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H K Selbmann

Publications and source records attributed to H K Selbmann.

At least 73 records · Page 4Linked to original sources
PubMed1990

[Age structure and incidence of cancer. An epidemiologic observation in West Germany].

Cancer is the second most common cause of death in West Germany. With increasing age, however, its significance decreases--in men and women to differing extents. The incidence and mortality of cancer increase exponentially with age; every second woman with fatal cancer was older than 75, the median age in men being 71. Since 1970, the age-corrected cancer mortality rate in men has remained unchanged, while in women it has decreased by about 9%. On the basis of the changing age structure in the general population, by the year 2005, an increase in deaths from cancer of almost one-third is expected, with 27,000 more deaths among men than among women. In view of all the possible influencing factors, the present data do not suffice to permit a causal interpretation of the statistical relationship between age and malignant tumor development.

Adult↗
PubMed1990

Hospital information systems and quality assurance.

Hospital information systems may contribute in different ways to quality assurance activities such as assessing the quality of primary care, monitoring quality indicators, supporting clinical care evaluation studies, and auditing concurrently the ongoing process of care using reminders or decision support techniques. Examples of effective contributions are given. However, to meet all requests of quality assurance in real-world settings many efforts developing new technologies will still be necessary.

Decision Support Systems, Management↗
PubMed1990

[Clinical types of immunologic transplant reactions following perforating keratoplasty].

The incidence of allograft rejection was determined for 740 penetrating keratoplasties performed between 1980 and 1987. All 740 cases were followed up for at least 1 year. The reaction forms of allograft rejection were grouped according to biomicroscopic appearance. The incidence and progression of symptoms are described. Rejection types are subdivided into patients with favorable versus poor prognosis. Of the patients 37.9% demonstrated an immune response (including discrete forms). Clear reaction patterns within the two groups of patients became apparent when reaction variations were carefully differentiated. Epithelial immune reaction was found in 5.2%/10.5% and subepithelial infiltration in 1.7%/4.8% of the patients with favorable/poor prognosis. The largest disparity in frequency occurred in progressive endothelial reaction; 3.8% in patients with favorable versus 36.7% in patients with poor prognosis. Focal endothelial reactions occurred in both groups with comparable frequencies (14.1%/13.3%). The large percentage of immunological reactions, including late manifestations (approximately 12% after 1 year) and some with irreversible progression, warrants continuing efforts to treat and prevent this complication.

Cornea↗
PubMed1989

[Data from the Bavarian perinatal survey on the problem of the incidence of cesarean section].

Data are presented on caesarean section rates during the first five-year period of the Bavarian Perinatal Study (BPE 1982-1986), comprising 450,000 births. In order to identify long-term trends, statistical studies from the Munich Perinatal Study (MPS) dating back to 1975 were continued in the same Munich hospitals through to 1982-1984. The results may be broken down as follows: 1. The overall rate of caesarean sections has been increasing, steadily, reaching 15% in the 1986 BPE. No clear levelling-off is evident yet. 2. The highest rates of caesarean sections and vaginal operative deliveries were found in university hospitals. Spontaneous deliveries occurred least often in university hospitals (about 70%), and most frequently in the larger country and private hospitals (77-79%). Smaller externally staffed private hospitals had about the same rate of vaginal-operative deliveries as university hospitals. 3. Following caesarean section, postoperative complications prompted a three- to sixfold higher rate of maternal transfer to other hospitals over that following spontaneous delivery. 4. As maternal age increases, so does the rate of caesarean section for primiparae. Nevertheless, recent years have witnessed a levelling-off for women over 34 years of age. No trend toward further increase is evident for this age group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

Prevention of colonization and respiratory infections in long-term ventilated patients by local antimicrobial prophylaxis.

In a randomized clinical trial the prophylactic effects of locally administered antimicrobials on quantitative colonization and respiratory infections were studied in intubated patients with an expected period of mechanical ventilation of greater than 6 days. Nineteen patients received 50 mg of polymyxin B and 80 mg of gentamicin distributed among nose, oropharynx and stomach at 6-h intervals, as well as 300 mg of amphotericin B in the oropharynx. Twenty untreated patients served as controls. In the control group colonization by respiratory pathogens was more common (oropharynx 19 vs 6 patients (p less than 0.001); trachea 19 vs 11 (p less than 0.01)), and the number as well as the count of the colonizing species was usually higher. Fourteen patients of the control group developed respiratory infections, including nine cases of pneumonia, as compared to four patients with prophylaxis, including one case of pneumonia (p less than 0.01). Pneumonia-associated deaths were prevented with prophylaxis; however, the overall mortality remained unchanged. Respiratory infections in the prophylaxis group were associated with organisms resistant to the agents used, but the overall occurrence of resistance was not increased, as compared to the control group. We conclude that unrestrained upper airway colonization by respiratory pathogens and respiratory tract infection were causally related. Local antimicrobial prophylaxis proved to be a highly effective strategy for the prevention of potentially life-threatening pneumonias in critically ill patients, but in the present study the host setting appeared to be the major determinant of outcome.

Administration, Intranasal↗
PubMed1984

[Extent of pregnancy supervision in Bavaria and measurement of its effectiveness].

Perinatal mortality is high in the Federal Republic of Germany when compared with that in the Scandinavian countries, and it is often claimed that this is due to the unsatisfactory utilisation of prenatal care examinations in this country. Good prenatal care is characterised by the fact that it starts early, that it is carried out intensively, and that it is flexibly adapted to the individual risk situation. Of 83,308 pregnant women covered 1981 by the Bavarian Perinatal Analysis Inquiry, 65.5% had consulted the doctor for the first time before the 13th week of pregnancy, whereas 1.8% consulted the doctor after the 36th week. 53.1% were examined 10 or more times. Every 8th pregnant woman (12.8%) had omitted at least two or more consultations compared with the recommendations for prenatal care and independent of the onset of the care programme. Factors exercising a positive influence on perinatal care resulted in better utilisation, and vice versa. The care programme was frequently neglected by primigravidae who where less than 16 years old, by multigravidae, unmarried mothers and foreigners. Data on the effectiveness of prenatal care are supplied by the Bavarian Perinatal Inquiry Data especially in the analysis of risk-free pregnancies. The later perinatal care was instituted, the more frequent were risk factors at birth. On the average, birth risk was seen after every 5th risk-free pregnancy (21.3%).(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1983

[Role of medical information processing for quality assurance in obstetrics].

The paradigma of problem-orientated assuring of the professional quality of medical case is a kind of "control loop system" consisting of the following 5 steps: routine observation, identification of the problem, analysis of the problem, translation of problem solutions into daily practice and control as to whether the problem has been solved or eliminated. Medical data processing, which involves documentation, electronic data processing and statistics, can make substantial contributions especially to the steps of observation, identification of the problem, and follow-up control. Perinatal data collection, which has already been introduced in 6 Länder of the Federal Republic of Germany, has supplied ample proof of this. These operations were conducted under the heading "internal clinical assuring of quality with external aid". Those clinics who participated in this programme, were given the necessary aid in self-observation (questionnaires, clinical statistics), and they were also given comparative informative data to help them in identifying the problems (clinical profiles, etc.). It is entirely left to the responsibility of the clinics themselves--voluntary cooperation and guarantee of remaining anonymous being a matter of course -- to draw their own consequences from the collected data and to translate these into clinical everyday practice.

Electronic Data Processing↗