W Gaus

Universität Ulm, Ulm, Baden-Württemberg, Germany

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Publications (93)226.6 Total impact

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    ABSTRACT: The relevance of low ceruloplasmin serum concentrations for the differential diagnosis in neurology and psychiatry rests upon the association with neurodegenerative disorders with brain iron accumulation, on the one hand, and Wilson disease, on the other hand. The present study reports immunonephelometrical measurements of ceruloplasmin serum concentrations in a large randomized population sample. Results are in accordance with published data and show dependency on markers of inflammation, gender and history of oral contraception; in addition, a strong correlation to serum cholesterol fractions is being demonstrated. It would appear useful to account for these when evaluating ceruloplasmin serum concentrations.
    No preview · Article · Jan 2011
  • M. Ebinger · W. Gaus
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    ABSTRACT: Medical documentation is a very important part of information retrieval and information science. The main emphasis of medical documentation is medical data processing in hospitals, physicians' offices, institutions of the health care system, contract research institutes (CROs), and pharmaceutical industries as well as the documentation of medical literature. The field of activities therefore is widespread: The most important employers are the chemical-pharmaceutical industry, University Hospitals, CROs, and hospitals. The first school of Medical Documentation in Europe was founded in Ulm in 1969. At present, there are 21 programs for Health Data Technicians, eight programs for Health Data Administrators, and nine programs for medical informatics, in Germany. To give an example: The program for Health Data Administrators at the School for Medical Documentation of the University Hospital Ulm lasts three years and includes theoretical lessons, exercises at school, practices in the field, and a thesis. It is composed from subjects in medicine, documentation and information retrieval, mathematics and statistics, data processing, and some professional subjects like organisation, management, confidentiality, legal aspects, English, etc. All education and training programmes in Medical Documentation offer excellent career prospects and a variety of further training possibilities.
    No preview · Article · Jan 2004
  • M. Ebinger · W. Gaus
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    ABSTRACT: In Germany various programs are offered for education and training in information retrieval and information science. These programs are on the level of (i) practical training run by organisations or companies together with professional schools, (ii) polytechnical colleges or (iii) universities. The just published 5th edition of the book "Berufe im Informationswesen, ein Wegweiser zur Ausbildung" [1] offers a detailed overview of all training programs in information retrieval business and information science covering archives, public and scientific libraries, book and library science, information and documentation, health records and medical documentation, health in-formatics, computer linguistics and museums. A trend is observed going towards the integration of information professionals like an integrated training program for public and scientific libraries, or further for archives, libraries and information retrieval. In Germany students have to select a program and then follow it until graduation (diploma), but now, bachelor and subsequent master programs are installed as well.
    No preview · Article · Jan 2003
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    ABSTRACT: Although effective conventional therapies are available to treat basal cell carcinoma (BCC), undesirable side effects, including scarring, and in some cases permanent damage, often occur in problematic areas of the body, especially around the eyes, mouth, and cartilage of the nose and ears. In previous studies, intratumoural injection of recombinant interferon beta-1a (rIFN-beta-1a) has been shown to result in complete remission (CR) in 47% to 86% of patients with BETACC. The primary objective of the study was to determine the response rate to rIFN-beta-1a, in a larger BETACC patient population. Secondary objectives included evaluating the effect of tumour type/size on response as well as residues, cosmetic results, and relapse rate after CR. The safety profile of intratumoural rIFN-beta-1a in BETACC patients was also evaluated. This was an open-label, multicentre study involving 139 patients with BETACC (diameter between 5.0 and 20 mm). Intratumoural injections of rIFN-beta-1a (1.0 x 106 IU) were administered three times a week for 3 weeks. The response was determined 16 weeks after start of treatment and the status of patients was followed for up to 5 years. At 16 weeks, the response rate to intratumoural rIFN-beta-1a was 66.9% (95% CI, range 58.2-74.8%). There was no significant difference between the response rates for patients with solid or other BETACC tumour types. Similarly, tumour size did not significantly affect the response rate. The cosmetic result of treatment was rated as good or very good in 83% of responders. The relapse rate after CR was 4.5% (median follow-up 2 years). All patients showed local inflammatory reactions, which were generally considered to be the adverse drug reactions (ADRs). Systemic ADRs mostly consisted of flu-like symptoms and occurred in 32/139 patients. No ADRs were considered to be the serious. These results show that intratumoural injections of rIFN-beta-1a are effective in the treatment of BETACC in the majority of patients. In addition, rIFN-beta-1a is safe and generally well tolerated. rIFN-beta-1a represents an effective alternative treatment for BETACC.
    No preview · Article · Nov 2002 · European journal of dermatology: EJD
  • R Muche · F Rohlmann · G Büchele · W Gaus
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    ABSTRACT: New therapies in rehabilitation medicine have to be evaluated with clinical trials. For drug approval the methodology of clinical trials is standardized world wide and the results of these studies are widely accepted. This standard should be achieved in clinical trials in rehabilitation research, too. One of the standards is the existence of a control group, comparing the effect of the new intervention against controls. In addition, the investigational and control groups must be equal in terms of the structure of possible confounders. Randomisation is the best possibility to distribute the patients to the therapy-groups, confounders will be equally distributed by chance. Other procedures for assignment to the study groups can result in confounding and lead into biased results. In spite of these advantages, randomisation is not generally accepted in rehabilitation research up to now. There are some reservations, mostly ethical, organisational and methodological ones. However, randomised clinical trials should be conducted in rehabilitation research in order to obtain more convincing results. Our intention is to bring some input in this debate and to present basics and practical aspects of randomisation.
    No preview · Article · Nov 2002 · Die Rehabilitation
  • R. Muche · F. Rohlmann · G. Büchele · W. Gaus

    No preview · Article · Oct 2002 · Die Rehabilitation
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    ABSTRACT: For an efficient rehabilitation it is essential to identify patients as early as possible, who will probably loose their working capacity. Using this information supporting measures could be undertaken during inpatient rehabilitation or intensified aftercare. The purpose of this study was to show, how well a statistical model predicts long-term return to work, using routinely documented data during inpatient rehabilitation. In addition it was important to find, which variables out of the available data-pool contribute to the prediction for a time-period of 1–2 years. For 841 patients the probability of return to work was estimated using data from inpatient rehabilitation. The probability was compared with information from the regional pension insurance institute of Wuerttemberg about the actually granting of pension due to loss of working capacity. For the prognosis “working capacity 1–2 years after rehabilitation” the model obtains a sensitivity of 75% and a specificity of 80%. The positive predictive value amounts to 34%, the negative predictive value to 97%. Therefore it is possible to predict long-term return to work with a statistical model using routinely registered data only. The model could be further improved in appending further disease specific information.
    No preview · Article · Aug 2002 · Journal of Public Health
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    ABSTRACT: For an efficient rehabilitation it is essential to identify patients as early as possible, who will probably loose their working capacity. Using this information supporting measures could be undertaken during inpatient rehabilitation or intensified after care. The purpose of this study was to show, how well a statistical model predicts long-term return to work, using routinely documented data during inpatient rehabilitation. In addition it was important to find, which variables out of the available data-pool contribute to the prediction for a time-period of 1-2 years. For 841 patients the probability of return to work was estimated using data from inpatient rehabilitation. The probability was compared with information from the regional pen sion insurance institute of Wuerttemberg about the actually granting of pension due to loss of working capacity. For the prognosis "working capacity 1-2 years after rehabilitation" the model obtains a sensitivity of 75% and a specificity of 80%. The positive predictive value amounts to 34%, the negative predictive value to 97%. Therefore it is possible to predict long-term return to work with a statistical model using routinely registered data only. The model could be further improved in appending further disease specific information.
    No preview · Article · Jan 2002

  • No preview · Article · Jan 2002
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    ABSTRACT: Perioperative antibiotic prophylaxis surely reduces surgical infection rate. Pharmacokinetic data of oral ofloxacin in combination with its antibacterial spectrum suggest effective protection against perioperative infection. In addition, costs, adverse effects, and induction of microbial resistance are low. Therefore we performed a controlled randomized study comparing oral and intravenous single dose prophylaxis. A total of 61 patients undergoing colonic or pancreatic resection randomly received either a single dose standard intravenous prophylaxis or ofloxacin 400 mg and metronidazole 500 mg orally 2 h before surgery. Postoperative infections were recorded for 3 weeks. Groups were very well comparable regarding age, overweight, concomitant disease, type and duration of surgery, blood loss, and volume support. Infectious complications occurred in 14.8% after parenteral and 3.3% after enteral antibiotic prophylaxis. There was no difference in post-operative hospital stay. The data demonstrate that single-dose oral ofloxacin is at least as effective as a standard intravenous prophylaxis in patients with colonic or pancreatic resection. It offers significant advantages regarding costs and ease of administration.
    No preview · Article · Dec 2001 · Langenbeck s Archives of Surgery
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    ABSTRACT: Failed-back syndrome is still an unsolved problem. Use of ADCON-L gel, already commercially available, has been proven to reduce postoperative scarring in animal experiments. The authors of two controlled clinical studies have also shown positive results when applying the gel. They did not, however, establish patient-oriented endpoints. The authors report a study of ADCON-L in which they focus on patient-oriented endpoints. Patients with lumbar disc herniation were randomized to an ADCON-L-treated or control group. Therapeutic success was evaluated using the validated Hannover Questionnaire on Activities of Daily Living (FFbH) 6 months after surgery. The study took place between November 14. 1996, and April 20, 1998, in eight neurosurgical centers in Germany. A total of 398 patients was recruited; 41 patients dropped out during follow up. The mean functional FFbH score (100 points = all activities are possible without problem; 0 points = no activity is possible) was 78.5 points in the ADCON-L-treated group compared with 80 points in the control group. Furthermore, in terms of secondary outcome variables, the ADCON-L group did not have an advantage over the control group. Only the mean magnetic resonance imaging score showed a slight advantage of ADCON-L over the control group. The authors found no positive effect of treatment with ADCON-L gel in patients in whom one-level lumbar microdiscectomy was performed. Because of its rather large sample size and its homogeneity, the study had sufficient power to detect even small differences between the two groups.
    No preview · Article · Nov 2001 · Journal of Neurosurgery
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    ABSTRACT: In extremely-low-birth-weight (ELBW) infants, formula feeding is required if human milk is not available. The tolerance of a new 'high' lactose (55 g/L), low protein, low phosphate, hydrolyzed protein formula (HLF) for early enteral feeding advancement of ELBW infants was compared with that of a low lactose (1 g/L) hydrolyzed protein formula (LLF). In a randomized multicenter trial, 99 ELBW infants were fed according to a standardized protocol beginning at 48 hours of age with 12 ml/kg daily increments. Primary outcome was the cumulative milk feeding volume (CFV) from days 3 to 14. The authors hypothesized that feeding HLF as a supplement to human milk would increase the CFV at least by 20% in at least 60% of matched pairs compared with LLF. A secondary issue was to investigate whether human milk would increase the CFV compared with formula. The CFV was 720 mL/kg (range, 0-962 mL/kg) with HLF and 613 mL/kg (range, 3-1,283 mL/kg) with LLF feeding. There was no 20% difference. On day 14, the median feeding volume was 103 mL/kg. The CFV was 533 mL/kg (range, 0-962 mL/kg) in infants who received less than 10% of human milk and 832 mL/kg (range, 74-1,283 mL/kg) in infants who received more than 10%. Necrotizing enterocolitis (Bell stage > or =2) occurred only with LLF feeding (n = 5; P < 0.05). The study failed to find the hypothesized 20% advantage of the new HLF. The observed advantage of human milk supports the hypothesis that it should be the first diet in ELBW infants; however, this hypothesis still must be confirmed in a controlled, randomized trial.
    No preview · Article · Aug 2001 · Journal of Pediatric Gastroenterology and Nutrition
  • R Muche · M Rösch · S Flierl · B Alt · E Jacobi · W Gaus
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    ABSTRACT: For efficient rehabilitation it is important to identify, as early as possible, the patients likely to be successfully returned to work after rehabilitation. The aim of this pilot study was to develop a statistical model for predicting this return as reliably as possible. The model uses only information readily available at the beginning of rehabilitation. A multiple regression analysis with backward elimination was used from a routine data base and identified 8 variables of prognostic value. The model offers a comfortable possibility to predict the probability of return to work of a patient on the basis of routinely registered data. The prognosis was found correct in 68% of those returning to work after rehabilitation (sensitivity) and in 80% of those who did not (specificity). Further work to improve the model for prognosis in rehabilitation research is considered reasonable.
    No preview · Article · Nov 2000 · Die Rehabilitation

  • No preview · Article · Oct 2000 · Die Rehabilitation
  • R Muche · M Rösch · S Flierl · W Gaus
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    ABSTRACT: Methodology of clinical studies is highly sophisticated in drug research. But clinical trials are also necessary to demonstrate efficacy and safety of rehabilitation treatment. The call for evidence based medicine has also reached rehabilitation. However, in rehabilitation medicine it is much more difficult to design and conduct clinical trials with a high methodological standard. Among the reasons are: A comparable control group is necessary because spontaneous healing and unspecific measures contribute to therapeutic success, too. But what could "placebo rehabilitation" look like? The masking of therapies (blinded studies) will hardly ever be possible. Therefore, it is more difficult to achieve the same treatment and observation for the treatment and control group. Treatments in rehabilitation take longer to become effective than a drug and maybe the success will disappear after some time. Therefore, long-term trials and follow-ups are necessary. Such studies are expensive, need a strong organisation, and drop-outs are unavoidable. An appropriate outcome variable does not always exist. "Return to work" is an important, reliable and valid variable, but it delivers only one bit of information per patient. As a consequence, smaller progress in rehabilitation can only be demonstrated with large sample sizes. Outcome variables based on time enable studies with reasonable sample sizes. Sometimes it is more difficult to obtain acceptance of randomisation in rehabilitation patients than in acute patients. Some rehabilitation hospitals have only recently begun to take an interest in controlled clinical trials, hence are not so experienced. Nevertheless, controlled clinical trials delivering convincing results are possible in rehabilitation medicine as well. But biometrical consultation is necessary e.g. for study design, study conduction and evaluation. Most important points are the methodology of the study design and its practicability. Especially in these topics rehabilitation physicians and biometrician have to cooperate.
    No preview · Article · Sep 2000 · Die Rehabilitation

  • No preview · Article · Aug 2000 · Die Rehabilitation
  • Josef Högel · Wilhelm Gaus
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    ABSTRACT: K.R. Popper's philosophy of critical rationalism is concerned with the detection and removal of error. Fundamental contradictions exist between Popper's theory of knowledge and the present-day practice of the clinical investigation of new drugs. Currently, the public authorities concerned with the licensing of drugs pass judgment on trials, which are closely linked by the one-sponsor problem: the assertions made by the sponsor are not independently confirmed. This lack leads to excessive documentation and to costly monitoring and auditing, which are intended to ensure the credibility of results. In Popper's view, confirmatory trials, independent of the sponsor and supervised by the regulatory bodies, would be a better way to achieve reliable knowledge. The consequence would, among other things, be a reorganization of phase III of the clinical investigation of new drugs by dividing it into independent parts, one under the control of the sponsor and one under the control of the public authority. The implementation of this suggestion would lead to a more scientific manner of dealing with new drugs and to savings in terms of unproductive measures during the application process.
    No preview · Article · Jan 2000 · Controlled Clinical Trials
  • J Högel · M Grabert · W Sorgo · S Wudy · W Gaus · E Heinze
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    ABSTRACT: In adult patients with type 1 diabetes good metabolic control was associated with an undesired weight gain. In the present report the possible association of HbA1c and body mass index (BMI) in children and adolescents with type 1 diabetes (IDDM) was investigated in a long-term retrospective study from 1976 to 1995. Further, the relationship between BMI on one hand and age, gender, duration of IDDM, the number of units of insulin used and the number of injections per day on the other hand were considered. Statistical analysis was performed using repeated measurements analyses of variance. The 208 girls and 201 boys were 5-17 years old and had diabetes for beyond one year. For analysis 2512 data sets, in part measurements on the same patient in the course of the disease, were available. In various statistical models, the results show that age, gender, the daily amount of insulin, and the HbA1c level (p<0.001-0.005) were associated with the BMI. Extremely high HbA1c levels coincided with a remarkably low BMI. Hence, in children and adolescents with IDDM it may be difficult to achieve a constantly good metabolic control accompanied by a normal body weight.
    No preview · Article · Jan 2000 · Experimental and Clinical Endocrinology & Diabetes
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    ABSTRACT: The inhabitants of a rural community in southwestern Germany were examined for alveolar echinococcosis (AE). The study was prompted by the recent increase of the prevalence of the parasite in foxes and the increase of fox populations: in the study area, 75% of the foxes carried Echinococcus multilocularis. The human population was screened using hepatic ultrasound and serology. All participants were interviewed for demographic and potential risk factors. Of 2,560 participants, one was identified with active AE, while 3 others had suspicious liver lesions. Another 9 participants were seropositive for specific antibodies without detectable lesions. Demographic and behavioral factors were not correlated with active or suspected cases nor with seropositivity. If the prevalence of 40/100,000 (95% confidence interval = 15-295/100,000) for active cases would be representative for the rural population in high endemicity areas, the current number of AE cases in southwestern Germany is considerably higher than previously suspected.
    Full-text · Article · Nov 1999 · The American journal of tropical medicine and hygiene
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    ABSTRACT: The pharmacological inhibition of exocrine pancreatic secretion with the somatostatin analogue octreotide has been advocated as a specific treatment of acute pancreatitis. To investigate the efficacy of octreotide in acute pancreatitis in a randomised, placebo controlled trial. 302 patients from 32 hospitals, fulfilling the criteria for moderate to severe acute pancreatitis within 96 hours of the onset of symptoms, were randomly assigned to one of three treatment groups: group P (n=103) received placebo, while groups O1 (n=98) and O2 (n=101) received 100 and 200 microg of octreotide, respectively, by subcutaneous injection three times daily for seven days. The primary outcome variable was a score composed of mortality and 15 typical complications of acute pancreatitis. The three groups were well matched with respect to pretreatment characteristics. An intent to treat analysis of all 302 patients revealed no significant differences among treatment groups with respect to mortality (P: 16%; O1: 15%; O2: 12%), the rate of newly developed complications, the duration of pain, surgical interventions, or the length of the hospital stay. A valid for efficacy analysis (251 patients) also revealed no significant differences. This trial shows no benefit of octreotide in the treatment of acute pancreatitis.
    Full-text · Article · Aug 1999 · Gut

Publication Stats

2k Citations
226.60 Total Impact Points

Institutions

  • 1977-2002
    • Universität Ulm
      • • Institute of General Medicine
      • • Institute of Biophysics
      • • Department of Internal Medicine
      Ulm, Baden-Württemberg, Germany
  • 1996-1998
    • University of Leipzig
      • Institut für Medizinische Mikrobiologie und Infektionsepidemiologie
      Leipzig, Saxony, Germany
  • 1997
    • Martin Luther University of Halle-Wittenberg
      Halle-on-the-Saale, Saxony-Anhalt, Germany
    • University of Cologne
      • Department of Dermatology and Venerology
      Köln, North Rhine-Westphalia, Germany
  • 1992
    • Institut für klinische Pharmakologie
      Stuttgart, Baden-Württemberg, Germany