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Vienna, Austria

Staudenherz A.,University of Vienna | Leitha T.,Danube Hospital
International Journal of Occupational and Environmental Medicine | Year: 2011

The currently reactor wreckage in Fukushima raised the following important questions: Is our knowledge of the possible dangers of ionizing radiation sufficient to warrant special action? What is the role of the medical community in technical radiation accidents from Windscale to Fukushima? What is the role of the medical community in terrorist radiation attacks? Are we prepared for those challenges? How can medical services communicate information in the media framework? What have we learned recently? And, what should be improved? In this review of the current literature on ionizing radiation, we try to answer these questions. Our conclusion is that medical services have to improve their communication skills and convince the public that the dangers of ionizing radiation can be quantitated within certain limits to support a qualified discussion about its risks and benefits.

Schauer I.,Medical University of Vienna | Madersbacher S.,Danube Hospital | Jost R.,Medical University of Vienna | Hbner W.A.,Landesklinikum Weinviertel Korneuburg | Imhof M.,Landesklinikum Weinviertel Korneuburg
Journal of Urology | Year: 2012

Purpose: We determined the impact of 3 surgical techniques (high ligation, inguinal varicocelectomy and the subinguinal approach) for varicocelectomy on sperm parameters (count and motility) and pregnancy rates. Materials and Methods: By searching the literature using MEDLINE and the Cochrane Library with the last search performed in February 2011, focusing on the last 20 years, a total of 94 articles published between 1975 and 2011 reporting on sperm parameters before and after varicocelectomy were identified. Inclusion criteria for this meta-analysis were at least 2 semen analyses (before and 3 or more months after the procedure), patient age older than 19 years, clinical subfertility and/or abnormal semen parameters, and a clinically palpable varicocele. To rule out skewing factors a bias analysis was performed, and statistical analysis was done with RevMan5® and SPSS 15.0®. Results: A total of 14 articles were included in the statistical analysis. All 3 surgical approaches led to significant or highly significant postoperative improvement of both parameters with only slight numeric differences among the techniques. This difference did not reach statistical significance for sperm count (p = 0.973) or sperm motility (p = 0.372). After high ligation surgery sperm count increased by 10.85 million per ml (p = 0.006) and motility by 6.80% (p <0.00001) on the average. Inguinal varicocelectomy led to an improvement in sperm count of 7.17 million per ml (p <0.0001) while motility changed by 9.44% (p = 0.001). Subinguinal varicocelectomy provided an increase in sperm count of 9.75 million per ml (p = 0.002) and sperm motility by 12.25% (p = 0.001). Inguinal varicocelectomy showed the highest pregnancy rate of 41.48% compared to 26.90% and 26.56% after high ligation and subinguinal varicocelectomy, respectively, and the difference was statistically significant (p = 0.035). Conclusions: This meta-analysis suggests that varicocelectomy leads to significant improvements in sperm count and motility regardless of surgical technique, with the inguinal approach offering the highest pregnancy rate. © 2012 American Urological Association Education and Research, Inc.

Mossaheb N.,Medical University of Vienna | Zehetmayer S.,Medical University of Vienna | Jungwirth S.,Ludwig Boltzmann Research Institute | Weissgram S.,Ludwig Boltzmann Research Institute | And 3 more authors.
Journal of Clinical Psychiatry | Year: 2012

Objective: To investigate whether specific symptoms of major depression are associated with later development of possible or probable Alzheimer's dementia. Method: The analysis is part of the Vienna Transdanube Aging Study, a prospective, community-based cohort study of all 75-year-old inhabitants of 2 Viennese districts. Current depressive symptoms were captured with a DSM-IV-TR-based questionnaire. Diagnosis of possible or probable Alzheimer's dementia was performed according to criteria by the National Institute of Neurologic and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association. The baseline sample included 437 not-demented and not previously depressed individuals. At 60-month follow-up, 65 of the remaining 296 subjects had possible or probable Alzheimer's dementia. The primary outcome measure was the probability of diagnosis of Alzheimer's dementia related to baseline depressive symptoms. Baseline data were collected between May 2000 and December 2002; 60-month follow-up data were collected between June 2005 and February 2008. Results: 10.8% of those who were diagnosed with possible or probable Alzheimer's dementia at 60-month follow-up had shown loss of interest versus 2.2% in the nondemented group. The analysis showed a significant association of loss of interest only with the later occurrence of possible or probable Alzheimer's dementia (adjusted P value <.05, OR = 5.27 [95% CI, 1.62-17.2], area under the receiver operating characteristic curve = 0.541). The specificity of this symptom in predicting Alzheimer's dementia was 97.8, and the sensitivity was 10.4. Conclusions: Of 9 symptoms of depression, only loss of interest was associated with the development of Alzheimer's dementia over a period of 5 years in a sample of 75-year-old not-demented, never-depressed subjects, suggesting that depressive symptoms in the elderly are mostly symptoms of genuine depression. © Copyright 2012 Physicians Postgraduate Press, Inc.

Hammerer P.,Academic Hospital Braunschweig | Madersbacher S.,Danube Hospital
BJU International | Year: 2012

It is >70 years since the responsiveness of symptomatic metastatic prostate cancer to androgen deprivation was first demonstrated. Since those pivotal studies, progress in hormonal therapy of prostate cancer has been marked by several important developments and the availability of various androgen-suppressing agents. Treatment guidelines have continued to evolve with clinical and therapeutic progress, but androgen-deprivation therapy (ADT) remains the standard of care for non-localised prostate cancer. Because of the long-term experience (>20 years) and wealth of evidence from the large number of clinical trials, the luteinizing hormone-releasing hormone (LHRH) agonists are currently the main forms of ADT. Treatment strategies should be adapted to the individual patient in terms of timing, duration and choice of agent. Prostate cancer remains the most common type of cancer in men and the development of castration-resistant disease seems inevitable, which together drive the clear and continuing need for new, effective agents for ADT to be used alongside the LHRH agonists. © 2012 BJU INTERNATIONAL.

Altenberger J.,Paracelsus Medical University | Parissis J.T.,National and Kapodistrian University of Athens | Costard-Jaeckle A.,University of Hamburg | Winter A.,Hospital of the Sisters of Charity Linz | And 8 more authors.
European Journal of Heart Failure | Year: 2014

Aims The aim of this study was to determine whether intermittent ambulatory treatment with levosimendan would improve functional capacity, quality of life, and event-free survival in patients with advanced heart failure. Methods and results This was a prospective, randomized, double-blind, placebo-controlled, multicentre, parallel-group trial of pulsed infusions of levosimendan in 120 outpatients with advanced heart failure (EF ≤35%, NYHA class III or IV). The study was conducted at 11 centres in Austria, Greece, and Germany. Levosimendan (0.2 μg/kg/min) or placebo was administered for 6 h at 2-week intervals over 6 weeks, in addition to standard care therapy. The primary outcome was the proportion of patients with a ≥20% improvement in the 6 min walk test and a ≥15% score increase on the Kansas City Cardiomyopathy Questionnaire at the end of the 24-week study period. Secondary outcomes included event-free survival after 24 weeks. Analyses were performed on an intention-to-treat basis. The primary endpoint was reached in 19% of patients receiving levosimendan and 15.8% of patients receiving placebo (odds ratio 1.25; 95% confidence interval 0.44-3.59; P = 0.810). Cardiac death (four vs. one), heart transplants (two vs. one), and acute heart failure (14 vs. nine) were more frequent with placebo as compared with levosimendan. The incidence of side effects was comparable between groups. Conclusion Intermittent ambulatory treatment with levosimendan in patients with advanced heart failure did not improve significantly functional capacity or quality of life as compared with placebo. An adequately powered, event-driven trial is warranted to enlarge on our findings. Trial registration: NCT01065194. © 2014 The Authors. European Journal of Heart Failure © 2014 European Society of Cardiology.

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