Cornelius Bollheimer’s research while affiliated with University Hospital RWTH Aachen and other places

All relevant functional tests are explained with a detailed presentation of indications, contraindications, side effects, test preparation, framework conditions, concrete instructions for the actual test execution, and the interpretation of test results. Specific normal ranges and cut-off values are always provided, even for special situations (gender, age, BMI, puberty phases, menstrual cycle phases, acute illnesses, medications, etc.). A special feature is the emphasis on test preparation, execution, and interpretation, as well as the interdisciplinary nature. This chapter provides a practical overview of the sonographic, radiological, and nuclear medicine imaging procedures for important endocrinopathies. Classic cardinal findings of imaging are explained using illustrations, and sensitivities and specificities for the individual procedures are provided. The significance of Hounsfield units in CT and fat suppression in MRI for adrenal imaging is discussed in detail.

All relevant functional tests are explained with a detailed presentation of indications, contraindications, side effects, test preparation, framework conditions, specific instructions for the actual test execution, and the interpretation of test results. Specific normal ranges and cut-off values are always provided, even for special situations (gender, age, BMI, puberty phases, cycle phases, acute illnesses, medications, etc.). A special feature is the emphasis on test preparation, execution, and interpretation, as well as the interdisciplinary nature. Adrenal cortex diseases are discussed in terms of functional test diagnostics, categorized by zona reticularis, zona fasciculata, and zona glomerulosa. This chapter is of eminent importance for endocrinological diagnostics per se and is characterized by many different, sometimes very demanding test procedures, up to and including adrenal vein catheterization. Drug interactions and the interpretation of test diagnostics play a practically relevant role, as does the distinction between screening, confirmation, and localization tests. The chapter covers all dexamethasone suppression tests, free cortisol in urine, midnight cortisol, ACTH test, all aldosterone-based test procedures, saline stress test, orthostasis test, captopril test, fludrocortisone test, detailed considerations of the aldosterone-renin ratio, androgens, and androgen suppression test.

All relevant functional tests are explained with a detailed presentation of indications, contraindications, side effects, test preparation, framework conditions, specific instructions for the actual test execution, and the interpretation of test results. Specific normal ranges and cut-off values are always provided, even for special situations (gender, age, BMI, puberty phases, menstrual cycle phases, acute illnesses, medications, etc.). A special feature is the emphasis on test preparation, execution, and interpretation, as well as the interdisciplinary nature. For the male gonads, the interpretations of androgens, gonadotropins, the spermogram, and the HCG test are conveyed.

All relevant functional tests are explained with a detailed presentation of indications, contraindications, side effects, test preparation, framework conditions, concrete instructions for the actual test execution, and the interpretation of test results. Specific normal ranges and cut-off values are always provided, even for special situations (gender, age, BMI, puberty phases, cycle phases, acute illnesses, medications, etc.). A special feature is the emphasis on test preparation, execution, and interpretation, as well as the interdisciplinary nature. The anterior pituitary hormones and their dynamic functional testing are detailed in this chapter. Even difficult, complex, rare, and newer test procedures such as inferior petrosal sinus catheterization, pulsatile GnRH test, combined GHRH-arginine infusion test, and Macimorelin test are extensively presented.

All relevant functional tests are explained with a detailed presentation of indications, contraindications, side effects, test preparation, framework conditions, specific instructions for the actual test execution, and the interpretation of test results. Specific normal ranges and cut-off values are always provided, even for special situations (gender, age, BMI, puberty phases, menstrual cycle phases, acute illnesses, medications, etc.). A special feature is the emphasis on test preparation, execution, and interpretation, as well as the interdisciplinary nature. The disease entity of pheochromocytoma is the focus of this chapter (catecholamines, normetanephrines, metanephrines) with reference to catecholamine metabolism and its dynamic testing, including the clonidine suppression test and glucagon stimulation test.

All relevant functional tests are explained with a detailed presentation of indications, contraindications, side effects, test preparation, framework conditions, specific instructions for the actual test execution, and the interpretation of the test results. Specific normal ranges and cut-off values are always provided, even for special situations (gender, age, BMI, puberty phases, cycle phases, acute illnesses, medications, etc.). A special feature is the emphasis on test preparation, execution, and interpretation, as well as the interdisciplinary nature. Hypothalamic function tests such as insulin-induced hypoglycemia, exercise, clonidine, and propranolol-glucagon tests are demanding, both in execution and interpretation. In particular, the cut-off values for GH are subject to constant adjustments and influences and must always be considered in the overall clinical context.

Aims Phenoconversion, a genotype‐phenotype mismatch, challenges a successful implementation of personalized medicine. The aim of this study was to detect and determine phenoconversion using the solanidine metabolites 3,4‐seco‐solanidine‐3,4‐dioic acid (SSDA) and 4‐OH‐solanidine as diet‐derived cytochrome P450 2D6 (CYP2D6) biomarkers in a geriatric, multimorbid cohort with high levels of polypharmacy. Methods Blood samples and data of geriatric, multimedicated patients were collected during physician counsel (CT: NCT05247814). Solanidine and its metabolites were determined via liquid chromatography/tandem mass spectrometry and used for CYP2D6 phenotyping. CYP2D6 genotyping was performed and activity scores (AS) were assigned. Complete medication intake was assessed. A shift of the AS predicted via genotyping as measured by phenotyping was calculated. Results Solanidine and its metabolites were measured in 88 patients with complete documentation of drug use. Patients had a median age of 83 years (interquartile range [IQR] 77‐87) and the majority (70.5%, n = 62) were female. Patients took a median of 15 (IQR 12‐17) medications. The SSDA/solanidine metabolic ratio correlated significantly with the genotyping‐derived AS (P < .001) and clearly detected poor metabolizers. In the model adjusted for age, sex, Charlson Comorbidity Index and estimated glomerular filtration rate each additional CYP2D6 substrate/inhibitor significantly lowered the expected AS by 0.53 (95% confidence interval 0.85‐0.21) points in patients encoding functional CYP2D6 variants (R² = 0.242). Conclusions Phenotyping of CYP2D6 activity by measurement of diet‐derived biomarkers elucidates phenoconversion in geriatric patients. These results might serve as a prerequisite for the validation and establishment of a bedside method to measure CYP2D6 activity in multimorbid patients for successful application of personalized drug prescribing.

Background Vertebral and pelvic fractures are associated with a significant burden of negative health and psychosocial outcomes. The number of vertebral and pelvic fractures is increasing in an aging society. Vertebral and pelvic fractures are increasingly significant injuries for individuals and society. However, few epidemiological studies have examined the clinical course of vertebral and pelvic fractures. This is the protocol for a study that observes patients who have been admitted to the hospital with an incident vertebral or pelvic fracture for a period of 12 months. Methods The observational cohort study is conducted at three study sites in Germany. Patients affected by vertebral or pelvic fractures are recruited within the first few days of hospital admission. Data collection takes place at four-time points: baseline, before discharge, after 4 months, and after 12 months after admission to the hospital. Particular emphasis is laid on the assessment of the fall mechanisms, physical function, physical activity, life space, mobility, treatment approach, and quality of life. The hospital stay involves the collection of biomaterials (blood and urine). Discussion The study aims to enhance understanding of the clinical progression and outcomes in patients with fractures in the vertebrae or pelvis.