PubMed Health⌕ Search

Biomedical subjects

W Buchinger

Publications and source records attributed to W Buchinger.

At least 19 recordsLinked to original sources
PubMed2003

[Influence of nocturnal surgery on mortality and complications in patients with hip fractures].

UNLABELLED: SUBJECT OF INVESTIGATION: The appropriate time of day for surgery of hip fractures and the question of whether surgery should be performed at night are controversial. We therefore investigated the influence of the time of day on mortality and complication rates in surgery for hip fractures. METHOD: A total of 170 persons were included in the study with 128 operations being performed during the day and 42 at night, after 9 p.m. All patients were operated as early as possible. Patients were randomly assigned to groups. The recorded data were mainly demographic, perioperative and those concerning the patient's history. Mortality and complication rates 6 months after surgery were compared. RESULTS: The two groups were largely homogeneous. Patients operated on at night had a non-significantly higher mortality rate. Mortality was highest in those operated on between 9 and 10 p.m. Of those who underwent surgery after midnight, no patient died. No differences were registered with regard to complications. The team of surgeons and anesthetists was equally qualified in both groups. CONCLUSIONS: Given a medical team with equal qualifications and size, we consider nocturnal surgery for hip fractures to be as appropriate as surgery during the day.

Aged↗
PubMed2003

The influence of immediate surgical treatment of proximal femoral fractures on mortality and quality of life. Operation within six hours of the fracture versus later than six hours.

We compared the mortality and outcome of 182 patients with proximal fractures of the femur after immediate and delayed surgical treatment. Seventy-nine patients were operated upon within six hours of the fracture (group 1) and 103 patients were operated upon after this period of time (group 2). At six months follow-up, group 1 had a significantly lower mortality rate. There was a good outcome in both groups with no differences in the outcome. Neither surgical nor anaesthetic factors appeared to have influenced mortality. The subdivision of groups revealed that patients operated on within 24 hours had a better outcome than those whose surgery was delayed. Although there may have been a bias, as patients were not randomly assigned to immediate or delayed surgical treatment, the data suggest that early stabilisation may be associated with a lower mortality rate. Even with pre-clinical delays of more than six hours early treatment should still be attempted, as better results seem to be achieved after 24 hours compared to a later time in our patients.

Adult↗
PubMed2000

[The treatment of severe head-brain injuries in Austria] .

INTRODUCTION: We performed this study in order to assess epidemiology and current practice of treatment of severe traumatic brain injury in Austria. Our survey followed the methods of a study published by J. Ghajar et al in the USA in 1995 and we compared the results to the Brain Trauma Foundation's "Guidelines For The Management Of Severe Head Injury". METHODS: The collected data represent answers to telephone interviews of 60 surgical intensive care units. We were able to evaluate data from all departments which treat severe brain traumas (Glasgow Coma Scale < or = 8) in Austria. RESULTS: At the time the treatment modalities of severe head injuries are not homogeneous and there are also big interdisciplinary management differences (trauma surgeons versus neurosurgeons). CONCLUSIONS: Results showed that there is a need for a brain trauma databank in Austria. We also recommend formation of an interdisciplinary brain trauma working group in order to control whether guidelines and standardized therapeutic modalities are being followed.

Anesthesia↗
PubMed2000

[Seasonal variations in the diagnosis of hyperthyroidism].

Seasonal variations in the frequency of thyrotoxicosis are known for a long time. Both, variations in the temperature and in the iodine supplementation are believed to affect the incidence of the diagnosis of hyperthyroidism. Seasonal variation of the incidence of hyperthyroidism was investigated before and after increase of salt iodination in 1990/1991. In the period from January 1987 to December 1995 hyperthyroidism was diagnosed for the first time on 4711 patients in our department. This population was subdivided according to etiology (Graves' disease, autonomous nodular goiter) and grade of hyperthyroidism (preclinical or clinical form). The so formed groups were divided according to the month of diagnosis into further 12 subgroups. Significant differences in month to month variation were found in the patients suffering from Graves' disease and autonomous nodular goiter with preclinical hyperthyroidism after increased iodine supplementation. The peak incidence of the diagnosis occurred in June, July, and August. Our results indicate that improved iodine supplementation may be the main cause of seasonal variations in the incidence of thyrotoxicosis.

Austria↗
PubMed2000

[Measurement of free triiodothyronine (FT3) using an electrochemiluminescence immunoassay in patients with autoantibodies to triiodothyronine].

Thyroid hormone autoantibodies may lead to abnormal values of free triiodothyronine (FT3) and free thyroxine (FT4) by interference with the radio immunoassay (RIA). We examined thyroid function in six patients with known triiodothyronine-binding autoantibodies using a RIA and an electro-chemiluminescence immunoassay (ECLIA). FT3 values measured by RIA were spuriously high, ECLIA measurement of FT3 led to correct values according to the patients' thyroid status. We conclude from these results that in patients with triiodothyronine-binding autoantibodies FT3 measurement by ECLIA is more useful than measurement by RIA.

Adult↗
PubMed2000

[Effect of aceclofenac on thyroid hormone binding and thyroid function].

Influences of non-steroidal anti-inflammatory drugs (NSAID) on concentrations of thyroid hormones are known for a long time. These effects could be explained with interference between NSAIDs and thyroid hormone binding. We investigated the effects of a single dose of aceclofenac on thyroid function and thyroid hormone binding in 18 healthy volunteers. Serum levels of free thyroid hormones (FT3, FT4) and thyrotropin (TSH) were measured with commercial available kids and thyroid hormone binding was estimated with a specially modified horizontal argarose-gel-electrophoresis prior to and 2 hours after receiving a single dose of aceclofenac. We found a significant decrease in T3 binding on TBG and a significant increase of albumin-bound T3. All other investigated thyroid hormone binding parameters, FT3 and FT4, showed no significant changes. We conclude that aceclofenac leads to a significant redistribution of T3 protein binding. These effects seem to be explained by T3 displacement from TBG induced by aceclofenac.

Adult↗
PubMed2000

[Increased occurrence of autoimmune thyroiditis in patients with chronic rheumatoid arthritis].

The frequent occurrence of both rheumatoid arthritis and autoimmune thyroiditis was already investigated with in part many conflicting results. We investigated a number of 792 patients (383 of them suffering from rheumatoid arthritis and 409 with osteoarthritis). In all patients antithyroid peroxidase and antithyroglobulin antibodies were determined. Patients with rheumatoid arthritis showed a significantly higher occurrence of circulating thyroid antibodies than those with osteoarthritis (9.1% versus 3.7%, p = 0.0016). We conclude that there exists a cumulate coincidence of both diseases. Patients suffering from rheumatoid arthritis should undergo a thyroid examination especially for the presence of autoimmune thyroiditis.

Aged↗
PubMed1999

[Quantitative scintigraphy of the sacroiliac joints].

Effects of gender and age on quantitative sacroiliac joint imaging are discussed controversially. In most investigations the number of controls has been small and might not exactly reflect the change of sacroiliac/sacral (SI/S) ratios related to different age and gender. The aim of our study was to evaluate the changes SI/S ratios according to age and gender. In 125 patients without any history of either diseases or complaints of the sacroiliac joints a bone scintigraphy was obtained and the SI/S ratios were calculated. We observed a significant negative correlation of SI/S index with age. After separation into 4 different age groups a significant decline of the ratios could be shown. There were no significant differences between male and female patients. We conclude that the influence of age on SI/S ratios is substantial. But also many other factors like patient position, algorithm of SI/S ratio calculation, the time interval between application of the radiopharmaceutical and data acquisition may exert effects on SI/S ratios. It seems necessary for each department to evaluate their own age related reference values of SI/S ratios.

Adult↗
PubMed1997

Thyrotropin and thyroglobulin as an index of optimal iodine intake: correlation with iodine excretion of 39,913 euthyroid patients.

The recommendations for the dietary allowance of iodine are 150 micrograms per day for adolescents and adults. Thyrotropin (TSH) and thyroglobulin (Tg) can be used as surveillance indicators for assessing iodine deficiency disorders. We compared the relation between TSH and Tg, free triiodothyronine, and thyroxine serum levels with urinary iodine excretion in 2311 untreated euthyroid patients using our modified cericarsenite method. An adequate iodine intake may be assumed when TSH and Tg values are at the lower end of the normal range. Patients were grouped according to urinary iodine excretion and goiter size. In the group with an iodine excretion between 201 and 300 micrograms of iodine per gram of creatinine, the lowest TSH values and even low Tg levels could be shown. We conclude that an iodine intake of approximately 250 micrograms/day is associated with the lowest TSH stimulation to thyrocytes. In the groups separated according to thyroid size, significantly higher Tg levels were found in the patients with uninodular and multinodular goiter as a result of longstanding iodine deficiency, whereas actual urinary iodine excretion did not differ significantly. Additionally, iodine excretion of 39,913 euthyroid patients between 1984 was 1996 was examined. In Austria iodized salt (10 mg KI/kg) was introduced by law in 1963 and increased to 20 mg KI/kg salt in 1990. An initial increase of iodine excretion until 1993 was followed by a decrease in 1994 and 1995 without further changes in 1996. These results show that iodine intake has improved since 1984; however, in 1996 iodine excretion in one-third of the investigated patients was under 100 micrograms per gram of creatinine and more than 80% had less than 200 micrograms per gram of creatinine.

Adult↗
PubMed1996

Are there stereoselective electrophysiologic effects of intravenously administered (S)- or (R)-propafenone hydrochloride in patients with supraventricular tachycardia?

OBJECTIVE: The electrophysiological effects of intravenously administered pure (S)- and (R)-propafenone hydrochloride has been determined for the first time in humans-12 patients with supraventricular tachycardia. METHODS: Measurements were performed before and during drug therapy. RESULTS: (S)- and (R)-propafenone prolonged the AH interval from 82 to 107 ms and 75 to 84 ms, respectively, and significantly increased the V nodal Wenckebach cycle length by 58 ms and 37 ms, respectively. The AV nodal effective refractory period in both groups was increased significantly to the same extent (45 vs 42 ms). Sinus node recovery times were not significantly influenced by either enantiomers. Both (S)- and (R)-propafenone significantly prolonged the HV interval to the same extent (from 41 to 51 ms, and 42 to 53 ms). Changes in the electrophysiological characteristics of the myocardium were more pronounced in the atria than in the ventricles. Only (S)-propafenone significantly increased the atrial effective refractory period from 204 to 230 ms, and the ventricular effective refractory period from 225 to 241 ms compared to (R)-propafenone (from 221 to 239 ms, and from 219 to 222 ms, respectively). There was a more pronounced electrophysiological effect on AV nodal conduction of (S)- than (R)-propafenone, probably as a result of its beta-blocking activity. CONCLUSION: The electrophysiological effects of (S)-compared to (R)-propafenone were not very pronounced, so it still remains questionable whether one of the enantiomers might be clinically superior to the other, or to the racemic mixture.

Adult↗
PubMed1996

[Isolated ossicle of the dens axis. Case reports and differential diagnosis].

Two patients with an incidental finding of isolated ossicles adjacent to the dens axis are presented. One case was thought to be based on an isolated part of the dens axis, possibly due to trauma; the second case could be a true ossiculum terminale. Such ossicles can be confused with acute fractures, initiating treatment that is not indicated.

Adolescent↗
PubMed1995

[Late potentials in high resolution ECG in thyroid gland dysfunction].

In this study we examined 278 patients as to the effect of thyroidal dysfunctions upon late-potential parameters in high-resolution ECG (HR-ECG). It could be demonstrated that both hyper- and hypothyroidism tend to produce late potentials. It is remarkable that even "subclinical" dysfunctions reveal significant alterations in HR-ECG. As late potentials represent a risk factor for ventricular arrhythmias these results are an additional indication that already "subclinical" dysfunctions of thyroid gland call for an appropriate therapy. In hyperthyroidism late potentials may be eliminated rapidly by propranolol even in low dosages.

Anti-Arrhythmia Agents↗
PubMed1995

[Do increased lipoprotein(a) levels in euthyroid autoimmune thyroid diseases predict an increased risk of arteriosclerosis?].

Elevated serum levels of lipoprotein(a) [Lp(a)] represent an independent risk factor in the development of arteriosclerosis and coronary heart disease. In overt but also in subclinical hypothyroidism a reversible increase of Lp(a) occurs. We compared Lp(a) serum levels, cholesterol, triglyceride, HDL- and LDL-cholesterol in 19 hypothyroid patients prior to and following the state of euthyroidism (group 1). On the other hand in group 2 we investigated 20 euthyroid patients having elevated thyroid antibodies as against 50 euthyroid normolipemic control subjects without detectable thyroid antibodies. Group 1: The elevated Lp(a) serum levels of the hypothyroid patients decreased significantly in the euthyroid state (37.9 +/- 8.24 vs. 28.1 +/- 6.13 mg/dl, mean +/- SEM). Group 2: The mean Lp(a) serum levels of the patients with increased thyroid antibodies were significantly higher than those of the control group (24.8 +- 5.78 vs. 9.6 +/- 1.56 mg/dl, mean +/- SEM). In other parameters of lipid metabolism and thyroidal function no significant differences between both groups could be seen. The question arises whether such isolated Lp(a) elevation will lead to an increased arteriosclerotic risk. To minimize this possible risk regular controls of thyroid function should be carried out in euthyroid patients with elevated thyroid antibodies. In this way hypothyroidism may be detected and treated at an early stage.

Adult↗