11 results on '"Bücking B"'
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2. Der stationäre Verlauf bei postoperativer Intensivüberwachung - wie unterscheidet sich das Outcome von Patienten mit proximaler Femurfraktur zu anderen geriatrischen Traumapatienten
- Author
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Knauf, T, Lotz, N, Bücking, B, Aigner, R, Bäumlein, M, Bökeler, U, Ruchholtz, S, Eschbach, DA, Knauf, T, Lotz, N, Bücking, B, Aigner, R, Bäumlein, M, Bökeler, U, Ruchholtz, S, and Eschbach, DA
- Published
- 2023
3. Erfassung von Mangelernährung bei geriatrischen Traumapatienten
- Author
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Barthel, J., Fischer, M., Aigner, R., Hack, J., Bücking, B., Ruchholtz, S., and Eschbach, D.
- Abstract
Mangelernährung bei geriatrischen Traumapatienten ist assoziiert mit einer erhöhten Komplikations- und Mortalitätsrate und stellt somit einen entscheidenden Risikofaktor dar. Die Erfassung der betroffenen Patienten spielt eine wichtige Rolle in der Verbesserung des Outcome dieser wachsenden Patientengruppe. Bundesweit wurde im Jahr 2016 ein Fragebogen an 571 traumatologische/orthopädische Fachabteilungen versandt. Erfasst wurden u. a. Versorgungsstufe, alterstraumatologische Ausrichtung, ernährungsbezogene Screeningverfahren und die Durchführung von Ernährungsvisiten. Die Antwortquote betrug 57 % (n= 325) und spiegelte, bezogen auf die Versorgungsstufe (überregionales, regionales, lokales Traumazentrum bzw. kein Traumazentrum) annähernd die deutsche Versorgungsrealität wider. Bei 14 % (n= 45) der Teilnehmer handelte es sich um DGU(Deutsche Gesellschaft für Unfallchirurgie)-zertifizierte Zentren für Alterstraumatologie, während bei weiteren 5 % (n= 15) eine kurzfristige Zertifizierung angestrebt wurde. Der Ernährungszustand wurde in 56 % (n= 181) der Kliniken erhoben. Häufigstes Instrument hierzu war der Body-Mass-Index mit 74 %, gefolgt von Mini-Nutritional-Assessment mit 30 %, Laborparametern mit 29 % und Nutritional-Risk-Screening 2002 mit 19 %. Vereinzelt wurden weitere Methoden angegeben. Etwa in der Hälfte der Abteilungen fanden in unterschiedlicher Häufigkeit Ernährungsvisiten auf Normalstationen (50 %) und Intensivstationen (57 %) statt. Die hohe Antwortrate dieser Studie lässt ein besonderes Interesse an der Problematik der Mangelernährung bei geriatrischen Traumapatienten vermuten. Dies spiegelt sich in einer im Vergleich zu vergangenen Erhebungen zunehmenden Anzahl an Kliniken wider, die nicht nur gezielt den Ernährungsstatus erheben, sondern auch Ernährungsvisiten durchführen. Die Etablierung geeigneter und zeiteffektiver Screeninginstrumente und deren Umsetzung im Klinikalltag stellen weiterhin eine Herausforderung dar. Malnutrition in geriatric trauma patients is associated with an increased risk of complications and mortality and is therefore a key risk factor. The assessment of the affected patients plays an important role in improving the outcome of this growing patient group. In 2016 a questionnaire was sent to 571 departments specialized in traumatology and orthopedics throughout Germany. The following were recorded: level of care, expertise in geriatric trauma, nutrition-based screening procedures and nutritional ward round procedures. The response rate was 57% (n= 325) and closely reflected the treatment reality in Germany with respect to the level of care (superregional, regional or local trauma center and those without special qualifications). In 14% (n= 45) the participants were German Society for Trauma Surgery(DGU)-certified centers for age-related traumatology, while a further 5% (n= 15) were in the process of certification. The nutritional status was assessed in 56% (n= 181) of the clinics. Most frequently used was the body mass index (74%) followed by the mini nutritional assessment (30%), laboratory parameters (29%) and nutritional risk screening 2002 (19%). Some additional methods were specified. In approximately half of the departments nutritional ward rounds took place in regular wards (50%) and intensive care units (57%). The high response rate of this study seems to show the particular interest for malnutrition in geriatric trauma patients. This is reflected in an increase in the participating clinics compared to past surveys and also the more regularly performed assessment of nutritional status and implementation of nutritional visits. The establishment of suitable and time-effective screening instruments and their implementation are still a challenge.
- Published
- 2024
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4. Evaluation eines einfachen Testverfahrens in der ambulanten Sturzprävention
- Author
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Knobe, M., Rasche, P., Rentemeister, L., Bliemel, C., Bücking, B., Bollheimer, L., and Pape, H.-C.
- Abstract
Obwohl Stürze eine enorme volkswirtschaftliche Bedeutung verkörpern, ist das Thema Prävention auf ambulanter Ebene bisher nur unzureichend umgesetzt. Indem der Aachener Sturzpass (ASP) als einfaches Testverfahren eine schnelle und regelmäßige Abschätzung des persönlichen Sturzrisikos in der häuslichen Umgebung erlaubt, kann er ältere Personen und ihre Angehörigen für die reale Sturzgefahr, aber auch für die Sturzprophylaxe sensibilisieren. Es war die Akzeptanz des ASP unter geriatrischen Patienten zu evaluieren. Daneben sollten signifikante Einflussfaktoren wie objektives/subjektives Sturzrisiko, Sturzangst oder demografische Kennzahlen auf diese Nutzenbewertung des ASP analysiert und die Bereitschaft für präventive Maßnahmen (potenzielle Arztkontakte, Veränderungen des häuslichen Umfelds oder Nutzung von Sport- und Fitnessgruppen) detektiert werden. Es wurden retrospektiv alle Patienten erfasst, die im Zeitraum Juli 2014 bis April 2016 unfallchirurgisch stationär behandelt wurden (Alter >70 Jahre). Nach Determinierung einer Patientenzahl von 884 wurden den Patienten postalisch ein Fragebogen (47 Fragen, Ja/Nein, Likert-Skala) sowie erneut eine aktuelle Version des ASP zugesendet. Zuzüglich wurden von Juli bis August 2016 Patienten der ambulanten Frakturnachsorge zur Teilnahme an der Studie eingeladen. Es nahmen 201 Patienten (80,4 (63 bis 97) Jahre) an der Studie teil. Nach Absolvieren beider Teile des ASP sahen 95 (47 %) Teilnehmer in der Selbsteinschätzung ein relevantes Sturzrisiko. In der ambulanten Sturzprävention spielt der Hausarzt eine entscheidende Rolle. Zunächst würden sich 67 % (n= 77) der Befragten an ihn wenden. Generell sahen 43 % der Befragten den ASP als wichtiges Hilfsmittel zur Beurteilung des Sturzrisikos an, bei nur 8 %, die diesen Ansatz komplett ablehnten. Es waren 88 Patienten (44 %) objektiv sturzgefährdet. Dieses objektive Sturzrisiko hatte dabei einen signifikanten Einfluss auf die Bewertung des ASP, wie auch auf das subjektive Sturzrisiko. Nur 12 % der Teilnehmer sahen eine App-Nutzung des ASP als praktikable Option an. Risikopersonen zunächst in ihrer vertrauten Umgebung unter Nutzung simpler Testmethoden zu evaluieren, mit dem Ziel der Identifikation von potenziellen Balanceproblemen, erscheint aus vielerlei Sicht von Vorteil. Die Chancen dieser Form der ambulanten Sturzprävention sind enorm, da nicht nur Kosteneinsparungen möglich wären, sondern auch die Lebensqualität der älteren Mitbürger verbessert werden könnte. An individual’s risk of falling is generally difficult to detect and it is likely to be underestimated. Thus, preventive measures are challenging and they demand sufficient integration and implementation into aftercare and outpatient management. The Aachen Falls Prevention Scale (AFPS) is a quick and easy tool for patient-driven fall risk assessment. Older adults’ risk of falling is identified in a suitable manner and they then have the opportunity to independently assess and monitor their risk of falling. The aim of the current study was to evaluate the AFPS as a simple screening tool in geriatric trauma patients via the identification of influencing factors, e.g. objective or subjective fall risk, fear of falling (FOF) and demographic data. In this context, we investigated older adults’ willingness to take part in special activities concerning fall prevention. Retrospectively, all patients over 70 years of age who received in-hospital fracture treatment between July 2014 and April 2016 were analyzed at a level I trauma center. After identification of 884 patients, participants completed a short questionnaire (47 questions, yes/no, Likert scale) comprising the AFPS. A history of falls in the past year was considered an indicator of a balance disorder. In addition, ambulant patients were invited to participate between July and August 2016. In total, 201 patients (mean 80.4 years, range 63–97 years) performed a self-assessment based on the AFPS. After steps 1 and 2 of the AFPS had been completed, 95 (47%) participants rated their subjective risk of falling as high (more than 5 points). Of the participants 84 (42%) were objectively classified as “fallers” with significant effects on their AFPS evaluation and rating of their subjective risk of falling. Furthermore, 67% of the participants identified a general practitioner as their main contact person, and 43% of the respondents viewed the AFPS as a beneficial screening tool in fall risk evaluation (8% negative attitudes). Only 12% of the participants could imagine using the AFPS app version as a feasible option. It would be advantageous to pretest at-risk individuals in their environment using a simple self-assessment approach, with the main purpose of identifying potential balance problems. With this approach, cost savings in the healthcare system are possible, combined with a higher health-related quality of life in the geriatric population.
- Published
- 2024
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5. Beeinflussung des funktionelles Outcome nach geriatrischer Komplexbehandlung bei operativ versorgten proximalen Femurfrakturen durch das Vorliegen einer Demenz und/oder Depression
- Author
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Becker, L, Kamp, O, Eschbach, DA, Bücking, B, Ruchholtz, S, Gehrke, J, Dudda, M, and Dodel, R
- Subjects
ddc: 610 ,Medicine and health - Abstract
Fragestellung: Neben der altersgerechten chirurgischen Versorgung ist auch die geriatrische Mit- bzw. Weiterbehandlung zur Vermeidung von Komplikationen und zur bestmöglichen Rehabilitation eminent wichtig. Ziel ist hierbei idealerweise die Wiederherstellung der vorherigen Eigenständigkeit [zum vollständigen Text gelangen Sie über die oben angegebene URL]
- Published
- 2022
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6. Kostenfaktoren nach Beendigung der stationären Krankenhausversorgung geriatrischer Patienten mit operativ versorgter proximaler Femurfraktur
- Author
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Wolf, M, Kamp, O, Eschbach, DA, Ruchholtz, S, Bücking, B, Dodel, R, Dudda, M, and Becker, L
- Subjects
proximale Femurfraktur ,ddc: 610 ,Kostenberechnung ,Medicine and health ,Alterstraumatologie ,geriatrische Komplexbehandlung - Abstract
Fragestellung: Die proximale Femurfraktur gehört zu den häufigsten Frakturen des geriatrischen Patienten. Die Akutkosten für stationäre Behandlungen bei einer operativen Versorgung dieser Verletzungen belaufen sich in diesem speziellen Patientengut im Durchschnitt auf 8049,17 Euro [zum vollständigen Text gelangen Sie über die oben angegebene URL]
- Published
- 2022
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7. Proximal Femur Fractures: Evaluating the Necessity of On-Call Surgery.
- Author
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Ketter V, Korschinsky A, Bökeler U, Aigner R, Bücking B, Eschbach DA, Rascher K, Ruchholtz S, and Knauf T
- Abstract
Background: The decision of the Joint Federal Committee on the treatment of hip fractures stipulates that proximal femur fractures must be treated within the first 24 h. This leads to organizational and personnel difficulties in day-to-day care. Therefore, we investigated the question at what times of day we operate to maintain this timeline and whether there is a difference in the outcome for the patients according to treatment hours. Methods: Data from the DGU's "AltersTraumaRegister" from 2016 to 2020 were analyzed. For the analysis, the patients were divided into seven cohorts depending on the time of surgery. Pre-operative, operative, and follow-up data were analyzed. Results: A total of 29,470 patients were included in our study. The results showed that 74% of patients were treated within 24 h. 72% of patients operated on between 0-7 h had pertrochanteric fractures, while 56% of all arthroplasties were performed during normal working hours. In supra-regional trauma centers, significantly fewer operations were performed during normal working hours, while significantly more surgeries were carried out in the late evening and at night ( p < 0.001). There were no significant differences in mortality and morbidity between the individual groups. Conclusions: Although we manage to treat most patients within 24 h, only 46% of patients are operated on within normal working hours. In terms of the outcome parameters, this does not appear to be a disadvantage for the patients. Nevertheless, night work and fatigue affect concentration and post-operative results in many areas, as we know. Consequently, patient care during normal working hours within 24 h creates the best possible initial situation for the patient, as significantly more personnel resources are available during normal working hours. The aim should be to create the logistical and personnel requirements for this.
- Published
- 2024
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8. [Effects of the COVID-19 pandemic on the course of geriatric trauma patients with proximal femoral fractures].
- Author
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Knauf T, Eschbach D, Bücking B, Knobe M, Rascher K, Schoeneberg C, Bliemel C, Ruchholtz S, Aigner R, and Bökeler U
- Subjects
- Humans, Aged, Pandemics, Delivery of Health Care, COVID-19 epidemiology, Proximal Femoral Fractures, Hip Fractures epidemiology
- Abstract
Background/objective: In 2020 the COVID-19 pandemic posed a major challenge to the healthcare system. The hypothesis is that the COVID-19 pandemic in 2020 had an impact on the care of older adults with proximal femoral fractures due to resource scarcity, regardless of whether or not the patient was infected., Material and Methods: This study analyzed the data of 87 hospitals which entered 15,289 patients in the Geriatric Trauma Register ("AltersTraumaRegister DGU®", ATR-DGU) in Germany in 2019 and 2020. In this study we analyzed the influence of the COVID-19 pandemic on the inpatient treatment of hip fractures as well as the mid-term follow-up during the first 120 days. For the main analysis, we compared patients documented during the COVID-19 pandemic in 2020 (April-December) with a control group in 2019 (April-December). Additionally, we performed a subgroup analysis of the periods with high COVID-19 incidence rates., Results: Between 2019 and 2020 a total of 11,669 patients (2020: n = 6002 patients vs. 2019: n = 5667 patients) were included in this study. Only minor differences were found between the patients treated during the pandemic; however, when the COVID-19 incidence in Germany was greater than 50/100,000 residents, significantly fewer patients (p < 0.001) were discharged to a geriatric rehabilitation ward (27.2% vs. 36.3%) and an increased mortality rate during inpatient treatment was determined (8.4% vs. 4.6%) (p < 0.001)., Discussion: The healthcare system was able to respond to the pandemic and patients' clinical courses were not impaired as long as the incidences were low. Nevertheless, the healthcare system reached its limits in times of higher incidence, which was also directly reflected in the patient outcome, mortality and place of discharge., (© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)
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- 2024
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9. Factors Influencing Vertical Transmission of Psittacine Bornavirus in Cockatiels ( Nymphicus hollandicus ).
- Author
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Link J, Herzog S, Gartner AM, Bücking B, König M, and Lierz M
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- Animals, Female, RNA, Viral genetics, Cockatoos genetics, Bornaviridae, Bird Diseases, Mononegavirales Infections veterinary, Parrots
- Abstract
The transmission of parrot bornavirus is still not fully understood. Although horizontal transmission through wounds can be one route, vertical transmission is still discussed. PaBV RNA and PaBV antigen were detected in psittacine embryos, but isolation of the virus failed, raising doubts about this route. In this study, cockatiels were infected either as adults (adult group) or during the first 6 days after hatching (juvenile group) and raised until sexual maturity to breed and lay eggs. A total of 92 eggs (adult group: 49, juvenile group: 43) were laid and incubated until day 17. The embryos and yolk samples were examined by RT-PCR for PaBV RNA and by infectivity assay for infectious virus. In the adult group, 14/31 embryos (45.2%) and 20/39 (51%) of the yolk samples demonstrated PaBV RNA in the PCR. Isolation of PaBV was not possible in any embryo of this group, but it was achieved in six yolk samples from one female. Anti-PaBV antibodies were detected in the yolk samples after seroconversion of all female parents. In the juvenile group, 22/29 embryos (74.9%) were positive for PaBV RNA. In 9/21 embryos (42.9%), PaBV isolation was possible. PaBV RNA was detected in 100% and infectious virus in 41% of the yolk samples. Anti-PaBV antibodies were detected in all yolk samples. For the first time, successful vertical transmission of PaBV was proven, but it seems to depend on the age when the parent birds are infected. Therefore, the age of the bird at time of infection may be an important factor in the occurrence of vertical transmission.
- Published
- 2022
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10. The modulating effect of food composition on the immune system in growing ring-necked pheasants (Phasianus colchicus).
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Gethöffer F, Liebing J, Ronnenberg K, Curland N, Puff C, Wohlsein P, Baumgärtner W, Bücking B, Heffels-Redmann U, Voigt U, Sonne C, Lierz M, and Siebert U
- Subjects
- Animals, Chickens, Food, Hemagglutination Tests, Immune System, Galliformes, Quail
- Abstract
The decline in the population of ring-necked pheasants (Phasianus colchicus) in northwestern Germany since 2007 raises questions about the underlying causes. We therefore studied the growth and immune status of ring-necked pheasant chicks dependent on different feed composition. Here, 490 ring-necked pheasant chicks were raised in five groups up to nine weeks. While control groups C1 and C2 received sufficient crude protein (28%) and energy (12.5 MJ/Kg feed) according to current standards, group C2 was treated with cyclosporine eight hours prior to phythemagglutination (PHA) testing, serving as a positive immune suppressed control. Group V1 was fed with reduced protein (20%) but optimal energy content (12.5 MJ/Kg feed), group V2 was fed with sufficient protein (28%) and reduced energy content (10 MJ/kg feed) whereas group V3 was fed reduced crude protein (20%) and reduced energy content (10MJ/kg feed). On all chicks, health status was checked each week, and 20 birds of each group were weighed randomly per week. PHA-testing was performed on 12 birds of each group to study the in vivo non-specific activation of lymphocytes at week 2, 4, 6, 7, 8 and 9. In addition, hemolysis-hemagglutination-assay (HHA) was performed on each of the PHA-tested chicks, which were subsequently euthanized and dissected. Histopathologic examinations of 5 birds that were randomly chosen were performed. The PHA-test results demonstrate significant differences between control (C1, C2) and experimental groups (V1-V3) in several developmental stages. According to the HHA results, weekly testing detected a significant increase of titres per week in all groups without significant differences. Here, only hemagglutination and no lysis of samples was observed. It seems appropriate to conclude that during their first weeks of life, protein content is of higher importance in ring-necked pheasant chicks than energy intake. In particular T-cell response is significantly reduced, which indicate a weaker immune system resulting in a higher risk for clinical diseases. Therefore, we assume that protein i.e. insect availability is a highly important co-factor in the free-ranging population dynamics, and is linked to declines of the northwestern German population., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2022 Gethöffer et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
- Published
- 2022
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11. Tissue Distribution of Parrot Bornavirus 4 (PaBV-4) in Experimentally Infected Young and Adult Cockatiels ( Nymphicus hollandicus ).
- Author
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Petzold J, Gartner AM, Malberg S, Link JB, Bücking B, Lierz M, and Herden C
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- Animals, RNA, Viral genetics, Tissue Distribution, Phosphoproteins, Bornaviridae, Cockatoos genetics, Parrots genetics, Mononegavirales Infections veterinary, Bird Diseases
- Abstract
Proventricular dilatation disease (PDD) caused by parrot bornavirus (PaBV) infection is an often-fatal disease known to infect Psittaciformes. The impact of age at the time of PaBV infection on organ lesions and tissue distribution of virus antigen and RNA remains largely unclear. For this purpose, tissue sections of 11 cockatiels intravenously infected with PaBV-4 as adults or juveniles, respectively, were examined via histology, immunohistochemistry applying a phosphoprotein (P) antibody directed against the bornaviral phosphoprotein and in situ hybridisation to detect viral RNA in tissues. In both groups of adult- and juvenile-infected cockatiels, widespread tissue distribution of bornaviral antigen and RNA as well as histologic inflammatory lesions were demonstrated. The latter appeared more severe in the central nervous system in adults and in the proventriculus of juveniles, respectively. During the study, central nervous symptoms and signs of gastrointestinal affection were only demonstrated in adult birds. Our findings indicate a great role of the age at the time of infection in the development of histopathological lesions and clinical signs, and thus provide a better understanding of the pathogenesis, possible virus transmission routes, and the development of carrier birds posing a risk to psittacine collections.
- Published
- 2022
- Full Text
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