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Biomedical subjects

G Gerstner

Publications and source records attributed to G Gerstner.

At least 19 recordsLinked to original sources
PubMed1990

Ammoniated mercury ointment: outdated but still in use.

Although severe mercury-associated side effects, such as poisoning and high irritant and allergic potential, as well as the weak potency of mercury as an antiseptic or antipsoriatic agent, are well-known, topical mercury preparations are still listed in several pharmacopoeias, including that of the United States, UK and several other European countries. Thus, topical mercurials are still in use, even though more effective and less toxic drugs are now available. We report 2 cases of severe allergic reaction to ammoniated mercury and hope, in agreement with the pertinent literature, to contribute to its removal, and that of most other mercurials, from the therapeutic armamentarium.

Administration, Cutaneous↗
PubMed1987

Pap screening in Austria.

In view of the efficacy of the pap-smear, particularly little advantage is taken of this early detection test: only 35% of Austrian women (over 20 years of age) go to at least one gynecological-cytological check-up per year. Previously when low participation in the pap-test program was analysed, mostly socioeconomic and psychosocial factors were taken into consideration, whereas less attention was given to what local preventive and curative services are being offered in this field. Hereby a structural lack of services offered to the target group of older women results in urban areas, because the elderly population primarily takes advantage of curative medical services offered through general practitioners, of whom, however, only 8-27% take smear tests. Regional low participation can also be found in rural areas, due to the lack of preventive behaviour of the rural population regarding prevention. Based on these results, increasing health information through the physician and improving his motivation to take the smear test seem to be a purposeful strategy for increasing participation in the pap-test program.

Adult↗
PubMed1986

[Does radiosterilization of the vagina occur through therapeutic radiation dosages?].

The endogenous genital flora is a major source of infections of the female genital tract, especially in patients with cervical or endometrial cancer. Until recently the "radiosterilisation of the vagina", respectively a prophylactic and/or therapeutic effect of irradiation (external high voltage as well as intracavitary-radium) concerning infections was postulated in the literature. This theory was disproved in a prospective clinical and bacteriological study covering 48 patients with advanced cervical cancer undergoing primary intracavitary radium-irradiation and 38 patients with inoperable endometrical cancer, undergoing primary Iridium-192-afterloading. Following intracavitary radium for cervical cancer some typical nosocomial pathogens like Streptococcus faecalis, Enterobacter, Klebsiella, Proteus and Pseudomonas were isolated significantly more frequently than before treatment. Likewise, the mean number of aerobic bacterial species increased significantly after irradiation. Also primary Ir-192 (afterloading) irradiation did not alter the frequency of isolation of the resident flora in endometrial cancer patients. Therefore, "radiosterilisation" of the vagina as result of radiotherapy does not exist.

Adenocarcinoma↗
PubMed1984

Self-healing strategies among schizophrenics: attempts at compensation for basic disorders.

New experimental findings show that schizophrenics, as well as some of their non-schizophrenic relatives, manifest basic cognitive disorders defined in terms of variables from the field of experimental psychology. These basic disorders can be regarded as markers--if not, indeed, as psychological manifestations--of vulnerability to schizophrenia. They can be associated with subjectively experienced forms of non-clinically manifest impairments in psychological functioning. It was therefore hypothesised that schizophrenics, as well as non-schizophrenic subjects vulnerable to schizophrenia, will, in the course of learning processes, develop compensatory efforts which may be more or less effective. It is assumed that effective efforts of this kind will take on special significance in stress situations which would tend to elicit the occurrence of a schizophrenic episode. Effective efforts at compensation for basic disorders should be able to act as a 'buffer' against negative stressor effects (moderator function), thus reducing the danger of a psychotic breakdown. These compensation efforts were studied in 40 inpatients in remission after an acute schizophrenic episode. It was found that significant correlations exist between the extent of subjectively experienced basic disorders and the number and kind of conscious compensation attempts. Although the findings to date are of a preliminary and purely descriptive nature they would seem to justify further research.

Adaptation, Psychological↗
PubMed1983

[Radiotherapy of recurrences of endometrial carcinoma].

In a retrospective study the data of 79 patients undergoing radiation-therapy for recurrent endometrial cancer during the years 1972-1978 were evaluated. Group I consisted of 43 patients, who primarily underwent irradiation, group II consisted of 36 patients, who primarily underwent surgery (total abdominal hysterectomy) mostly without irradiation. All patients were primarily classified as FIGO-stage I, the median age was 69 and 67 years respectively. In 32 cases (74%) of group I the localisation of the recurrence was the uterus, in 8 (19%) the vagina and in 3 (7%) the small pelvis. In group II a vaginal recurrence was found in 25 patients (69%), in 11 (31%) a pelvic recurrence. In two thirds of all cases the recurrences were diagnosed within three years of the primary treatment. Late recurrences after 5 years occurred in group I in 10%, in group II twice as often. The treatment of all recurrences was irradiation. 54 patients (68%) died within 2 years, 25 survived their recurrence for more than 2 years, (32%). In group I 23% survived for more than 2 years, in group II 42%. At the time of performance of the study the 5-year-survival-rate is 13%. Thus in two thirds of patients we succeeded in extending the survival for at least 2 years. The prognosis of a recurrence following surgery is distinctly better than following primary intracavitary irradiation. 56% of vaginal recurrences following primary surgery survived more than 2 years. The 5-year-survival-rate was similar in these vaginal recurrences however to the uterine recurrences following primary irradiation. The prognosis of patients undergoing primary surgery was the better, the later the recurrence occurred.

Aged↗
PubMed1983

[Breast feeding habits before and after the introduction of a partial rooming-in system].

From January 1981 to May 1982 a prospective study was conducted investigating the breast-feeding patterns following the introduction of a partial rooming-in-system in 1978. The present data were compared to a previous survey from the period before 1977. The incidence of breast-feeding increased over that time from 67% to 86,6%. Accordingly the rate of non-breast-feeding mothers decreased from 33% to 13,4%. In 10% of these mothers lactation-inhibition was carried out with drugs and in 3,4% a severe hypogalactia was found. The lactation-inhibition was carried out in 80% for maternal and in 20% for neonatal reasons. Concerning the maternal causes one-third of the mothers did not want to breast-feed; other predominant causes were severe hypogalactia, adoption of the baby, maternal diseases, breast-feeding problems following preceding deliveries and single cases of mastitis and state after mamma-surgery. Among the neonatal reasons prematurity was predominating, followed by antenatal fetal death and perinatal death, malformations and diseases of the infant. Our results suggest, that the introduction of a partial rooming-in led to an increase of the incidence of breast-feeding at our department. Certainly, however, also the current trend back towards breast-feeding has contributed to these results. Nevertheless, we believe that much could still be improved by more adequate medical advice, which should start during pregnancy already. A reasonable promotion of breast-feeding should be the concern of all obstetricians today.

Breast Feeding↗
PubMed1982

[Vulvovaginitis in childhood. Experiences in a pediatric-gynecologic clinic].

Vulvovaginitis was diagnosed in 43% of more than 1000 gynecologic-pediatric patients. The etiology, the diagnosis and the treatment of nonspecific as well as of specific infections are discussed according to the frequency of occurrence during the different hormonal (endocrinological) periods. An easy and practicable application of diagnostic and therapeutic measurements is of importance for the treatment of this most common disease in gynecologic pediatric patients.

Child↗
PubMed1982

[Anaerobic microflora of praepubertal children (author's transl)].

Bacteriologic cultures of the vagina and the cervix of 38 praepubertal children, aged 3 months to 16 years (average age 9 years) from the outpatient department for infants and juveniles of the 1st Department of Obstetrics and Gynecology of the University of Vienna were obtained vaginascopically using anaerobic transportmedia (Port a Cul) and were examined for aerobic and anaerobic bacteria. An average of 5.3 species was also isolated per child (2.9 aerobic and 2.5 anaerobic species). The commonest anaerobes were Peptococcus, Peptostreptococcus, Bact. melaninogenicus, Proprionibacterium and Veillonella parvula, the prevalent aerobes, were Enterococci, E coli and Staphylococcus epidermidis. Our results suggest that anaerobic bacteria amount a significant component of the flora of the lower genital-tract of healthy children, as well as of infants with vaginal discharge.

Adolescent↗
PubMed1982

[Prognostic value of haematocrit in cases of severe EPH gestosis (author's transl)].

Haematocrit values were determined in 48 of 65 women hospitalised for severe EPH gestosis in 1979. Values in excess of 38 per cent were recorded from two thirds of the probands. An unambiguous correlation also was found to exist between gestosis severity, as reflected in gestosis index, and haematocrit values. False negative findings were obtained merely from mild cases, whereas false positive findings could be eliminated by repetitive measurement and resulting trend projection. -- Correlations were found to exist also between foetal outcome and elevated blood viscosity. These findings were likely to suggest that while classical gestosis symptoms might be aggravated by rise in haemoconcentration, via reduced perfusion resistance and increased peripheral vascular resistance, such higher haemoconcentration might deserve more attention for prognostication.

Adolescent↗
PubMed1982

[Vaginal bacterial flora of patients with operated endometrial carcinoma prior to and following intracavitary vaginal irradiation (Ir-192, afterloading)].

In a prospective bacteriological and clinical study the vaginal bacterial flora of 35 patients with endometrial carcinoma, who underwent surgery 4 to 6 weeks earlier, was investigated prior to and following intracavitary vaginal irradiation with 10 Gy in 0,75 cm(Ir-192, afterloading device, Buchler). Bacteriological swabs were taken prior to and following ther insertion of a tube applicator. Anaerobic transport-media were used an cultures were performed aerobically and anaerobically. The mean number of aerobic species per patient increased slightly from 3.26 to 3.60 (n.s), anaerobic species remained constant (1.36 before and 1.30 after irradiation). Also the frequency of isolation of most aerobic and of all anaerobic species was statistically not altered following irradiation. Staphylococcus epidermidis decreased from 51.4% to 22.8% significantly (2 p less than 0.05), Micrococci increased from 0.0% to 11.4% (2 p less than 0.05) and aerobic sporeformers form 0.0% to 34.3% (2 p less than 0.01). Among the anaerobes Pepto- and Peptostreptococci were isolated prior to and following intracavitary irradiation in 11 to 14%, Bacteroides-species in 11 to 20%. Our bacteriological results suggest, that intracavitary irradiation in the therapeutically usual doses has no sterilizing effect on the vaginal flora. This flora plays an important role in infection following gynecologic radiotherapy.

Adult↗
PubMed1981

[Endometrial bacteriology in puerperal infections (author's transl)].

From the third to the sixth day postpartum transcervical endometrial swabs were taken from 51 women with the clinical signs of endometritis, like fever over 38 degree C, uterine tenderness and purulent lochia using prereduced anaerobic transport-media. The specimens were cultured aerobically and anaerobically. 27 women had an endometritis following vaginal delivery, 24 following caesarian section. Following vaginal delivery aerobic bacteria were isolated in 85.2% of the cases and anaerobic bacteria in 62.9%, post caesarian section in 75.1% aerobic and in 83.3% anaerobic bacteria. A mixed aerobic/anaerobic infection was found in 48.1% following vaginal delivery and in 58.4% post caesarian section. The aerobes most frequently recovered were Staphylococcus epidermidis, E. coli, Enterocococci and Streptococci, the prevalent anaerobes were the grampositive anaerobic cocci, Peptostreptococcus and Peptococcus, and Bacteroides species. Our results suggest that anaerobic bacterial play an important role in the endometritis post partum and that frequently a polymicrobial aerobic/anaerobic infection is present. Therapeutically, anaerobes should be taken into consideration especially for the treatment of severer infections following caesarian section. In such cases the 5-Nitroimidazoles, such as Metronidazole or antibiotics effective against anaerobes as Clindamycin or Cefoxitin should be administered.

Anaerobiosis↗
PubMed1980

[Timing of ovulation in clomiphene-induced cycles (author's transl)].

214 menstrual cycles, induced by clomiphene in 121 women desiring a family but manifesting disturbances of cycle, type WHO II (1976) were investigated with regard to pattern of cervical function. 184 were ovulatory cycles. The time of ovulation was predictable within a range of two days in 58.7% of cases by means of the cervical score, consisting of the dilatation of the cervical os, the degree of transparency, the quantity and the consistency of the cervical mucus. The occurence of the "LH peak" and the rise in basal body temperature (BBT) were set in relation to this. In 41.3% of cycles the cervical score, influenced by the antioestrogenic effect of clomiphene, gave only insufficient evidence. In subsequent treatment cycles the cervical function, in relation to the individual case and the inducible quality of the cycle, showed a similar response rate as in the first treatment cycle. Our results suggest that, after examination of the first clomiphene-induced cycle by the combined means of cervical score and hormoneanalytic methods, patients with a positive cervical response, can be investigated by any interested doctor, even if he doesn't have a laboratory at his disposal, in order to assess the timing of ovulation for therapeutic measures.

Body Temperature↗
PubMed1980

[The importance of second-look surgery following radio-chemotherapy for advanced ovarian cancer (author's transl)].

Fifteen patients with advanced, initially inoperable ovarian cancer (stages III and IV) were subjected to second-look surgery between May 1976 and August 1979 following combined radio-chemotherapy. Each case had shown a distinct reduction in tumour size and a demarcation of the foreign tissue, which is considered to be prerequisite for second-look surgery. The diagnostic goal of the operation was to verify the success of the preceding radio-chemotherapeutic treatment by means of exact determination of the extent of the residual tumour. The subsequent therapeutic regimen can, if necessary, be modified accordingly. The therapeutic goal is complete surgical removal of the tumour, if at all possible, since the success of subsequent chemotherapy is dependent on the achievement of this aim. The mean interval between initial and second-look surgery was three and a half months. Tumour tissue of varying extent was found in 14 out of 15 cases. In 12 cases total extirpation of the internal genitals was successfully carried out, tumour resection was performed twice, and only one case proved inoperable. The case in question was one of third-look surgery, when after two years of radio-chemotherapy and secondary removal of the internal genitals abdominal tumour recurrence occurred. Two years and six months after initial diagnosis this patient is now undergoing further chemotherapeutic treatment. We believe that this very case illustrates the importance of second-look surgery and of consistent continuation with radio-chemotherapy in cases of advanced inoperable ovarian cancer.

Adult↗