Biomedical subjects

A Thöni

Publications and source records attributed to A Thöni.

8 recordsLinked to original sources

PubMed2005

[Water birth and neonatal infections. Experience with 1575 deliveries in water].

AIM: The aim of our study is to provide an answer on the advantages offered by water births, to compare them with 2 other delivery positions and to analyse the pathogenous microorganisms present in the water from the bath. METHODS: We compared 725 primiparae deliveries in water, 407 primiparae deliveries in bed and 142 on the delivery stool over the last 7 years. We evaluated the duration of labour, perineal trauma, arterial cord blood pH, shoulder dystocia and postpartum maternal hemoglobin levels. We have evaluated 200 water samples, taken from the bath after filling it and after delivery, and analyzed the pathogenous microorganisms and the possibility of neonatal infections. RESULTS: The duration (first stage) of labour and the rate of episiotomies was significantly reduced in primiparae delivering in water compared with the other delivery positions. Nevertheless, the percentage of perineal trauma was not increased. There were no differences in the duration of the second stage and arterial umbilical cord blood pH. Postpartum maternal hemoglobin levels remained unchanged. No woman delivering in the water required analgesics. Infections after water births do not occur more frequently than after traditional births. CONCLUSIONS: Our results show that water birth has major advantages compared with traditional delivery methods. It is associated with a significantly shorter first stage of labour, a lower episiotomy rate and reduced analgesic requirements when compared with other delivery positions. Provided that the women are selected appropriately, and the hygiene rules are respected, water birth is safe for mother and neonate.

Bacterial Infections↗

PubMed2001

[Birth in water. A comparative study after 555 births in water].

BACKGROUND: The object of our study is to research into the quality of the different delivery positions, offered in our hospital with special focus on the advantages for birth in water. METHODS: From February 1997 to 1 October 2000 we do research retrospectively on data of 555 deliveries in water, 320 on the traditional bed and 125 on the delivery stool give us the possibility to investigate about duration of birth, rate of episiotomies and perineum lacerations, consumption of painkillers, arterial umbilical cord pH and haemoglobin postpartum. RESULTS: In our comparing analysis of the duration of birth we could show a relevant reduction especially for primiparae which had delivered in water. The reduction is only significant for the first part of labor (360 minutes in the pool, 445 minutes on the traditional bed and 420 minutes on the stool) whereas there is no difference for the second part of labor. The significant reduction on episiotomies (1%) in comparison to the one on the traditional bed (20%) or on the stool (10%) for primiparae in water doesn t mean an increase at perineum lacerations. (each 25%). In water we saw no lacerations/injuries of the perineum for 58% of primiparae, on the traditional bed 36% and on the stool 43%. No woman in labour needed a painkiller in the pool. There was no difference found between the three groups referring to the arterial umbilical cord pH or the haemoglobin postpartum. CONCLUSIONS: Our study shows relevant medical advantages for a delivery in water: and a significant reduction of the duration of the first part of labour, significant less episiotomies and perineum lacerations and no need for painkillers. The security of the neonate is guaranteed under attention to the known contraindications.

Adolescent↗

PubMed1995

[Cardioprotection in chemo- and radiotherapy for malignant diseases--an echocardiographic pilot study].

AIM: Pilot study, examining the cardioprotective effect of an antioxidant regimen in patients with malignancies receiving high dose chemo- or radiotherapy. PATIENTS AND METHODS: 14 patients with chemotherapy and 10 patients with radiotherapy were randomized in a double-blind fashion (placebo versus vitamin E and C and N-acetylcysteine). Systolic and diastolic echocardiographic parameters were determined before and within three weeks of treatment completion. RESULTS: Left ventricular ejection fraction fell significantly in patients receiving placebo (radiotherapy: 67 +/- 6 to 56 +/- 2%, p = 0.008, chemotherapy: 67 +/- 7 to 60 +/- 8%, p = 0.05). Patients on antioxidants showed no significant fall in EF (radiotherapy: 63 +/- 8 to 61 +/- 7%, chemotherapy: 67 +/- 5 to 64 +/- 6%). CONCLUSION: The small number of patients in the study precludes a definitive statement. The preliminary results, however, suggest efficient cardioprotection by this cheap and safe antioxidant combination, so that larger studies are warranted for confirmation.

Acetylcysteine↗

PubMed1993

Prognosis of human chorionic gonadotropin-producing seminoma treated by postoperative radiotherapy.

PURPOSE: To clarify the controversy about the management and prognosis of human chorionic gonadotropin-producing seminoma, the records of 132 patients with abnormal human chorionic gonadotropin values treated with radiotherapy were analyzed. METHODS AND MATERIALS: The records of 1169 patients with pure seminoma treated in 10 institutions were screened for serum or urinary human chorionic gonadotropin. One hundred and thirty two patients with elevated human chorionic gonadotropin were found: 96 Stage I, 20 IIA, 7 IIB, 8 III and 1 IV. Median age was 34 y., mean follow-up was 5.0 years [range 1-12 y]. All received infradiaphragmatic radiotherapy (median dose 30 Gy), 25 (2 Stage I, 11 IIA, 5 IIB and 7 III) supradiaphragmatic radiotherapy (median dose: 28.5 Gy) and 10 had also initial chemotherapy (3 Stage IIB 6 III and 1 IV). Patients were allocated to three groups according to human chorionic gonadotropin values: (a) moderate elevation: up to 10 times (104 pts), (b) high elevation: 10 to 100 times (20 pts), (c) very high elevation: over 100 times the upper limit of normal value (8 pts). RESULTS: The proportion of Stage I, II and III was 76%, 19%, 5% in the ME group versus 50%, 35%, 15% in the high elevation group (p < 0.05). In the very high elevation group there were 7 Stage I and 1 Stage IV. Of 132 patients, six died (three dead of disease, two suicides, one acquired immunodeficiency syndrome). The 5 years overall survival probability was 94%. There were seven recurrences (initial stage: 1 Stage I, 2 IIB, 3 III and 1 IV). Of these, there were one in-field recurrence, 3 out of field and 3 in both sites. In 5 of 7, the human chorionic gonadotrophin level was again elevated at recurrence. The 5 years recurrence-free-survival probability was 94% (98% for Stage I, 100% for Stage IIA and 65% for Stage IIB and III [p < 0.001 between I and IIB + III, p < 0.05 between IIA and IIB + III]). Four of the 7 recurrences were salvaged by chimiotherapy +/- radiotherapy. In the high elevation and very high elevation groups, the 5 years recurrence-free-survival was 88%, vs. 96% for the moderate elevation group (p = 0.10). CONCLUSION: Based on this series of patients, human chorionic gonadotropin production is not an unfavorable prognostic factor in pure seminoma. Even in the subgroups with high or very high human chorionic gonadotropin levels (who had a higher proportion of advanced stages), the prognosis remained excellent. In Stage I and IIA seminoma with abnormal human chorionic gonadotropin levels, recurrence rate after post-operative radiotherapy alone is extremely low.

Adolescent↗

PubMed1985

Radionephrographic follow-up with hypertensive patients after angioplasty of renal artery stenosis.

Radionephrographies were performed in 23 hypertensive patients before and after 28 transluminal dilatations (PTD) of their stenosed renal arteries. The changing clearances for both kidneys (global = Clgl) and for stenosed and contralateral kidneys (Clst and Clco) were followed for three groups, dependent on their clinical outcome, as well as the parenchymal transit time (re-entry time) for the diseased (Rtst) and contralateral kidneys (Rtco): (A) Normalized hypertension: for 9 patients the preoperative Clco was never lower than 150 ml/min, but increased significantly after PTD. Rtst fell significantly, Rtco remained constant. Mean increase in Clgl = 91 ml/min (+25%). (B) Improved hypertension: in 12 patients Clst and Clco had been lower than with those in group A; postoperatively Clst increased, Rtst fell significantly. The Rtco was prolonged early after PTD but normalized later. (C) Permanent hypertension: for 7 of these patients there were no preoperative criteria for a discrimination against the other groups. But in all Rtst did not normalize, and Rtco increased early after PTD. Even in later examinations Rtco remained higher than preoperatively. These results imply that the success of PTD depends mainly on the behavior of the contralateral kidney. The examination 1 day after the PTD gives an optimal prognosis concerning the end result.

Angioplasty, Balloon↗

PubMed1983

Histiocytosis-X in gynecology.

(1) Histiocytosis-X can manifest itself in virtually every organ, but in gynecology it is an absolute curiosity. (2) Differential diagnosis must exclude specific and nonspecific ulcerations and granulations such as syphilis, tuberculosis, Boeck's disease, and also neoplastic processes like lymphomas, sarcomas, carcinomas, and malignant diseases of the hemopoietic system. (3) The diagnosis by light microscopy alone, as in our case, may be insufficient; therefore, electron microscopy should be used. As soon as the diagnosis is confirmed histologically, an extensive examination of all organs is necessary in order to establish an exact prognosis and an optimal plan of therapy. (4) Because of the unknown etiology of histiocytosis-X, a causal treatment is not yet possible. In spite of this, with a symptomatic, individualized therapy by means of excision, low-dose irradiation and cytotoxic agents a 5-year survival of 90% was obtained for the patients. (5) Because of its rarity and multidisciplinary character, histiocytosis-X is a challenge to interdisciplinary and interregional cooperation. Though not being a malignoma in the strict sense, diagnosis, therapy, and in part prognosis are not essentially different from a malignant disease.

Adult↗

PubMed1983

[Epidemiology of endometrial carcinoma in the tyrol].

The incidence rates of endometrial cancer during 1955-1980 were calculated for Tyrol and its political areas. The tumor registry of the Department of Obstetrics and Gynecology, University of Innsbruck, and the population statistics of the Austrian Central Office of Statistics were the sources of our data. We found a rising incidence although the increase was different in the various areas of Tyrol and during the time of observation. The age specific incidence rates were maximal in the age group 70 years and older in the last decennium of the observation time. The rising incidence of endometrial cancer can be explained partly by the changing age related structure of the population and by the better diagnostic efficiency, partly it is due to a factor which is not known until today.

Adult↗

PubMed1982

[Ectopic pregnancy: changes in diagnostic procedures? (author's transl)].

Patients with ectopic pregnancy and those suspected having ectopic pregnancy were reviewed in a twenty years interval (1957-59, 1977-79). These patients were evaluated with regard to medical history, clinical and laboratory findings, diagnostic procedures, and clinical course. The diagnostic usefulness of symptoms and diagnostic procedures is expressed in terms of sensitivity and specificity. According to our results laparoscopy is an ideal procedure for early diagnosis of ectopic pregnancy. Nevertheless, puncture of the Douglas pouch in our experience has its place as a diagnostic tool in the diagnosis of ectopic pregnancy.

Curettage↗