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Biomedical subjects

W Koller

Publications and source records attributed to W Koller.

At least 19 recordsLinked to original sources
PubMed1992

Test models for hygienic handrub and hygienic handwash: the effects of two different contamination and sampling techniques.

Two methods for artificial contamination of hands and two sampling techniques to recover the test organisms were compared for their effects on the results of two post-contamination hand treatments: a handrub with two portions of 3 ml of 2-propanol 60% v/v for 1 min, and a handwash with liquid soap 20% w/v for 1 min followed by a 15 s rinse. The two contamination methods involved a short immersion of the hands (up to the middle of the mid-hand) in a suspension of the test organism followed by either air-drying (3 min) or drying by rubbing the hands' vigorously against each other (3 min) in a standardized way. The two sampling techniques consisted of rubbing the fingertips in either 10 ml trypticase soy broth (TSB) against the bottom of a Petri dish; or 100 ml TSB against glass beads contained in a bowl. Sixteen volunteers were randomly allotted to four blocks of four. They carried out the four possible combinations of two treatments and two contamination methods in a series of four tests arranged in a Latin-square design. In addition, the two sampling techniques were compared with each other concurrently by sampling of the right and left hand each with a different one of the two techniques. The alcoholic handrub reduced the release of test organisms significantly (2P less than 0.005) more effectively, by 1.1-1.3 x log10, than did the handwash with liquid soap, regardless of the contamination or sampling method. Whereas the two recovery techniques yielded virtually identical results in corresponding situations, the method of artificial contamination affected the mean reduction factors, strongly.(ABSTRACT TRUNCATED AT 250 WORDS)

1-Propanol↗
PubMed1992

The effect of acetazolamide on essential tremor: an open-label trial.

We studied the effect of the carbonic anhydrase inhibitor acetazolamide on 24 patients with essential tremor by patient self-evaluation of functional disability, rating of motor task function, and clinical rating of tremor severity. Acetazolamide significantly reduced tremor severity, but there was no statistically significant change in patient self-assessment of function or motor task rating. Although side effects were common, over half the patients elected to remain on the drug.

Acetazolamide↗
PubMed1992

Essential tremor.

Explore the source record for details and available documents.

Data Collection↗
PubMed1992

Assessment of changes in lung microvascular permeability in posttraumatic acute lung failure after direct and indirect injuries to lungs.

We prospectively studied the variation in sequence of occurrence of lung microvascular permeability (LMVP) increase and clinical onset of posttraumatic acute lung failure (ALF) in the sequential failure of organ systems after direct and indirect lung injury. Acute lung failure developed in 52 of 255 trauma patients. Thirty-seven of these developed ALF after a direct injury to lung tissue and 11 after an indirect injury. Lung microvascular permeability was measured with a gamma camera simultaneously over both lungs using indium 113m-labeled transferrin and technetium 99m-labeled erythrocytes in 24 patients with ALF due to direct lung injury and in 4 with ALF due to indirect injury. A localized increased LMVP was observed initially only in the directly traumatized lung (traumatized/nontraumatized lung: 10.03 +/- 5.08/3.73 +/- 3.33 %/h), but involved the primarily nontraumatized lung within 4 days (traumatized/nontraumatized lung: 9.13 +/- 4.49/10.89 +/- 5.05 %/h). In contrast, in ALF due to indirect lung injury, an increased LMVP over both lungs was observed initially (right/left lung: 11.57 +/- 6.18/12.63 +/- 5.73 %/h) and 4 days later (right/left lung: 12.3 +/- 5.49/11.92 +/- 5.75 %/h). Acute lung failure due to direct lung injury occurred significantly earlier (less than 72 h) (P less than 0.01), whereas onset of indirectly induced ALF was later (greater than 72 h). Sepsis syndrome and multiple organ failure were the major complications once ALF occurred after a direct injury. In contrast, sepsis syndrome and multiple organ failure commonly preceded or paralleled the onset of ALF due to an indirect injury.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1991

Educational programmes for infection control in Austria.

Educational aims and strategies (simply arousing awareness, sensitivity and understanding; and/or training in practical skills and knowledge; or the ability to teach infection control, and to convince those taught) depend on the target group. Infection control is part of the curriculum for students of medicine and other health care professions, and is included in course examinations. Postgraduate doctors may seek training on courses which are organized by the Hygiene Institute of the University of Vienna in co-operation with the Austrian Society of Hygiene, Microbiology and Preventive Medicine. Registered nurses may enroll in the Austrian Nurses' Association training scheme (6 weeks of theory with professional work for 2 years), leading to approval as Hygieneschwester/-pfleger. Postgraduate in-hospital education for all health-care professions occurs in many Austrian hospitals, with resources from Vienna and Linz. Hospital managements, health authorities and politicians are influenced via their own educational activities and via publications.

Austria↗
PubMed1991

The influence of cosmetic additives on the acceptability of alcohol-based hand disinfectants.

A prospective, randomized double-blind study with intra-individual comparison of the results was undertaken with 20 volunteers to assess the influence of cosmetic additives on the acceptability of a mixture of n-propanol (50% v/v) and isopropanol (30% v/v) for hand disinfection. Three to 5 ml of antiseptic was rubbed into the hands until dry 15 times a day, 5 days a week and for 2 weeks per preparation. For self-assessment the parameters 'appearance', 'intactness', 'turgor' and 'sensation' were evaluated weekly by visual analogue; for assessment by a dermatologist the same parameters except 'sensation' were used. Each score was compared before and after treatment. The antimicrobial efficacy of the alcoholic mixture was equivalent to or better than the standard (isopropanol 60% v/v, 1 min). The frequent application of these antiseptic preparations caused a slight but significant deterioration of the skin condition as judged by both self-assessment and dermatologist; however, this was significantly less when the antiseptic contained cosmetic additives. It is concluded that the addition of suitable emollients can significantly increase the acceptability of alcoholic disinfectants.

1-Propanol↗
PubMed1991

Improvement of septic syndrome after administration of recombinant human growth hormone (rhGH)?

Twenty patients with generalized sepsis were studied prospectively to evaluate the effects of recombinant human growth hormone (rhGH) administration. Five patients had developed sepsis after major abdominal surgery, 15 patients after multiple trauma with head injury (HTI-ISS 38 +/- 2 and Glasgow Coma Scale 4 +/- 1). The urea production rate (UPR) could be significantly reduced by the intramuscular administration of 1.5 IU of rhGH/kg bodyweight (BW) per day (UPR day: 5, 62 +/- 6.7 gm/d vs. UPR day: 10, 42.6 +/- 5.9 gm/d). The catabolic index of Bistrian (BI) was significantly lower after rhGH therapy on day 10 compared to day 5. IGF-1 increased significantly after the administration of rhGH. The nitrogen balance, however, did not become positive, despite the administration of rhGH. The changes in sepsis were estimated by the scoring system according to Elebute and Stoner on days 3, 5, 7, 10, and 13. In those patients who were available for post-treatment evaluation the parameters had returned to baseline values after the withdrawal of rhGH. Results indicate that this therapy might ameliorate the nitrogen intake, but has no influence on the course of sepsis. Compared to previously published results in nonseptic patients, the somatomedin inhibitors as well as the split-products of the complement system and the metabolites of arachidonic acid may have been responsible for this weak effect of rhGH and IGF-1 in septicemia.

Adult↗
PubMed1990

Autologous transplantation of adrenal medulla in Parkinson's disease. 18-month results.

Eighteen of 19 patients who underwent autologous adrenal medullary transplantation to the right caudate nucleus have been followed up for 18 months. During the course of this study, a statistically significant improvement was noted in percent "on" time, percent "on" time without dyskinesia, activity of daily living (ADL) scores during the "on" stages, and ADL, motor, and Schwab-England scores during the "off" stages. Benefits tended to be maximal at 6 months and to gradually lessen thereafter, although statistically significant improvement in comparison with baseline was still present at 18 months for ADL, motor, and Hoehn-Yahr scores during the "off" stages. Almost all parameters had deteriorated by 18 months compared with 12 months, including those remaining significantly improved in comparison with baseline. These patterns were similar for each of the three participating centers. Complications were largely restricted to the perioperative period.

Adrenal Medulla↗
PubMed1990

The secretion of human growth hormone stimulated by human growth hormone releasing factor following severe cranio-cerebral trauma.

Patients suffering from severe cranio-cerebral trauma show alterations of the secretory patterns of thyroid stimulating hormone (TSH) and human growth hormone (HGH) which may be of prognostic significance. We studied 10 patients following severe brain injury and prospectively compared a new synthetic human growth hormone releasing factor (HGHRF) test with the thyrotropin releasing hormone (TRH) test. On admission, all patients had a Glasgow Coma Scale score of 3 or 4. All patients had a low T3 syndrome. In the patients who died the TSH response after stimulation with TRH was also absent. In the patients who survived a significant TSH increase was observed (p less than 0.05). In comparison to the patients who died those who survived showed a significant (p less than 0.001) HGH increase after HGHRF stimulation. This test might be useful as an additional tool in establishing early prognosis in patients with severe brain injury.

Adult↗
PubMed1990

Surgical hand disinfection: effect of sequential use of two chlorhexidine preparations.

The antimicrobial efficacy of three 'two-phase' surgical hand disinfection procedures was compared, in a volunteer study, to 60% n-propanol, applied for 5 min, which is the reference hand-disinfection procedure used in Austria and West Germany (FRG). The procedures involved sequential use of unmedicated soap or a disinfectant-detergent containing 4% chlorhexidine gluconate (CHX; 'Hibiscrub') followed by a handrub preparation containing 70% w/w isopropanol plus 0.5% CHX ('Hibisol'). The immediate and sustained effects (3 h) of washing with unmedicated soap (3 min) followed by rubbing on 'Hibisol' (4 min) were significantly smaller (log10 reductions of 1.72 and 1.12) than with each of the other procedures. Use of 'Hibiscrub' (3 min) and 'Hibisol' (4 min) produced log10 reductions of 2.50 and 1.71, equalling those of the reference procedure with n-propanol (2.49 and 1.78). When 'Hibisol' was used for 5 min rather than 4 min, a considerable, though not significant, increase in effect was achieved (log10 reductions of 2.90 and 2.07). Replacement of unmedicated soap by 'Hibiscrub' could significantly improve the effectiveness of the hand disinfection procedure commonly used by surgeons in German-speaking countries; namely to wash hands first with soap and then disinfect them with an alcoholic preparation. It may also be of additional advantage as this adds another 'layer' of CHX when 'Hibisol' rather than alcohol alone is used.

1-Propanol↗
PubMed1990

[Treatment of fresh muscle injury].

A prospective double-blind randomized study comparing the results of a protein-free-haemodialisate (Actovegin) with placebo was performed in 103 patients. There has been 68 patients in the haemodialysate group. In acute muscle injuries we find a dent in the muscle and a loss of function. There has been three injections in the injured muscle every three to four days. The follow up examination occurred at least three months after the beginning of the study. Full sports activity was reached in the haemodialysate group after 5.5 weeks, in the non-haemodialysate group after 8.3 weeks. There has been a significant difference in the time of rehabilitation between the shank and the thigh muscles. The results show a high statistic significance.

Adult↗
PubMed1990

Failure of fixed-dose, fixed muscle injection of botulinum toxin in torticollis.

We studied the effect of botulinum toxin injection in 30 patients with torticollis in a double-blind, placebo-controlled, crossover study. A fixed dose of toxin was injected into the contralateral sternocleidomastoid and both trapezius muscles. Clinical improvement was assessed by a rating scale and by patient self-evaluation. Subjective rating noted improvement in some patients, but there was no change in objective measures. The use of larger doses and injection of additional muscles may be necessary to achieve increased efficacy of botulinum toxin in the treatment of torticollis.

Adult↗
PubMed1990

Diminished reactive hyperemia in the skin of critically ill patients.

Reactive hyperemia (RH) in the forearm skin after an arterial occlusion of 5 min was investigated in 29 ICU patients and 17 age-matched healthy control subjects using a transcutaneous PO2/PCO2 electrode heated to 37 degrees C. There was no difference in preocclusive baseline PtCO2 between patients (8 +/- 5 torr) and control subjects (8 +/- 4 torr). Patients exhibited a significantly decreased RH (16 +/- 9 torr) in comparison with control subjects (26 +/- 8 torr) and a diminished CO2 elimination. There was no correlation between the RH response and the oxygen extraction ratio, Hgb concentration, and hemodynamic and blood gas variables in patients. In contrast with control subjects, there was a significant correlation between CO2 elimination from the skin and the amount of RH in patients. The finding of a diminished RH in the patients was not related to a specific disease but correlated with the degree of physiologic derangement as assessed by the APACHE II score.

Adolescent↗
PubMed1990

Correlation between essential tremor and migraine headache.

The relationship between essential tremor (ET) and migraine was investigated in a prospective study. In a group of 74 ET patients 36.5% had migraine compared with 17.7% of 102 control subjects without tremor. In a group of 58 patients with migraine 17.2% had ET compared with 1.2% of 85 controls without migraine. The prevalence of ET in migraine controls was greater than controls without migraine (22% compared with 1%; p = 0.002). It is concluded that there is an association between essential tremor and migraine.

Adolescent↗
PubMed1990

Nutritional aspects and swallowing function of patients with Parkinson's disease.

Seven patients with Parkinson's disease and three patients with progressive supranuclear palsy underwent adrenal medullary transplant to the caudate nucleus for treatment of their neurologic disease. Preoperative nutritional assessment demonstrated that a significant number of the Parkinson's patients had mild to moderate nutritional depletion. Motility problems, manifest by dysphagia and delayed gastric emptying causing problems over a number of years, were probably responsible. Of the 10 patients studied, 6 were studied by videofluoroscopy. All patients had variable dysphagia of variable servility with or without aspiration. Etiologic factors included the basic underlying neurologic disease, delay in resumption of anti-parkinsonian medications, use of metoclopramide, and postoperative medical complications leading to a debilitated clinical state.

Adult↗