Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Oct 2011
Comparative StudySensitivity of Plasmodium vivax to chloroquine, mefloquine, artemisinin and atovaquone in north-western Thailand.
Excepting tropical Africa, where Plasmodium falciparum prevails, Plasmodium vivax is the most frequent cause of malaria in Asia and Latin America. First reliable reports of chloroquine resistance came in 1989 from the area of the distribution of the Chesson-strain of P. vivax. Since then, reports also came from other areas of the world. ⋯ The values for chloroquine indicate the existing or imminent occurrence of specific resistance. High prevalence of mefloquine resistance precludes its alternative use. However, atovaquone, in combination with proguanil, may be a possible alternative.
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Wien. Klin. Wochenschr. · Oct 2011
Current status of the clinical development and implementation of paediatric artemisinin combination therapies in Sub-Saharan Africa.
Timely treatment of infected children with artemisinin based combination therapies is an essential tool for the effective control and potential elimination of malaria. Until recently only tablet formulations have been available for the treatment of children leading to problems of swallowability, palatability and dosing. In consequence, paediatric drug formulations of artemisinin-based combination therapy (ACT) have been developed, showing a clinically significant improvement of tolerability in young children and of their implementation is an increasingly important public health issue. ⋯ To date, only two paediatric ACTs have been certified with WHO prequalification status as an internationally accepted quality standard. Many more paediatric ACTs are available and in use in sub-Saharan Africa despite a lack of publicly available evidence from stringent clinical development programs. The conduct of effectiveness studies to support the introduction of paediatric ACTs in official treatment recommendations is crucial in the global strategy of malaria elimination and quality assurance of available products is a public health priority.
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Wien. Klin. Wochenschr. · Sep 2011
Prehospital pediatric emergencies in Austrian helicopter emergency medical service - a nationwide, population-based cohort study.
Arguably, the most challenging emergencies encountered by emergency medical service crews involve children. Because only scant data exist about the epidemiology of pediatric emergencies in helicopter emergency medical service (HEMS) on a population level, we sought to determine the epidemiological characteristics stratified by responding area in a large nationwide sample. ⋯ Pediatric emergencies in Austrian HEMS show different epidemiological characteristics in alpine, urban and rural operational environments. Because of challenges and infrequency of prehospital pediatric emergencies, HEMS crews need to maintain their skills in pediatric advanced life support and trauma care.
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Wien. Klin. Wochenschr. · Sep 2011
Multicenter StudyClinical efficacy of OROS® hydromorphone in patients suffering from severe chronic pain: A Study undertaken in routine clinical practice.
Strong opioids are efficient drugs for treating chronic pain. In cancer patients, strong opioids are the mainstay of pain management, but in non-cancer pain caution is advised due to possible adverse effects, addictive potential and drug abuse. ⋯ The severity of patients' pain decreased during treatment with OROS hydromorphone with few adverse effects. The observed pain relief was accompanied by an improvement in the quality of the patients' lives.
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Wien. Klin. Wochenschr. · Sep 2011
Clinical features of unilateral headaches beyond migraine and cluster headache and their response to indomethacin.
The majority of previous studies on unilateral headaches beyond migraine and cluster headache have focussed on certain disorders such as paroxysmal hemicrania, SUNCT and primary stabbing headache. We assessed headache characteristics, importance of neuroimaging and response to indomethacin in an unselected series of uncommon unilateral headaches. We investigated all consecutive patients presented with unilateral headaches not fulfilling ICHD-II criteria of migraine and cluster headache. ⋯ Among classifiable headaches primary stabbing headache was the most common. Imaging should be considered to rule out secondary headaches. The course is favourable in one third of the patients.