Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Feb 2004
Comment Letter Comparative Study[Ruptured abdominal aortic aneurysms: status quo after a quarter century of treatment experience].
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Acute liver failure is a rare and life-threatening clinical syndrome following severe hepatic injury. Depending on the rapidity of its development, two distinct complications contribute to a high mortality: in hyperacute liver failure, rapid development of massive hepatic necrosis and apoptosis gives rise to severe hyperammonemia, hepatic encephalopathy and life-threatening cerebral edema. The high risk of cerebral herniation requires early listing for emergency liver transplantation. ⋯ Experimental treatment methods including detoxification by artificial or bioartificial liver support or by stimulating hepatic regeneration are currently evaluated. Recognition of ammonia toxicity has stimulated the search for early ammonia-lowering strategies and strongly renewed the interest in dialytic therapies. Anti-apoptotic interventions are among the most promising pharmacological options for the near future.
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Wien. Klin. Wochenschr. · Feb 2004
Biography Historical Article[Peter Safar--"father of resuscitation"].
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Wien. Klin. Wochenschr. · Feb 2004
Randomized Controlled Trial Comparative Study Clinical TrialActive warming of critically ill trauma patients during intrahospital transfer: a prospective, randomized trial.
Hypothermia in trauma victims is a frequently observed phenomenon in acute care. Known complications of hypothermia are impaired wound healing, cardiac complications, hemodynamic instability, impaired immune function and increased blood loss. We compared active warming versus passive warming in hypothermia in critical-care patients undergoing intrahospital transfer from ICU to computer tomography (CT). ⋯ Hypothermia is common when critically ill trauma patients require intrahospital transport for diagnostic procedures. Resistive heating during intrahospital transport kept the core temperature stable and assured normothermia in all actively warmed patients. We therefore recommend active warming for critically ill trauma patients during intrahospital transport.
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Wien. Klin. Wochenschr. · Feb 2004
Acute chest pain--identification of patients at low risk for coronary events. The impact of symptoms, medical history and risk factors.
The evaluation of patients with acute chest pain remains challenging, as it implies the risk of fatal misdiagnosis. It is well recognized that typical angina does not specifically identify patients at high risk. We investigated the predictive value of characteristics atypical for myocardial ischemia for exclusion of acute or subacute coronary events, focusing on patients' symptoms, medical history and risk factors. ⋯ Evaluation of criteria atypical for myocardial ischemia with acute chest pain may help to identify candidates for early discharge, whereas typical characteristics have very little diagnostic value.