[Elective orthopaedic surgery (EOS) in haemophilia. Proposals for optimizing and standardization].

In particular health economists promise to improve healthcare processes, cost-effectiveness and outcomes by standardised procedures. In the area of EOS indication, operative procedures and postal-surgical pain therapy can partly be standardised. In addition, clinical pathways have impact on the organisation of care if the care process is structured in a standardised way.

[A 62 year old woman with spontaneous onset of distinct walking disorder and pancytopenia].

Our case-report presents a 62 year old woman with spontaneous onset of a distinct walking disorder and pancytopenia. The diagnosis showed a sub-acute combined degeneration of the spinal cord (SACD) and a megaloblastic anemia as a result of a cobalamin deficiency. This was caused by a strict vegetarian nutrition since 18 years.

[Flexion contracture in haemophilic knee arthropathy--10-year follow-up after hamstring release and dorsal capsulotomy].

Introduction: The aim of this study was to evaluate the long term results of joint preserving surgery with hamstring release and dorsal capsulotomy for the treatment of therapy resistant knee flexion contracture in patients with severe haemophilia.

Methods: 16 patients having undergone hamstring release and dorsal capsulotomy were prospectively observed and clinically evaluated over a period of at least 10 years. Follow-up was on average 16.

[First manifestation of multiple myeloma as lethal streptococcal sepsis].

Background: The multiple myeloma has the highest incidence among tumors of the bone and the bone marrow. Due to its rather mild and uncharacteristic clinical onset, first diagnosis of multiple myeloma is often delayed.

Case Report: The case of a 60-year-old female patient is reported who had been admitted to the authors' hospital in a state of severe septicemia.

Osteoporosis in haemophilia - an underestimated comorbidity?

A relationship between haemophilia and osteoporosis has been suggested, leading to the initiative for a larger study assessing this issue. Bone mineral density (BMD) was measured by osteodensitometry using dual energy X-ray absorptiometry (DEXA) in 62 male patients with severe haemophilia A; mean age 41 +/- 13.1 years, mean body mass index (BMI) 23.

Successful pain treatment in arthropathic lower extremities by acupuncture in haemophilia patients.

Acupuncture is successfully used in the treatment of degenerative osteoarthritis. The treatment of haemophilic arthropathies can require strong painkillers with severe side-effects. Therefore, a special yet simple acupuncture technique was evaluated in the treatment of these joint problems.

Achilles tendon lengthening for ankle equinus deformity in hemophiliacs: 23 patients followed for 1-24 years.

Background: Bleeding in the calf or ankle joint may lead to ankle equinus deformity, particularly in childhood and during adolescence. We assessed the long-term functional and radiographic results after Achilles tendon lengthening for ankle equinus deformity in hemophiliacs.

Patients And Methods: Between 1975 and 1986, 30 hemophilic patients with pes equinus were surgically managed by Achilles tendon lengthening.

[Rupture of the uterine artery after spontaneous delivery with unusual course in childbed].

Haemorrhage from ruptured uterine vessels is a rare but life-threatening complication during pregnancy. The high rate of mortality associated with this condition is correlated to the rapidity of haematoma formation. The dynamics of this event become particularly evident at the time of birth when the uterus requires one-fifth of the cardiac output.

Cytoreductive combination chemotherapy for regionally advanced unresectable extramammary Paget carcinoma.

Extramammary Paget carcinoma (EPC) is considered to originate from the eccrine and apocrine glands of the adnexal skin of the axilla, vulva or penis, scrotum, or perineum. If immunohistochemical techniques with the use of cytoskeletal markers are applied in addition to histologic examination, EPC lesions are found to be multifocal adenocarcinoma of the adnexal sweat glands. So far, therapeutic approaches have included primary surgery, followed optionally by radiation therapy.