Biomedical subjects

A Berghold

Publications and source records attributed to A Berghold.

47 records · Page 3Linked to original sources

PubMed1998

Neopterin concentrations in cerebrospinal fluid and serum as an aid in differentiating central nervous system and peripheral infections in children.

Neopterin is a sensitive indicator for cellular immune activation. Its concentrations were determined in cerebrospinal fluid (CSF) and serum specimens from 91 children with no evidence of central nervous system (CNS) or peripheral inflammations, 43 with definite neuroborreliosis, 51 with other CNS infections, and 33 with peripheral infections. The aim of our study was (a) to establish a range of normal CSF neopterin concentrations in control children, and (b) to inquire into the diagnostic potential of neopterin measurements in both body compartments for aiding in differential diagnosis of inflammatory vs noninflammatory diseases, and CNS vs peripheral inflammations. CSF neopterin concentrations in controls were invariably low (up to 9.3 nmol/L), but in children with neuroborreliosis and, even more so, with other CNS infections neopterin concentrations were significantly (P <0.0001) increased. Children with peripheral infections, however, rarely showed raised CSF neopterin concentrations. Serum concentrations of neopterin, on the other hand, were not significantly different between controls and children with neuroborreliosis. Although serum concentrations were significantly different between controls and children with other CNS infections, diagnostic efficiency was poor for this comparison. Peripheral infections, in contrast, were associated with significantly higher (P <0.0001) serum neopterin concentrations when compared with controls. A classification tree was constructed on the basis of CSF and serum neopterin concentrations, allowing with high accuracy the discrimination between controls, children with CNS infections, and children with peripheral infections. Thus, on the basis of a comparatively large control group, our data underline the diagnostic validity of neopterin as an aid in differential diagnosis of inflammatory vs noninflammatory diseases, and confirm that CSF neopterin concentrations are not correlated with serum neopterin concentrations, and, therefore, CSF neopterin appears to be produced intrathecally.

Adolescent↗

PubMed1998

Educational status and resources for child care as predictors of TBE vaccination coverage in schoolchildren of an endemic area in Austria.

Since the introduction of the Austrian tick-borne encephalitis (TBE) vaccination program in 1981 vaccination coverage of children has not been investigated sufficiently. Numerous socioeconomic and demographic factors have been identified as being associated with low vaccination coverage in childhood for most vaccinations. This study focuses on parental educational status and on resources for child care as determinants of tick-borne encephalitis (TBE) vaccination coverage of schoolchildren in an endemic TBE area of Austria. The target population were children in the first, fourth and seventh year of school education in Styria, Austria. Therefore, the sample consisting of 2470 children was divided into three age groups, children aged 7, 10 and 13 years. We performed a representative cross-sectional study. The information concerning the vaccination status of each child was recorded by means of an anonymous questionnaire given to the parents by the classroom teachers. This procedure ensured a high overall response rate of 79.8%. The prevalence of at least one TBE vaccination was 93.9% for the 7 year old, 97.8% for the 10 and 97.9% for the 13 year old. The lowest vaccination rates were found in families with four or more children (94.0%) and for those children who had unemployed parents (92.9%). The multivariate analysis indicates that TBE vaccination coverage is affected by a large number of children in the family (p = 0.0003), an urban place of residence (p = 0.0001) and by a low level of education of the mother (p = 0.013). The results suggest that, though overall high coverage in schoolchildren, vaccination programmes should be focused on large and socially deprived families.

Adolescent↗

PubMed1997

Application of HELP in nonarteritic anterior ischemic optic neuropathy: a prospective, randomized, controlled study.

BACKGROUND: Heparin-induced extracorporeal LDL/fibrinogen precipitation (HELP) eliminates selectively fibrinogen, LDL, cholesterol, triglycerides and LP(a) from blood plasma using extracorporeal circulation. The reduction of fibrinogen and LDL by about 50% after only one procedure immediately improves the hemorheological situation. METHOD: In a prospective, randomized, controlled study over a period of 3 months, 40 patients with nonarteritic ischemic optic neuropathy (NAION) were randomly assigned to either HELP or hemodilution therapy to determine the efficacy of these two treatments on visual acuity and fields. RESULTS: After transformation of the Snellen acuity into logMAR units the statistical analysis did not show a significant difference between the two groups (P = 0.48). An increase of the visual acuity by two or more lines was obtained in 9 patients (47.4%) of the HELP group, 10 (52.6%) remained stable and none got worse. In the hemodilution group, visual acuity increased in patients (33.4%), 9 (42.8%) remained stable and 5 (23.8%) experienced a decrease. The calculated mean sensitivity of visual fields at baseline improved statistically significantly (P < 0.01) in the HELP group from 6.83 +/- 4.52 dB to 8.27 +/- 4.89 dB, but did not change significantly in the hemodilution group (6.25 +/- 4.12 dB to 6.12 +/- 3.92 dB). CONCLUSION: The HELP system seems to be safe and more effective than hemodilution in improving the hemorheological and the functional situation in NAION and could be a promising regimen in the treatment of NAION.

Aged↗

PubMed1997

[The significance of tissue storage time for success after corneal transplantation].

BACKGROUND: HLA-DR antigen plays a key role in transplantation immunology. Organ culture storage leads to loss of HLA-DR-positive corneal Langerhans cells. This study investigates the importance of prolonged storage period for the success rate after penetrating keratoplasty. PATIENTS AND MATERIAL: Eighty-four patients with 99 penetrating corneal transplantations were examined retrospectively. Group 1 represented keratoplasty patients with an average corneal storage period of 1.9 days (+/- 1.4) and in group 2 the patients received tissues stored for 9.8 days (+/- 4.7). RESULTS: The success rate of high-risk patients was 34.4% (+/- 8.7) in group 1 and 69.2% (+/- 12) in group 2 after 18 months (p < 0.01). In non-risk patients we had a success quota of 72.7% (+/- 8.2) in group 1 and 91% (+/- 6.1) in group 2 (p < 0.01). CONCLUSION: We found significantly better results in patients receiving tissues stored for an average time of 9.8 days than in those receiving corneas preserved for 1.9 days. The results are thought to be based on the loss of HLA-DR-positive cells during prolonged organ culture preservation.

Cornea↗

PubMed1997

Intracerebral hemorrhage during fibrinolytic therapy in children: a review of the literature of the last thirty years.

In a retrospective study all available publications concerning children with thromboembolic disease and fibrinolytic therapy between January 1, 1964, and June 30, 1995, were reviewed with regard to the occurrence of intracerebral hemorrhages (ICH). ICH was found in 14/929 patients analyzed. According to the age when thrombolytic therapy was performed, ICH was described in 2/468 children after the neonatal period, in 1/83 term infants; and in 11/86 preterm infants; 10/40 preterm infants who were treated in the first week of life developed ICH. ICH during thrombolytic therapy in children is reported with the use of streptokinase, urokinase (UK), UK-activated plasmin, UK and plasminogen, and recombinant tissue plasminogen activator (rt-PA). The risk of developing an ICH from thrombolytic therapy seems to be low in children after the neonatal period and in term infants. Because of the high incidence of "spontaneous" ICH in preterm infants, it cannot be established whether the more frequently described ICH in these patients is a complication of thrombolytic therapy. In the absence of randomized trials this analysis may be helpful for decision making in children with thromboembolic disorders. However, the data have to be regarded with caution because of the summation of cases with different thromboembolic disorders, treatment with different substances in different dosages, and the retrospective study design that could lead to an underrepresentation of this complication.

Adolescent↗

PubMed1997

[Effect of the mode of delivery on the newborn infant with gastroschisis. With data from the Styrian Malformation Register].

OBJECTIVE: Our purpose was to investigate the influence of the mode of delivery on the outcome of children with gastroschisis. METHODS: 38 children were born and treated at the University Hospital of Graz between 1977 and 1995. The perinatal and surgical data were analyzed retrospectively. Furthermore, we compared the prevalence of gastroschisis in Styria to international data. RESULTS: The mode of delivery did not influence the fetal outcome. The higher rate of acidosis and shorter interval from rupture of the membranes to delivery in cases of cesarean section may be attributable to the obstetric decision for an operative delivery. The prevalence of gastroschisis is high as compared to European data. CONCLUSIONS: Our data and the majority of publications do not show a benefit of cesarean section for children with gastroschisis. A randomized prospective trial is still lacking to end controversies.

Abdominal Muscles↗

PubMed1996

[The triple test scenario for Styria. With data of the Styria Abnormalities Register].

OBJECTIVE: The aim of the study was to clarify by a cost-effectiveness analysis, if a triple-marker screening for trisomy 21 (triple test) should be established in Austria. METHODS: The published triple-test results of the last years were combined with the data of the Styrian Malformation Register covering the years 1985-1992. The cost-effectiveness analysis was based on total costs of prenatal diagnosis, costs per fetus diagnosed as affected, the number of affected fetuses detected, and the number of procedure-related losses. RESULTS: If low costs are given priority, the triple test should be offered to women 35 years of age or older. If a high detection rate is given top priority, the test should be offered to all pregnant women. CONCLUSION: The results suggest that the present policy of maternal age screening in Austria should be replaced by maternal serum screening.

Adult↗

PubMed1996

[Pregnancy termination after prenatal diagnosis--data of the Styrian malformation register (1985-1992)].

3098 embryos, fetuses or newborns with congenital anomalies were registered in the period from 1985 to 1992 by the Styrian Malformation Register (prevalence 2.88%) the common screening tool for prenatal diagnosis is sonography. About 1/2 of all pregnant women aged 35 or more took advantage of karyotyping offered to this group of patients. Altogether 4004 fetal karyotypes were performed, leading to 89 terminations of pregnancy. A total of 181 terminations of pregnancy following prenatal diagnosis of congenital anomalies were recorded by the Styrian Malformation Register. The annual rate of terminations of pregnancy did not change over the years (5.3-6.7%). About 2/3 of severe congenital anomalies were missed or diagnosed too late in pregnancy. A comparison of our data with those of EUROCAT, the central malformation register of Europe, showed that hydrocephalus was terminated significantly more frequently in the EUROCAT data, but the difference in other congenital anomalies was less marked. It follows that prenatal diagnosis in Austria and all over Europe is subject to equal social demands and medical standards. The study highlights, furthermore, the need for specialist doctors to receive standardized high-quality training in prenatal diagnosis in Austria.

Abnormalities, Multiple↗

PubMed1992

The influence of the post-Chernobyl fallout on birth defects and abortion rates in Austria.

OBJECTIVES: We analyzed the influence of the radioactive fallout after the Chernobyl disaster on the rate and regional distribution of birth defects and abortion rates in southern Austria. STUDY DESIGN: During 1985 to 1989 a total of 66,743 births was monitored. Twelve sources provided data on 1695 cases of birth defects, 1579 of which were suitable for analysis. All cases were analyzed in terms of their calculated conception date and divided into three main groups according to their vulnerable phase of embryogenesis, spermatogenesis, and oogenesis. To study possible regional changes, the findings were plotted in 17 political subdistricts. The overall abortion rate and the counseling frequency at termination clinics was determined. RESULTS: No significant changes in the incidence of birth defects, abortion rate, or counseling rate at pregnancy termination clinics were observed. CONCLUSIONS: Assessing the teratologic potential of low-dose radiation is difficult and requires adequate grouping of birth defects, sufficient baseline data, and highly reliable registries.

Abortion, Induced↗

PubMed1989

Patterns of cortical activation during planning of voluntary movement.

The influence of planning of self-paced voluntary finger movements on alpha band components was studied in 6 volunteers. Brain potentials from 29 electrodes, referred to the right ear, were recorded 4 sec before and 2 sec after movement onset. These data were transformed to obtain the laplacian operator, which was done by computing the local average reference. The event-related desynchronization (ERD) of upper alpha components was then calculated in each record at intervals of 250 msec and topographically displayed in the form of serial ERD maps. A first significant ERD (P less than 0.01, sign test) was found 1.75 sec +/- 0.61 before the movement, most prominent over the contralateral sensorimotor area and over midfrontal areas (the latter can probably be interpreted as an activation of the supplementary motor area). From these data we can conclude that the side of movement is predetermined more than 1 sec before movement onset.

Adult↗

PubMedDate not supplied

Different policies on prenatal ultrasound screening programmes and induced abortions explain regional variations in infant mortality with congenital malformations.

OBJECTIVE: To compare the impact of induced abortions (IA) on the mortality of infants with congenital malformations in four European regions with different policies on IA and prenatal ultrasound screening for congenital malformations. METHODS: A registry-based collection of data on congenital malformations in four different countries: Ireland (Dublin), Denmark (Funen County), Austria (Styria), and France (Strasbourg). RESULTS: The proportion of infant deaths with malformations ranged from 23 to 44% of all infant deaths with the highest proportion in Dublin, where IA is not allowed and prenatal ultrasound screening not performed. There were highly significant differences in the prevalences of IA (p < 0.001), fetal deaths (p < 0.01), and deaths in infants with congenital malformations (p < 0.001) between the four regions. The differences in total mortality with congenital malformations (IA + fetal deaths + infant deaths) between regions decreased, and only Strasbourg differs significantly from the other three regions. CONCLUSION: Prenatal ultrasound screening programmes have only a minor impact on total mortality with congenital malformations from 2nd trimester of pregnancy to 1 year of age, but seem to change the time of death which may be important for both the parents and the community.

Abortion, Induced↗