[German S1 Guideline Long-/Post-COVID]. / S1-Leitlinie Long-/Post-COVID.

The German Society of Pneumology initiated 2021 the AWMF S1 guideline Long COVID/Post-COVID. In a broad interdisciplinary approach, this S1 guideline was designed based on the current state of knowledge.The clinical recommendations describe current Long COVID/Post-COVID symptoms, diagnostic approaches, and therapies.In addition to the general and consensus introduction, a subject-specific approach was taken to summarize the current state of knowledge.The guideline has an explicit practical claim and will be developed and adapted by the author team based on the current increase in knowledge.

Differences in neurology residency training programmes across Europe - a survey among the Residents and Research Fellow Section of the European Academy of Neurology national representatives.

BACKGROUND AND PURPOSE: Neurology is rapidly evolving as a result of continuous diagnostic and therapeutic progress, which influences the daily work of neurologists. Therefore, updating residency training programmes is crucial for the future of neurology. Several countries are currently discussing and/or modifying the structure of their neurology residency training programme. A detailed and up-to-date overview of the available European residency training programmes will aid this process. METHODS: A questionnaire addressing numerous aspects of residency training programmes in neurology was distributed among 38 national representatives of the Resident and Research Fellow Section of the European Academy of Neurology. RESULTS: We obtained data from 32 European countries (response rate 84%). The median (range) duration of the residency training programmes was 60 (12-72) months. In the majority of countries, rotations to other medical disciplines were mandatory, mostly psychiatry (69%), internal medicine (66%) and neurosurgery (59%). However, the choice of medical fields and the duration of rotations varied substantially between countries. In 50% of countries, there were formal regulations regarding training in evidence-based medicine, teaching skills and/or leadership qualities. In many countries (75%), residents had to take an examination. CONCLUSIONS: We found substantial variation among European countries in the duration of residency training programmes, and especially in the choice of obligatory rotations to external medical disciplines. Despite a presumably similar spectrum of patients, neurology residency training programmes across Europe are not harmonized. The structure of the programme should be determined by its relevance for neurologists today and in the future.

Outcomes and measurement instruments used in congenital melanocytic naevi research: A systematic review.

BACKGROUND: Congenital melanocytic naevi (CMN) can have a great impact on patients' lives due to the remarkable appearance and the risk of developing melanoma and neurocutaneous melanosis. Comparison of treatment efficacy is currently hindered by the lack of standard and uniform outcome reporting; this impedes guidance on optimal management policy. To address this, we aim to perform the first step in developing a core outcome set. With this systematic review, we identified a list of domains, outcomes (including patient reported outcomes) and outcome measurement instruments used in CMN research. METHODS: The review was registered in PROSPERO, registration number CRD42018095235. A search was conducted in EMBASE (Ovid), PubMed and the Cochrane Library from 2006 to January 2019. Studies with 10 or more patients, with all sizes of CMN and reporting outcomes on interventional and conservative management were included. RESULTS: A total of 1,285 individual studies was found; 63 studies were included. We extracted 57 different outcomes and 34 outcome measurement instruments showing large heterogeneity. Patient-reported outcomes were included in 38% of studies. Few outcome measurement instruments were described. Moreover, none of the studies reported that the used instruments were ever validated in a CMN population. CONCLUSION: Heterogeneity exists in outcomes and instruments used in CMN research. The development of a core outcome set may reduce this heterogeneity in future research, thereby enabling treatment comparison and eventually facilitating guidance on management. Furthermore, this overview demonstrates a need for the use and validation of (patient reported) outcome measurement instruments for CMN.

[Delirium in idiopathic Parkinson's disease]. / Das Delir beim idiopathischen Parkinson-Syndrom.

BACKGROUND: The development of delirium in patients with idiopathic Parkinson's disease (IPD) is a feared complication, which is often associated with sustained worsening of motor symptoms and psychopathological sequelae. Little is known regarding the prevalence and incidence rates, course and prognosis. Clinical studies from which recommendations for evidence-based management of delirium in IPD can be derived are lacking. OBJECTIVE: To summarize the state of the art regarding epidemiological and clinical features of delirium in IPD. Discussion of prevention strategies and non-pharmacological and pharmacological treatment options. METHODS: A literature search was carried out in PubMed. RESULTS: The IPD is an independent risk factor for the development of delirium. Patients with IPD show poorer clinical outcome frequently with cognitive worsening and motor complications following development of delirium. CONCLUSION: So far no validated rating scales for recognition and course evaluation of delirium in IPD are available. Preventive strategies and non-pharmacological measures should be consistently implemented to improve management. There are insufficient data concerning pharmacotherapy with quetiapine and clozapine, whereas other neuroleptics are contraindicated for delirium in IPD due to antidopaminergic side effects.

[Nationwide survey of postgraduate medical training in clinical neurology]. / Deutschlandweite Evaluation der ärztlichen Weiterbildung in der klinischen Neurologie.

BACKGROUND: Currently, no data are available, which reflect the situation of medical doctors specializing in neurology in German hospitals. In order to secure the high standard of neurological patient care it is essential to evaluate the working conditions and the specialty training in neurology. OBJECTIVE: This nationwide survey was conducted throughout Germany with the aim to address problems and to give suggestions for improvements in neurological training curricula. MATERIAL AND METHODS: The survey was online from February to May 2017 and 953 neurologists undergoing further training participated. RESULTS: More than half of the young neurologists were satisfied with their medical training. One of the main problems that complicates clinical training is the workload. In addition, organizational obstacles within the clinic, such as poor structure of education or a lack of mentors, lead to dissatisfaction among participants. The size or type of the department, as well as the prevailing service system, exert only a minor influence on the quality of specialist training, although there were differences especially in the self-assessment of the participants in connection with the type of department (university hospital versus public or private hospital). CONCLUSION: Specialist training in neurology can be improved by simple arrangements, e. g., the introduction of a binding rotation scheme, internal mentoring and structured feedback. In addition, it will be necessary to relieve medical staff of administrative duties in order to create time for training and the learning of competencies.

Porosity and optical properties of zirconia films prepared by plasma ion assisted deposition.

The porosity of zirconia films prepared by plasma ion assisted deposition has been investigated by means of optical (spectrophotometric) and nonoptical analytic techniques such as transmission electron microscopy, x-ray reflection, and energy dispersive x-ray spectroscopy. A discrimination between large (open) and small (closed) pores was achieved by means of measurement of the thermal and vacuum-to-air shift. Depending on the level of plasma assistance during film preparation, the porosity was found to vary between 30 vol. % and nearly 0 vol. %. With decreasing porosity, the surface roughness determined by atomic force microscopy tends to decrease as well.

[Positionpaper on Telemonitoring in Sleep-Related Breathing Disorders]. / Positionspapier zum Telemonitoring bei schlafbezogenen Atmungsstörungen.

The use of telemonitoring in the care of patients with Sleep-related Breathing Disorders (SBD) can enhance medical support significantly. Telemonitoring aims at helping physicians to detect therapy problems early and thus improve patients' therapy adherence. Diagnostics and therapy decisions in the telemonitoring process nevertheless remain the responsibility of sleep specialists. The selection of data monitored, their evaluation and resulting consequences fall to the physician, who makes decisions and prescribes therapy in consultation with the patient. In light of professional legal and ethical requirements, it must be ensured that the extensive changes to the process flow in sleep medicine are designed in a way to guarantee high-quality patient care. In this position paper, the German Sleep Society, the German Respiratory Society, the Association of Pneumological Hospitals and the Federal Association of German Pneumologists comment on important aspects for implementation of telemonitoring for SRBD and describe the basic conditions required for its use.

Ocorrência de Chlamydophila psittaci em pombos (Columba livia) na cidade de Salvador, Bahia / Occurrence of the pigeon Chlamydophila psittaci in pigeons (Columba livia) within the city of Salvador, Bahia

A existência de populações numerosas de pombos (Columba livia) em centros urbanos, em quase todo o mundo, tem se tornado um risco à saúde pública em vista das zoonoses que podem transmitir. A infecção por Chlamydophila psittaci foi avaliada em pombos que frequentam áreas públicas, como praças, ruas e pontos turísticos na cidade de Salvador, Bahia, por meio da PCR em amostras de fezes frescas, suabes cloacais e orofaríngeos. O estudo revelou uma frequência de infecção por C. psittaci de 11,7% (16/137) dos pombos, e oito dos 10 locais pesquisados apresentavam aves infectadas. A detecção de C. psittaci em amostras de cloaca e orofaringe foi maior (15,8% - 3/19) que em amostras de fezes frescas (11% - 13/118). Os resultados demonstram a ocorrência de infecção por C. psittaci em pombos que habitam as áreas públicas da cidade de Salvador e apontam para a necessária elaboração de medidas de controle e monitoramento das populações de pombos urbanos, bem como de ações voltadas à conscientização da sociedade sobre os riscos à saúde pública.

The existence of numerous pigeon (Columba livia) populations in urban centers, in most of the world, has become a public-health risk given the zoonoses they can transmit. Infection with Chlamydophila psittaci was evaluated in pigeons that frequent public areas, such as squares, streets and tourist sites in the city of Salvador, through PCR from fresh feces samples, cloacal swabs and oropharyngeals. The study revealed a frequency of infection with C. psittaci of 11.7% (16/137) in pigeons, and infected birds were found in eight of the ten locales researched. The detection of C. psittaci in samples of cloaca and oropharyngs was greater (15.8% - 3/19) than in the samples of fresh feces (11% - 13/118). The results show the occurrence of infection with C. psittaciem in pigeons that live in public areas in the city of Salvador and points to the necessity of elaborating control and monitoring measures for the populations of urban pigeons as well as developing actions that will raise society´s awareness of these risks to public health.

Estimation of the composition of coelectron-beam-evaporated thin-mixture films by making use of the Wiener bounds.

Material mixtures offer prospective possibilities for synthesizing coating materials with tailored optical constants. We present experimental results for mixture coatings of alumina/aluminum fluoride and alumina/hafnia deposited by electron beam evaporation. Thereby, the volume filling factors of the components are commonly estimated on the basis of deposition rates measured by quartz crystal microbalance. The interplay between the vapor fluxes from the two evaporation sources, the crosstalk between quartz crystal microbalances, and the influence of the plasma source on the tooling factors limit the accuracy of this estimation, and this has motivated us to develop an alternative approach. The general idea of our approach is based on the commonly high accuracy in thin-film optical constant determination using spectrophotometry. Therefore, these optical constants serve as a reliable input for a rather simple but robust evaluation procedure based on the concept of Wiener bounds. The consistency of the obtained results is illustrated by opposing the data to the elementary film composition estimated from energy-dispersive x-ray spectroscopy.

Reasons for family refusal of ocular tissue donation.

INTRODUCTION: Corneal donations do not fill the transplant demand. The waiting list had 5512 individuals in Brazil and 143 in Rio Grande do Sul in December 2012. The aim of this study was to identify the reasons for family refusal of ocular tissues donation. METHODS: This retrospective study analyzed interview records for ocular tissue procurement performed in a general, public university hospital located in Southern Brazil between January 2008 and December 2012. It identified the reasons of family refusal for ocular tissue donation. RESULTS: A total of 1010 interviews for ocular tissues procurement were performed. From these, 513 (50.79%) refused donation with the following reasons: 60 (11.69%) family members were unaware of the desire of the potential donor, 153 (29.82%) of potential donors spoke against donation in life, 113 (22.02%) family members were undecided about the donation, 156 (30.40%) family members were against donation, 3 (0.58%) family members were unhappy with the service, 11 (2.14%) family members were afraid of body release delay, 6 (1.16%) families expressed religious convictions against donation, and 11 (2.14%) family members wanted to keep the body intact. CONCLUSION: There are many reasons for ocular tissues donation refusal, and the knowledge provides better strategies for family interviews. In this study, most of the reasons, around 90%, can be related to lack of information or communication about the subject. Greater awareness of the population about the subject can be a good way to increase ocular tissue procurement indexes.

Risk factors associated with Chlamydia psittaci infection in psittacine birds.

Chlamydia psittaci is the aetiological agent of chlamydiosis in birds, especially Psittaciformes. The objective of the present study was to detect C. psittaci by means of semi-nested PCR among psittacine birds sold at pet markets and kept as pet birds in Salvador, Bahia, Brazil. Questionnaires were used to identify risk factors involved in the epidemiology of the disease. In addition, the management of birds and cages was observed at each location studied. The frequency of C. psittaci infection was 10.6% (33/311) in the psittacine birds studied. Birds kept in households were less frequently positive (3.4%; 5/148) than those at pet markets (17.2%; 28/163). Among the several factors analysed in the epidemiology of the disease, only population density (P = 0.001) and cage hygiene (P = 0.041) in birds at pet markets were significantly associated with C. psittaci infection. These results demonstrate the presence of C. psittaci infection in Psittaciformes kept as pets and held at pet markets in Salvador, Bahia, showing that this micro-organism is a public health concern. Control measures should be encouraged to prevent the spread of the agent among birds, as well as among employees and customers.

Guidelines for maintenance of adult patients with brain death and potential for multiple organ donations: the Task Force of the Brazilian Association of Intensive Medicine the Brazilian Association of Organs Transplantation, and the Transplantation Center of Santa Catarina.

INTRODUCTION: The organ shortage for transplantation, the principal factor that increases waiting lists, has become a serious public health problem. In this scenario, the intensivist occupies a prominent position as one of the professionals that first has a chance to identify brain death and to be responsible for the maintenance of the potential deceased donor. OBJECTIVE: This report attempts to establish guidelines for care and maintenance of adult deceased donor organs guiding and standardizing care provided to patients with brain death. METHOD: These guidelines were composed by intensivists, transplant coordinators, professionals from various transplant teams, and used transplant center. The formulated questions were forwarded to all members and recommendations were constructed after an extensive literature review selecting articles with the highest degree of evidence. RESULTS: Guidelines were developed in the form of questions reflecting frequent experiences in clinical intensive care practices. The main questions were: Is there an optimal interval for keeping organs of deceased donors viable? What actions are considered essential for maintaining deceased donors in this period? What are the limits of body temperature? How should the patient be warmed? Which laboratory tests should be performed? What is the collection interval? What are the limits in the laboratory and the capture scenario? What are the limits of blood pressure? When and how should one use catecholamines? CONCLUSIONS: This pioneer project involved a multidisciplinary team working in organ transplantation seeking to provide treatment guidance to increase the number of viable organs from deceased adult donors.

Potential of integrated [18F] fluorodeoxyglucose positron-emission tomography/CT in identifying vulnerable carotid plaques.

BACKGROUND AND PURPOSE: There is a need for improved risk stratification of patients with TIA/stroke and carotid atherosclerosis. The purpose of this study was to prospectively investigate the potential of integrated (18)F-FDG PET/MDCT in identifying vulnerable carotid plaques. MATERIALS AND METHODS: Fifty patients with TIA/stroke with an ipsilateral carotid plaque causing <70% stenosis and a plaque on the contralateral asymptomatic side underwent integrated (18)F-FDG PET/MDCT within 36.1 ± 20.0 days (range, 9-95 days) of the last symptoms. Carotid plaque (18)F-FDG uptake was measured as both the mean and maximum blood-normalized SUV, known as the TBR. Using MDCT, we assessed volumes of vessel wall and individual plaque components. RESULTS: Mean TBR was only significantly larger in the ipsilateral plaques of patients who were imaged within 38 days (1.24 ± 0.04 [SE] versus 1.17 ± 0.05, P = .014). This also accounted for maximum TBR (1.53 ± 0.06 versus 1.42 ± 0.06, P = .015). MDCT-assessed vessel wall and LRNC volumes were larger in ipsilateral plaques of all patients (982.3 ± 121.3 versus 811.3 ± 106.6 mm(3), P = .016; 164.7 ± 26.1 versus 134.3 ± 35.2 mm(3), P = .026, respectively). CONCLUSIONS: In the present study, (18)F-FDG PET only detected significant differences between ipsilateral and contralateral asymptomatic plaques in patients with TIA/stroke who were imaged within 38 days, whereas MDCT detected larger vessel wall and LRNC volumes, regardless of time after symptoms. In view of the substantial overlap in measurements of both sides, it remains to be determined whether the differences we found will be clinically meaningful.

Serum antibodies to conformational and linear epitopes of myelin oligodendrocyte glycoprotein are not elevated in the preclinical phase of multiple sclerosis.

BACKGROUND: The proposed predictive value of serum anti-myelin antibodies for the development of multiple sclerosis after a first clinically isolated syndrome was recently challenged. OBJECTIVE: To investigate myelin autoantibodies before first disease manifestation using different detection methods. METHODS: Patients with multiple sclerosis who had donated blood at a time prior to development of clinically isolated syndrome were identified via the German National Multiple Sclerosis Society. Control sera were obtained from age- and gender-matched blood donors. IgG-/IgM-antibodies against the extracellular part of native, cell surface-expressed myelin oligodendrocyte glycoprotein were detected by flow cytometry. Antibodies against linear epitopes were identified by immunoblot using recombinant myelin oligodendrocyte glycoprotein (aa1-125) and human myelin basic protein preparations. RESULTS: Fifty eight serum samples from 25 patients covering an interval of 7.3 years-2 months prior to disease onset were available. Longitudinal investigations were performed in 19 patients (2-14 samples per patient, 7 years-2 months prior to disease onset). No significant differences in the prevalence or titres of anti-myelin antibodies were detected between sera of preclinical individuals and healthy donors by either flow cytometry or immunoblot. There was no correlation between interval before clinically isolated syndrome and autoantibody status. Occurrence of antibodies was not associated with symptomatology/severity of clinically isolated syndrome. CONCLUSION: Neither anti-myelin autoantibodies against cell surface-expressed native myelin oligodendrocyte glycoprotein nor against linear epitopes have a predictive or discriminative role during the preclinical disease phase for developing clinically isolated syndrome or multiple sclerosis later in life.

[Success of carotid endarterectomy dependent on type of atherosclerotic plaque and gender, among others]. / Succes van carotisendarteriëctomie afhankelijk van onder meer het type atherosclerotische plaque en het geslacht.

Carotid endarterectomy (CEA) reduces the risk of stroke in both symptomatic and asymptomatic patients with a high-grade stenosis of the internal carotid artery. Surgery, however, is less beneficial for women than for men. Besides gender, other factors, like degree ofstenosis and plaque morphology, influence the risk of stroke and the beneficial effect of CEA. A recent study shows that women, asymptomatic women in particular, have more stable atherosclerotic carotid plaques than men. Increasing knowledge regarding local plaque characteristics should be carried through to clinical practice. Further studies, especially prospective studies, are needed to identify subgroups of patients that will benefit most from CEA. Low surgical morbidity and mortality remain a prerequisite to perform CEA in symptomatic carotid stenosis and even more so in asymptomatic carotid stenosis.

Dietary intake of natural sources of docosahexaenoic acid and folate in pregnant women of three European cohorts.

BACKGROUND: Folic acid plays a fundamental role in cell division and differentiation. Docosahexaenoic acid (DHA) has been associated with infantile neurological and cognitive development. Thus, optimal intrauterine development and growth requires adequate supply of these nutrients during pregnancy. METHODS: Healthy pregnant women, aged 18-41 years, were recruited in Granada (Spain; n = 62), Munich (Germany; n=97) and Pécs (Hungary; n=152). We estimated dietary DHA and folate intake in weeks 20 (w20) and 30 of gestation (w30) using a food frequency questionnaire with specific focus on the dietary sources of folate and DHA. RESULTS: Both w20 and w30 Spanish participants had significantly higher daily DHA intakes (155+/-13 and 161+/-9 mg/1,000 kcal) than the German (119+/-9 and 124 +/- 12 mg/1,000 kcal; p=0.002) and Hungarian participants (122+/-8 and 125 +/- 10 mg/1,000 kcal; p=0.005). Hungarian women had higher folate intakes in w20 and w30 (149+/-5 and 147+/-6 microg/1,000 kcal) than Spanish (112+/-2 and 110+/-2 microg/1,000 kcal; p<0.001) and German participants (126+/-4 and 120+/-6 microg/1,000 kcal; p<0.001), respectively. CONCLUSION: Dietary DHA and folate intake of pregnant women differs significantly across the three European cohorts. Only 7% of the participants reached the recommended folate intake during pregnancy, whereas nearly 90% reached the DHA recommended intake of 200 mg per day.

[Differences between hospitals in outcome after a stroke are only partially explained by differences in the quality of care]. / Verschillen tussen ziekenhuizen in uitkomst na een herseninfarct vooral verklaard door patiëntkenmerken en slechts ten dele door verschillen in de kwaliteit van zorg.

OBJECTIVE: To determine the extent to which the outcome of stroke patients stroke is correlated with patient characteristics and care process parameters, and to determine whether outcome measures can be used to measure the quality of hospital care provided for these patients. DESIGN: Descriptive cohort study. METHODS: At 10 hospitals in the Netherlands, in the period October 2002-April 2003, patients with acute stroke were included in the study. Poor outcome was defined as dead or disabled at 1 year (a score on the modified Rankin scale > or = 3). Quality of the care was assessed by relating diagnostic, therapeutic and preventive procedures to indication. Multiple logistic regression models were used to compare observed numbers of patients with a poor outcome with expected numbers per hospital, after adjustment for patient characteristics and quality of care parameters. RESULTS: In total, 579 patients were included in the study, of which 271 (47%) were dead or disabled at 1 year. Poor outcome varied across the hospitals from 29 to 78%. The mean age was 70 years. There were large differences between hospitals with respect to patient characteristics and quality of care. Most of the differences in outcome between hospitals were explained by the differences in patient characteristics (Akaike's information criterion (AIC) = 134). Quality of care parameters explained just a small additional part of the variation in patient outcome (AIC = 5.5). CONCLUSIONS: Large differences between Dutch hospitals in the patient outcome after stroke could mostly be explained by differences in patient characteristics. Only a small part of the hospital variation in patient outcome was related to differences in quality of care. Therefore, outcome indicators cannot be regarded as valid performance indicators for care following a stroke.

Cross-sectional serological study of canine Leishmania infection in Fortaleza, Ceará state, Brazil.

Visceral leishmaniasis (VL) is one of the most important reemerging parasitic disease in the world. The domestic dog is the main reservoir in urban environments. The aim of this work was to extend the knowledge on canine Leishmania infection in the city of Fortaleza in northeastern Brazil, identifying the risk factors inherent in dog susceptibility to the infection. Two populations were analyzed, domestic dogs from clinics and the Veterinary Hospital Unit of Ceará State University and stray dogs captured by the Center for Zoonosis Control in Fortaleza. Blood samples were collected and centrifuged and the sera were stored at -20 degrees C. ELISA, with soluble crude Leishmania chagasi antigens (LTCC - WDCM731) was used for diagnosis. A total of 1,381 samples were tested, 750 from domestic and 631 from stray dogs. The seroprevalence of canine VL was 21.4% (135/631) in stray dogs and 26.2% (197/750) in domestic dogs. The seroprevalence of Leishmania infection in the six administrative regions of the city (Secretarias Executivas Regionais, or SER) among stray dogs was highest in SER V, representing 31.4% of the cases, with large dogs more infected (27.7%). Among domestic dogs Leishmania infection was most prevalent in SER V (38.5%) and VI (37.6%). The dogs' age (1-6 years), large size, environment with dense vegetation and presence of clinical signs compatible with Leishmania infection were associated with the illness in domestic dogs. The frequency of the infection varied seasonally. The seroprevalence was greatest in July and December. These results confirm Fortaleza is an endemic area for canine VL and suggest some variables associated with increasing infection risk in dog populations.

[Recurrence of Crohn's disease after surgery--causes and risks]. / Das postoperative rezidiv des m. Crohn--ursachen und risiken.

BACKGROUND: In spite of the important role of conservative treatment, up to 90 % of all patients with Crohn's disease will undergo an operation during the course of their illness. Up to 50 % even need a second operation or further surgical procedures - with an increasing risk for perioperative complications. This study was designed to identify the risk factors for recurrence in patients with Crohn's disease and the influence of the primary operation. METHODS: Between 1986 and 2004, 412 patients with Crohn's disease required operative treatment. 218 underwent a primary procedure and 194 needed a reoperation. In particular, the indications for surgical treatment, the surgical procedures and the perioperative complications were registered and evaluated in the context of a possible recurrence of Crohn's disease. In this study, "recurrence" is defined as a reoperation because of Crohn's disease after a primary operation. RESULTS: The most common indications for a surgical treatment were stenosis (58.4 %) and fistulas (38.5 %). As the most frequent procedures, the ileocoecal resection and the partial resection of the small bowel were performed. Altogether, the complication rate was 11.5 %. The primary procedures (6.52 %) had less complications than the operations for a recurrence of Crohn's disease (17.70 %). The rate for the recurrence of Crohn's disease was 17.4 % after 5 years, 36.7 % after 10 years and 52.8 % after 15 years. Patients with fistulas as the indication for primary operation had the highest rate of recurrence (45 %). Patients with an isolated Crohn's lesion of the small intestine had a significantly higher risk for recurrence (59.5 %) than patients with lesions in the ileocoecal region or the colon. The anastomosis region (73 %) was the most common localisation for recurrence. CONCLUSION: On the basis of defined risk factors, patients with a high risk for recurrence can be identified. This is very important because of the higher risk for complications caused by reoperations compared to primary procedures. That is why interdisciplinary cooperation including postoperative care and optimal conservative treatment are absolutely essential.