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Biomedical subjects

R Lassmann

Publications and source records attributed to R Lassmann.

15 recordsLinked to original sources

Survey of computerized obstetric information systems in Austria.

The aim of this study was to evaluate obstetric electronic data processing (EDP) in Austria and to analyse its problems, advantages and acceptance in a single big obstetric department. We sent questionnaires to every obstetric department in the country. The overall response rate was 77% (73 departments). Only 24 (33%) were using computer aided documentation, but these covered 63% of deliveries in Austria. The proportionate times spent on documentation were 57% for physicians and 43% for midwives, with physicians playing a bigger role in larger departments using electronic documentation. Sixty-five percent of physicians and 31% of midwives readily accepted computerization. We also studied an obstetric department with over 3000 births per year. Twenty-five percent of the medical staff did not believe that computerization saved time, although they appreciated its value to administration and for producing printouts. Advantages in completeness (92%) and accuracy (76%) were recognized. After 6 month's use acceptance of EDP documentation improved significantly.

Attitude of Health Personnel

[Comparison of biochemical and Doppler sonographic monitoring of high-risk pregnancies].

We performed in 113 patients at least three simultaneous determinations of serum-HPL and oestriol in 24-hour urine samples, as well as Doppler flow studies at the arcuate artery (AA), umbilical artery (UA), foetal aorta and internal carotid, because of suspicion of IUGR. The diagnostic value was studied with regard to IUGR, placental weight and mode of delivery. Concerning the detection of IUGR, the superiority of Doppler parameters (AA, UA) is shown. In the total number of patients, the rates for sensitivity and specificity for UA (78/91%) and AA (58/89%) exceed the hormone parameters. Oestriol, in particular, (13/63%) shows a marked difference, but even HPL (37/63%) cannot compete with respect to diagnostic value.

Acidosis

[Doppler examination as an indication for surgical delivery. A case report].

Pathological alterations in foetoplacental circulation can lead to zero flow or even to reverse flow in the diastole. In these cases, a high fetal risk can be expected. Based on our Doppler measurements, we recommend by zero flow in the umbilical artery or foetal aorta, that the childbirth could be postponed under an observant attitude using intensive controls (CTG, foetal movements), but pregnancy has to be terminated immediately by Caesarean section at the first sign of reverse flow.

Adolescent

[Clinical value of a decrease in diastolic flow in obstetric Doppler sonography].

Doppler ultrasound in obstetrics is being increasingly accepted in foetal surveillance. For clinical practice, a good correlation between Doppler findings and biochemical data such as blood gas analysis and lactate as a metabolical parameter, would be desirable. To clarify this question, these results have to be compared. Prepartal Doppler results which are correlated with postpartal blood gas analyses of umbilical vessels cannot be a satisfactory criterion due to the influence of labour on these parameters. Therefore, we depend on results from foetal blood sampling procedure. The five cases presented here should be a contribution to this discussion. In summary it can be concluded, that in cases of a highly pathological Doppler analysis in the umbilical artery, intrauterine growth retardation must be expected. If there is an acidosis in the foetal organism, it can be assessed via the foetal carotid findings. This, therefore is our contribution to the discussion on the indication for Caesarean section in cases of absent diastolic flow: Absence of diastolic flow in the umbilical artery and foetal aorta only without centralisation by increased perfusion in the foetal carotid, is, in our opinion, not an indication for Caesarean section. We believe, that foetal acidosis confirmed by foetal blood gas analysis indicated by the Doppler result, is an efficient completion of obstetrical management in risk pregnancies. Any further decision on conservative management or termination of pregnancy can be taken more easily on the basis of biochemical data, especially in situations, where conventional methods of foetal surveillance cannot clarify the perinatal risk sufficiently.

Adolescent

[Struma ovarii, a rare ovarian tumor].

Teratomas, which consist only or predominantly of thyroid tissue, are termed struma ovarii. Two cases are reported, where after previous strumectomy the histologic diagnosis was struma ovarii. Because of postoperative TSH-rise hormonal activity can be assumed. The proper diagnosis is seldomly made preoperatively, this could be done by abdominal scintigraphic imaging of radioiodine uptake in the tumour.

Female

[Induction of ovulation using pulsatile GnRH administration to infertile females].

6 infertile women with primary or secondary amenorrhoea or anovulation, who failed to ovulate after clomiphene and HMG/HCG treatment, underwent 11 treatment cycles with pulsatile GnRH therapy using a portable pump. Normal ovulation occurred in 9 out of 11 treatment cycles; the luteal phase was normal in 6 cycles. One woman conceived in the second treatment cycle.

Adult

[Hierdence of X-chromatin post partum].

Determinations of the X-chromatin frequency in buccal smears were performed in 33 pregnant women at the day before delivery and daily for seven days thereafter. In 23 women with a spontaneous delivery there was a statistically significant drop in the X-chromatin frequency after delivery being lowest on the second day. On the fifth day the X-chromatin frequency had reached the predelivery level. In 10 women with operative delivery by cesarean section and hormonal suppression of lactation no such changes in the X-chromatin-frequency have been noted.

Analysis of Variance

Morphological and morphometric studies of the skeletal muscles of rachitic rats.

The question of "myopathia rachitica" was pursued in a disease progress study using rachitic rats. The length of the study was 18 weeks. During this time a discrete dystrophic myopathy formed. The morphometric examination showed muscle fibre diameters 8--24 mu less than those of healthy control rats in correlation with the degree of rachitis. The absence of fiber growth in the C fibres was conspicuous. The question of the relation of these findings to the inactivity, osteomalacia and changes in metabolism in rachitis was discussed. The myopathic changes can not be solely interpreted as a result of inactivity, but the cause of myopathia rachitica remains unclear.

Alkaline Phosphatase