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PubMed | University of Vienna, Otto Von Guericke University of Magdeburg, Universitatsklinik zu Cologne, Pediatric Endocrinology and 6 more.
Type: Journal Article | Journal: American journal of hypertension | Year: 2016

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.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.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/m(2)/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.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.


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.


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.


PubMed | Universitatsklinik zu Cologne and University of Cologne
Type: Journal Article | Journal: 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.


Hackl M.,Universitatsklinik zu Cologne | Wegmann K.,Universitatsklinik zu Cologne | Leschinger T.,Universitatsklinik zu Cologne | Borda A.,Universitatsklinik zu Cologne | Muller L.P.,Universitatsklinik zu Cologne
Obere Extremitat | Year: 2016

Background: Arthroscopic arthrolysis is a minimally invasive but technically demanding treatment option for elbow stiffness. Prospective clinical data are limited thus far. Objectives: The aim was to analyze the clinical short-term results of arthroscopic elbow arthrolysis and to evaluate factors predictive of the outcome. Materials and methods: 28 patients (16 men, 12 women) following arthroscopic arthrolysis were enrolled in this study. The VAS (visual analogue scale) score, range of motion (ROM), and DASH score were obtained preoperatively as well as 6 weeks and 12 months after surgery. Posttraumatic elbow stiffness was present in 15 cases, elbow stiffness was due to primary osteoarthritis in 10 cases and due to other reasons in 3 cases. Osteoarthritis was absent in 1 case, grade 1 osteoarthritis was present in 7 cases, grade 2 in 9 cases and grade 3 in 11 cases according to the Broberg and Morrey classification. Results: The VAS score was 5.3 ± 2.4 points preoperatively and decreased to 2.8 ± 2.7 points after 6 weeks and 1.6 ± 1.8 points after 12 months (p ≤ 0.001). The ROM increased from 86± 30° to 106± 28° after 6 weeks and to 121± 18° 12 months postoperatively (p ≤ 0.01). The DASH score improved from 39.3 ± 17.8 points to 23.8 ± 15.7 points after 6 weeks and to 11.3 ± 8.7 points 12 months postoperatively (p ≤ 0.001). Sex, age, grade of osteoarthritis and cause of elbow stiffness were not predictive of the clinical outcome. Complications were seen in 2 patients (7 %). Conclusions: Arthroscopic arthrolysis represents an effective treatment method for elbow stiffness, which increases the range of motion, decreases pain levels and thus improves the functionality of the affected extremity regardless of sex, age, severity of osteoarthritis and etiology of elbow stiffness. © 2016 Springer-Verlag Berlin Heidelberg


Leschinger T.,Universitatsklinik zu Cologne | Muller L.P.,Universitatsklinik zu Cologne | Hackl M.,Universitatsklinik zu Cologne | Wegmann K.,Universitatsklinik zu Cologne
Obere Extremitat | Year: 2016

Elbow stiffness usually occurs after elbow trauma. Depending on the patient’s demands, even a small loss of motion can lead to severe functional limitations of the elbow joint which are likely to substantially reduce the quality of life. If conservative treatment does not provide a satisfying result, arthrolysis of the stiff elbow can be performed either arthroscopically or using an open approach (with external fixation) or distraction arthroplasty. This article discusses the etiology and treatment options for elbow stiffness and the different arthrolysis techniques with their indications and results. © 2016 Springer-Verlag Berlin Heidelberg


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.


Vollbrecht C.,Universitatsklinik zu Cologne | Konig K.,Universitatsklinik zu Cologne | Heukamp L.,Universitatsklinik zu Cologne | Buttner R.,Universitatsklinik zu Cologne | Odenthal M.,Universitatsklinik zu Cologne
Pathologe | Year: 2013

Lung cancer is one of the most frequent malignancies in the western world. Its frequent association with a wide spectrum of mutations in genes encoding various signal transducers that are often linked to therapy response, emphasizes the obvious need for improved, fast and highly efficient approaches in molecular pathology. Comprehensive analyses of the mutation status of progression and therapy relevant genes can be performed by the novel sequencing forms named next generation sequencing (NGS) providing extremely high capacities for ultra-deep sequence analyses. The 454 pyrosequencing method, the sequencing by synthesis and the semiconductor sequencing platform are now available for parallel sequencing approaches of multitudinous target genes linked to multiple tumor DNA applications. The "one molecule, one clone, one read" principle by the NGS approaches supplies not only information on allele frequencies and mutation rates but also has the advantage of a very sensitive detection of low frequency variants. © 2013 Springer-Verlag Berlin Heidelberg.


Hackl M.,Universitatsklinik zu Cologne | Wegmann K.,Universitatsklinik zu Cologne | Bartsch V.,Universitatsklinik zu Cologne | Ries C.,Universitatsklinik zu Cologne | And 2 more authors.
Obere Extremitat | Year: 2014

Background: Double-plate osteosynthesis has to be considered the gold standard for treating complex distal humeral fractures in adults. Impingement of the posterolateral plate with the olecranon or the radial head in extension of the elbow joint is a possible complication after double-plate osteosynthesis with a 90° configuration, especially after olecranon osteotomy.Objectives: The goal of this study was to analyze the positioning of the posterolateral humeral plate in order to define guidance values for intraoperative application.Methods: The positioning of the posterolateral humeral plate in relation to the olecranon in full extension of the elbow joint was analyzed in 71 dissected upper extremities of cadavers. Values on the cadavers were measured under image-intensifier control (distal olecranon impingement line) that can be reproduced intraoperatively.Results: The average distance between the distal edge of the plate and junction of cartilage and bone at the capitulum humeri was 4.8 mm (SD ± 1.2 mm). The average distances from the medial border of the plate to the lateral border of the olecranon fossa and to the lateral epicondyle were 2.5 mm (SD ± 0.9 mm) and 22.7 mm (SD ± 2.4 mm), respectively. The distal olecranon impingement line averaged 5.2 mm (SD ± 1.5 mm) on the left and 7.2 mm (SD ± 1.4 mm) on the right side of cadavers.Conclusions: The measured values offer landmarks for correct positioning of the posterolateral humeral plate. The distance between the lateral border of the olecranon fossa and the medial edge of the posterolateral plate as well as the proximal end of the distal olecranon impingement line should be respected in order to avoid impingement. If possible, the posterolateral plate should be placed at least 4.3 mm lateral to the radial edge of the olecranon fossa so that impingement can be successfully avoided. © 2014, Springer-Verlag Berlin Heidelberg.


PubMed | Universitatsklinik Zu Cologne and Abteilung Radiologie
Type: Case Reports | Journal: 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 patients symptoms. This case report discusses the clinical, diagnostic and therapeutic features of IFI.

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