Wiener klinische Wochenschrift
-
Wien. Klin. Wochenschr. · Nov 2003
Review Comparative StudyThe cumulative effects of Transcendental Meditation on cognitive function--a systematic review of randomised controlled trials.
It is claimed that regular practice of Transcendental Meditation (TM) improves cognitive function and increases intelligence. This systematic review assesses the evidence from randomised controlled trials for cumulative effects of TM on cognitive function. Searches were made of electronic databases and the collected papers and official websites of the TM organisation. ⋯ The other 6 trials recruited subjects with no specific interest in TM, and 5 of them used structured control procedures. The association observed between positive outcome, subject selection procedure and control procedure suggests that the large positive effects reported in 4 trials result from an expectation effect. The claim that TM has a specific and cumulative effect on cognitive function is not supported by the evidence from randomised controlled trials.
-
Wien. Klin. Wochenschr. · Nov 2003
Comparative StudyChanges in cholesterol and its precursors during the first days after major trauma.
The causes of hypocholesterolemia in the critically ill, including major trauma patients, have not yet been fully elucidated. ⋯ Decreased synthesis of cholesterol precursors is the major cause of hypocholesterolemia in patients with multiple trauma. Lathosterol concentration is proposed as a marker of cholesterol synthesis.
-
Wien. Klin. Wochenschr. · Nov 2003
Review Comparative Study[Progress in the prevention of type 2 diabetes].
Type 2 diabetes mellitus is a major health problem associated with excess morbidity and mortality. Defects in the action and/or secretion of insulin are the two major abnormalities leading to development of glucose intolerance. Any intervention in the impaired glucose tolerance phase that reduces resistance to insulin or protects the beta-cells, or both, should prevent or delay progression to diabetes. ⋯ Remarkably, cardiovascular event rates, in particular myocardial infarction, were significantly reduced when acarbose was used instead of placebo in subjects with glucose intolerance. The ACE inhibitors captopril (CAPPP) or ramipril (HOPE) and the Angiotensin-II receptor antagonist losartan (LIFE) have been shown to reduce the appearance of diabetes by one third when given to patients with hypertension. Since many hypertensive patients are insulin-resistant and have an increased risk in developing type 2 diabetes, the protective effect of these classes of antihypertensive drugs might be explained by their antiinsulin-resistance effects.
-
Wien. Klin. Wochenschr. · Nov 2003
Comparative StudyLong-term follow-up after renal artery stenting.
Renal artery stenosis may cause secondary arterial hypertension and lead to end-stage renal disease. Percutaneous transluminal angioplasty with stent implantation (PTRAS) allows effective and consistent treatment with a high technical success rate. The present trial focuses on the morphological and clinical results as assessed at a long-term follow-up (FU) visit. The main goals were assessment of the restenosis rate and evaluation of arterial hypertension and renal function. ⋯ PTRAS gives excellent morphological long-term results. However, the clinical long-term outcome regarding arterial hypertension and renal function is only moderate.
-
Wien. Klin. Wochenschr. · Nov 2003
Comparative Study[Cardiac rehabilitation in Austria. A need to treat analysis].
The aim of this analysis is to survey the general demand and current supply of cardiac rehabilitation in Austria on the basis of best evidence practice and to produce recommendations for a cost-effective structure of the entire cardiac rehabilitation system. Following the standards of indication of the Austrian Society of Cardiology an analysis of demand of cardiac rehabilitation has been carried out and juxtaposed with the current supply of facilities for cardiac rehabilitation. According to hospitalizations in the year 2000, 11,630 patients per annum would require inpatient phase II rehabilitation, 6,270 patients institutional based outpatient phase II rehabilitation and 14,319 patients institutional based phase III rehabilitation. ⋯ At present, the supply of cardiac rehabilitation in Austria is sufficient for inpatient phase II, but insufficient for the institutional based outpatient phase II and mainly phase III. Thus, a striking asymmetry exists between supply and demand. In view of the enduring effects of institutional based phase III rehabilitation, the individual and social use and finally the expected efficiency in terms of costs, this program should at least be offered without limits to all eligible patients.