High cure rates and reduced long-term toxicity in pediatric Hodgkin's disease: the German-Austrian multicenter trial DAL-HD-90. The German-Austrian Pediatric Hodgkin's Disease Study Group.
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PURPOSE: To further reduce therapy-related late effects in patients with pediatric Hodgkin's disease (HD) while maintaining the high cure rates achieved with vincristine, prednisone, procarbazine, and doxorubicin (OPPA) or OPPA/cyclophosphamide, vincristine, prednisone, and procarbazine (COPP) chemotherapy and involved-field radiotherapy. The risk of testicular dysfunction was addressed by substituting etoposide for procarbazine (OEPA) in the induction therapy for boys. Radiation doses and fields were further reduced. PATIENTS AND METHODS: Three hundred nineteen boys and 259 girls younger than 18 years with previously untreated HD, enrolled onto the study between 1990 and 1995, were allocated to treatment group (TG)1 (early stages), TG2 (intermediate stages), or TG3 (advanced stages). All groups underwent two cycles of OEPA (boys) or OPPA (girls) for induction chemotherapy. TG2 and TG3 continued on additional two or four cycles, respectively, of COPP. Low-dose radiotherapy was given to the initially involved sites, ie, reduced involved fields. RESULTS: Initial response to OPPA or OEPA induction was virtually identical. Eight of 578 patients experienced early progression of HD. Thirty-seven relapses, three secondary tumors, and no secondary leukemias have been recorded, with a median follow-up duration of 5.1 years (maximum, 8.1 years). Thirteen of 578 patients died. The probability of 5-year event-free survival/overall survival is 91%/98% in the total group, 94%/97% with OPPA, and 89%/98% with OEPA induction therapy. Risk factor analysis showed two significant prognostic factors: histologic subtype NS2 and "B" symptoms. OEPA induction therapy, large mediastinal tumor, and age were not significant. Preliminary studies of testicular function indicate a lower risk of germ cell damage than previously documented with OPPA. CONCLUSION: OEPA is a satisfactory alternative to OPPA. Radiotherapy can be confined to involved sites when combined with appropriate chemotherapy. The DAL-HD-90 regimen represents a comprehensive treatment program for all stages of pediatric HD and offers a favorable benefit/risk ratio, combining excellent disease control, moderate acute toxicity, and reduced long-term toxicity. (+info)
Serological detection of Capillaria hepatica by indirect immunofluorescence assay.
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In this paper, a serological assay for the detection of antibodies to Capillaria hepatica, a zoonotic parasite, is described. In the past, the only way of detecting Capillaria hepatica was to perform a liver biopsy. The indirect immunofluorescence (IIF) assay, based on liver sections of naturally infected mice and human serum samples, is suitable for detecting early stages of human infections and for screening purposes. No cross-reactivity with other parasitic infections was detected. We have applied the IIF assay to serum samples of 60 employees of the Zoological Garden of Vienna, Schonbrunn, Austria, and found one positive and one questionable sample. (+info)
Blood pressure awareness in Austria. A 20-year evaluation, 1978-1998.
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AIM: To evaluate public awareness following a nationwide educational campaign on hypertension. METHODS AND RESULTS: In 1978 the Austrian Heart Foundation conducted a nationwide educational campaign to increase the awareness of the population regarding the importance of recognizing and treating high blood pressure. Following this campaign, five opinion polls of random and representative samples were conducted to measure the awareness and knowledge of the population relating to issues of high blood pressure. The poll results indicated that during the period immediately following the awareness campaign, knowledge and perception of the dangers of high blood pressure increased. However, this effect dissipated during subsequent years. In 1978, 14% of the population were reported to be hypertensive and 10% had no relevant information about their blood pressure status. In 1998, those who labelled themselves as hypertensive dropped to 12%, while those who did not know their blood pressure values, increased to 14%. The percentage of the population who recalled having their blood pressure measured during the last 3 months dropped from 49% in 1978, to 34% in 1993, and remained at 34% in 1998. CONCLUSION: We conclude that the intensive blood pressure education campaign had only a temporary effect on improving blood pressure awareness. Improved strategies are needed to achieve better community control of hypertension. (+info)
Sport related proximal femoral fractures: a retrospective review of 31 cases treated in an eight year period.
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In an eight year period, 31 patients with proximal femoral fractures resulting from sports accidents were treated by implantation of either a Gamma nail or a dynamic hip screw. Return to work or sports and the time to bone healing did not differ very much between the treatments. Gamma nailing was clearly the best with regard to stability and time to full mobilisation (4.5 days), but required 39 minutes to perform compared with insertion of a dynamic hip screw (27 minutes). The incidence of complications and malalignments did not differ very much between the two, although, when Gamma nailing was first used in the authors' clinic, more intraoperative complications occurred than with the dynamic hip screw. Stable pertrochanteric fractures may be treated with a dynamic hip screw. Unstable pertrochanteric or subtrochanteric fractures are treated with a Gamma nail at the authors' institution. (+info)
From colloids to proteases.
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The present autobiographical review describes my professional experiences as a graduate student in Vienna, Austria, the postdoctoral experiences at the University of London, University of Minnesota, and at Cornell University, Ithaca, NY. This was followed by a faculty appointment at Duke University where I rose through the ranks from assistant professor to professor of physical biochemistry from 1938 to 1950. This account includes both scientific and cultural episodes and anecdotes. In 1950 I moved to Seattle to become founding chairman and professor in the Department of Biochemistry as will be described elsewhere. (+info)
International comparisons of child injuries and prevention programs: recommendations for an improved prevention program in Germany.
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OBJECTIVES: To compare child injury mortality in Germany with that of four neighboring countries, and to examine injury prevention models in these countries with a view to improving prevention programs in Germany. METHODS: Based on official cause of death certificates, child injury mortality rates in Germany are compared with those of Austria, The Netherlands, Sweden, and Switzerland. The main structures and funding of injury prevention programs in these countries are described. RESULTS: In all five countries, mortality is highest among children aged 1-4 years for home and leisure accidents and drownings. Transport accidents are the main cause of death in the 5-14 age group. Mortality in both age groups has fallen significantly since 1980, most markedly in Sweden and The Netherlands. CONCLUSION: Drawing on the injury mortality data and experience of the comparison countries, the following recommendations are proposed to further reduce home and leisure injuries among children in Germany: (1) establish a soundly funded, central institution responsible for child injury surveillance, research, and the coordination of injury prevention activities, (2) improve product control legislation, and (3) disseminate specific safety information to target groups and the general public. (+info)
Distribution of rotavirus VP4 genotypes and VP7 serotypes among nonhospitalized and hospitalized patients with gastroenteritis and patients with nosocomially acquired gastroenteritis in Austria.
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To assess the potential benefits of a reassortant tetravalent rotavirus vaccine, we investigated stool specimens from children in three different groups by reverse transcription-PCR (RT-PCR) for rotavirus G and P types: (i) children not hospitalized with community-acquired rotavirus-acute gastroenteritis (RV-AGE), (ii) children hospitalized for RV-AGE, and (iii) children with nosocomially acquired RV-AGE. From a total of 553 samples investigated, 335 were positive by enzyme-linked immunosorbent assay, of which 294 (88%) were positive by RT-PCR. Among the RT-PCR-positive samples, the predominant types were G1P[8] (84%), followed by G4P[8] (9%) and G3P[8] (2%). No differences between the three groups were observed, suggesting that community vaccination will diminish the most cost-relevant cases of hospitalizations and nosocomial infections. (+info)
MRI cerebral white matter lesions and paraoxonase PON1 polymorphisms : three-year follow-up of the austrian stroke prevention study.
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White matter lesions (WMLs) on magnetic resonance imaging (MRI) scans of older persons are thought to be caused by cerebral small-vessel disease. As they progress, these brain abnormalities frequently result in cognitive decline and gait disturbances, and their predictors are incompletely understood. Genetic risk factors have been implicated but remain undetermined so far. We examined whether 2 common polymorphisms of the paraoxonase (PON1) gene leading to a methionine (M allele)-leucine (L allele) interchange at position 54 and an arginine (B allele)-glutamine (A allele) interchange at position 191 are associated with the presence and progression of WMLs. We studied 264 community-dwelling subjects without neuropsychiatric disease (ages 44 to 75 years). All underwent vascular risk factor assessment, brain MRI, and PON1 genotyping. MRI scanning was repeated after 3 years. The extent and number of WMLs were recorded by 3 independent readers. Progression of WMLs was assessed by direct scan comparison. The final rating relied on the majority judgment of the 3 readers. The LL, LM, and MM genotypes were noted in 111 (42.0%), 118 (44.7%), and 35 (13.3%) subjects, respectively; the AA, AB, and BB genotypes occurred in 146 (55.3%), 98 (37.1%), and 20 (7.8%) individuals, respectively. Carriers of the LL genotype showed a nonsignificant trend toward more extensive WMLs and more frequently demonstrated lesion progression over the 3-year observation period (P=0.03). The polymorphism at position 191 had no effect. Logistic regression analysis yielded age (odds ratio, 1.08/y), diastolic blood pressure (odds ratio, 1.05/mm Hg), and LL paraoxonase genotype (odds ratio, 2. 65) to be significant predictors of WML progression. These data suggest that the LL PON1 genotype at position 54 influences the extent and progression of WMLs in elderly subjects. (+info)