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"Within the framework of the National Health Interview and Examination Survey 1998 the Short Form Questionnaire SF-36 has been applied to measure the health related quality of life ( HRQOL ) . This opened more opportunities than simply creating a new normative sample for the German adult population . Thus , the very complex interdependence between morbidity , satisfaction , risk factors , health related behaviours , social status , age and sex on the one side and the subjective assessment of health related quality of life on the other hand may be investigated . First results of the Survey data are presented which open the discussion of the possibilities and limits of the SF-36 instrument for measuring health related quality of life at the population level ."
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Bundesgesundheitsblatt.00430400.eng.abstr | Bundesgesundheitsblatt.00430400.eng.abstr | [
{
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"The results of the German National Health Interview and Examination Survey 1998 confirm allergies as widespread diseases in Germany . In total 40 to 43 % of the adult population have or have had an allergic disease . The morbidity was assessed using a self-administered questionnaire and a personal interview performed by a physician . The agreement between questionnaire and interview data is greater than 90 % for allergic rhinitis , food allergy and urticaria and about 80 % for contact dermatitis and asthma . The results of both assessment methods showed remarkable differences between East and West Germany . Using the interview data 17 % of the West but only 11 % of the East German adults have/had e.g. an allergic rhinitis . Comparable differences exist for contact dermatitis . Many people with allergies suffer or have suffered from several allergies . Frequent patterns of combination are food allergy/allergic rhinitis and asthma/allergic rhinitis . In comparison with former studies we observed an increase of 70 % in the prevalence of allergic rhinitis between 1990/92 and 1998. The relative increase is higher in East than in West . The time trend in prevalence of asthma could only be calculated for the West German population . The results show a remarkable increase here , too ."
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Bundesgesundheitsblatt.00430415.eng.abstr | Bundesgesundheitsblatt.00430415.eng.abstr | [
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"The data of the National Health Interview and Examination Survey provides information about the prevalence of cardiovascular risk factors in the population living in Germany . The survey consists of a health oriented questionnaire and an examination of 7124 persons from a representative sample of the 18 to 79 year-old population . Even using strict criteria for each risk factor in order to avoid overestimating the number of subjects at risk , the results show an alarmingly high dissemination of risk factors among the population . Thus one third of the 18 to 79 year-old men and women got cholesterol levels > = 250 mg/100 ml . Obesity , i . e . a body mass index > = 30 kg/m2 is prevalent in one of five persons . More than half of the overweight , over 50-year-old women , show an abdominal fat distribution , which is an additional factor to the risks in question . 18% of the men and women show a \" moderate \" to \" severe \" hypertension ( as defined by the WHO criterias ) . More than 20% of the 20 to 49 year-old men are heavy smokers with a daily consumption of > = 20 cigarettes a day . Only one third of all 18 to 79 years old do not have any of the risk factors , as there are daily smoking , hypercholesterolemia , obesity and hypertension ( the last terms defined as mentioned above ) . About 40% show one factor , ca. 20% two factors . There is a strong dependence between the distribution of the risk factors and the socio-economic level . For women , an increase of the total risk has been shown over the last years ."
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Bundesgesundheitsblatt.00430424.eng.abstr | Bundesgesundheitsblatt.00430424.eng.abstr | [
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"id": "Bundesgesundheitsblatt.00430424.eng.abstr-passage-0",
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"Pain is a widely occurring disturbance of well-being and has serious consequences for the quality of life of patients suffering from acute or chronic pain . Thus , pain makes high demands on the health system . For the first time in the Federal Republic of Germany the National Health Interview and Examination Survey allows to make representative statements concerning the prevalence of pain , its intensity , frequency , duration and localisation . Furthermore , the results enable to differentiate according to age , gender , and social classes . The SF-36, used as an instrument to measure health related quality of life , has been employed to demonstrate the overwhelming significance of pain for the well-being of the population . In this publication the connection between certain disease syndromes like migraine and arthrosis and the prevalence of different qualities of pain is investigated . Additional more complex evaluation of the epidemiological data on pain are in preparation ."
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Bundesgesundheitsblatt.00430432.eng.abstr | Bundesgesundheitsblatt.00430432.eng.abstr | [
{
"id": "Bundesgesundheitsblatt.00430432.eng.abstr-passage-0",
"type": "abstract",
"text": [
"More than 2/3 of German adults are using seeing aids . Individuals who are wearing eyeglasses are consulting their opthalmic practitioner about every 3rd year while persons with contact lenses see their practitioner every 2nd year . Almost only people under age 40 are buying contact lenses . The market for spectacles is very large for consumers older than 45 years since hypermetropia is mainly corrected with eyeglasses in this age group . The prevalence of hard of hearing is 8% for adults and is increasing with age , but only 2,5% of the study population are equipped with hearing aids . The distribution between males and females is 59% vs. 41% for hard of hearing . 12,4% of the interviewed persons report a handicap . There are regional and gender-specific differences . The proportion of handicapped person raises with increasing age and counts of diseases ."
],
"offsets": [
[
0,
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]
}
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}
] |
Bundesgesundheitsblatt.00430443.eng.abstr | Bundesgesundheitsblatt.00430443.eng.abstr | [
{
"id": "Bundesgesundheitsblatt.00430443.eng.abstr-passage-0",
"type": "abstract",
"text": [
"To improve the insufficient vaccination rates of the general population in Germany , general practitioners play an important role as mediators . In actual practice , doctor's receptionists often have to control the certificates of vaccination and advise the patients . Therefore , in the offices for public health in Trier and Wittlich training courses were held . At the beginning the knowledge of the 102 participants was measured by a questionnaire . Results show that even those doctor's receptionists , who were very interested in vaccinations , had insufficient knowledge and to some part alarmingly few vaccinations themselves , especially to protect them against Influenza and Hepatitis B."
],
"offsets": [
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0,
697
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]
}
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{
"id": "Bundesgesundheitsblatt.00430443.eng.abstr-s5-t5",
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],
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"db_name": "UMLS",
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}
]
}
] | [] | [] | [
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{
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{
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{
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{
"id": "Bundesgesundheitsblatt.00430443.eng.abstr-s1-r6-t2.1-t3.1",
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{
"id": "Bundesgesundheitsblatt.00430443.eng.abstr-s1-r7-t6.1-t4.1",
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{
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{
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{
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{
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{
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{
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{
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{
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{
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{
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{
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"normalized": []
}
] |
Bundesgesundheitsblatt.00430449.eng.abstr | Bundesgesundheitsblatt.00430449.eng.abstr | [
{
"id": "Bundesgesundheitsblatt.00430449.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Data for HIV infection on transmission probabilities per contact are of widely differing quality . Estimates of infection probabilities after sexual exposures are the most problematic , even though sexual exposure is the most frequent transmission risk . Extrapolations of data from discordant couple cohort studies and from US seroincidence studies may be seriously biased . Infectivity of and susceptibility to HIV may be influenced by concomitant STDs , antiretroviral therapy , alloimmunization and/or subinfectious virus exposures and thus may show a wide range of inter- and intraindividual variability . Differences in factors influencing transmission probability of HIV most likely outweigh differences in sexual behaviour in explaining the differences in epidemic spread of HIV ."
],
"offsets": [
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788
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]
}
] | [
{
"id": "Bundesgesundheitsblatt.00430449.eng.abstr-s1-t1",
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{
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122,
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{
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{
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{
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294,
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{
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]
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]
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{
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{
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{
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]
},
{
"id": "Bundesgesundheitsblatt.00430449.eng.abstr-s4-t5",
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]
},
{
"id": "Bundesgesundheitsblatt.00430449.eng.abstr-s5-t1",
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]
},
{
"id": "Bundesgesundheitsblatt.00430449.eng.abstr-s5-t2",
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"probability"
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],
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]
},
{
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"type": "umlsterm",
"text": [
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Bundesgesundheitsblatt.00430839.eng.abstr | Bundesgesundheitsblatt.00430839.eng.abstr | [
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Bundesgesundheitsblatt.00430870.eng.abstr | Bundesgesundheitsblatt.00430870.eng.abstr | [
{
"id": "Bundesgesundheitsblatt.00430870.eng.abstr-passage-0",
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"With the new Protection against infection Act , the system of notifiable diseases in Germany will have a new basis . In the future , certain diseases will be reportable by physicians and laboratory confirmed results for certain pathogens will be reportable by laboratories . The law clearly lays out which information has to be passed along with the report by the reporting physician or laboratory . It also states which parts of this information can be transmitted further on by the local health departments . Particularly for reports of suspected diseases or for laboratory results , not all the information which the health department should transmit will be available with the first report . Thus , the local health departments have to conduct own investigations . The local health departments have the task to join the report of a disease and a laboratory result concerning one person and transmit it as a single case . In order to facilitate this task of putting together all transmittable data , surveillance case definitions were developed and a defined data entry program will be provided . The data will be transmitted via the respective State authority to the Robert Koch-Institut ."
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"According to the former notification procedures , most notifiable infectious diseases ( with the exception of HIV ) were reported to the local health authorities . With the institution of the new Protection against infection Act ( IPA ) the diagnosis of a number of infectious pathogens will be reported anonymous directly to the Robert Koch Institute ( RKI ) . These mandatory notifications refer to the diagnosis of Treponema pallidum , HIV , Echinococcus sp . , Plasmodium sp . , Rubellavirus ( only connatal infections ) and Toxoplasma gondii ( only connatal infections ) . The head of the facility conducting the diagnostic test ( laboratory ) is responsible for the carrying out of the notification . In order to obtain all information required in the notification , the physician , who is sending in the material for testing , is required by law , to support the person responsible for carrying out of the notification by supplying the necessary data . First , the laboratory fills out the notification form with all the available information and sends the original to the RKI . Then , together with the test results , a copy of the notification is sent to the physician who initiated the diagnostic test . The physician completes any missing data in the form and sends this copy to the RKI . By doing so the physician has fulfilled his obligation to support the notification process . This new reporting system will yield better data about infectious pathogens that do not require direct intervention by the local health authorities . In order to obtain reliable data , it is important that all physicians support the notification process ."
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"Hospitals and clinics for ambulant surgery shall identify and register certain officially defined nosocomial infections ( Surveillance ) as well as the isolation of bacteria with special and important antimicrobial resistancies ( § 23 Abs. 1 IfSG = Infection Prevention Act ) . The nosocomial infections to be recorded , i . e device associated infections and postsurgical woundinfections , have been selected on the basis of national and international experiences with the surveillance of nosocomial infections . Important antimicrobial resistancies have been determined according to both the prevalence of the bacteria in nosocomial settings as well as their clinical and epidemiological importance . Most of the relevant data may be provided by the clinical microbiology laboratory but shall be collected , listed and discussed by the staff of wards or surgery clinics . Both types of documentation shall be used to identify and eradicate problems in hygiene management and to stop further distribution of difficult to treat bacteria like MRSA . They are part of the quality assurance management according to § 137 SGB V."
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"Germany's new Protection against infection Act ( Infektionsschutzgesetz ) will take effect on January 1 , 2001. It will result in an increase of notifications on reportable infections . Counties and states have to adjust the infrastructure of their reportable disease notification systems to meet the demands of the new legislation . An increased demand for human resources at the non-medical staff level is anticipated . Continuing education programs for medical and non-medical staff at public health offices are mandatory . Physicians in private practice , hospitals and diagnostic laboratories and leaders of nursing homes are target groups for special information . A timely review and epidemiological evaluation of all notifications forwarded by county health offices has to be performed at the state level . This is a prerogative for immediate response in case of non-localized increases in reported disease incidence . The author advocates the development of an epidemiological rapid reaction scheme ( epidemiological fire brigade ) in which public health physicians at the county , state , and federal level cooperate in a gradual response to outbreak situations according to actual demand ."
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{
"id": "Bundesgesundheitsblatt.0043s009.eng.abstr-passage-0",
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"HIV remains infectious at room temperature for about six to twelve hours under sterile conditions , the time is shorter in the presence of bacteria and when clotting occurs . HIV infectivity is easily destroyed by disinfectants . The human infectious dose of HIV is around 100 to 1000 particles , dependent on the virus and the site of entry into the host . After inoculation new HIV is produced after 24 hours , and HIV has spread over the whole organism by the end of one or two weeks . HIV infection may be detected after four to twelve weeks by antibody assays , and after eleven days by nucleic acid based assays . Anti-HIV production might be slowed down under initial therapy ."
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Bundesgesundheitsblatt.0043s013.eng.abstr | Bundesgesundheitsblatt.0043s013.eng.abstr | [
{
"id": "Bundesgesundheitsblatt.0043s013.eng.abstr-passage-0",
"type": "abstract",
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"The risk of occupational infection with HIV is subjectively often overestimated . This is in contrast to the fact , that other viral infections are more frequent and contagious . In medical services Hepatitis B is now the most frequent occupational viral infection . Prevention of infection is the most important measure . The \" Unfallverhuetungs-Vorschriften \" of the \" Berufsgenossenschaft \" are giving advices how to work in medical services to prevent infections . Another important issue are vaccinations . There is a clear recommendation for hepatitis B vaccination in health care workers . After contamination of unvaccinated health care workers with suspicious materials for hepatitis B an active and passive immunisation is demanded . For the case of hepatitis C there does not exist medical post-exposure-prophylaxis . The early intervention with Interferon after establishing the diagnosis of acute hepatitis C seems to have a high efficacy ."
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Bundesgesundheitsblatt.0043s026.eng.abstr | Bundesgesundheitsblatt.0043s026.eng.abstr | [
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"It is not clear whether public health insurance will cover post exposure prophylaxis ( PEP ) , whereby the question of costs being covered by private health insurance companies is not taken into consideration here . Regulations concerning prevention ( § 20 SGB V ) , precautionary medical services ( § 23 SGB V ) and health examination ( § 25 SBG V ) offer no legal basis for cost coverage . PEP is patient care in the sense of § 27 SGB V. However , this particular treatment has not yet been adapted into public health insurance financial guidelines because the federal committees have not yet made appropriate recommendations . This should be achieved soon , in order to eliminate legal ambiguities in this area . The principles of the so called \" new methods of examination and treatment \" legal construct may support cost coverage liability . On the whole , however , German-Austrian recommendations concerning indication and use of PEP must be formulated more concretely and unambiguously . If a doctor , in the case of an indication according to the German-Austrian recommendations , does not prescribe PEP , this would probably not be malpractice , because there are still many scientific questions to be answered ."
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Bundesgesundheitsblatt.0043s045.eng.abstr | Bundesgesundheitsblatt.0043s045.eng.abstr | [
{
"id": "Bundesgesundheitsblatt.0043s045.eng.abstr-passage-0",
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"In June 1998 the German and Austrian AIDS Clinical Societies issued guidelines on HIV Post-Exposure Prophylaxis ( PEP ) . They provided a standard for consultation and treatment process , including advice on how to proceed in cases of non-nosocomial exposure to HIV . The guidelines were published in scientific and community media . This study aims to asses the impact of national guidelines on demand for and practice of non-nosocomial Post-Exposure Prophylaxis ( NN-PEP ) in Germany . Specialised HIV-practitioners ( n=80), clinics ( n=100) and health services including AIDS service organizations ( n=170) were evaluated regarding demand for and practice of NN-PEP in their institutions during the previous twelve month period . This analysis is based on 100 structured questionnaires . In addition 29 clinical emergency departments and 10 ambulatory emergency services were contacted . They were asked to provide consultation to a man with risk factors that compose an indication for treatment under the current guidelines . One year after establishment of a coherent guideline for NN-PEP in Germany , consultation and treatment practices are well established . 68 institutions provided consultation in 531 cases and a treatment recommendation was given in 143 cases . 75 men and 14 women were treated . Ten of them reported needle-sharing as their exposure risk ( 8 men/2 women ) . In 90.2% treatment was administered within 24 hours of the risk event . Treatment consists of triple-combination therapy ( ten different standards in 40 institutions ) . Viral load measurements ( PCR , bDNA ) are used to assess viral replication . There are different levels of qualification and accessibility , reflecting a specialisation of services . Consultation and treatment are heavily clustered ( e.g. two institutions account for 55.2% of all treatment cases ) . The cost of treatment is 1500,- til 2800,- DM ( 750-1400 Euro ) per case . Specialisation is also found in the qualitative analysis of the interviews . Out of 33 telephone contacts 8 yield a consultation in line with current guidelines . The interviews reveal high barriers to NN-PEP during weekend hours ( Fri 6 p.m. to Sun 12 p.m. ) through ambulatory emergency services . The demand for consultation and treatment in Germany remains to be low in more than 100 institutions . The specialisation of services provides a basis for data collection and evaluation of the cost-effectiveness of NN-PEP . The process of qualification through guidelines does not appear to have been completed . The different practices of treatment and the low use of treatment in the i.v. drug-using population need to be further investigated ."
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Bundesgesundheitsblatt.0043s054.eng.abstr | Bundesgesundheitsblatt.0043s054.eng.abstr | [
{
"id": "Bundesgesundheitsblatt.0043s054.eng.abstr-passage-0",
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"A study is presented where after educative counselling HIV-negative partners of HIV-positive people are provided with an emergency pack of postexposure prophylaxis ( PEP ) medication . This enables them to start a post exposure prophylaxis immediately in a case of HIV exposure and helps to avoid delays until a physician with experience in HIV care can be consulted . The study is aimed to investigate how often HIV exposures occur in serodiscordant couples , whether the availability of PEP increases risk behaviour , whether the individual participants are able to distinguish PEP-justifying exposures from those with a lower risk of transmission , and whether an emergency pack is adequate to enable timely initiation of PEP . 13 participants were recruited so far . Of these , 5 couples were aware of the HIV-serodiscordance at the time the relationship started , while the other 8 found out about the HIV infection of one partner while the relationship was already going on for some time . The first group had a median number of 35 sexual contacts within the last three months prior to the start of the study , whereas the second group had a median number of 3,5 sexual contacts . In the course of the observation which included a cumulative time of 56 patient months , three HIV exposures occured . In two cases PEP was initiated within less than an hour , in one case no medication was taken . Whether the number of risk contacts increases in these couples as a consequence of the availability of PEP medication remains to be seen . The current data support the assumption that an emergency pack is a reasonable and feasible intervention for HIV-serodiscordant couples ."
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] | [] | [] | [
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Bundesgesundheitsblatt.90420105.eng.abstr | Bundesgesundheitsblatt.90420105.eng.abstr | [
{
"id": "Bundesgesundheitsblatt.90420105.eng.abstr-passage-0",
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"In principle , haematopoietic stem cell preparations offer a paramount array of clinical opportunities and future perspectives . They are the basis for stem cell transplantation , e.g. for rescue of haematopoiesis after high dose cytotoxic therapy , for treatment of immunologic deficiencies and congenital metabolic disorders , and , in the future , a vehicle for gene therapy . Stem cells may be obtained from bone marrow , peripheral blood , or umbilical cord blood . This article provides an overview of the biology of stem cells , procedures for their collection , the legal basis for the manufacture of stem cell preparations , and essential requirements for their marketing authorisation . According to German legislation , stem cell preparations are medicinal products necessitating a marketing authorisation , if they are not produced for a certain ill person , but manufactured beforehand and banked until needed ."
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}
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Bundesgesundheitsblatt.90420113.eng.abstr | Bundesgesundheitsblatt.90420113.eng.abstr | [
{
"id": "Bundesgesundheitsblatt.90420113.eng.abstr-passage-0",
"type": "abstract",
"text": [
"New therapeutic approaches in surgery , transplantation , and cancer therapy make likely that the need for blood and blood components will continue . The development of artificial oxygen carriers for clinical use appears to be desirable , to overcome several problems encountered with human blood and blood products : the risk of transmission of infectious diseases ( which , however is very low meanwhile ) , the need for determination of blood groups and the use of compatible blood , the limited availability of blood donations , and the precautions necessary to store the liable blood components for a limited time . Native stroma free haemoglobin cannot be used as blood substitute . Different approaches to solve the problem of breakdown into dimers of stroma free haemoglobin after injection into circulation have been used . Modification of the haemoglobin-molecule has to be performed , either by crosslinking or conjugation , or by enclosure in encapsulated particles . Several preclinical and clinical trials have been carried out showing different results relating to their indication , efficacy and side effects compared to native blood products . Further investigations will be necessary to develop suitable artificial haemoglobins and to demonstrate their therapeutic value ; so far , the classical donated blood is far from being superseded by artificial blood substitutes ."
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Bundesgesundheitsblatt.90420118.eng.abstr | Bundesgesundheitsblatt.90420118.eng.abstr | [
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Bundesgesundheitsblatt.90420121.eng.abstr | Bundesgesundheitsblatt.90420121.eng.abstr | [
{
"id": "Bundesgesundheitsblatt.90420121.eng.abstr-passage-0",
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"Red cells , platelet concentrates and fresh frozen plasma of a single donation contain leucocytes , causing a lot of side effects . Modern filtration- and apheresis-techniques lead to a reduction of residual leucocyte counts of 1x106 per unit . The best method to achieve controlled and validated conditions is the blood bank performed standardised prestorage-filtration . This is an effective method , to prevent cytokine-mediated and leucocyte-mediated febrile nonhaemolytic transfusion reactions ( FNHTR ) , to prevent a primary immunisation to leucocyte- and histocompatibility-antigens , to avoid transmission of viral infections by blood transfusion , e.g. Cytomegalovirus ( CMV ) and to exclude in special cases bacterial septicaemia . In addition , there are references to reduce the postoperative infections , the rate of recurrence of a tumor and the postoperative complications in patients undergoing cardiac surgery . The use of leucocyte-depleted blood components for special indications is meanwhile established . Some European countries have made a decision for a general filtration of all blood components containing leucocytes . The authors recommend the general leucocyte-depletion of blood components considering the German medical law ( AMG ) and cost/benefit ratio ."
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Bundesgesundheitsblatt.90420150.eng.abstr | Bundesgesundheitsblatt.90420150.eng.abstr | [
{
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"In contrast to the regulations in other European countries , blood components for transfusion are defined by the German Drug Law as medicinal products , for which a national marketing authorisation is required . In the case of blood components , i.e. concentrates prepared from individual donations , official batch release testing , as it is in place for plasma products , is not practicable . Thus during the licensing process the Paul-Ehrlich-Institute has to focus on compliance with the state of the art regarding donor selection and testing , as well as on the assessment of quality by means of testing random samples . The current practice of quality control and the available tests and their value are critically reviewed . There is still a need for development of meaningful and feasible test methods , research in this field is a task also of our group . Moreover , the Paul-Ehrlich-Institute is permanently involved in discussions in relevant national and European expert groups and official bodies with the aim of further improvements of quality and safety of blood components ."
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"The term \" Ecstasy \" includes a group of different methylenedioxyamphetamines which produce hallucinogenic activity , stimulation and the so-called ' entactogenic ' effects . - \" Entactogen \" is usually translated as \" producing a touching within \" or \" creating an internal contact \" and refers to the special psychotropic effect of this substances . Entactogens have been reported to make users aware of previously unconscious feelings and experiences . The \" entactogenic \" effect is the most typical of the psychedelic effects n 3,4-methylenedioxyamphetamine ( MDMA ) . MDMA induces euphoria and acts stimulating , but the most common effect of MDMA is a heightened sense of \" closeness \" with other people . The negative effects , especially depression and a general sense of anxiety , may endure after the acute phase of ecstasy . Ecstasy is not a novel substance . However , the rapid spread connected with the arising techno-scene and the increasing prevalence of ecstasy-use world-wide is unprecedented ."
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Bundesgesundheitsblatt.90420196.eng.abstr | Bundesgesundheitsblatt.90420196.eng.abstr | [
{
"id": "Bundesgesundheitsblatt.90420196.eng.abstr-passage-0",
"type": "abstract",
"text": [
"To assess the epidemiological situation of salmonellosis in Germany a total of 1608 strains of salmonella sampled in a sentinel-study were isolated and typed . The results on occurrence , distribution , types and antbiotic resistance of salmonella were compared with both the strains forwarded to the National Reference Center ( NRC ) for Salmonellosis for typing from all regions of Germany and the strains notified according to the duty of notification in the five new Laender ( federal countries ) and Berlin ."
],
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0,
513
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]
}
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"id": "Bundesgesundheitsblatt.90420196.eng.abstr-s1-t1",
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"id": "Bundesgesundheitsblatt.90420196.eng.abstr-s2-t3",
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"text": [
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"id": "Bundesgesundheitsblatt.90420196.eng.abstr-s2-t5",
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"id": "Bundesgesundheitsblatt.90420196.eng.abstr-s2-t6",
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"id": "Bundesgesundheitsblatt.90420196.eng.abstr-s2-t7",
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"id": "Bundesgesundheitsblatt.90420196.eng.abstr-s2-t8",
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"id": "Bundesgesundheitsblatt.90420196.eng.abstr-s2-t9",
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"id": "Bundesgesundheitsblatt.90420196.eng.abstr-s2-t10",
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"db_name": "UMLS",
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]
}
] | [] | [] | [
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Bundesgesundheitsblatt.90420212.eng.abstr | Bundesgesundheitsblatt.90420212.eng.abstr | [
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"id": "Bundesgesundheitsblatt.90420212.eng.abstr-passage-0",
"type": "abstract",
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"According to the EU Regulation on Novel Foods and Novel Food Ingredients , novel foods have to be as safe for the consumer as comparable conventional products . In order to ensure this , they are subjected to a health evaluation , which is performed on a case- by-case basis according to the principle of substantial equivalence , before they are placed on the market . For this purpose , information concerning toxicity , allergenicity and nutritional aspects is needed and in the individual case the requirements depend on the nature of the food as well as on the potential exposure to the consumer ."
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Bundesgesundheitsblatt.90420219.eng.abstr | Bundesgesundheitsblatt.90420219.eng.abstr | [
{
"id": "Bundesgesundheitsblatt.90420219.eng.abstr-passage-0",
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"The increasing importance of Lyme-Borreliosis in Saxony was the reason to perform this study with the intention to get information about the infection rate of ticks with Borrelia burgdorferi sensu lato . The infection rate was determined by PCR and testing slide-fixed ticks by immunofluorescence . For this analysis 3234 ticks from Saxony and neighbouring regions were collected and investigated . 252 of 1378 ticks checked by immunofluorescence were positive ( 18,3% ) , 440 of 1856 ticks examined by PCR were infected ( 23,7% ) . 50 ticks with multiple infection by several genospecies of Borrelia burgdorferi were found . The importance of these findings and possible conclusions are discussed ."
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"id": "Bundesgesundheitsblatt.90420219.eng.abstr-s5-r4-t1.1-t3.1",
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}
] |
Bundesgesundheitsblatt.90420327.eng.abstr | Bundesgesundheitsblatt.90420327.eng.abstr | [
{
"id": "Bundesgesundheitsblatt.90420327.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The public perception of the importance of environmental factors for carcinogenesis was investigated in a representative sample of Austrians ( n=2073) who in 1995 were > =15 years of age . Results show that about 60% of the respondents attribute great importance to environmental pollution as a cause for cancer development . Only smoking ranks higher . Approximately 56% of the respondents rate toxic agents in the workplace to be of great importance . In the case of pesticide residues this is true for 50% and in the case of passive smoking for 44% . High voltage power lines , ' earth rays ' and ' water veins ' are rated to be of great importance by about 25% of the respondents . The ratings of women and men do not differ except for the last two esoteric factors , with women giving more importance to them . The survey shows that the role of environmental factors in cancer development is overestimated . A better information of the public about the various cancer risks seems to be necessary . It should be based on the recommendations concerning risk communication , risk didactics and risk comparisons ."
],
"offsets": [
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0,
1114
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]
}
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"id": "Bundesgesundheitsblatt.90420327.eng.abstr-s1-t1",
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"Considering its frequency and fatality rate dengue fever repesents the most important tropical virus infection . Several millions of infected people including thousands of German tourists are recorded annually . Due to the increase of insect populations and intercontinental travelling the four dengue serotypes nowadays can be found worldwide . Sequential dengue fever infections have been reported to occur with increasing severity . Secondary infections , which are also found in tourists , may be associated with hemorrhagic fever and may be life- threatening , especially in children . During primary infection , a laboratory diagnosis can be made by detecting both IgM- and IgG-antibodies . The serotype involved can be identified by PCR . Dengue fever-like symptoms can also be caused by a variety of parasitic or virus infections . Although a specific therapy is not available , intravenous infusions may be of vital importance during dengue hemorrhagic fever ."
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Bundesgesundheitsblatt.90420412.eng.abstr | Bundesgesundheitsblatt.90420412.eng.abstr | [
{
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Bundesgesundheitsblatt.90420471.eng.abstr | Bundesgesundheitsblatt.90420471.eng.abstr | [
{
"id": "Bundesgesundheitsblatt.90420471.eng.abstr-passage-0",
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"In a retrospective study examination- and spermiogram-data were collected from 3821 men . The data came from the vicinity of the andrological department of the Leipzig university-clinic . It should be examined , whether first-examined patients without anamnestic or abnormal clinical findings did show a deterioration of the sperm-quality within the examination-years 1985 to 1996. Furtheron information should be collected concerning a possible dependence of the spermiogram data from the year of birth . Within the group of the 25 to 34 year old men ( n=1650) in the time frame from 1985 until 1996 the absolute sperm count of 195 millions changed to 138 millions , the sperm concentration of 79,7 was reduced to 52,6 Mio/ml and the fraction of morphological normal sperm was diminished from 64,6% to 59,6% ( all results with p 0,001 ) . With increasing birth-year sperm count as well as sperm concentration decreased . The causes for the observed decrease remain unresolved ."
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Bundesgesundheitsblatt.90420499.eng.abstr | Bundesgesundheitsblatt.90420499.eng.abstr | [
{
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Bundesgesundheitsblatt.90420507.eng.abstr | Bundesgesundheitsblatt.90420507.eng.abstr | [
{
"id": "Bundesgesundheitsblatt.90420507.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Do hepatitis C virus ( HCV ) infected food handlers represent a risk for the consumer ? Epidemiological data on HCV transmission in our opinion do not provide a basis for excluding HCV positive individuals from working as food handlers in general . Such restrictions seem to be justified only if HCV infected employees might infect their colleagues while performing occupational activities that are associated with a high risk of contracting percutaneous injuries and overt bleeding ."
],
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Bundesgesundheitsblatt.90420548.eng.abstr | Bundesgesundheitsblatt.90420548.eng.abstr | [
{
"id": "Bundesgesundheitsblatt.90420548.eng.abstr-passage-0",
"type": "abstract",
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"A report is given on the infection of pregnant women with Toxoplasma and on the laboratory diagnosis on mother , fetus and newborn . The next chapters deal with the consequences for the child and its chemotherapy . Prevention and problems of mother care are discussed in detail , as well as the infection as a notifiable one ."
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Bundesgesundheitsblatt.90420553.eng.abstr | Bundesgesundheitsblatt.90420553.eng.abstr | [
{
"id": "Bundesgesundheitsblatt.90420553.eng.abstr-passage-0",
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"The proportion of women among people with HIV infection and AIDS in Germany is considerably smaller than the proportion of men . The differential extent of the HIV epidemic in women in developed and developing countries is caused by certain social , cultural and economic conditions . During the course of the HIV epidemic in Germany the proportion of females among the infected persons has increased slowly , but steadily and has reached 20% by now . Also the transmission risks have changed . In the beginning of the epidemic the majority of women with HIV infection were IDU ( intravenous drug users ) , since the nineties the majority has been infected by heterosexual intercourse . Despite the increase of HIV infected females the number of perinatally infected children has been decreasing in the last five years . This is because a combination of antiretroviral prophylactic therapy with primary cesarean section as the mode of delivery has been established as the standard procedure in Germany . With this procedure the transmission risk from mother to children declined to below 2% . Because these measures can only be used , if the HIV status of the pregnant women is known , HIV antibody testing with adequate counselling should be offered to all pregnant women ."
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}
] |
Bundesgesundheitsblatt.90420562.eng.abstr | Bundesgesundheitsblatt.90420562.eng.abstr | [
{
"id": "Bundesgesundheitsblatt.90420562.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Children of mothers chronically infected with hepatitis-C-virus ( HCV ) during pregnancy and delivery were prospectively followed . 90 children born to 85 infected mothers were included in our study ; nine of the mothers were known to be co-infected with HIV-1. These 90 children were first tested within 60 days after birth and followed for at least three months . Three of the 90 children became infected perinatally with HCV as shown by persistence of antibodies after 2 years of life and a positive result in the RT-PCR . One of these 3 children has evidence of ongoing hepatitis as shown by slightly elevated alanine aminotransferase values , but is otherwise clinically well , likewise the other 2 infected children . 54 of the 87 uninfected children were followed until they lost maternal antibodies after an average of one year ."
],
"offsets": [
[
0,
837
]
]
}
] | [
{
"id": "Bundesgesundheitsblatt.90420562.eng.abstr-s1-t1",
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0,
8
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{
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79,
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{
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"type": "umlsterm",
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"Children of"
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0,
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{
"id": "Bundesgesundheitsblatt.90420562.eng.abstr-s2-t1",
"type": "umlsterm",
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"children"
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{
"id": "Bundesgesundheitsblatt.90420562.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"mothers"
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164,
171
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{
"db_name": "UMLS",
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{
"id": "Bundesgesundheitsblatt.90420562.eng.abstr-s2-t3",
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"mothers"
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213,
220
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"db_name": "UMLS",
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{
"id": "Bundesgesundheitsblatt.90420562.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"children"
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271,
279
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"db_name": "UMLS",
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{
"id": "Bundesgesundheitsblatt.90420562.eng.abstr-s2-t5",
"type": "umlsterm",
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"birth"
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319,
324
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"db_name": "UMLS",
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{
"id": "Bundesgesundheitsblatt.90420562.eng.abstr-s3-t1",
"type": "umlsterm",
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"children"
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382,
390
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"db_name": "UMLS",
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{
"id": "Bundesgesundheitsblatt.90420562.eng.abstr-s3-t2",
"type": "umlsterm",
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"HCV"
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424,
427
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"db_name": "UMLS",
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"id": "Bundesgesundheitsblatt.90420562.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
"antibodies"
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455,
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{
"id": "Bundesgesundheitsblatt.90420562.eng.abstr-s3-t4",
"type": "umlsterm",
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"life"
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483,
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"db_name": "UMLS",
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"id": "Bundesgesundheitsblatt.90420562.eng.abstr-s3-t5",
"type": "umlsterm",
"text": [
"RT-PCR"
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517,
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{
"id": "Bundesgesundheitsblatt.90420562.eng.abstr-s4-t1",
"type": "umlsterm",
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{
"id": "Bundesgesundheitsblatt.90420562.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"hepatitis"
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574,
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"db_name": "UMLS",
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{
"id": "Bundesgesundheitsblatt.90420562.eng.abstr-s4-t3",
"type": "umlsterm",
"text": [
"alanine"
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614,
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"db_name": "UMLS",
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{
"id": "Bundesgesundheitsblatt.90420562.eng.abstr-s4-t4",
"type": "umlsterm",
"text": [
"aminotransferase"
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622,
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"db_name": "UMLS",
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{
"id": "Bundesgesundheitsblatt.90420562.eng.abstr-s4-t5",
"type": "umlsterm",
"text": [
"values"
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"offsets": [
[
639,
645
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{
"db_name": "UMLS",
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{
"id": "Bundesgesundheitsblatt.90420562.eng.abstr-s4-t6",
"type": "umlsterm",
"text": [
"children"
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[
713,
721
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{
"db_name": "UMLS",
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{
"id": "Bundesgesundheitsblatt.90420562.eng.abstr-s4-t7",
"type": "umlsterm",
"text": [
"alanine aminotransferase"
],
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[
614,
638
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{
"db_name": "UMLS",
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{
"id": "Bundesgesundheitsblatt.90420562.eng.abstr-s5-t1",
"type": "umlsterm",
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748,
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"db_name": "UMLS",
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{
"id": "Bundesgesundheitsblatt.90420562.eng.abstr-s5-t2",
"type": "umlsterm",
"text": [
"antibodies"
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[
796,
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{
"db_name": "UMLS",
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] | [] | [] | [
{
"id": "Bundesgesundheitsblatt.90420562.eng.abstr-s1-r1-t2.1-t6.1",
"type": "interacts_with",
"arg1_id": "Bundesgesundheitsblatt.90420562.eng.abstr-s5-t2",
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{
"id": "Bundesgesundheitsblatt.90420562.eng.abstr-s1-r2-t1.1-t2.1",
"type": "interacts_with",
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"normalized": []
},
{
"id": "Bundesgesundheitsblatt.90420562.eng.abstr-s1-r3-t5.1-t3.1",
"type": "affects",
"arg1_id": "Bundesgesundheitsblatt.90420562.eng.abstr-s4-t5",
"arg2_id": "Bundesgesundheitsblatt.90420562.eng.abstr-s4-t3",
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{
"id": "Bundesgesundheitsblatt.90420562.eng.abstr-s1-r4-t6.1-t2.1",
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{
"id": "Bundesgesundheitsblatt.90420562.eng.abstr-s1-r5-t3.1-t1.1",
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{
"id": "Bundesgesundheitsblatt.90420562.eng.abstr-s1-r6-t1.1-t5.1",
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{
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Bundesgesundheitsblatt.90420683.eng.abstr | Bundesgesundheitsblatt.90420683.eng.abstr | [
{
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"From a global viewpoint , tuberculosis is one of the most important infectious diseases of our time . The situation in Germany , as in most comparable industrialized nations , is stable . The declining trend of previous years continued in 1997 , when 11,163 people developed active tuberculosis - an incidence of 13.6/100,000. However , the tuberculosis problem cannot be restricted to one country , and Germany is particularly affected by trends in Eastern Europe and in the former Soviet countries . These countries experienced a marked increase of tuberculosis cases and resistant strains during recent years , a tendency which can only be countered by fast , well-aimed and efficient action in the affected areas . The industrialized nations in particular should consider financial and logistic contributions as their duty . Crucial for control of the tuberculosis situation within each country are registration and close observation of epidemiological trends , identification of high-risk groups , and continuation of established tuberculosis control measures ."
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"Despite wide-spread immunisation programs epidemic influenza continues to cause ten thousands of deaths worldwide , every year , especially in the high risk groups of elderly or immunocompromised persons . At present , amantadine and rimantadine are the only approved agents available for prophylactic and therapeutic use , yet , the deployment of these substances is problematic : neither of the two drugs is effective against influenza B , their use is accompanied by rapid development of viral resistance , and they show many adverse effects . In contrast , zanamivir and GS4071/GS4104 are rationally developed influenza-specific neuraminidase inhibitors , proving prophylactic and therapeutic efficacy against influenza A and B , as well in vitro as in animal models , and in experimental human studies . Zanamivir and GS4071/GS4104 are well tolerated without adverse reactions after topic and oral administration , respectively . Resistant viral strains have been found in cell culture in the presence of both drugs , but the frequency of resistance emergence during clinical use is unclear . To date , the biggest recognizable disadvantage of neuraminidase inhibitors and Amantadin/Rimantadin alike is that they need to be given within 30-48 h after onset of symptoms , but seeking medical attention at this stage of infection does not seem to be realistic in medical practice . As neuraminidase inhibitors up to now could mainly be assessed by experimental data , specifically performed clinical trials will have to prove the positive influence of these drugs on the morbidity , course of infection , and mortality of high risk persons when administered for prophylaxis as well as for therapy ."
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"There are no unequivocal symptoms linked to Influenza and hence diagnosis only considering the clinical picture is uncertain . The predictive value of typical symptoms of Influenza depends largely on the incidence of the infection . Some studies and observations indicate a high predictive value when the epidemic situation is additionally considered . Concepts taking into account the epidemic situation of influenza can enhance the proportion of proper diagnoses and thereby the appropriate use of neuraminidase inhibitors , as supplement to vaccine prophylaxis ."
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Bundesgesundheitsblatt.90420769.eng.abstr | Bundesgesundheitsblatt.90420769.eng.abstr | [
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Bundesgesundheitsblatt.90420776.eng.abstr | Bundesgesundheitsblatt.90420776.eng.abstr | [
{
"id": "Bundesgesundheitsblatt.90420776.eng.abstr-passage-0",
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"Herpes simplex virus type 1 ( HSV-1) and type 2 ( HSV-2) are the most frequent infections cause of genital ulcerations . Although genital infections by HSV-1 are increasing HSV-2 is dominant in recurrent infections . This study was conducted on a panel of sera collected anonymously in 1996 and 1997 from blood donors ( 1979 samples ) and hospital patients ( 3079 samples ) without risk factors for herpesvirus infections such as STD , other infectious diseases and immunosuppression . Serum samples were tested with ELISAs using monoclonal antibody-selected native gG1 and gG2 as antigens and an immunoblot using type-specific recombinant glycoproteins . Equivocal results were confirmed with an in-house Western blot ."
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720
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Bundesgesundheitsblatt.90420847.eng.abstr | Bundesgesundheitsblatt.90420847.eng.abstr | [
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"Ninety-two strains of glycopeptide-resistant enterococci ( GRE ) from 80 patients of 31 hospitals in 11 federal states were analyzed . They were primarily isolated in intensive care units ( general , surgical , internistic , pediatric , oncological ones ) , but also in nephrologic/dialysis or neurologic/orthopaedic wards . A dominance of VanA type E. faecium strains was observed ( n=81; 88.0% ) . In addition , strains of E. faecalis ( VanA ; n=4; 4.4% ) , E. faecium ( VanB ; n=1; 1.1% ) , and E. gallinarum ( VanC1, n=6; 6.5% ) were found . The 81 VanA strains of E. faecium possessed the following resistances to other antibiotics : erythromycin , ciprofloxacin ( both 93.8% ) , ampicillin , oxytetracycline ( both 88.9% ) , rifampicin ( 79.0% ) , trimethoprim/sulfameracin ( 61.7% ) , chloramphenicol ( 18.9% ) , fusidic acid ( 12.3% ) , quinupristin/dalfopristin ( 7.4% ) ; gentamicin ( 46.9% ) and streptomycin ( 37.0% ) , also together with ampicillin resistance ( 9.9-35.8%). In some of these VanA type strains resistance to teicoplanin cannot be completely expressed in-vitro . Macrorestriction analysis of E. faecium outbreak isolates ( VanA type ) from hospitals in different federal states indicated an intra- and interhospital spread of a defined strain . However , heterogeneous plasmid and plasmid restriction patterns showed that these strains were not completely identical ."
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DerAnaesthesist.00490002.eng.abstr | DerAnaesthesist.00490002.eng.abstr | [
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"Stroke is an emergency . Treatment must begin as soon as possible because significant sustained neurological improvement has been demonstrated when thrombolytic treatment , mainly with recombined tissue plasminogen activator ( rtPA ) is initiated within the first hours of stroke onset . On the other hand in the acute phase of stroke it is critical that patients get adequate management for the prevention of early complications . Management of the acute phase of stroke is the target of this article . Preclinically started treatment must be continued in the neurological emergency unit . Clinical examination is followed by technical investigations : cerebral computertomography ( CCT ) is the most useful radiological investigation in the acute phase . It allows to distinguish between ischemia and hemorrhagic lesions and also to rule out nonstroke brain conditions . Multimodal magnetic resonance imaging ( mMRI ) may provide data on viable versus irreversibly damaged tissue . Sufficient stroke treatment is based on well managed in-hospital infrastructure . Thrombolysis is the only causative treatment of stroke in selected patients . Complications of acute stroke comprise changes of blood pressure with hemodynamically relevant effects on cerebral perfusion pressure , acute post- ischemic brain edema , and intracerebral bleedings ."
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] |
DerAnaesthesist.00490025.eng.abstr | DerAnaesthesist.00490025.eng.abstr | [
{
"id": "DerAnaesthesist.00490025.eng.abstr-passage-0",
"type": "abstract",
"text": [
"A 36-year old woman was presented to our hospital with congenital ventricular septal defect and one-vessel coronary artery disease ( 75% proximal left main coronary artery ) for CABG and repair of the VSD . After induction , a transesophageal echocardiographic ( TEE ) baseline examination was performed , showing a severely dilated coronary sinus ( CS ) measuring approximately 3 cm ( abnormal > 1 cm ) . We suggested a persistent left superior vena cava ( PLSVC ) draining into the CS . PLSVC is a common venous congenital anomaly , with a reported incidence of 0.5% in general population and in 3-5 % of patients with congenital heart defect . Injection of echo-contrast solution in a left arm vein , visualizing microbubbles passing through the PLSVC into the CS confirmed our suspicion . The diagnosis of a PLSVC and dilated CS is a contraindication for retrograde cardioplegia because of the loss of cardioplegia into the PLSVC resulting in a inadequate myocardial protection . It may be difficult to pass a pulmonary artery catheter ( PAC ) through a left internal or left subclavian vein and it may be associated with arrythmias . A chest radiograph shows the anomalous course of the PAC along the left heart ."
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"id": "DerAnaesthesist.00490025.eng.abstr-s1-t6",
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"one-vessel"
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"id": "DerAnaesthesist.00490025.eng.abstr-s1-t8",
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"id": "DerAnaesthesist.00490025.eng.abstr-s1-t9",
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"text": [
"artery"
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165,
171
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"id": "DerAnaesthesist.00490025.eng.abstr-s1-t10",
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"id": "DerAnaesthesist.00490025.eng.abstr-s1-t12",
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"id": "DerAnaesthesist.00490025.eng.abstr-s1-t13",
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"id": "DerAnaesthesist.00490025.eng.abstr-s1-t14",
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"id": "DerAnaesthesist.00490025.eng.abstr-s2-t2",
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"id": "DerAnaesthesist.00490025.eng.abstr-s2-t3",
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"id": "DerAnaesthesist.00490025.eng.abstr-s3-t1",
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{
"id": "DerAnaesthesist.00490025.eng.abstr-s3-t2",
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"id": "DerAnaesthesist.00490025.eng.abstr-s3-t3",
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{
"id": "DerAnaesthesist.00490025.eng.abstr-s4-t1",
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]
},
{
"id": "DerAnaesthesist.00490025.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"anomaly"
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525,
532
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"db_name": "UMLS",
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},
{
"id": "DerAnaesthesist.00490025.eng.abstr-s4-t3",
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"id": "DerAnaesthesist.00490025.eng.abstr-s4-t4",
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"id": "DerAnaesthesist.00490025.eng.abstr-s4-t7",
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"id": "DerAnaesthesist.00490025.eng.abstr-s4-t9",
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"id": "DerAnaesthesist.00490025.eng.abstr-s5-t2",
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"id": "DerAnaesthesist.00490025.eng.abstr-s7-t7",
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"id": "DerAnaesthesist.00490025.eng.abstr-s8-t1",
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"id": "DerAnaesthesist.00490025.eng.abstr-s8-t2",
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"Abstract Objectives : The paO2 and AaDO2 are routinely measured for evaluating pulmonary gas exchange . The normal value of the AaDO2 amounts 10 mmHg when breathing atmospheric air and is said to increase with rising FIO2. This increase is discussed controversially . One possible reason for incongruities in AaDO2 measurement may be the impact of so called preanalytical errors during paO2 measurement , which are often neglected . Therefore , the aim of this study was to evaluate the relevance of preanalytical errors on the AaDO2 under hyperoxic conditions ."
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DerAnaesthesist.00490034.eng.abstr | DerAnaesthesist.00490034.eng.abstr | [
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"Although autoantibodies against factor VIII or factor IX are a rare phenomenon , they are associated with a high risk of bleeding and high mortality . The condition , termed ac- quired haemophilia , occurs equally in both sexes and is most frequent in higher age groups . Patients typically present with severe bleedings in muscles and skin . In contrast to patients with congenital haemophilia and inhibitors , joint bleedings are very rare . In approximately half of all cases an associated disease state can be identified as the cause of autoantibody formation . An immediate and comprehensive diagnosis is essential for a rapid initiation of therapy . Equally important are a careful diagnostic differentiation between congenital and acquired factor deficiencies and the exclusion of non-specific inhibitors , which increase the occurrence of thrombolic events . The inhibitor titre , quantified using the Bethesda assay , is an important criterion for selecting the appropriate therapy . A wide range of treatment options is now available for the management of bleedings in patients with acquired haemophilia , namely porcine factor VIII , recombinant factor VIIa , prothrombin complex concentrates , and immunoadsorptions . In addition , immunosuppressive therapies are used to achieve permanent reduction or elimination of inhibitors ."
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DerAnaesthesist.00490113.eng.abstr | DerAnaesthesist.00490113.eng.abstr | [
{
"id": "DerAnaesthesist.00490113.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Background : Malignant hyperthermia ( MH ) is an autosomal dominantly inherited disorder , triggered in susceptible individuals by inhalation anesthetics and depolarizing muscle relaxants such as succinylcholine . Because of its high sensitivity ( 97-99% ) and specificity ( 93,6% ) as well as the genetic heterogeneity of MH disorder , the in vitro contracture test ( IVCT ) following the European-MH-Group is considered to be the \" Gold Standard \" for phenotypical determination of predisposed patients . On the other hand mutations in the skeletal muscle ryanodine receptor gene ( RYR1) are tightly linked with MH susceptibility . After detecting a C1840T-mutation ( Arg614Cys) in the RYR1 gene in one individual of a large MH family , we searched for this mutation in the remaining family members and determined the concordance with IVCT ."
],
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0,
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"id": "DerAnaesthesist.00490113.eng.abstr-s1-t7",
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"id": "DerAnaesthesist.00490113.eng.abstr-s1-t8",
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"id": "DerAnaesthesist.00490113.eng.abstr-s1-t9",
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"id": "DerAnaesthesist.00490113.eng.abstr-s1-t10",
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] | [] | [] | [
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"The mortality of perioperative myocardial infarction is still high and according to recently published data amounts to 17 to 42% . In the seventies introduction of thrombolytic therapy has led to a dramatic reduction in mortality of non-perioperative myocardial infarction . However , in the perioperative situation thrombolytic therapy remains to be problematic in most cases because of expected severe bleeding complications . In the last 4-6 years acute-PTCA has been established in the therapy of acute myocardial infarction . Up to date no data are available concerning the effect of acute-PTCA on mortality of perioperative myocardial infarction . Nevertheless it can be assumed , that acute-PTCA will lead to a considerable reduction in mortality of perioperative myocardial infarction . Therefore , in patients with significant perioperative myocardial infarction immediate coronary angiography and , if indicated , acute-PTCA should be performed . In principle , thrombolytic therapy is considered to be contraindicated in the intra- or postoperative situation . However , if coronary angiography and PTCA are not possible , thrombolysis might be taken into consideration , in particular if the expected bleeding complications are small in relation to the expected benefit of thrombolysis . Since acute-PTCA has been shown to remarkably reduce mortality in patients with cardiogenic shock after acute myocardial infarction , this group of patients should be especially considered ."
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DerAnaesthesist.00490187.eng.abstr | DerAnaesthesist.00490187.eng.abstr | [
{
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"During the last 30 years a great number of case reports presented severe anaesthetic complications with sudden cardiac arrest in patients with muscular dystrophies , mostly unsuspected at the time of the event . As succinylcholine was involved in the majority of the intractable incidents with lethal outcome the Food and Drug Administration ( FDA ) of the United States recommended a warning of the administration of succinylcholine in young children and adolescents in 1992 and an extensive international discussion on the routine use of succinylcholine in paediatric anaesthesia . Epidemiological studies on this issue are rare . We projected an inquiry about the incidence rate and type of severe anaesthetic complications in an utmost large number of patients and families with Duchenne ( DMD ) and Becker type ( BMD ) muscular dystrophy ."
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"Based on a case report , we offer brief guidelines on the perioperative management of patients with Sleep-Apnea-Syndrome ( SAS ) who present with a high incidence of a difficult airway and a high risk of respiratory depression during the perioperative period . A 39 year old male patient with a body mass index of 34,22 kg/m2 and receiving continuous-positive-airway-pressure- ( CPAP ) therapy for known SAS was scheduled for elective plastic surgery . After induction of anaesthesia and direct laryngoscopy no adequate airway could be established and the patient became hypoxic , hypercapnic and developed hypotension and bradycardia . With the use of a laryngeal mask airway the patient was stabilized and did not show neurologic sequale after immediate awakening . The following fiberoptic intubation of the awake patient , still showing tendency of upper airway obstruction , confirmed the difficult anatomical structures . The subsequent general anesthesia was uneventful . The patient received CPAP therapy and was monitored during the first postoperative night in the Intensive Care Unit . He made an uneventful recovery . He was advised to have regional anaesthesia or planned fiberoptic intubation , where possible , in the case of further anesthetic intervention . SAS has major implications for the anaesthesiologist and whenever patients exhibiting the high risk factors ( obesity , male sex , history of intense snoring , impaired daytime performance , nonrefreshing daytime naps ) are presented for surgery this condition should be considered . Elective surgery should be postponed until after adequate examination and treatment when necessary . Patients with SAS should always be suspected of having cardiopulmonary dysfunctions such as hypertension , cardiac dysrhythmia or cor pulmonale . It is most important to avoid sedative premedication , to initiate CPAP therapy preoperatively , to encourage regional anaesthesia if possible and to ensure close monitoring over the complete perioperative period . Planned fiberoptic intubation , preferably with surgical personnel available for an emergency airway , is a safe method for the induction of anaesthesia . Postoperatively , patients are at high risk from respiratory depression , even in the awake state . Postoperative opioid analgesia , no matter what route , should only be given under close monitoring . Independently of regional or general anaesthesia there is an increased risk of respiratory depression in the middle of the first postoperative week , suspected to be caused by the catching up on lost REM-sleep , due to shifts in the normal sleep pattern during the first postoperative days ."
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DerAnaesthesist.00490332.eng.abstr | DerAnaesthesist.00490332.eng.abstr | [
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"The main reason for posttraumatic secondary brain damage is cerebral hypoxia . Both , severity and duration of hypoxia are crucial in determining wether irreversible cerebral infarction will occur or not . For the clinical routine , the diagnosis of hypoxia is indirectly made by low CPP , low jugularvenous oxygen saturation ( SjO2) or low tissue PO2. To minimize misleading false negative SjO2, the CT-Approach for the side of monitorig and calculation of arterial-jugularvenous lactate content for detection of anaerobic metabolism is recommended . Targeted treatment of hypoxia according to the underlying cause is mandatory . Primary goal is to increase cellular oxygen delivery by correction of low arterial oxygen content and elevation of regional CBF . Within the autoregulatory range decreasing CPP causes vasodilation and increasing CPP vasoconstriction with increasing or decreasing cerebral blood volume respectively . Initially elevation of the lower autoregulatory threshold often requires CPP 70 mmHg . Targeted treatment of intracranial hypertension must avoid decreasing CPP . In the early postrautmatic phase prevention of cerebral hypoxia relies on management of CBF by means of CPP and cerebral vascular resistance . Thereafter targeted treatment of intracranial hypertension caused by cerebral edema and hypervolemia are increasingly important ."
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DerAnaesthesist.00490345.eng.abstr | DerAnaesthesist.00490345.eng.abstr | [
{
"id": "DerAnaesthesist.00490345.eng.abstr-passage-0",
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"During general anaesthesia even healthy lungs tend to collapse . Thus , up to 20% of previously functional lung tissue may be lost for gas exchange . It should be advantageous to treat this pathologic condition . After explaining the clinical problem of lung collapse , the concept of opening these lungs and keeping them open will be discussed . Some results of the first randomized clinical trials on intraoperative lung recruitment will be presented . Finally , a systematic description of all treatment steps tries to provide the anaesthesiologist with a useful practical guide for applying the \" alveolar recruitment strategy \" in their daily care of patients undergoing general anaesthesia ."
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DerAnaesthesist.00490349.eng.abstr | DerAnaesthesist.00490349.eng.abstr | [
{
"id": "DerAnaesthesist.00490349.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Acute renal failure ( ARF ) is characterized by an acute decrease in glomerular filtration rate ( GFR ) . ARF complicates 4% to 23% of intensive care unit admissions , and is associated with a mortality of approximately 50% among critically ill patients . In the intensive care setting the term ARF is usually applied to acute tubular necrosis ( ATN ) , a form of intrinsic ARF caused by ischemia or nephrotoxins . Pathophysiological mechanisms involved in the decline in GFR include tubular obstruction caused by detachment of tubular epithelial cells from the basement membrane and backleak of glomerular filtrate as a consequence of disruption of the epithelial cell layer . Vascular mechanisms involved in the pathophysiology of ATN are vasoconstriction due to an imbalance between vasoconstrictive and vasodilatatory mediators and vascular obstruction caused by cell aggregation . Currently , there is no real time method to monitor renal function comparable to the real time monitoring of blood pressure or arterial oxygen saturation . Urinary output does not reflect glomerular filtration which may be critically reduced despite normal urine volumes and creatinine clearance still provides the clinically most applicable estimate of GFR . Tubular function can be assessed using the fractional excretion of sodium or the ratio of urinary and serum osmolality ; both parameters can be obtained from spot samples of urine and serum and no urinary sampling period is necessary . However , both parameters are strongly affected by the administration of loop diuretics and high fluid and sodium inputs which are common in the intensive care unit . We determined the day to day variability of creatinine clearance , fractional excretion of sodium and the urinary to serum osmolality ratio in critically ill patients without renal dysfunction ( i.e. creatinine clearance in the normal range ) and found differences of 16% for creatinine clearance , 79% for fractional excretion of sodium and 22% for urinary to serum osmolality ratio . Treatment of ARF is mainly supportive and there is no clinically accepted therapy that attenuates the course of ATN . Treatment of the underlying disease and renal replacement therapy are the main options for the treatment of patients with ARF . In critically ill patients continuous veno-venous hemo ( dia ) filtration is the first choice because it provides more hemodynamic and metabolic stability than intermittent therapy . Acute lifethreatening hyperkalemia is an indication for intermittent hemodialysis because of the higher efficacy of dialysis in the clearance of low molecular weight substances ."
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DerAnaesthesist.00490353.eng.abstr | DerAnaesthesist.00490353.eng.abstr | [
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"id": "DerAnaesthesist.00490353.eng.abstr-passage-0",
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"Extensive Catabolism is a hallmark of patients with acute renal failure ( ARF ) complicating critical illnesses . Catabolism is due to dysregulation of protein metabolism as well as a consequence of deminished renal excretion and renal replacement therapy ( RRT ) . Inadequate nutritional support predisposes patients to malnutrition and increased mortality risk . Since the catabolic rate varies widely in ARF patients and can not be predicted by clinical parameters , direct quantification of the protein catabolic rate should be performed regularly . The urea nitrogen appearance rate ( UNA ) is a valid and reproducible estimate of nitrogen balance in critically ill patients undergoing continuous RRT . Amino acid losses up to 50 g/day and protein losses up to 15 g/day occur during continuous RRT and need to be compensated for . In order to achieve neutral or positive nitrogen balance a nutritional regimen providing 1.5-2.0 g protein/kg/day and 25-35 kcal/ kg/day may be required . Since glutamine losses during continuous RRT may exceed 4 g/day , glutamine supplementation ( 0.3-0.5 g/kg/day ) appears to be recommendable ."
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DerAnaesthesist.00490387.eng.abstr | DerAnaesthesist.00490387.eng.abstr | [
{
"id": "DerAnaesthesist.00490387.eng.abstr-passage-0",
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"Background : The present study compared the quality of neuromuscular block and costs after equipotent doses of mivacurium and vecuronium in the context of paediatric ENT surgery . Methods : A total of 30 children undergoing elective tonsillectomy were included and randomised in two groups ( n=15 for each ) according to the neuromuscular blocking agent ( NMBA ) used . Anaesthesia was induced with alfentanil ( 15 µg/kg), propofol ( 3 mg/kg ) and either 0.2 mg/kg mivacurium or 0.14 mg/kg vecuronium . For maintenance of anaesthesia propofol ( 8-12 mg/kg/h ) was given . Neuromuscular block was assessed by electromyography using train-of four stimulation and the following parameters were quantified : Twitch height ( T1) 2 min after the initial bolus of the myorelaxant ; duration until recovery to 10% T1, number and duration of bolus injections of the myorelaxant needed to maintain neuromuscular block to a T1 10% . In addition , the intubating conditions , number of patients needing pharmacological reversal at the end of surgery , adverse reactions and the costs for neuromuscular block and pharmacological antagonization were assessed ."
],
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