Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Oct 2017
Efficacy of a multidisciplinary pulmonary rehabilitation outpatient program on exacerbations in overweight and obese patients with asthma.
Even though many studies have investigated the effectiveness of weight loss interventions, the efficacy of pulmonary rehabilitation (PR) has not yet been proven in obese patients with asthma. The aims of this study were to investigate the efficacy of PR on asthma exacerbations in the first year after PR and to evaluate the efficacy of PR in exercise capacity, quality of life, psychosocial symptoms and control of asthma in overweight patients. ⋯ This study showed that comprehensive multidisciplinary PR was associated with a decreased number of emergency admissions and hospitalizations for asthma exacerbations in 1 year, and improvements of dyspnea sensation, quality of life, exercise capacity, and psychosocial status in overweight and obese patients.
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Wien. Klin. Wochenschr. · Sep 2017
Randomized Controlled Trial Comparative StudyAcetate-buffered crystalloid infusate versus infusion of 0.9% saline and hemodynamic stability in patients undergoing renal transplantation : Prospective, randomized, controlled trial.
Infusion therapy is one of the most frequently prescribed medications in hospitalized patients. Currently used crystalloid solutes have a variable composition and may therefore influence acid-base status, intracellular and extracellular water content and plasma electrolyte compositions and have a major impact on organ function and outcome. The aim of our study was to investigate whether use of acetate-based balanced crystalloids leads to better hemodynamic stability compared to 0.9% saline. ⋯ The use of an acetate-buffered, balanced infusion solution results in reduced need for use of catecholamines and cumulative catecholamine dose for hemodynamic support and in less occurrence of arterial hypotension in the perioperative period. Further research in the field is strongly encouraged.
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Wien. Klin. Wochenschr. · Sep 2017
Randomized Controlled Trial Comparative StudyRandomized controlled trial of induction at 38 weeks versus 40 weeks gestation on maternal and infant outcomes in women with insulin-controlled gestational diabetes.
To compare the impact of induction of labor at 38 weeks of gestation with the induction of labor at 40 weeks of gestation in women with insulin-treated gestational diabetes on maternal and fetal outcome. ⋯ In a cohort of women with insulin-treated gestational diabetes, induction of labor at 38 weeks did not significantly reduce the rate of large for gestational age newborns compared to induction at 40 weeks but seems to increase the rate of neonatal hypoglycemia.
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Wien. Klin. Wochenschr. · Sep 2017
Case ReportsCombined metformin-associated lactic acidosis and euglycemic ketoacidosis.
In renal failure metformin can lead to lactic acidosis. Additional inhibition of hepatic gluconeogenesis by accumulation of the drug may aggravate fasting-induced ketoacidosis. We report the occurrence of metformin-associated lactic acidosis (MALA) with concurrent euglycemic ketoacidosis (MALKA) in three patients with renal failure. ⋯ This case series highlights the parallel occurrence of MALA and euglycemic ketoacidosis, the latter exceeding ketosis due to starvation, suggesting a metformin-triggered inhibition of gluconeogenesis. Affected patients benefit from glucose infusion counteracting suppressed hepatic gluconeogenesis.
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Wien. Klin. Wochenschr. · Aug 2017
Comparative StudyProgress in eradication of HCV in HIV positive patients with significant liver fibrosis in Vienna.
We aimed to investigate the efficacy of interferon and ribavirin-free sofosbuvir/ledipasvir (SOF/LDV) and ritonavir boosted paritaprevir/ombitasvir with or without dasabuvir (2D/3D) regimens in a real-life cohort of human immunodeficiency virus/hepatitis C virus (HIV/HCV) coinfected patients. The study focused on efficacy, need for changes in antiretroviral therapy (ART) due to drug-drug interaction (DDI), and treatment-associated changes in liver stiffness. ⋯ We confirmed the excellent HCV eradication rates >95% in a real-life cohort of HIV/HCV coinfected patients treated with SOF/LDV and 2D/3D. We observed no HCV relapse or breakthrough. More patients treated with 2D/3D required a change in ART than patients treated with SOF/LDV. Additionally, HCV eradication led to a rapid decline in liver stiffness.