[Effects of smoking on the genital tract of the woman]. / Auswirkungen des Rauchens auf den Genitaltrakt der Frau.

Cigarette smoking exerts a carcinogenous effect in various organs, either by direct contact or by distant nocivity. The authors present a survey of literature dealing with the effect of cigarette smoking on the female genital tract. The respective data show clearly that cigarette smoking may induce carcinoma of the cervix, whereas no significant correlation between cigarette smoking and carcinoma of the uterus can be established. Epidemiologic, etiologic and pathogenetic aspects of cigarette smoking and its influence on the genital tract are presented and discussed.

[Breast cancer: morbidity and mortality in Austria. Descriptive epidemiology 1983-1987]. / Mammakarzinom: Morbidität und Mortalität in Osterreich. Deskriptive Epidemiologie 1983-1987.

The incidence and mortality rate from breast cancer in Austria from 1983 to 1987 were obtained from data of the Austrian Cancer Register. There were on average 3012 new cases per year (75.8 per 100,000 women). Age-standardized incidence (European standard population) as calculated by the WHO was 64.1 per 100,000. Distribution by stages ("US end-result group") showed stage I (localized) in 44.7%, stage II (spread to immediate neighbouring structures and regional lymph nodes) in 41.3% and stage III (generalized) in 14%. There was no significant difference between the various age groups regarding stage distribution. The number of deaths increased from 1,462 in 1983 to 1,675 in 1987, a raw mortality rate of 36.8 and 42.2, respectively. Age-standardized mortality increased from 29.0 to 31.2, respectively. These data point to a further increase in incidence and mortality rate from breast cancer in Austria.

[Prenatal ultrasound diagnosis of complex heart abnormality in routine screening]. / Antenatale Ultraschall-Diagnose einer komplexen Herzmissbildung im Routine-Screening.

Case report on a severe cardial malformation associated with trisomia 21, diagnosed by ultrasound-screening in the 34th week of gestation. Further diagnostic evaluation of the case and therapeutic management are described. The problems of modern malformation diagnostics by routine ultrasound scanning in pregnancy are discussed.

Comparison of ceftriaxone (1 x 1 g/day) versus cefotaxime (3 x 1 g/day) for gynecologic and obstetric infections. A randomized clinical trial.

A prospective, randomized clinical trial was conducted to compare the efficacy and tolerance of a single dose of 1 g ceftriaxone i.v. daily with 3 doses of 1 g cefotaxime i.v. daily for obstetric and gynecologic infections. Both agents are characterized by a wide spectrum and potent activity. Furthermore, ceftriaxone has an outstanding serum half-life of 8 h. 41 patients with pelvic inflammatory disease, pelvic or wound infections after vaginal or abdominal hysterectomy, endomyometritis and urinary-tract infection were included. Patients were monitored clinically by routine laboratory methods (erythrocyte sedimentation rate, white blood cell count and cross-reacting protein) and bacteriologically. Clinical parameters of infection were fever, local pain and/or tenderness, a sactosalpinx or pyosalpinx at palpation and cervical secretion. Clinical cure was achieved in 77.3% in the ceftriaxone and in 78.9% in the cefotaxime group, improvement in 3 (13.6%) and 4 patients (21.0%), respectively. 2 clinical failures were seen in the ceftriaxone group. One was a severe pelvic infection following vaginal hysterectomy, which responded to the addition of metronidazole, the other was due to a chlamydial salpingitis, which was cured with a 10-day course of doxycycline. Both antibiotics were well tolerated. Our results suggest that for obstetric and gynecologic infections a single 1-gram dose of ceftriaxone is equally effective as three 1-gram doses of cefotaxime.

Interstitial fluid concentrations of ceftriaxone (1 g.i.v.) in the subperitoneal space after hysterectomy.

The ability of an antibiotic to penetrate into the extravascular site of infection is particularly important for a successful perioperative antibiotic prophylaxis and postoperative therapy of bacterial infection. We, therefore, measured interstitial fluid concentrations of ceftriaxone in the subperitoneal space following hysterectomy using Rubinstein's disc method after intravenous administration of 1 g of ceftriaxone preoperatively. After removal of the uterus, two disc units were implanted intraoperatively in the right and left subperitoneal space of 16 patients and were drawn out through the open vaginal cuff after given periods of time. Five disc and blood specimens were obtained after 90 min and 2, 6, 12, 24, and 48 h, respectively. Ceftriaxone concentrations were determined by bioassay. After administration of 1 g of ceftriaxone, interstitial fluid concentrations following hysterectomy were above the MIC90 of most pathogens encountered in gynecologic infections over a period of 24 h.

Influence of brachytherapy (192Ir afterloading) on cell-mediated immune reactions in patients with stage I endometrial cancer.

The influence of radiation therapy on cell-mediated immune reactions in cancer patients seems to depend on source, dose, and area of irradiation, as well as on the variables reflected by the patient population investigated. In the present study we demonstrated that brachytherapy (192Ir afterloading), applied to patients with inoperable stage I endometrial cancer, has no immediate or sustained effect on lymphocyte function. Both lymphocyte mitogen response and natural killer cell (NK) activity are not significantly changed in terms of baseline values compared with test results during and after therapy. Brachytherapy, as used in this study, has no influence on cell-mediated immunity in patients with endometrial cancer stage I.

[Results of a survey of experts regarding early diagnosis of breast cancer]. / Ergebnisse von Expertenbefragungen zur Mammakarzinom-Frühdiagnostik.

An anonymous expert inquiry was carried out during the First Annual Meeting of the Austrian Society for Senology in Vienna in December 1984. To 230 participants - all of them experts in the fields of gynaecology, surgery, radiology and internal medicine - a semi-structurised inquiry form was handed out, questioning for actual problems of routine screening mammography and efficacy of breast self-examination. Only 27 persons (12%) returned the completely filled out inquiry form, 14 experts (52%) advocated a mass-screening with the legal health examinations, most of them from the 30th year of age on in intervals of two years, 17 doctors (63%) agreed with the screening of well defined risk groups with individually determined screening intervals, most of them also from the 30th year of age on. 17 colleagues (63%) rather preferred a screening consisting of basis-mammography with individualised, according to age and personal risk factors adjusted screening intervals, again mostly from the 30th year of age on. Thus our study suggests no particular expert preference of a certain screening modality. 22 experts (81%) believe that breast self-examination from the 20th year of age on is of value, half of them recommending monthly controls. These doctors also believe that one should inform women about this early detection method through directed campaigns in the mass media. A representative inquiry among 1,000 Austrian women, carried out from the fund "Kampf dem Krebs" during summer 1986, showed that, although 70% are informed about the possibility and importance of early detection of breast cancer as well as of the method of breast self-examination, only about 14% perform it indeed regularly.

Amoxicillin in the treatment of asymptomatic bacteriuria in pregnancy: a single dose of 3 g amoxicillin versus a 4-day course of 3 doses 750 mg amoxicillin.

A prospective, randomized, controlled comparative clinical trial was carried out with the aim of investigating the efficacy and tolerance of two different dosage regimens of amoxicillin in the treatment of asymptomatic bacteriuria during pregnancy. Patients in group A received a single dose of 3 g amoxicillin, which was compared to a 4-day course of 3 X 750 mg amoxicillin tablets taken every 8 h (group B). Significant bacteriuria (CFU greater than or equal to 10(5)/ml clean catch midstream urine and CFU greater than or equal to 10(4)/ml urine obtained by bladder catheterization) was diagnosed using the dip-slide method (Uricult). 91 pregnant women with a mean gestational age of 25 weeks (14-38) were randomly allocated to the two treatment groups. 53 patients were assigned to group A and 38 patients to group B. The treatment groups were comparable in terms of age and duration of pregnancy. Urine culture tests were performed 1 and 4 weeks after completion of therapy. The predominant species was Escherichia coli, which was isolated in 60-65% of the cases. Bacteriological cure rates at 1 and 4 weeks, respectively, were 77 and 74% in group A, and 62 and 62% in group B. These differences were statistically not significant. The incidence of side effects was 4% in group A and 13% in group B. The results obtained in the present study suggest that in the treatment of asymptomatic bacteriuria in pregnancy, a single dose of 3 g amoxicillin is as effective and acceptable as a 4-day course. In addition, the single-dose regimen offers the advantage of a reduction in total dose, lower costs and better patient compliance.