Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Sep 2011
Case ReportsAtypical "mid-ventricular" Tako-tsubo cardiomyopathy in a patient suffering from posttraumatic stress disorder: A case report.
The syndrome of "left ventricular ballooning" summarizes an acute onset of transient extensive akinesia of several segments (apical, mid-ventricular) of the left ventricle, without significant lesions on the coronary angiogram, accompanied by chest symptoms, electrocardiographic changes, and limited release of cardiac markers disproportionate to the extent of akinesia. Initially, the vast majority of cases has been reported among Japanese population. Emotional or physical stress or other preceding triggering factors might play a key role in this reversible form of cardiomyopathy, but the precise etiology remains unknown. We describe a case of a 52-year-old woman with posttraumatic stress disorder after cerebral bleeding presenting with an atypical form of left ventricular ballooning ("midventricular ballooning") syndrome.
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Wien. Klin. Wochenschr. · Aug 2011
Randomized Controlled Trial Comparative StudyIs the systemic inflammatory reaction to surgery responsible for post-operative pain after tonsillectomy, and is it "technique-related"?
Investigate the influence of operative technique on post-operative morbidity and the systemic inflammatory response after tonsillectomy. In addition, our aim was to compare the systemic inflammatory reaction, post-operative pain severity, and required time before the resumption of normal physical activity between two groups of tonsillectomized children and to correlate characteristics of the systemic inflammatory reaction to post-operative morbidity. ⋯ Post-operative morbidity after tonsillectomy appears to depend on the systemic inflammatory response to surgery. This response is "technique-related," wherein a less-aggressive surgical technique produces a weaker post-operative inflammatory response and less post-operative morbidity.
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The coexistence of thyroid autonomy (Plummer's disease) and Graves' disease has been termed "Marine-Lenhart syndrome". During the last years, several papers have been published on the development of Graves' disease shortly after radioiodine therapy of Plummer's disease (autonomy). Especially in patients with elevated thyroid antibodies, the incidence of this event is significantly higher after radioiodine therapy of autonomy. ⋯ The original paper published by Marine and Lenhart comes to the conclusion that the two diseases are different expressions of one disease. Looking at the literature, we have to state now that the Marine-Lenhart syndrome has never existed: With Plummer we know now that Plummer's and Graves' disease are different diseases. They may develop in the same patient but independent from each other.
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Wien. Klin. Wochenschr. · Aug 2011
Case ReportsCharcot shoulder caused by Chiari type I malformation with syringomyelia with six-year follow-up.
We are presenting a case report of neuropathic arthropathy of the shoulder secondary to a syringomyelia and Chiari type I malformation, with detailed clinical and radiological findings. Neuropathic joints were first described in 1868 by Charcot, and subsequently were described in many types of peripheral diseases and central neuron diseases. ⋯ Subsequently, shoulders and elbows are most commonly affected by syringomyelia-induced neuropathy. Our patient was observed for six years after being diagnosed with neuropathic arthropathy and syringomyelia caused by Chiari and did not show any disease progression after their surgery.
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Wien. Klin. Wochenschr. · Aug 2011
Homocysteine and asymmetric dimethylarginine in relation to B vitamins in elderly people.
Homocysteine is a cardiovascular risk factor, its metabolism is influenced by certain B vitamins and it is associated with endothelial dysfunction probably due to impaired bioavailability of NO caused by homocysteine-induced accumulation of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of NO synthase. On this basis, we investigated the cardiovascular risk factors homocysteine and ADMA in relation to vitamins B(6), B(12) and folate in elderly people. ⋯ The significant correlation between homocysteine and ADMA observed in this study may be an important mechanism decreasing NO bioavailability and so causing endothelial dysfunction. Due to the significant relation of vitamins B(6), B(12) and folate to plasma homocysteine, these vitamins may thus indirectly influence endothelial function and cardiovascular risk in elderly people.