Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Feb 2006
Case ReportsSuccessful administration of levosimendan in a patient with low-gradient low-output aortic stenosis.
Aortic valve replacement in patients suffering from low-gradient aortic stenosis and congestive heart failure is associated with high operative mortality, and the perioperative use of inotropes is common. Levosimendan is a calcium sensitizer with positive inotropic and vasodilatory effects and has been developed for treatment of decompensated heart failure. Although its use in patients with low-gradient aortic stenosis is not established, we hypothesized that it might have beneficial effects on outcome after aortic valve replacement. ⋯ Levosimendan was administered perioperatively (0.1 mg/kg/min 16 hours prior to the operation without a loading dose) and allowed rapid recovery of the patient, who required only brief treatment in the intensive care unit. No levosimendan-specific adverse events were observed, in particular no hypotension. The excellent postoperative result was maintained after the patient was discharged from hospital.
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Wien. Klin. Wochenschr. · Feb 2006
Randomized Controlled TrialOral acupuncture in the therapy of craniomandibular dysfunction syndrome -- a randomized controlled trial.
Patients with disorders of the stomatognathic system describe pain and clicking phenomena as primary symptoms. Rapid improvement of the pain is required to ensure and maintain adequate patient compliance. ⋯ On the basis of the results of the present study, acupuncture may be recommended as acute treatment of craniomandibular disorders, but studies with larger numbers of patients as well as about long-term treatment outcomes should be conducted.
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Wien. Klin. Wochenschr. · Feb 2006
Controlled Clinical TrialHyperalgesia against capsaicin in persons with un-investigated dyspepsia: potential as a new diagnostic test.
Lack of understanding of the pathogenesis of functional dyspepsia is one reason for the paucity of effective treatment options. Whereas mechanical sensitivity in persons suffering from dyspepsia might be impaired, chemically induced hypersensitivity has received little attention. The aim of this study was to evaluate whether vanilloid receptors stimulated by capsaicin are hypersensitive in persons with dyspepsia. ⋯ Jejunal sensitivity to capsaicin is increased in persons with un-investigated dyspepsia, and vanilloid receptors might be involved in the pathophysiology of this condition. Patients with hypersensitivity to chemical stimuli may represent a distinct subpopulation based on the underlying pathophysiology and may require specific treatment to restore normal visceral sensitivity.