Universitatsklinikums Bonn

Bonn, Germany

Universitatsklinikums Bonn

Bonn, Germany

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Mohle F.,Universitatsklinikums Bonn | Ortmann J.,Universitatsklinikums Bonn | Miiller A.M.,des Universitatsklinikums Bonn | Kernbach-Wighton G.,Universitatsklinikums Bonn | Madea B.,Universitatsklinikums Bonn
Archiv fur Kriminologie | Year: 2017

The article reports on the case of a premature and stillborn child. As a first step it had to be clarified whether the child had been alive. The pathological examination of the placenta performed after autopsy could prove a retroplacental hematoma as the cause of death. Furthermore the autopsy revealed a severe skull deformity that would probably have made the survival of the child impossible.


Vilz T.O.,Universitatsklinikums Bonn | Pantelis D.,Universitatsklinikums Bonn | Kalff J.C.,Universitatsklinikums Bonn
Chirurgische Praxis | Year: 2013

Postoperative ileus is defined as a transient cessation of coordinated bowel motility after surgical intervention, which prevents effective transit of intestinal contents or tolerance of oral intake. This frequent postoperative complication is accompanied by a considerable increase in morbidity and hospitalization costs. Multiple pathophysiological mechanisms of postoperative ileus have been suggested, especially inflammatory, neurogenic and pharmacological. Clinical presentation is characterized by a lack of bowel sounds and varies between moderate discomfort and strong pain accompanied by abdominal distension, persistent nausea, vomiting and constipation of stool. Until today no prophylaxis or evidence based single approach has demonstrated the ability to influence postoperative ileus. Combining these parts to a multimodal treatment («fast-track» regime), there is a significant decrease in duration of postoperative ileus and a shortened hospital stay, which contributed to the success of «fast-track» surgery. Since this regimen is not appropriate for all patients and operations the aim must be to develop an easy feasible medical prophylaxis for postoperative ileus.


Diepenseifen C.J.,Universitatsklinikums Bonn | Heister U.,Universitatsklinikums Bonn | Schewe J.-C.,Universitatsklinikums Bonn
Notarzt | Year: 2011

The currently valid guidelines for resuscitation of the European Resuscitation Council (ERC) do not give any unambiguous recommendations for transport with ongoing cardiopulmonary resuscitation. Furthermore, up to now there are no generally accepted criteria for terminating cardiopulmonary resuscitation, apart from certain signs of death. In spite of the generally poor outcome of patients being transported with ongoing cardiopulmonary resuscitation, there are a number of positive case reports and undisputable indications (e.g., in cases with a potentially reversible cause of cardiac arrest). The increase observed over the past few years in the number of patients being transported under cardiopulmonary resuscitation has as yet not been reflected in an improved prognosis for these patients. The use of mechanical chest compression devices with a better quality of chest compression, also under transport conditions, may have an influence on the number transports but this has not yet been evaluated sufficiently with regard to patient outcome. However, the decision to transport a patient resides with the responsible emergency physician who has to evaluate the prognosis for the patient on an individual basis. © Georg Thieme Verlag KG Stuttgart.


Diepenseifen C.J.,Universitatsklinikums Bonn | Heister U.,Universitatsklinikums Bonn | Schewe J.-C.,Universitatsklinikums Bonn
Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie | Year: 2011

The currently valid guidelines for resuscitation of the European Resuscitation Council (ERC) do not give any unambiguous recommendations for "transport with ongoing cardiopulmonary resuscitation". Furthermore, up to now there are no generally accepted criteria for terminating cardiopulmonary resuscitation, apart from certain signs of death. In spite of the generally poor outcome of patients being transported with ongoing cardiopulmonary resuscitation, there are a number of positive case reports and undisputable indications (e.g., in cases with a potentially reversible cause of cardiac arrest). The increase observed over the past few years in the number of patients being transported under cardiopulmonary resuscitation has as yet not been reflected in an improved prognosis for these patients. The use of mechanical chest compression devices with a better quality of chest compression, also under transport conditions, may have an influence on the number transports but this has not yet been evaluated sufficiently with regard to patient outcome. However, the decision to transport a patient resides with the responsible emergency physician who has to evaluate the prognosis for the patient on an individual basis.


Erler T.,Universitatsklinikums Bonn | Rohde A.,Universitatsklinikums Bonn | Swientek C.,Universitatsklinikums Bonn
Chirurgische Praxis | Year: 2012

Since 2000 the number of baby hatches in Germany has risen to around 80. Furthermore, the number of maternity clinics providing anonymous child birth is now around 150. It is hoped that the ability to give birth anonymously will lead to the increased prevention of neonaticide. In reality however the anonymous choice allowing mothers to abandon their child without divulging their identity has not affected the incidence of neonaticide. It has in fact led to a situation where, since the year 2000,500 children have been abandoned at hatches or maternity wards offering this service to become foundlings, who will never obtain any details about their personal parentage. International research can confirm these observations. Tests carried out on women, who murdered their own newborns, could prove that they often suffered personality disorders, which hindered them from actively dealing with their pregnancy. Thus, these women were not in the right mental state to seek any help, or to take any other rational actions - even under conditions of anonymity. The anonymous abandonment of children is against the law and should not be considered as a solution to the problem of infanticide or pregnant women/mothers in time of need.


Messing-Junger A.M.,Universitatsklinikums Bonn | Martini M.,Universitatsklinikums Bonn
Chirurgische Praxis | Year: 2015

Craniosynostotic deformities are resulting from developmental disorders of the skull. Genetic and epigenetic factors have already been identified in some of them. Single suture craniosynostoses are differentiated from syndro-mal, mainly complex forms. Surgery is mainly performed during the first year of life. Beside clinical diagnostic a variety of imaging techniques exist in order to define the deformity and plan surgery. Radiation exposure should be avoided if possible. Modern scan techniques have proven to be useful in follow up studies of these patients. The authors present in their overview aspects of surgical indication, diagnostic as well as therapeutic techniques and their own patient series.


Schaaff F.,Universitatsklinikums Bonn | Bartmann P.,Universitatsklinikums Bonn
Gynakologische Praxis | Year: 2012

Kernicterus is still seen in the US and Europe regularly, although it seemed to have vanished after introduction of effective therapy modalities for hyperbilirubinemia. Formerly Kernicterus used to develop in neonates with extreme haemolysis due to e.g. Rhesus incompatibility. In contrast, nowadays newborns without known pre-existing conditions, very often near-term preterms are affected, who develop extreme hyperbilirubinemia after hospital discharge. Incomplete knowledge of the condition, its diagnostic and therapeutic pathways and missing organisatory structures for identification and treatment of cases with extreme hyperbilirubinemia are important reasons. Kernicterus almost always is a preventable disease with lifelong severe implications for patients and their families. Thus further education in this field is urgently needed. The object of this article is to explain pathophysiological, clinical, diagnostic and therapeutic features of kernicterus, to specify reasons for the ongoing occurence, and to describe basic strategies for prevention of the disease.


Musshoff F.,Universitatsklinikums Bonn | Hottmann L.,Universitatsklinikums Bonn | Hess C.,Universitatsklinikums Bonn | Madea B.,Universitatsklinikums Bonn
Archiv fur Kriminologie | Year: 2013

The appearance of dangerous and insufficiently studied designer drugs has increased substantially within the last few years. Mixtures containing centrally active compounds are often declared as "bath salt", "incense", "plant food", "bong cleaners" and are marketed in head shops and on the Internet. As the majority of the ingredients of such products are not subject to regulations of the German Narcotics Law (Betäubungsmittelgesetz, BtMG), the vendors and consumers mistake the sale of such products for legal. An alternative possibility to prosecute the distribution of so-called "legal highs" arises from the regulations of the German Medicinal Products Act (Arzneimittelgesetz, AMG). Indicating a private address, several products were purchased via the Internet. The products were analyzed by gas chromatography - mass spectrometry using computer-assisted database search and potential hits were checked for plausibility. The analysis of 100 samples revealed centrally acting compounds (including caffeine) in 98 % (75 % of all samples positive for caffeine). In 16 % of the samples, drugs subject to the BtMG at the time of purchase (end of 2011) were found including 2, 5-dimethoxy-4-methylamphetamine, amphetamine, etilamphetamine, N-benzylpiperazine, mephedrone, methcathinone, and phenobarbital. In 55 % of the samples, drugs subject to the current BtMG were found (after its amendment on 20 July 2012). In 37 % of the samples, substances subject to the AMG were found (e.g. ephedrine). In 35 % of the samples, drugs with a potential psychotropic effect were found. In 57.3 % of the positive samples, more than one active ingredient was determined and in some cases up to five active components were found. Other interesting pharmacologically active ingredients found were 4-methylcathi-none (n=13), flephedrone (n=8), trifluoromethylphenyl-piperazine (n=7), methylone (n=5), butylone (n=2), hordenine (n=2), and harmane (n=2). Most of the substances not covered by the BtMG can be classified as "unsafe" drugs. The distribution of unsafe drugs is illegal in Germany. However, the easy availability of real or potential drugs has to be seen critically. Little is known about the toxicological and pharmacological effects of those single substances, let alone of interactions in mixtures of such substances. In chat rooms, users advertise such drugs and blaze abroad their own experiences.


Schlaepfer T.E.,Universitatsklinikums Bonn | Agren H.,Gothenburg University | Monteleone P.,University of Naples | Gasto C.,University of Barcelona | And 4 more authors.
Journal of Psychopharmacology | Year: 2012

Treatment-resistant depression (TRD) presents many challenges for both patients and physicians. This review aims to evaluate the current status of the field of TRD and reflects the main findings of a consensus meeting held in September 2009. Literature searches were also conducted using PubMed and EMBASE. Abstracts of the retrieved articles were reviewed independently by the authors for inclusion. Evaluation of the clinical evidence in TRD is complicated by the absence of a validated definition, and there is a need to move away from traditional definitions of remission based on severity of symptoms to one that includes normalisation of functioning. One potential way of improving treatment of TRD is through the use of predictive biomarkers and clinical variables. The advent of new treatments may also help by focusing on neurotransmitters other than serotonin. Strategies such as the switching of antidepressants, use of combination therapy with lithium, atypical antipsychotics and other pharmacological agents can improve outcomes, and techniques such as deep brain stimulation and vagus nerve stimulation have shown promising early results. Despite consistent advances in the pharmacotherapy of mood disorders in the last decade, high rates of TRD are still a challenging aspect of overall management. © The Author(s) 2012.


Messing-Junger A.M.,Universitatsklinikums Bonn | Martini M.,Universitatsklinikums Bonn
Padiatrische Praxis | Year: 2014

Craniosynostotic deformities are resulting from developmental disorders of the skull. Genetic and epigenetic factors have already been identified in some of them. Single suture craniosynostoses are differentiated from syndromal, mainly complex forms. Surgery is mainly performed during the first year of life. Beside clinical diagnostic a variety of imaging techniques exist in order to define the deformity and plan surgery. Radiation exposure should be avoided if possible. Modern scan techniques have proven to be useful in follow up studies of these patients. The authors present in their overview aspects of surgical indication, diagnostic as well as therapeutic techniques and their own patient series.

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