Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Jan 2005
Controlled Clinical TrialIn vitro activity of artemisinin alone and in combination with retinol against Plasmodium falciparum.
Increasing resistance of Plasmodium falciparum to antimalarial drugs is an important public health problem, demanding novel therapeutic approaches. This study had the objective of assessing the in vitro activity of artemisinin and its combination with retinol in fresh isolates of P. falciparum in an area with a high proportion of multidrug-resistant strains. The tests were based on the inhibition of schizont maturation. ⋯ The EC50 and EC90 for artemisinin in the artemisinin-retinol mixture were 2.71 nM and 13.37 nM, respectively. The combination showed synergistic activity. Retinol appears to be a promising partner for the antimalarial therapy with artemisinins.
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Wien. Klin. Wochenschr. · Jan 2005
Case ReportsMajor response and clinical benefit following third-line treatment for Bellini duct carcinoma.
Bellini duct carcinoma accounts for 1-3% of all renal carcinomas and is characterized by an aggressive course and extremely poor prognosis. Conventional treatment for renal-cell carcinoma seems to be ineffective. Since the histology of Bellini duct carcinoma is similar to urothelial carcinoma, chemotherapy for urothelial cancer might be more promising than conventional treatment. ⋯ The combination of cisplatin and gemcitabine was highly active in this patient with metastatic Bellini duct carcinoma, even given as third-line treatment. This regimen fulfils all criteria for palliative treatment, as our patient showed an impressive improvement in WHO performance status and therefore in quality of life. Histopathologic characteristics should be a major criterion for treatment strategy in renal carcinoma, particularly in Bellini duct carcinoma.
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Wien. Klin. Wochenschr. · Jan 2005
Review[Influence of new dialysis solutions on clinical results in patients treated with peritoneal dialysis].
Long-term peritoneal dialysis is associated with changes in the peritoneal membrane. Conventional dialysate solutions are bioincompatible because of their low pH, high glucose content, hyperosmolality and increased concentration of glucose degradation products. The development of double-compartment systems has made it possible to separate glucose from the buffer during heat sterilization, resulting in a higher or even physiologic pH of the solution with reduced concentration of glucose degradation products. ⋯ Icodextrin may induce a fall of sodium plasma levels. Because of cross-reaction with elevated plasma levels of maltose, serum amylase is determined falsely low and glucose (using the glucose-dehydrogenase method) is measured falsely high, but high plasma levels of maltose do not affect measurement of lipase or measurement of glucose using the glucose-oxidase method. New dialysate solutions will have a positive influence on both survival and technical drop-out rates in patients receiving peritoneal dialysis treatment.
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Wien. Klin. Wochenschr. · Dec 2004
Comparative StudyProcalcitonin in patients with acute and chronic renal insufficiency.
Bacterial infections are associated with a high morbidity and mortality rate in patients with acute and chronic renal failure. Because C-reactive-protein (CRP) is elevated in many patients with renal failure, even in the absence of infection, procalcitonin (PCT) might be useful for the detection of systemic bacterial infections. This cross-sectional observation study measured PCT and CRP in several groups of patients with various types, degrees and treatments of kidney diseases, including patients with sepsis treated with renal replacement therapy. ⋯ With the exception of CAPD patients, PCT levels were not significantly affected by renal diseases or treatments but were markedly elevated in the presence of infections. Thus PCT is a valuable marker for early diagnosis of systemic bacterial infections in patients with CRF or patients undergoing HD. In contrast, CRP is elevated in several groups with renal diseases and has low specificity for the diagnosis of bacterial infections.
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Wien. Klin. Wochenschr. · Nov 2004
Intravenous amiodarone bolus for treatment of atrial fibrillation in patients with advanced congestive heart failure or cardiogenic shock.
The clinical course of patients with advanced organic heart disease is often complicated by the occurrence of atrial fibrillation. Slowing the ventricular rate and, if possible, restoration of normal sinus rhythm is crucial but difficult in the state of decreased ventricular function. ⋯ Amiodarone, given as a single intravenous bolus through a peripheral vein rapidly reduced ventricular rate and was well tolerated in patients with atrial fibrillation, even in the presence of congestive heart failure and cardiogenic shock.