42 results on '"J. Böhme"'
Search Results
2. [Glomuvenous malformations]
- Author
-
N, Spindler, S, Hanske, K, Schierle, E, Aydogan, J, Böhme, S, Langer, and C, Josten
- Subjects
Adult ,Diagnosis, Differential ,Foot Diseases ,Male ,Paraganglioma, Extra-Adrenal ,Humans ,Neuralgia ,Glomus Tumor - Abstract
A patient presented suffering from neural pain in the medial foot for a period of over 20 years.Diagnostic showed a widely spread soft-tissue tumor consisting of confluent glomuvenous malformations that was responsible for the immense pain syndrome.The solitary or multiform-appearing knots are not compressible and manifest as the characteristic syndromes of regional pain, sensitivity to coldness, or local pressure pain. Alternatively, the patient could also be completely symptom-free.Because of the dimension of the tumor and the degree of suffering, a radical resection with simultaneous microsurgical reconstruction was carried out. Twelve weeks postoperatively, healing of the flap stabilized, the foot is fully weight-bearing, and the patient is pain-free.
- Published
- 2015
3. [Cutaneous infection with Aggregatibacter actinomycetemcomitans]
- Author
-
J, Böhme, T E, Glaenz, A, Kaiser, and C, Allmacher
- Subjects
Male ,Treatment Outcome ,Debridement ,Ceftizoxime ,Wound Infection ,Administration, Oral ,Humans ,Skin Diseases, Bacterial ,Middle Aged ,Pasteurellaceae Infections ,Aggregatibacter actinomycetemcomitans ,Combined Modality Therapy ,Anti-Bacterial Agents - Abstract
Aggregatibacter actinomycetemcomitans is a small, gram-negative, non-motile, coccobacillus. Aggregatibacter actinomycetemcomitans is known to cause periodontal disease and to be associated with actinomycosis.We report a patient developed a chronic wound following trauma about the right heel. The lesion resolved after oral antibiotic therapy with cefpodoxime und surgical debridement. Bacterial cultures grew abundant Aggregatibacter actinomycetemcomitans, but no actinomyces species.The importance of Aggregatibacter actinomycetemcomitans in chronic wounds needs to be explored.
- Published
- 2014
4. [Efficacy of doxycycline for treatment of chlamydiosis in flocks of racing and fancy pigeons]
- Author
-
M-E, Krautwald-Junghanns, J, Stolze, V, Schmidt, J, Böhme, K, Sachse, and K, Cramer
- Subjects
Treatment Outcome ,Chlamydophila psittaci ,Bird Diseases ,Doxycycline ,Animals ,Psittacosis ,Columbidae ,Anti-Bacterial Agents - Abstract
Evaluation of the clinical efficacy of doxycycline application via drinking water in the treatment of chlamydiosis in infected, clinically ill flocks of racing and fancy pigeons (Columba livia f. domestica) under field conditions.In the scope of a field study, 13 pigeon flocks with clinically manifest ornithosis were treated over a period of 25 days with a novel doxycycline formulation via drinking water. Infection with Chlamydia psittaci had been confirmed beforehand by molecular-biological investigation of organ material from dissected pigeons in each flock. Therapeutic success was evaluated by PCR-analysis of triple swabs from 10 animals of each flock on day 25 of treatment and 7 days after completion of the therapy, as well as by repeated individual and daily herd examination.The causative agent Chlamydia psittaci together with additionally documented atypical chlamydia species in six of the 13 flocks could thereby no longer be detected. Furthermore, a resolution of clinical symptoms was achieved in each of the treated pigeon flocks.Application of doxycycline in the described therapy regimen proved successful for the treatment of ornithosis. In addition, excellent acceptance and tolerance of the deployed formulation could be confirmed in praxis.
- Published
- 2013
5. Innovationsmanagement : Erkennen und Ueberwinden von Innovationsbarrieren
- Author
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Olaf J. Böhme, Eduard Hauser, Olaf J. Böhme, and Eduard Hauser
- Subjects
- Management, Business, Success
- Abstract
Das Thema «Innovation» ist ein Dauerbrenner und steht stets an der Spitze der Prioritätenliste einer Unternehmung. Es ist existenziell für den Fortbestand einer Volkswirtschaft. In diesem Zusammenhang liegt die Schweiz in den verschiedenen Rankings zur Innovationskraft und Wettbewerbsfähigkeit weltweit an vorderster Front. In der vorliegenden Publikation wird dem schweizerischen Phänomen nachgegangen. In einem ersten Teil werden das Innovationsmanagement und dessen Chancen, Potenziale und Triebkräfte näher untersucht. In einem zweiten Teil geht es um Methoden und Tools zur Innovationsunterstützung, wobei insbesondere auf die Bedeutung des Wissensmanagements und auf die Web2.0-Technologie eingegangen wird. Der dritte Teil zeigt Erfolgsfaktoren für Innovationen an praktischen Beispielen auf, wobei unter anderem das neue Clustermanagement «aerospace», die Jungunternehmerförderung sowie die Schweizer Förderagentur für Innovation KTI ausführlich dargestellt werden. Im Anhang finden sich ein Fragebogen zur eigenen Messung und Beurteilung von Innovationen sowie ein Überblick über neuere Literatur zum Ideen- und Innovationsmanagement.
- Published
- 2011
6. [Influence of routine CT examination on fracture classification and therapy for pelvic ring fractures in patients aged over 65 years old]
- Author
-
J, Böhme, A, Höch, A, Boldt, and C, Josten
- Subjects
Aged, 80 and over ,Trauma Severity Indices ,Comorbidity ,Prognosis ,Wounds, Nonpenetrating ,Fractures, Bone ,Treatment Outcome ,Risk Factors ,Germany ,Prevalence ,Humans ,Female ,Pelvic Bones ,Tomography, X-Ray Computed ,Geriatric Assessment ,Aged - Abstract
The incidence of pelvic ring fractures in elderly patients increases continuously. Several studies showed that the complexity of injury is often underestimated and a fracture of the posterior pelvic ring not visible with conventional X-rays. The aim of this study was to determine the influence of routine CT on incidence, classification of and therapy for pelvic ring fractures in patients aged over 65 years.Between 2004 and 2010, 310 elderly patients with a pelvic ring fracture were admitted to a German university level 1 trauma centre. Patients of group 1 (2004-2006) were examined with CT only if a pelvic ring fracture was diagnosed by X-ray and pain in the posterior pelvic ring persisted so that mobilisation was impossible. In group 2 (2007-2010) CT was used for routine examination. Demographic data, injury mechanism and severity (ISS) were documented as well as time and type of diagnostic procedure. Also fracture classification (AO), time and type of treatment were investigated in correlation with total hospital stay.252 (82 %) patients were female, the median age was 81 years (65-100 years). 228 (74 %) had a low energy trauma, 41 (13 %) a traffic accident and 12 (4 %) had fallen from heights over 3 m. Only in 29 (9 %) cases was no trauma evident. 35 (11 %) patients were injured with an ISS over 16 and classified as polytrauma. The mean ISS was 26.8 ± 11.7. In group 2 the incidence of type A fractures decreased from 64 % to 36 %, whereas the incidence of type B fractures increased from 25 % to 49 % as did isolated sacrum fractures from 1 % to 6 %. Also the indication for operative stabilisation changed in type B fractures from 33 % to 40 % and in isolated sacrum fractures to 71 %. Total hospital stay was between eight and ten days in non-operative and between 20 and 22 days in operative treatment.A low energy trauma is the major cause of injury for patients of an age over 65 years with a pelvic ring fracture. With the routine CT examination type B fractures and isolated sacrum fractures are seen more often than expected and resulting in a change of treatment procedures.
- Published
- 2012
7. [Osteoporotic fractures of the pelvis]
- Author
-
J, Böhme, A, Höch, and C, Josten
- Subjects
Male ,Sacrum ,Arthroplasty, Replacement, Hip ,Bone Screws ,Fracture Fixation, Internal ,Sex Factors ,Humans ,Pelvic Bones ,Physical Therapy Modalities ,Aged ,Pubic Bone ,Aged, 80 and over ,Fracture Healing ,Hip Fractures ,Incidence ,Age Factors ,Middle Aged ,Prognosis ,Combined Modality Therapy ,Magnetic Resonance Imaging ,Biomechanical Phenomena ,Cross-Sectional Studies ,Female ,Tomography, X-Ray Computed ,Bone Plates ,Algorithms ,Osteoporotic Fractures - Abstract
The incidence of osteoporotic pelvic fractures is rapidly increasing. Following low energy trauma fractures are frequently classified as pelvic girdle fractures. Based on the pelvic expert group database of the German Trauma Society the estimated rate of osteoporotic pelvic ring fractures is about 51%. In cases of fractured pubic rami standard X-ray in anterior-posterior, inlet and outlet views should be carried out by computed tomography (CT) scanning to identify fractures of the sacrum. Only if pain persists and no fracture is evident with CT is magnetic resonance imaging (MRI) indicated. Therapy should be carried out under biomechanical instability aspects. Pubic rami fractures are stable and treated conservatively with sufficient pain medication, thromboembolic prophylaxis and physiotherapy. In cases of persisting pain or biomechanical instability operative treatment is indicated and stabilization methods should be chosen under biomechanical aspects. Therefore external fixator for pubic rami fractures and iliosacral screws, optionally with cement augmentation for posterior pelvic girdle fractures are the preferred techniques. Sacral fractures with severe osteolysis should be stabilized by lumbopelvic fixation techniques.
- Published
- 2012
8. [Polytrauma with pelvic fractures and severe thoracic trauma: does the timing of definitive pelvic fracture stabilization affect the clinical course?]
- Author
-
J, Böhme, A, Höch, F, Gras, I, Marintschev, U X, Kaisers, A, Reske, and C, Josten
- Subjects
Adult ,Aged, 80 and over ,Time Factors ,Adolescent ,Thoracic Injuries ,Multiple Trauma ,Comorbidity ,Length of Stay ,Middle Aged ,Prognosis ,Respiration, Artificial ,Fracture Fixation, Internal ,Fractures, Bone ,Young Adult ,Treatment Outcome ,Risk Factors ,Germany ,Prevalence ,Humans ,Prospective Studies ,Erythrocyte Transfusion ,Pelvic Bones ,Aged - Abstract
The aim of this study was to investigate the influence of the surgical timing in patients with pelvic fractures and severe chest trauma on the clinical course, especially on postoperative lung function.A total of 47 patients were included in a prospective dual observational study. The study investigated the clinical course depending on the time of operation based on the functional lung parameters, SAPS II, SOFA and total hospital stay.The average ISS was 32±6, PTS was 34±11 and TTSS was 9±3 points. The pelvic fractures were stabilized definitively after an average of 7±2 days. The early stabilization correlated significantly with a lower TTSS and SAPS II on admission (p0.05), shorter time of ventilation (p0.05) and stay in the intensive care unit (p0.01) as well as the decreased need for packed red blood cells (p0.01).In this study patients with pelvic fractures and thoracic trauma benefited positively from an earlier definitive pelvic fracture stabilization with respect to a shorter time of ventilation and stay in the intensive care unit due to a lower need for red cell concentrates.
- Published
- 2012
9. [Complex ligament instabilities after 'open book'-fractures of the pelvic ring - finite element computer simulation and crack simulation]
- Author
-
J, Böhme, H, Steinke, R, Huelse, N, Hammer, T, Klink, V, Slowik, and C, Josten
- Subjects
Fractures, Bone ,Ligaments ,Finite Element Analysis ,Humans ,Computer Simulation ,Pelvic Bones ,Models, Biological - Abstract
Instability of pelvic ring fractures is also caused by ligament disruption. Classifications are based on the major forces leading to fracture. Data from injury mechanisms as well as clinical and radiological criteria are used to determine the degree of instability. The major aim of all kinds of stabilisation is the anatomic reconstruction of the bony pelvic ring. The injured ligamentous apparatus is still ignored. Some clinical trials assume that soft-tissue injuries may be the reason for the poor patient outcome in "open book" pelvic ring fractures. The aim of the study was to develop a realistic finite element (FE) computer model to simulate "open book" fractures and predict injury-associated instabilities for osteosynthesis planning. PATIENTS/MATERIAL: We developed a realistic FE computer model of the pelvic ring based on CT data. With anatomic studies a computer model of the ligamentous apparatus was created and inserted into the pelvic ring to complete the bone-ligament complex. Numerical simulations were performed to identify the influence of single pelvic ligaments on the shifting at the intact anterior and posterior pelvic ring. Additionally, a biomechanical validated virtual crack simulation with anterior-posterior compression forces was undertaken to predict complex instabilities in "open book" pelvic ring fractures.The pelvic ligaments have local and general stabilising functions. The sacrospinous and sacrotuberous ligaments are providing the vertical load transfer, whereas the ligaments of the iliosacral joint and the iliolumbal ligament are necessary for the horizontal load transfer. In "open book" fractures ligaments are ruptured stepwise from anterior to posterior. If the intraosseous and posterior ligaments of the iliosacral joint are intact, only single rotational instability along the ipsilateral iliosacral joint occurs. If the ligaments at the posterior pelvic ring are ruptured too, a second axis across both iliosacral joints was measured. In this particular case additional stabilisation of the posterior pelvic ring should be performed.With numerical simulations, prediction of injury-associated instabilities is possible. Because of incomplete radiological data the implementation of patient-specific FE pelvic computer models into the clinical routine is still not realistic.
- Published
- 2010
10. [Ligament healing results after type C pelvic ring fractures. Results of triangular vertebropelvic support]
- Author
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J, Böhme, A, Lägel, F, Schmidt, A H, Tiemann, and C, Josten
- Subjects
Fracture Healing ,Fractures, Bone ,Ligaments ,Treatment Outcome ,Fracture Fixation ,Humans ,Pelvic Bones - Abstract
Posterior pelvic ring fractures are often associated with injuries of lumbopelvic soft tissue structures. The aim of this prospective MR study was to examine whether ruptured iliolumbal ligaments could be diagnosed in types B and C pelvic ring fractures. The influence of triangular lumbopelvic stabilization (TLPS) was also investigated with respect to stiffening of the lumbopelvic region.Using a 1.5 Tesla MRI, 20 patients with types B and C fractures were examined to identify ruptured iliolumbal ligaments. In a retrospective study of 30 patients previously stabilized with a TLPS, pain scores, clinical instability testing and measuring of the segmental dislocation in extension, flexion and lateral flexion based on x-rays were also investigated.Of the patients 3 (1 type B, 2 type C fractures) had incompletely ruptured iliolumbal ligaments. In five patients pain intensity and localization could be significantly correlated with clinical instability of the lumbopelvic region, segmental hypermobility and instability.Pelvic ring fractures types B and C can be associated with ruptured iliolumbal ligaments. Lumbopelvic instability can be correlated with early implant loosening of TLPS.
- Published
- 2010
11. [Fatal risk thrombosis? A prospective study for the incidence of deep vein thrombosis in pelvic fractures]
- Author
-
J, Böhme, J, Müller, S, Fröhlich, A H, Tiemann, and C, Josten
- Subjects
Adult ,Male ,Risk ,Adolescent ,Premedication ,Fractures, Bone ,Young Adult ,Postoperative Complications ,Fibrinolytic Agents ,Cause of Death ,Humans ,Hospital Mortality ,Prospective Studies ,Enoxaparin ,Ultrasonography, Doppler, Color ,Pelvic Bones ,Aged ,Aged, 80 and over ,Postoperative Care ,Venous Thrombosis ,Dose-Response Relationship, Drug ,Heparin ,Multiple Trauma ,Incidence ,Acetabulum ,Middle Aged ,Cross-Sectional Studies ,Female - Abstract
The aim of the study was to determine the incidence of deep vein thrombosis (DVT) after pelvic trauma and surgical stabilisation of pelvic and acetabular fractures under medicamentous prophylaxis.Within 20 months we prospectively included 50 patients. 25 had an isolated pelvic trauma, 25 patients had multiple injuries. 21 of them were polytrauma patients (average ISS: 31.4; min. 26 pts., max. 50 pts.), four patients had additional highly unstable spine fractures or fractures of the lower extremities. Low molecular-weight heparin (Enoxaparin 40 g/d) was administered on average within 24 hours of injury in 44 cases, one patient received low-dose heparin (Liquemin 15,000 to 22,500 I. E./d), five patients received both. 31 patients were treated operatively and 19 conservatively. Colour-flow duplex ultrasonography was performed within 72 hours of injury and stabilisation of the pelvic and acetabular fracture, or weekly. By means of ultrasound, 97 to 100 % of the deep and superficial leg veins could be examinated safely, as well as 88 to 89 % of the external iliac veins and 64 to 66 % of the common iliac veins. Only in 36 to 40 % of the patients the internal iliac veins were visible by ultrasound.Proximal DVTs were detected postoperatively in two patients (4 %), one patient (2 %) died after a fatal P. E. before the scheduled duplex scan.Early medicamentous prophylaxis can prevent deep vein thrombosis after pelvic trauma. Delayed applications due to pelvic operations are risk factors. In such cases duplex scanning should be performed routinely and postoperative medicamentous prophylaxis should be increased.
- Published
- 2009
12. [Use of the pelvic clamp in polytraumatised patients with unstable disruption of the posterior pelvic ring. Modified technique--risks--problems]
- Author
-
A H, Tiemann, J, Böhme, and C, Josten
- Subjects
Adult ,Male ,Reoperation ,Adolescent ,External Fixators ,Multiple Trauma ,Bone Nails ,Middle Aged ,Surgical Instruments ,Ilium ,Radiography ,Fracture Fixation, Internal ,Injury Severity Score ,Humans ,Manipulation, Orthopedic ,Female ,Hospital Mortality ,Emergencies ,Pelvic Bones ,Aged - Abstract
Unstable fractures of the posterior pelvic ring are frequently combined with severe hemorrhage. In 80% of cases the bleeding originates in the ruptured presacral venous plexus or the fracture itself. Arterial bleeding is less common. The pelvic clamp introduced by Ganz can make it possible to stabilise the pelvis, with subsequent compression of the fracture planes and reduction of the intrapelvic volume in such cases, so improving the prognosis. Use of the pelvic clamp can be integrated into the management in the emergency room with no problem.This paper presents the authors' own modification of the technique for using the pelvic clamp in the emergency situation when only a clinical examination of the patient has been possible and also analyses specific problems that arise in this situation. To this end, the data relating to 29 polytraumatised patients with unstable posterior pelvic ring fractures were analysed in a retrospective study.In all, 8 complications were seen in 6 patients. There were 2 cases of pin malposition and 2 of over-compression of the ossa coxae and local wound problems. Secondary pin dislocation was observed in 1 case. In all these cases it was possible to correct the pelvic clamp, so that emergency stabilisation was practicable without further surgical intervention. Minor complications were found in 2 patients. These took the form of bleeding at the pin-insertion site. In 1 case an unstable transiliacal fracture was found, and in this case it was not possible to stabilise the posterior pelvic ring with the pelvic clamp. No iatrogenic lesions were detected following application of the pelvic clamp.In the hands of an experienced and practised user application of the pelvic clamp is a safe method for emergency stabilisation of the posterior pelvic ring in polytraumatised patients, even without blood volume control. Problems can be solved and do not generally mean the pelvic clamp cannot be used. The immediate radiological check (e.g. during the emergency CT -scan performed for primary diagnosis) is a must, however.
- Published
- 2006
13. [The TRALI syndrome--a life-threatening transfusion reaction]
- Author
-
J, Voss, K, Westphal, J, Böhme, J, Bux, and A, Greinacher
- Subjects
Male ,Radiography ,Respiratory Distress Syndrome ,Acute Disease ,Humans ,Transfusion Reaction ,Pulmonary Edema ,Syndrome ,Middle Aged ,Intraoperative Complications ,Antibodies ,Granulocytes - Abstract
Transfusion related acute lung injury (TRALI) is a serious complication of blood transfusion, characterized by non-cardiogenic lung oedema. We describe a case of TRALI due to granulocyte-specific antibodies. The 58-year-old patient received 2 units of fresh frozen plasma following colon surgery and within 30 min the patient developed an acute respiratory distress syndrome. Granulocyte-specific antibodies were found in one of the transfused plasma of a female blood donor who most likely became immunized against granulocyte alloantigens during her three pregnancies.
- Published
- 2002
14. [Diagnosis of Hermansky-Pudlak syndrome]
- Author
-
M, Woinke, M, Koksch, H, Scheel, H J, Böhme, and C, Rühlmann
- Subjects
Adult ,Platelet Aggregation ,Hermanski-Pudlak Syndrome ,Humans ,Female ,Blood Coagulation Tests ,Flow Cytometry - Abstract
A 27-year-old woman presented with increased bleeding tendency and known oculocutaneous albinism. In addition to frequent nasal and gingival bleedings she had since childhood spontaneous extensive cutaneous bleedings. In addition she was extreme sensitive to UV light with visual disturbances. Bone-marrow biopsy when aged 9 years had revealed abnormal pigment-storing cells. Physical examination showed a very fair skin and hair, spontaneous nystagmus and extensive rash in the face.Prothrombin, partial thromboplastin and thrombin times as well as fibrinogen level were normal. On re- admission bleeding time varied greatly, while platelet count was normal. Mean platelet volume was slightly reduced. Von Willebrand antigen, factor VIII:C, factor IX:C, factor XIII and alpha (2)-antiplasmin were all normal. Aggregometry indicated abnormal platelet function; there was reduced platelet aggregation after stimulation with adenosine diphosphate. Flow cytometry of whole blood demonstrated abnormal storage function of thrombocytic delta-granules. The underlying cause of the described symptoms was shown to be a gene defect in typical location on the long arm of chromosome 10.The triad of tyrosinase-positive oculocutaneous albinism, abnormal thrombocytic delta-granules and ceroid deposition in the cells of the reticuloendothelial system or the bone-marrow is called Hermansky-Pudlak syndrome (after those who first reported it). There is as yet no causal treatment. But the patient was advised to use a nasal spray of desmopressin for spontaneous or difficult to stop bleedings after minor injuries. Desmopressin i. v. should be given prophylactically before any operation.
- Published
- 2001
15. [Combined alcohol dependence and personality disorder and its legal consequences with respect to commitment]
- Author
-
T, Allhoff, J, Böhme-Molle, and M, Banger
- Subjects
Adult ,Male ,Alcoholism ,Germany ,Commitment of Mentally Ill ,Humans ,Personality Disorders - Abstract
People frequently consuming an excessive amount of alcohol often show symptoms of personality disorder. Personality disorder and alcohol dependence are frequently connected with each other. However, there are only very few conditions enhancing concomitant dependence and personality disorder to the rank of a mental disease according to German guardianship legislation. If the patient's condition meets the criteria of a psychic disease and endangers his own health and public safety, commitment to a mental hospital or guardianship are justified. The purpose of this clinical analysis was to compare the medical proposal for treatment with legal prerequisites which are indispensable for involuntary admission to a mental hospital. Whereas the Psychiatric Disorders Act intends to avert danger to the public, guardianship legislation aims at individual help. We present a patient who suffered from alcoholism and simultaneously met criteria of a serious personality disorder, which was classified according to ICD-10 (F 60.31). As the aggravation of the symptoms was most likely to entail serious danger to his health the judge ordered immediate involuntary admission. Two other patients had similar comorbidity but had to be released from hospital because of finalisation of detoxification. Neither dependence nor personality disorder were pronounced enough to restrict the rights of the individual. Our analysis shows that the psychiatrist must present with an expert medical report that quantifies the extent of alcoholism and personality disorder and characterises them as psychic disease. Consequently, for the purpose of quantifying the extent of dependence, we recommend to apply the European Addiction Severity Index whose suitability should be assessed.
- Published
- 1999
16. [Different phenotypes of type IXb glycogenosis (phosphorylase-b-kinase deficiency) in adult- and early childhood]
- Author
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P, Müller, P, Bührdel, B, Freidt, and H J, Böhme
- Subjects
Diagnosis, Differential ,Male ,Phenotype ,X Chromosome ,Phosphorylase Kinase ,Child, Preschool ,Genetic Carrier Screening ,Humans ,Genes, Recessive ,Middle Aged ,Glycogen Storage Disease ,Sex Chromosome Aberrations - Published
- 1996
17. [Hemoglobin A1 in hypoglycemias in childhood]
- Author
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P, Bührdel, B, Stach, and H J, Böhme
- Subjects
Glycated Hemoglobin ,Glycogen Storage Disease Type III ,Hyperinsulinism ,Humans ,Glycogen Storage Disease Type I ,Glycogen Storage Disease Type VI ,Child ,Hypoglycemia - Abstract
The average HbA1 concentrations of 20 patients with hypoglycaemic diseases were not significantly different from metabolically healthy controls. There was also no correlation between the HbA1 and the blood glucose levels of these patients. Remarkably, two patients which responded to therapy with an increase of blood glucose showed also an increase of HbA1.
- Published
- 1990
18. [N-procollagen(III)peptide and lysosomal beta-galactosidase in progressive scleroderma and silicosis]
- Author
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E, Schulze, K, Herrmann, U F, Haustein, J, Mehlhorn, and H J, Böhme
- Subjects
Adult ,Male ,Scleroderma, Systemic ,Silicosis ,Humans ,Female ,Quartz ,Middle Aged ,Lysosomes ,beta-Galactosidase ,Peptide Fragments ,Procollagen ,Aged - Abstract
The concentration of type III collagen aminopropeptide and the activity of lysosomal beta-galactosidase were determined in the serum of patients with progressive sclerosis (PS), silicosis and PS associated with silicosis. In PS-patients, the serum levels of both parameters were significantly increased with a high correlation to the stage of the disease and to each other. In patients with silicosis normal serum concentrations of both parameters were found, whereas in all patients suffering from silicosis and PS significantly elevated serum levels were detectable, independent of the stage of PS. Both parameters can also be used as markers of therapy (e.g. with D-penicillamine) and as early indicators for the development of PS in patients with silicosis.
- Published
- 1990
19. [Metabolic adaptation in the fasting test in children with glycogenosis type I]
- Author
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P, Bührdel, J, Hubald, and H J, Böhme
- Subjects
Blood Glucose ,Humans ,Insulin ,Fasting ,Glycogen Storage Disease Type I ,Child ,Energy Metabolism - Published
- 1987
20. [Kinetic determination of peroxidase activity of human leukocytes]
- Author
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I, Morwinski and H J, Böhme
- Subjects
Kinetics ,Peroxidases ,Leukocytes ,Humans ,Electrophoresis, Polyacrylamide Gel ,Peroxidase - Published
- 1982
21. [Microcalorimetric determination of thermochemical parameters of the phosphofructokinase reaction]
- Author
-
H J, Böhme, W, Schellenberger, and E, Hofmann
- Subjects
Adenosine Diphosphate ,Adenosine Triphosphate ,Neutralization Tests ,Microchemistry ,Phosphofructokinase-1 ,Thermodynamics ,Magnesium ,Buffers ,Calorimetry ,Hydrogen-Ion Concentration - Abstract
A calorimetric procedure for determining deltaH, deltaG, deltaS and Keq of a bimolecular reaction with two or more products is described. By using this method the thermodynamic parameters of the phosphofructokinase reaction are determined. At pH 7.0 and 25 degrees C a reaction enthalpy of-6.96kcal/mole was found after correction for the neutralization enthalpy of the buffer and of the enthalpy difference of the magnesium complexes of ATP and ADP, respectively. The free energy of the phosphofructokinase reaction has been found under these conditions to be -3.96kcal/mole.
- Published
- 1975
22. [Use of leukocytes for enzyme tests in the diagnosis of carbohydrate metabolism disorders]
- Author
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P, Bührdel and H J, Böhme
- Subjects
Leukocytes ,Humans ,Clinical Enzyme Tests ,Carbohydrate Metabolism, Inborn Errors - Published
- 1982
23. [Determination of the gestational age of Wistar rats]
- Author
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W, Goltzsch, R, Bittner, L, Didt, G, Sparmann, H J, Böhme, and E, Hofmann
- Subjects
Pregnancy ,Body Weight ,Animals ,Female ,Gestational Age ,Organ Size ,Rats - Published
- 1980
24. [Significance of lysosomal beta-galactosidases for the diagnosis and differential diagnosis of progressive scleroderma and silicosis]
- Author
-
E, Schulze, K, Herrmann, J, Mehlhorn, V, Ziegler, H J, Böhme, and U F, Haustein
- Subjects
Adult ,Diagnosis, Differential ,Male ,Scleroderma, Systemic ,Silicosis ,Humans ,Female ,Middle Aged ,Lysosomes ,beta-Galactosidase ,Aged ,Galactosidases - Published
- 1987
25. [Determination of fertility in female and male Wistar rats. Short communication]
- Author
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W, Goltzsch, H J, Böhme, and E, Hofmann
- Subjects
Male ,Fertility ,Fertilization ,Body Weight ,Age Factors ,Animals ,Female ,Rats - Published
- 1981
26. [The Need of Evidence-Based Treatment of Early-Onset Feeding Tube Dependency: A Pico- Framework Based Analytic Review of Clinical Features and Treatment of Feeding Tube Dependency].
- Author
-
Wilken M, Mink CM, and Böhme J
- Subjects
- Female, Pregnancy, Humans, Treatment Outcome, Germany, Enteral Nutrition methods, Enteral Nutrition psychology, Feeding and Eating Disorders
- Abstract
Feeding Tube Dependency is a constant increasing perinatal mental health condition, with estimated 350 new cases per year in Germany.The early onset feeding tube dependency is the consequence of a generalized food aversion. To establish an evidence-based nationwide treatment plan, relevant research from the past twenty years were narratively reviewed. Feeding tube dependency is an international increasingmental health condition, with a high symptom persistence and a low spontaneous remission. The generalized food aversion would prevent the transition to oral feeding.The treatment protocols, supported by the German Health System, based on low-frequency individual treatment and intensive inpatient treatments are not supported by the most recent evidence. In treatment outcome research more promising and effective programs can be distinguished from ineffective programs. As a result, treatment which are designed as intensive treatment, home-based or inpatient and are psychodynamicbased are most effective. Day-clinic and behavioral modification programs are not or low in treatment effectiveness.The German Health System approach to assist families with feeding tube dependency is not evidence-based. A new structure of treatment is imperatively required.
- Published
- 2023
- Full Text
- View/download PDF
27. [Potential for intervention of private health insurers in discharge management using the example of stroke patients].
- Author
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Sterl E and Böhme J
- Subjects
- Critical Pathways organization & administration, Germany, Humans, Patient Participation methods, Insurance, Health organization & administration, Models, Organizational, Patient Discharge, Patient Transfer organization & administration, Private Sector organization & administration, Stroke therapy
- Abstract
The study reveals that stroke patients today can still experience gaps in the provision of healthcare and fragmented therapy. This is often the case on transferral from the inpatient to outpatient sector, causing complications that could be avoided by means of good discharge management across all sectors. Private health insurance can actively support and positively influence the treatment process in the form of case management. Individual contact with stroke patients and their relatives allows for early planning and organisation of the next steps, and offers patients the support they need during a difficult phase of life.
- Published
- 2016
28. [Glomuvenous malformations].
- Author
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Spindler N, Hanske S, Schierle K, Aydogan E, Böhme J, Langer S, and Josten C
- Subjects
- Adult, Diagnosis, Differential, Foot Diseases complications, Glomus Tumor complications, Humans, Male, Neuralgia etiology, Paraganglioma, Extra-Adrenal complications, Foot Diseases diagnosis, Foot Diseases surgery, Glomus Tumor diagnosis, Glomus Tumor surgery, Neuralgia diagnosis, Neuralgia prevention & control, Paraganglioma, Extra-Adrenal diagnosis, Paraganglioma, Extra-Adrenal surgery
- Abstract
Symptoms: A patient presented suffering from neural pain in the medial foot for a period of over 20 years., Diagnosis: Diagnostic showed a widely spread soft-tissue tumor consisting of confluent glomuvenous malformations that was responsible for the immense pain syndrome.The solitary or multiform-appearing knots are not compressible and manifest as the characteristic syndromes of regional pain, sensitivity to coldness, or local pressure pain. Alternatively, the patient could also be completely symptom-free., Treatment: Because of the dimension of the tumor and the degree of suffering, a radical resection with simultaneous microsurgical reconstruction was carried out. Twelve weeks postoperatively, healing of the flap stabilized, the foot is fully weight-bearing, and the patient is pain-free.
- Published
- 2015
- Full Text
- View/download PDF
29. [Cutaneous infection with Aggregatibacter actinomycetemcomitans].
- Author
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Böhme J, Glaenz TE, Kaiser A, and Allmacher C
- Subjects
- Administration, Oral, Anti-Bacterial Agents administration & dosage, Ceftizoxime administration & dosage, Ceftizoxime analogs & derivatives, Combined Modality Therapy methods, Debridement, Humans, Male, Middle Aged, Pasteurellaceae Infections microbiology, Skin Diseases, Bacterial microbiology, Treatment Outcome, Wound Infection microbiology, Cefpodoxime, Aggregatibacter actinomycetemcomitans, Pasteurellaceae Infections diagnosis, Pasteurellaceae Infections therapy, Skin Diseases, Bacterial diagnosis, Skin Diseases, Bacterial therapy, Wound Infection diagnosis, Wound Infection therapy
- Abstract
Background: Aggregatibacter actinomycetemcomitans is a small, gram-negative, non-motile, coccobacillus. Aggregatibacter actinomycetemcomitans is known to cause periodontal disease and to be associated with actinomycosis., Case Report: We report a patient developed a chronic wound following trauma about the right heel. The lesion resolved after oral antibiotic therapy with cefpodoxime und surgical debridement. Bacterial cultures grew abundant Aggregatibacter actinomycetemcomitans, but no actinomyces species., Objective: The importance of Aggregatibacter actinomycetemcomitans in chronic wounds needs to be explored.
- Published
- 2014
- Full Text
- View/download PDF
30. [Impact of potentially inappropriate drug usage on health insurance business results].
- Author
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Kirschke M and Böhme J
- Subjects
- Aged, Azabicyclo Compounds adverse effects, Azabicyclo Compounds economics, Benzodiazepines adverse effects, Benzodiazepines economics, Cost Savings, Drug Costs statistics & numerical data, Drug Interactions, Drug Therapy, Combination, Drug Utilization economics, Germany, Humans, Piperazines adverse effects, Piperazines economics, Population Dynamics, Pyridines adverse effects, Pyridines economics, Zolpidem, Inappropriate Prescribing economics, National Health Programs economics, Prescription Drugs economics, Quality Improvement economics
- Abstract
In Germany a list was drawn up that included 83 potentially inappropriate drugs. The PRISCUS list published in 2010 was intended to highlight certain problems in the pharmakotherapy of elderly patients and serve as a support for improved medicine safety. Almost a third of the insurance portfolio of the HALLESCHE Krankenversicherung aged over 75 years takes drugs that are on the PRISCUS list. Benzodiazepine and Z-drugs are taken most frequently. The costs per insurant with potentially inappropriate medication are on average higher than for policyholders who do not take drugs on the PRISCUS list. The costs per insurant are rising, with an increase in the number of PRISCUS agents being taken as well. However, there is still no scientific proof that potentially inappropriate drugs lead to adverse drug events.
- Published
- 2014
31. [Polytrauma with pelvic fractures and severe thoracic trauma: does the timing of definitive pelvic fracture stabilization affect the clinical course?].
- Author
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Böhme J, Höch A, Gras F, Marintschev I, Kaisers UX, Reske A, and Josten C
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Comorbidity, Erythrocyte Transfusion statistics & numerical data, Fracture Fixation, Internal statistics & numerical data, Germany epidemiology, Humans, Length of Stay statistics & numerical data, Middle Aged, Pelvic Bones surgery, Prevalence, Prognosis, Prospective Studies, Respiration, Artificial statistics & numerical data, Risk Factors, Time Factors, Treatment Outcome, Young Adult, Fractures, Bone epidemiology, Fractures, Bone therapy, Multiple Trauma epidemiology, Multiple Trauma therapy, Pelvic Bones injuries, Thoracic Injuries epidemiology, Thoracic Injuries therapy
- Abstract
Background: The aim of this study was to investigate the influence of the surgical timing in patients with pelvic fractures and severe chest trauma on the clinical course, especially on postoperative lung function., Methods: A total of 47 patients were included in a prospective dual observational study. The study investigated the clinical course depending on the time of operation based on the functional lung parameters, SAPS II, SOFA and total hospital stay., Results: The average ISS was 32±6, PTS was 34±11 and TTSS was 9±3 points. The pelvic fractures were stabilized definitively after an average of 7±2 days. The early stabilization correlated significantly with a lower TTSS and SAPS II on admission (p<0.05), shorter time of ventilation (p<0.05) and stay in the intensive care unit (p<0.01) as well as the decreased need for packed red blood cells (p<0.01)., Conclusions: In this study patients with pelvic fractures and thoracic trauma benefited positively from an earlier definitive pelvic fracture stabilization with respect to a shorter time of ventilation and stay in the intensive care unit due to a lower need for red cell concentrates.
- Published
- 2013
- Full Text
- View/download PDF
32. [Efficacy of doxycycline for treatment of chlamydiosis in flocks of racing and fancy pigeons].
- Author
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Krautwald-Junghanns ME, Stolze J, Schmidt V, Böhme J, Sachse K, and Cramer K
- Subjects
- Animals, Chlamydophila psittaci isolation & purification, Psittacosis drug therapy, Treatment Outcome, Anti-Bacterial Agents therapeutic use, Bird Diseases drug therapy, Bird Diseases microbiology, Columbidae, Doxycycline therapeutic use, Psittacosis veterinary
- Abstract
Objective: Evaluation of the clinical efficacy of doxycycline application via drinking water in the treatment of chlamydiosis in infected, clinically ill flocks of racing and fancy pigeons (Columba livia f. domestica) under field conditions., Material and Methods: In the scope of a field study, 13 pigeon flocks with clinically manifest ornithosis were treated over a period of 25 days with a novel doxycycline formulation via drinking water. Infection with Chlamydia psittaci had been confirmed beforehand by molecular-biological investigation of organ material from dissected pigeons in each flock. Therapeutic success was evaluated by PCR-analysis of triple swabs from 10 animals of each flock on day 25 of treatment and 7 days after completion of the therapy, as well as by repeated individual and daily herd examination., Results: The causative agent Chlamydia psittaci together with additionally documented atypical chlamydia species in six of the 13 flocks could thereby no longer be detected. Furthermore, a resolution of clinical symptoms was achieved in each of the treated pigeon flocks., Conclusion: Application of doxycycline in the described therapy regimen proved successful for the treatment of ornithosis. In addition, excellent acceptance and tolerance of the deployed formulation could be confirmed in praxis.
- Published
- 2013
33. [Influence of routine CT examination on fracture classification and therapy for pelvic ring fractures in patients aged over 65 years old].
- Author
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Böhme J, Höch A, Boldt A, and Josten C
- Subjects
- Aged, Aged, 80 and over, Comorbidity, Female, Fractures, Bone classification, Fractures, Bone epidemiology, Geriatric Assessment methods, Geriatric Assessment statistics & numerical data, Germany epidemiology, Humans, Prevalence, Prognosis, Risk Factors, Trauma Severity Indices, Treatment Outcome, Wounds, Nonpenetrating epidemiology, Fractures, Bone diagnostic imaging, Fractures, Bone therapy, Pelvic Bones diagnostic imaging, Pelvic Bones injuries, Tomography, X-Ray Computed statistics & numerical data, Wounds, Nonpenetrating diagnostic imaging, Wounds, Nonpenetrating therapy
- Abstract
Background: The incidence of pelvic ring fractures in elderly patients increases continuously. Several studies showed that the complexity of injury is often underestimated and a fracture of the posterior pelvic ring not visible with conventional X-rays. The aim of this study was to determine the influence of routine CT on incidence, classification of and therapy for pelvic ring fractures in patients aged over 65 years., Patients and Methods: Between 2004 and 2010, 310 elderly patients with a pelvic ring fracture were admitted to a German university level 1 trauma centre. Patients of group 1 (2004-2006) were examined with CT only if a pelvic ring fracture was diagnosed by X-ray and pain in the posterior pelvic ring persisted so that mobilisation was impossible. In group 2 (2007-2010) CT was used for routine examination. Demographic data, injury mechanism and severity (ISS) were documented as well as time and type of diagnostic procedure. Also fracture classification (AO), time and type of treatment were investigated in correlation with total hospital stay., Results: 252 (82 %) patients were female, the median age was 81 years (65-100 years). 228 (74 %) had a low energy trauma, 41 (13 %) a traffic accident and 12 (4 %) had fallen from heights over 3 m. Only in 29 (9 %) cases was no trauma evident. 35 (11 %) patients were injured with an ISS over 16 and classified as polytrauma. The mean ISS was 26.8 ± 11.7. In group 2 the incidence of type A fractures decreased from 64 % to 36 %, whereas the incidence of type B fractures increased from 25 % to 49 % as did isolated sacrum fractures from 1 % to 6 %. Also the indication for operative stabilisation changed in type B fractures from 33 % to 40 % and in isolated sacrum fractures to 71 %. Total hospital stay was between eight and ten days in non-operative and between 20 and 22 days in operative treatment., Conclusion: A low energy trauma is the major cause of injury for patients of an age over 65 years with a pelvic ring fracture. With the routine CT examination type B fractures and isolated sacrum fractures are seen more often than expected and resulting in a change of treatment procedures., (Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2012
- Full Text
- View/download PDF
34. [Osteoporotic fractures of the pelvis].
- Author
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Böhme J, Höch A, and Josten C
- Subjects
- Age Factors, Aged, Aged, 80 and over, Algorithms, Arthroplasty, Replacement, Hip, Biomechanical Phenomena, Bone Plates, Bone Screws, Combined Modality Therapy, Cross-Sectional Studies, Female, Fracture Fixation, Internal methods, Fracture Healing physiology, Hip Fractures diagnosis, Hip Fractures surgery, Humans, Incidence, Magnetic Resonance Imaging, Male, Middle Aged, Osteoporotic Fractures classification, Osteoporotic Fractures diagnosis, Osteoporotic Fractures epidemiology, Physical Therapy Modalities, Prognosis, Pubic Bone injuries, Pubic Bone surgery, Sacrum injuries, Sacrum surgery, Sex Factors, Tomography, X-Ray Computed, Osteoporotic Fractures surgery, Pelvic Bones injuries, Pelvic Bones surgery
- Abstract
The incidence of osteoporotic pelvic fractures is rapidly increasing. Following low energy trauma fractures are frequently classified as pelvic girdle fractures. Based on the pelvic expert group database of the German Trauma Society the estimated rate of osteoporotic pelvic ring fractures is about 51%. In cases of fractured pubic rami standard X-ray in anterior-posterior, inlet and outlet views should be carried out by computed tomography (CT) scanning to identify fractures of the sacrum. Only if pain persists and no fracture is evident with CT is magnetic resonance imaging (MRI) indicated. Therapy should be carried out under biomechanical instability aspects. Pubic rami fractures are stable and treated conservatively with sufficient pain medication, thromboembolic prophylaxis and physiotherapy. In cases of persisting pain or biomechanical instability operative treatment is indicated and stabilization methods should be chosen under biomechanical aspects. Therefore external fixator for pubic rami fractures and iliosacral screws, optionally with cement augmentation for posterior pelvic girdle fractures are the preferred techniques. Sacral fractures with severe osteolysis should be stabilized by lumbopelvic fixation techniques.
- Published
- 2012
- Full Text
- View/download PDF
35. [Current treatment concepts for mid-shaft fractures of the clavicle - results of a prospective multicentre study].
- Author
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Böhme J, Bonk A, Bacher GO, Wilharm A, Hoffmann R, and Josten C
- Subjects
- Adolescent, Adult, Aged, Female, Germany epidemiology, Humans, Male, Middle Aged, Prevalence, Treatment Outcome, Clavicle injuries, Clavicle surgery, Fracture Fixation statistics & numerical data, Fractures, Bone epidemiology, Fractures, Bone surgery
- Abstract
Background: Mid-shaft clavicular fractures are mainly treated conservatively with an average incidence of non-union in 4.5 %. Gender, age, grade of fragment dislocation and comminution are risk factors to develop a pseudarthrosis. In contrast to patients who where operated on, conservative treatment was also associated with a higher complication rate and pain level as well as a poor shoulder function and cosmetic result. Therefore more patients are treated operatively, especially modern minimally invasive techniques have been developed and remain as equals to the standard plate fixation. PATIENTS/MATERIAL: Within a period of 24 months patients with a mid-shaft clavicular fracture were included into a prospective, non-randomised multicentre study. A modified AO classification was used. Patients were treated either conservatively, by plating or intramedullary nailing. Pain level, cosmetic result, shoulder function and complication rate were documented as well as the influence of the profession on the therapeutic strategy and duration of unfitness for work., Results: 120 patients (95 male, 25 female) were included in the study. Fractures were caused in 35 (29 %) by a direct, in 85 (71 %) by an indirect trauma mechanism. Because of their lower grade fractures with overlapping fragments 47 (39 %) patients were treated conservatively with a figure-of-eight-bandage. Patients with higher graded fractures and fragment displacement were stabilised either by intramedullary nailing (n = 20, 27 %) or plate fixation (n = 53, 73 %). 96 (80 %) patients were examined at a follow-up of eight weeks and eight months after injury. Early freedom from pain (p = 0.014), a better cosmetic result (p = 0.1) and an improved subjective (p = 0.004) and objective (p = 0.01) shoulder function were statistically significant in operated patients. Clavicle shortening was often found to be significant in conservatively treated patients (p = 0.006). Duration of unfitness for work depended on the physical activity in the job. The complication rate was 15 % for each therapy, non-union was detected in one (0.8 %) patient., Conclusion: Mid-shaft clavicular fractures have to be classified by the criteria contact and number of fragments. Advantages of operative procedures are early freedom from pain and shoulder function recovery. Non-displaced low grade shaft fractures without shortening should be treated conservatively, whereas displaced low-grade shaft fractures have a better result after intramedullary nailing. Plate fixation should be predominantly used in dislocated and comminuted fractures as well as in patients with a high level of physical activity in their jobs., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2011
- Full Text
- View/download PDF
36. [Complex ligament instabilities after "open book"-fractures of the pelvic ring - finite element computer simulation and crack simulation].
- Author
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Böhme J, Steinke H, Huelse R, Hammer N, Klink T, Slowik V, and Josten C
- Subjects
- Computer Simulation, Finite Element Analysis, Humans, Fractures, Bone physiopathology, Ligaments injuries, Ligaments physiopathology, Models, Biological, Pelvic Bones injuries, Pelvic Bones physiopathology
- Abstract
Background: Instability of pelvic ring fractures is also caused by ligament disruption. Classifications are based on the major forces leading to fracture. Data from injury mechanisms as well as clinical and radiological criteria are used to determine the degree of instability. The major aim of all kinds of stabilisation is the anatomic reconstruction of the bony pelvic ring. The injured ligamentous apparatus is still ignored. Some clinical trials assume that soft-tissue injuries may be the reason for the poor patient outcome in "open book" pelvic ring fractures. The aim of the study was to develop a realistic finite element (FE) computer model to simulate "open book" fractures and predict injury-associated instabilities for osteosynthesis planning. PATIENTS/MATERIAL: We developed a realistic FE computer model of the pelvic ring based on CT data. With anatomic studies a computer model of the ligamentous apparatus was created and inserted into the pelvic ring to complete the bone-ligament complex. Numerical simulations were performed to identify the influence of single pelvic ligaments on the shifting at the intact anterior and posterior pelvic ring. Additionally, a biomechanical validated virtual crack simulation with anterior-posterior compression forces was undertaken to predict complex instabilities in "open book" pelvic ring fractures., Results: The pelvic ligaments have local and general stabilising functions. The sacrospinous and sacrotuberous ligaments are providing the vertical load transfer, whereas the ligaments of the iliosacral joint and the iliolumbal ligament are necessary for the horizontal load transfer. In "open book" fractures ligaments are ruptured stepwise from anterior to posterior. If the intraosseous and posterior ligaments of the iliosacral joint are intact, only single rotational instability along the ipsilateral iliosacral joint occurs. If the ligaments at the posterior pelvic ring are ruptured too, a second axis across both iliosacral joints was measured. In this particular case additional stabilisation of the posterior pelvic ring should be performed., Conclusion: With numerical simulations, prediction of injury-associated instabilities is possible. Because of incomplete radiological data the implementation of patient-specific FE pelvic computer models into the clinical routine is still not realistic., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2011
- Full Text
- View/download PDF
37. [Ligament healing results after type C pelvic ring fractures. Results of triangular vertebropelvic support].
- Author
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Böhme J, Lägel A, Schmidt F, Tiemann AH, and Josten C
- Subjects
- Fracture Healing, Humans, Treatment Outcome, Fracture Fixation instrumentation, Fracture Fixation methods, Fractures, Bone surgery, Ligaments injuries, Ligaments surgery, Pelvic Bones injuries, Pelvic Bones surgery
- Abstract
Background: Posterior pelvic ring fractures are often associated with injuries of lumbopelvic soft tissue structures. The aim of this prospective MR study was to examine whether ruptured iliolumbal ligaments could be diagnosed in types B and C pelvic ring fractures. The influence of triangular lumbopelvic stabilization (TLPS) was also investigated with respect to stiffening of the lumbopelvic region., Material and Methods: Using a 1.5 Tesla MRI, 20 patients with types B and C fractures were examined to identify ruptured iliolumbal ligaments. In a retrospective study of 30 patients previously stabilized with a TLPS, pain scores, clinical instability testing and measuring of the segmental dislocation in extension, flexion and lateral flexion based on x-rays were also investigated., Results: Of the patients 3 (1 type B, 2 type C fractures) had incompletely ruptured iliolumbal ligaments. In five patients pain intensity and localization could be significantly correlated with clinical instability of the lumbopelvic region, segmental hypermobility and instability., Conclusion: Pelvic ring fractures types B and C can be associated with ruptured iliolumbal ligaments. Lumbopelvic instability can be correlated with early implant loosening of TLPS.
- Published
- 2010
- Full Text
- View/download PDF
38. [Examination of rearing standards and health status in turkeys in Germany].
- Author
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Krautwald-Junghanns ME, Ellerich R, Böhme J, Cramer K, DellaVolpe A, Mitterer-Istyagin H, Ludewig M, Fehlhaber K, Schuster E, Berk J, Aldehoff D, Fulhorst D, Kruse W, Dressel A, Noack U, and Bartels T
- Subjects
- Animals, Female, Floors and Floorcoverings standards, Germany, Male, Poultry Diseases epidemiology, Poultry Diseases etiology, Risk Factors, Wounds and Injuries epidemiology, Wounds and Injuries etiology, Wounds and Injuries veterinary, Animal Husbandry standards, Animal Welfare, Health Status, Turkeys
- Abstract
Within the framework of a cooperative research project, sponsored by the Federal Ministry of Food, Agriculture and Consumer Protection in Germany (BMELV), turkey health as well as numerous aspects of animal welfare in various intensive commercial farms with varying rearing forms were examined. For this purpose extensive documentation of flock management and health status information was conducted over the past two years at the farms. Additional information was ascertained from the carcasses at the slaughterhouse. The first results of this study, which look at flock management, will be presented here. Upon reviewing the questionnaires, it is clear that on one hand almost all farmers orientate there stocking rate upon the allowed limits, on the other hand, however, when considering national general requirements, which are very important parameters thatargely influence animal health (i. e. litter quality and care of sick/injured animals) farmer compliance lacks. Especially the litter quality, which, among other parameters, plays a very important role in food pad health, proved to be unsatisfactory. Unfortunately, no instruments are available that measure the litter quality, yet. The status of footpad health was a major problem in all the rearing systems. However, the prevalence of epithelial necrosis and deep skin lesions varied immensely among different flocks of the same age.
- Published
- 2009
39. [Fatal risk thrombosis? A prospective study for the incidence of deep vein thrombosis in pelvic fractures].
- Author
-
Böhme J, Müller J, Fröhlich S, Tiemann AH, and Josten C
- Subjects
- Acetabulum injuries, Acetabulum surgery, Adolescent, Adult, Aged, Aged, 80 and over, Cause of Death, Cross-Sectional Studies, Dose-Response Relationship, Drug, Enoxaparin administration & dosage, Female, Fibrinolytic Agents administration & dosage, Fractures, Bone mortality, Heparin administration & dosage, Hospital Mortality, Humans, Incidence, Male, Middle Aged, Multiple Trauma mortality, Pelvic Bones surgery, Postoperative Care, Postoperative Complications diagnostic imaging, Postoperative Complications mortality, Postoperative Complications prevention & control, Premedication, Prospective Studies, Risk, Ultrasonography, Doppler, Color, Venous Thrombosis diagnostic imaging, Venous Thrombosis prevention & control, Young Adult, Fractures, Bone surgery, Multiple Trauma surgery, Pelvic Bones injuries, Venous Thrombosis mortality
- Abstract
Aim: The aim of the study was to determine the incidence of deep vein thrombosis (DVT) after pelvic trauma and surgical stabilisation of pelvic and acetabular fractures under medicamentous prophylaxis., Patients and Method: Within 20 months we prospectively included 50 patients. 25 had an isolated pelvic trauma, 25 patients had multiple injuries. 21 of them were polytrauma patients (average ISS: 31.4; min. 26 pts., max. 50 pts.), four patients had additional highly unstable spine fractures or fractures of the lower extremities. Low molecular-weight heparin (Enoxaparin 40 g/d) was administered on average within 24 hours of injury in 44 cases, one patient received low-dose heparin (Liquemin 15,000 to 22,500 I. E./d), five patients received both. 31 patients were treated operatively and 19 conservatively. Colour-flow duplex ultrasonography was performed within 72 hours of injury and stabilisation of the pelvic and acetabular fracture, or weekly. By means of ultrasound, 97 to 100 % of the deep and superficial leg veins could be examinated safely, as well as 88 to 89 % of the external iliac veins and 64 to 66 % of the common iliac veins. Only in 36 to 40 % of the patients the internal iliac veins were visible by ultrasound., Results: Proximal DVTs were detected postoperatively in two patients (4 %), one patient (2 %) died after a fatal P. E. before the scheduled duplex scan., Conclusion: Early medicamentous prophylaxis can prevent deep vein thrombosis after pelvic trauma. Delayed applications due to pelvic operations are risk factors. In such cases duplex scanning should be performed routinely and postoperative medicamentous prophylaxis should be increased.
- Published
- 2009
- Full Text
- View/download PDF
40. [Use of the pelvic clamp in polytraumatised patients with unstable disruption of the posterior pelvic ring. Modified technique--risks--problems].
- Author
-
Tiemann AH, Böhme J, and Josten C
- Subjects
- Adolescent, Adult, Aged, Female, Fracture Fixation, Internal, Hospital Mortality, Humans, Ilium diagnostic imaging, Ilium injuries, Ilium surgery, Injury Severity Score, Male, Manipulation, Orthopedic, Middle Aged, Multiple Trauma diagnostic imaging, Multiple Trauma mortality, Pelvic Bones diagnostic imaging, Pelvic Bones surgery, Radiography, Reoperation, Bone Nails, Emergencies, External Fixators, Multiple Trauma surgery, Pelvic Bones injuries, Surgical Instruments
- Abstract
Background: Unstable fractures of the posterior pelvic ring are frequently combined with severe hemorrhage. In 80% of cases the bleeding originates in the ruptured presacral venous plexus or the fracture itself. Arterial bleeding is less common. The pelvic clamp introduced by Ganz can make it possible to stabilise the pelvis, with subsequent compression of the fracture planes and reduction of the intrapelvic volume in such cases, so improving the prognosis. Use of the pelvic clamp can be integrated into the management in the emergency room with no problem., Methods: This paper presents the authors' own modification of the technique for using the pelvic clamp in the emergency situation when only a clinical examination of the patient has been possible and also analyses specific problems that arise in this situation. To this end, the data relating to 29 polytraumatised patients with unstable posterior pelvic ring fractures were analysed in a retrospective study., Results: In all, 8 complications were seen in 6 patients. There were 2 cases of pin malposition and 2 of over-compression of the ossa coxae and local wound problems. Secondary pin dislocation was observed in 1 case. In all these cases it was possible to correct the pelvic clamp, so that emergency stabilisation was practicable without further surgical intervention. Minor complications were found in 2 patients. These took the form of bleeding at the pin-insertion site. In 1 case an unstable transiliacal fracture was found, and in this case it was not possible to stabilise the posterior pelvic ring with the pelvic clamp. No iatrogenic lesions were detected following application of the pelvic clamp., Conclusion: In the hands of an experienced and practised user application of the pelvic clamp is a safe method for emergency stabilisation of the posterior pelvic ring in polytraumatised patients, even without blood volume control. Problems can be solved and do not generally mean the pelvic clamp cannot be used. The immediate radiological check (e.g. during the emergency CT -scan performed for primary diagnosis) is a must, however.
- Published
- 2006
- Full Text
- View/download PDF
41. [The TRALI syndrome--a life-threatening transfusion reaction].
- Author
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Voss J, Westphal K, Böhme J, Bux J, and Greinacher A
- Subjects
- Acute Disease, Antibodies immunology, Granulocytes immunology, Humans, Intraoperative Complications diagnostic imaging, Intraoperative Complications physiopathology, Male, Middle Aged, Pulmonary Edema diagnostic imaging, Pulmonary Edema physiopathology, Radiography, Respiratory Distress Syndrome physiopathology, Syndrome, Intraoperative Complications etiology, Pulmonary Edema etiology, Transfusion Reaction
- Abstract
Transfusion related acute lung injury (TRALI) is a serious complication of blood transfusion, characterized by non-cardiogenic lung oedema. We describe a case of TRALI due to granulocyte-specific antibodies. The 58-year-old patient received 2 units of fresh frozen plasma following colon surgery and within 30 min the patient developed an acute respiratory distress syndrome. Granulocyte-specific antibodies were found in one of the transfused plasma of a female blood donor who most likely became immunized against granulocyte alloantigens during her three pregnancies.
- Published
- 2001
- Full Text
- View/download PDF
42. [Combined alcohol dependence and personality disorder and its legal consequences with respect to commitment].
- Author
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Allhoff T, Böhme-Molle J, and Banger M
- Subjects
- Adult, Germany, Humans, Male, Alcoholism complications, Alcoholism psychology, Commitment of Mentally Ill legislation & jurisprudence, Personality Disorders complications, Personality Disorders psychology
- Abstract
People frequently consuming an excessive amount of alcohol often show symptoms of personality disorder. Personality disorder and alcohol dependence are frequently connected with each other. However, there are only very few conditions enhancing concomitant dependence and personality disorder to the rank of a mental disease according to German guardianship legislation. If the patient's condition meets the criteria of a psychic disease and endangers his own health and public safety, commitment to a mental hospital or guardianship are justified. The purpose of this clinical analysis was to compare the medical proposal for treatment with legal prerequisites which are indispensable for involuntary admission to a mental hospital. Whereas the Psychiatric Disorders Act intends to avert danger to the public, guardianship legislation aims at individual help. We present a patient who suffered from alcoholism and simultaneously met criteria of a serious personality disorder, which was classified according to ICD-10 (F 60.31). As the aggravation of the symptoms was most likely to entail serious danger to his health the judge ordered immediate involuntary admission. Two other patients had similar comorbidity but had to be released from hospital because of finalisation of detoxification. Neither dependence nor personality disorder were pronounced enough to restrict the rights of the individual. Our analysis shows that the psychiatrist must present with an expert medical report that quantifies the extent of alcoholism and personality disorder and characterises them as psychic disease. Consequently, for the purpose of quantifying the extent of dependence, we recommend to apply the European Addiction Severity Index whose suitability should be assessed.
- Published
- 1999
- Full Text
- View/download PDF
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