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Biomedical subjects

R Winkler

Publications and source records attributed to R Winkler.

At least 109 records · Page 6Linked to original sources
PubMed1990

[After care in treatment of functional disorders after tumor excision--from the surgical viewpoint].

Radical cancer surgery cures by setting defects. Consequently there are limits to the conservation or restoration of organ functions. These problems are mainly relevant to gastric and rectal surgery. Conservative treatment is the treatment of choice for functional deficiencies. If it fails, surgical intervention can be successful in rebuilding reservoir functions and eliminating transport disturbances, but it can only poorly imitate the function of digestive sphincters.

Aftercare↗
PubMed1990

[Indications for radiotherapy of rectal cancer].

Surgery and radiotherapy complete each other in local control of suffering from rectal carcinoma. A radiotherapeutic effect on tumor is secured often. The adjuvant radiotherapy is the most interesting indication, though the most controversial as present too. Analysing all data and with experiences of an own irradiation study we have not any doubt that the indication is qualified for a combined therapy, if the therapeutic aim with priority is to prevent a local relapse as the most frequent and complained of form of therapeutic failure. In this problem, radical irradiation forms, as pre- and accumulating irradiation (sandwich-technique) and after-irradiation, render superior to an exclusive pre irradiation. In result of this study we practise a preirradiation of 25 Gy with immediately following operation and an accumulating irradiation to 50 Gy in proved high-risk-stage (T greater than or equal to 3 NoMo,Tx N1-3 Mo). If there is a primary local incurability by tumor invasion into the neighbourhood a pre-irradiation is done with 50 Gy and following explorative laparatomy within 4-6 weeks. Nearly 60% of these tumors become operable after that. Likewise we practise in unirradiated patients with locoregional tumor recurrence. Also here the extirpation quota of patients with general or systemic incurability, that a stoma construction is required in, we carry out a transanal tumor reduction and irradiate with 50 Gy after that. Especially this therapeutic principle has proved its worth in patients that are past eighty. Here with acceptable living quality and avoiding a stoma construction a survival can be reached that corresponds to the statistical survival of this stage of life.

Combined Modality Therapy↗
PubMed1990

[Systematic procedures in endodontics].

Endodontic treatment is an important part in operative dentistry. While quantity of treatment increases, the quality should not be neglected. Means to improve the individual success rate are shown in the article. The simplification of the armamentarium and systematics of procedures are of utmost importance. As the basic technique the hand instrumentation is described.

Dental Instruments↗
PubMed1989

[131 I accumulation in the thyroid gland of the rat following balneotherapy iodine dose administration].

The effect of oral administration of iodine brine as used in the Austrian health resort Bad Hall on 131I uptake in thyroid, skin and serum, and on the renal radioiodine excretion was studied in 22 rats. Intake of iodine brine resulted in a marked decrease of 131I uptake by the thyroid, both in the long-term experiments (3 weeks of iodine brine supplementation, 131I administration 24 hours before the final evaluation) and in the short-term experiments (1 day iodine, 131I administration 2 hours before evaluation). Reductions in thyroid 131I uptake to 19.4% of the control uptake in the long-term and about 36% in the short-term experiments were observed. No alteration in 131I uptake was seen in the skin, whereas the radioiodine excretion in the urine was somewhat increased. The administration of iodide at a dosage easily achieved by drinking the iodine brine of Bad Hall is discussed as a protective measure against radiation hazards.

Animals↗
PubMed1989

A clinical trial of a self-care approach to the management of chronic headache in general practice.

This paper reports a trial which assessed the clinical effectiveness of adding a behavioural self-management programme to the existing management of chronic headache by general practitioners (GPs). Eighty-seven chronic headache sufferers, referred to the study by 35 GPs, were randomly allocated to either a self-care group or a GP-control group. Headaches, drug usage, visits to health-care providers and time off work were self-monitored daily by all subjects for 4 weeks prior to intervention, for 4 weeks during intervention, and for 4 weeks immediately after intervention. Additionally, self-monitoring was carried out for two further 4-week periods, one at 6 months and one at 12 months post intervention. Headache records showed that the self-care program significantly enhanced GP management. This effect was well maintained. However, drug usage, visits to health-care providers and time off work did not differ significantly between the treatment and control groups. 'No-show' rates, defined as those referred by a GP but who did not attend, were high--largely due to time requirements of the self-care program. However, drop-out rates, defined as those who left the self-care groups were low. It was concluded that this behavioural self-management program was a clinically effective adjunct to general practice management of headache but its use is likely to be limited due to problems of patient enrollment.

Adult↗
PubMed1989

Morbidity coding in general practice.

If research is to be of any use the phenomena being studied must be clearly defined. Almost 30 years ago the difficulty of classifying primary care problems using the International Classification of Diseases (ICD-8) was demonstrated. This led to the development of the International Classification of Health Problems in Primary Care-2-Defined which is based on ICD-9. Despite the work that has gone into the development of ICHPPC-2-Defined, relatively little work has been undertaken to assess the validity and reliability of its use. This paper describes the results of such a study conducted as a preliminary to the use of ICHPPC-2-Defined in a study of consulting patterns in general practice. The participating general practitioners were trained in the use of ICHPPC-2-Defined and then coded problems which they identified in a set of clinical vignettes. Following the coding exercise, a review session was held in which difficulties and errors in the use of ICHPPC-2-Defined were discussed. Subsequently, the general practitioners were required to code two more sets of vignettes, which included some problems repeated from the preceding sets. Comparisons were then made of changes in the validity and reliability of coding from one round to the next. The results of the study suggest that the reliability and validity of morbidity data collected using ICHPPC-2-Defined can be increased by training sessions for the coders which focus on the main sources of error in the use of ICHPPC-2-Defined.(ABSTRACT TRUNCATED AT 250 WORDS)

Australia↗
PubMed1989

[Diagnosis and principles of treatment for fissure in ano].

The diagnosis of an anal fissure can be made definitively on the basis of history and inspection. Therapy aims to stop the vicious circle of increased resting pressure, decreased perfusion, pain and obstipation. Chronic fissures are complicated by an incomplete fistula-in-ano. It is treated by laying open the fistula and sphincterotomy.

Adult↗
PubMed1989

[Theory and practice of the application of rubber dam].

The application of Kofferdam offers a series of advantages for patients and medical personnel which especially speak well for an application in the preserving stomatology. Among other things, these advantages are: protection from aspiration, protection from infections, provision of an aseptic working place, keeping the soft tissues away, which results in an improved sight and easy access. Moreover, the application of Kofferdam enables by absolute drainage a material application in nearly due form. Besides the description of the application of Kofferdam, the article comprises practice-related recommendations facilitating the application of technique.

Dentistry, Operative↗
PubMed1988

[Surgical treatment of acute conditions of ulcerative colitis].

Acute complications of ulcerative colitis that require surgery are rare (toxic megacolon, 5-8%, perforation, 2-3%, massive hemorrhage less than 1%), but pose a high risk. Surgery within 48 h after the failure of intensive conservative treatment is decisive for success. Turnbull's procedure is still less risky than colectomy for toxic megacolon. In case of perforation colectomy is considered the standard procedure. Massive hemorrhage (greater than 2000 ml blood/24 h) always requires colectomy. Preservation of the rectal stump shortens the operation, lessens the trauma and allows reconstruction of the continence function by pouch-ileoanostomy.

Acute Disease↗