Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Aug 2001
Comparative Study[Intramedullary fixation of humerus shaft fractures. An analysis of complications of 2 implants with special reference to outcome after management with the unreamed humerus interlocking nail].
Operative treatment of humeral shaft fractures has gained a new impetus with the development of intramedullary interlocking systems for the humerus. Because of the anatomical structure of the humeral marrow cavity, a regular jamming of nail into bone is not to be expected, so that the stability of these systems needs to be achieved through an interlocking mechanism. Among the commercially available interlocking nailing systems the unreamed humeral nail (UHN) and the Seidel-nail (SHN) can be regarded as the standard implants. ⋯ The possibilities of operative methods in treatment of humeral shaft fractures are enhanced by intramedullary interlocking systems. Comparing with the Seidel nail, the unreamed humeral nail (UHN) has two advantages: it can be inserted anterogradely as well as retrogradely, and it provides the possibility of compressing the fracture, resulting in a high rotational stability. Due to these results, the application of the UHN is recommended.
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Wien. Klin. Wochenschr. · Jun 2001
Importance of surveillance of tularemia natural foci in the known endemic area of Central Europe, 1991-1997.
Marked activation of natural foci of tularemia in the known endemic area of Central Europe, comprising the borderland of Slovakia, Austria and the Czech Republic, led to an epidemic outbreak in western Slovakia and an increase in the number of human tularemia cases in the adjoining regions of northeastern Austria and southern Moravia from 1995 to 1997. The aim of this paper was to present the results of a longitudinal study on the prevalence of infection with Francisella tularensis in small mammals and ticks in six localities of western Slovakia and northeastern Austria from 1991 to 1997, and to draw attention to the importance of systematic surveillance of natural foci for epidemiologic prognoses and for taking preventive measures. ⋯ Our findings clearly demonstrate that long-term surveillance of natural foci in endemic regions provides useful information on the activation of tularemia foci before the onset of epidemic outbreaks, thus permitting timely epidemiologic prognoses and the institution of preventive measures.
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Wien. Klin. Wochenschr. · Jun 2001
Medical students' attitudes towards psychotherapy: an intervention-based pre-post comparison.
Despite a wealth of studies on medical students' attitudes towards psychiatry in general, little is known about their specific attitudes towards psychotherapy. There is no evidence on the flexibility of these attitudes in the context of a curriculum-implemented psychotherapy information session. ⋯ Even minimal educational interventions can enhance medical students' predominantly positive attitudes towards psychotherapy. This finding calls for further implementation of psychotherapy-related material in medical curricula.
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Wien. Klin. Wochenschr. · Apr 2001
Persistent hypercapnia in children after treatment of obstructive sleep apnea syndrome by adenotonsillectomy.
Obstructive sleep apnea syndrome (OSAS) in childhood is frequently in part a consequence of enlarged adenoids and/or tonsils and may lead to hypoxemia and hypercapnia during sleep. Whereas long-term blood gas alterations are well documented in adults, only few polygraphic data are available for children. It was the aim of this study to document blood gas alterations before and after treatment in this population. 9 children with OSAS (6 male, 3 female, median age 5.9 years, range 1.1-13.5 years) were investigated by polysomnography before and after adenotonsillectomy. ⋯ Following adenotonsillectomy subsequent polygraphic investigations displayed normalisation of oxygen saturation (saturation mean 96.1 +/- 0.8%, minimum 90.1 +/- 3.1%). In contrast, moderate hypercapnia in several patients persisted up to five months after treatment (ETCO2 mean 44.9 +/- 2.8 mm Hg, ETCO2 maximum 51.2 +/- 3.6). Persistent hypercapnia most likely reflects an adaptation process of chemosensitivity and respiratory control due to preceding long-term hypercapnia.
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Wien. Klin. Wochenschr. · Mar 2001
Different patterns of angioedema in patients with and without angiotensin-converting enzyme inhibitor therapy.
There is convincing evidence for a causal relationship between angiotensin converting enzyme inhibitor (ACEI) therapy and angioedema, but the clinical features of the patients remain unclear. The aim of the study was to compare patterns of angioedema in patients under ACEI therapy and those without ACEI therapy. ⋯ Patients with angioedema under ACE inhibitor therapy differ significantly from those receiving no ACEI therapy in terms of patterns of angioedema and age. The applicability of this observation as a tool for deciding whether to continue or terminate ACEI therapy requires prospective evaluation.