney disease. In order to discuss the latest findings related to chronic metabolic acidosis (cma), an expert group met in September 2013 in Frankfurt. © 2014 Dustri-Verlag Dr. Karl Feistle. Source


Wefer B.,Universitatsklinikum Schleswig Holstein | Ehlken B.,IMS Health | Bremer J.,Neurologisches Rehabilitationszentrum Greifswald GmbH | Burgdorfer H.,Neuro urologische Abteilung | And 7 more authors.
World Journal of Urology | Year: 2010

Purpose: To evaluate treatment outcomes and resource consumption of patients with neurogenic detrusor overactivity (NDO) before and after botulinum toxin A (Botox®) therapy in Germany. Methods: In a multi-center, cross-sectional, retrospective cohort study, data of patients with NDO 12 months before and after the first Botox® therapy were analyzed. Results: 214 patients (mean age 38 ± 14.8 years, 145 male, 69 female) with NDO due to spinal cord injury (81%); myelomeningocele (14%), or Multiple Sclerosis (5%) from seven hospitals were included. Mean interval between treatments was 8 months. Following treatment, mean maximum detrusor pressure, maximum cystometric capacity and detrusor compliance improved significantly. Prior to Botox® therapy, 68% reported urinary tract infections (UTI), 63% had incontinence episodes, and 58% used incontinence aids. These numbers decreased significantly (p < 0.05) after treatment to 28, 33, and 28%, respectively. In patients using incontinence aids, mean costs per patient decreased from €2 to €1 per day, whereas the mean cost of drugs to treat UTIs per patient decreased from €163 to €80 per year, respectively. Conclusion: This is the first study demonstrating the clinical usefulness of Botox® therapy in clinical practice. Successful treatment resulted in lower costs for NDO associated morbidity due to less need for incontinence aids and UTI medication. © 2009 Springer-Verlag. Source


Domurath B.,Klinik fur Neuro Urologie | Kutzenberger J.,Klinik fur Neuro Urologie
Urologe - Ausgabe A | Year: 2012

Modern treatment methods for neurogenic bladder dysfunction take into consideration the primacy of obtaining good bladder storage capacity by merely lowering the leak point pressure. The medical benefit for the patient is seen in the stability of renal function and the social advantage in achieving continence. The development of modern findings on the management of neuro-urological disorders in spinal cord injury as well as the underlying principles, indications, and benefits of the most frequently applied treatment approaches are described. © Springer-Verlag 2012. Source

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