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Search Results: 1 - 10 of 31003 matches for " Thomas Salzberger "
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Thomas Salzberger,Monika Koller
REMark : Revista Brasileira de Marketing , 2010, DOI: 10.5585/remark.v9i1.2148
Abstract: The concept of cognitive dissonance has been an important construct in consumer behaviour research ever since it was first suggested. However, longitudinal studies on dissonance related to other post-purchase constructs such as satisfaction, loyalty and complaint behaviour are still scarce. In part, this is due to difficulties in the actual measurement of dissonance. Building upon recent contributions, the current study is concerned with the relationship between dissonance and satisfaction and their impact on loyalty and complaint behaviour. One hundred and twenty-five consumers who purchased consumer electronics or household goods were interviewed twice: at the time of purchase and three months afterwards. The results suggest that dissonance and satisfaction are complementary constructs describing different facets of the mental state of the customer after the purchase. Cognitive dissonance and satisfaction govern a different array of actions. While satisfaction has an impact on loyalty, i.e. future purchase intention and word of mouth, cognitive dissonance contributes to the explanation of complaint behaviour. Desde a primeira vez que foi sugerido, o conceito de dissonancia cognitiva tem sido uma ferramenta importante no estudo do comportamento do consumidor. Entretanto, estudos longitudinais de dissonancia relacionados a outras ferramentas pós-compra como satisfa o, lealdade e comportamento pós-insatisfa o ainda s o escassos. Isto é devido, em parte, às dificuldades em quantificar concretamente a dissonancia. Baseando-se em contribui es recentes, o presente estudo trata da rela o entre dissonancia e satisfa o e de seu impacto na lealdade e no comportamento pós-insatisfa o. Cento e vinte e cinco consumidores que compraram eletr nicos e produtos domésticos foram entrevistados duas vezes: no momento da compra e três meses depois. Os resultados sugerem que dissonancia e satisfa o s o ferramentas complementares, que descrevem diferentes faces do estado mental do consumidor depois da compra. A dissonancia cognitiva e a satisfa o governam um conjunto de a es. Enquanto a satisfa o tem um impacto na lealdade, i.e. inten o de compra futura e boca a boca, a dissonancia cognitiva contribui para explicar o comportamento pós-insatisfa o.
Risk factors for negative blood cultures in adult medical inpatients – a retrospective analysis
Boris P Ehrenstein, Vera Ehrenstein, Christine Henke, Hans-J?rg Linde, Bernd Salzberger, Jürgen Sch?lmerich, Thomas Glück
BMC Infectious Diseases , 2008, DOI: 10.1186/1471-2334-8-148
Abstract: We studied the association of clinical factors, CRP levels and changes of CRP documented prior to blood culture draws with the absence of bacteremia for hospitalized medical patients.In the retrospective analysis of 710 blood cultures obtained from 310 medical inpatients of non-intensive-care wards during one year (admission blood cultures obtained in the emergency room were excluded), the following retrospectively available factors were the only independent predictors of blood cultures negative for obligate pathogens: a good clinical condition represented by the lowest of three general nursing categories (OR 4.2, 95% CI 1.8 – 9.5), a CRP rise > 50 mg/L documented before the blood culture draw (OR 2.0 95% CI 1.8–9.5) and any antibiotic treatment in the previous seven days (OR 2.0, 95% CI 1.1–3.5).Including the general clinical condition, antibiotic pre-treatment and a substantial rise of CRP into the decision, whether or not to obtain blood cultures from medical inpatients with a suspected infection, could improve the diagnostic yield.Blood cultures (BC) are especially important in the diagnosis of endovascular infections. At the same time, the benefits and cost effectiveness of blood culture diagnosis for many other infectious syndromes are less clearly defined. The identification of clinical factors associated with negative blood cultures could help to avoid unnecessary BC. Serum C-reactive protein (CRP) is a well-established marker of inflammation [1,2]. It is commonly used in many clinical settings to evaluate and monitor severity of disease in patients with presumed infections [1]. We aimed to evaluate associations of different CRP levels or changes in CRP prior to BC draw with subsequent BC results. The association of negative BC results with other clinical factors commonly used to decide whether a BC draw is indicated and available by chart review were studied additionally.At our tertiary care university hospital, we reviewed medical charts of all 363 patient
Influenza pandemic and professional duty: family or patients first? A survey of hospital employees
Boris P Ehrenstein, Frank Hanses, Bernd Salzberger
BMC Public Health , 2006, DOI: 10.1186/1471-2458-6-311
Abstract: We surveyed employees at our university hospital regarding ethical issues arising during the management of an influenza pandemic.Of 644 respondents, 182 (28%) agreed that it would be professionally acceptable for HCP to abandon their workplace during a pandemic in order to protect themselves and their families, 337 (52%) disagreed with this statement and 125 (19%) had no opinion, with a higher rate of disagreement among physicians (65%) and nurses (54%) compared with administrators (32%). Of all respondents, 375 (58%) did not believe that the decision to report to work during a pandemic should be left to the individual HCP and 496 (77%) disagreed with the statement that HCP should be permanently dismissed for not reporting to work during a pandemic. Only 136 (21%) respondents agreed that HCW without children should primarily care for the influenza patients.Our results suggest that a modest majority of HCP, but only a minority of hospital administrators, recognises the obligation to treat patients despite the potential risks. Professional ethical guidelines allowing for balancing the needs of society with personal risks are needed to help HCP fulfil their duties in the case of a pandemic influenza.Medical providers worldwide are gearing up for a likely pandemic of human influenza. Professional duty of healthcare professionals (HCP) may clash with fear of contracting influenza or its transmission to family members. Triggered by the experience responding to the SARS epidemic in 2003, the lack of official ethical guidelines on balancing public needs and personal risk has been pointed out [1]. Prompted by discussions at our institution on proper response to a pandemic influenza outbreak, we examined employees' knowledge on H5N1 (avian) influenza and solicited their opinions on professional ethics.In February 2006, we distributed anonymous self-administered, multiple-choice paper questionnaires to the 637 physicians and final-year medical students (FYMS), 994 nurses, and
Syphilitic Aortitis Mimicking Takayasu’s Arteritis  [PDF]
Anna Sophia P?rings, Bernd Salzberger, Lothar Veits, Boris Ehrenstein, Wolfgang Hartung, Martin Fleck
Case Reports in Clinical Medicine (CRCM) , 2014, DOI: 10.4236/crcm.2014.38100

SIR, Syphilis is a sexually-transmitted infectious disease caused by the bacteria Treponemapallidum. A characteristic manifestation of the third stage is arteritis of the aorta, which leads to necrosis and loss of tissue. Here, we report on a 48-year-old woman admitted with suspected Takayasu’s arteritis (TA) due to localized inflammation confined to the aortic root and valve, which could be diagnosed as syphilitic aortitis.

Smoldering myeloma presenting as progressive multifocal leukoencephalopathy: a case report
Martina Troppmann, Roland Büttner, Michael Boewer, Bernd Salzberger
Journal of Medical Case Reports , 2012, DOI: 10.1186/1752-1947-6-177
Abstract: A 76-year-old Caucasian woman presented with progressive left-sided hemiparesis, accompanied by hypoesthesia, hypoalgesia and neuropsychological symptoms. Magnetic resonance imaging demonstrated new hyperattenuating lesions in the right thalamus and left-sided subcortically. A polymerase chain reaction test revealed 4500 copies of John Cunningham virus-deoxyribonucleic acid/ml in cerebrospinal fluid. Human immunodeficiency virus infection was ruled out. A bone marrow biopsy showed an early stage immunoglobulin G-kappa plasmacytoma. Cidofovir (5mg/kg) weekly for three weeks was started. A significant improvement of her neuropsychological symptoms was achieved, but motor system and sensory symptoms did not change.This case shows a rapid course of progressive multifocal leukoencephalopathy with severe residual deficits. In the diagnostic workup of all patients with atypical neurologic symptoms or immunodeficiency, progressive multifocal leukoencephalopathy should be included as a differential diagnosis.
Successful treatment of HCV/HBV/HDV-coinfection with pegylated interferon and ribavirin
Janine Hartl,Claudia Ott,Gabriele Kirchner,Bernd Salzberger
Clinics and Practice , 2012, DOI: 10.4081/cp.2012.e64
Abstract: Dual and triple infections with hepatitis virus C (HCV), B (HBV) and D (HDV) frequently lead to severe liver damage. Hereby we describe a 38-year-old Caucasian male coinfected with HCV (genotype 3a), HBV [positive hepatitis B surface antigen (HbsAg) and antibody to hepatitis B core antigen; negative hepatitis B e antigen (HbeAg) and antibody to hepatitis B e antigen (anti-HBe)] and HDV. Laboratory diagnostics revealed increased liver enzymes and histological examination of the liver showed signs of fibrosis with moderate inflammation. On therapy with pegIFN-a2b and ribavirin HCV-RNA was undetectable at week 8. After week 24 the antiviral therapy was stopped because of a HBs-seroconversion, the loss of HbeAg and the detection of anti-HBe. Furthermore the HCV-RNA was negative. Six months after successful treatment of the triple-infection, HCV- and HDV-RNA and HbsAg remained negative and the liver enzymes had been completely normalized. In conclusion, pegylated-interferon plus ribavirin may be an effective therapy for HCV, HBV and HDV-coinfected patients.
Extensively drug resistant tuberculosis in a high income country: A report of four unrelated cases
Stefan H Blaas, Ralf Mütterlein, Johannes Weig, Albert Neher, Bernd Salzberger, Norbert Lehn, Ludmila Naumann
BMC Infectious Diseases , 2008, DOI: 10.1186/1471-2334-8-60
Abstract: We evaluated all isolates of M. tuberculosis, in which drug susceptibility testing was performed at our institution since 1997, for multi and extensive drug resistance. Clinical courses of patients infected by strains fulfilling the recently revised criteria for XDR tuberculosis were analysed.Four XDR M. tuberculosis isolates were identified. All patients had immigrated to Germany from Russia, Georgia, and former Yugoslavia and none were infected by the human immunodeficiency virus. All patients where treated for tuberculosis for 5.5 to 15 years and for XDR tuberculosis for 1.9 to 2.5 years. They received inhospital treatment in Germany for 11 months, 4.5 years and twice for 6 years. Non-compliance was an important factor in all four patients, three patients had to be treated in Germanys only locked facility for tuberculosis treatment. One patient with XDR tuberculosis died, one patient had still open pulmonary tuberculosis at last contact and 2 patients were cured.Cases of XDR tuberculosis have been treated in our region for several years. Even in a high income setting, XDR tuberculosis has a tremendous impact on quality of live, outcome and the total cost. All reasonable efforts to prevent the spread of XDR tuberculosis must be made and maintained.Tuberculosis (TB) remains one of the major causes of death from a single infectious agent worldwide. The emergence of multi drug resistance, defined as resistance to at least rifampin (RMP) and isoniazid (INH) is of great concern. Recently, reports of strains with extensively drug resistant (XDR) TB have been described and the question was raised, whether we enter the post-antibiotic era [1-4]. In October 2006 the WHO Global Task Force on XDR-TB met in Geneva, Switzerland, and approved the following revised laboratory case definition of XDR-TB: "TB showing resistance to at least rifampin and isoniazid, which is the definition of multi drug resistant (MDR) TB, in addition to any fluoroquinolone, and to at least 1 of the 3
Clinical impact of a commercially available multiplex PCR system for rapid detection of pathogens in patients with presumed sepsis
Christine Dierkes, Boris Ehrenstein, Sylvia Siebig, Hans-J?rg Linde, Udo Reischl, Bernd Salzberger
BMC Infectious Diseases , 2009, DOI: 10.1186/1471-2334-9-126
Abstract: Blood samples from patients with presumed sepsis were cultured with the Bactec 9240? system (Becton Dickinson, Heidelberg, Germany) and aliquots subjected to analysis with the LightCycler? SeptiFast? (SF) Test (Roche Diagnostics, Mannheim, Germany) at a tertiary care centre. For samples with PCR-detected pathogens, the actual impact on clinical management was determined by chart review. Furthermore a comparison between the time to a positive blood culture result and the SF result, based on a fictive assumption that it was done either on a once or twice daily basis, was made.Of 101 blood samples from 77 patients, 63 (62%) yielded concordant negative results, 14 (13%) concordant positive and 9 (9%) were BC positive only. In 14 (13%) samples pathogens were detected by SF only, resulting in adjustment of antibiotic therapy in 5 patients (7,7% of patients). In 3 samples a treatment adjustment would have been made earlier resulting in a total of 8 adjustments in all 101 samples (8%).The addition of multiplex PCR to conventional blood cultures had a relevant impact on clinical management for a subset of patients with presumed sepsis.Early adequate antibiotic treatment improves the outcome of patients with sepsis [1-5]. Even if broad spectrum antibiotics are used empirically, adjustments of antimicrobial therapy may be necessary. Generally adjustments are based on the results of positive blood or other cultures that are available after 8 to 48 hours [6].Additionally, the likelihood of a positive result in conventional culture methods can be reduced by concomitant or prior antibiotic treatment. Amplification of bacterial and fungal nuclear acids directly from blood specimen is a newly established detection method for pathogens. Tests based on this method may improve clinical care by shortening the time to a positive result and by being more independent of antibiotic pre-treatment. The impact of these methods on therapeutic decisions and outcome has not yet been studied.We co
Cryptococcosis mimicking cutaneous cellulitis in a patient suffering from rheumatoid arthritis: a case report
Corina Probst, Georg Pongratz, Silvia Capellino, Rolf M Szeimies, Jürgen Sch?lmerich, Martin Fleck, Bernd Salzberger, Boris Ehrenstein
BMC Infectious Diseases , 2010, DOI: 10.1186/1471-2334-10-239
Abstract: An 81-year-old woman developed severe necrotizing cellulitis on her left arm without any preceding injury. The patient had been treated with systemic corticosteroids over twenty years for rheumatoid arthritis (RA). Skin biopsies of the wound area were initially interpreted as cutaneous vasculitis of unknown etiology. However, periodic acid Schiff staining and smear analysis later revealed structures consistent with Cryptococcus neoformans, and the infection was subsequently confirmed by culture. After the initiation of therapy with fluconazole 400 mg per day the general condition and the skin ulcers improved rapidly and the patient was discharged to a rehabilitation facility. Subsequently surgical debridement and skin grafting were performed.Opportunistic infections such as cryptococcosis can clinically and histologically mimic cutaneous vasculitis and have to be investigated rigorously as a differential diagnosis in immunosuppressed patients.Cryptococcus neoformans is an opportunistic encapsulated yeast and the most frequent cryptococcal species found in humans. Cryptococcus neoformans is composed of three variants: C. neoformans var. gattii, var. grubii, and var. neoformans. Cryptococcus neoformans var. gattii is encountered mostly in tropical areas, but C. neoformans var. gattii has been found recently responsible for an ongoing outbreak of cryptococcosis in immunocompetent humans and animals on Vancouver Island, Canada, and surrounding areas [1,2]. Cryptococcus neoformans var. gattii has now been shown to be different enough from other subspecies for authors suggesting to elevate it to its own species level [3,4].Infections caused by C. neoformans var. gattii occur predominantly in apparently healthy hosts [5]. Cryptococcus neoformans var. grubii and var. neoformans have a worldwide distribution. Although, Cryptococcus neoformans being isolated from decaying wood, fruits, vegetables, hay and dust [6], bird droppings, especially of pigeons, are an important sourc
Outcome of patients with acute, necrotizing pancreatitis requiring drainage-does drainage size matter?
T Bruennler, J Langgartner, S Lang, CE Wrede, F Klebl, S Zierhut, S Siebig, F Mandraka, F Rockmann, B Salzberger, S Feuerbach, J Schoelmerich, OW Hamer
World Journal of Gastroenterology , 2008,
Abstract: AIM: To assess the outcome of patients with acute necrotizing pancreatitis treated by percutaneous drainage with special focus on the influence of drainage size and number.METHODS: We performed a retrospective analysis of 80 patients with acute pancreatitis requiring percutaneous drainage therapy for infected necroses. Endpoints were mortality and length of hospital stay. The influence of drainage characteristics such as the median drainage size, the largest drainage size per patient and the total drainage plane per patient on patient outcome was evaluated.RESULTS: Total hospital survival was 66%. Thirty-four patients out of all 80 patients (43%) survived acute necrotizing pancreatitis with percutaneous drainage therapy only. Eighteen patients out of all 80 patients needed additional percutaneous necrosectomy (23%). Ten out of these patients required surgical necrosectomy in addition, 6 patients received open necrosectomy without prior percutaneous necrosectomy. Elective surgery was performed in 3 patients receiving cholecystectomy and one patient receiving resection of the parathyroid gland. The number of drainages ranged from one to fourteen per patient. The drainage diameter ranged from 8 French catheters to 24 French catheters. The median drainage size as well as the largest drainage size used per patient and the total drainage area used per patient did not show statistically significant influence on mortality.CONCLUSION: Percutaneous drainage therapy is an effective tool for treatment of necrotizing pancreatitis. Large bore drainages did not prove to be more effective in controlling the septic focus.
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