Publications by authors named "Michael Muntean"

2 Publications

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General and Disease-Specific Health Indicator Changes Associated with Inpatient Rehabilitation.

J Am Med Dir Assoc 2020 12 28;21(12):2017.e10-2017.e27. Epub 2020 Jul 28.

Division of Physiology, Otto Loewi Research Center, Medical University of Graz, Graz, Austria; Human Research Institute, Weiz, Austria.

Objectives: Rehabilitation plays a vital role in the mitigation and improvement of functional limitations associated with aging and chronic conditions. Moderating factors such as sex, age, the medical diagnosis, and rehabilitation timing for admission status, as well as the expected change related to inpatient rehabilitation, are examined to provide a valid basis for the routine assessment of the quality of medical outcomes.

Design: An observational study was carried out, placing a focus on general and disease-specific health measurements, to assess representative results of multidisciplinary inpatient rehabilitation. Aspects that were possibly confounding and introduced bias were controlled based on data from a quasi-experimental (waiting) control group.

Measures: Existing data or general health indicators were extracted from medical records. The indicators included blood pressure, resting heart rate, self-assessed health, and pain, as well as more disease-specific indicators of physical function and performance (eg, activities of daily living, walking tests, blood lipids). These are used to identify moderating factors related to health outcomes.

Setting And Participants: A standardized collection of routine data from 16,966 patients [61.5 ± 12.5 years; 7871 (46%) women, 9095 (54%) men] with different medical diagnoses before and after rehabilitation were summarized using a descriptive evaluation in terms of a content and factor analysis.

Results: Without rehabilitation, general health indicators did not improve independently and remained stable at best [odds ratio (OR) = 0.74], whereas disease-specific indicators improved noticeably after surgery (OR = 3.20). Inpatient rehabilitation was shown to reduce the risk factors associated with certain lifestyles, optimize organ function, and improve well-being in most patients (>70%; cutoff: z-difference >0.20), with a standardized mean difference (SMD) seen in overall medical quality outcome of -0.48 ± 0.37 [pre- vs post-rehabilitation: η = 0.622; d = -1.22; 95% confidence interval (95% CI) -1.24 to -1.19]. The baseline medical values obtained at the beginning of rehabilitation were influenced by indication, age, and sex (all P < .001); however, these factors have less significant effects on improvements in general health indicators (η < 0.01). According to the disease-specific results, the greatest improvements were found in older patients (SMD for patients >60 vs ≤60 years: 95% CI 0.08-0.11) and during the early rehabilitation stage (η = 0.063).

Conclusions And Implications: Compared with those who received no inpatient rehabilitation, patients who received rehabilitation showed greater improvements in 2 independent areas, general and disease-specific health measures, regardless of their diagnosis, age, and sex. Due to the study design and the use of a nonrandomized waiting group, causal conclusions must be drawn with caution. However, the comparability and stability of the presented results strongly support the validity of the observed improvements associated with inpatient rehabilitation.
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December 2020

Intravenous injection of metallic mercury: case report and course of mercury during chelation therapy with DMPS.

Clin Toxicol (Phila) 2008 Jul;46(6):566-9

Karl-Franzens University Graz, Institute of Chemistry-Analytical Chemistry, Graz, Austria.

Introduction: Although several cases of i.v. injection of metallic mercury have been reported, it still remains an uncommon event.

Case Report: A 34-year-old male came to hospital because complaining of pleuritic chest pain. X-ray showed radio dense punctate lesions in both lung fields, as well as around both elbows. Mercury concentration in blood (140 microg/L) and urine (320 microg/L) from the patient were significantly elevated, compared with the reference concentrations of < or = 2.0 mug/L mercury in blood and urine. The course of renal elimination of mercury and the mercury concentration in whole blood during 5 months of chelation therapy with sodium 2,3-dimercapto-1-propanesulfonate (Dimaval) were monitored. Furthermore, the time-course of mercury in scalp hair from the patient was determined.

Conclusion: We report a case of probable consecutive i.v. administration of metallic mercury.
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July 2008