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Biomedical subjects

A Raber

Publications and source records attributed to A Raber.

At least 19 recordsLinked to original sources
PubMed2004

Late pulmonary valve replacement after correction of Fallot's tetralogy.

BACKGROUND: The aim of this study was to investigate necessity and outcome of late pulmonary valve replacement (PVR) after repair of tetralogy of Fallot (TOF). METHODS: Hospital records from patients operated on for TOF at our institution between 1960 and 2002 were reviewed and patients were interviewed by questionnaires. RESULTS: Out of 411 long-term survivors after TOF-repair, 47 (11.4 %) patients required reoperation after 13.2 +/- 7.4 years. Preoperative right ventricular (RV) dilatation was present in 36 (76.6 %) patients including 16 (34 %) with impaired RV function. Isolated PVR was performed in 12 patients (25.5 %). Additional procedures were necessary in 35 patients (74.5 %), including closure of residual defects (VSD, n = 11), tricuspid valve replacement (n = 1) and repair (n = 3). Obstructive right ventricular or pulmonary artery lesions (34 patients, 72.3 %) were all surgically addressed. RV pressure decreased from 61.1 +/- 27.7 to 42.9 +/- 13.3 mm Hg (p < 0.01) after PVR. RV size was reduced and RV function improved compared to preoperative values. Early mortality after reoperation was 2.1 % (n = 1) with one patient dying from biventricular failure. There was no late mortality. CONCLUSIONS: PVR after Fallot repair is frequently required because of progressive RV enlargement with dysfunction. It can be performed with relatively low risk, even in the setting of multiple reoperation. Obstructive lesions (RVOTO, PA stenosis) and residual defects are frequently observed in patients needing late PVR and may play a crucial role in the development of RV failure. Timely valve replacement with repair of all obstructive lesions proximal and distal to the implanted valve is the key to preserving RV function.

Adolescent↗
PubMed1996

The efficacy and tolerability of aceclofenac compared to indomethacin in patients with rheumatoid arthritis.

The efficacy and tolerability of aceclofenac (100 mg bid; n = 109), a new non-steroidal anti-inflammatory agent, was compared to that of indomethacin (50 mg bid; n = 110) in a multi-centre, 12-week, randomized, double-blind clinical trial in patients with rheumatoid arthritis. The efficacy of aceclofenac, on the basis of several clinical features characteristic for rheumatoid arthritis, was comparable to that of indomethacin. Patients in both treatment groups showed a notable and significant improvement during the study. Under aceclofenac treatment, the number of painful and swollen joints decreased by a median of six and nine, respectively, morning stiffness was shortened by 1 h, and the grip strength of both hands increased by a median of 8 mmHg. Pain at rest was relieved in 65.3% of aceclofenac-treated patients and in 67.1% of those treated with indomethacin (n.s.). With regard to safety, aceclofenac tended to be better tolerated than indomethacin. Among the 109 aceclofenac-treated patients, 26 incidents of adverse effects due to the drug were noted in 20 patients (18.4%). Sixty-four incidents of adverse events were documented in 32 (29.1%) of the 110 patients treated with indomethacin. The most common adverse events reported during treatment with aceclofenac were heartburn (four patients) and vertigo (three patients).

Alanine Transaminase↗
PubMed1996

The efficacy and tolerability of aceclofenac in the treatment of patients with ankylosing spondylitis: a multicenter controlled clinical trial. Aceclofenac Indomethacin Study Group.

OBJECTIVE: To evaluate the efficacy and tolerability of aceclofenac, a new nonsteroidal antiinflammatory drug, in patients with active ankylosing spondylitis (AS). METHODS: 310 outpatients with active AS were enrolled in a 3 month, multicenter, parallel, double blind trial and were randomly assigned to receive aceclofenac (200 mg daily) or indomethacin (100 mg daily). They were evaluated after a washout period of 7 days, at baseline, 15, 30, 60, and 90 days. RESULTS: No significant differences were found between aceclofenac and indomethacin in the number of withdrawals due to lack of efficacy or adverse events. A repeated measures analysis (ANOVA) of patients who completed the trial showed no significant differences between either treatment. Within-group comparisons in an intention-to-treat analysis showed improvement (p < 0.05) in all the primary efficacy variables: pain visual analog scale (VAS) (37 vs 41%), morning stiffness (51 vs 46%), modified Schober's test (21 vs 16%), C7-iliac crest line distraction (11 vs 14%), lateral spinal flexion (6 vs 10%), in aceclofenac and indomethacin treated patients, respectively. Other variables including chest expansion, occiput-to-wall, Likert pain score, use of analgesic rescue, and patient and physician global assessment, also showed significant improvement from baseline values. No significant differences between treatments were noted for any efficacy variable. Good to excellent improvement in pain (52 vs 64%) and morning stiffness (70 vs 68%) was observed in aceclofenac and indomethacin treated patients, respectively. Patients taking aceclofenac had significantly fewer central nervous system related adverse events than patients treated with indomethacin (p < 0.001). CONCLUSION: Aceclofenac and indomethacin did not differ with respect to efficacy in the treatment of active AS, although aceclofenac was slightly better tolerated.

Adult↗
PubMed1992

Hearing loss from industrial noise, head injury and ear disease. A multivariate analysis on audiometric examinations of 110,647 workers.

From compulsory screening examinations of 260,917 noise-exposed workers standardized audiograms as well as medical and occupational histories of 110,647 workers were selected because of full-time exposure to well-defined noise greater than 85 dB (A) and analyzed by loglinear and multiple linear regression. The most important factors for prediction of pure-tone hearing loss at 4 kHz were found to be age, sex and noise immission level. For predicting speech impairment and handicap the history of ear disease, head injury and tinnitus were more important than noise immission level. Dose-response relationships are given to improve prevention and compensation of hearing loss from combined factors.

Adolescent↗
PubMed1992

[Impact noise and hearing. A study from audiometry screening in noisy occupational environments].

The hearing loss of 46,776 subjects exposed to hazardous impact or continuous noise was measured: 11% were exposed to impact noise (10.3% in men, 12.7% in women). Impact noise causes less hearing loss than continuous noise up to a noise emission level (NIL) of 115 dB(A). This result is still compatible with the concept of equivalent continuous A-weighted sound pressure level (LA,eq) and seems to be caused by the protective effect of the stapedius muscle. However, at emission levels higher than 115 dB(A), not covered by ISO 1999 prognosis, impact noise becomes more detrimental. This could be the effect of mechanical damage to the organ of Corti, as observed in animal experiments at sound pressure levels exceeding 114 dB(A). A diminishing protective function of the stapedius muscle could explain the more serious hearing impairment after long exposure to impact noise compared with shorter exposures to an equal dose. Since the hearing loss caused by impact or continuous noise is clearly different in the highest NIL ranges, safety criteria for impact noise should be revised. The NIL defined by Burns and Robinson underestimates the effect of the exposure time for impact noise.

Adolescent↗
PubMed1991

Risk factors for hearing loss at different frequencies in a population of 47,388 noise-exposed workers.

Weighted regression analysis was applied to determine the dependence of the hearing thresholds of 47,388 noise-exposed workers on age, sex, noise immission level, ear disease, head injury, tinnitus, hearing protector usage, and audiometric frequency in the range from 0.5 to 6 kHz. It could be shown that the hearing thresholds at any frequency are dominated by the age of the worker and that women, after equivalent exposure conditions, hear better than men. The relative effects of sex, noise immission level, ear diseases, tinnitus, and hearing protector usage are related to the audiometric frequency. Users of hearing protectors at the last audiometric investigation hear worse than nonusers. Hearing protector usage is strongly related with the hearing threshold in the low-frequency range. The noise immission level does not noticeably affect the hearing threshold below 3 kHz. The most important frequency of the noise immission level is as expected 4 kHz. For 4 kHz, it was shown that the variables age, noise immission level, tinnitus, head injuries, and ear diseases act in a good approximation additively on the pure-tone hearing threshold.

Adolescent↗
PubMed1983

[Different selection rates--fallacies in epidemiological studies].

Practical examples from preventive and curative medicine are given to demonstrate how competing selection rates distort the results of epidemiological studies. In order to quantify this distorsion the bias is tabulated and graphed for different combinations of features (diseases, symptoms, findings, etc.) on the one hand and different admission or participation rates on the other hand. With the help of a formula which can be stored in a pocket calculator the sample bias can be quantified also. Prerequisite is the estimation of selection rates. They have such a bearing on the results of epidemiological studies that it is advisable to ask two questions before any interpretation: 1. which factors can lead to different admission rates in the groups (A,B) under study and 2. which factors can lead to different admission rates of persons with and without the feature (X) under study.

Asbestosis↗
PubMed1979

[Silicotuberculosis in Austria and the industrial injuries act (author's transl)].

The case material comprising all persons who developed silico-tuberculosis since it was listed as an occupational disease almost 50 years ago is analysed. The relationship between various occupations and the incidence of silicosis is reviewed with special reference to the most exposed group: the wokers in the granite quarries of Upper Austria. The changes in the clinical picture of the lesion, legal aspects, diagnostic difficulties in distinguishing between silicosis with or without complicating tuberculosis are discussed.

Adult↗
PubMed1978

[Endemic pleural plaques and environmental factors (author's transl)].

In an agricultural town in Burgenland (Austria) we found an increased prevalence of pleural plaques. These calcifying thickenings of the pleura are related to minimal asbestos exposure such as is mesothelioma, but they cannot be regarded as a precancerosis. The increased occurrence of pleural plaques in this town of nearly 3500 inhabitants (in which during 1916 to 1945 asbestos was mined) we first found at the chest x-ray archives of a pulmologic hospital, then by mass radiography and blind comparison with control groups. A photofluoroscopy of 300 persons yielded 16 cases with definite pleural plaques (5.3%) among which were 4 cases with suspected asbestosis and another 14 cases with uncertain pleural plaques (4.7%). The 600 control persons showed no such radiological changes. Interviews wich persons detected for pleural plaques at mass radiography gave no indication that they had occupational asbestos exposure. But asbestos was detected in the soil of vineyards and in the dust of the houses. Asbestos was also detectable in the atmospheric dust by x-ray diffraction and scanning electron microscopic techniques.

Asbestos↗