Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Jan 2009
Review Case ReportsThrombotic microangiopathy in adult-onset Still's disease: case report and review of the literature.
Coexistence of thrombotic microangiopathy and adult-onset Still's disease is extremely rare. There is increasing evidence that this association could be more than just coincidental. We report on the case of a 34-year-old male diagnosed with adult-onset Still's disease and successfully treated with intravenous glucocorticoids. ⋯ Of the four patients who were not treated with plasmapheresis, two died, one developed end-stage renal disease and one had complete remission. Awareness of the possible development of thrombotic microangiopathy in patients with adult-onset Still's disease is critical, so that treatment can be initiated early and the complications and recurrence of thrombotic microangiopathy prevented. Patients with adult-onset Still's disease should be closely monitored for signs and symptoms of thrombotic microangiopathy during the first six months after diagnosis of the Still's disease.
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Wien. Klin. Wochenschr. · Jan 2009
Clinical TrialTreatment of inappropriate sinus tachycardia with ivabradine.
Inappropriate sinus tachycardia is most often treated with beta-blockers; in resistant cases, nonpharmacologic treatment has been attempted. Recent case reports have shown a favorable response to ivabradine in some patients. ⋯ The results of our study show that patients with inappropriate sinus tachycardia can be successfully treated with ivabradine.
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Wien. Klin. Wochenschr. · Jan 2009
Review Comparative Study[Mirror therapy for phantom limb pain--a systematic review].
The aim of this review was to evaluate the evidence for the treatment of phantom limb pain with mirror therapy. ⋯ More sufficiently powered randomised controlled studies with high methodological quality are mandatory to investigate the analgesic effect of mirror therapy in phantom limb pain.
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A positive relationship between patient volume and outcome has been demonstrated for a variety of clinical conditions and procedures, but the evidence is sparse for critically ill patients. ⋯ Our results provide evidence for a relationship between patient volume and outcome in critically ill patients. Besides the total number of patients, diagnostic variability plays an important role. The relationship between volume and outcome seems, however, to be complex and to be influenced by other variables, such as workload of nursing staff.
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Wien. Klin. Wochenschr. · Jan 2009
Case ReportsVerrucous carcinoma of the tibia arising after chronic osteomyelitis: a case report.
Verrucous carcinoma is an uncommon complication of chronic osteomyelitis. The incidence of fistular carcinomas is reported to be between 0.21% and 3.36%. We present a case of verrucous carcinoma of the tibia arising after 58 years of chronic osteomyelitis. ⋯ We used modern diagnostic investigations (biopsy, computed tomography, angiography, immunoscintigraphy, magnetic resonance tomography) to visualize the extent of the malignant lesion. No metastases were detected. Knee exarticulation was successful in treating the tumor and chronic infection in this case.