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Steinau an der Straße, Germany

Bonfig W.,TU Munich | Roehl F.-W.,Otto Von Guericke University of Magdeburg | Riedl S.,University of Vienna | Dorr H.G.,Friedrich - Alexander - University, Erlangen - Nuremberg | And 7 more authors.
American Journal of Hypertension | Year: 2016

BACKGROUND Data on blood pressure (BP) in children and adolescents with classic congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency are conflicting in the literature. PATIENTS AND METHODS BP data of n = 716 children and adolescents (aged 3-18 years) from a national CAH database were analyzed. BP data were adjusted for height and compared to contemporary national reference data. A systolic and diastolic BP above the 95th centile was defined as hypertensive. RESULTS Overall prevalence of hypertension was 12.5%. Prevalence of hypertension was higher in younger children than in adolescents (18.5% vs. 4.9%). Until 8 years of age, fludrocortisone dose/m2/day correlated significantly with BP in regression analysis (P < 0.0001). BP correlated significantly with body mass index standard deviation score (BMI-SDS) (P < 0.0001), but not with hydrocortisone dose. In patients with salt-wasting CAH, BMI-SDS and BP were significantly higher compared to patients with simple virilising CAH, P < 0.01. CONCLUSION Especially young CAH children seem to be at risk for - most likely transient - hypertension, since the prevalence of hypertension decreases with age. In children up to 8 years of age, the used fludrocortisone dose is a significant risk factor for hypertension. Therefore we recommend accurate measurement of BP and careful fludrocortisone dosing in children with CAH. © American Journal of Hypertension, Ltd 2015. Source

Mader N.,Universitatsklinik zu Cologne | Rudolph T.,University of Cologne | Baldus S.,University of Cologne | Wahlers T.,Universitatsklinik zu Cologne
Herz | Year: 2016

Transcatheter aortic valve implantation (TAVI) has become an established treatment for symptomatic aortic valve stenosis in inoperable patients and high-risk patients. In Germany the TAVI procedure has now surpassed the annual numbers of isolated surgical aortic valve replacement with a recent trend towards treatment of intermediate-risk patients; however, before TAVI can also be used in patients with lower surgical risk, studies are required to demonstrate the safety and efficacy of this method for this patient population. © 2016, Springer Medizin Verlag. Source

Hackl M.,Universitatsklinik zu Cologne | Trost M.,Universitatsklinik zu Cologne | Boese C.K.,Universitatsklinik zu Cologne | Muller D.,Abteilung Radiologie | And 2 more authors.
Zeitschrift fur Orthopadie und Unfallchirurgie | Year: 2016

Ischiofemoral impingement (IFI) is a rare cause of hip pain and was first described in 1977. While it can be related to trauma, it may also be idiopathic. We report a case of IFI in a 22-year old female, who was successfully treated by resection of the lesser trochanter. However, 8 months later, symptoms recurred on the contralateral side. Surgical intervention was required to alleviate the patient's symptoms. This case report discusses the clinical, diagnostic and therapeutic features of IFI. © Georg Thieme Verlag KG. Source

Hackl M.,Universitatsklinik zu Cologne | Hackl M.,University of Cologne | Wegmann K.,Universitatsklinik zu Cologne | Wegmann K.,University of Cologne | And 6 more authors.
Journal of Marine Science and Technology (Japan) | Year: 2015

Background: Currently available radial head prostheses reproduce the variable anatomy of the proximal radius only to a limited extent. This could influence the anatomy and kinematics of the proximal radioulnar joint (PRUJ), which has not yet been fully investigated. Objectives: The aim was to analyze the native joint congruity of the PRUJ depending on forearm rotation and to compare the results to the joint congruity after monopolar radial head replacement. Materials and methods: A total of 20 formalin-fixed elbow joint specimens were available for this study. Optosil putty impressions of the joint space of the PRUJs were obtained from the native specimens and following radial head replacement (MoPyC, Tornier, France) in neutral rotation, in 80° pronation and in 80° supination. Axial sections of these impressions were performed at the upper and lower borders as well as in the middle of the lesser sigmoid notch of the ulna. The respective joint spaces at the anterior edge, at the center and at the posterior edge of the PRUJ were then measured digitally. Results: The native radial head is centered within the lesser sigmoid notch in neutral rotation. It shifts anteriorly in pronation and posteriorly in supination, which also applies to the radial head implant; however, the anterior and posterior shift of the radial head replacement is significantly more pronounced which leads to a misalignment of the PRUJ with gaping of the joint space of up to 3 mm at either the anterior or posterior edge of the joint. Conclusion: Radial head prostheses reduce the contact area to the lesser sigmoid notch. This could lead to an imbalance of contact pressure in the PRUJ with subsequent development of osteoarthritis, which might cause pain and a decrease in range of motion. © 2015, Springer-Verlag Berlin Heidelberg. Source

Hackl M.,Universitatsklinik zu Cologne | Wegmann K.J.,Universitatsklinik zu Cologne | Muller L.P.,Universitatsklinik zu Cologne | Gohlke F.,Klinik fur Schulterchirurgie | Burkhart K.J.,Klinik fur Schulterchirurgie
Trauma und Berufskrankheit | Year: 2015

Elbow stiffness represents the most common complication after elbow trauma. The loss of motion may lead to severe restrictions for the patient. Operative release of a stiff elbow by arthrolysis is indicated when conservative treatment does not lead to a satsfactory result and depending on patient demands and needs. While open arthrolysis is still the gold standard in Germany especially for severe contractures, arthroscopic techniques are becoming more important. This article describes the various techniques for arthrolysis, the indications and results. © 2015, Springer-Verlag Berlin Heidelberg. Source

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