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Biomedical subjects

Manfred Maier

Publications and source records attributed to Manfred Maier.

9 recordsLinked to original sources
PubMed2006

Characteristics and trends in required home care by GPs in Austria: diseases and functional status of patients.

BACKGROUND: Almost all societies carry responsibility towards patients who require continuous medical care at home. In many health systems the general practitioner cooperates with community based services of home care and coordinates all medical and non medical activities. In Austria the general practitioner together and in cooperation with relatives of the patient and professional organisations usually takes on this task by visiting his patients. This study was carried out to identify diseases that need home care and to describe the functional profile of home care patients in eastern Austria. METHODS: Cross sectional observational study with 17 GP practices participating during 2 study periods in 1997 and in 2004 in eastern Austria. Each GP identified patients requiring home care and assessed their underlying diseases and functional status by filling in a questionnaire personally after an encounter. Patients in nursing homes were excluded. Statistical tests used were t-tests, contingency tables, nonparametric Wilcoxon signed rank sum test and Fisher-combination test. RESULTS: Patients with degenerative diseases of the central nervous system (65%) caused by Alzheimer's disease and cerebrovascular occlusive disease and patients with degenerative diseases of the skeletal system (53%) were the largest groups among the 198 (1997) and 261 (2004) home care cases of the 11 (1997) and 13 (2004) practices. Malignant diseases in a terminal state constituted only 5% of the cases. More than two thirds of all cases were female with an average age of 80 years. Slightly more than 70% of the patients were at least partially mobile. CONCLUSION: Home care and home visits for patients with degenerative diseases of the central nervous and skeletal system are important elements of GP's work. Further research should therefore focus on effective methods of training and rehabilitation to better the mental and physical status of patients living in their private homes.

Activities of Daily Living↗
PubMed2006

[Medical quality circles for drug replacement therapy].

Drug replacement therapy using synthetic opioids is in Vienna mostly carried out by primary care physicians. Group teaching in quality assurance groups has been installed in order to give these doctors the necessary personal and informational assistance. Evaluation has shown that: 1. 90% of the doctors were highly or well satisfied with the teaching. Only 10% were slightly critical. 2. They could better communicate with, and were able to show more tolerance towards, the "difficult" patients. 3. Specialized knowledge increased (risk of infection, "management of hepatitis", contact with authorities, co-medication). 4. Some critical remarks pointed towards ways in which this particular further education could in future be better organized and dealt with more intensively.

Austria↗
PubMed2005

Hey basic helix-loop-helix transcription factors are repressors of GATA4 and GATA6 and restrict expression of the GATA target gene ANF in fetal hearts.

The Hey basic helix-loop-helix transcription factors are downstream effectors of Notch signaling in the cardiovascular system. Mice lacking Hey2 develop cardiac hypertrophy, often associated with congenital heart defects, whereas combined Hey1/Hey2 deficiency leads to severe vascular defects and embryonic lethality around embryonic day E9.5. The molecular basis of these disorders is poorly understood, however, since target genes of Hey transcription factors in the affected tissues remain elusive. To identify genes regulated by Hey factors we have generated a conditional Hey1 knockout mouse. This strain was used to generate paired Hey2- and Hey1/2-deficient embryonic stem cell lines. Comparison of these cell lines by microarray analysis identified GATA4 and GATA6 as differentially expressed genes. Loss of Hey1/2 leads to elevated GATA4/6 and ANF mRNA levels in embryoid bodies, while forced expression of Hey factors strongly represses expression of the GATA4 and GATA6 promoter in various cell lines. In addition, the promoter activity of the GATA4/6 target gene ANF was inhibited by Hey1, Hey2, and HeyL. Protein interaction and mutation analyses suggest that repression is due to direct binding of Hey proteins to GATA4 and GATA6, blocking their transcriptional activity. In Hey2-deficient fetal hearts we observed elevated mRNA levels of ANF and CARP. Expression of ANF and Hey2 is normally restricted to the trabecular and compact myocardial layer, respectively. Intriguingly, loss of Hey2 leads to ectopic ANF expression in the compact layer, suggesting a direct role for Hey2 in limiting ANF expression in this cardiac compartment.

Animals↗
PubMed2004

The Notch target genes Hey1 and Hey2 are required for embryonic vascular development.

The Delta-Notch signaling pathway plays a central role in the development of most vertebrate organs. The Hey family of bHLH transcription factors are direct targets of Notch signaling. Loss of Hey2 in the mouse leads to cardiac defects with high postnatal lethality. We have now generated a mouse Hey1 knockout that has no apparent phenotypic defect. The combined loss of Hey1 and Hey2, however, results in embryonic death after embryonic day 9.5 (E9.5) with a global lack of vascular remodeling and massive hemorrhage. Initial vasculogenesis appears unaffected, but all subsequently developing major vessels in the embryo and yolk sac are either small or absent. Furthermore, the placental labyrinth completely lacks embryonic blood vessels. Similar vascular defects are observed in Jagged1 and Notch1 knockout mice. In the latter we found Hey1 and Hey2 expression in yolk sacs to be strongly reduced. Remaining large arteries in both Notch1 and Hey1/Hey2 knockout mice fail to express the arterial endothelial markers CD44, neuropilin1, and ephrin-B2. This indicates that Hey1/Hey2 are essential transducers of Notch signals in cardiovascular development that may mediate arterial cell fate decision.

Animals↗
PubMed2004

Allocation of training posts to applicants for postgraduate medical education in austria: survey and analysis.

PURPOSE: To analyze the consequences of the current procedure for allocating training posts to medical graduates in Austria. METHOD: In this cross-sectional study, a questionnaire was sent in two mailings to 8,127 licensed general practitioners and specialists based on the register of the Vienna Medical Chamber in June 2000. The main outcome measures were the percentage of licensed male and female physicians who did not obtain training in their originally preferred medical specialty and the percentage of physicians who were working in a medical specialty other than their originally preferred specialty. RESULTS: A total of 2,736 respondents (34%) completed the questionnaire in the two mailings: 50.3% of physicians--43.2% of male physicians and 58.6% of female physicians--were not practicing in their originally preferred specialty. An average 9% of physicians changed their minds about their preferred specialty during their training. Twenty-one percent of all physicians completed training in an additional specialty. An average of 11 months of additional training was spent at official training posts in specialties other than those finally practiced. CONCLUSIONS: The Austrian allocation procedure is ineffective, uneconomical, and unfair for the applicants. Many medical graduates accept training in a specialty other than the one preferred, not because it is their wish but because Austria's allocation process leaves them no alternative. The authors call the way in which the Austrian training post allocation system governs specialty choice the "musical-chairs effect." This allocation process requires review and the incorporation of recruitment guidelines to ensure equal rights and fair opportunities.

Austria↗
PubMed2003

Complementary therapies in cancer patients: prevalence and patients' motives.

BACKGROUND: Data relating to the use of complementary/alternative medicine (CAM) in cancer patients have been published for a number of European countries. No recent data are available for Austria. AIM: To ascertain the extent of CAM use by cancer patients, what patients' motives are, what methods are used and who the CAM providers are. DESIGN: Self-administered questionnaire; cross-sectional study. PATIENTS AND METHODS: A sample of 231 cancer patients who had consulted the Viennese Cancer League. Chi-square and Mantel-Haenszel tests were used for the statistical evaluation. RESULTS: 27.3% of the cancer patients had received CAM therapy: 33.1% of the female and 20.5% of the male participants (p = 0.045). Those who were below the median of the age categories (53.8 years) had used CAM to a statistically higher degree (35.5% vs. 21.1%; p = 0.023). The most important motives were the enhancement of "nature" and the GPs' recommendation. CAM was administered in 44.4% of cases by the family doctor, in 39.7% by patients themselves, in 6.3% by a hospital doctor, in 6.3% by a lay-practitioner or "non-medical practitioner against payment" and in 4.8% of cases by a practising oncologist. CONCLUSION: From the high percentage of patients who use CAM without consulting a physician or who follow the advice of others, it would seem highly probable that conventional and complementary methods are rarely effectively coordinated. To rectify this we conclude that oncologists and GPs should have a basic knowledge of CAM and address the issue when counselling their cancer patients.

Adolescent↗