Search PubMed⌕ Search

Biomedical subjects

G Winkler

Publications and source records attributed to G Winkler.

At least 73 records · Page 4Linked to original sources
PubMed1997

[From infant nurse to "baby-friendly hospital"--promotion of breast feeding in the University Women's Hospital in Leipzig].

The attitude of medical professionals towards natural infant feeding is decisive in the support of mothers who want to breastfeed. The atmosphere in a "Baby-Friendly Hospital" is determined by the creation of conditions for breastfeeding on demand and for early, undisturbed mother-child contact. At the University Women's Hospital in Leipzig the development of good breastfeeding management was supported by the employment of a "breastfeeding nurse" and enhanced by continuing education for physicians, nurses and midwives in lactation and breastfeeding. In this way comprehensive, uniform information as well as practical guidance important for breastfeeding success were ensured for pregnant and young mothers.

Adult↗
PubMed1996

Long-term management of acute respiratory failure in metabolic myopathy.

OBJECTIVE: To describe how patients cope with the proposal of treatment with intermittent artificial ventilation after acute respiratory failure due to progressive respiratory muscle weakness. DESIGN: Case series, follow-up study. SETTING: Neurological intensive care unit (ICU). PATIENTS: 7 consecutive patients with metabolic myopathy treated for acute respiratory failure between 1983 and 1992. INTERVENTIONS: Intermittent positive pressure ventilation (IPPV) via tracheostomy. MEASUREMENTS AND RESULTS: Symptoms of chronic hypoventilation preceded acute respiratory failure for months. With one exception, patients were mainly disabled from respiratory muscle weakness and sleep-related breathing disorders. IPPV was recommended to prevent recurrent respiratory failure. Two of three patients who accepted home IPPV returned to full-time jobs. One patient, who decided against IPPV, died from CO2 narcosis several months after discharge. All patients adhered to the respiratory regimen once instituted. CONCLUSIONS: Acute respiratory failure in chronic myopathy is heralded by daytime drowsiness. IPPV, or at least regular monitoring of waking and sleeping partial pressure of carbon dioxide, is highly recommended even if weaning is successful. IPPV improved quality of life. The treatment strategy at discharge from the ICU should be optimal, as patients are reluctant to modify regimens.

Activities of Daily Living↗
PubMed1996

Trends in food consumption in a south German population from 1984/85 to 1989/90: results from the WHO MONICA project Augsburg.

In the risk factor surveys of the WHO MONICA project Augsburg 1984/85 (S1) and 1989/90 (S2), a qualitative food frequency questionnaire with 24 items was used to monitor trends in food consumption in two independent age- and sex-stratified two-stage cluster samples of the population aged 25-64 years (S1: n = 4,022; S2: n = 3,966). Alcohol intake was assessed by separate questions. From S1 to S2 slight but encouraging trends towards a better agreement with dietary guidelines could be found with a decreasing monthly consumption of meat, sausages and ham, eggs, and beer and an increasing consumption of cooked vegetables and cereals. These trends correspond well with trends in food supply data.

Adult↗
PubMed1996

[MRI of musculature in myalgia--indications and image findings].

This paper deals with the question of the clinical circumstances in which MRI seems to be promising in patients with myalgia. 241 patients suffering from myalgic symptoms were examined by axial scans of the muscular system with T1w and STIR-sequences. All patients underwent a complete neuromuscular examination, which included an MRI guided muscle-biopsy of 203 patients. The images were retrospectively analysed as to the typical characteristics of differential diagnosis. In cases of idiopathic or bacterial/viral induced myositis, primary vasculitis, and rhabdomyolysis, edematous changes of the muscles could always be found. Abscesses were only found in bacterial myositis. In cases of poly- and dermatomyositis as well as inclusion-body-myositis, MRI showed a uniform distribution pattern with emphasis on the quadriceps muscles. In contrast to other neuromuscular diseases in bacterial induced myositis, focal myositis, and rhabdomyolysis a strong contrast agent enhancement was seen. All patients with myalgic syndromes without any other additional neuropathological findings and 86% of the patients suffering from polymyalgia rheumatica had normal MR-findings. MRI allows a correct exclusion of an inflammatory, tumorous, or rhabdomyolitic cause of a myalgia and leads to pathognomonic findings for these diseases. Diseases belonging to the group of endocrine, toxic, or metabolic myopathies might be normal in MRI. We believe that an indication for MRI is given when muscular pain is associated with additional neuromuscular symptoms, especially if an inflammatory origin of the myalgia is suspected or if a muscle biopsy is planned.

Adolescent↗
PubMed1996

[Determining cause of death from death certificates in public health offices--experiences with a data custodian model].

In a study on the long-term outcome after thrombolysis in patients with acute myocardial infarction, we had to ascertain the cause of death as noted in the confidential section of the official death certificate at the Public Health Office. Since current data protection legislation does not permit direct access to the death certificates we used a custodian model which strictly separates the institution storing the addresses in touch, and carries out the inquiry and the institution receiving the anonymised data for analysis. Forty Public Health Offices in ten German Bundesländer were asked for causes of death of 118 patients. Data were delivered by 35 Public Health Offices from nine Bundesländer on 106 patients (response = 89.8%). The custodian model which was often proposed as a tool for epidemiological research within the restrictive legal framework in Germany, proved to be successful in practice, with good response.

Cause of Death↗
PubMed1995

[Mealtime patterns in a southern German population. Results from the WHO MONICA 1984/1985 Augsburg nutritional survey project].

Seven-day food records of the MONICA project Augsburg dietary survey, which were collected between October 1984 and May 1985 in 899 men aged 45-64 years (random sample), were used to analyze meal patterns. Among other variables, the emphasis was placed on meal frequency and rhythm, frequency of meal combinations, place and time of meal intake as well as on the contribution of different meals to selected nutrient intake. Breakfast delivers 17%, lunch 29%, and dinner 33% of the total daily energy intake; all other meals (snacks) deliver 21% of the energy intake. The mean contribution of the three major meals, such as breakfast, lunch and dinner to daily protein intake is 14%, 36%, and 36%; to fat intake 17%, 33%, and 35%, and to carbohydrate intake 23%, 25%, and 29%, respectively. Data on meal patterns are useful for the development of preventive strategies.

Diet Records↗
PubMed1995

[Correlation between dietary behavior and educational attainment: results of the 1984/85 nutrition survey of the Augsburg MONICA project].

The relationship between educational attainment and dietary behaviour was examined in a South German population of men aged 45 to 64 years. Analyses are based on data from the MONICA Augsburg Dietary Survey 1984/85 (7-day dietary records, n = 899). The evaluation of the daily food consumption shows that men with higher educational attainment prefer healthier food items than men with lower educational attainment. The healthier food pattern in men with higher educational attainment is reflected in a lower cholesterol intake and in a higher fibre intake. The mean daily intake of vitamins, minerals and trace elements is better in men with higher educational attainment with the exception of the vitamin niacin. The total daily caloric intake, fat intake and the combination of saturated, monounsaturated and polyunsaturated fatty acids is independent of educational attainment. The percentage of carbohydrates, protein and fat of the total caloric intake is nearly the same in all educational attainment groups. The results concerning food pattern and nutrient intake by educational attainment offer important information with regard to the development of strategies for the improvement of nutrition habits.

Cross-Sectional Studies↗
PubMed1993

[The diagnosis of inflammatory muscular and vascular diseases using MRT with STIR sequences].

The role of MRT in the prebiopsy diagnosis of muscular and vascular inflammatory conditions was evaluated prospectively and an optimal method of examination was investigated. 92 patients with a suspected diagnosis of myositis (60 cases) or vasculitis (32 cases) were examined, in each case two extremities were studied using transverse T1 and T2 weighted SE sequences and double echo STIR sequences on a 0.5 Tesla (56 patients) or 1.5 Tesla magnet (36 patients; T5/S15 Gyroscan, Philips). The site of the biopsy depended on the MRT findings. In 41 patients the suspected diagnosis was confirmed histologically, in two patients an infective myositis was diagnosed on clinical grounds despite negative histology. MRT demonstrated muscle oedema in 86% of patients. There were negative findings after immuno-suppressive therapy (two patients), in focal myositis (3 out of 4 patients) and in one of 7 patients with untreated vasculitis. Amongst 49 patients in whom the suspected diagnosis could not be confirmed there was muscle oedema in 11 cases (9 neuropathies out of 22, two myopathies out of 10). Oedema indicated inflammatory muscular or vascular disease with a sensitivity of 97% (except in treated patients and for focal myositis). The number of false negative biopsies can be greatly reduced by the use of MRT.

Adult↗
PubMed1993

[Right ventricular assist device (RVAD) in septic, fulminating pulmonary artery embolism].

We describe a 34-year-old male with pulmonary embolism. The patient had been admitted to a peripheral hospital for incision and drainage of a very large ischio-rectal abscess. Four days after successful surgical intervention and during a change of dressings he developed a massive pulmonary artery embolism. The patient was transferred to the Department of Cardiac Surgery in Graz; on arrival he had a cardiac arrest. Resuscitation was initiated and the patient was transferred to the operating theatre where emergency sternotomy and embolectomy revealed large thrombotic masses in the pulmonary circulation. Extracorporeal circulation was initiated, but despite aggressive medical measures (dopamine, dobutamine, isoproterenol, enoximone, and prostaglandin E1 in maximum therapeutic doses) and a long reperfusion time weaning was not possible. Despite the septic state, a right ventricular assist device (RVAD; ABIOMED BVS 5000) was installed. Weaning was finally accomplished with a pump flow of 2.2 l/min m2 and the patient transferred to the intensive care unit. On post-operative day 3 the pump flow was reduced to 2 l/min. The patient's condition remained stable, which made removal of the RVAD possible on postoperative day 5. The further course was uneventful, with secondary ischio-rectal wound closure. His initial psychomotor impairment had nearly disappeared and he was discharged 2 months later.

Adult↗
PubMed1992

Inhibition of HIV infection by a novel CD4 domain 2-specific monoclonal antibody. Dissecting the basis for its inhibitory effect on HIV-induced cell fusion.

HIV use the CD4 molecule as their primary cellular receptor. Residues in the N-terminal domain (D1) of CD4 are crucial to HIV attachment through the gp120 envelope component. However, other regions of CD4 appear to be required subsequently for virus- and cell-cell fusion. Little is understood of the post-binding steps which may differ between HIV variants. We report a novel anti-CD4 mAb that does not block CD4/gp120 binding, but that does efficiently block both viral infection and cell-cell syncytia formation, and define its contact site as residues in CD4 D2 using both mouse/human CD4 chimeras and CD4 substitution mutants. We also investigated the basis for its antiviral effect. Using the CD4 D2 specific mAb, we identify another conserved step in HIV infection, as evidenced by its ability to neutralize a broad range of primary isolates and T cell-line passaged strains. Monovalent forms of the mAb were used to determine if its activity was due to masking of the D2 epitope, to steric inhibition, or bivalency. Our data indicate that both binding site and bivalency of the mAb underlie its potency. The need for bivalency is not simply explained by affinity, because monovalent forms can displace the intact mAb and reverse its protective effect. These results provide evidence that binding of the D2-specific mAb prevents structural alterations necessary for membrane fusion.

Animals↗
PubMed1992

Comparison of dietary intakes in four selected European populations.

The composition of diet and food intakes in four selected European populations were compared. Dietary data (from the World Health Organization Project on Monitoring Trends and Determinants in Cardiovascular Disease) were measured by record methods and were available for middle-aged men in Finland (n = 653), France (n = 1128), Northern Ireland (n = 356), and southern Germany (Augsburg region; n = 899). Nutritional variables--which are independent of the absolute energy intake, such as the percentage supply of energy from macronutrients and the ratio of polyunsaturated to saturated fatty acids--were on the whole similar. However, striking differences were found in food intake and in the percentage supply of fat from different foods. The results indicate that detailed knowledge of consumption figures is necessary to develop prudent and acceptable nutrition intervention programs.

Adult↗
PubMed1992

[Seasonal variations in nutrition behavior: results of the dietary survey of 1984/85 of the MONICA project in Augsburg].

Seven-day food records of the MONICA project Augsburg dietary survey, which were collected between October 1984 and May 1985 in 899 men aged 45-64 years, were used to analyse seasonal variations. Variations could be found in several food groups, but nutrient intake was nearly the same in autumn, winter and spring--with the exceptions of total fibre and alcohol.

Alcohol Drinking↗
PubMed1992

Food intake and nutrient sources in the diet of middle-aged men in southern Germany: results from the WHO MONICA Augsburg Dietary Survey 1984/85.

Diet records of the WHO MONICA Augsburg dietary survey 1984/85 sample of 899 men aged 45-64 were used to derive quantitative data about food intake and the contribution of food groups to energy intake and the intake of those nutrients relevant to the discussion about nutrition and cardiovascular disease: protein, fat, saturated, mono- and polyunsaturated fatty acids, cholesterol, carbohydrate, polysaccharides and total fiber. The present lists of nutrient sources should be helpful for the development of acceptable dietary advises, which make allowance for actual eating patterns as well as for developing improved instruments of dietary assessment.

Diet Surveys↗
PubMed1992

Comparison of food intakes of selected populations in former East and West Germany: results from the MONICA Projects Erfurt and Augsburg.

The intakes of selected food groups in former East and West Germany were compared, based on data from the dietary surveys of the MONICA project Erfurt 1987 and of the MONICA project Augsburg 1984/85. Three-day records from 132 middle-aged men from the city of Erfurt (response 73%) and 3-day records from 424 middle-aged men from the city of Augsburg (response 70%) could be included in the comparison. The differences in the consumption of animal products were rather small. The intake of bread and baked goods, potatoes and cooked vegetables was higher in Erfurt, whereas the intake of raw vegetables was lower. The most striking differences appeared in the consumption of fat.

Diet↗