Features and trends in Helicobacter pylori antibiotic resistance in Lisbon area, Portugal (1990-1999)

The features of Helicobacter pylori antibiotic resistance in Lisbon from 1990 to 1999 were studied. Overall resistance rates to amoxycillin, tetracycline, metronidazole, clarithromycin and ciprofloxacin were 0, 0, 30.6, 19.0 and 9.6%, respectively. The incidence of resistance to clarithromycin was much higher in isolates from children (44.8%) than adults (14.6%). For metronidazole, the contrary was observed (children: 19.0%, adults: 32.3%). Ciprofloxacin-resistant isolates were all from adult patients. Concerning the adult population, the resistance rate to metronidazole showed a slight increase during the decade, while for clarithromycin and ciprofloxacin a significant increase was observed (4.6 to 22.0% and 0 to 20.9%, respectively).     

Suicide and Schizophrenia: A Review of Literature for the Decade (1990-1999) and Implications for Mental Health Nursing

This paper presents an overview of recent evidence on general and specific risk factors for suicide in patients with schizophrenia. The authors highlight the significant factors contributing to the likelihood of suicide in patients diagnosed with schizophrenia. This information will enhance the delivery of nursing care to these patients in all health care settings. A review of literature was conducted by two methods of investigation: Medline and CINAHL search and a manual search through articles from 1990 to 1999. The lifetime risk of committing suicide is estimated at about 9-13% of persons with schizophrenia, and it is 20 to 50 times higher than that in the general population. Young white males diagnosed with schizophrenia who are depressed, unmarried, unemployed, socially isolated, and functionally impaired and who lack external support are the most vulnerable in the early stages of schizophrenic illness. Findings can be instrumental in identifying and treating patients who are most vulnerable and in making psychiatric nurses aware of the scenarios and critical stages of the disease process when suicide is most likely to occur.     

Orthotopic heart transplantation at the 2d Surgical Department of the University of Vienna: 4-year experience

Between March 1984 and August 1988, 89 orthotopic cardiac transplants were performed in 87 patients at the Second Department of Surgery, University of Vienna. 2 patients underwent retransplantation and 3 patients received previously a total artificial heart bridge. Recipients were immunosuppressed with low dose cyclosporine, azathioprine and since May 1986 with additional low dose prednisolone; all patients were supplemented perioperatively with either ATG or OKT3. 1-year survival rates continuously increased from 33% in 1984 to 88% in 1987 (p = 0.07). The one-year survival rate in recipients given double drug therapy (cyclosporine and azathioprine) was 43% as compared with 77% on triple therapy (cyclosporine, azathioprine and prednisolone, p = 0.003). Acute rejection was the leading cause of death. These data indicate that the substantial improvement in survival rates is attributable to augmented immunosuppression and to improved patient management and recipient selection.     

Senate's project at the University of Vienna, Studies in anatomical science in Vienna from 1938-1945]

SUMMARY: Since much criticism was expressed by the public concerning an association between the Anatomical Atlas of Pernkopf and National Socialism, the Senate of the University of Vienna decided in 1997 to establish a Commission composed of medical professionals and historians who were assigned with the task of clarifying the issue and investigating the reproaches. The aim of the research project was defined as follows: to provide a thorough and comprehensive clarification for the suspicion that bodies of victims of the National Socialist regime were misused for the purpose of producing anatomical preparations for research and education. In a laborious procedure, the Commission investigated the supply of cadavers to the Institute of Anatomy and their application, documented the persons executed at the Provincial Court of Vienna, and the use of these cadavers by the Institute of Anatomy. Both, at the Institute of Anatomy as well as in all departments of the Medical Faculty of University of Vienna, the Commission looked for remains of victims of National Socialistic judicature. In order to document the historical context of the Pernkopf atlas, a biography of Pernkopf, his association with Nazism, the emergence of his atlas, and the way Austrians deal with the mortal remains of humans since 1945, were included in the study. One outcome of the work of the Commission is a complete list of those persons who were executed from 1938 to 1945 and were handed over to the Institute of Anatomy either completely or partially. It is a list that has never existed in this form until now. Neither did the Commission find evidence of the use of corpses from concentration camps, nor were they able to identify (name) the individuals used for the illustrations in Pernkopf's atlas. The Commission suggested that all preparations whose origin could not be determined with certainty, which definitely did not belong to the National Socialist period, and which could not be clearly assigned to a particular category, should be buried.     

Orthotopic heart transplantation--experiences at the University Surgical Clinic II in Vienna (status: June 1986)

Since 1984 27 heart transplantations (HTX) were carried out in 25 patients at the 2nd Department of Surgery, University of Vienna. The classic orthotopic technique of Lower and Shumway was used in all cases. Routine immunosuppression consisted of azathioprine and cyclosporin-A. In order to treat the main complications successfully, i.e. rejection and infections, we were compelled to establish an extensive follow up regimen. The early recognition of acute rejection was based on the findings obtained by cutaneous as well as epicardial ECG leads, in conjunction with cytoimmunological monitoring on the basis of RIA measurements of the serum levels of Neopterin and gamma-Interferon. Furthermore, we recorded some parameters of ventricular performance, such as the isovolumetric relaxation time and the radiologically measured heart volume. An endomyocardial biopsy was carried out to secure the diagnosis. Pulsed doses of methylprednisolone were used for the treatment of rejection, facultatively combined with ATG in the absence of improvements. Infections were pinpointed by comprehensive serum tests and various blood, sputum and urine cultures. The management consisted of treatment with the requisite antibiotics. Of 25 primarily transplanted patients 15 patients are still alive. 5 persons, amongst them 2 children, have survived already for more than 1 year. 6 patients died at an early stage. In 3 cases the cause of death was intractable infection. In 1 case multi-organ failure occurred and 1 patient died due to acute organ failure. 4 patients died at a late stage and acute severe rejection was responsible in all these cases.(ABSTRACT TRUNCATED AT 250 WORDS)     

Suicide and schizophrenia: a review of literature for the decade (1990-1999) and implications for mental health nursing

This paper presents an overview of recent evidence on general and specific risk factors for suicide in patients with schizophrenia. The authors highlight the significant factors contributing to the likelihood of suicide in patients diagnosed with schizophrenia. This information will enhance the delivery of nursing care to these patients in all health care settings. A review of literature was conducted by two methods of investigation: Medline and CINAHL search and a manual search through articles from 1990 to 1999. The lifetime risk of committing suicide is estimated at about 9-13% of persons with schizophrenia, and it is 20 to 50 times higher than that in the general population. Young white males diagnosed with schizophrenia who are depressed, unmarried, unemployed, socially isolated, and functionally impaired and who lack external support are the most vulnerable in the early stages of schizophrenic illness. Findings can be instrumental in identifying and treating patients who are most vulnerable and in making psychiatric nurses aware of the scenarios and critical stages of the disease process when suicide is most likely to occur.     

Clinical epidemiologic data of malignant melanoma based on 1,368 patients of the Graz University Dermatology Clinic (1970-1989)]

Epidemiological and histological data of 1368 patients with invasive malignant melanoma treated at the Department of Dermatology between 1970 and 1989 were analysed retrospectively. Frequency of melanoma increased from 103 cases between 1970 and 1974 to 593 between 1985 and 1989. The male/female ratio was 1/1.5 and did not change during the study period. Mean age of patients at the time of primary operation was 56.1 years and was approximately the same for males and females (males 55.8, females 56.3 years). The predominant site was the trunk in males (58.7 per cent) and the lower leg in females (41.6 per cent). There was a relative increase of melanomas of the back in males and the lower leg in females at the expense of melanomas of the face. The Breslow index was significantly higher in males than in females. In patients older than 69 years, the proportion of thick melanomas was above average. During the study period, the frequency of thick melanomas (greater than 1.5 mm) showed an encouraging decrease in both sexes. In 1989, 50 per cent of all melanomas were thinner than 1.01 mm. This can be interpreted as a successful outcome of efforts in preventive medicine.     

Patterns of non-conductive olfactory disorders in eastern Austria: a study of 120 patients from the Department of Otorhinolaryngology at the University of Vienna

BACKGROUND: About 1% of the population suffer from disorders of the chemosensory system. In the United States at least two million people have problems related to smell and taste. The sense of smell enables the individual to determine the flavour of food and beverages and is most important as a sophisticated warning system. For the present investigation, we collected data on the age pattern and causes of olfactory disorders in eastern Austria. METHODS: 120 patients with non-conductive olfactory disorders were examined over a 9-month period starting from July 1998 at the outpatient clinic of the Ear Nose and Throat Department of the University of Vienna. Data concerning the underlying population taken from the 1998 population census in Vienna were used for comparison, in order to gain a more representative estimation of the distribution of these disorders. The diagnosis was based on thorough history taking, physical examination, CT scan, and olfactory testing for sensitivity by means of so-called "sniffin' sticks". RESULTS: The patients' ages ranged from 16 to 86 years (mean, 54.5 years; 74 females, 46 males). Those older than 50 years seem to have a higher risk of developing olfactory disorders. Only 15 of the female patients were pre-menopausal. Olfactory disorders were most frequently caused by viral infections in the upper respiratory tract (n = 51). Fifteen patients reported head trauma as a cause of olfactory loss, and 45 causes were idiopathic. Most of those in whom the olfactory disorder had been in existence for less than 3 months were anosmic (84%), very few were hyposmic (16% of a total of 19 patients). In contrast, 38% (of a total of 29 patients) in whom the disease had been in existence for 3 and 6 months were hyposmic. Parosmia was reported in 16 cases. Most parosmias appeared after viral infection (56%). Eight of the 120 patients reported dysgeusia. CONCLUSIONS: The present study is a first step towards an assessment of olfactory disorders in Austria. We found similar causes of non-conductive olfactory disorders as have been reported in the literature for other countries, namely upper respiratory infection leading to postviral olfactory disorders, and head trauma. With increasing age women seem to suffer more often from chemosensory dysfunction than men, which may be related to hormonal factors.     

The research programme "Artificial Heart" at the 2nd Department of Surgery, University of Vienna: a ten year review (author's transl)]

The experimental and clinical results are presented of the research programme "Artificial Heart" carried out by the 2nd Department of Surgery, University of Vienna. In particular, an assessment of the clinical experience in 177 patients with the intra-aortic balloon pump is documented and it is concluded that only limited cardiac support is possible by this pump. In view of this fact more efficient methods of mechanical circulatory support, such as the interaortic auxilliary ventricle, the aortic "Windkessel" ventricle with guiding balloon, and two types of ventriculo-aortic bypass ventricle were tested with regard to their haemodynamic and long-time efficacy. The transatrio-aortic auxilliary ventricle (E-LVAD) was also clinically tested in 11 patients. In conclusion the problems of total mechanical heart replacement are discussed.     

Gram-positive microorganisms isolated from patients treated in the Department and Clinic of Rehabilitation at Rydygier Medical University in Bydgoszcz, Poland, 2000-2001

Background. The purpose of our study was to evaluate the occurrence of Gram-positive microorganisms isolated from patients hospitalized in the Department and Clinic of Rehabilitation at the Rydygier Medical University in Bydgoszcz. Materials and methods. The material analyzed consisted of 533 clinical samples collected from patients hospitalized in 2000-2001. The study included 485 Gram-positive bacterial strains isolated from clinical material. Morphological characteristics provided the basis for the identification of bacteria. The species were identified by using API 20 STREP and API STAPH tests (bioMerieux). The isolates were screened for antimicrobial susceptibility by the disk-diffusion method. Results. The most often isolated bacteria were Enterococcus spp. (46,8%) and Staphylococcus spp. (31,5%), followed by Corynebacterium spp. (9,1%) and Streptococcus spp. (6,6%). The most frequently identified Enterococcus species were E. faecalis (92,9%) and E. faecium (7,1%). All the Enterococcus strains were susceptible to glycopeptides. More than 90% of the Enterococus isolates were sensitive to nitrofurantoine, about 44% to high concentrations of gentamycin, 17,9% to ciprofloxacin. During this period, and S. simulans, and 21 strains of S. auerus (46,7%). 92% of all the tested CNS strains (80%) than in the S. aureus isolates (10%). Conclusions. The most frequently observed bacterium was E. faecalis, which showed significant resistance to quinolones and to high level aminoglycosides. The CNS strains showed a high level of resistance to methicilline. All these strains were susceptible to glycopeptides.     

Karl Frederik Wenkebach (1864-1940) and the establishment of the Institute for the History of Medicine in the historical building of the Joseph Academy in Vienna: 1990 as a double anniversary year

The Vienna Chair for the History of Medicine was founded in 1848, and the History of Medicine Department has been in existence since 1907-1913. Karel Frederik Wenckebach, the famous specialist in internal medicine, who died exactly 50 years ago, was instrumental in creating a permanent domicile for this institute in 1920, in the historical building of the Vienna Military Medical Academy (Joseph's Academy).     

沙门菌分型血清对比研究(上海市,1999至2007年)

目的比对国产和进口沙门菌诊断血清,并了解本地区沙门菌血清型的分布和特征。方法对1999至2007年收集和分离的1 077株沙门菌进行血清学鉴定;2006和2007年全球沙门菌监测(GSS)项目病例分离沙门菌以泰国产血清的分型结果作为参照,分别和成都生物所、兰州生物所产血清进行分型比对试验。结果除肠炎沙门菌外,不同来源沙门菌间的优势血清型分布没有规律性特征。成都生物所血清与泰国血清的分型符合率为94.4%(185/196);兰州生物所血清的符合率为89.9%(151/168),H相因子c、i、e,h、r、k存在交叉凝集现象,易产生错误的结果。包括GSS分离到的7个血清型在内确认有8株沙门菌血清型为国内首次报道。结论泰国产沙门菌诊断血清在使用性能、分群及分型能力和准确性方面均优于国产的配套血清。建议基层实验室在掌握正确的使用习惯和建立相对标准化的沙门菌分型及相位诱导方法的前提下,使用国产血清搭配部分泰国因子血清的组合,即能达到低成本和高效率的分型效果。     

沙门菌分型血清对比研究（上海市，1999至2007年）

目的比对国产和进口沙门菌诊断血清,并了解本地区沙门菌血清型的分布和特征。方法对1999至2007年收集和分离的1077株沙门菌进行血清学鉴定;2006和2007年全球沙门菌监测（GSS）项目病例分离沙门菌以泰国产血清的分型结果作为参照,分别和成都生物所、兰州生物所产血清进行分型比对试验。结果除肠炎沙门菌外,不同来源沙门菌间的优势血清型分布没有规律性特征。成都生物所血清与泰国血清的分型符合率为94．4％（185／196）;兰州生物所血清的符合率为89．9％（151／168）,“H”相因子c、i、e,h、r、k存在交叉凝集现象,易产生错误的结果。包括GSS分离到的7个血清型在内确认有8株沙门菌血清型为国内首次报道。结论泰国产沙门菌诊断血清在使用性能、分群及分型能力和准确性方面均优于国产的配套血清。建议基层实验室在掌握正确的使用习惯和建立相对标准化的沙门菌分型及相位诱导方法的前提下,使用国产血清搭配部分泰国因子血清的组合,即能达到低成本和高效率的分型效果。     

Predictors of clinical severity in subjects attending the Emergency Department for substance use: a ten-year cross-sectional study

ObjectiveSubstance-related referrals to the Emergency Department (ED) are rising. Multiple substance use is frequent, and psychiatric patients represent a high-risk population. Our study aimed at identifying risk factors for increased severity in ED attendances for substance use.MethodsWe retrospectively evaluated consecutive patients attending the ED over ten years for substance-related problems, subdivided according to the triage code as having a life-threatening (LT), potentially life-threatening (P-LT), and non-life-threatening (N-LT) condition.ResultsSubstance/drug intake for deliberate self-harm was a risk factor for being classified as LT compared to both P-LT (OR = 6.357; p ≤ 0.001) and N-LT (OR = 28.19; p ≤ 0.001). Suicide attempts (OR = 4.435; p = 0.022) and multiple substance use (OR = 1.513; p = 0.009) resulted as risk factors for P-LT, compared to N-LT. Psychiatric diagnosis (OR = 1.942; p = 0.042) and multiple substance use (OR = 1.668; p = 0.047) were risk factors for being classified as LT rather than N-LT.ConclusionsIn our sample, self-harming overdoses were the strongest risk factor for highest overall severity in a real-world setting. Psychiatric disorders and multiple substance use also increased the risk for greater severity at presentation. Substance use worsens patients' clinical picture and management, suggesting the need for consultation-liaison psychiatry services in emergency contexts and highlighting the role of EDs as key sites for identification and early intervention.