Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · May 2012
Comparative Study Controlled Clinical TrialAdjacent level fracture after osteoporotic vertebral compression fracture: a nonrandomized prospective study comparing balloon kyphoplasty with conservative therapy.
In literature, there are conflicting clinical data regarding the incidence of subsequent fracture after balloon kyphoplasty (BK); moreover, the risk of adjacent vertebral fractures has not been well established because there are limited comparative data available with conservatively treated control groups. ⋯ These results indicated that BK carries a low risk of adjacent level fractures. Lower BMD values and altered biomechanics in the treated area of the spine due to resistant kyphosis are possible predictive factors for adjacent level fractures. A positive effect of BK over conventional treatment was observed upon reduction of the incidence of adjacent level fracture, vertebral morphology, and pain reduction.
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Wien. Klin. Wochenschr. · May 2012
Heparin-induced effects of prothrombin complex concentrates in thromboelastometry.
Prothrombin complex concentrates (PCC) are currently used to treat congenital or acquired coagulation factor deficiency. In case of serious bleeding caused by new oral anticoagulant agents, reversing treatment with PCC is under debate. PCC preparations mostly contain heparin to prevent thromboembolic events. In factor VIII and IX deficient plasma, Takeyama et al. observed in vitro a heparin effect at appropriate concentrations of PCCs. The aim of the present experiment was to investigate the heparin effect of four factor-PCC at clinically relevant concentrations in whole blood. In an in vitro experiment, we compared the PCC preparation used in the experiments of Takeyama with a high heparin content to a new heparin-free PCC preparation. ⋯ Our results extend the report of Takeyama et al. At clinically relevant PCC concentrations, the heparin effect was significant in thromboelastometry. The heparin content of PCCs should be considered in clinical routine.
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Wien. Klin. Wochenschr. · May 2012
Dabigatran in patients with atrial fibrillation: perioperative and periinterventional management.
In any type of invasive surgery, the patient's individual risk of thromboembolism has to be weighed against the risk of bleeding. Based on various everyday situations in clinical routine, the purpose of the present expert recommendations is to provide appropriate perioperative and periinterventional management for patients with atrial fibrillation undergoing long-term treatment with the thrombin inhibitor dabigatran. As we currently have no routine laboratory test to measure therapeutic levels of the substance or the risk of bleeding, general measures such as a standardized documentation of the patient's history, a sufficient time interval between the last preoperative dose and the procedure, and careful control of local hemostasis should be given special attention.
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Wien. Klin. Wochenschr. · May 2012
Biography Historical Article[Researcher of the month, May 2012].
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Wien. Klin. Wochenschr. · Apr 2012
Rapid detection of bloodstream pathogens by real-time PCR in patients with sepsis.
Rapid detection of bloodstream infections is an important issue for a better patient outcome. The aim of our study was thus to evaluate the LightCycler SeptiFast assay for diagnosis of bloodstream pathogens in a tertiary hospital in Western Austria. The 71 blood samples of 61 patients with presumed sepsis were investigated and compared with conventional blood culture system results. ⋯ In 3 samples, the blood culture assay was positive whereas the SeptiFast assay yielded negative results. In two of these cases, the pathogens involved were not included in the SeptiFast detection list, in the third case SeptiFast assay failed to detect Candida glabrata. Thus we recommend the SeptiFast assay as a valuable tool for rapid diagnosis of bloodstream infections in addition to, but not as replacement for, the blood culture test.