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Bremer S, Kiess W, Thome U, Knüpfer M, Bühligen U, Vogel M, Friedrich A, Janisch U, Rißmann A. Errata: Prävalenz von Gastroschisis, Omphalozele, Spina bifida und orofazialen Spaltbildungen bei Neugeborenen im Zeitraum Januar 2000–Dezember 2010 in Leipzig, Sachsen, Sachsen-Anhalt und Deutschland. Gesundheitswesen 2018; 80:e11. [DOI: 10.1055/s-0042-114082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- S. Bremer
- Department für Frauen- und Kindermedizin, Klinik für Kinder- und Jugendmedizin, Leipzig
| | - W. Kiess
- Department für Frauen- und Kindermedizin, Klinik für Kinder- und Jugendmedizin, Leipzig
| | - U. Thome
- Universitätsklinikum Leipzig, Department für Frauen- und Kindermedizin, Klinik und Poliklinik für Kinder und Jugendliche, Selbstständige Abteilung für Neonatologie, Leipzig
| | - M. Knüpfer
- Universitätsklinikum Leipzig, Department für Frauen- und Kindermedizin, Klinik und Poliklinik für Kinder und Jugendliche, Selbstständige Abteilung für Neonatologie, Leipzig
| | - U. Bühligen
- Universitätsklinikum Leipzig, Department für Frauen- und Kindermedizin, Klinik und Poliklinik für Kinderchirurgie, Leipzig
| | - M. Vogel
- Universitätsklinikum Leipzig, LIFE – Leipziger Forschungszentrum für Zivilisationserkrankungen, Leipzig
| | - A. Friedrich
- Sächsische Landesärztekammer, Qualitätssicherung, Dresden
| | - U. Janisch
- Statistischen Landesamt des Freistaates Sachsen, Forschungsdatenzentrum der Statistischen Ämter des Bundes und der Länder, Dresden
| | - A. Rißmann
- Fehlbildungsmonitoring Sachsen-Anhalt, Neugeborenen-Hörscreening Trackingzentrale Sachsen-Anhalt, Medizinische Fakultät der Otto-von-Guericke Universität Magdeburg, Magdeburg
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Bremer S, Kiess W, Thome U, Knüpfer M, Bühligen U, Vogel M, Friedrich A, Janisch U, Rißmann A. Prävalenz von Gastroschisis, Omphalozele, Spina bifida und orofazialen Spaltbildungen bei Neugeborenen im Zeitraum Januar 2000–Dezember 2010 in Leipzig, Sachsen, Sachsen-Anhalt und Deutschland. Gesundheitswesen 2018; 80:122-128. [DOI: 10.1055/s-0042-102345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Zusammenfassung
Hintergrund: Zahlreiche Studien beschreiben weltweit eine Zunahme angeborener Fehlbildungen. Diese sind in Deutschland die häufigste Todesursache im frühen Kindesalter. Die hier vorliegende Studie untersuchte lokale und nationale Trends der Prävalenz von Gastroschisis, Omphalozele, Spina bifida und orofazialen Spaltbildungen von 2000 bis 2010.
Methoden: Die Prävalenz der 4 Fehlbildungen wurde im Zeitraum Januar 2000–Dezember 2010 mithilfe von 4 Datenquellen aus Leipzig, Sachsen, Sachsen-Anhalt und Deutschland untersucht.
Ergebnisse: Die Prävalenz der Fehlbildungen betrug im Untersuchungszeitraum in Deutschland bzw. in Sachsen 1,97/2,12 (Gastroschisis), 1,63/1,48 (Omphalozele), 5,80/8,11 (orofaziale Spaltbildungen) und 2,92/2,50 (Spina bifida) je 10 000 Lebendgeborene. In Sachsen zeigte sich ein Trendanstieg, dessen Effektstärken jedoch sehr gering sind (OR/Jahr zwischen 1,01–1,09). Auch in Deutschland insgesamt wurde eine signifikante Zunahme der Fehlbildungen beobachtet (OR/Jahr zwischen 1,01–1,04), ausgenommen davon war die Lebendgeborenenprävalenz der Spina bifida, die abzunehmen schien (OR/Jahr 0,986 (0,97–1,0), p-korrigiert=0,04).
Schlussfolgerung: Ob ein tatsächlicher Anstieg der Prävalenzen besteht oder lediglich Artefakte einen Anstieg vortäuschen, ist unklar. Änderungen in der Erfassungs- und Verschlüsselungspraxis, Fehlcodierungen, Doppel- und/oder lückenhafte Erfassung der Fehlbildungen könnten die Daten verfälschen. Da nur in Sachsen-Anhalt und Rheinland-Pfalz das Auftreten von Fehlbildungen prospektiv erfasst wird, könnten im Übrigen auch nur in diesen Bundesländern zeitnah Veränderungen der Fehlbildungsprävalenz erkannt werden. Angesichts der anscheinenden oder scheinbaren Zunahme von Fehlbildungen und der offensichtlich fehlerhaften Datenlage ist ein bundesweites oder sind weitere regionale Register für eine bessere und zeitnahe Erkennung und Erfassung von Fehlbildungen in Deutschland notwendig.
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Affiliation(s)
- S. Bremer
- Department für Frauen- und Kindermedizin, Klinik für Kinder- und Jugendmedizin, Leipzig
| | - W. Kiess
- Department für Frauen- und Kindermedizin, Klinik für Kinder- und Jugendmedizin, Leipzig
| | - U. Thome
- Universitätsklinikum Leipzig, Department für Frauen- und Kindermedizin, Klinik und Poliklinik für Kinder und Jugendliche, Selbstständige Abteilung für Neonatologie, Leipzig
| | - M. Knüpfer
- Universitätsklinikum Leipzig, Department für Frauen- und Kindermedizin, Klinik und Poliklinik für Kinder und Jugendliche, Selbstständige Abteilung für Neonatologie, Leipzig
| | - U. Bühligen
- Universitätsklinikum Leipzig, Department für Frauen- und Kindermedizin, Klinik und Poliklinik für Kinderchirurgie, Leipzig
| | - M. Vogel
- Universitätsklinikum Leipzig, LIFE – Leipziger Forschungszentrum für Zivilisationserkrankungen, Leipzig
| | - A. Friedrich
- Sächsische Landesärztekammer, Qualitätssicherung, Dresden
| | - U. Janisch
- Statistischen Landesamt des Freistaates Sachsen, Forschungsdatenzentrum der Statistischen Ämter des Bundes und der Länder, Dresden
| | - A. Rißmann
- Fehlbildungsmonitoring Sachsen-Anhalt, Neugeborenen-Hörscreening Trackingzentrale Sachsen-Anhalt, Medizinische Fakultät der Otto-von-Guericke Universität Magdeburg, Magdeburg
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Bühligen U, Neumuth T, Schumann S. Distance Measures for Surgical Process Models. Methods Inf Med 2018; 52:422-31. [DOI: 10.3414/me12-01-0111] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 04/09/2013] [Indexed: 11/09/2022]
Abstract
SummaryBackground: The development of new resources, such as surgical techniques and approaches, results in continuous modification of surgery. To assess these modifications, it is necessary to use measures that quantify the impact of resources on surgical processes.Objectives: The objective of this work is to introduce and evaluate distance measurements that are able to represent differences in the courses of surgical interventions as processes.Methods: Hence, we present four different distance measures for surgical processes: the Jaccard distance, Levenshtein distance, Adjacency distance, and Graph matching distance. These measures are formally introduced and evaluated by applying them to clinical data sets from laparoscopic training in pediatric surgery.Results: We analyzed the distances of 450 surgical processes using these four measures with a focus on the difference in surgical processes performed by novices and by experienced surgeons. The Levenshtein and Adjacency distances were best suited to measure distances between surgical processes.Conclusion: The measurement of distances between surgical processes is necessary to estimate the benefit of new surgical techniques and strategies.
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Ritter L, Götz G, Sorge I, Lehnert T, Hirsch FW, Bühligen U, Vieweger A, Geyer C. Significance of MR angiography in the diagnosis of aberrant renal arteries as the cause of ureteropelvic junction obstruction in children. ROFO-FORTSCHR RONTG 2014; 187:42-8. [PMID: 25226231 DOI: 10.1055/s-0034-1385106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE To determine the importance of MRI with contrast-enhanced MRA for the detection or exclusion of aberrant or obstructing renal arteries in ureteropelvic junction obstruction in children. MATERIALS AND METHODS Key word-based search in RIS database (ureteropelvic junction obstruction/ MRI) and retrospective comparison of arterial findings from preoperative contrast -enhanced MRA and intra-operative inspection. From 2007 to 2013, 19 children with ureteropelvic junction obstruction underwent contrast-enhanced MRA. Based on the results of the MRI scan and MAG3 scintigraphy, the children were referred to surgery (Anderson-Hynes-pyeloplasty). RESULTS An aberrant renal artery was diagnosed with MRI in 14 of 19 children, and intra-operative inspection confirmed 13 of those 14. In the remaining 5 children, no aberrant vessel could be observed in MRI and this was confirmed intra-operatively in 3 of the 5 cases, while in the remaining 2, an aberrant vessel was found. Of the 14 children with aberrant vessels, 12 underwent surgery due to assumed ureteral obstruction, which was confirmed by surgery in 11 cases. In one case, an aberrant artery was found intra-operatively, but obstruction could not be confirmed. In one of the 14 children, the vessel was found in MRI, but its obstructing character was negated via MRA, which was confirmed intra-operatively. In the diagnosis of aberrant and obstructing renal arteries, contrast-enhanced MRA presents 85% sensitivity and 80% specificity, with a positive predictive value of 0.8. CONCLUSION MRI with contrast-enhanced MRA is suitable to detect aberrant and obstructing renal arteries. An obstructive effect of the aberrant vessel is to be assumed if the vessel has a close relationship to the ureteropelvic junction and if it is linearly stretched. KEY POINTS • MRI with contrast-enhanced MRA is a sure method for the detection of aberrant renal arteries in children with ureteropelvic junction obstruction. • The obstructive effect of the aberrant vessel can be derived from the close proximity of the vessel to the ureteropelvic junction and from the streched course of the vessel.
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Affiliation(s)
- L Ritter
- Department of Pediatric Radiology, University of Leipzig
| | - G Götz
- Department of Pediatric Surgery, University of Leipzig
| | - I Sorge
- Department of Pediatric Radiology, University of Leipzig
| | - T Lehnert
- Department of Pediatric Surgery, University of Leipzig
| | - F W Hirsch
- Department of Pediatric Radiology, University of Leipzig
| | - U Bühligen
- Department of Pediatric Surgery, University of Leipzig
| | - A Vieweger
- Department of Pediatric Radiology, University of Leipzig
| | - C Geyer
- Department of Pediatric Surgery, University of Leipzig
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Hans HJ, Krause H, Bühligen U. [Juvenile bone cysts - current status of treatment options - 6th regional meeting paediatric traumatology - a postscript]. Zentralbl Chir 2011; 137:e2-3. [PMID: 21495004 DOI: 10.1055/s-0031-1271427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- H-J Hans
- Universitätsklinikum Magdeburg A. ö. R., Arbeitsbereich Kinderchirurgie, Klinik für Chirurgie, Magdeburg, Deutschland. hans-juergen.hassmed.ovgu.de
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Till H, Wachowiak R, Marinoni F, Bühligen U, Stolzenburg JU. Laparoendoskopische Single-Site-Cholezystektomie (LESS) bei einem 16-jährigen Mädchen: Ein Weg auch für die Kinderchirurgie? Zentralbl Chir 2010; 135:188-9. [DOI: 10.1055/s-0029-1224683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Tröbs RB, Hoepffner W, Bühligen U, Limbach A, Keller E, Schütz A, Horn LC, Kiess W, Bennek J. Video-assisted gonadectomy in children with Ullrich Turner syndrome or 46,XY gonadal dysgenesis. Eur J Pediatr Surg 2004; 14:179-84. [PMID: 15211408 DOI: 10.1055/s-2004-815870] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Patients with dysgenetic gonads carry a high risk for the development of gonadal neoplasia. The aim of the study is to evaluate indications and feasibility of laparoscopy and video-assisted prophylactic gonadectomy in children with Ullrich Turner syndrome (UTS) or 46,XY gonadal dysgenesis (GoDy). Between 1996 and December 2002 five girls with UTS and nine patients with 46,XY GoDy (female gender role) were explored by laparoscopy. Video-assisted salpingo-oophorectomy or gonadectomy was performed using a three-port technique. Prophylactic salpingo-oophorectomy was exclusively performed in UTS patients with proven presence of translocated parts of the Y chromosome. In three patients with 46,XY GoDy laparoscopy was followed by surgical revision of the groin and open gonadectomy in four patients. In two cases with UTS the removed streak gonads contained small unilateral tumours stage pT1a, and in four cases of 46, XY GoDy histopathological investigation revealed bilateral neoplasms stage pT1b. We found the following tumour types: gonadoblastoma, dysgerminoma, testicular intraepithelial neoplasia, and mature teratoma. In conclusion, investigative laparoscopy gives a good image of the internal genital structures and allows the safe removal of the dysgenetic gonads during the same operation. The high rate of gonadal tumours underlines the indication for early gonadectomy in these patients.
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Affiliation(s)
- R-B Tröbs
- Department and Outpatient Department of Paediatric Surgery, University of Leipzig, Leipzig, Germany.
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Tröbs RB, Siekmeyer W, Bühligen U, Berr F, Bennek J. Treatment of transient posttraumatic bile-duct stenosis by laparoscopic-assisted cholecystotomy. Pediatr Surg Int 2002; 18:503-4. [PMID: 12415393 DOI: 10.1007/s00383-002-0851-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/18/2002] [Indexed: 11/30/2022]
Abstract
A 10-year-old boy developed severe obstructive jaundice following blunt abdominal trauma. Endoscopic retrograde cholangiography and magnetic resonance cholangiography revealed a stricture of the common bile duct. A cholecystostomy tube was inserted under laparoscopic guidance. After temporary bile drainage and a cholecystoenteric bypass the patient recovered.
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Affiliation(s)
- R-B Tröbs
- Klinik und Poliklinik für Kinderchirurgie, Universitätsklinikum Leipzig AöR, Oststr. 21-25, D-04317 Leipzig, Germany.
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Nounla J, Bennek J, Bühligen U, Rolle U. [External femorotibial transfixation in femoral fracture with joint involvement in a child]. Unfallchirurg 2001; 104:665-7. [PMID: 11490960 DOI: 10.1007/s001130170098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Long bone fractures combined with joint injuries run a high risk of destabilising the articulations. Remaining joints incongruence can lead to early arthosis especially in cases of severe injuries or not achieved anatomical reduction. A number of osteosynthesis methods are available for anatomical repair of the articular facet. This report presents a seven years old boy with an open comminuted fracture of the distal femur and consecutive joint instability, treated with a Transfixation (Orthofix) of the knee joint. The functional results suggest this method as an alternative treatment.
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Affiliation(s)
- J Nounla
- Klinik und Poliklinik für Kinderchirurgie, Universität Leipzig, Oststrasse 21-25, 04317 Leipzig.
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Abstract
A retrospective analysis of 332 children with osteomyelitis (OM), managed from 1966 to 1996, was undertaken to evaluate etiology, clinical course and treatment results. In 64% of all patients positive bacterial cultures were obtained, Staphylococcus aureus, streptococci, pneumococci, and Haemophilus influenzae were the most frequently cultured pathogens. In two-thirds of the cases long bones (femur, tibia, humerus) were affected. Osteoarthritis or suppurative arthritis was evident in 27%; 32 of 170 (19%) re-evaluated patients had moderate or severe sequelae. Risk factors for an unfavorable course were the onset of disease in early infancy, suppurative arthritis, and an affected epiphysis. Suppurative arthritis, in particular, needs early evacuation to prevent sequelae. In recent years we observed an increasing number of patients presenting with atypical forms of OM. Since 1989 10 patients were considered to have chronic recurrent multifocal OM (CRMO). In 6 of them the clavicle was involved; their ages ranged from 3 to 14 years. The erythrocyte sedimentation rate was elevated (median 48, range 9-110 mm), while other inflammatory parameters like C-reactive protein (median 9, range <5-85 mg/l) or leucocyte count were slightly elevated or normal. Histopathology was stage-dependent, with a predominance of lymphoplasmacellular infiltration. A nonbacterial origin of CRMO is probable but not proven. Histopathology is not suitable for differentiation between bacterial and nonbacterial forms of bone inflammation.
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Affiliation(s)
- R Tröbs
- Klinik und Poliklinik für Kinderchirurgie, Theresienstrasse 43, D-04129 Leipzig, Germany
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