Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Dec 2020
Recommendations on the utilization of telemedicine in cardiology.
The enormous progress made in recent years in the field of information and communication technology and also in sensor and computer technology has affected numerous fields of medicine and is capable of inducing even radical changes in diagnostic and therapeutic processes. This is particularly true for cardiology, where, for example, telemetric monitoring of cardiac and circulatory functions has been in use for many years. Nevertheless, broad application of newer telemedical processes has not yet been achieved to the extent one would expect from the encouraging results of numerous clinical studies in this field and the state of the art of the underlying technology. ⋯ Accordingly, follow-up care of patients with cardiological rhythm implants, management of chronic heart failure and secondary prevention following an acute cardiac event during rehabilitation are currently the most important fields of application. Telemedicine is intended to enable high-quality and cost-efficient care for an increasing number of patients, whose care poses one of the greatest challenges to our healthcare system. Not least of all, telemedicine should make a decisive contribution to improving the quality of life of this segment of the population by favorably influencing mortality, morbidity and hospitalization as well as the patient's contribution to treatment.
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Toxoplasma gondii is a widespread protozoan parasite that infects one third of the global human population. Very little information is known about the impact of T. gondii on patients with heart disease. The aim of the present study was to determine the association between T. gondii exposure and patients suffering from myocardial infarction. ⋯ The PCR-RFLP results showed that 2 of the 3 positive sample had 75bp and 623 bp DNA fragments belonging to type II genotype. The sequencing result confirmed the genotype II of T. gondii. Toxoplasma infection should be considered in myocardial infarction cases.
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Wien. Klin. Wochenschr. · Dec 2020
Review Meta AnalysisPartial oral antibiotic therapy is non-inferior to intravenous therapy in non-critically ill patients with infective endocarditis : Review and meta-analysis.
Antimicrobial therapy is a cornerstone in the treatment of infective endocarditis (IE). Typically, intravenous (i.v.) therapy is given for 6 weeks or longer, leading to prolonged hospital stays and high costs. Several trials evaluating the efficacy of partial oral therapy (POT) have been published. This article aimed to review and meta-analyze studies comparing i.v. therapy versus POT in non-critically ill patients suffering from IE. ⋯ Data comparing POT with standard care in IE is limited and to date only one sufficiently powered stand-alone trial exists to support its use. In this meta-analysis POT was non-inferior to i.v. therapy with respect to mortality and IE relapse in non-critically ill patients suffering from both left-sided and right-sided IE. These findings indicate that POT is a feasible treatment strategy in selected patients suffering from IE but further validation in future studies will be required.
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Wien. Klin. Wochenschr. · Dec 2020
Meta AnalysisImpella in cardiogenic shock following acute myocardial infarction: a systematic review and meta-analysis.
Cardiogenic shock (CS) conveys a high mortality risk. A cardiac assist device may serve as bridge to patient recovery. We aimed to provide a pooled estimate on mortality and complications from studies evaluating the use of the left ventricular assist device Impella in CS following acute myocardial infarction. In addition, we evaluated whether mortality risk differed with device placement before or after percutaneous coronary intervention (PCI). ⋯ Pooled estimates of Impella use in myocardial infarction with CS revealed a high 30-day mortality; however, as compared to post-PCI, Impella initiation prior to PCI was associated with a survival benefit.