Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Jan 2009
Randomized Controlled Trial Comparative StudyCardiopulmonary resuscitation and the 2005 universal algorithm: has the quality of CPR improved?
Chest compressions are crucial in cardiopulmonary resuscitation (CPR), although the optimal number, rate and sequence are unknown. The 2005 CPR guidelines of the European Resuscitation Council (ERC) brought major changes to the basic life support algorithm. One of the major aims of the ERC was to decrease hands-off time in order to improve perfusion of the coronary vessels and the brain. Using a manikin model of basic life support in simulated cardiac arrest, we compared hands-off time and total number of chest compressions according to the guidelines of 2000 and those of 2005. ⋯ In this manikin setting, both hands-off time and the total number of chest compressions improved with basic life support performed according to the ERC guidelines of 2005.
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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
Review[Evidence-based cosmetics: concepts and applications in photoaging of the skin and xerosis].
As well as for topically used dermatological agents, studies performed according to the rules of evidence-based medicine (EBM) are also needed for cosmetics. Although the concept of evidence-based cosmetics has been only partly developed so far, there are some agents and preparations available that can be considered as evidence-based. In this paper we present data from several studies that claim to have examined and demonstrated the efficacy of cosmetic preparations for the management of solar damage and aging skin as well as lentigo and melanosis according to EBM criteria. ⋯ However, the lack of controlled studies confirming the efficacy of dermocosmetic products as well as the superiority of the preparation incorporating the active agent over the corresponding base is a problem yet to be solved. Undoubtedly, the efficacy and the sustainability of the achieved effects have to be examined and proven accordingly to EBM criteria in further active cosmetic agents. Moreover, generally accepted guidelines for the examination of efficacy and tolerability of dermocosmetics have to be developed.
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Wien. Klin. Wochenschr. · Jan 2009
Randomized Controlled TrialPostoperative pain and systemic inflammatory stress response after preoperative analgesia with clonidine or levobupivacaine: a randomized controlled trial.
With adequate control of perioperative pain it is possible to control central and peripheral inflammatory responses to surgery and influence patient outcomes. Use of analgesics before the pain stimulus (preventive analgesia) obstructs development of neuroplastic changes in the central nervous system and reduces pain. Our investigation hypothesis is that preoperative central (epidural or intrathecal) clonidine will reduce postoperative pain and the systemic inflammatory stress response more effectively than levobupivacaine. ⋯ These results support the importance of the central effect of clonidine on pain pathways and blockade of the systemic inflammatory stress response.
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Wien. Klin. Wochenschr. · Jan 2009
Clinical TrialSerum levels of N-terminal pro-B-type natriuretic peptide are associated with allograft function in recipients of renal transplants.
B-type natriuretic peptide (BNP) plays a key role in the regulation of volume homeostasis, and elevated blood levels of BNP are associated with end-stage renal disease. Renal transplantation leads to a decrease of elevated BNP levels with established graft function. Assessment of N-terminal pro-BNP (NT-proBNP) is established as reflecting volume homeostasis, and we therefore studied the relationship between NT-proBNP and allograft function in a prospective study. ⋯ An association was observed between renal allograft function and post-transplant levels of NT-proBNP. The association was not found to be a useful general predictor for graft function in individual patients in a clinical setting, as the range of NT-proBNP levels measured was too wide.