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R Thurmayr

Publications and source records attributed to R Thurmayr.

At least 19 recordsLinked to original sources
PubMed1992

Recommendations of the German Association for Medical Informatics, Biometry and Epidemiology for education and training in medical informatics.

In the fields of health care and medicine there is an immense demand for a systematic application of methods of information processing and for the use of computers. Obviously, to that end well-trained scientists and qualified personnel must be available. With the present recommendations on education and training in medical informatics the German Association for Medical Informatics, Biometry and Epidemiology (GMDS) proposes structure and contents of medical informatics curricula and courses. The recommendations describe a 2-dimensional educational framework with different education levels in one dimension and various types of educational needs and orientation in the other one. The recommendations comprise at the university level education as well specialized curricula covering the total spectrum of medical informatics as well as informatics curricula with medical informatics as integrated applied subject or subsidiary subject, respectively. Besides these informatics-oriented approaches medical-oriented programs of education in medical informatics are recommended, e.g., post-graduate education in medical informatics for physicians based on foundations in medical informatics as part of their initial training in medicine. At the level of polytechnical schools curricula of medical documentation and informatics and at the level of professional schools training in medical documentation are recommended. This report is a translation of its German original. Although considered by the GMDS as recommendations for the Federal Republic of Germany, the text may also contribute to the development of an international, especially European framework of training in medical informatics.

Germany↗
PubMed1988

[Genital infections and the course of pregnancy: a prospective study].

The reported study investigates the relationship of genital infections, pathobiochemical findings and demographic data to preterm labor, premature rupture of membranes (PROM) and premature delivery. The predictability of chorioamnionitis, puerperal and neonatal infections by these parameters was evaluated concurrently. 301 patients were included in this study between July 1985 and June 1986. 147 of these patients were studied longitudinally during pregnancy, delivery and puerperium (longitudinal group). A second group consisted of 154 women who presented themselves on start of labor to the labor and delivery unit of our Department (peripartal group). The incidence of preterm labor and of PROM was 26%. The incidence of premature delivery, chorioamnionitis, puerperal and neonatal infection was 11.4%, 5.5%, 7.6% and 3% respectively. Cervical colonization with Mycoplasma hominis correlated positively with PROM (relative risk 2.2), premature delivery (3.9) and neonatal infection (6.9). Chorioamnionitis, premature delivery and puerperal infection were also significantly increased in patients with positive vaginal Ureaplasma urealyticum cultures during pregnancy and delivery. Premature delivery (2.8) and puerperal infection (4.0) were associated with a vaginal group B-Streptococci (GBS) colonization during pregnancy, as was a positive GBS culture during delivery associated with puerperal infection. Bacterial vaginosis also correlated positively with premature delivery (5.6) and puerperal infection. Preterm labor correlated negatively with the socioeconomic level, PROM correlated negatively with the marital status, positively with age, a history of cervical cerclage, conization or PROM during former pregnancies. Sexual intercourse more often than once weekly during the last month of pregnancy was also associated with an increased number of PROM. Gardnerella vaginalis, Candida and Trichomoniasis during pregnancy and delivery were associated with preterm labor and puerperal infections. Levels of maternal plasma fibrinogen concentrations in patients with PROM were elevated 48 hours after delivery in accordance to the characteristics of acute phase proteins. In contrast, the maternal PMN-granulocyte-elastase concentration was significantly elevated at time of delivery and 24 hours thereafter in those patients who developed puerperal infections. The derived positive predictive value was 26%, the negative 94.7%, respectively. The overall accuracy of the prediction was 83.1%. Six out of seven mothers with neonates treated because of neonatal infection showed significantly elevated plasma concentration of PMN-granulocyte-elastase.(ABSTRACT TRUNCATED AT 400 WORDS)

Bacterial Infections↗
PubMed1988

[Peri-operative preventive use of antibiotics in abdominal hysterectomy].

In patients undergoing abdominal hysterectomy, the efficacy of antibiotic prophylaxis was compared to no treatment. Additional studies on the influence of risk factors such as D&C, conisation and IUD's on post-operative morbidity were evaluated. 144 patients were recruited into the study and prospectively randomised into one of four groups. Groups IV and II received 2 g i.v. Cefotetan and were comprised of patients with or without risk factors, respectively. Similarly, groups III and I, again with or without risk factors, received no treatment and served as the control groups. Infectious post-operative morbidity was significantly reduced in both groups of patients receiving antibiotic prophylaxis, the maximum benefit being observed in those patients with accompanying risk factors. The need for additional antibiotic therapy was highest in those patients receiving no antibiotic prophylaxis, i.e. groups III and I. Additionally if concomitant risk factors were present, the duration of hospitalisation was increased by a further 1.4 days.

Bacteriuria↗
PubMed1988

Antibiotic therapy of early European Lyme borreliosis and acrodermatitis chronica atrophicans.

In a study on 121 consecutive patients with erythema migrans, 65 patients obtained oral penicillin, 36 tetracyclines, and 20 amoxicillin-clavulanic-acid. Follow-up was carried out for a median of 29, 17, and 7 months, respectively. In another limited trial on 29 patients with acrodermatitis chronica atrophicans (ACA), 14 patients received oral penicillin, 9 parenteral penicillin, and 6 tetracyclines. There was no statistically significant difference among treatment groups in both therapeutic trials, with the exception of different follow-ups due to the nonrandomized study design and different occurrence of the Jarisch-Herxheimer reaction in patients with erythema migrans. Later extracutaneous manifestations developed in 27% of the patients with erythema migrans and in 47% of the patients with ACA despite antibiotic therapy. We could not prove the superiority of any antibiotic tested in either early or late European Lyme borreliosis.

Acrodermatitis↗
PubMed1987

Antibiotic therapy in early erythema migrans disease and related disorders.

Between December 1978 and July 1985, we used various antibiotics for the treatment of 97 adult patients with early erythema migrans disease (EMD). Six patients with borrelial lymphocytoma (BL) and 20 with acrodermatitis chronica atrophicans (ACA) were treated similarly. Follow-up was for a median of 20, 14, and 12 months, respectively. The erythema migrans and all associated symptoms resolved within a median of 3 weeks (0.5-18.4), BL within 7 weeks (4-16), and ACA partly or completely within several months. A Jarisch-Herxheimer (-like) reaction was observed in 8 patients with EMD. Fourteen patients with EMD and one with ACA developed an exacerbation of symptoms or new manifestations between the 2nd and 20th day, and 28 patients with EMD and one with ACA continued to have or acquired various symptoms greater than or equal to 3 weeks after initiation of therapy. Arthralgia, neurologic and constitutional symptoms, and in one instance a slight pulmonary interstitial edema developed in EMD. More severe initial illness was a risk factor for the development of later symptoms in EMD. Retreatment was more often necessary in ACA than in EMD. A patient with ACA had a recurrence after 5 1/2 years. IgG antibody titers rose at least fourfold in 5 patients with ACA and in 1 with EMD despite therapy. We tentatively recommend minocycline or high doses of parenteral penicillin for the treatment of these disorders.

Acrodermatitis↗
PubMed1987

[Condition and satisfaction of patients after gynecologic surgery].

The effects of gynaecological operations on the well-being and satisfaction of patients can be viewed as important supplements to quality assurance which is mainly based on clinical parameters and medical ratings. In the present study 215 patients undergoing gynaecological operations assessed different components of their subjective health status at times of admission to the hospital, at discharge and six weeks after discharge. Additionally, the patients gave satisfaction ratings at discharge. The study resulted in demonstrating considerable improvements of complaints and well-being that continued into the postdischarge period. The improvements were most pronounced in the cases of patients with vaginal hysterectomy. Satisfaction with the hospital department was high, especially with regard to the care given by the physicians and the nurses. After mastectomy, women expressed problems with their self-image and with their partners. Considerations to take the results of the study into account for quality assurance are discussed.

Adult↗
PubMed1987

Computer-aided formulation of physician's reports and storage of ERCP data.

In the 2nd Medical Dept. of the Technical University of Munich, endoscopic retrograde cholangiopancreatography (ERCP) reports are written with the aid of a computer. The doctor doing the examination enters the ERCP data into screen masks. The data are stored at once in a data bank. This data bank system permits immediate error checks of the variables entered, singly and in combination. Errors can be corrected in a loop. Generating of ERCP reports is controlled by a text file, which contains both control statements and standard phrases. A special program for the document generating was developed by the authors and has been used for 15 years in various applications.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1986

[Perioperative antibiotic prevention with cefoxitin in cesarean section. Management and uses].

Antibiotic prophylaxis and febrile morbidity following non-elective Caesarean section were studied retrospectively. Febrile morbidity was found to be 5.4% in the treated group as compared to 20% in the untreated group. Percentage of endomyometritis was 2.2% in the treated group and 16% in the untreated group. Our results prove the efficacy of antibiotic prophylaxis in patients undergoing Caesarean section. Antibiotic application in 79% of all these patients led to a significant reduction in puerperal febrile morbidity and endomyometritis. Experience shows that positive results gained by the study do not have a positive feedback on the ward if there is lack of communication or reconfirmation.

Cefoxitin↗
PubMed1985

[Pancreatic secretion in domestic sprue].

Pancreatic function was determined (using the secretin-pancreozymin test) before the use of gluten-free diet in 22 patients with endemic (celiac) sprue. Water and bicarbonate secretion were within normal limits, if anything there was a trend to high-normal values. Remarkable and apparently characteristic for celiac sprue was the only slight contraction of the gallbladder after intravenous injection of submaximal doses of cholecystokinin-pancreozymin (CCK). Secretion of the 3 enzymes amylase, lipase and trypsin was decreased in about one third of cases, the difference relating both to the concentrations and the amount secreted, compared with normal control values was significant (P greater than 0.01). But in no case was the reduced enzyme secretion so marked that one would expect maldigestion. Multivariate non-linear discriminance analysis demonstrated that pancreatic secretion in sprue is quite distinct from that in healthy subjects and those with chronic pancreatitis. It is assumed that there is a pattern of exocrine pancreatic secretion typical for sprue.

Adult↗
PubMed1976

[Computer-oriented documentation of quantitative and qualitative data in gastroenterology (author's transl)].

Computer-oriented documentation of quantitative and qualitative data obtained from patients with gastroenterological diseases is described as an example of a method when considering a relatively small number of patients. All qualitative and quantitative features are entered uncoded in a data booklet and subsequently on port-a-punch cards. After extensive computerized error check - and correction, as need arises, - the data are transferred to a data base and stored on magnetic disk. The ISIS information system, in conjunction with special routines provides access to the data in any combination desired. Analysis of the data, both on an individual and a statistical basis is thus facilitated.

Diagnosis, Computer-Assisted↗