TY  - JOUR
A1  - Güsgen, C.
A1  - Anger, F.
A1  - Hauer, T.
A1  - Willms, A.
A1  - Buhr, H. J.
A1  - Germer, C.-T.
A1  - Schwab, R.
A1  - Lock, J. F.
T1  - Fortbildung von Allgemein- und Viszeralchirurgen in der lebensrettenden Notfallchirurgie. Ergebnisse einer Umfrage unter Operationskursteilnehmern
JF  - Der Chirurg
N2  - Hintergrund
Die geringe Anzahl operativ zu versorgender Körperhöhlenverletzungen erfordert ein Umdenken in der chirurgischen Aus- und Weiterbildung. Ein entsprechendes Kursformat wird seit 2014 über die DGAV angeboten. Um Berechtigung, Bedarf, Nutzen und Erfolg eines solchen Kursformates zu erheben, erfolgte eine Evaluation durch die bisherigen Kursteilnehmer.

Material und Methoden
Kursevaluation und zusätzliche Onlinebefragung der bisherigen Kursteilnehmer hinsichtlich Alter, Geschlecht, Ausbildungsstand, Fachrichtung, Versorgungsstufe des Krankenhauses, notfallchirurgischer Erfahrungen, der Häufigkeit chirurgischer Notfallversorgungen, Teilnahme an anderen Kursformaten, Erfahrungen nach der Kursteilnahme, Einschätzung der aktuellen Fort- und Weiterbildungssituation und Finanzierung solcher Kurse.

Ergebnisse
Insgesamt 142 Kursteilnehmer evaluierten ihre Kursteilnahme, zusätzlich beantworteten 83 den Onlinefragebogen. Über 90 % berichteten von einem nachhaltigen positiven Einfluss des Kurses auf ihr notfallchirurgisches Handeln. Mehr als die Hälfte konnte von konkreten Notfallsituationen berichten, die sie aufgrund der Kursteilnahme besser bewältigen konnten. In der Notfallversorgung erfahrene Chirurgen bewerteten den eigenen Lernerfolg durch die Kursteilnahme signifikant häufiger positiv als ihre weniger erfahrenen Kollegen. Keinen Einfluss auf den Lernerfolg hatten eine Ober- oder Chefarztposition, die Versorgungsstufe des Krankenhauses, das Alter oder Geschlecht der Teilnehmer. Die Mehrheit der antwortenden Chirurgen befürwortet die Integration eines solchen Kursformates in die chirurgische Weiterbildung und fordert hierzu eine finanzielle Unterstützung.

Schlussfolgerung
Kursformate, in denen notfallchirurgische Strategien und Fähigkeiten vermittelt werden, sind etabliert und werden sehr positiv evaluiert. Die Fort- und Weiterbildung in notfallchirurgischen Fähigkeiten und Kenntnissen liegt im gesellschaftlichen Interesse und zumindest anteilig auch in ihrer Verantwortung.
N2  - Background
Due to a decreasing number of emergency procedures for body cavity injuries, surgical training is inadequate and current educational concepts must be reconsidered. The German Society for General and Visceral Surgery has set up a surgical training course in 2014 to overcome this shortage. In order to assess the eligibility, needs, benefits and success of such a training format, participants were asked to evaluate the program.

Material and methods
All participants evaluated the course during participation and were later asked to answer an online survey regarding their age, gender, level of surgical education, surgical discipline, level of care of the hospital, emergency surgical experience and frequency of performing emergency surgery, participation in other programs, experiences after participating in the course, rating of the current training curriculum and funding of such courses.

Results
Out of 142 participants 83 replied to the online survey. Over 90% reported a lasting positive influence of the course on emergency surgical skills. More than half of the responders remembered a clinical situation which they successfully managed due to the skills they gained during the course. Surgeons experienced in emergency treatment felt significantly more benefit than less experienced colleagues. A consultancy position, the level of care of the hospital, age and sex of the participants did not influence the overall benefits reported. The majority of responding surgeons were in favor of including such a training course in surgical education and stipulated public financial support.

Conclusion
Course formats that mediate emergency surgery strategies and skills are established and well accepted. Training of surgeons in life-saving emergency surgery is in the public interest and is also partly the responsibility of society.
T2  - Advanced training of general and visceral surgeons in life-saving emergency surgery. Results of a survey among participants of a surgery course
KW  - Damage control surgery
KW  - Terroranschlagtrauma
KW  - Abdominaltrauma
KW  - Messerstichverletzung
KW  - Schussverletzung
KW  - damage control surgery
KW  - terror attack trauma
KW  - abdominal trauma
KW  - stab wounds
KW  - shooting injuries
Y1  - 2020
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-235246
SN  - 0009-4722
VL  - 91
ER  - 
TY  - JOUR
A1  - Hauer, Nadine N.
A1  - Popp, Bernt
A1  - Taher, Leila
A1  - Vogl, Carina
A1  - Dhandapany, Perundurai S.
A1  - Büttner, Christian
A1  - Uebe, Steffen
A1  - Sticht, Heinrich
A1  - Ferrazzi, Fulvia
A1  - Ekici, Arif B.
A1  - De Luca, Alessandro
A1  - Klinger, Patrizia
A1  - Kraus, Cornelia
A1  - Zweier, Christiane
A1  - Wiesener, Antje
A1  - Abou Jamra, Rami
A1  - Kunstmann, Erdmute
A1  - Rauch, Anita
A1  - Wieczorek, Dagmar
A1  - Jung, Anna-Marie
A1  - Rohrer, Tilman R.
A1  - Zenker, Martin
A1  - Doerr, Helmuth-Guenther
A1  - Reis, André
A1  - Thiel, Christian T.
T1  - Evolutionary conserved networks of human height identify multiple Mendelian causes of short stature
JF  - European Journal of Human Genetics
N2  - Height is a heritable and highly heterogeneous trait. Short stature affects 3% of the population and in most cases is genetic in origin. After excluding known causes, 67% of affected individuals remain without diagnosis. To identify novel candidate genes for short stature, we performed exome sequencing in 254 unrelated families with short stature of unknown cause and identified variants in 63 candidate genes in 92 (36%) independent families. Based on systematic characterization of variants and functional analysis including expression in chondrocytes, we classified 13 genes as strong candidates. Whereas variants in at least two families were detected for all 13 candidates, two genes had variants in 6 (UBR4) and 8 (LAMA5) families, respectively. To facilitate their characterization, we established a clustered network of 1025 known growth and short stature genes, which yielded 29 significantly enriched clusters, including skeletal system development, appendage development, metabolic processes, and ciliopathy. Eleven of the candidate genes mapped to 21 of these clusters, including CPZ, EDEM3, FBRS, IFT81, KCND1, PLXNA3, RASA3, SLC7A8, UBR4, USP45, and ZFHX3. Fifty additional growth-related candidates we identified await confirmation in other affected families. Our study identifies Mendelian forms of growth retardation as an important component of idiopathic short stature.
KW  - disease genetics
KW  - DNA sequencing
KW  - genetic counselling
Y1  - 2019
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-227899
VL  - 27
ER  - 
TY  - JOUR
A1  - Hauer, Nadine N.
A1  - Popp, Bernt
A1  - Schoeller, Eva
A1  - Schuhmann, Sarah
A1  - Heath, Karen E.
A1  - Hisado-Oliva, Alfonso
A1  - Klinger, Patricia
A1  - Kraus, Cornelia
A1  - Trautmann, Udo
A1  - Zenker, Martin
A1  - Zweier, Christiane
A1  - Wiesener, Antje
A1  - Jamra, Rami Abou
A1  - Kunstmann, Erdmute
A1  - Wieczorek, Dagmar
A1  - Uebe, Steffen
A1  - Ferrazzi, Fulvia
A1  - Büttner, Christian
A1  - Ekici, Arif B.
A1  - Rauch, Anita
A1  - Sticht, Heinrich
A1  - Dörr, Helmuth-Günther
A1  - Reis, André
A1  - Thiel, Christian T.
T1  - Clinical relevance of systematic phenotyping and exome sequencing in patients with short stature
JF  - Genetics in Medicine
N2  - Purpose
Short stature is a common condition of great concern to patients and their families. Mostly genetic in origin, the underlying cause often remains elusive due to clinical and genetic heterogeneity.

Methods
We systematically phenotyped 565 patients where common nongenetic causes of short stature were excluded, selected 200 representative patients for whole-exome sequencing, and analyzed the identified variants for pathogenicity and the affected genes regarding their functional relevance for growth.

Results
By standard targeted diagnostic and phenotype assessment, we identified a known disease cause in only 13.6% of the 565 patients. Whole-exome sequencing in 200 patients identified additional mutations in known short-stature genes in 16.5% of these patients who manifested only part of the symptomatology. In 15.5% of the 200 patients our findings were of significant clinical relevance. Heterozygous carriers of recessive skeletal dysplasia alleles represented 3.5% of the cases.

Conclusion
A combined approach of systematic phenotyping, targeted genetic testing, and whole-exome sequencing allows the identification of the underlying cause of short stature in at least 33% of cases, enabling physicians to improve diagnosis, treatment, and genetic counseling. Exome sequencing significantly increases the diagnostic yield and consequently care in patients with short stature.
KW  - growth
KW  - phenotypic spectrum
KW  - short stature
KW  - skeletal dysplasia
KW  - whole-exome sequencing
Y1  - 2018
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-227888
VL  - 20
ER  -