General Hospital of Klagenfurt

Klagenfurt am Wörthersee, Austria

General Hospital of Klagenfurt

Klagenfurt am Wörthersee, Austria
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Worda K.,Medical University of Vienna | Bancher-Todesca D.,Medical University of Vienna | Husslein P.,Medical University of Vienna | Worda C.,Medical University of Vienna | Leipold H.,General Hospital of Klagenfurt
Wiener Klinische Wochenschrift | Year: 2017

Summary: Objective: To compare the impact of induction of labor at 38 weeks of gestation with the induction of labor at 40 weeks of gestation in women with insulin-treated gestational diabetes on maternal and fetal outcome. Summary: Study design: In this study 100 pregnant women with insulin-treated gestational diabetes were randomized to either induction of labor at 38 (group I) or 40 weeks (group II) to evaluate the rate of large for gestational age newborns, neonatal hypoglycemia, success rate of deliveries within 48 h and cesarean section rate after induction in both groups. Summary: Results: The difference of large for gestational age newborns was not significant between the two groups (6.8% vs. 12.8%, p = 0.49), 16 (36.4%) newborns in group I and 8 (17.0%) newborns in group II developed hypoglycemia <35 mg/dl (p = 0.04). The success rate for deliveries within 48 h after induction of labor for groups I and II was 77.3% and 92.3%, respectively (p = 0.25). The cesarean section rate after induction of labor was not significantly different between the two groups (24.1% vs. 18.7%, p = 0.49). Summary: Conclusion: In a cohort of women with insulin-treated gestational diabetes, induction of labor at 38 weeks did not significantly reduce the rate of large for gestational age newborns compared to induction at 40 weeks but seems to increase the rate of neonatal hypoglycemia. © 2017 Springer-Verlag Wien

Klobassa D.S.,Medical University of Graz | Zoehrer B.,Medical University of Graz | Paulke-Korinek M.,Medical University of Vienna | Gruber-Sedlmayr U.,Medical University of Graz | And 20 more authors.
European Journal of Pediatrics | Year: 2014

The present study was conducted to evaluate the burden of pneumococcal meningitis in Austrian children between 2001 and 2008. Clinical outcome was retrospectively analyzed both on discharge and on follow-up investigations. This study was based on a prospective multicentre surveillance study on hospitalized invasive pneumococcal infections in Austrian children with a total annual "study population" of about 399,000 children aged below 5 years per year. Between 2001 and 2008, 74 cases of pneumococcal meningitis were identified in children aged below 5 years. The mean annual incidence rate for pneumococcal meningitis was 2.3 per 100,000 children in this age group. In 57/74 children (mean age on admission 14.5±13.3 months), outcome data on hospital discharge were available: 5 deaths (8.8 %), 20 children (35.1 %) with sequelae and 32 children (56.1 %) without sequelae were observed. Sequelae on discharge included motor impairment in 8 children (14.0 %), hearing impairment in 9 children (15.8 %) and/or other complications in 14 children (24.6 %). In 7/8 children with motor deficits, matching cerebral lesions were identified by neuroimaging: cerebral infarction in five children, cerebral vasculitis and cerebral abscess in one child each. In 40/57 children, long-term outcome (18.9±20.2 months after discharge) could be assessed: 1 child (2.5 %) died 9 months after hospital discharge, 11 children (27.5 %) had one or two long-term sequelae and 28 children (70.0 %) had no sequelae. Long-term sequelae included motor impairment in three children (7.5 %), hearing impairment in nine children (22.5 %) and other deficits in two children (5.0 %). Conclusion: Our study confirms that pneumococcal meningitis causes high mortality and severe long-term sequelae. On long-term follow-up, we observed improvements of motor impairment, but not of hearing impairment. © 2014 Springer-Verlag.

Celedin S.,General Hospital of Klagenfurt | Kau T.,General Hospital of Klagenfurt | Gasser J.,General Hospital of Klagenfurt | Kraschl R.,General Hospital of Klagenfurt | Sinzig M.,General Hospital of Klagenfurt
Pediatric Neurology | Year: 2010

Fetal magnetic resonance imaging is increasingly being used as an adjunct to ultrasound. It allows for better visualization of in utero brain development and intracranial abnormalities (especially cerebral malformations). Hypothalamic hamartoma is a nonneoplastic malformation resembling normal hypothalamic tissue both histologically and on magnetic resonance imaging. Although it is rare, this entity is important to recognize for appropriate management and genetic counseling. We describe a unique patient in whom magnetic resonance imaging of the fetal brain allowed a prenatal diagnosis of Pallister-Hall syndrome. © 2010 Elsevier Inc. All rights reserved.

Klein K.,Medical University of Vienna | Mailath-Pokorny M.,Medical University of Vienna | Leipold H.,General Hospital of Klagenfurt | Krampl-Bettelheim E.,Medical University of Vienna | Worda C.,Medical University of Vienna
Twin Research and Human Genetics | Year: 2010

Objective: To evaluate the influence of gestational diabetes mellitus on weight discrepancy in twin pregnancies. Methods: 200 twin pregnancies were included in the study. 157 nondiabetic pregnant women with twin gestations and 43 twin pregnancies with gestational diabetes mellitus (GDM) with viable fetuses born after 24 weeks of gestation were enrolled. Influence of maternal age, body-mass-index at the time of the oral glucose tolerance test, parity, smoking, chorionicity, gestational age at delivery and diagnosis of GDM on weight discrepancy of the twins was evaluated. Results: Mean weight discrepancy of all analyzed twin pregnancies was 285 grams (± 231), relative weight discrepancy was 11.3% (± 8.6). Univariate regression analyses showed that GDM, chorionicity and gestational age at delivery were significantly associated with weight discrepancy. In the multivariate model only diagnosis of GDM was significantly associated with weight discrepancy. Conclusion: Twin pregnancies with insulin requiring gestational diabetes seem to have less birth weight discrepancy than twin pregnancies with normal glucose tolerance.

Grossauer S.,General Hospital of Klagenfurt | Koeck K.,General Hospital of Klagenfurt | Kraschl J.,General Hospital of Klagenfurt | Olipitz O.,University of Graz | And 2 more authors.
Neurosurgery | Year: 2016

BACKGROUND: Early detection of vasospasm (VS) following aneurysmal subarachnoid hemorrhage (aSAH) is vital to trigger therapy and to prevent infarction and subsequent permanent neurological deficit. Although motor evoked potentials (MEPs) are a wellestablished method for intraoperative detection of cerebral VS and cerebral ischemia during aneurysm surgery, there are no studies investigating the diagnostic value of MEPs for detecting delayed VS following aSAH in an intensive care unit. OBJECTIVE: A prospective study was conceived to assess the diagnostic accuracy of MEPs in comparison with digital subtraction angiography. METHODS: MEP threshold changes were determined in patients both with and without angiographic VS following high-grade aSAHs. Sensitivity, specificity, and the positive and negative predictive values of significant MEP threshold increases, which indicate angiographic VS, were calculated. RESULTS: In all patients experiencing VS of the arteries supplying cerebral motor areas, a minimal MEP threshold increase of 50 mA (mean 66.25 mA) was observed, whereas a maximum MEP threshold increase of 30 mA was observed in patients without VS. Therefore, an increase from a baseline of ≥50 mA was considered significant and resulted in a sensitivity of 0.83, a specificity of 0.92, a positive predictive value of 0.83, and a negative predictive value of 0.92. CONCLUSION: VS following aSAH can be detected accurately by using MEPs. MEPs are a feasible bedside tool for online VS detection in an intensive care unit and, therefore, may complement existing diagnostic tools. Copyright © 2015 by the Congress of Neurological Surgeons.

Gaggl A.,University of Salzburg | Burger H.,University of Salzburg | Virnik S.,General Hospital of Klagenfurt | Schachner P.,University of Salzburg | Chiari F.,General Hospital of Klagenfurt
Cleft Palate-Craniofacial Journal | Year: 2012

Objective: Free nonvascularized alveolar bone grafting in severe defects of the cleft region often results in poor implant bed conditions. Here an alternative augmentation technique using a new technique of vascularized bone transfer is described. Design: In five patients with clefts of the lip, palate, and alveolus (four unilateral, one bilateral) there was a severe defect of the anterior maxillary alveolar ridge after tooth loss. The patients previously had augmentative surgery one to three times without success. The defect was covered using a microvascular corticocancellous transplant from the medial distal femur. The defects to be corrected measured 2.5 to 4.0 cm long, 1.0 to 1.5 cm wide, and 1 to 1.5 cm high. The microvascular pedicle of the femur bone flap was 3 to 7 cm long. The descending genicular artery was anastomosed to the facial or labial superior artery and the accompanying veins accordingly. In every case, the anastomoses were performed via an intraoral transmucosal approach. Results: There were no serious complications and no flap loss. In all patients the defect was covered by a flap of the correct size and design. All patients were treated with dental implants (13 total) 6 months after successful reconstruction of the ridge. The implants were loaded 4 to 6 months after placement with fixed superstructures. There were good peri-implant conditions and no implant loss. Conclusion: The microvascular osteoperiosteal femur flap can be used successfully in individual reconstruction of segmental defects of the alveolar ridge in adult cleft patients.

Posch C.,Rudolfstiftung Hospital | Kaulfersch W.,General Hospital of Klagenfurt | Rappersberger K.,Rudolfstiftung Hospital
Pediatric Dermatology | Year: 2014

Cryopyrin-associated periodic syndromes (CAPS) are characterized by apparently unprovoked attacks of fever, rashes, and musculoskeletal and sensorineural inflammation accompanied by high acute-phase reactants. Excessive interleukin-1 (IL-1) signaling appears to be a constant feature in the pathomechanism of the disease, driven by a gain-of-function mutation in the NLRP3 gene. Herein, we present the case of a 9-month-old boy with recurrent nonpruritic rashes and episodes of fever. The difficulties of early diagnosis due to initially mild clinical symptoms and the dramatic response to anti-IL-1 therapy after diagnosis emphasize the practical relevance of considering CAPS as a differential diagnosis in these patients. © 2012 Wiley Periodicals, Inc.

Kau T.,General Hospital of Klagenfurt | Eicher W.,General Hospital of Klagenfurt | Reiterer C.,General Hospital of Klagenfurt | Niedermayer M.,General Hospital of Klagenfurt | And 3 more authors.
European Radiology | Year: 2011

Objective To evaluate the accuracy of dual-energy CT angiography (DE-CTA) maximum intensity projections (MIPs) in symptomatic peripheral arterial occlusive disease (PAOD). Methods In 58 patients, DE-CTA of the lower extremities was performed on dual-source CT. In a maximum of 35 arterial segments, severity of the most stenotic lesion was graded (<10%, 10-49% and 50-99% luminal narrowing or occlusion) independently by two radiologists, with DSA serving as the reference standard. Results In DSA, 52.3% of segments were significantly stenosed or occluded. Agreement of DE-CTA MIPs with DSA was good in the aorto-iliac and femoro-popliteal regions (κ=0.72; κ=0.66), moderate in the crural region (κ=0.55), slight in pedal arteries (κ=0.10) and very good in bypass segments (κ=0.81). Accuracy was 88%, 78%, 74%, 55% and 82% for the respective territories and moderate (75%) overall, with good sensitivity (84%) and moderate specificity (67%). Sensitivity and specificity was 82% and 76% in claudicants and 84% and 61% in patients with critical limb ischaemia. Conclusion While correlating well with DSA above the knee, accuracy of DE-CTA MIPs appeared to be moderate in the calf and largely insufficient in calcified pedal arteries, especially in patients with critical limb ischaemia. © European Society of Radiology 2011.

PubMed | General Hospital of Klagenfurt and University of Würzburg
Type: Journal Article | Journal: Journal of neurological surgery reports | Year: 2015

Primary intramedullary spinal glioblastoma multiforme (sGBM) with a secondary cerebral manifestation is a very rare entity with a poor outcome. Case studies show a mean average of survival of 10 months after diagnosis. These tumors tend to develop at a young age. A combination with an arteriovenous malformation in the same location has never been published before. Vascular malformations in association with cerebral glioblastomas have only been reported in five cases so far. Proangiogenic factors are assumed to be involved in the appearance of both entities. We present a case study and a review of the literature.

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