Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Oct 2010
Multicenter StudyLower prevalence of common filaggrin mutations in a community sample of atopic eczema: is disease severity important?
Recent studies have shown an association of loss-of-function mutations in the filaggrin gene (FLG) with ichthyosis vulgaris and atopic eczema (AE). Case selection may have distorted the hitherto reported prevalence of FLG mutations and their relation to atopic disease. The aim of the study was to determine the true population prevalence of FLG mutations in unselected children with and without reported physician diagnoses of asthma, allergic rhinitis and AE and their relationship with family history of atopic disease. ⋯ Case selection may be responsible for overestimating the prevalence of FLG mutations in atopic disease.
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Wien. Klin. Wochenschr. · Oct 2010
Randomized Controlled TrialBenefit of the minimal invasive ultrasound-guided single shot femoro-popliteal block for ankle surgery in comparison with spinal anesthesia.
Ultrasound-guided regional anesthesia has gained popularity for ankle and foot surgery. The aim of our study was to investigate the sufficiency of anesthesia for ankle surgery as well as duration of analgesia in postoperative period, using minimal invasive ultrasound-guided regional anesthesia, and to compare it with anesthesia and postoperative analgesia following spinal anesthesia. ⋯ Minimal invasive US-FPB provides sufficient anesthesia for ankle fracture. In comparison to the SA group, patients from the US-FPB group achieved significantly longer postoperative analgesia, while faster onset of anesthesia was noted in SA group.
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Wien. Klin. Wochenschr. · Oct 2010
Review[Bats and other reservoir hosts of Filoviridae. Danger of epidemic on the African continent?--a deductive literature analysis].
Ebola and Marburg virus, forming the Filoviridae family, cause hemorrhagic fever in countries of sub-Saharan Africa. These viral diseases are characterized by a sudden epidemic occurrence as well as a high lethality. Even though a reservoir host has not been approved yet, literature indicates the order of bats (Chiroptera) as a potential reservoir host. ⋯ Risk groups can be defined through chronological reprocessing and interpretation of existing epidemic-outbreaks on the African continent and the search for infection reasons of the index cases. The following risk factors for an infection with Ebola or Marburg virus must be put into consideration: Contact with and consumption of wild animal carcasses, sightseeing in caves as well as work in mines. The focus of this review is the demonstration of risk profiles and their exposure to Chiroptera and other potential reservoir hosts.
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Wien. Klin. Wochenschr. · Oct 2010
Synergism between mefloquine and artemisinin and its enhancement by retinol in Plasmodium falciparum in vitro.
Following the advent of mefloquine resistance in Plasmodium falciparum in Thailand in the 1990s, the combined treatment of falciparum malaria with artesunate and mefloquine was found to be highly effective in treating and curing the patients in the affected areas. Monitoring of the clinical-parasitological response and of the in vitro sensitivity of P. falciparum was systematically conducted in order to detect any signs of failure of this type of artemisinin-based combination treatment (ACT). In earlier observations the in vitro activity of artemisinin was found to be significantly enhanced when combined with retinol. ⋯ The retinol concentrations in the low, medium and high formulations corresponded to the 50th, 65th and 80th percentile of the physiological mean concentrations in the blood of healthy adults. The IC(50), IC(90) and IC(99) values for mefloquine alone showed a further increase over the data of 2008. In the combinations with artemisinin and retinol moderate synergism was observed at the IC(50), but synergism increased strongly at the IC(90) and the IC(99).
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Wien. Klin. Wochenschr. · Aug 2010
Review[Sedation and analgesia in intensive care: physiology and application].
Many therapeutic and diagnostic procedures in intensive care medicine are perceived as painful by most patients. As a consequence analgesia and sedation represent two of the main pillars in the treatment of the critically ill. Adaptation to the individual needs of the patients poses one of the biggest challenges that we are confronted with. ⋯ In the first part of this review we will discuss the physiology of sleep patterns and pain. Furthermore modes of action and side effects of the most common anesthetics and analgetics will be presented. Finally, the last part of the manuscript deals with the practical application of these therapeutics and their monitoring in intensive care medicine.