Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Jan 2008
Malariological baseline survey and in vitro antimalarial drug resistance in Gulu district, Northern Uganda.
A comprehensive, representative malaria survey has been carried out in a population of internally displaced persons (IDP) in the district of Gulu, Northern Uganda. It included 74 households and 390 persons, and covered socio-economic and environmental information, individual physical data, malaria and the drug sensitivity of Plasmodium falciparum. ⋯ P. falciparum turned out to be highly resistant to chloroquine and amodiaquine. It showed also reduced sensitivity against lumefantrine and artemisinin, obviously the result of the liberal use of the lumefantrine-artemether combination without evidence-based indication.
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Wien. Klin. Wochenschr. · Jan 2008
Abnormal pulmonary arterial pressure limits exercise capacity in patients with COPD.
Pulmonary hypertension (PH) is common in patients with chronic obstructive pulmonary disease (COPD). Mean pulmonary artery pressure (mPAP) is often only slightly elevated at rest but is increased by exercise. The purpose of this study was to determine whether abnormal pulmonary artery pressure impairs exercise capacity in patients with COPD. ⋯ In patients with COPD, abnormal pulmonary artery pressure impairs gas exchange, decreases maximum oxygen uptake during exercise and impairs exercise capacity.
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Wien. Klin. Wochenschr. · Jan 2008
Hospital antibiotic management in Belgium--results of the ABS maturity survey of the ABS International group.
While debate about optimal organization for hospital antibiotic stewardship programs is ongoing, limited information is available about the implementation of such programs in acute-care institutions. The ABS International project conducted a survey on the implementation and characteristics of hospital antibiotic management programs in several European countries. This paper summarizes the results for Belgium, where a federal program for developing multidisciplinary antibiotic management teams was started in 2002. ⋯ Antibiotic stewardship programs are well developed in Belgian hospitals, particularly in those which first qualified for federal support. Extension of funding and technical assistance should help all hospitals to catch up with excellence standards, provided that adequate support is given to laboratory services and advanced training of professional specialists.
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Wien. Klin. Wochenschr. · Jan 2008
[Emergency outpatient palliative care in acute situations by paramedics].
In recent years outpatient palliative care, even for patients in an advanced state of their disease, has gained importance. Therefore, also paramedics are more often confronted with palliative emergencies, advance directives, and ethical end-of-life issues. Presently in emergency medicine there is undoubtedly a lack of education on palliative medicine and ethical questions for paramedics. ⋯ The emergency treatment of palliative patients can present a particular challenge to paramedics. Most of the interviewed paramedics felt insecure both about the social care and the assessment of legal issues in dealing with advance directives and decisions at the end of life. Therefore emergency medical training apparently needs to be improved in these fields. Further information and training are necessary to guarantee adequate patient-oriented care of palliative patients und their relatives also in emergency situations.
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Wien. Klin. Wochenschr. · Jan 2008
Historical Article[Variola: the history of a museal present plague].
Smallpox, once a major menace of humankind, is the only endemic anthroponosis that has completely disappeared due to organized human action. The history of variola and of the rationales of prevention and control associated with ancient variolation, modern vaccination and the surrounding research enterprises and sanitary regimes provide paradigmatic examples of the involvement of medical thought and scientific dynamics with natural and cultural necessities and technological evolution. ⋯ They range from textual documents to wet specimens recently reactivated for virological research. Special focus lies on waxen moulages, crafted in the context of early 20th century clinical research and teaching.