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PubMed2005

Mortality and morbidity in extremely preterm infants (22 to 26 weeks of gestation): Austria 1999-2001.

OBJECTIVE: The aim of this retrospective study was to analyze the mortality and morbidity for extremely preterm infants with a gestational age from 22 to 26 weeks. All infants were born in Austria during the years 1999-2001. METHODS: Data were collected from 16 neonatal intensive care units in Austria. Main outcome criteria were mortality, the rates of chronic lung disease (CLD) and severe retinopathy of prematurity (ROP, stage > or =3) to determine the short-term outcome; the rate of cerebral palsy (CP) at the corrected age of twelve months to assess the long-term outcome. RESULTS: Overall, 796 preterm infants with a gestational age less than 27 weeks were born in Austria and 581 (73%) were registered as live-born infants. Of those live born, 508 (87%) were analyzed. The mortality rates were 83%, 76%, 43%, 26% and 13% for 22, 23, 24, 25 and 26 weeks' gestation, respectively. The rates of CLD were 33% (22 weeks), 36% (23 weeks), 42% (24 weeks), 31% (25 weeks) and 22% (26 weeks). The rates of ROP of stage > or =3 were 0% (22 weeks), 29% (23 weeks), 23% (24 weeks), 18% (25 weeks) and 10% (26 weeks). The rates of CP at the corrected age of 12 months were 33%, 50%, 33%, 26% and 25% for 22, 23, 24, 25 and 26 weeks' gestation, respectively. CONCLUSIONS: The results of this national study are in accordance with the international literature: mortality and morbidity increased with decreasing gestational age.

Age Distribution↗
PubMed2000

Discrimination between clinically relevant and nonrelevant Acanthamoeba strains isolated from contact lens- wearing keratitis patients in Austria.

Eighteen cases of Acanthamoeba-associated keratitis among contact lens wearers seen at the Department of Ophthalmology, Karl-Franzens-University, Graz, Austria, between 1996 and 1999 are reviewed. The amoebae were proven to be the causative agents in three patients. The aim of our study was to discriminate between clinically relevant and nonrelevant isolates and to assess the relatedness of the isolates to published strains. Altogether, 20 strains of free-living amoebae, including 15 Acanthamoeba strains, 3 Vahlkampfia strains, and 2 Hartmannella strains, were isolated from clinical specimens. The virulent Acanthamoeba strains were identified as A. polyphaga and two strains of A. hatchetti. To our knowledge this is the first determination of keratitis-causing Acanthamoeba strains in Austria. Clinically relevant isolates differed markedly from nonrelevant isolates with respect to their physiological properties. 18S ribosomal DNA sequence types were determined for the three physiologically most-divergent strains including one of the keratitis-causing strains. This highly virulent strain exhibited sequence type T6, a sequence type not previously associated with keratitis. Sequence data indicate that Acanthamoeba strains causing keratitis as well as nonpathogenic strains of Acanthamoeba in Austria are most closely related to published strains from other parts of the world. Moreover, the results of our study support the assumption that pathogenicity in Acanthamoeba is a distinct capability of certain strains and not dependent on appropriate conditions for the establishment of an infection.

Acanthamoeba↗
PubMed1985

[Resistance of blood culture isolates in vitro to 4 aminoglycoside antibiotics in Austria--1982/83].

Over the period September 1982 to February 1983 268 blood culture isolates were consecutively collected in 4 microbiological laboratories in Austria (Linz, Vienna, Graz, Feldkirch) and 251 of these strains (streptococci excluded) were tested for resistance to Gentamicin (G), Tobramycin (T), Netilmicin (N) and Amikacin (A) using a microtitre broth dilution method. This investigation was part of an international study. Of the bacterial strains examined 57% were staphylococci (34% Staphylococcus aureus) and 43% gram-negative rods (18% E. coli, 17% other enterobacteriaceae and 5% Pseudomonas aeruginosa etc.). 25% of all strains tested were resistant to Gentamicin (MIC greater than 4 mg/l), 27% to Tobramycin (MIC greater than 4 mg/l), 6% to Netilmicin (MIC greater than 4 mg/ml) and 5% to Amikacin (MIC greater than 8 mg/l). The resistance rate of staphylococci was markedly greater towards Gentamicin (35%) and Tobramycin (39%) than Netilmicin (4%) and Amikacin (6%). The respective percentages of resistant gram-negative rods were considerably smaller, except in the case of Netilmicin (G 13%, T 11%, N 8%, A 4%). Regional differences were observed between Linz and Vienna in the resistance of staphylococci to Gentamicin (24% versus 49%) and Tobramycin (33% versus 53%). On a weight basis Netilmicin was the most active substance in combating nearly all groups of bacteria. Also in strains sensitive to the other aminoglycosides the MIC values of Netilmicin were considerably lower than for the other substances. A noteworthy feature in comparison with the results of other countries participating in this international study was the distinctly higher incidence of staphylococci among the blood culture isolates and the considerably higher percentage of aminoglycoside-resistant strains in Austria. Analysis of the data suggests that the high resistance rates among staphylococci are a consequence of selection by frequently used antibiotics. Hence, it appears essential to observe the development of aminoglycoside resistance in Austria closely and to recommend that these substances, of extreme value in the treatment of severe infections, should be used solely for the most stringent indications.

Aminoglycosides↗
PubMedDate not supplied

Employment status and its health-related effects in rural Styria, Austria.

BACKGROUND: Unemployment has become a serious social problem in industrialized countries. Job loss produces health-related disorders. Health-related data of the unemployed are scarce and prompted us to survey this group. METHODS: A database of a health survey conducted between 1989 and 1993 in 79 selected rural communities of Styria (Austria) was used to analyze risk factors and employment status. The sample consisted of 8,747 individuals, 345 unemployed and 8,402 employed. RESULTS: Risk behavior is higher among unemployed individuals than among those employed, particularly for males. Unemployed males were significantly less motivated to reduce weight and to change dietary habits than their counterparts, and they had significantly more anxieties, sleeping disorders, and lack of appetite. A similar pattern was found with regard to gastrointestinal and chronic liver and respiratory diseases. In addition, the unemployed utilized medical services more often. CONCLUSIONS: This is the first study on health-related indicators and unemployment status in Austria. Job loss implies health-related disorders. The effectiveness of reducing the morbidity of the population in general is also dependent on intervention programs focusing on the specific needs of this high-risk group, e.g., adapting primary health care to its needs and fostering social support networks.

Adult↗
PubMedDate not supplied

The prevalence of smoking in Austria.

BACKGROUND: A population-based cross-sectional study was performed to assess smoking prevalence in Austria and to compare the results with data from 1986. METHODS: A representative sample of Austrians (n = 2,400) who in 1995 were > or = 15 years of age was obtained. A total of 2,065 respondents were interviewed about their smoking habits. RESULTS: Approximately 31% of the population age > or = 15 are regular cigarette smokers, 12% are former smokers, 6% smoke occasionally, and 51% have never smoked. Among males, the prevalence of regular smoking increases with age and reaches its highest level between the ages of 25 and 34. The age distribution among female regular smokers shows a similar pattern, peaking in the same age group (35.7% smokers). No significant differences in smoking prevalence were found according to monthly household income, years of school, and number of inhabitants at place of residence. At the time of interview 45.7% of male and 20.9% of female regular smokers consumed > 20 cigarettes per day. Compared with data from 1986 the prevalence of regular smokers increased from 18.1 to 24.2% among females and from 35.5 to 38.9% among males. CONCLUSIONS: Smoking prevalence increased in Austria between 1986 and 1995 by 33.7% among females and by 9.6% among males. Patterns of smoking among females (prevalence and cigarettes per day) are approaching those of males.

Adolescent↗
PubMed2000

History of biotechnology in Austria.

Austria has contributed significantly to the progress of the biotechnologies in the past and is actively engaged in doing so today. This review describes the early history of biotechnology in Austria, beginning with the Vienna process of baker's yeast manufacture in 1846, up to the achievements of the 20th century, e.g. the submerged vinegar process, penicillin V, immune biotechnology, biomass as a renewable source of fermentation products (power alcohol, biogas, organic acids etc.), biopulping, biopolymers, biocatalysis, mammalian cell technology, nanotechnology of bacterial surface layers, and environmental biotechnology.

Acetic Acid↗
PubMed1994

Mortality from cancer of the head and neck, lung and esophagus in eastern Austria between 1960 and 1989.

In eastern Austria, mortality from cancer of the mouth and pharynx, larynx, esophagus and lung between 1960 and 1989 developed differently by site and gender. In males, a decrease in lung cancer contrasted with an increase in mouth/pharynx cancer, while rates for cancer of the larynx and esophagus changed only slightly. At all sites, similar double-wave shaped cohort effects were discernible, with a period of decreasing risk separating two periods of increasing risks. The extents of these cohort effects, especially in the later rise of mouth/pharynx neoplasms, shaped the respective mortality curves. In females, lung cancer was found to increase over the whole period, while mouth/pharynx cancer increased during the last decade with risks increasing from cohort to cohort. Larynx rates became somewhat greater during the last two decades. Esophageal cancer demonstrated a steady decrease. For tobacco-related cancers, deglutitional sites were affected in a growing proportion. The combined topical effects of tobacco and alcohol suggest an increasing influence of the co-factor alcohol upon the occurrence of upper aerodigestive cancers in eastern Austria.

Adult↗
PubMed1994

Prevalence of antibodies against Toxoplasma gondii in pigs in Austria--an evaluation of data from 1982 and 1992.

To obtain information on the prevalence of antibodies against Toxoplasma gondii in pigs in Austria, 4697 blood samples from pigs were collected in the years 1982 and 1992 and tested by an indirect fluorescence antibody test. The results of the studies show that due to modern fattening systems the prevalence of infections with T. gondii in slaughtered pigs has obviously decreased in Austria during the last 10 years. The investigations indicate a significant difference in the rate of infection of pigs between 1982 (13.7%) and 1992 (0.9%). Additionally, the prevalence of T. gondii antibodies in breeding sows (1982, 43.4%; 1992, 4.3%) was higher than that in fattening pigs (1982, 12.2%; 1992, 0.8%).

Animal Husbandry↗
PubMed1992

Tobacco-related cancer in relation to prevalence of drinking and smoking in eastern Austria.

Eastern Austrian regional mortality patterns of oral cancer (oral cavity, pharynx and larynx) and oesophageal, lung and urinary bladder cancer were compared to smoker rates and to liver cirrhosis mortality by type of residence: Vienna (1.7 x 10(6) inhabitants), middle towns (50,000-100,000 and 10,000-50,000 inhabitants), small towns (2000-10,000 inhabitants) and rural areas categorized by agrarian quota less than or equal to 10%, 10%-20% and greater than 20%. The study area (Vienna, Lower Austria and Burgenland) covers 23,600 km2 with 3.23 x 10(6) inhabitants. In men, liver cirrhosis correlated negatively with smoker rates (r = 0.74, P = 0.1). Deaths from oral cancer and oesophageal cancer correlated significantly with deaths from liver cirrhosis (r = 0.81, P = 0.03; r = 0.78, P = 0.04, respectively) but not with smoker rates; lung cancer and bladder cancer correlated significantly with smoker rates (r = 0.91, P = 0.01; r0.83, P = 0.04, respectively), but not with liver cirrhosis. In women, similar urban-rural gradients for all parameters resulted in a positive correlation between liver cirrhosis and smoker rates (r = 0.59, P = 0.22) and a significant correlation of lung cancer with liver cirrhosis (r = 0.75, P = 0.05). Oral cancer correlated significantly with liver cirrhosis (r = 0.83, P = 0.02), but not with smoker rates; lung cancer correlated more significantly with smoker rates (r = 0.92, P = 0.01) than with liver cirrhosis; bladder cancer correlated positively with smoker rates (r = 0.70, P = 0.12). Geographical distribution of oral and oesophageal cancer in Eastern Austria seems thus to be highly subject to the prevalence of heavy drinking. Sociocultural influences upon the occurrence of these cancers seem to be mediated through drinking habits rather than through smoking habits alone.

Adolescent↗
PubMed1995

Historical regional patterns of infant mortality in Austria.

"First an overview is given of the secular decline of infant mortality in Austria between 1820 and 1950.... Second the study analyses the historical regional differences of infant mortality in Austria comparing data for all 99 political districts (Politische Bezirke) for the period 1900 to 1950. The most important results are: At the turn of the 19th century infant mortality rates were generally lower in Alpine than in non-Alpine regions and lower in cities than in their surrounding areas. This geographical pattern which remained constant until the 1950s was solely determined by differences in post-neonatal mortality rates. Plausible explanations for these regional differences are discussed." (SUMMARY IN FRE)

Austria↗
PubMed1997

[Hospitalization of young women after selected cardiovascular and thromboembolic incidents in Austria 1993 and 1994].

The aim of this study is to describe the hospitalization and regional distribution of selected cardiovascular and thrombo-embolic events (cardiac infarction, cerebral strokes, deep vein thromboses, pulmonary embolism) of young women in Austria in the years 1993 and 1994, and to collect basic epidemiologic data for the study of the side effects of oral contraceptives. The calculated hospitalization rates are based on the Austrian hospitals' discharge records of 1993 and 1994. The persons concerned are women aged between 15 and 44 who live in Austria. The results of the study reveal that--in 1993--of the above mentioned group 51 out of 100,000 inhabitants were hospitalized because of the selected cardiovascular and thromboembolic events: 4/100,000 had a cardiac infarction, 5/100,000 had a stroke, 17/100,000 had a pulmonary embolism, and 27/100,000 suffered a deep vein thrombosis. In 1994 the counted cases per 100,000 inhabitants were 48, out of which 4/100,000 where cardiac infarcts, 5/100,000 strokes, 16/100,000 pulmonary embolism, and 25/100,000 deep vein thromboses.

Adolescent↗
PubMed1992

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↗
PubMed2003

[Adverse effects of non-steroidal anti-inflammatory drugs. A prevalence study in Austria].

OBJECTIVE: Gastrointestinal side effects are the limiting factor in the prescription of non-steroidal antirheumatic drugs (NSAID). However, there are no recent data from Austria. The aim of this prevalence study was therefore to assess the gastrointestinal risk from NSAID in Austria. METHODS: A total of 1347 patients were observed in an outpatient setting between March 2000 and February 2001. Side effects from NSAID were documented by questionnaire at two time points with a mean interval of 31 days. Documented data were analysed descriptively using an explorative strategy. The prevalence of side effects was compared to data from literature. RESULTS: Side effects were reported by 18.1% of the patients, severe gastro-intestinal complications (ulcer, bleeding, perforation) were diagnosed in 0.7%. Prescription of effective GI-protection (proton pump inhibitors, misoprostole, famotidin in high dose) was seen in only one third of the patients at risk. CONCLUSION: The prevalence of severe gastrointestinal side effects by NSAIDs assessed in our study was clearly lower than the prevalence reported in the Anglo-American literature. This may be due to a different prescription behaviour: about 75% of the patients took Diclofenac, lbuprofen or Meloxicam, drugs which have a very low potential of gastrointestinal complications. However, more information for general practitioners is needed yet to sufficiently protect patients at gastrointestinal risk from NSAID.

Adult↗
PubMed2003

First documented case of human granulocytic ehrlichiosis in Austria.

We report the first documented case of human granulocytic ehrlichiosis (HGE) in Austria. The infection was acquired near Arzl in the surroundings of Innsbruck in northern Tyrol. Except for a biphasic course of illness, presentation in this 33-year-old female patient was comparable to clinical findings observed in other European adults with high fever, transient thrombocytopenia, elevated levels of CRP and LDH, arthralgias, myalgias, fatigue and subfebrile temperature. Flu-like symptoms started about seven days after a tick bite and lasted for ten days, followed by an asymptomatic interval of three days and an acute onset of fever up to 39.5 degrees C on day 20. On admission, the patient showed high antibody titres against Anaplasma phagocytophilum (IgG 1:1024, IgM 1:640); six weeks later the IgG-titre had risen to 1:2048, and IgM-levels had fallen below 1:40. The demonstration of anti-platelet antibodies in acute-phase serum was noteworthy. We conclude that also in Austria HGE should be considered in patients with febrile thrombocytopenia, especially when the medical history reveals recent tick exposure.

Adult↗
PubMed2003

Pain and stress management in the Neonatal Intensive Care Unit--a national survey in Austria.

UNLABELLED: Neonates are sensitive to pain and vulnerable to both its short-term and long-term effects. Management of analgesia is thought to be hampered by lack of awareness that newborns are capable of experiencing pain and by fears about adverse effects associated with analgesics. The purpose of this study was to assess current medical practice in preventive analgesia and sedation in the neonate throughout Austria. This report details the results of a survey in 28 neonatal intensive care units (NICUs) in Austria. Data collection took place from October to December 2001. All NICUs reported the capability of newborns to experience and express pain and nearly all stated the possibility of pain affecting morbidity. Validated scores for pain assessment were used by 11% of NICUs, standardized protocols for analgesia existed in 75%, and 100% practiced non-pharmacological treatment strategies. The use of preventive measures in routinely performed painful procedures ranged from 8% to 96%. For example, only 8% of NICUs prevent distress and pain prior to umbilical vessel catheterization, 29% prior to subcutaneous injections and 46% prior to heel lancing. Nearly all NICUs apply analgesia before lumbar puncture and thoracic-drain placement, and all use analgesic and/or sedative medication in elective intubation. CONCLUSION: There is widespread awareness among neonatologists of the importance and effects of distress caused by pain in newborns. However, the necessity of providing sufficient analgesia is underestimated. Further information on the safety of analgesic drugs in neonatology is imperative.

Analgesics↗
PubMed2006

[Current state of research on migration in Austria. A brief review].

Although Austria has been the aim of immigration for many years, research in the field of migration and integration is not yet established. Of the Austrian population, 9.6% have foreign citizenship and the proportion of the migrant population is highest in Vienna, where it is 18.0%. In 2002 a population register system was implemented in Austria which allows a more detailed description of migration processes and a differentiation of population by citizenship and country of birth. In social science and public health research as well as in official statistics and surveys the item of migration is not given sufficient consideration. On a political level, especially in Vienna, a comprehensive strategy of integration and diversity is being increasingly regarded as essential, and federal health policy has recently also focused on the health of migrants. In the future migration will hopefully be re-evaluated as the need for a humanitarian approach is recognized but also the benefits from migration in cultural, economic and demographic affairs are better appreciated and research is allowed to play an appropriate role in this process.

Acculturation↗
PubMed2006

[The system of continuing professional education of medical doctors in Austria. Structure, guidelines and quality management].

This article describes the system of continuing medical education in Austria. Pursuant to section sign 49 para.1* of the Austrian Medical Law 1998/Amendment 2001, Austrian doctors are under the obligation to participate in continuing professional education according to the guidelines of the Austrian Medical Chamber. The Austrian doctors see themselves as members of an independent profession. The Austrian system of continuing (physician) professional education developed continuously, for one, based on the principle of self-responsibility of licensed doctors and for the other, on the responsibility for self-administration of the medical profession. The participation in CPD or CME events, which are quality assured by a given set of rules, is documented by a time-limited diploma issued by the Austrian Medical Chamber. The recognition system comprises CPD-CME events in Austria as well as abroad, literature study under specific rules including an assessment system and the use of electronic media. The CPD-CME guidelines are updated annually by the Austrian Medical Chamber. The permanent maintenance and administration of the CPD-CME Programme of the Austrian Medical Chamber (Diplom-Fortbildungs-Programm, DFP), was handed over to the Austrian Academy of Physicians, which is under the obligation to report to its founding body, the Austrian Medical Chamber.

Accreditation↗
PubMed2004

[Health care costs of multiple sclerosis in Austria. Cross-sectional study including consideration of quality of life].

A retrospective, cross-sectional study was performed to evaluate direct and indirect costs related to multiple sclerosis (MS) in Austria in a representative cohort of patients ( n=895) with typical symptoms. Demographic, socioeconomic, and disease-related data including degree of disability and health-related quality of life as well as consumption of medical and nonmedical resources were recorded and mean total costs per patient and year were calculated (based on 1999 figures). Total direct costs borne by public sources were 15,684 euro per MS patient per year. Overall societal costs increased disproportionately with the progression of the disease, from 12,990 euro per year in patients with mild disability to 69,554 euro per year in patients with severe disability. Increasing disability was reflected by substantial deterioration of health status-related quality of life. Direct costs of MS in Austria are similar to those in other countries.

Adult↗