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B Häussler

Publications and source records attributed to B Häussler.

13 recordsLinked to original sources
PubMed2001

Spina bifida as an independent risk factor for sensitization to latex.

PURPOSE: Patients with spina bifida are at a high risk for having an immediate type allergy to latex products. The number of surgical interventions, atopy and catheterization are well known responsible factors, whereas the condition of spina bifida per se has not been established as an independent risk factor. MATERIALS AND METHODS: A total of 131 patients with a shunted hydrocephalus (48 with spina bifida and 83 of other origin) were investigated for sensitization to latex by skin prick tests and determination of specific IgE. We hypothesized that the diagnosis of spina bifida will increase the risk for latex sensitization while considering potential confounding factors. Thus, we performed a multiple logistic regression analysis to determine independent risk factors. RESULTS: Whereas 56.3% (27/48) of children with spina bifida proved sensitized against latex, this result was the case in only 16.9% (14/83) with another cause of hydrocephalus (p <0.001). The mean number of surgical interventions was 6.2 for patients with no latex sensitization and 9.3 for those with sensitization (p = 0.02). Of patient sensitized to latex 43.9% had a history of atopy compared to 15.5% of those not sensitized (p = 0.02). Sensitized and nonsensitized patients were comparable regarding gender and catheterization. In a multiple logistic regression analysis the cause of the hydrocephalus (odds ratio 6.76 for spina bifida), atopy (odds ratio 3.37) and the number of surgical interventions (odds ratio 1.14 per operation) were identified as independent risk factors. CONCLUSIONS: The increased risk of latex sensitization in patients with spina bifida seems to be disease associated. Possible explanations for this finding may be genetic, antigen mediated, early latex exposure and immunological reasons.

Adolescent↗
PubMed2000

Comparison of ropivacaine 0.1% and 0.2% with bupivacaine 0.2% for single-shot caudal anaesthesia in children.

We compared analgesic efficacy and degree of motor block induced by ropivacaine 0.1% (R 0.1) and 0.2% (R 0.2) vs. bupivacaine 0.2% (B 0. 2) after caudal anaesthesia in children. Total and free plasma concentrations were measured after caudal injection. Duration of caudal analgesia (median/range) was significantly shorter in group R 0.1 (1.7 h/0.2-6 h) than in group R 0.2 (4.5 h/1.7-6 h) or group B 0. 2 (4 h/1-6 h) (P<0.05). Motor block in the first 2 h postoperatively was significantly less for both ropivacaine groups compared with bupivacaine (P<0.05). Peak plasma concentrations after ropivacaine 0.2% were higher and protein binding lower than after bupivacaine 0.2% (P<0.05). We conclude that caudal analgesia with ropivacaine 0.1% is less effective and of shorter duration than that of ropivacaine 0.2%, whereas ropivacaine 0.2% provides pain relief similar to bupivacaine 0.2%. Motor block in the early postoperative period is less with ropivacaine than with bupivacaine.

Amides↗
PubMed1999

[Utilization of services at the Berlin Center of Ambulatory Rehabilitation].

The Center for Ambulatory Rehabilitation (ZaR) in Berlin provides rehabilitative services for orthopedic and neurological patient problems offering a rehabilitation program that is flexible, individually adapted and close to the patient's home. This paper analyzes the development of utilization of the ZaR using patient application, admission and discharge data for a one year period (April 1997 to March 1998). Treatment was started for 1,009 patients (mean age 51.1 years; 55% female). While mean duration of a treatment period was 28.5 days, overall utilization of the ZaR was 49%, being higher for the neurological department than for the orthopedic department (74% and 40%, respectively). The variety of patient problems treated was fairly small: more than two thirds of the cases treated were patients after stroke (ICD 430-438) in the neurological department and patients with back problems (ICD 721-724) in the orthopedic department, respectively. Acute care hospitals still play a minor role in referring patients to the ZaR. Referrals of many office-based physicians suggest that the ZaR will achieve its intention to provide rehabilitative services close to the patient's home.

Adult↗
PubMed1998

[Quality circles in rehabilitation clinics. What has been effective in general practice?].

Within the framework of their quality assurance programme, the German statutory pension funds in 1994 and 1995 required over 400 rehabilitation hospitals to develop structures permitting to establish comprehensive quality management programmes. In particular, they asked that these hospitals should establish quality circles. Structured information could be gathered from 380 hospitals at the end of a pilot phase. According to this information, 233 hospitals conduct a total of 558 quality circles. However, only 23.5% of these quality circles fulfil the criteria of a well-structured quality circle. Another 34.7% of the reported activities can, in a broader sense, be considered as activities that might be helpful in developing Total Quality Management (TQM) systems, whereas 41.8% account for more routine activities such as floor meetings etc. A detailed analysis of the documented information revealed that a high proportion of quality circle participants are recruited from leadership positions. From a subject matter perspective, quality circles still focus on their conceptualization. Taking into consideration the large number of hospitals, the introduction of quality circles can be considered quite successful.

Documentation↗
PubMed1997

[Improvement in occupational rehabilitation of myocardial infarct patients--results of a model study in Rhineland-Pfalz].

In a pilot trial in Rhineland-Palatinate two instruments for optimizing medical and occupational rehabilitation of myocardial infarction patients were tested: (1) A regional cardiology working group was founded which selected measures to accelerate the rehabilitation process in model region hospitals. (2) At the pilot rehabilitation clinic a counselling service for patients under a case management trial scheme was established. The evaluation showed that three weeks after the heart attack, exercise ECGs were carried out in 77.1% of pilot trial patients (case group) as opposed to only 54.5% of patients receiving standard treatment (control group). During in-patient rehabilitation, a higher proportion of case patients discussed their return to work with their employers. After rehabilitation, the occupational future still was uncertain in 13.2% of the case group, in contrast with 29.5% of the control group. 91.8% of case group patients (64% of controls) had been briefed about support possibilities facilitating a stepwise return to work according to section 74 SGB V; half a year following the beginning of rehabilitation, case group patients were reentergrated into working life in 56.3% (50% of controls).

Adult↗
PubMed1997

Seasonal influence on 7,12-dimethylbenz[a]anthracene-induced mammary carcinogenesis in Sprague-Dawley rats under controlled laboratory conditions.

There is good evidence in some species, including rats, that circannual rhythms are innate and can occur even under constant environmental conditions. Such circannual rhythms, e.g. in hormone levels and immune system function, may influence tumourigenesis. This prompted us to study 7,12-dimethylbenz[a]anthracene(DMBA)-induced mammary carcinogenesis at different seasons of the year in female Sprague-Dawley rats under constant environmental conditions (photoperiod, temperature, air humidity, food). DMBA was administered orally at a dose of 5 mg per rat at the first day of the experiment and then at weekly intervals up to a total dose of 20 mg per rat. Rats were palpated once weekly for the presence of mammary tumours. After 13 weeks, they were necropsied for examination of the number and size of mammary tumours. Age-matched groups of 36-99 rats were used per experiment. When the experiment was performed twice within 2 years during the same season (spring/summer), tumour incidence (56 and 61%) and tumour burden were almost equal, indicating that data obtained in this way were reproducible. However, the same experiment performed in autumn yielded a significantly lower tumour incidence (34%) and tumour burden. When the experiment was started during winter, tumour incidence was similar to the spring/summer groups, but tumour burden was lower. The data indicate a seasonal variation in the development and growth of DMBA-induced breast cancer in Sprague-Dawley rats. One possible explanation for this phenomenon may be the seasonal variation in pineal melatonin production and immune function previously reported in rodents under constant environmental conditions.

9,10-Dimethyl-1,2-benzanthracene↗
PubMed1995

[Changes in life expectancy and mortality in East Germany after reunification (1989-1992)].

Whereas some arguments can be advanced suggesting that the life expectancy in east Germany should have declined directly after the fall of the Berlin Wall in 1989, other arguments suggest an increase. The aim of this study was to identify the actual developments and to explain the findings. Census data and mortality statistics from East and West Germany before unification were used to calculate standardized mortality ratios and life expectancies for various population groups. The differences in life expectancy between East and West were broken down according to age groups. The main finding was that the life expectancy of east German men declined in 1990 by 0.9 years, and only reached the 1989 level again in 1992. This was due solely to an increase in mortality for men under the age of 65. In 1990 and 1991, there were 3,400 more deaths among men under the age of 65 than would have been expected on the basis of the mortality rates of 1989. In contrast, the life expectancy of women hardly declined at all in 1990, and in 1992 it was already one year more than for 1989. The most important reasons for the increased numbers of deaths of men under the age of 45 were motor vehicle accidents, whereas ischaemic heart disease and cirrhosis of the liver were more significant for men between the ages of 45 and 65. Suicides did not increase after the fall of the Berlin Wall. It could be shown that the findings were not the results of artifacts.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

View from Germany.

Explore the source record for details and available documents.

Delivery of Health Care↗
PubMed1993

Tumorectomy plus tamoxifen for the treatment of breast cancer in the elderly.

Between 1987 and 1991 a total of 37 breast cancer patients with a mean age of 78.8 (68-89) years underwent local tumor excision and were continuously given 20-30 mg tamoxifen. Thirteen patients presented with clinical stage I, 21 with stage II, two patients with stage III and one woman with stage IV. Surgical complications were minimal and hospital stay 3.5 days. Four patients were lost to follow-up. After a mean observation time of 44.5 months, three of the remaining patients developed local recurrence, which was excised, and 12 patients (32.4%) died. Death, however, was never related to breast cancer. One further patient developed visceral metastases after 46 months of treatment, which responded well to an increase in tamoxifen. The patient with osseous metastases at the time of diagnosis is still alive with stable disease after 75 months. Growing axillary lymph nodes were dissected 16 and 22 months after primary surgery in two patients. It is concluded from this series that limited surgery with hormonal therapy is an effective treatment of breast cancer in elderly patients.

Aged↗
PubMed1991

[Myocardial infarct and occupational reintegration in insured patients of a regional sickness fund].

For a region in the Federal Republic of Germany, some important indicators for procedures and outcomes of the care of myocardial infarction patients have been demonstrated. The study was restricted to patients under 65 years of age and was based on routine data from the health insurance fund. Length of stay in the hospital was more than five weeks. Half of the patients who underwent coronary angiography coronary bypass surgery had to wait longer than three or five months, respectively, for the procedure. Half of the patients who were treated in a rehabilitation clinic had to wait more than two weeks elapsed after discharge from the acute care hospital. Utilization of this type of service was about 75% for patients who were employed before the infarction compared to only about 15% for patients who had already been retired from work. Only about half of the men under 60 years returned to work after their infarction. Half of the patients were still disabled after nine months after onset of disease. The study was part of a project for the development of care for patients with myocardial infarction in that region. It turned out that routine data are effective for the description of the situation. Studies of this type can be repeated in other regions with comparable little effort.

Adult↗
PubMed1989

[Incidence of appendectomy and length of hospital stay in a region of West Germany].

Based on public health routine data, a study on the incidence of appendectomies was carried out in the Federal Republic of Germany. The result of 130 appendectomies per 100,000 inhabitants per annum comes very close to the findings made in England and Wales though it only represents one fifth of the figure, Lichtner and Pflanz had established for some other region about 20 years ago. Duration of hospitalization averaged 10.6 days, thus showing a reduction of 2 days compared to the earlier study. In England and Wales however, the average length of stay in hospital came up to only 5.6 days. The length of stay, standardized by age and sex, showed differences of more than 4 days on the various wards. The possible influences of institution inherent factors on the frequency of operations and on the duration of hospitalization are discussed.

Adolescent↗