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Article: Minimal-invasive Endoprothetik der Hüfte. Wie kommen wir mit dem DAA Zugang zu guten Ergebnissen? Less invasive hip joint replacement. Aspects to improve surgical outcome using the direct anterior approach (DAA)

Hachenberg, Andreas / Kraft, Clayton N.

2021 Volume 10, Issue 2, Page(s) 57

Language	German
Document type	Article
ZDB-ID	2645147-5
ISSN	2193-5785
Database	Current Contents Medicine

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Article ; Online: Fracture of the Dens Axis Due to Spinal Manifestation of Sarcoidosis: Treatment Option and Review of the Literature.

Eid, Kevin / Friedrich, Michael / Kudlek, Claudia / Huenerlituerkoglu, Ali / Schultz, Johannes / Kraft, Clayton N

Spine

2021 Volume 46, Issue 13, Page(s) E743–E749

Abstract: Study design: Case report and literature review.: Objective: We present a case of a pathologic unstable fracture of the odontoid process due to vertebral osseous sarcoidosis. The surgical management of this unreported pathology is described and a ... ...

Abstract	Study design: Case report and literature review. Objective: We present a case of a pathologic unstable fracture of the odontoid process due to vertebral osseous sarcoidosis. The surgical management of this unreported pathology is described and a review of the literature is given. Summary of background data: Sarcoidosis is a chronic inflammatory systemic disease of unknown etiology, characterized by multiorgan noncaseating granulomatous infiltrations. It affects primarily the lungs, lymphatic system, eyes, skin, heart, and nervous system. Osseous sarcoidosis is usually clinically asymptomatic and therefore frequently under-diagnosed. When it does affect the skull or vertebral column, specific surgical therapy is only necessary in cases with nonmanageable pain or where structural integrity is threatened. Methods: Our patient underwent a so-called semiconservative approach, consisting of a minimally invasive transoral-transpharyngeal approach, surgical debridement of the lytic bony lesion, transplantation of cancellous homologous bone, and carbon chest halo-immobilization. Halo-immobilization was left for 8 weeks, followed by a further 6 weeks with a hard cervical collar. Results: Routine computed tomography scans 3 days, 6, 12, 18 weeks, and 1 year after surgery showed good filling of the original defect with cancellous bone, correct alignment of the upper cervical spine, and progressive fracture consolidation and stability. Surgical site infection (SSI) was not observed. The patient had no neurological postoperative deficits. After initial dysphagia, swallowing was not permanently impaired. Conclusion: Sarcoidosis-induced odontoid fractures can be managed successfully using a semiconservative approach, consisting of transoral-transmucosal, minimally invasive surgical procedure for debridement of the lesion and transplantation of cancellous bone with additional halo-immobilization. Permanent fusion of C1-2 with loss of the cervical range of motion is avoided. Despite performing bone surgery in a potentially markedly contaminated site, bacterial infection was not an issue, possibly supported by the temporary discontinuation of immunosuppressive agents and the prudent use of antibiotics.Level of Evidence: 4.
Language	English
Publishing date	2021-06-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	752024-4
ISSN	1528-1159 ; 0362-2436
ISSN (online)	1528-1159
ISSN	0362-2436
DOI	10.1097/BRS.0000000000003992
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Article ; Online: Factor analysis of the stigma scale-child in pediatric inflammatory bowel disease.

Gamwell, Kaitlyn L / Roberts, Caroline M / Kraft, Jacob D / Edwards, Clayton S / Baudino, Marissa N / Grunow, John E / Jacobs, Noel J / Tung, Jeanne / Mullins, Larry L / Chaney, John M

Journal of psychosomatic research

2022 Volume 164, Page(s) 111095

Abstract: Objective: Illness stigma, or perceived stigma related to a chronic health condition, is pervasive among youth with inflammatory bowel disease (IBD). However, no studies exist examining the psychometric properties of illness stigma measures in this ... ...

Abstract	Objective: Illness stigma, or perceived stigma related to a chronic health condition, is pervasive among youth with inflammatory bowel disease (IBD). However, no studies exist examining the psychometric properties of illness stigma measures in this population. Using a modified version of the Child Stigma Scale originally developed for youth with epilepsy, the current study investigated the factor structure and validity of this adapted measure (i.e., Stigma Scale - Child; SS-C) in youth with IBD. Methods: Factor analyses were conducted to determine the most parsimonious factor structure for the adapted 8-item Stigma Scale - Child in a sample of 180 youth with IBD. Correlations were conducted to assess convergent validity, and a multiple regression was conducted to further evaluate the measure's predictive validity of child depressive symptoms. Results: The most parsimonious model for the SS-C is a one-factor solution with an error covariance between the two items assessing concealment/disclosure of IBD diagnosis. Conclusions: The SS-C is a psychometrically sound illness stigma measure in pediatric IBD that demonstrates strong convergent validity with psychosocial adjustment factors such as thwarted belongingness, illness uncertainty, and illness intrusiveness, as well as strong predictive validity with youth depressive symptoms. The SS-C is a viable option for use as a brief screener in youth with IBD across clinical and research settings.
MeSH term(s)	Adolescent ; Humans ; Child ; Inflammatory Bowel Diseases/psychology ; Social Stigma ; Disclosure ; Psychometrics ; Factor Analysis, Statistical ; Reproducibility of Results ; Surveys and Questionnaires
Language	English
Publishing date	2022-11-24
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	80166-5
ISSN	1879-1360 ; 0022-3999
ISSN (online)	1879-1360
ISSN	0022-3999
DOI	10.1016/j.jpsychores.2022.111095
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Article ; Online: Serum C-reactive protein and WBC count in conservatively and operatively managed bacterial spondylodiscitis.

van Gerven, Christina / Eid, Kevin / Krüger, Tobias / Fell, Michael / Kendoff, Daniel / Friedrich, Michael / Kraft, Clayton N

Journal of orthopaedic surgery (Hong Kong)

2020 Volume 29, Issue 1, Page(s) 2309499020968296

Abstract: Purpose: C-reactive protein (CRP) and white blood cell (WBC) count are routine blood chemistry parameters in monitoring infection. Little is known about the natural history of their serum levels in conservative and operative spondylodiscitis treatment.!# ...

Abstract	Purpose: C-reactive protein (CRP) and white blood cell (WBC) count are routine blood chemistry parameters in monitoring infection. Little is known about the natural history of their serum levels in conservative and operative spondylodiscitis treatment. Methods: Pre- and postoperative serum levels of CRP and WBC count in 145 patients with spondylodiscitis were retrospectively assessed. One hundred and four patients were treated by debridement, spondylodesis, and an antibiotic regime, 41 only with a brace and antibiotics. The results of the surgical group were compared to 156 patients fused for degenerative disc disease (DDD). Results: Surgery had a significant effect on peak postoperative CRP levels. In surgically managed patients, CRP peaked at 2-3 days after surgery (spondylodiscitis: pre-OP: 90 mg/dl vs. post-OP days 2-3: 146 mg/dl; DDD: 9 mg/dl vs. 141 mg/dl; Conclusion: CRP is a predictable serum parameter in patients with spondylodiscitis. WBC count is unspecific. Initial CRP increase after surgery is of little value in monitoring infection. A preoperative CRP value, and control once during the first 3 days after surgery is sufficient. Closer monitoring should then be continued. Should a decline not be observed, therapy needs to be scrutinized, antibiotic treatment reassessed, and concomitant infection contemplated.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/therapeutic use ; C-Reactive Protein/analysis ; Discitis/blood ; Discitis/drug therapy ; Discitis/microbiology ; Discitis/surgery ; Female ; Humans ; Leukocyte Count ; Male ; Middle Aged ; Retrospective Studies ; Spinal Fusion/methods ; Young Adult
Chemical Substances	Anti-Bacterial Agents ; C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2020-12-30
Publishing country	England
Document type	Comparative Study ; Journal Article
ZDB-ID	1493368-8
ISSN	2309-4990 ; 1022-5536
ISSN (online)	2309-4990
ISSN	1022-5536
DOI	10.1177/2309499020968296
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Article ; Online: Changes in frailty among patients hospitalized for spine pathologies during the COVID-19 pandemic in Germany-a nationwide observational study.

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

2023 Volume 33, Issue 1, Page(s) 19–30

Abstract: Purpose: In spine care, frailty is associated with poor outcomes. The aim of this study was to describe changes in frailty in spine care during the coronavirus disease 2019 (COVID-19) pandemic and their relation to surgical management and outcomes.: ... ...

Abstract	Purpose: In spine care, frailty is associated with poor outcomes. The aim of this study was to describe changes in frailty in spine care during the coronavirus disease 2019 (COVID-19) pandemic and their relation to surgical management and outcomes. Methods: Patients hospitalized for spine pathologies between January 1, 2019, and May 17, 2022, within a nationwide network of 76 hospitals in Germany were retrospectively included. Patient frailty, types of surgery, and in-hospital mortality rates were compared between pandemic and pre-pandemic periods. Results: Of the 223,418 included patients with spine pathologies, 151,766 were admitted during the pandemic and 71,652 during corresponding pre-pandemic periods in 2019. During the pandemic, the proportion of high-frailty patients increased from a range of 5.1-6.1% to 6.5-8.8% (p < 0.01), while the proportion of low frailty patients decreased from a range of 70.5-71.4% to 65.5-70.1% (p < 0.01). In most phases of the pandemic, the Elixhauser comorbidity index (ECI) showed larger increases among high compared to low frailty patients (by 0.2-1.8 vs. 0.2-0.8 [p < 0.01]). Changes in rates of spine surgery were associated with frailty, most clearly in rates of spine fusion, showing consistent increases among low frailty patients (by 2.2-2.5%) versus decreases (by 0.3-0.8%) among high-frailty patients (p < 0.02). Changes in rates of in-hospital mortality were not associated with frailty. Conclusions: During the COVID-19 pandemic, the proportion of high-frailty patients increased among those hospitalized for spine pathologies in Germany. Low frailty was associated with a rise in rates of spine surgery and high frailty with comparably larger increases in rates of comorbidities.
MeSH term(s)	Humans ; COVID-19 ; Frailty/epidemiology ; Frailty/complications ; Pandemics ; Retrospective Studies ; Germany/epidemiology
Language	English
Publishing date	2023-11-16
Publishing country	Germany
Document type	Observational Study ; Journal Article
ZDB-ID	1115375-1
ISSN	1432-0932 ; 0940-6719
ISSN (online)	1432-0932
ISSN	0940-6719
DOI	10.1007/s00586-023-08014-7
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Article ; Online: Effects of the COVID-19 Pandemic on Spinal Fusion Procedures for Spinal Infections in a Nationwide Hospital Network in Germany.

Journal of neurological surgery. Part A, Central European neurosurgery

2022

Abstract: Background: The full impact of the COVID-19 pandemic on surgical spine care is difficult to assess due to a lack in nationwide evidence from more recent phases of the pandemic. We aimed to describe changes in in-hospital processes associated with ... ...

Abstract	Background: The full impact of the COVID-19 pandemic on surgical spine care is difficult to assess due to a lack in nationwide evidence from more recent phases of the pandemic. We aimed to describe changes in in-hospital processes associated with spinal fusion procedures in the treatment of spinal infections (SI) during different phases of the pandemic. Methods: In this retrospective observational study, we examined the in-hospital prevalence and outcomes of spinal fusion procedures for SI (along with patient characteristics, rates of transfer to intensive care units, and mortality rates) during the first four waves of the pandemic compared with the corresponding prepandemic periods in 2019. We used administrative data from a nationwide network of 76 hospitals managing 7% of all in-hospital cases in Germany. Results: We observed no significant change in the prevalence of SI fusion procedures during the pandemic, neither in total numbers (349 vs. 373) nor for each wave separately. On a patient level, we found no differences in age, sex, and the prevalence of paresis, and no relevant differences in associated comorbidities. The rate of mechanical ventilation did not change during any of the examined pandemic waves: it ranged between 9.5 and 18.6% during the pandemic and 3.1 and 16.0% during the corresponding prepandemic control periods. The rate of transfer to intensive care changed only during wave 4 (from 70.4 to 54.8%; Conclusions: The main finding of our study is that within this nationwide network of spine care centers in Germany, the delivery of surgical treatment of SI by means of spinal fusion procedures was maintained throughout the first four waves of the pandemic. Furthermore, there were no relevant changes in patient demographics, in-hospital processes, and mortality rates.
Language	English
Publishing date	2022-06-27
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2651663-9
ISSN	2193-6323 ; 2193-6315
ISSN (online)	2193-6323
ISSN	2193-6315
DOI	10.1055/s-0042-1749353
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Article ; Online: Difficulties of Breast Reconstruction - Problems That No One Likes to Face.

Friedrich, Michael / Krämer, Stefan / Friedrich, Dominique / Kraft, Clayton / Maass, Nicolai / Rogmans, Christoph

Anticancer research

2021 Volume 41, Issue 11, Page(s) 5365–5375

Abstract: Reconstructive breast surgery following total or partial mastectomy can be performed using autologous tissues or breast implants, and each has its own set of complications. Most women do not experience significant complications and are highly satisfied ... ...

Abstract	Reconstructive breast surgery following total or partial mastectomy can be performed using autologous tissues or breast implants, and each has its own set of complications. Most women do not experience significant complications and are highly satisfied but breast reconstruction must consider potential complications from surgical techniques, as well as additional complications that may arise from oncological treatment modalities such as radiation therapy and chemotherapy. The aim of this article is to provide a systemic overview of possible complications that may arise in the course of reconstructive breast surgery. Complications associated with flap-based or implant-based breast reconstruction can be classified as: i) Complications inherent to surgery and common to all, including seroma, bleeding, and hematoma; skin necrosis; and infection, among others. ii) Complications specifically related to reconstruction, such as flap ischemia/necrosis/loss; fat necrosis; implant capsular contracture; implant failure, exposure, or malposition. In conclusion, this overview of possible complications is intended to improve the decision-making process when considering breast reconstruction.
MeSH term(s)	Breast Implantation/adverse effects ; Breast Implantation/instrumentation ; Breast Implants/adverse effects ; Clinical Decision-Making ; Female ; Humans ; Mammaplasty/adverse effects ; Mammaplasty/instrumentation ; Mastectomy/adverse effects ; Postoperative Complications/diagnosis ; Postoperative Complications/etiology ; Postoperative Complications/therapy ; Prosthesis Design ; Quality of Life ; Risk Assessment ; Risk Factors ; Treatment Outcome
Language	English
Publishing date	2021-10-31
Publishing country	Greece
Document type	Journal Article ; Review
ZDB-ID	604549-2
ISSN	1791-7530 ; 0250-7005
ISSN (online)	1791-7530
ISSN	0250-7005
DOI	10.21873/anticanres.15349
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Article ; Online: Emergency physician gender and head computed tomography orders for older adults who have fallen.

Academic emergency medicine : official journal of the Society for Academic Emergency Medicine

2024

Abstract: Objective: Physicians vary in their computed tomography (CT) scan usage. It remains unclear how physician gender relates to clinical practice or patient outcomes. The aim of this study was to assess the association between physician gender and decision ... ...

Abstract	Objective: Physicians vary in their computed tomography (CT) scan usage. It remains unclear how physician gender relates to clinical practice or patient outcomes. The aim of this study was to assess the association between physician gender and decision to order head CT scans for older emergency patients who had fallen. Methods: This was a secondary analysis of a prospective observational cohort study conducted in 11 hospital emergency departments (EDs) in Canada and the United States. The primary study enrolled patients who were 65 years and older who presented to the ED after a fall. The analysis evaluated treating physician gender adjusted for multiple clinical variables. Primary analysis used a hierarchical logistic regression model to evaluate the association between treating physician gender and the patient receiving a head CT scan. Secondary analysis reported the adjusted odds ratio (OR) for diagnosing intracranial bleeding by physician gender. Results: There were 3663 patients and 256 physicians included in the primary analysis. In the adjusted analysis, women physicians were no more likely to order a head CT than men (OR 1.26, 95% confidence interval 0.98-1.61). In the secondary analysis of 2294 patients who received a head CT, physician gender was not associated with finding a clinically important intracranial bleed. Conclusions: There was no significant association between physician gender and ordering head CT scans for older emergency patients who had fallen. For patients where CT scans were ordered, there was no significant relationship between physician gender and the diagnosis of clinically important intracranial bleeding.
Language	English
Publishing date	2024-04-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	1329813-6
ISSN	1553-2712 ; 1069-6563
ISSN (online)	1553-2712
ISSN	1069-6563
DOI	10.1111/acem.14928
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Article: Effects of the COVID-19 Pandemic on Spinal Fusion Procedures for Spinal Infections in a Nationwide Hospital Network in Germany

Journal of Neurological Surgery Part A: Central European Neurosurgery

2022 Volume 84, Issue 01, Page(s) 58–64

Abstract	Background: The full impact of the COVID-19 pandemic on surgical spine care is difficult to assess due to a lack in nationwide evidence from more recent phases of the pandemic. We aimed to describe changes in in-hospital processes associated with spinal fusion procedures in the treatment of spinal infections (SI) during different phases of the pandemic. Methods: In this retrospective observational study, we examined the in-hospital prevalence and outcomes of spinal fusion procedures for SI (along with patient characteristics, rates of transfer to intensive care units, and mortality rates) during the first four waves of the pandemic compared with the corresponding prepandemic periods in 2019. We used administrative data from a nationwide network of 76 hospitals managing 7% of all in-hospital cases in Germany. Results: We observed no significant change in the prevalence of SI fusion procedures during the pandemic, neither in total numbers (349 vs. 373) nor for each wave separately. On a patient level, we found no differences in age, sex, and the prevalence of paresis, and no relevant differences in associated comorbidities. The rate of mechanical ventilation did not change during any of the examined pandemic waves: it ranged between 9.5 and 18.6% during the pandemic and 3.1 and 16.0% during the corresponding prepandemic control periods. The rate of transfer to intensive care changed only during wave 4 (from 70.4 to 54.8%; p = 0.046) but not in any other pandemic phases. We observed no changes in in-hospital mortality rates (range: 2.9–9.7% vs. 6.2–11.3%) or in duration of hospital stay (range: 26.2–30.8 days vs. 20.8–29.2 days). Conclusions: The main finding of our study is that within this nationwide network of spine care centers in Germany, the delivery of surgical treatment of SI by means of spinal fusion procedures was maintained throughout the first four waves of the pandemic. Furthermore, there were no relevant changes in patient demographics, in-hospital processes, and mortality rates.
Keywords	spinal infection ; vertebral osteomyelitis ; spondylodiskitis ; spinal fusion ; spinal osteosynthesis
Language	English
Publishing date	2022-06-27
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2651663-9
ISSN	2193-6323 ; 2193-6315
ISSN (online)	2193-6323
ISSN	2193-6315
DOI	10.1055/s-0042-1749353
Database	Thieme publisher's database

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Article ; Online: A Distinct Nasal Microbiota Signature in Peritoneal Dialysis Patients.

Khan, Iman / Wu, Sylvia / Hudson, Anika / Hughes, Clayton / Stryjniak, Gabriel / Westblade, Lars F / Satlin, Michael J / Tedrow, Nicholas / Uhlemann, Anne-Catrin / Kraft, Colleen / Dadhania, Darshana M / Silberzweig, Jeffrey / De Vlaminck, Iwijn / Li, Carol / Srivatana, Vesh / Lee, John Richard

Kidney360

2023 Volume 4, Issue 10, Page(s) 1419–1429

MeSH term(s)	Humans ; Nose ; Peritoneal Dialysis ; Microbiota
Language	English
Publishing date	2023-08-29
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ISSN	2641-7650
ISSN (online)	2641-7650
DOI	10.34067/KID.0000000000000249
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