Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Oct 2014
ReviewBiological pathways involved in the development of inflammatory bowel disease.
Apoptosis, autophagy and necrosis are three distinct functional types of the mammalian cell death network. All of them are characterized by a number of cell's morphological changes. The inappropriate induction of cell death is involved in the pathogenesis of a number of diseases. ⋯ Recent findings have begun to explain the mechanisms by which intestinal epithelial cells are able to survive in such an environment and how loss of normal regulatory processes may lead to inflammatory bowel disease (IBD). This review focuses on the regulation of biological pathways in development and homeostasis in IBD. Better understanding of the physiological functions of biological pathways and their influence on inflammation, immunity, and barrier function will simplify our expertice of homeostasis in the gastrointestinal tract and in upgrading diagnosis and treatment.
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Wien. Klin. Wochenschr. · Oct 2014
Comparative StudyComparability and quality of IgE-based in vitro allergy diagnosis: 25 years of external quality assessment.
A large variety of methods and a wide range of products from several manufacturers are available for IgE-based in vitro allergy testing. In the large majority of cases, the attending physician lacks information about the devices and products used in the laboratory performing the tests. To determine the comparability and reliability of different laboratories, we analyzed the findings of an international ring trial established in Austria 25 years ago. ⋯ Further analysis revealed more false-positive than false-negative antigen-specific IgE levels (17.1 vs. 5.2 %). The investigation of different allergen groups yielded excellent results for some allergens (97.8 % correct values for mites, or 99.6 % correct values for recombinant antigens), but quite unfavorable for others (21.4 % incorrect values for drugs). In view of this paucity of comparability and reliability, it would be appropriate to establish mandatory quality control in laboratories and manufacturing units.
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Wien. Klin. Wochenschr. · Oct 2014
Daytime sleepiness in patients with obstructive sleep apnea and severe obesity: prevalence, predictors, and therapy.
We sought to determine prevalence and predictors of excessive daytime sleepiness in patients with severe obesity with a body mass index (BMI) > 35 kg/m(2) and obstructive sleep apnea (OSA) with an apnea-hypopnea index > 15/h. ⋯ Obese patients with OSA and excessive daytime sleepiness are characterized by younger age, longer TSTs, more frequent obstructive apneas, and oxygen desaturations < 80 % compared with patients without excessive daytime sleepiness. Excessive daytime sleepiness can be improved in more than 90 % of patients using CPAP therapy.
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Wien. Klin. Wochenschr. · Oct 2014
Evaluation of a meal replacement-based weight management program in primary care settings according to the actual European Clinical Practice Guidelines for the Management of Obesity in Adults.
The purpose of this study was the evaluation of a weight loss program in primary care settings with respect to the European Clinical Practice Guidelines for the Management of Obesity in Adults with regard to the long-term success of changes in body weight and composition. ⋯ The evaluated program complies with the European Clinical Practice Guidelines for Management of Obesity in Adults (2008), which recommend a weight reduction of 5-15 % from initial weight within 6 months. Furthermore, the data showed a significant reduction of body fat and a relative increase of body cell mass.
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Wien. Klin. Wochenschr. · Oct 2014
Risk factors for the prescription of potentially inappropriate medication (PIM) in the elderly : an analysis of sickness fund routine claims data from Germany.
Elderly people are especially prone to suffer adverse drug reactions (ADR). Main reasons for the higher vulnerability of the elderly to ADR are changes in metabolism as i.e. slower renal clearance and polypharmacie which often results from multimorbidity. To prevent ADR careful prescription with special consideration of these aspects is warranted. ⋯ Prescription rates for PIMs in Germany in the elderly is pretty much stable at around 23% with only a small decline in the past years. Also, more than 5% of all prescriptions in the elderly are PIM prescriptions. Physicians specially trained in geriatrics tend to prescribe less PIMs compared to other physicians.