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Franz D.,Universitatsklinikum Munster | Schemmann F.,Klinik fur Orthopadie und Orthopadische Chirurgie | Selter D.D.,Medizincontrolling | Wirtz D.C.,Universitatsklinikums Bonn | And 3 more authors.
Unfallchirurg | Year: 2012

Background. Orthopedics and trauma surgery are subject to continuous medical advancement. The correct and performance-based case allocation by German diagnosis-related groups (G-DRG) is a major challenge. This article analyzes and assesses current developments in orthopedics and trauma surgery in the areas of coding of diagnoses and medical procedures and the development of the 2012 G-DRG system.Methods. The relevant diagnoses, medical procedures and G-DRGs in the versions 2011 and 2012 were analyzed based on the publications of the German DRG Institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI).Results. Changes were made for the International Classification of Diseases (ICD) coding of complex cases with medical complications, the procedure coding for spinal surgery and for hand and foot surgery. The G-DRG structures were modified for endoprosthetic surgery on ankle, shoulder and elbow joints. The definition of modular structured endoprostheses was clarified.Conclusion. The G-DRG system for orthopedic and trauma surgery appears to be largely consolidated. The current phase of the evolution of the G-DRG system is primarily aimed at developing most exact descriptions and definitions of the content and mutual delimitation of operation and procedures coding (OPS). This is an essential prerequisite for a correct and performance-based case allocation in the G-DRG system. © Springer-Verlag 2012. Source


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. Source


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. Source


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. Source


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. Source

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