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Background: Spinal injuries in childhood are rare. There are few meaningful data for German-speaking countries., Questions/aim of the Study: Evaluation of the registry data of the German Spine Society (DWG) with respect to the reality of care for thoracolumbar injuries in childhood., Material and Methods: This retrospective study was initiated by the Spinal Trauma in Childhood Working Group of the Spine Section of the German Society for Orthopaedics and Trauma Surgery (DGOU). All patients under the age of 16 years who underwent surgery between 1 January 2017 and 31 June 2023 were included. An anonymized evaluation of the demographic data was carried out with respect to age, gender, level of injury, neurological impairment, classification and treatment performed with intraoperative and postoperative complications. The specified documentation in the spine register served as the information basis. Regarding age classification 3 groups were used: I: 0-6 years, II: 7-9 years, III: 10-16 years., Results: Data from 83 children with 150 injuries in the thoracic and lumbar spine areas with a mean age of 11.4 (± 3.45) years were analyzed. A total of 78 (52%) thoracic and 72 (48%) lumbar injuries were found. Type A injuries were most common (n = 89; 59.2%). Type B injuries were found in 32.2% (n = 48) and occurred mainly in group III. According to the AO neurological injury classification 18 (21%) patients had incomplete and 4 (4.8%) patients had complete paraplegia. Various methods were used for surgical treatment, the most common being dorsal stabilization (n = 73; 87.9%). The majority of operations were uncomplicated (n = 75; 90.4%)., Discussion: According to the registry data 83 children were treated surgically with an acceptable complication rate. Older children and adolescents (group III) had a significantly higher injury severity compared to younger children. As with most registry studies, only limited conclusions can be drawn about surgical strategies, indications and techniques., Competing Interests: Einhaltung ethischer Richtlinien. Interessenkonflikt: H. Rüther, S. Alayesh, C. Heyde, D. Wiersbicki, Y. Youssef, J. Bolte, P. Brecht, A.C. Disch und J.-S. Jarvers geben an, dass kein Interessenkonflikt besteht. Diese retrospektive Studie erfolgte nach Konsultation der zuständigen Ethikkommission und im Einklang mit nationalem Recht., (© 2024. The Author(s).)

Background: Guidelines serve as practice-based decision support and recommend the use of standardized instruments to measure functional capacity in individuals with multiple sclerosis (MS). However, the extent to which a person's functioning is captured by these instruments is unclear., Objectives: The aim of this study is to link the content of the MS disease guideline with the International Classification of Functioning, Disability and Health (ICF) in order to capture the distribution of the content on the functional domains and contextual factors and to uncover existing gaps., Materials and Methods: Instruments of the S2k guideline "Diagnosis and therapy of multiple sclerosis, neuromyelitis optica spectrum diseases and MOG-IgG-associated diseases", which were available free of charge in German or English and designed for adult people, were included. The instruments were classified into their meaningful concepts (meaningful concepts = MCs) and subsequently coded using standardized ICF rules by two raters., Results: The 23 included instruments contained 351 items and 718 MCs. Of these, 663 MCs could be linked to the ICF according to the coding rules. Of these, 51% (340 MCs) related to body functions, 44% (291 MCs) to the activity and participation component, and 5% (32 MCs) to environmental factors. The most frequently coded chapter was mobility (d4) with 201 MCs. Interrater agreement was k = 0.79., Discussion: The linking of the guideline-recommended instruments to the ICF shows that the instruments cover different themes. The area of environmental factors is underrepresented. The ICF linkage reveals a broad spectrum of functioning covered by the guideline-recommended instruments and facilitates the selection of appropriate instruments for the affected persons., Competing Interests: Einhaltung ethischer Richtlinien. Interessenkonflikt: J. Bolte, E.-M. Dilger und A.L. Brütt geben an, dass kein Interessenkonflikt besteht. Im Rahmen der vorliegenden Arbeit wurden keine Daten von Menschen erhoben, sondern verschriftlichte Instrumente der MS-Leitlinie qualitativ untersucht. Das Einholen eines Ethikvotums war dementsprechend nicht erforderlich., (© 2024. The Author(s).)

History and Clinical Findings: A 32-year-old man of Albanian descent had for ten years been complaining of pain over the apex of the heart with gradually increasing dyspnoea. He was hospitalised because of an acute duodenal ulcer., Investigations: Clinical and biochemical examinations were within normal limits. Computed tomography and magnetic resonance imaging revealed a myocardial tumour in the right ventricle, 4 x 3 x 3 cm., Treatment and Course: A primary myocardial tumour of unknown malignancy was suspected, but at surgery it was found to be an echinococcal cyst, which was resected. Echinococcal antigen titre, first measured postoperatively, was positive (ELISA and IHA tests). Albendazole was administered (50 mg/kg daily) to prevent recurrence. The patient was still symptom-free two years postoperatively., Conclusion: Echinococcal cyst should be considered in the differential diagnosis of cardiac tumour. If untreated the condition may be fatal. Resection under cardiopulmonary bypass with cardioplegia, as in this patient, carries a low risk and is therefore the treatment of choice.

History and Clinical Findings: A 58-year-old man, previously resident in Russia, was known since the age of 18 years to have arterial hypertension of unknown cause in only the right arm. A single syncope was the only previous symptom. On examination the pressure was 230/110 mmHg in the right arm, 150/100 mmHg in the left one. The pulse in the right arm and neck was strong and heaving, that in the left arm and the legs much more weakly palpable., Investigations: Electrocardiogram and echocardiogram showed left ventricular hypertrophy. The chest radiogram demonstrated rib notching. Digital subtraction angiography revealed aortic arch atresia just distal to the common carotid artery. No other cardiovascular abnormalities were found., Treatment: The patient declined operative treatment. Cautious antihypertensive drug treatment with Atenolol (25 mg daily) reduced the pressure in the right arm to 180/90 mmHg., Conclusion: This rare malformation of aortic arch atresia should be considered in the differential diagnosis of asymmetrical arterial hypertension in an adult.

Out of a total of 1640 consecutive left heart catheterizations, 70 (58 males and 12 females; mean age 56 +/- 8 years) were performed via the right brachial artery, in most instances because of occlusive disease of the arteries in the pelvic region. 5F catheters were then successfully used for both the coronary and left-ventricular angiographies. Noninvasive examinations after two days (Doppler ultrasound, oscillography at rest and on exercise, acral plethysmography and colour-coded duplex sonography) revealed small haematomas in the region of the arterial puncture in four and a haemodynamically insignificant fistula between brachial artery and vein in one patient but no aneurysm, stenosis or thrombosis at the puncture site. This procedure is thus a valuable addition to invasive cardiological diagnosis.

A new model for experimental research in pigs is reported. It allows comparative analyses in blood, bile and urine in the unanaesthetized pig. Preliminary results to the physiology of biliary excretion and multicompartmental analysis of conjugated bile acids emphasize the applicability of the experimental model. On the basis of these results it is pointed out, that it is possible to analize the distribution and excretion kinetics of conjugated bile acids, namely C14-glycocholic acid, by a 3-compartmental analysis.