Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Feb 2005
Editorial Comment ReviewThe painful bone marrow edema syndrome of the hip joint.
In this issue of the WKW, Aigner et al have published that, for the first time, a conservative approach with iloprost has shown to be equally successful as the well-documented core decompression surgical approach in patients with BMES of the hip joint. The BME pattern on MR-imaging of the hip joint represents a common but unspecific finding, which may be associated with several diseases requiring different therapeutic strategies (Table 1). It is still controversial, whether BMES of the hip represents a distinct self-limiting disease also known as transient osteoporosis, transient marrow edema, or algodystrophy, or merely reflects a subtype of ON. ⋯ In contrast to classical CRPS, the imaging changes are located in all periarticular bones, and the soft tissues are always affected. The histological bone marrow changes are similar in all three diseases, but with abundant new bone formation in BMES and CRPS, whereas in ON only limited new bone formation surrounds the focal necrosis with a sclerotic rim. Protected weight-bearing and treatment with iloprost for BMES, but operative treatment for ON, and a sophisticated physiotherapy for CRPS in combination with iloprost are the preferred treatment strategies in our institution.
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Wien. Klin. Wochenschr. · Feb 2005
Randomized Controlled Trial Clinical Trial[Reduction of pressure sores during prone positioning of ventilated intensive care patients by the prone-head support system: a pilot study].
Prone positioning in patients with adult respiratory distress syndrome is a well-known method to improve oxygenation. The aim of our study was to evaluate a new device for prone positioning, the prone-head support system (PHS system), with regard to reduction of cutaneous pressure sores. ⋯ The PHS system with its face mask is able to reduce the extent and the severity of pressure sores in patients ventilated in prone position. Controlled randomized studies with large study populations seem justified.
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Wien. Klin. Wochenschr. · Feb 2005
Clinical Trial Controlled Clinical TrialBone marrow edema syndrome of the femoral head: treatment with the prostacyclin analogue iloprost vs. core decompression: an MRI-controlled study.
The purpose of this study was to assess the efficacy of the vasoactive drug iloprost in Bone Marrow Edema Syndrome (BMES) and to compare it to the results of a control group treated by core decompression. ⋯ The parenteral application of iloprost can achieve equal or better results in the treatment of bone marrow edema syndrome of the hip compared to core decompression.
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Wien. Klin. Wochenschr. · Feb 2005
Clinical Trial Controlled Clinical TrialIbutilide for rapid conversion of atrial fibrillation or flutter in a mixed critically ill patient population.
Ibutilide is an intravenous class III antiarrhythmic agent that has been shown to be effective in converting acute onset atrial fibrillation/flutter in stable medical and cardio-surgical patients. Data on its use in critically ill patients are rare. The aim of this open, non-randomized, prospective trial was to assess the potential role of ibutilide for conversion of recent onset atrial fibrillation/flutter in a mixed critically ill ICU-population. ⋯ Ibutilide is an effective treatment for conversion of acute tachycardic atrial fibrillation/flutter in critically ill patients. Higher efficacy can be expected in medical than cardiac-surgical patients. Ventricular proarrhythmia, especially in patients with severely depressed left ventricular function represents the most important limitation of ibutilide treatment.