Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Sep 2024
Deciphering the role of lactate as a prognostic indicator in pediatric diabetic ketoacidosis.
Serum lactate levels have been recognized as a robust marker for predicting disease severity and survival in many critically ill children but consensus is lacking regarding its utility in diabetic ketoacidosis. This study aimed to investigate the relationship between initial lactate levels and disease severity in pediatric patients presenting with diabetic ketoacidosis. ⋯ Although there is an association between the severity of acidosis and lactate levels in diabetic ketoacidosis, contrary to expectations, this relationship was not found to be associated with adverse outcomes. An important point not to be overlooked by pediatricians is that elevated lactate levels in diabetic ketoacidosis may not always herald poor outcomes.
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Wien. Klin. Wochenschr. · Sep 2024
ReviewPalliative care in terminally ill advanced chronic liver disease patients.
While mortality rates from advanced chronic liver disease (ACLD) are rapidly increasing, patients with an advanced disease stage have a comparable or even higher symptom burden than those with other life-limiting diseases. Although evidence is limited there is increasing recognition of the need to improve care for patients with ACLD; however, there are many limiting factors to providing good palliative care for these patients, including unpredictable disease progression, the misconception of palliative care and end of life care as being equivalent, a lack of confidence in prescribing medication and a lack of time and resources. Health professionals working with these patients need to develop the skills to ensure effective palliative care, while referral to specialized palliative care centers should be reserved for patients with complex needs. ⋯ Liver disease is closely associated with significant social, psychological, and financial burdens for patients and their caregivers. Strategies to engage the discussion in multidisciplinary teams early in disease progression help to ensure addressing these issues proactively. This review summarizes the evidence on palliative care for patients with ACLD, provides examples of current best practice and offers suggestions on how disease-modifying and palliative care can coexist, to ensure that patients do not miss opportunities for quality of life improving interventions.
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Wien. Klin. Wochenschr. · Sep 2024
Effects of low-level laser therapy on symptomatic calcific rotator cuff tendinopathy : A prospective randomized controlled study.
Rotator cuff calcific tendinitis (RCCT) is a benign but incapacitating condition and in some patients it is the cause of chronic debilitating pain and functional disability. We aimed to reveal the short-term effects of low-level laser therapy (LLLT) on clinical and sonographic parameters in patients with symptomatic RCCT. ⋯ Adding LLLT to the home program in treatment of symptomatic RCCT outperformed the home program alone, reducing the number and severity of calcifications, improving pain and disability.
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Wien. Klin. Wochenschr. · Sep 2024
Association of family history with patient characteristics and prognosis in a large European gastroesophageal cancer cohort.
The role of the family history in the development and prognosis of gastroesophageal cancer is a controversially discussed topic as appropriate data from western cohorts are lacking. This study aims to explore its associations with disease and outcome parameters in a large European cohort. ⋯ Our results emphasize that a positive family history is neither statistically significantly associated with prognosis nor with specific histopathological features in patients with gastroesophageal cancer. Yet, associations with distinct patient characteristics and positive family history indicate that specific subgroups might profit from endoscopic surveillance. Prospective studies are warranted to investigate these findings further.
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Wien. Klin. Wochenschr. · Sep 2024
Maternal and neonatal outcomes in kidney transplant recipients: a single-center observational study.
Pregnancy poses a high risk for adverse maternal and neonatal outcomes in kidney transplant recipients (KTRs), and data on long-term allograft functions compared to the healthy population are still limited. Therefore, we aimed to conduct a comparative analysis of maternal and neonatal outcomes in KTRs. ⋯ The KTRs exhibit comparable neonatal mortality and NICU admission rates but have higher rates of preeclampsia and preterm birth. Importantly, graft functions worsen significantly during postpartum follow-up.