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Biomedical subjects

C Brezinka

Publications and source records attributed to C Brezinka.

At least 55 records · Page 3Linked to original sources
PubMed1993

[The end of home delivery midwifery in German-speaking sections of Upper Italy].

The German language islands in Northern Italy are a string of remote mountain villages stretching from Aosta in the west to Friuli in the east. These villages were founded in the middle ages by settlers from present-day Switzerland, Austria and Germany. The descendents of these settlers, almost all of them farmers, speak antiquated form of German and have maintained traditions that have long died out in the countries of their ancestors. The transformation from home births attended by the midwife to hospital births attended by a gynecologist took place in rural Italy in the 1960s. The aim of this study was investigate how this change took place in the language islands in their combination of geographical and linguistic isolation. The language islands of Macugnaga (Novara), Luserna and Val Fersina (Trento), the 13 Communities (Verona), Sappada (Belluno) and Timau (Udine) were visited and semi-structured interviews with midwives and other inhabitants in German dialect and in Italian were tape recorded. Home births accounted for almost 100% of all births in the language islands in the 1950s and ceased to exist after 1973. The German-speaking population stayed longer with home births than the Italian inhabitants of the same villages. Several reasons, practical and to a lesser extent psychological account for this behaviour: until 1962 the farmers' insurance policy did not cover hospital births, extensive road building to make the villages accessible all year round began after the flood summer of 1966, the inhabitants of the language islands felt they were considered as a backward rural minority in the hospitals of the towns.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1993

Antimicrobial susceptibility pattern of Neisseria gonorrhoeae in western Austria.

From January to October 1992 24 Neisseria gonorrhoeae isolates from clinical specimens were collected at the Federal Public Health Laboratory in Innsbruck (Austria) and screened for resistance to penicillin G, erythromycin, tetracycline, spectinomycin, ceftriaxone, cefuroxime, ciprofloxacine, and silver nitrate. Patients originated from the Austrian provinces Salzburg, Tirol, and Vorarlberg, and presented with manifest gonorrhoea. Two of 24 isolates were penicillinase-producing N. gonorrhoeae. Both strains were isolated from men who had just returned from Thailand or Kenya. The isolate from Africa was also resistant to tetracycline. Five of 24 infections were acquired abroad, sex tourism being involved in four cases. The antimicrobial resistance pattern found in gonococci in western Austria revealed that topical silver nitrate and erythromycin are equally acceptable for use in prophylaxis of neonatal ophthalmia. Penicillin is still the drug of choice in the treatment of endemic infections. If gonorrhoea has been acquired abroad, especially in Asia or Africa, ceftriaxone, spectinomycin or ciprofloxazine are recommended for therapy.

Adolescent↗
PubMed1992

Normal Doppler flow velocity waveforms in the fetal ductus arteriosus in the first half of pregnancy.

Ductus arteriosus flow velocity patterns were studied in 298 women between 9 and 25 weeks of gestation using transvaginal or transabdominal Doppler ultrasound. Technically acceptable recordings were first obtained at 11 weeks resulting in 231 women for further analysis. Ductal waveforms show a significant change in shape from early pregnancy to mid-pregnancy, in that end-diastolic velocities are absent until 13 weeks, are present in 50% at 15 weeks and are present in all cases from 17 weeks. Regression analysis demonstrated a statistically significant linear increase with advancing gestational age for all flow velocity parameters except for the pulsatility index which remained stable during the entire study period.

Journal Article↗
PubMed1992

Low sensitivity of serum fructosamine as a screening parameter for gestational diabetes mellitus.

Oral glucose tolerance testing (OGTT) and quantification of serum fructosamine levels were performed in 190 asymptomatic women in weeks 24-28 of pregnancy. OGTT identified 10 of the 190 women as having gestational diabetes, but serum fructosamine quantification failed to do so because none of these 10 women exhibited levels exceeding the normal limit of 2.76 mmol/l. The mean fructosamine level in this group was 1.72 +/- 0.25 mmol/l compared to 1.60 +/- 0.15 mmol/l in the other 180 women without gestational diabetes. Fructosamine was found to correlate only with postload glucose values in excess of 180 mg/dl at 2 h (r = 0.87; p = 0.01), i.e. with the highest overall glucose values, but not with fasting glucose or milder postprandial hyperglycemia of under 180 mg/dl. We conclude that quantification of fructosamine detects only the rather severe cases of gestational hyperglycemia, but is too insensitive to uncover mild asymptomatic gestational diabetes mellitus, and we do not consider fructosamine to be a useful parameter for the diagnosis of this condition.

Diabetes, Gestational↗
PubMed1992

[The spectrum of pathogens in positive blood cultures--Tyrol 1991].

In a recent study by the Centers for Disease Control (CDC) it was noted that there had been a resurgence of Gram-positive bacteremia together with an increase in fungemia. This reported trend is confirmed by data from the Austrian Tirol. In 1991 1,750 out of 13,679 specimens (12.8%) yielded bacterial or fungal growth, accounting for 1,248 cases of "bacteremia"; no decision was made about the clinical significance of the culture isolates. We consider laboratory reports of blood isolates to be fairly well suited to reflect the frequency of the various bacterial and fungal pathogens. The most common organisms were coagulase-negative staphylococci (41%). The proportion of Staphylococcus aureus (17%), E. coli (4%), Klebsiella-Enterobacter (4%), Pseudomonas (5%) and Candida (3%) corresponded well with the situation in the USA and the UK. Remarkably, anaerobes accounted for only 0.3%, possibly due to our use of a "single bottle"--blood-culture system. Various fastidious organisms, including Brucella melitensis and Haemophilus aphrophilus, were detected by this blood-culture system. Also 15 Haemophilus influenzae-strains, nontyphoidal salmonellae (9 strains), and meningococci (7 strains) were isolated. These data show that the microbiologic features of blood-cultured seen in Austrian Tyrol are broadly similar to those in the UK and North America.

Austria↗
PubMed1992

[Postpartum diabetes screening: value of fructosamine determination].

After birth of an infant with a birthweight of 4000 g or more maternal glucose tolerance should be examined. We measured blood glucose values after a 100 g oral glucose challenge and compared them with serum fructosamine values of the same subjects. 40 women who had given birth to an infant with macrosomia (group I) were matched with 40 women who had delivered babies with normal birthweight (group II). Impaired glucose tolerance was found in 6 women (15%) of group I, and in one woman (2.5%) of group II. Fructosamine values were within the normal range in each of the seven women (1.74 + 0.2 mmol/l vs 1.73 + 0.2 mmol/l). Thus, fructosamine determination is not sensitive enough to detect impaired glucose tolerance in asymptomatic women post partum. It is not feasible to replace the oral glucose tolerance test in screening for gestational diabetes mellitus.

Birth Weight↗
PubMed1991

[Recurrent multicystic peritoneal mesothelioma in endometriosis of the pelvis].

In the case of a 21-year old woman, who complained of chronic pelvic pain and where cystic structures in the adnexal region had been diagnosed ultrasonically and by laparoscopy, a tumour made up of many small cysts was discovered in the pouch of Douglas next to a typical endometrial cyst. Both the endometrial cyst and the cystic tumour were excised by laparotomy. Histology established the tumour as a multicystic peritoneal mesothelioma. Postoperative recurrence was noticed by ultrasound less than one year later. Laparotomy revealed a 5 cm serous cyst of the right ovary and again countless liquid-filled grape-like small cysts in the pouch of Douglas. Histology revealed a multicystic peritoneal mesothelioma identical to the previously excised tumour. Multicystic peritoneal mesothelioma is a rare soft tissue tumour noted for its frequent recurrences. Most authors agree, that it belongs to the morphological spectrum of reactive mesothelial proliferative lesions and not the neoplastic spectrum. It appears mostly in women, often concomitant with endometriosis and pelvic inflammatory disease and frequently in women, who had previous surgical interventions in the abdominal region.

Adult↗
PubMed1990

Cerebral metastasis of endometrial carcinoma.

The case of a woman who died from cerebral metastasis of adenocarcinoma of the uterine corpus, clinical stage IA at the time of first referral, is described. Three months after preoperative endocavitary radiotherapy followed by radical surgery followed by postoperative radiotherapy, the 59-year-old patient developed neurological symptoms. A cerebral tumor was diagnosed and subsequently excised. Histology showed metastasis of an adenocarcinoma. The patient died 3 weeks after cranial surgery. Meticulous postmortem examination failed to reveal any other tumor besides the endometrial neoplasm. Comparative immunohistochemical examination of the primary tumor and the cerebral process supported the assertion that the brain metastasis derived from the adenocarcinoma of the endometrium. Literature reports on cerebral metastasis of endometrial carcinoma are discussed.

Adenocarcinoma↗
PubMed1990

[The "vanishing twin"].

Three cases of a vanishing twin are reported. We observed twin pregnancies in three women, who had their ultrasound examination before the 10th week of pregnancy. Positive heartbeat was registered in both embryos. When a further sonographic examination took place at the 11th week, intrauterine death of one of the embryos was observed. All three pregnancies continued as singleton pregnancies to uneventful term deliveries. When the placentae and chorionic membranes were examined after delivery, small nodular pigmented areas were observed. Histological examination showed the remains of the embryo, who had vanished in the first trimester of pregnancy.

Embryo, Mammalian↗
PubMed1990

Diagnosis of extrauterine pregnancy with transvaginal ultrasound.

We reviewed all cases of suspected ectopic pregnancy (EP) that had transvaginal ultrasound (TVU) prior to surgery from 1987 to 1989. Of 265 patients who had culdocentesis and laparoscopy for suspected EP, 206 had EP. IN 28 of the 59 cases that proved negative at laparoscopy, EP was suspected at TVU. An ectopic embryo was seen at TVU in 28 cases where laparoscopy confirmed the TVU diagnosis. In 163 cases where EP was considered probable at TVU this was confirmed at laparoscopy. 15 cases of EP were overlooked at TVU.

Culdoscopy↗
PubMed1990

[Acinetobacter as a problem pathogen in patients with long-term tocolysis].

A hospital outbreak of Acinetobacter Calcoaceticus in a ward with patients with intravenous tokolysis is reported. Within 2 months 9 pregnant women who had tokolysis for premature labour developed septic fever that only subsisted after the administration of tokolysis was stopped. In 7 cases blood culture was positive for Acinetobacter Calcoaceticus. This endemic outbreak was responsible for premature deliveries in four cases, leading top post partum death of two infants. Source identification was inconclusive, no further outbreaks have occurred since the reported endemic occurrence. Dangers of nosocomial infections in patients with intravenous tokolysis are discussed.

Acinetobacter↗
PubMed1990

[Cerebral malformations in the 30th-36th pregnancy week--diagnosis and consequences].

When serious cerebral malformations of the fetal cerebrum are diagnosed, the pregnancy is in most cases so far advanced, that termination would be difficult medically, controversial ethically and--depending on legislation--impossible legally. Most cerebral malformations associated with hydrocephalus appear late in the 2nd and early in the 3rd trimester. Routine pregnancy ultrasound scan of the fetal brain is difficult due to the dynamic changes in cerebral anatomy during normal pregnancy and due to the artefacts produced by intra-cranial reverberations. The concept that there is a "right time" for in utero diagnosis of fetal hydrocephalus is reviewed. Unequivocal early diagnosis is only possible in cases of anencephaly. 15 cases of severe cerebral malformations that were seen during prenatal ultrasound at Innsbruck University Hospital are presented "Nonaggressive Obstetric Management" as a novel and structured approach to such cases is discussed.

Abortion, Induced↗
PubMed1990

[Twin pregnancy with discordant abnormalities].

3 cases of severe discordant malformations diagnosed by ultrasound (anencephaly, myelomeningocele, prune belly-syndrome) in multiple pregnancies have been described. Operations have been given up consciously.

Adult↗