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Stuttgart Mühlhausen, Germany

Bazner H.,Klinikum Stuttgart
Progress in Brain Research | Year: 2015

Georg Friedrich Händel was not only one of the greatest musical giants ever but also he was probably the first composer who was also the manager and promoter of his own works. Various myths embellish his various biographies. This is also true for his pathography: several articles written by authors from various specialties suggested him having suffered from psychiatric diseases, like cyclothymia or mania, and rheumatologic disorders, like arthritis, while others tended to interpret his recurrent palsies as typical sequelae of ischemic strokes. More recently, reports proposing lead poisoning as the main source of disease in Händel gained the attention of musical and lay press. During his last years of life, Händel was struck with blindness, which in his era had been interpreted as being due to cataracts. This led to three "coucher" operations, all of them without any lasting effect. Although a definite diagnosis cannot be proven from the original sources, the most plausible explanation for Händel's palsies and visual impairment may be based on one single context, i.e., cerebrovascular disease. The possible differential diagnosis will be discussed in this chapter. © 2015 Elsevier B.V. Source


Ludwig-Seibold C.U.,Oberschwabenklinik GmbH | Holder M.,Klinikum Stuttgart | Rami B.,Medical University of Vienna | Raile K.,Charite - Medical University of Berlin | And 2 more authors.
Pediatric Diabetes | Year: 2012

Objective: To determine frequency, duration, and relationship of continuous glucose monitoring (CGM) to glycemic control and rate of hypoglycemia in children and adults in Germany and Austria. Research design and methods: From 59 920 patients documented in the DPV (Diabetessoftware zur prospektiven Verlaufsdokumentation) database, 144 385 sensor days of 2874 patients using CGM between January 2008 and September 2010 were analyzed. Results: Overall, 4.8% of patients used CGM. In pediatric patients, study period (p = 0.0309), age (p = 0.0140), insulin dose (p < 0.0001), and use of insulin analogs (p < 0.0001) significantly influenced hemoglobin A1c (HbA1c), but duration of diabetes, sex, and CGM use did not. In contrast, adults with longer CGM use (>30 d) had significantly lower HbA1c (p < 0.0016). Severe hypoglycemia was not reduced in patients using CGM for <30 d. Conclusions: CGM is still rarely used in Germany and Austria. CGM use is associated with a significant reduction of HbA1c in adults but not in children. Hypoglycemic events were not reduced, irrespective of age. © 2011 John Wiley & Sons A/S. Source


Wiemer-Kruel A.,Epilepsy Center Kork | Woerle H.,Klinikum Stuttgart | Strobl K.,Epilepsy Center Kork | Bast T.,Epilepsy Center Kork
Neuropediatrics | Year: 2014

We are reporting on a 13.5-year-old girl with tuberous sclerosis complex (TSC) who was treated with everolimus because of giant cell astrocytoma and bilateral angiomyolipoma. She suffered from pharmacoresistant partial epilepsy with clusters of tonic and tonic-clonic seizures. Treatment with carbamazepine and sulthiame had led to a stable situation for more than 2.5 years. The dosage of everolimus had to be increased and refractory status epilepticus followed after 12 days. In the absence of any other possible cause, we believe that the status epilepticus was provoked by everolimus. So far, only a few cases of possible seizure aggravation by everolimus have been reported. The clinical relevance of possible negative effects in epileptic patients remains unclear. Similar observations should be documented and reported. © 2014 Georg Thieme Verlag KG. Source


Burgy M.,Klinikum Stuttgart
Nervenheilkunde | Year: 2012

The recent developments in social psychiatry with de-hospitalisation, i.e. the move away from hospital care for people with chronic mental disorder, the closure of long-term hospital units and the development of community psychiatric services, have reached a provisional conclusion. The successes of these developments must not, however, deceive us into believing that all there are no more problems to be overcome. We have not succeeded, for example, in completely moving away from hospital care for the elderly with chronic mental disorder. These patients have in the main simply been transferred into care homes which are further away from the patients' own homes and where the care is provided by less well qualified staff. There is also a group of younger people with chronic mental health problems which is characterised by a rising number of in-patient admissions to hospital as well as increased rates of suicidal tendencies, criminality and readiness to resort to violence. It is becoming clear that further developments in social psychiatry will above all have to be aimed at providing a closer and more effective integration of community and hospital psychiatric services than has been achieved so far. © Schattauer 2012. Source


Kniesel B.,Klinikum Stuttgart | Huth J.,Sportklinik Stuttgart | Bauer G.,Sportklinik Stuttgart | Mauch F.,Sportklinik Stuttgart
Archives of Orthopaedic and Trauma Surgery | Year: 2014

Purpose: In recalcitrant epicondylitis innumerable operative techniques have been published, nevertheless a certain percentage of patients remains symptomatic after operative treatment. We developed an individual, systematic diagnostic pathway including arthroscopic assessment of elbow stability to identify the optimal and respectively less invasive therapy.Methods: We so far included 40 patients with recalcitrant lateral epicondylitis (mean age 46 ± 11). 5 patients had previous surgery. In all patients, we did an elbow arthroscopy and a systematic arthroscopic stability testing. 25 patients were treated exclusively arthroscopically once instability was excluded. In 13 patients with slight instability, we did an open debridement of the lateral tendon complex and local refixation. Two patients with severe instability were treated with open debridement and additional stabilization of the LUCL with a trizeps graft. With a minimum follow-up of 1 year, we assessed the DASH score and subjective patient satisfaction.Results: Mean follow-up was 24 ± 12 months, mean duration of symptoms before surgery was 19 ± 18 months. The mean DASH score at follow-up was 22 ± 19.36 patients reported symptoms improvement, 34 patients would repeat surgery given the same situation; in 30 cases, patients expectations had been fulfilled. We did not observe any intraoperative complications or infections. One patient developed joint stiffness requiring reoperation.Conclusion: Using a systematic diagnostic pathway including assessment of elbow stability and consecutive individualized, respectively, less invasive surgical procedure we acquired high patients satisfaction and good clinical outcome with a low complication rate.Level of evidence: Level III. © 2014, Springer-Verlag Berlin Heidelberg. Source

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