Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Apr 2016
Case ReportsMoclobemide as add-on therapy to agomelatine in a patient with treatment-resistant major depressive disorder: a psychopharmacological case.
Treatment-resistant depression is a major depressive disorder that does not respond to adequate treatment of at least two antidepressants and is one of the major clinical challenges for clinicians and clinical pharmacists. One treatment option is to switch the patient to a different medication. Another option is to add a medication to the patient's current pharmacotherapy. This article presents an improvement of symptoms induced by a combination of moclobemide (MOC) and agomelatine (AG) treatment in a 48-year-old Caucasian woman with treatment-resistant major depressive disorder (MDD). The patient had been treated with numerous antidepressants in the last 2 years that had not been effective or had caused serious adverse effects. When MOC 300 mg daily was added to AG 25 mg daily, the patient recovered progressively without any adverse effects. Her functional status also appeared stable. No other drugs known to interact with AG were administered. The MOC dose was subsequently increased to 600 mg daily and was taken with AG 25 mg daily and zolpidem 5 mg daily. ⋯ In this report, we identified a case with positive evidence of this antidepressant combination relieving the symptoms of treatment-resistant MDD, which is otherwise difficult to manage. This case report may serve to help clinicians and clinical pharmacists as a new treatment option for treatment-resistant MDD, although further research is needed to confirm this practice.
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Wien. Klin. Wochenschr. · Apr 2016
Review[Geriatric aspects for the management of diabetes mellitus].
There is a high prevalence of diabetes mellitus in the elderly population of industrial countries. The present article provides recommendations for the screening, prevention and treatment of elderly diabetic patients according to current scientific evidence.
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Wien. Klin. Wochenschr. · Apr 2016
Use of nonsteroidal anti-inflammatory drugs and renal failure in nursing home residents-results of the study "Inappropriate Medication in Patients with Renal Insufficiency in Nursing Homes".
Use of potentially inappropriate medications may result in increased morbidity, mortality and resource utilisation. Due to polypharmacy and age-related decline in renal function the elderly population is at particular risk. Therefore, the Beers Criteria include use of nonsteroidal anti-inflammatory drugs in chronic renal failure stage 4 and 5 as these drugs may worsen renal function. According to the summary of product characteristics, the nonsteroidal anti-inflammatory drugs ibuprofen and diclofenac are contraindicated in these patients. Objective was to assess the extent of nonsteroidal anti-inflammatory drug use in nursing homes with a focus on residents with severe renal failure. ⋯ Notwithstanding their classification as potentially inappropriate medications and underlying contraindications, use of nonsteroidal anti-inflammatory drugs is common among nursing home residents with severe renal failure.
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Wien. Klin. Wochenschr. · Apr 2016
Influence of tobacco smoking on dental periapical condition in a sample of Croatian adults.
Since current evidences support a negative influence of tobacco smoking on the periodontal bone, an increased prevalence or severity of periapical lesions would be expected among smokers. The aim of this study was to investigate the difference in the periapical status of endodontically treated and untreated teeth in current smokers and never-smokers. ⋯ Current smokers had higher fraction of teeth with apical periodontitis (AP) than never-smokers (0.13 vs. 0.10; P = 0.025), while fractions of endodontically treated teeth and endodontically treated teeth with AP did not differ significantly. When overall number of teeth was controlled for, smokers were 16.4 times more likely to have AP than a non-smokers (95% CI: 5.7-47.7; P < 0.001) and if a person was male, he was 3.1 times more likely to have AP than if the person was female (95% CI: 1.1-8.9; P = 0.039). The probability of AP increases with increase of age. Smokers will on average have two teeth with AP more than non-smokers, while controlling for gender, age and overall number of teeth.
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Wien. Klin. Wochenschr. · Apr 2016
[Physical activity and exercise training in the prevention and therapy of type 2 diabetes mellitus].
Lifestyle in general (nutrition, exercise, smoking habits), besides the genetic predisposition, is known to be a strong predictor for the development of diabetes. Exercise in particular is not only useful in improving glycaemia by lowering insulin resistance and positively affect insulin secretion, but to reduce cardiovascular risk. To gain substantial health benefits a minimum of 150 min of moderate or vigorous intense aerobic physical activity and muscle strengthening activities per week are needed. ⋯ The effect of exercise is independent of age and gender. It is reversible and reproducible. Based on the large evidence of exercise referral and prescription the Austrian Diabetes Associations aims to implement the position of a "physical activity adviser" in multi-professional diabetes care.