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  1. Article ; Online: Physicians' exodus: why medical graduates leave Austria or do not work in clinical practice.

    Scharer, Sebastian / Freitag, Andreas

    Wiener klinische Wochenschrift

    2015  Volume 127, Issue 9-10, Page(s) 323–329

    Abstract: Background: Austria has the highest number of medical graduates of all Organisation for Economic Co-operation and Development (OECD) countries in relation to its population size, but over 30% choose not to pursue a career as physicians in the country.!## ...

    Abstract Background: Austria has the highest number of medical graduates of all Organisation for Economic Co-operation and Development (OECD) countries in relation to its population size, but over 30% choose not to pursue a career as physicians in the country.
    Objective and research design: This article describes under- and postgraduate medical education in Austria and analyses reasons for the exodus of physicians.
    Medical education: In Austria, medicine is a 5- or 6-year degree offered at four public and two private medical schools. Medical graduates have to complete training in general medicine or a speciality to attain a licence to practice. While not compulsory for speciality training, board certification in general medicine has often been regarded as a prerequisite for access to speciality training posts.
    Analysis: Unstructured postgraduate training curricula, large amounts of administrative tasks, low basic salaries and long working hours present for incentives for medical graduates to move abroad or to work in a non-clinical setting. The scope of current reforms, such as the establishment of a new medical faculty and the implementation of a common trunk, is possibly insufficient in addressing the issue.
    Conclusion: Extensive reforms regarding occupational conditions and the structure of postgraduate medical education are necessary to avoid a further exodus of junior doctors.
    MeSH term(s) Attitude of Health Personnel ; Austria ; Career Choice ; Curriculum ; Education, Medical, Graduate ; Emigration and Immigration ; Faculty, Medical ; General Practice/education ; Health Care Reform ; Humans ; Job Satisfaction ; Licensure, Medical ; Medicine ; National Health Programs ; Physician's Role/psychology ; Specialty Boards ; Students, Medical/psychology
    Language English
    Publishing date 2015-05
    Publishing country Austria
    Document type Journal Article
    ZDB-ID 200462-8
    ISSN 1613-7671 ; 0043-5325 ; 0300-5178
    ISSN (online) 1613-7671
    ISSN 0043-5325 ; 0300-5178
    DOI 10.1007/s00508-015-0786-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 902: Show issues Location:
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  2. Article ; Online: Thrombectomy in basilar artery occlusion.

    Sommer, Peter / Scharer, Sebastian / Posekany, Alexandra / Serles, Wolfgang / Marko, Martha / Langer, Agnes / Fertl, Elisabeth / Sykora, Marek / Lang, Wilfried / Dafert, Sebastian / Seiringer, Fiona / Kiechl, Stefan / Knoflach, Michael / Greisenegger, Stefan

    International journal of stroke : official journal of the International Stroke Society

    2022  Volume 17, Issue 9, Page(s) 1006–1012

    Abstract: Background and purpose: The benefit of thrombectomy (TE) for acute ischemic stroke (AIS) in patients suffering basilar artery occlusion (BAO) is still unclear. Our aim was to analyze functional outcome after 3 months in BAO compared to anterior ... ...

    Abstract Background and purpose: The benefit of thrombectomy (TE) for acute ischemic stroke (AIS) in patients suffering basilar artery occlusion (BAO) is still unclear. Our aim was to analyze functional outcome after 3 months in BAO compared to anterior circulation large vessel occlusion (ACLVO) in a nationwide registry.
    Methods: Patients enrolled into the Austrian Endostroke Registry from 2013 to 2018 were analyzed. We used propensity score matching to control for imbalances and to compare patients with BAO and ACLVO. The primary outcome was favorable functional outcome after 3 months measured by the modified Rankin Scale (mRS) (0-2). Multivariate models were applied to estimate the effect of localization (BAO vs ACLVO).
    Results: In total, 2288 patients underwent TE for AIS with proximal vessel occlusion, of these 267 with BAO. Two hundred and sixty-four patients with BAO were matched to 264 patients with ACLVO. Baseline characteristics were well-balanced. The 90-day mortality did not significantly differ between patients with BAO and ACLVO. In a multivariate logistic regression model, we did not detect a significant difference in functional outcome between BAO and ACLVO (odds ratio for favorable outcome defined as mRS = 0-2: 1.19; 95% confidence interval (CI) = 0.78-1.81; p = 0.42). In patients with an onset-to-door-time ⩾270 min, TE of BAO was associated with poor functional outcome defined as mRS 3-6 (odds ratio (OR) = 3.97; 95% CI = 1.32-11.94; p = 0.01) as compared to ACLVO.
    Conclusion: In this study, functional outcome did not differ after TE in patients with BAO and ACLVO overall; however, we detected an association of BAO with poor outcome in patients arriving late.
    MeSH term(s) Humans ; Basilar Artery ; Ischemic Stroke ; Endovascular Procedures/adverse effects ; Stroke/diagnosis ; Treatment Outcome ; Retrospective Studies ; Thrombectomy ; Arterial Occlusive Diseases/surgery ; Vertebrobasilar Insufficiency/surgery
    Language English
    Publishing date 2022-01-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2303728-3
    ISSN 1747-4949 ; 1747-4930
    ISSN (online) 1747-4949
    ISSN 1747-4930
    DOI 10.1177/17474930211069859
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 6582: Show issues Location:
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  3. Article ; Online: Trends of r-tPA (Recombinant Tissue-Type Plasminogen Activator) Treatment and Treatment-Influencing Factors in Acute Ischemic Stroke.

    Marko, Martha / Posekany, Alexandra / Szabo, Simon / Scharer, Sebastian / Kiechl, Stefan / Knoflach, Michael / Serles, Wolfgang / Ferrari, Julia / Lang, Wilfried / Sommer, Peter / Greisenegger, Stefan

    Stroke

    2020  Volume 51, Issue 4, Page(s) 1240–1247

    Abstract: Background and Purpose- Frequencies of treatment with r-tPA (recombinant tissue-type plasminogen activator) are increasing over the past 15 years. However, published data on the influence of various demographic and clinical factors on r-tPA treatment as ... ...

    Abstract Background and Purpose- Frequencies of treatment with r-tPA (recombinant tissue-type plasminogen activator) are increasing over the past 15 years. However, published data on the influence of various demographic and clinical factors on r-tPA treatment as well as estimates of future trajectories are limited. We evaluated time trends and future trajectories of r-tPA treatment in patients with acute stroke and the influence of various factors on r-tPA treatment by analyzing data of 103 970 patients enrolled in the Austrian Stroke Unit Registry from 2006 to 2018, of which 18 953 were treated with r-tPA. Methods- Time trends of r-tPA-treatment were investigated in predefined subgroups (minor/major stroke, age, anterior/posterior circulation stroke); limited exponential time series models were calculated to estimate future trends of r-tPA-treatment. Logistic regression models were calculated to estimate the influence of clinical variables on r-tPA-treatment. Results- Overall, r-tPA treatment frequencies increased from 9.9% in 2006 to 21.8% in 2018. We observed a particular increase in patients >80 years, patients presenting with a National Institutes of Health Stroke Scale Score of 2 to 3, patients with posterior circulation stroke, patients with wake-up stroke, and patients without atrial fibrillation. Forecast of overall r-tPA frequencies predicted a further but flattened increase up to 24% by 2025. Logistic regression of time-dependent associations of clinical variables with r-tPA-treatment revealed increasing odds of r-tPA-treatment in patients with a posterior circulation stroke and decreasing odds of r-tPA-treatment in patients with atrial fibrillation. Conclusions- We observed a positive development of r-tPA-treatment frequencies mirroring increasing confidence with intravenous thrombolysis in clinical practice; however, decreasing odds of r-tPA-treatment over time in patients with atrial fibrillation deserve particular attention.
    MeSH term(s) Aged ; Aged, 80 and over ; Austria/epidemiology ; Brain Ischemia/diagnosis ; Brain Ischemia/drug therapy ; Brain Ischemia/epidemiology ; Female ; Fibrinolytic Agents/administration & dosage ; Humans ; Male ; Middle Aged ; Recombinant Proteins/administration & dosage ; Registries ; Stroke/diagnosis ; Stroke/drug therapy ; Stroke/epidemiology ; Tissue Plasminogen Activator/administration & dosage ; Treatment Outcome
    Chemical Substances Fibrinolytic Agents ; Recombinant Proteins ; Tissue Plasminogen Activator (EC 3.4.21.68)
    Language English
    Publishing date 2020-03-02
    Publishing country United States
    Document type Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 80381-9
    ISSN 1524-4628 ; 0039-2499 ; 0749-7954
    ISSN (online) 1524-4628
    ISSN 0039-2499 ; 0749-7954
    DOI 10.1161/STROKEAHA.119.027921
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 448: Show issues Location:
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  4. Article ; Online: Systematic review of rugby injuries in children and adolescents under 21 years.

    Freitag, Andreas / Kirkwood, Graham / Scharer, Sebastian / Ofori-Asenso, Richard / Pollock, Allyson M

    British journal of sports medicine

    2015  Volume 49, Issue 8, Page(s) 511–519

    Abstract: A systematic review of rugby union and league injuries among players under the age of 21 years was carried out to calculate probabilities of match injury for a player over a season and a pooled estimate of match injury incidence where studies were ... ...

    Abstract A systematic review of rugby union and league injuries among players under the age of 21 years was carried out to calculate probabilities of match injury for a player over a season and a pooled estimate of match injury incidence where studies were sufficiently similar. The probability of a player being injured over a season ranged from 6% to 90% for rugby union and 68% to 96% for rugby league. The pooled injury incidence estimate for rugby union was 26.7/1000 player-hours for injuries irrespective of need for medical attention or time-loss and 10.3/1000 player-hours for injuries requiring at least 7 days absence from games; equivalent to a 28.4% and 12.1% risk of being injured over a season. Study heterogeneity contributed to a wide variation in injury incidence. Public injury surveillance and prevention systems have been successful in reducing injury rates in other countries. No such system exists in the UK.
    MeSH term(s) Absenteeism ; Adolescent ; Athletic Injuries/epidemiology ; Brain Concussion/epidemiology ; Child ; Contusions/epidemiology ; Craniocerebral Trauma/epidemiology ; Extremities/injuries ; Female ; Football/injuries ; Hematoma/epidemiology ; Humans ; Incidence ; Joint Dislocations/epidemiology ; Lacerations/epidemiology ; Male ; Neck Injuries/epidemiology ; Risk Assessment ; Sprains and Strains/epidemiology ; Torso/injuries ; Young Adult
    Language English
    Publishing date 2015-04
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 600592-5
    ISSN 1473-0480 ; 0306-3674
    ISSN (online) 1473-0480
    ISSN 0306-3674
    DOI 10.1136/bjsports-2014-093684
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.B 1893: Show issues Location:
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  5. Article ; Online: Severe Myasthenic Manifestation of Leptospirosis Associated with New Sequence Type of Leptospira interrogans.

    Tomschik, Matthias / Koneczny, Inga / Schötta, Anna-Margarita / Scharer, Sebastian / Smajlhodzic, Merima / Rosenegger, Paloma Fernandes / Blüthner, Martin / Höftberger, Romana / Zimprich, Fritz / Stanek, Gerold / Markowicz, Mateusz

    Emerging infectious diseases

    2019  Volume 25, Issue 5, Page(s) 968–971

    Abstract: We report the rapid development of a myasthenic crisis as the first-time manifestation of myasthenia gravis. The symptoms developed in the course of acute leptospirosis associated with a new sequence type of Leptospira interrogans. Antibiotic treatment ... ...

    Abstract We report the rapid development of a myasthenic crisis as the first-time manifestation of myasthenia gravis. The symptoms developed in the course of acute leptospirosis associated with a new sequence type of Leptospira interrogans. Antibiotic treatment led to rapid amelioration of myasthenia.
    MeSH term(s) Adult ; Austria ; DNA, Bacterial ; Humans ; Leptospira interrogans/classification ; Leptospira interrogans/genetics ; Leptospirosis/complications ; Leptospirosis/microbiology ; Male ; Myasthenia Gravis/complications ; Myasthenia Gravis/etiology ; Phylogeny ; Severity of Illness Index ; Symptom Assessment ; Thyroid Crisis/diagnosis ; Thyroid Crisis/etiology
    Chemical Substances DNA, Bacterial
    Language English
    Publishing date 2019-04-10
    Publishing country United States
    Document type Case Reports ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1380686-5
    ISSN 1080-6059 ; 1080-6040
    ISSN (online) 1080-6059
    ISSN 1080-6040
    DOI 10.3201/eid2505.181591
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4778: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (2.OG)
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  6. Article ; Online: Is Functional Outcome Different in Posterior and Anterior Circulation Stroke?

    Sommer, Peter / Posekany, Alexandra / Serles, Wolfgang / Marko, Martha / Scharer, Sebastian / Fertl, Elisabeth / Ferrari, Julia / Lang, Wilfried / Vosko, Milan / Szabo, Simon / Kiechl, Stefan / Knoflach, Michael / Greisenegger, Stefan

    Stroke

    2018  Volume 49, Issue 11, Page(s) 2728–2732

    Abstract: Background and Purpose- Posterior circulation stroke (PCS) account for 20% of all ischemic strokes. There is limited evidence whether functional outcome of PCS is comparable to that of anterior circulation stroke (ACS). We aimed to analyze whether 3- ... ...

    Abstract Background and Purpose- Posterior circulation stroke (PCS) account for 20% of all ischemic strokes. There is limited evidence whether functional outcome of PCS is comparable to that of anterior circulation stroke (ACS). We aimed to analyze whether 3-month functional outcome is different in PCS and ACS. Methods- Patients with acute ischemic stroke prospectively enrolled within the Austrian Stroke Unit Registry were stratified by infarct localization according to the Oxfordshire Community Stroke Project Classification. Propensity score matching was used to control for covariate imbalances and to match patients with PCS and ACS. Patients were matched for stroke severity, recombinant tissue-type plasminogen activator treatment, and demographic and vascular risk factors. Main outcomes were the distribution of modified Rankin Scale after 3 months and multiple proportional odds models to estimate the influence of the infarct localization on the functional outcome. Results- From a total of 90 484 patients enrolled within the Austrian Stroke Unit Registry, 9208 (4604 PCS/4604 ACS) were matched, of those 954 (477 in each group) were treated with recombinant tissue-type plasminogen activator. We detected a significant shift towards better 3-month functional outcome in patients with ACS compared with PCS (odds ratio [OR], 1.19; 95% CI, 1.1-1.28; P<0.0001). In particular, functional outcome was worse in PCS with onset-to-door-time >270 minutes (OR, 1.34; 95% CI, 1.17-1.54; P<0.0001) and in PCS with unknown onset-to-door-time (OR, 1.26; 95% CI, 1.13-1.42; P<0.0001); however, we did not detect any difference in functional outcome between ACS and PCS in patients with an onset-to-door-time ≤270 minutes (1-180 minutes: OR, 0.92, 95% CI, 0.78-1.09, P=0.3554; 181-270 minutes: OR, 1.04, 95% CI, 0.79-1.37, P=0.7689). In patients treated with recombinant tissue-type plasminogen activator, functional outcome was not significantly different between PCS and ACS. Conclusions- PCS was associated with worse outcome compared with ACS in patients arriving later than 4.5 hours at hospital or in those with unknown onset of symptoms. Our results urge for implementation of symptoms found in the posterior circulation into preclinical patient-triage tools.
    MeSH term(s) Aged ; Aged, 80 and over ; Austria ; Cerebrovascular Circulation ; Endovascular Procedures ; Female ; Fibrinolytic Agents/therapeutic use ; Humans ; Male ; Middle Aged ; Odds Ratio ; Prospective Studies ; Registries ; Stroke/physiopathology ; Stroke/therapy ; Time Factors ; Time-to-Treatment/statistics & numerical data ; Tissue Plasminogen Activator/therapeutic use ; Treatment Outcome
    Chemical Substances Fibrinolytic Agents ; Tissue Plasminogen Activator (EC 3.4.21.68)
    Language English
    Publishing date 2018-12-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80381-9
    ISSN 1524-4628 ; 0039-2499 ; 0749-7954
    ISSN (online) 1524-4628
    ISSN 0039-2499 ; 0749-7954
    DOI 10.1161/STROKEAHA.118.021785
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 448: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  7. Article ; Online: Effect of training and structured medication review on medication appropriateness in nursing home residents and on cooperation between health care professionals: the InTherAKT study protocol.

    Mahlknecht, Angelika / Nestler, Nadja / Bauer, Ulrike / Schüßler, Nadine / Schuler, Jochen / Scharer, Sebastian / Becker, Ralf / Waltering, Isabel / Hempel, Georg / Schwalbe, Oliver / Flamm, Maria / Osterbrink, Jürgen

    BMC geriatrics

    2017  Volume 17, Issue 1, Page(s) 24

    Abstract: Background: Pharmacotherapy in residents of nursing homes is critical due to the special vulnerability of this population. Medical care and interprofessional communication in nursing homes are often uncoordinated. As a consequence, polypharmacy and ... ...

    Abstract Background: Pharmacotherapy in residents of nursing homes is critical due to the special vulnerability of this population. Medical care and interprofessional communication in nursing homes are often uncoordinated. As a consequence, polypharmacy and inappropriate medication use are common and may lead to hospitalizations and health hazards. The aim of this study is to optimize communication between the involved professional groups by specific training and by establishing a structured medication review process, and to improve medication appropriateness and patient-relevant health outcomes for residents of nursing homes.
    Methods/design: The trial is designed as single-arm study. It involves 300 nursing home residents aged ≥ 65 years and the members of the different professional groups practising in nursing home care (15-20 general practitioners, nurses, pharmacists). The intervention consists of interprofessional education on safe medication use in geriatric patients, and a systematic interprofessional therapy check (recording, reviewing and adapting the medication of the participating residents by means of a specific online platform). The intervention period is divided into two phases; total project period is 3 years. Primary outcome measure is the change in medication appropriateness according to the Medication Appropriateness Index. Secondary outcomes are cognitive performance, occurrence of delirium, agitation, tendency of falls, total number of drugs, number of potentially dangerous drug-drug interactions and appropriateness of recorded analgesic therapy regimens according to the Medication Appropriateness Index. Data are collected at t
    Discussion: The project aims to establish a structured system for monitoring of drug therapy in nursing home residents. The newly developed online platform is designed to systematize and to improve the communication between the professional groups and, thus, to enhance quality and safety of drug therapy. Limitations of the study are the lack of a control group and the non-randomly recruited study sample.
    Trial registration: DRKS Data Management, DRKS-ID: DRKS00007900.
    MeSH term(s) Aged ; Aged, 80 and over ; Communication ; Female ; Humans ; Inappropriate Prescribing ; Interprofessional Relations ; Male ; Nursing Homes ; Polypharmacy
    Language English
    Publishing date 2017-01-18
    Publishing country England
    Document type Journal Article
    ZDB-ID 2059865-8
    ISSN 1471-2318 ; 1471-2318
    ISSN (online) 1471-2318
    ISSN 1471-2318
    DOI 10.1186/s12877-017-0418-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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