• 【食源性甲型肝炎暴发,奥地利2007年11月-2008年1月。】 复制标题 收藏 收藏
    DOI:10.1007/s10096-008-0633-0 复制DOI
    作者列表:Schmid D,Fretz R,Buchner G,König C,Perner H,Sollak R,Tratter A,Hell M,Maass M,Strasser M,Allerberger F
    BACKGROUND & AIMS: :An outbreak of hepatitis A affecting 21 residents of an Austrian city occurred from the end of November 2007 until mid-January 2008. A case series investigation suggested the consumption of food purchased from supermarket X as the common link. A food handler employed in the delicatessen department of that supermarket had been serologically diagnosed with hepatitis A on 28th November 2007. During the infectious period of approximately 3 weeks, he worked on 11 days. Interviews with the other cluster cases revealed that the hepatitis A virus (HAV)-infected food handler did not practice appropriate hand hygiene. The investigation revealed no other possible source of infection. We hypothesize that the food of the delicatessen department contaminated by the HAV-infected food handler during his infectious period was the source of the outbreak. The district public health authority recommended the reinforcement of hygiene precautions, i.e., access to viricidal hand disinfectant and the use of disposable gloves and single-use paper towels, in the involved supermarket. The federal ministry of health recommended HAV vaccination for all food handlers in food production and gastronomy companies; this recommendation was included in the Austrian national vaccination plan 2008, even though the vaccination of food handlers is costly and its cost-effectiveness is not proven. Appropriate and regular hand hygiene, particularly after toilet visits, is the most effective measure for preventing HAV transmission.
    背景与目标: : 从2007年11月底到2008年1月月中旬,发生了影响奥地利城市21名居民的甲型肝炎疫情。一系列案例调查表明,从超市X购买的食物的消费是共同的环节。2007年11月28日,该超市熟食店的一名食品管理员被血清学诊断为甲型肝炎。在大约3周的传染期内,他工作了11天。对其他集群病例的采访显示,感染甲型肝炎病毒 (HAV) 的食品处理人员没有采取适当的手卫生。调查没有发现其他可能的传染源。我们假设熟食部门的食物在其感染期间被感染了HAV的食物处理者污染是爆发的源头。地区公共卫生当局建议在涉及的超市中加强卫生预防措施,即使用杀病毒的手部消毒剂,并使用一次性手套和一次性纸巾。联邦卫生部建议为食品生产和美食公司的所有食品处理者接种HAV疫苗; 该建议已被纳入奥地利国家疫苗接种计划2008,尽管食品处理者的疫苗接种成本高昂且其成本效益尚未得到证实。适当和定期的手卫生,特别是在上厕所后,是防止HAV传播的最有效措施。
  • 【第21届欧洲风湿病学研究研讨会,奥地利维也纳,1-2001年3月4日。】 复制标题 收藏 收藏
    DOI:10.1186/ar306 复制DOI
    作者列表:Utz PJ
    BACKGROUND & AIMS: :Major advances in technology now drive how we approach questions in immunology, particularly in analyzing complex data sets commonly encountered in genomics and proteomics studies. Active areas of investigation include development of novel technologies, identification of elusive target antigens for RA and other diseases, dissection of signaling pathways connecting the lymphocyte cell surface with the nucleus, and exploration of new avenues for therapeutic interventions. The European Workshop for Rheumatology Research (EWRR) is a forum for many European and non-European scientists to present research findings of high quality. Arthritis researchers from around the globe should be strongly encouraged to attend future meetings, the next of which is the 22nd EWRR meeting in Leiden, the Netherlands, in 2002.
    背景与目标: : 现在,技术的重大进步推动了我们如何解决免疫学问题,特别是在分析基因组学和蛋白质组学研究中常见的复杂数据集时。积极的研究领域包括新技术的开发,RA和其他疾病的难以捉摸的靶抗原的鉴定,连接淋巴细胞表面与细胞核的信号通路的解剖以及探索治疗干预的新途径。欧洲风湿病研究研讨会 (EWRR) 是许多欧洲和非欧洲科学家展示高质量研究成果的论坛。应大力鼓励来自全球的关节炎研究人员参加未来的会议,下一次是2002年在荷兰莱顿举行的第22届EWRR会议。
  • 【奥地利结直肠癌筛查的有效性、获益危害和成本效益。】 复制标题 收藏 收藏
    DOI:10.1186/s12876-019-1121-y 复制DOI
    作者列表:
    BACKGROUND & AIMS: BACKGROUND:Clear evidence on the benefit-harm balance and cost effectiveness of population-based screening for colorectal cancer (CRC) is missing. We aim to systematically evaluate the long-term effectiveness, harms and cost effectiveness of different organized CRC screening strategies in Austria. METHODS:A decision-analytic cohort simulation model for colorectal adenoma and cancer with a lifelong time horizon was developed, calibrated to the Austrian epidemiological setting and validated against observed data. We compared four strategies: 1) No Screening, 2) FIT: annual immunochemical fecal occult blood test age 40-75 years, 3) gFOBT: annual guaiac-based fecal occult blood test age 40-75 years, and 4) COL: 10-yearly colonoscopy age 50-70 years. Predicted outcomes included: benefits expressed as life-years gained [LYG], CRC-related deaths avoided and CRC cases avoided; harms as additional complications due to colonoscopy (physical harm) and positive test results (psychological harm); and lifetime costs. Tradeoffs were expressed as incremental harm-benefit ratios (IHBR, incremental positive test results per LYG) and incremental cost-effectiveness ratios [ICER]. The perspective of the Austrian public health care system was adopted. Comprehensive sensitivity analyses were performed to assess uncertainty. RESULTS:The most effective strategies were FIT and COL. gFOBT was less effective and more costly than FIT. Moving from COL to FIT results in an incremental unintended psychological harm of 16 additional positive test results to gain one life-year. COL was cost saving compared to No Screening. Moving from COL to FIT has an ICER of 15,000 EUR per LYG. CONCLUSIONS:Organized CRC-screening with annual FIT or 10-yearly colonoscopy is most effective. The choice between these two options depends on the individual preferences and benefit-harm tradeoffs of screening candidates.
    背景与目标:
  • 【奥地利强化糖尿病足护理的成本和收益分析模型。】 复制标题 收藏 收藏
    DOI:10.1111/j.1365-2753.2006.00770.x 复制DOI
    作者列表:Habacher W,Rakovac I,Görzer E,Haas W,Gfrerer RJ,Wach P,Pieber TR
    BACKGROUND & AIMS: RATIONALE, AIMS AND OBJECTIVES:The diabetic foot is a common late complication among diabetic patients and due to its consequences an important financial burden for society. Intensified treatment has proved to reduce amputation rates, but in Austria so far no data have been available about financial implications and long-term effects of intensified treatment. The objective was to retrieve cost data for intensified treatment of diabetic foot ulcers and to estimate the long-term outcome. METHODS:A retrospective data analysis of 119 ulcers was done to get outcomes and costs for intensified treatment in a specialized outpatient hospital department in an Austrian setting. One-year results were categorized according to the San Antonio wound classification. Using a Markov model upon these data, long-term outcomes and costs for intensified treatment and for standard care were calculated. RESULTS:Costs for intensified treatment until healing vary from euro 1071 (range: 99-4089) per case to euro 7844 (range: 104-25 615) depending on the lesion's grade. One-year healing rates are 85.2% for grade A and 71.7%, 84.6% and 33.3% for the grades B, C and D respectively. The model-based comparison for treatment costs shows a cost reduction of 29.8% per patient year in grade A ulcerations and 49.7% in grade D for intensified versus standard treatment due to lower amputation rates. CONCLUSIONS:These results are the first cost data for diabetic foot care in Austria and demonstrate the advantages of intensified care over standard care in terms of patient-oriented outcome and financial impact pleading for the implementation of specialized foot care facilities and referral guidelines to standardize and improve treatment.
    背景与目标:
  • 【首次在奥地利的一个繁殖犬舍中检测到犬布鲁氏菌感染。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Hofer E,Bag ZN,Revilla-Fern Ndez S,Melzer F,Tomaso H,L Pez-Go I I,Fasching G,Schmoll F
    BACKGROUND & AIMS: :Brucella canis occurs almost worldwide and is a potential danger to the health of dogs and humans. The pathogen was detected in the placenta and fetuses of a Standard Poodle by direct culture and immunohistochemistry. Further, Brucellae were also isolated from the blood samples of two asymptomatic female Medium Poodles. The isolates were identified as B. canis by conventional microbiological methods and a novel Bruce-ladder multiplex PCR. Genotyping was performed by multiple locus variable number tandem repeats analysis (MLVA).
    背景与目标: : 犬布鲁氏菌几乎在世界范围内发生,对狗和人类的健康构成潜在危险。通过直接培养和免疫组织化学在标准贵宾犬的胎盘和胎儿中检测到病原体。此外,还从两只无症状的雌性中型贵宾犬的血液样本中分离出了布鲁氏菌。通过常规的微生物学方法和新型的Bruce-ladder多重PCR将分离物鉴定为犬B.。通过多基因座可变数量串联重复序列分析 (MLVA) 进行基因分型。
  • 【在俄罗斯,波兰,斯洛文尼亚和奥地利分离的淀粉欧文氏菌菌株的分子分析,描述了火疫病在欧洲的进一步蔓延。】 复制标题 收藏 收藏
    DOI:10.1016/j.micres.2013.01.008 复制DOI
    作者列表:Jock S,Wensing A,Pulawska J,Drenova N,Dreo T,Geider K
    BACKGROUND & AIMS: :Fire blight, a bacteriosis of apple and pear, was assayed with molecular tools to associate its origin in Russia, Slovenia and south-eastern Austria with neighboring countries. The identification of all investigated strains was confirmed by MALDI-TOF mass spectroscopy except one. Independent isolation was verified by the level of amylovoran synthesis and by the number of short sequence DNA repeats in plasmid pEA29. DNA of gently lysed E. amylovora strains from Russia, Slovenia, Austria, Hungary, Italy, Spain, Croatia, Poland, Central Europe and Iran was treated with restriction enzymes XbaI and SpeI to create typical banding patterns for PFGE analysis. The pattern Pt2 indicated that most Russian E. amylovora strains were related to strains from Turkey and Iran. Strains from Slovenia exhibited patterns Pt3 and Pt2, both present in the neighboring countries. Strains were also probed for the recently described plasmid pEI70 detected in Pt1 strains from Poland and in Pt3 strains from other countries. The distribution of pattern Pt3 suggests distribution of fire blight from Belgium and the Netherlands to Central Spain and Northern Italy and then north to Carinthia. The PFGE patterns indicate that trade of plants may have introduced fire blight into southern parts of Europe proceeded by sequential spread.
    背景与目标: : 火疫病是一种苹果和梨的细菌,已通过分子工具进行了分析,以将其在俄罗斯,斯洛文尼亚和奥地利东南部的起源与邻国联系起来。除一种菌株外,所有菌株的鉴定均通过maldi-tof质谱证实。通过amylovoran的合成水平和质粒pea29中短序列DNA重复序列的数量验证了独立隔离。用限制酶XbaI和SpeI处理了来自俄罗斯,斯洛文尼亚,奥地利,匈牙利,意大利,西班牙,克罗地亚,波兰,中欧和伊朗的轻度裂解的淀粉样曲霉菌株的DNA,以创建用于PFGE分析的典型条带模式。Pt2模式表明,大多数俄罗斯淀粉样芽孢杆菌菌株与来自土耳其和伊朗的菌株有关。来自斯洛文尼亚的菌株表现出Pt3和Pt2的模式,都存在于邻国。还对最近在波兰的Pt1菌株和其他国家的Pt3菌株中检测到的质粒pEI70进行了检测。模式Pt3的分布表明,从比利时和荷兰到西班牙中部和意大利北部,再到北部到克恩滕州的火疫病分布。PFGE模式表明,植物贸易可能通过顺序传播将火疫病引入了欧洲南部。
  • 【奥地利复发缓解型多发性硬化的口服疗法: 使用逆概率加权方法进行的2年比较。】 复制标题 收藏 收藏
    DOI:10.1007/s00415-020-09811-6 复制DOI
    作者列表:Guger M,Enzinger C,Leutmezer F,Kraus J,Kalcher S,Kvas E,Berger T,Austrian MS Treatment Registry (AMSTR).
    BACKGROUND & AIMS: OBJECTIVES:To compare the efficacies, frequencies and reasons for treatment interruption of fingolimod (FTY), dimethyl fumarate (DMF) or teriflunomide (TERI) in a nationwide observational cohort. MATERIALS AND METHODS:Two cohorts of patients with relapsing-remitting multiple sclerosis (RRMS) having started treatment with FTY, DMF or TERI documented in the Austrian MS Treatment Registry (AMSTR) since 2014 and either staying on therapy for at least 24 months (24 m cohort) or with at least one follow-up visit after start of treatment (total cohort). The 24 m cohort included 629 RRMS patients: 295 in the FTY, 227 in the DMF and 107 in the TERI group. We used multinomial propensity scores for inverse probability weighting in generalized linear and Cox proportional hazards models to correct for the bias of this non-randomised registry study. RESULTS:Estimated mean annualized relapse rates (ARR) over 24 months were 0.13 for FTY, 0.09 for DMF and 0.11 for TERI treatment. For TERI in comparison with DMF, we observed higher probability for treatment interruption (p = 0.023) and reduced sustained EDSS regression for 12 (p = 0.016) and 24 weeks (p = 0.031) and, for the comparison of DMF versus FTY, a reduced sustained EDSS progression for 12 weeks (p = 0.02). CONCLUSIONS:Relapse rates with treatment with FTY, DMF and TERI were similar. Patients treated with DMF showed less sustained disability progression for 12 weeks than FTY-treated patients. However, FTY and DMF treatment was associated with more likely EDSS regression for 12 and 24 weeks and a lower probability for treatment interruption as compared to TERI-treated patients.
    背景与目标:
  • 【根据tri,cfc和稳定同位素推断,奥地利东部Semmering集水区泉水的停留时间和年龄分布。】 复制标题 收藏 收藏
    DOI:10.1080/10256010601154015 复制DOI
    作者列表:Han L,Hacker P,Gröning M
    BACKGROUND & AIMS: :The groundwater system in the mountainous area of Semmering, Austria, was studied by environmental tracers in several karst springs. The tracers used included stable isotopes ((18)O, (2)H), tritium ((3)H) and chlorofluorocarbons (CFCs). The tracers provided valuable information in regard to (1) the mean altitude of the spring catchment areas; (2) the residence time and age distribution of the spring waters; and (3) the interconnection of the springs to a sinkhole. The combination of the stable isotopic data and the topography/geology provided the estimates of the mean altitudes of the catchment areas. Based on the stable isotopic data the recharge temperature of the spring waters was estimated. The smoothing of precipitation's isotopic signal in spring discharge provided information on the minimum transit time of the spring waters. Due to short observation time, (3)H data alone cannot be used for describing the mean residence time of the karst waters. CFCs, though useful in recognizing the co-existence of young (post-1993) water with old (CFC-free) water, could not be used to resolve age distribution models. It is shown in this article, however, that the combined use of tritium and CFCs can provide a better assessment of models to account for different groundwater age distributions. In Appendix A, a simplified method for collecting groundwater samples for the analysis of CFCs is described. The method provides a real facilitation for fieldwork. Test data are given for this sampling method in regard to potential contamination by atmospheric CFCs.
    背景与目标: : 通过环境示踪剂在几个喀斯特温泉中研究了奥地利塞默灵山区的地下水系统。使用的示踪剂包括稳定同位素 ((18)O,(2)H),tri ((3)H) 和氯氟烃 (cfc)。示踪剂提供了有关以下方面的宝贵信息 :( 1) 春季集水区的平均海拔; (2) 泉水的停留时间和年龄分布; (3) 泉水与天坑的相互连接。稳定的同位素数据和地形/地质的结合提供了集水区平均海拔高度的估计。根据稳定的同位素数据,估算了泉水的补给温度。春季排放中降水同位素信号的平滑提供了有关春季水最小通过时间的信息。由于观测时间短,(3)H数据不能单独用于描述岩溶水域的平均停留时间。氟氯化碳虽然有助于识别年轻 (1993后) 水与旧 (不含氟氯化碳) 水的共存,但不能用于解决年龄分布模型。但是,本文表明,tri和cfc的结合使用可以更好地评估模型,以说明不同的地下水年龄分布。在附录A中,描述了一种用于收集地下水样品以分析cfc的简化方法。该方法为实地工作提供了真正的便利。给出了这种采样方法的测试数据,涉及大气中氟氯化碳的潜在污染。
  • 【奥地利卡林西亚甲状腺癌的描述性流行病学: 1984-2001。食盐1990年一般碘化升高734例的组织病理学特征和肿瘤分类: 基于人群的甲状腺年龄分层分析】 复制标题 收藏 收藏
    DOI:10.1089/105072504323030933 复制DOI
    作者列表:Gomez Segovia I,Gallowitsch HJ,Kresnik E,Kumnig G,Igerc I,Matschnig S,Stronegger WJ,Lind P
    BACKGROUND & AIMS: INTRODUCTION:The aim of the study was to investigate the current thyroid carcinoma (TC) incidence in Carinthia, a former iodine-deficient, goiter-endemic region in Austria with approximately 550,000 inhabitants from 1984 to 2001. Using age-cohort analysis we analyzed the TC incidence under the impact of two regional risk factors: the contamination of Austrian soils by the radioactive fallout in from Chernobyl 1986 and the increased iodination of table salt in a general program of goiter prophylaxis begun in 1991. To evaluate the characteristics of TC incidence, we compared the results of the periods 1984-1989, 1990-1995, and 1996-2001. RESULTS:A total of 734 TC cases were diagnosed. Papillary, follicular, medullary, oxyphilic, and anaplastic TC accounted for 76%, 18%, 3%, 1%, and 2%, respectively. The female to male ratio was 3:1. The annual incidence rate increased by 8.05% in females and 11.6% in males. TC cases younger than 40 years of age accounted for 22.6%, with a rate increase of 18% per year in young males, the female-to-male ratio decreased from 8.3, 6.1, 2.7 younger than 40 in the compared periods. Along with a further increase in papillary TC incidence and papillary thyroid carcinoma (PTC) follicular thyroid carcinoma (FTC) ratio in the adult population, the ratio tended to decrease in the younger than 40-year-old population. T4 class TC and loco-regional lymph node involvement increased significantly. INTERPRETATION:The observed changes in TC incidence, particularly in the young population, as in adults, could be linked to the abovementioned risk factors involved in the initiation and early growth of TC, and iodine may play a role in stimulating overall thyroid activity.
    背景与目标:
  • 【自奥地利切尔诺贝利事故以来的食品污染调查。】 复制标题 收藏 收藏
    DOI:10.1016/j.apradiso.2004.03.008 复制DOI
    作者列表:Schwaiger M,Mueck K,Benesch T,Feichtinger J,Hrnecek E,Lovranich E
    BACKGROUND & AIMS: :In a large-scale investigation the decrease of the activity concentration of 137Cs in foodstuffs after the widespread Chernobyl fallout was determined. At different times after the deposition in 1986 more than 1000 samples of various foodstuffs in Austria were taken and investigated with regard to their activity concentration. The investigation showed that in the first year after deposition, the activity concentration decreased to about 6-10% (milk, fruit), and 3-6%, respectively (grain, potatoes, vegetables) of the values in the fallout maximum. The calculated effective half-lives are significantly shorter than observed after nuclear weapon test series and result in a smaller long-term exposure than estimated before. The effective ingestion dose in the 50 years following of a one-time nuclear fallout amounts to about 1.3 times of the first year ingestion dose. In 2002, the ingestion dose in Austria amounts to 2.24 microSv (adult), or 0.88 microSv (5-year infant) respectively, which is less than 0.5% of the ingestion dose of the first year and amounts to 0.7% of the ingestion dose from natural radionuclides.
    背景与目标: : 在大规模调查中,确定了广泛的切尔诺贝利事故后,食品中137Cs的活性浓度降低。在沉积1986年后的不同时间,采集了奥地利1000多种食品的样品,并对其活性浓度进行了调查。调查表明,在沉积后的第一年,活性浓度下降到约6-10% (牛奶,水果) 和3-6% (谷物,土豆,蔬菜) 的最大沉降值。计算出的有效半衰期比核武器试验系列后观察到的要短得多,并且导致的长期暴露比以前估计的要小。一次性核辐射后50年内的有效摄入剂量相当于第一年摄入剂量的约1.3倍。2002,奥地利的摄入剂量分别为2.24 microSv (成人) 或0.88 microSv (5岁婴儿),小于第一年的摄入剂量的0.5%,并且等于天然放射性核素的摄入剂量的0.7%。
  • 【奥地利医疗保健资源的分布-不同时间点不同医疗保健资源的不平等评估。】 复制标题 收藏 收藏
    DOI:10.1177/0020731419893058 复制DOI
    作者列表:Sommersguter-Reichmann M,Reichmann G
    BACKGROUND & AIMS: :A major objective of health policy in many countries is to avoid inequality in the distribution of health care resources. Our goal is to provide initial insight into the inequality in the regional distribution of different health care resources per capita and the variation of the inequality over time in Austria to provide starting points for policy recommendations and international comparisons. We also aim to examine whether the type of inequality measure and need-adjustment has an impact on the results. The findings reveal that inequality in the distribution of GPs with contracts with social health insurance is comparably small, but we observe an increase in inequality from 2002 to 2014. In general, there is a clear trend toward private physicians, of whom private specialists preferably open their practices in densely populated areas. Despite considerable reductions in public hospital beds between 2002 and 2014, the distribution across regions remains almost constant. The use of different inequality measures and need-adjustment provides additional insights so that custom-made policies to reduce inequalities can be developed.
    背景与目标: : 许多国家卫生政策的一个主要目标是避免卫生保健资源分配的不平等。我们的目标是初步了解奥地利人均不同医疗保健资源的区域分布不平等以及不平等随时间的变化,从而为政策建议和国际比较提供起点。我们还旨在检查不平等措施和需求调整的类型是否会对结果产生影响。研究结果表明,具有社会健康保险合同的全科医生分布的不平等程度相对较小,但我们观察到2014年2002年的不平等程度有所增加。总的来说,私人医生有明显的趋势,其中私人专家最好在人口稠密的地区开设诊所。尽管公立医院床位2002年和2014大幅减少,但各地区的分布几乎保持不变。使用不同的不平等措施和需求调整提供了更多的见解,以便可以制定定制的政策来减少不平等。
  • 【[奥地利预防自杀 (同上): 实施国家预防自杀计划]。】 复制标题 收藏 收藏
    DOI:10.1007/s40211-012-0025-7 复制DOI
    作者列表:Haring C,Sonneck G
    BACKGROUND & AIMS: :Suicide Prevention Austria (SUPRA) is a package of measures which should help the Austrian ministry of health to realize an evidence based suicide prevention program. That such a program is indispensible can be seen on the fact that suicide is on the second position as cause of death in male Austrians up to the age of forty. The concept itself summarizes successful national programs which fit to the Austrian situation. In the meantime the Austrian ministry of health established an office for coordination of the SUPRA program and a commission of experts which is responsible for the first activities of the national Austrian suicide prevention program.
    背景与目标: : 奥地利自杀预防 (同上) 是一揽子措施,应帮助奥地利卫生部实现基于证据的自杀预防计划。从自杀在40岁以下的男性奥地利人中处于第二位的死亡原因这一事实可以看出,这样的计划是必不可少的。该概念本身总结了适合奥地利情况的成功国家计划。同时,奥地利卫生部设立了SUPRA计划协调办公室和专家委员会,负责奥地利国家预防自杀计划的首次活动。
  • 【[医生处方行为以奥地利全科医生及其药品处方为例]。】 复制标题 收藏 收藏
    DOI:10.1055/s-0030-1255081 复制DOI
    作者列表:Müller M,Meyer H,Stummer H
    BACKGROUND & AIMS: BACKGROUND:In extramural setting, general practitioners serve as gatekeepers and therefore control the demand for medical treatment and pharmaceuticals. As a result prescription habits are of major interest. AIM:The aim of the present study is to identify sample characteristics in the prescription behaviour of the general practitioners that allow one to differentiate between the individual and the basic population. METHODS:The prescription behaviour of 4 231 general practitioners was operationalised by means of the two variables "quantity" and "price". Outliers in those categories, that indicate a doctor prescribing too many or too expensive drugs, were identified using Chebyshev's inequality. RESULTS:We found a statistically significant linear relationship between the individual characteristics of the medical doctors and their prescription behaviour (0.54≤ r ≤0.89) as well as between the variables "quantity" and "price" (r=0.86). Particularly notable seems to be the correlation between the number of the consultations and the quantity of the prescribed drugs. The average prescription amounts to approximately 1.8 pharmaceuticals per consultation. The quantity of drugs prescribed correlates with the demand for the physician's service. Only a few general practitioners deviate from this coherence. The tendency to prescribe disproportionately expensive drugs (average costs amount to € 18.4 per drug) especially applies to those general practitioners who, in addition to their occupation as a physician, are allowed to dispense the pharmaceuticals directly to the patient within their privately owned pharmacies ("Hausapotheke"). In addition to this attribute, the variables "number of patients" and "number of consultations" intensify the effect. The risk to be identified as an outlier is 7 times higher within the group of general practitioners who own a "Hausapotheke" and account for an above average number of consultations as within the group that does not incorporate those characteristics. CONCLUSION:The strong coherence between the quantity and the demand is inherent to the health-care system and explains 79% of the variance of the prescribed quantities. Only 21% of the variance is determined by outside influences such as state of health of the patients. Physicians who have a monetary benefit from also distributing the drugs, however, enhance the prescription of high priced pharmaceuticals.
    背景与目标:
  • 【奥地利穿孔憩室疾病的外科治疗。】 复制标题 收藏 收藏
    DOI:10.1007/BF00303274 复制DOI
    作者列表:Hold M,Denck H,Bull P
    BACKGROUND & AIMS: :Perforated diverticulitis is a much feared complication of diverticular disease and requires immediate surgical therapy to limit the incipient peritonitis and its sequelae. The ensuing surgical approach which could best irradiate the septic focus as well as restore normal intestinal continuity with less morbidity and mortality has been a matter of controversy. In the last ten years primary resection and colostomy has replaced the three-stage procedure in most cases of peritonitis. Primary anastomosis, when peritoneal involvement is well confined, has been shown to give excellent results. To assess the surgical management of perforating diverticulitis in Austria, a questionnaire was sent to leading hospitals throughout the country and information of 241 patients with perforating diverticulitis was compiled. The overall peroperative mortality was 9%, and the highest rate of complication (37.9%) was observed after primary resection and anastomosis with temporary defunctioning proximal colostomy. The mortality, as expected, is directly proportional to the extent of peritonitis; it was significantly greater among patients with generalised peritonitis and lowest among cases of covered perforation.
    背景与目标: : 穿孔憩室炎是憩室疾病的一种令人担忧的并发症,需要立即手术治疗以限制初期腹膜炎及其后遗症。随后的手术方法可以最好地照射脓毒症灶,并恢复正常的肠道连续性,降低发病率和死亡率,这一直是一个有争议的问题。在过去的十年中,大多数腹膜炎病例的原发性切除和结肠造口术已取代了三阶段手术。当腹膜受累受到很好的限制时,原发性吻合已被证明具有出色的效果。为了评估奥地利穿孔憩室炎的外科治疗,向全国各地的主要医院发送了一份问卷,并收集了241例穿孔憩室炎患者的信息。总的围手术期死亡率为9%,并且在一次切除和吻合术合并临时近端结肠造口术后观察到最高的并发症发生率 (37.9%)。如预期的那样,死亡率与腹膜炎的程度成正比; 在全身性腹膜炎患者中,死亡率显着更高,而在覆盖穿孔病例中最低。
  • 【优化器官捐赠: 来自奥地利,德国,西班牙和英国的专家意见。】 复制标题 收藏 收藏
    DOI:10.12659/AOT.921727 复制DOI
    作者列表:Becker F,Roberts KJ,Nadal M,Zink M,Stiegler P,Pemberger S,Castellana TP,Kellner C,Murphy N,Kaltenborn A,Tuffs A,Amelung V,Krauth C,Bayliss J,Schrem HH
    BACKGROUND & AIMS: :BACKGROUND Organ donation-rates using deceased donors and organizational approaches to organ donation differ drastically between countries at a similar level of health care as measured by the Euro Health Consumer Index (EHCI). MATERIAL AND METHODS Expert opinions from intensive care nurses, physicians, transplant coordinators and transplant surgeons from Austria, Germany, Spain, and the U.K. were obtained in semi-structured interviews followed by qualitative content analysis. Results were reported back to all interview partners to identify potential controversies and consensus recommendations. RESULTS No controversies could be detected. On a variety of beneficial factors an interprofessional consensus between interview partners could be reached: A) The relevance of standardization of the screening for potential donors, the family approach and training; B) standards and best-practice procedures should be regulated and supervised by state authorities; C) full transparency and the prevention of scandals is essential; D) overburdened intensive care unit (ICU) doctors need to be supported by full-time in-house special nurses who organize donor evaluation, transport logistics and pastoral care, if required; E) public awareness campaigns are helpful; F) a broad public consensus on the concept of donation after brain and cardiac death is essential; G) incentives for the reporting of potential organ donors are inappropriate; H) an opt-out system alone is not sufficient. CONCLUSIONS Expert opinions from different professional backgrounds from different European health care systems reach a broad consensus on the most relevant issues for the improvement of organ donation.
    背景与目标: : 背景器官捐赠-根据欧元健康消费者指数 (EHCI) 衡量,在医疗保健水平相似的国家之间,使用已故捐赠者的比率和器官捐赠的组织方法差异很大。材料和方法在半结构化访谈中获得了来自奥地利,德国,西班牙和英国的重症监护护士,医生,移植协调员和移植外科医生的专家意见,然后进行定性内容分析。结果已报告给所有访谈合作伙伴,以确定潜在的争议和共识建议。结果未发现任何争议。在各种有利因素上,可以在面试伙伴之间达成专业间共识: a) 筛选潜在捐助者的标准化,家庭方法和培训的相关性; B) 标准和最佳实践程序应由国家当局管理和监督; C) 充分透明和预防丑闻至关重要; D) 负担过重的重症监护病房 (ICU) 医生需要得到全职内部特殊护士的支持,这些护士在需要时组织捐助者评估,运输后勤和牧区护理; E) 公众意识运动是有帮助的; F) 对脑死亡和心源性死亡后的捐赠概念达成广泛的公众共识至关重要; G) 报告潜在器官捐献者的激励措施是不合适的; H) 仅选择退出系统是不够的。结论来自欧洲不同医疗体系的不同专业背景的专家意见在器官捐献改善最相关的问题上达成了广泛共识。

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