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Evaluation of process management of postpartum hemorrhage due to uterine atony  [PDF]
Iris Holzer, Rainer Lehner
Open Journal of Obstetrics and Gynecology (OJOG) , 2013, DOI: 10.4236/ojog.2013.37093

Objective: To evaluate the management process and the guidelines for management of postpartum hemorrhage due to uterine atony at the General Hospital Vienna, Medical University Vienna. Material and Methods: A retrospective analysis was carried out on all 24 cases of postpartum hemorrhage due to uterine atony with an estimated blood loss of more than 800 mL, in which standardized guidelines were obtained. We included all women who gave birth at the General Hospital of Vienna, the Medical University Vienna, during the period from January 1st 2003 and December 31st 2009 and who suffered blood loss 800 mL at minimum due to uterine atony. Results: The guidelines were in use for 14% - 71%. The average blood loss of the 24 cases with uterine atony was 1342 mL. Conclusion: The management process of postpartum hemorrhage due to uterine atony deviates from the hospital’s guidelines in many cases.

Maternal and Neonatal Outcome for Singleton and Twin Pregnancies in Emergency Cesarean Section vs. Urgent Cesarean Section in a Retrospective Evaluation from 2003-2012  [PDF]
Andrea M?lgg, Stefan Jirecek, Victoria Girtler, Rainer Lehner
Open Journal of Obstetrics and Gynecology (OJOG) , 2014, DOI: 10.4236/ojog.2014.414124
Abstract: Objectives: Emergency cesarean is performed, when a situation requires immediate action in order to reduce the risk to mother and/or child, while urgent cesarean is done if a non-life threatening but compromising situation occurs. The aim of the study was to investigate the maternal and fetal outcome for emergency and urgent cesarean. Study Design: A retrospective case-control study was performed; cases underwent emergency cesarean section, while controls underwent urgent cesarean section. We included 303 cases of women and 336 cases of children, and controls were matched. Maternal and fetal outcome parameters for singleton and twin pregnancies were investigated using the Wilcoxon test and the Chi-square-test. Results: Maternal outcome: Higher blood loss (cases: mean 383.12 ± 232.89, range 100 - 2500 vs. controls: 336.06 ± 129.19, range 100 - 1000, p = 0.008), hemorrhage (34 vs. 11, p < 0.001) and puerperal anemia (30 vs. 10, p < 0.001). Neonatal outcome: One, five, and ten minutes Apgar levels and umbilical cord pH values are lower for cases (p < 0.001 and p < 0.001, respectively). Twins had lower five and ten minutes Apgar levels (p = 0.040 and 0.002), but higher umbilical cord pH values than singletons (p < 0.001). The perinatal mortality among singletons was 3.8%, among twins 8.1%. For cases the perinatal mortality among singletons was 5.7% and 17.14% for twins (control group 1.41% and 2.63%, respectively). Conclusion: The maternal and fetal outcome is poorer in emergency cesarean section. Especially the perinatal mortality is high in emergency cesarean section, particular for twins.
Predictors for rTMS response in chronic tinnitus
Astrid Lehner,Martin Schecklmann,Peter M. Kreuzer,Timm B. Poeppl,Elmar Frank,Tobias Kleinjung,Rainer Rupprecht,Berthold Langguth
Frontiers in Systems Neuroscience , 2012, DOI: 10.3389/fnsys.2012.00011
Abstract: Background: Repetitive transcranial magnetic stimulation (rTMS) has been studied as a treatment option for chronic tinnitus for almost 10 years now. Although most of these studies have demonstrated beneficial effects, treatment results show high interindividual variability and yet, little is known about predictors for treatment response. Methods: Data from 538 patients with chronic tinnitus were analyzed. Patients received either low-frequency rTMS over the left temporal cortex (n = 345, 1 Hz, 110% motor threshold, 2000 stimuli/day) or combined temporal and frontal stimulation (n = 193, 110% motor threshold, 2000 stimuli at 20 Hz over left dorsolateral prefrontal cortex plus 2000 stimuli at 1 Hz over temporal cortex). Numerous demographic, clinical, and audiological variables as well as different tinnitus characteristics were analyzed as potential predictors for treatment outcome, which was defined as change in the tinnitus questionnaire (TQ) score. Results: Both stimulation protocols resulted in a significant decrease of TQ scores. Effect sizes were small, however. In the group receiving combined treatment, patients with comorbid temporomandibular complaints benefited more from rTMS than patients without those complaints. In addition, patients with higher TQ scores at baseline had more pronounced TQ reductions than patients with low TQ baseline scores. Also, patients who had already improved from screening to baseline benefited less than patients without initial improvement. Conclusions: The results from this large sample demonstrate that rTMS shows only small but clinically significant effects in the treatment of chronic tinnitus. There are no good demographic or clinical predictors for treatment outcome.
Supertranslations to All Orders*  [PDF]
Rainer Dick
Journal of Modern Physics (JMP) , 2010, DOI: 10.4236/jmp.2010.11007
Abstract: We calculate the transformation laws of the general linear superfield and chiral superfields under supertranslations to all orders in the translation parameters . We use the superfield formalism with complete expansions of the component fields in the coordinate shifts . The results show in particular how a general supertranslation transforms each component field of a supermultiplet into a complete superfield. The results also provide complete parametri-zations of orbits of component fields under supertranslations.
Collapsing Schwarzschild Interior Solution  [PDF]
Rainer Burghardt
Journal of Modern Physics (JMP) , 2015, DOI: 10.4236/jmp.2015.613195
Abstract: We extend the static interior Schwarzschild solution to a collapsing model by applying geometrical methods. We examine the field quantities and field equations in the comoving and non-comoving observer systems. The collapsing stellar object contracts asymptotically to its minimum extent and needs an infinitely long time to arrive at the final state. The event horizon of the exterior Schwarzschild solution is not reached or even crossed. A geometric model of ECOs (eternally collapsing objects) is presented.
Einstein’s Elevator in Cosmology  [PDF]
Rainer Burghardt
Journal of Modern Physics (JMP) , 2016, DOI: 10.4236/jmp.2016.716203
Abstract: The metrics of gravitational and cosmological models are brought into canonical form in comoving coordinates. The FWR curvature parameter k is read from this and it is shown that k=0 does not correlate to a flat model, but for a spatially positively curved geometry in which reference systems which are in free fall exist. This also corresponds to Einstein’s elevator principle. Moreover, we will show that our subluminal cosmos is associated with the Rh=ct model of Melia, assuming that k=0 is related to a free-falling system in the sense described above.
Incidents with Dioxins and PCBs in Food and Feed-Investigative Work, Risk Management and Economic Consequences  [PDF]
Rainer Malisch
Journal of Environmental Protection (JEP) , 2017, DOI: 10.4236/jep.2017.86048
Abstract: The identification of contamination sources within the food chain with polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzo-furans (PCDFs), (“dioxins”), and PCBs is difficult and complex. PCDD/PCDF can be formed as unintentional compounds in a number of chemical processes as well as in almost every combustion process. PCBs were intentionally produced chemicals that were manufactured for decades before the ban in marketing and use in many countries around 1985. The pattern of occurrence can change from the original source in particular via feedingstuffs to food of animal origin as result of bioaccumulation. A number of examples illustrate the challenging detective work and key scientific aspects for identification of the sources, for support of the risk management and for performance of monitoring programs. The contamination of milk and milk products in European countries with dioxins was caused by compound feeds containing citrus pulp pellets from Brazil which had high dioxin levels as a result of the use of heavily contaminated lime used for neutralization. The Belgian dioxin crisis was caused by a feed additive heavily contaminated with PCBs which were discharged into a recycled fat used in the production of animal feed. Guar gum from India was contaminated with sodium pentachlorophenate and dioxins. Clay was found to be possibly highly contaminated with dioxins possibly formed by geothermal processes over time; use of such clay as feed additive or for human intake led to elevated dioxin levels in food and humans. Bioanalytical screening in combination with comprehensive physicochemical investigations led to the detection of brominated flame retardants and brominated dioxins in a feed additive. Buffalo milk was contaminated in Italy presumably caused by illegal deposition of waste. High PCB levels in fuel oil for drying of breadcrumb used as a feed ingredient caused a major dioxin crisis with pork meat in Ireland. Fatty acids for technical purposes originating from a biodiesel company were used for production of feed fat which contaminated parts of the food chain in Germany. In addition to effects on human and animal health these incidents also have serious economic consequences which could be mitigated by more frequent control on food and feed. Addressing both these issues, the European Community has developed a strategy to reduce the presence of dioxins and PCBs in the environment and in feed and food comprising the establishment of maximum and action levels.
Generalization of the de Sitter Cosmos  [PDF]
Rainer Burghardt
Journal of Modern Physics (JMP) , 2018, DOI: 10.4236/jmp.2018.94047
Abstract: First of all, we investigate whether the transformation of Lemaître inevitably leads from the static de Sitter cosmos to an expanding cosmos. A Lorentz transformation which can be assigned to the Lemaître transformation results in a frame of reference that moves relatively to the static dS system. Because of the homogeneity of space, this applies to every point in the space which does not itself undergo any change. We interpret the “expansion” of the cosmos Milne-like. It is not the space that expands, but the mesh of the Lemaître coordinate system. The velocity parameter of the associated Lorentz transformation is geometrically based and shows that the joined observer systems are moving in free fall. We also discuss the question of whether the speed of light for free-falling observers in the universe can be reached or can be exceeded, respectively. We raise the question of whether the model can be extended in such a way that the motions take place with a velocity that is lower than the one of the free fall. We believe that the method we have derived can be generalized to models with genuine expansion.
Dark Matter without Matter  [PDF]
Rainer Burghardt
Journal of Modern Physics (JMP) , 2018, DOI: 10.4236/jmp.2018.913147
Abstract: We design a cosmological model that expands at a speed less than that of free fall and which allows accelerations of the recession velocity. In addition, the underlying geometry of the model can be adjusted in such a way that attractive forces arise in the cosmos, forces whose sources are not matter. This could explain dark matter as a property of space and one could also address the question of why galactic systems are not subject to expansion.
Drawing Kerr  [PDF]
Rainer Burghardt
Journal of Modern Physics (JMP) , 2019, DOI: 10.4236/jmp.2019.105036
Abstract: The Kerr metric is analyzed using strictly geometrical elements. A 4-dimensional surface representing the geometry of the Kerr model is embedded into a 5-dimensional flat space. The field strengths of the model are explicitly worked out and understanding of the theory is supported by numerous figures. The structure of the field equations is analyzed.
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