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Article: Medical Diagnoses, Mode of Residence, and Dental Treatment Demand under General Anesthesia in Special Needs Adults in Innsbruck, Austria. A Retrospective Breakdown of Four and a Half Years.

Schnabl, Dagmar / Oberhofer, Michael / Barbieri, Fabian / Laimer, Johannes / Steiner, René / Bruckmoser, Emanuel / Grunert, Ingrid

Healthcare (Basel, Switzerland)

2021 Volume 9, Issue 3

Abstract: Regarding oral/dental care and attendance, special needs individuals depend on their caregivers' commitment. The purpose of this retrospective data analysis of adults who received dental general anesthesia (DGA) in Innsbruck, Austria, was a breakdown of ... ...

Abstract	Regarding oral/dental care and attendance, special needs individuals depend on their caregivers' commitment. The purpose of this retrospective data analysis of adults who received dental general anesthesia (DGA) in Innsbruck, Austria, was a breakdown of demographic parameters (including the mode of accommodation/care), medical diagnoses (comprising intellectual/physical disablement (IPD) or psychiatric (anxiety) disorders (PDs)), and dental therapy performed under DGA. The sample was composed of 233 consecutive adults who underwent DGA from January 2015 to June 2019. Data were analyzed with descriptive and comparative statistics. In total, 133 (57.1%) subjects were male and 100 (42.9%) female; 176 (75.5%) had IPD and 57 (24.5%) PDs; 168 (72.1%) were living at private and 65 (27.9%) at nursing homes. Median age (IQR) was 35.6 (25.7-47.2) years. In the total sample, 5 (2-9) teeth were restored and 2 (0.5-6.5) teeth were extracted. Individuals with PDs had more teeth restored (
Language	English
Publishing date	2021-03-04
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2721009-1
ISSN	2227-9032
ISSN	2227-9032
DOI	10.3390/healthcare9030279
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Medical Diagnoses, Mode of Residence, and Dental Treatment Demand under General Anesthesia in Special Needs Adults in Innsbruck, Austria. A Retrospective Breakdown of Four and a Half Years

Dagmar Schnabl / Michael Oberhofer / Fabian Barbieri / Johannes Laimer / René Steiner / Emanuel Bruckmoser / Ingrid Grunert

Healthcare, Vol 9, Iss 3, p

2021 Volume 279

Abstract: Regarding oral/dental care and attendance, special needs individuals depend on their caregivers’ commitment. The purpose of this retrospective data analysis of adults who received dental general anesthesia (DGA) in Innsbruck, Austria, was a breakdown of ... ...

Abstract	Regarding oral/dental care and attendance, special needs individuals depend on their caregivers’ commitment. The purpose of this retrospective data analysis of adults who received dental general anesthesia (DGA) in Innsbruck, Austria, was a breakdown of demographic parameters (including the mode of accommodation/care), medical diagnoses (comprising intellectual/physical disablement (IPD) or psychiatric (anxiety) disorders (PDs)), and dental therapy performed under DGA. The sample was composed of 233 consecutive adults who underwent DGA from January 2015 to June 2019. Data were analyzed with descriptive and comparative statistics. In total, 133 (57.1%) subjects were male and 100 (42.9%) female; 176 (75.5%) had IPD and 57 (24.5%) PDs; 168 (72.1%) were living at private and 65 (27.9%) at nursing homes. Median age (IQR) was 35.6 (25.7–47.2) years. In the total sample, 5 (2–9) teeth were restored and 2 (0.5–6.5) teeth were extracted. Individuals with PDs had more teeth restored ( p = 0.01) and extracted ( p < 0.001) than individuals with IPD. Private home residents had more teeth restored ( p < 0.001) but less teeth extracted ( p = 0.003) than nursing home residents. Special needs individuals’ oral health backlog should be tackled in private and institutional care modalities alike.
Keywords	adults ; dental general anesthesia ; special needs ; intellectual disablement ; physical disablement ; psychiatric disorder ; Medicine ; R
Language	English
Publishing date	2021-03-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Panorama

Lux, Sebastian / Schmidt, Joana / Fahrenhold, Marie / Starostzik, Christine / Oberhofer, Elke / Kraus, Dagmar / Joppich, Alexander

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Keywords	covid19
Publisher	PMC
Document type	Article ; Online
DOI	10.1007/s16022-020-0093-y
Database	COVID19

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Article: Analysis of blood pressure changes in patients undergoing total hip or knee replacement in spinal and general anesthesia.

Kordić, Kresimir / Sakić, Katarina / Oberhofer, Dagmar

Acta clinica Croatica

2012 Volume 51, Issue 1, Page(s) 17–23

Abstract: The aim of this study was to analyze hemodynamic changes in hypertensive and normotensive patients undergoing total hip or knee replacement in spinal and general anesthesia. Eighty patients who underwent total hip or knee replacement surgery in the ... ...

Abstract	The aim of this study was to analyze hemodynamic changes in hypertensive and normotensive patients undergoing total hip or knee replacement in spinal and general anesthesia. Eighty patients who underwent total hip or knee replacement surgery in the period between July 2010 and February 2011 at Sveti Duh University Hospital were retrospectively evaluated. Seventeen patients underwent the operation in general anesthesia and 63 patients in regional anesthesia. They were allocated into groups of normotensive (n=24) or hypertensive patients (n=56). The anthropologic and hematologic parameters of normotensive and hypertensive patients were compared, as well as their blood pressures immediately before and during the operation. Blood pressure immediately before anesthesia induction, the highest and the lowest intraoperative blood pressures were recorded. Blood pressure immediately before anesthesia induction was significantly higher in hypertensive patients who underwent the operation in regional anesthesia compared to normotensive patients (158.48 mm Hg vs. 144.71 mm Hg, P<0.01). The highest intraoperative systolic blood pressure was also significantly higher in hypertensive patients operated on in regional anesthesia compared to normotensive patients (161.20 mm Hg vs. 146.76 mm Hg, P<0.01). The difference between the highest and the lowest intraoperative systolic blood pressure was significantly greater in hypertensive patients undergoing the operation in regional anesthesia compared to normotensive patients (46.41 mm Hg vs. 35.88 mm Hg, P<0.05). The results presented in this paper indicate that the fluctuations of intraoperative blood pressure were greater and the highest intraoperative systolic blood pressure was higher in hypertensive compared to normotensive patients undergoing the operation in regional anesthesia. In our study, there were no significant differences in intraoperative blood pressure between hypertensive and normotensive patients who underwent the operation in general anesthesia.
MeSH term(s)	Aged ; Anesthesia, General ; Anesthesia, Spinal ; Arthroplasty, Replacement, Hip ; Arthroplasty, Replacement, Knee ; Blood Pressure ; Female ; Humans ; Hypertension/physiopathology ; Intraoperative Period ; Male
Language	English
Publishing date	2012-03
Publishing country	Croatia
Document type	Journal Article
ZDB-ID	1478635-7
ISSN	0353-9466
ISSN	0353-9466
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Article: Kako poboljsati transfuzijsko lijecenje bolesnika podvrgnutih ugradnji totalnih endoproteza kuka i koljena?

Oberhofer, Dagmar / Sakić, Kata / Janković, Sasa / Tonković, Dinko / Vrgoc, Goran

Lijecnicki vjesnik

2012 Volume 134, Issue 11-12, Page(s) 322–327

Abstract: Total hip and knee arthroplasty is associated with significant perioperative blood loss, necessitating often blood transfusions. Because of risks and cost of allogenic blood transfusion and elective types of surgery several alternative methods have been ... ...

Title translation	How to improve perioperative blood management in patients undergoing total hip or knee replacement surgery?.
Abstract	Total hip and knee arthroplasty is associated with significant perioperative blood loss, necessitating often blood transfusions. Because of risks and cost of allogenic blood transfusion and elective types of surgery several alternative methods have been developed to reduce allogenic blood use. We prospectively audited 65 consecutive patients undergoing primary total hip (THR; n = 30) or knee replacement (TKR; n = 35) at our Department of Orthopaedic Surgery which did not use autologous blood collection methods. Total blood loss in THR (1329.7 +/- 364.8 ml) and TKR (1427.3 +/- 660.4 ml) was similar to previously reported and without significant difference between the groups. However, we reported high transfusion rates with 63.3% of THR and 82.6% of TKR patients receiving allogenic blood. Important steps to reduce allogenic blood use would include implementation of restrictive transfusion protocols with a defined hemoglobin value as a transfusion trigger, correction of preoperative anemia with i.v. iron +/- erythropoietin, use of one or more modalities of autologous transfusion (postoperative autotransfusion, preoperative blood donation), pharmacological agents like tranexamic acid (anti-fibrinolytic) and other complementary procedures. There is sufficient evidence in literature about the cost-benefit of certain methods which makes routine use of allogenic blood in THR and TKR surgery unacceptable even at general orthopaedic surgery departments.
MeSH term(s)	Aged ; Arthroplasty, Replacement, Hip ; Arthroplasty, Replacement, Knee ; Blood Transfusion, Autologous ; Erythrocyte Transfusion ; Female ; Humans ; Male
Language	Croatian
Publishing date	2012-11
Publishing country	Croatia
Document type	English Abstract ; Journal Article
ZDB-ID	128938-x
ISSN	1849-2177 ; 0024-3477 ; 1330-4917
ISSN (online)	1849-2177
ISSN	0024-3477 ; 1330-4917
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Article: Karotidna endarterektomija u simptomatskih bolesnika u ranoj fazi - naša iskustva.

Ivkošić, Ante / Trajbar, Tomislav / Budinčević, Hrvoje / Antolić, Stanko / Lojo, Nermin / Oberhofer, Dagmar

Acta medica Croatica : casopis Hravatske akademije medicinskih znanosti

2014 Volume 68, Issue 3, Page(s) 289–293

Abstract: Carotid endarterectomy is the gold standard as a therapeutic regimen for patients with high grade symptomatic stenosis of the internal carotid artery (ACI). This study analyzed the effect of early carotid endarterectomy in patients undergoing an ... ...

Title translation	Early carotid endarterectomy in symptomatic patients - our experience.
Abstract	Carotid endarterectomy is the gold standard as a therapeutic regimen for patients with high grade symptomatic stenosis of the internal carotid artery (ACI). This study analyzed the effect of early carotid endarterectomy in patients undergoing an operative procedure 2-3 weeks after the development of ischemic neurologic symptoms, considering the frequency and type of complications in the postoperative period. Patients included in this study were those with significant symptomatic ACI stenosis (70%-99%), which caused ischemic stroke or transient ischemic attacks (TIA). Patients with ischemic stroke were operated within twenty days of the initial neurologic event, whilst in those with symptoms of TIA, surgery was performed immediately after diagnostic work-up. In all cases, carotid endarterectomy was performed under general anesthesia with the use of protective intraluminal shunt. In the vast majority of cases, tucking or Kunlin's sutures of the distal intima were applied. All procedures were performed between January 2008 and October 2012, and the total number of patients was 69. All patients underwent the same follow up program. Follow up carotid ultrasound was performed routinely on postoperative day 7 and at 1, 3, 6 and 12 months. In this study, 27 (39%) patients suffered minor ipsilateral stroke and 42 (61 %) patients had TIA symptoms with verified significant ACl stenosis. Postoperative complications were observed in four (5.26%) patients. Two (2.63%) patients developed ischemic stroke after the procedure and two (2.63%) patients developed ACI restenosis in the late postoperative period and were treated by endovascular stenting. In conclusion, we found that early carotid endarterectomy was of greater benefit than delayed endarterectomy, which is in keeping with the published studies. The leading observation was that in selected patients, early carotid endarterectomy was not associated with a higher risk of postoperative complications in comparison with delayed endarterectomy and could be performed safely.
MeSH term(s)	Carotid Artery, Internal/surgery ; Early Diagnosis ; Endarterectomy, Carotid/statistics & numerical data ; Female ; Humans ; Ischemic Attack, Transient/diagnosis ; Ischemic Attack, Transient/surgery ; Male ; Middle Aged ; Postoperative Complications/etiology ; Postoperative Complications/prevention & control ; Secondary Prevention ; Stents/adverse effects ; Stroke/etiology
Language	Croatian
Publishing date	2014-06
Publishing country	Croatia
Document type	English Abstract ; Journal Article
ZDB-ID	1108025-5
ISSN	1330-0164 ; 0375-8338
ISSN	1330-0164 ; 0375-8338
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Zs.A 342: Show issues

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Article: Nekrotizirajuća infekcija mekih cesti ruke uz razvoj sindroma toksicnog soka--klinicki tijek i lijecenje.

Oberhofer, Dagmar / Kucisec-Tepes, Nastja / Huljev, Dubravko

Acta medica Croatica : casopis Hravatske akademije medicinskih znanosti

2008 Volume 62, Issue 5, Page(s) 505–510

Abstract: Necrotizing soft tissue infections (NSTI) are uncommon infections associated with considerable morbidity and mortality (20%-40%). They are characterized by rapidly progressive necrosis of soft tissue that primarily involves subcutaneous fat and fascia ... ...

Title translation	Necrotizing soft tissue infection of upper extremity complicated with toxic shock syndrome--clinical presentation and treatment options.
Abstract	Necrotizing soft tissue infections (NSTI) are uncommon infections associated with considerable morbidity and mortality (20%-40%). They are characterized by rapidly progressive necrosis of soft tissue that primarily involves subcutaneous fat and fascia with variable involvement of the overlying skin and muscle. Extensive soft tissue necrosis is often accompanied by systemic toxicity. Establishing the diagnosis in the early stage of the infection can be difficult, which leads to a delay in surgical treatment and a poor outcome. The principles of treatment are early and aggressive surgical debridement, broad spectrum antimicrobial therapy administered empirically and reassessed pending culture and sensitivity results, and intensive care management. We report a case of NSTI of the arm in a 64-year-old female patient caused by group A Streptococcus and Staphylococcus aureus complicated with toxic shock-like syndrome with emphasis on the pathophysiology of toxic shock-like syndrome and treatment modalities. NSTI developed 10 days after a knife cut wound of the thumb. The patient had no significant comorbidity. Treatment included aggressive surgical debridement with removal of necrotic tissue and extensive fasciotomies 24 h of admission, cardiovascular stabilization and monitoring at intensive care unit, and repeat surgical debridement at 72 h of admission. Early triple drug antimicrobial therapy included high-dose clindamycin, which inhibits protein synthesis and bacterial exotoxin production that is responsible for inflammatory response and toxic shock-like syndrome. In addition, the patient received hyperbaric oxygen therapy (8 treatments in total). The above management led to control of the infective process. Prolonged surgical wound care followed by thin split-skin grafting and placement of secondary sutures on day 36 of admission preserved the extremity with good functional and cosmetic result.
MeSH term(s)	Arm ; Female ; Humans ; Middle Aged ; Necrosis ; Shock, Septic/diagnosis ; Shock, Septic/etiology ; Shock, Septic/microbiology ; Soft Tissue Infections/complications ; Soft Tissue Infections/diagnosis ; Soft Tissue Infections/microbiology
Language	Croatian
Publishing date	2008-12
Publishing country	Croatia
Document type	Case Reports ; English Abstract ; Journal Article
ZDB-ID	1108025-5
ISSN	1330-0164 ; 0375-8338
ISSN	1330-0164 ; 0375-8338
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Article: Poslijeoperacijski poremećaji mentalnih funkcija u kardiovaskularnoj kirurgiji.

Tonković, Dinko / Marinić, Dragan Korolija / Baronica, Robert / Oberhofer, Dagmar / Pavlović, Danijela Bandić / Perić, Mladen

Acta medica Croatica : casopis Hravatske akademije medicinskih znanosti

2012 Volume 66, Issue 1, Page(s) 67–72

Abstract: Postoperative mental disorders are a common complication of cardiovascular surgery, with serious consequences. The main types of postoperative mental disorders include postoperative delirium and postoperative cognitive dysfunction. Their incidence ranges ...

Title translation	Postoperative mental disorders in cardiovascular surgery.
Abstract	Postoperative mental disorders are a common complication of cardiovascular surgery, with serious consequences. The main types of postoperative mental disorders include postoperative delirium and postoperative cognitive dysfunction. Their incidence ranges up to 15%-80%. Postoperative mental disorders may be reversible and irreversible. Although reversible in most cases, postoperative mental disorders are associated with increased mortality, morbidity and increasing costs of treatment. The treatment is usually symptomatic and may be associated with dangerous side effects. Safer and more effective is preventive action. Preoperative preventive action need to recognize, avoid and optimize risk factors. Intraoperative prevention involves maintaining optimal oxygenation of the brain during cardiovascular surgery. For postoperative prevention, multimodal approach is applied. It includes early extubation, early enteral nutrition, early mobilization, regular evaluation of cognitive function, activation of cognitive function and optimal analgesia, which requires teamwork of medical staff who care for patients. Combining all these methods can show promising results in reducing the incidence of postoperative mental disorders as a complication in cardiovascular surgery.
MeSH term(s)	Cardiovascular Surgical Procedures/adverse effects ; Cognition Disorders/etiology ; Cognition Disorders/prevention & control ; Cognition Disorders/therapy ; Delirium/etiology ; Delirium/prevention & control ; Delirium/therapy ; Humans ; Postoperative Complications/prevention & control
Language	Croatian
Publishing date	2012-03
Publishing country	Croatia
Document type	English Abstract ; Journal Article ; Review
ZDB-ID	1108025-5
ISSN	1330-0164 ; 0375-8338
ISSN	1330-0164 ; 0375-8338
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Article ; Online: Comparison of C-reactive protein and procalcitonin as predictors of postoperative infectious complications after elective colorectal surgery.

Oberhofer, Dagmar / Juras, Josip / Pavicić, Ana Marija / Rancić Zurić, Iva / Rumenjak, Vlatko

Croatian medical journal

2012 Volume 53, Issue 6, Page(s) 612–619

Abstract: Aim: To assess diagnostic value of perioperative procalcitonin (PCT) levels compared to C-reactive protein (CRP) levels in early detection of infectious complications following colorectal surgery.: Methods: This prospective observational study ... ...

Abstract	Aim: To assess diagnostic value of perioperative procalcitonin (PCT) levels compared to C-reactive protein (CRP) levels in early detection of infectious complications following colorectal surgery. Methods: This prospective observational study included 79 patients undergoing elective colorectal surgery. White blood cell count, CRP, and PCT were measured preoperatively and on postoperative days (POD) 1, 2, 3, 5, and patients were followed for postoperative complications. Diagnostic accuracy of CRP and PCT values on each day was analyzed by the receiver operating characteristics (ROC) curve, with infectious complications as an outcome measure. ROC curves with the largest area under the curve for each inflammatory marker were compared in order to define the marker with higher diagnostic accuracy. Results: Twenty nine patients (36.7%) developed infectious complications. CRP and PCT concentrations increased in the early postoperative period, with a significant difference between patients with and without complications at all measured postoperative times. ROC curve analysis showed that CRP concentrations on POD 3 and PCT concentrations on POD 2 had similar predictive values for the development of infectious complications (area under the curve, 0.746 and 0.750, respectively) with the best cut-off values of 99.0 mg/L for CRP and 1.34 μg/L for PCT. Diagnostic accuracy of CRP and PCT was highest on POD 5, however the cut-off values were not considered clinically useful. Conclusion: Serial postoperative PCT measurements do not offer an advantage over CRP measurements for prediction of infectious complications following colorectal surgery.
MeSH term(s)	Aged ; Biomarkers/blood ; C-Reactive Protein/metabolism ; Calcitonin/blood ; Calcitonin Gene-Related Peptide ; Colorectal Surgery ; Early Diagnosis ; Elective Surgical Procedures ; Female ; Humans ; Leukocyte Count ; Luminescent Measurements ; Male ; Middle Aged ; Nephelometry and Turbidimetry ; Postoperative Complications/blood ; Postoperative Complications/diagnosis ; Postoperative Period ; Prospective Studies ; Protein Precursors/blood ; ROC Curve
Chemical Substances	Biomarkers ; CALCA protein, human ; Protein Precursors ; Calcitonin (9007-12-9) ; C-Reactive Protein (9007-41-4) ; Calcitonin Gene-Related Peptide (JHB2QIZ69Z)
Language	English
Publishing date	2012-12-28
Publishing country	Croatia
Document type	Comparative Study ; Journal Article
ZDB-ID	1157623-6
ISSN	1332-8166 ; 0353-9504
ISSN (online)	1332-8166
ISSN	0353-9504
DOI	10.3325/cmj.2012.53.612
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Article: Upalni pokazatelji u bolesnika nakon operacija debelog crijeva.

Oberhofer, Dagmar / Rumenjak, Vlatko / Lazić, Jasenka / Vucić, Niksa

Acta medica Croatica : casopis Hravatske akademije medicinskih znanosti

2006 Volume 60, Issue 5, Page(s) 429–433

Abstract: Background and aims: Despite recent advances in surgical techniques and intensive care management, infectious complications and sepsis remain significant problem after abdominal surgery. Therefore, inflammatory parameters were looked for that could help ...

Title translation	Inflammatory indicators in patients after surgery of the large intestine.
Abstract	Background and aims: Despite recent advances in surgical techniques and intensive care management, infectious complications and sepsis remain significant problem after abdominal surgery. Therefore, inflammatory parameters were looked for that could help achieve an early and more reliable diagnosis of postoperative infections. C-reactive protein (CRP) is a nonspecific inflammatory mediator which is significantly increased postoperatively, regardless of the type of operation and the presence or absence of complications. Procalcitonin (PCT), the prohormone of calcitonin, referred to as a marker of sepsis, is increased significantly in severe bacterial and fungal infections. Quantitative PCT measurements in surgical patients have shown that postoperative PCT concentrations depend on the type and extent of surgery. PCT increased most after major abdominal surgery, although PCT concentrations were significantly higher in patients with complications compared to patients with uneventful postoperative course. The aim of the study was to determine PCT concentrations with a rapid semiquantitative PCT-Q test in the early postoperative period after colon surgery and to investigate its potential use in the diagnosis of infectious complications compared to CRP. Methods: Thirty-eight adult patients undergoing elective surgery of the intestine were followed up. None of the patients had clinical or laboratory signs of infection preoperatively. Leukocytes, CRP and PCT were determined preoperatively and on postoperative days 1-3 and 5. PCT was measured with the B. R. A. H. M. S PCT-Q semiquantitative test. CRP and PCT measurements in 30 patients with normal recovery were statistically analyzed. Results: CRP was significantly elevated postoperatively in all patients at the 4 time points with maximum values on postoperative day 2. There was no difference in CRP values between patients with and without complications. Although PCT concentration was increased in 15 of 30 patients with normal recovery, only mild increase (>0.5-2 ng/L) was recorded in 13, and moderate increase (>2-10 ng/L) in only two patients. PCT increase was most frequently found on postoperative day 1 or 2, and more rarely on postoperative day 3. The number of patients with elevated PCT was significantly higher (8 of 8 patients) in the group with complications, which included postoperative infections in 7 of 8 patients, than in the group without complications. Conclusion: In the early postoperative period after major abdominal surgery, CRP is invariably increased and cannot help in recognizing infectious complications. In our study, which included a relatively small number of patients after colon surgery, PCT >2 ng/mL, as measured with semiquantitative PCT-Q test on postoperative days 1-5, or >0.5 ng/ml after postoperative day 3, was rarely recorded in patients with normal postoperative course. We conclude that PCT-Q test can be helpful in the early diagnosis of infectious complications after abdominal surgery.
MeSH term(s)	Aged ; Biomarkers/blood ; C-Reactive Protein/analysis ; Calcitonin/blood ; Calcitonin Gene-Related Peptide ; Female ; Humans ; Infection/diagnosis ; Inflammation Mediators/blood ; Intestine, Large/surgery ; Male ; Postoperative Complications/diagnosis ; Protein Precursors/blood
Chemical Substances	Biomarkers ; CALCA protein, human ; Inflammation Mediators ; Protein Precursors ; Calcitonin Gene-Related Peptide (83652-28-2) ; Calcitonin (9007-12-9) ; C-Reactive Protein (9007-41-4)
Language	Croatian
Publishing date	2006-12
Publishing country	Croatia
Document type	Journal Article
ZDB-ID	1108025-5
ISSN	1330-0164 ; 0375-8338
ISSN	1330-0164 ; 0375-8338
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