Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Dec 2000
Review Comparative Study[Atypical neuroleptics: new approaches to drug therapy of schizophrenic disorders].
The introduction of conventional antipsychotics revolutionized the management of psychotic disorders in the 1950s. The use of these agents has been marked by several shortcomings, including their association with severe motor disturbances and their limited efficacy in treating the negative and cognitive symptoms of schizophrenia. Patients noncompliance has largely been the result of subjectively distressing extrapyramidal motor side-effects (EPMS). ⋯ The implications of EPMS reduction touch several domains of pathology in schizophrenia such as short- and long-term movement disorders, noncompliance, relapse rate, negative symptoms and cognitive dysfunction. Novel antipsychotics may represent the second pharmacological revolution in the treatment of psychotic disorders. There is, however, still a need for a critical evaluation of the risk-benefit-ratio of differing atypical agents.
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Wien. Klin. Wochenschr. · Dec 2000
Randomized Controlled Trial Clinical TrialEffect of pre-emptive hydromorphone administration on postoperative pain relief--a randomized controlled trial.
Pre-emptive analgesia represents a treatment strategy which tries to prevent the development of pain by inhibiting central reactions to peripheral sensory stimuli. In a prospective randomized double-blind placebo-controlled study, the effect of oral premedication with 4 mg of a slow-release hydromorphone preparation on postoperative piritramide consumption and subjective pain perception is being evaluated. ⋯ In our study, oral administration of 4 mg of slow-release hydromorphone did not show any greater pre-emptive analgesic effect than placebo.
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Wien. Klin. Wochenschr. · Nov 2000
Multicenter Study Comparative Study["The WHO/EURO Multicenter Study of Suicidal Behavior": results of the Austrian research center (in Tyrol) compared with Europe].
The article presents findings from the Austrian research center (Hall/the Tyrol) participating in the WHO/EURO Multicentre Study of Suicidal Behaviour compared to the other participating European countries. Between October 1997 and March 1999 a total number of 137 interviews were conducted (70 interviews from the defined catchment area, the city and county of Innsbruck, 67 interviews from other parts of the Tyrol) with psychiatric inpatients admitted due to a parasuicidal act (a non-habitual deliberate self-harm episode). Comparison with the total number of psychiatrically treated parasuicides in Tyrol during the same period of time showed the interviewed sample to be representative of the whole clinical population. ⋯ The repetition rate of parasuicides within the first 6 months after the initial parasuicide was very high (14% of the interviewed persons) compared to similar studies. An analysis of psychiatric diagnoses according to ICD-10 showed that more than 50% concerned either affective disorders or psychiatric disorders associated with substance abuse and dependence. The results indicate that the sample constitutes a high risk group for completed suicide.
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Even though there is no convincing evidence that eating disorders in general are on the rise, there has been an enormous increase in "treated" cases of patients with eating disorders. This review will cover important aspects of diagnosis and treatment of eating disorders. Psychotherapeutical and pharmacological treatment strategies in anorexia and bulimia nervosa will be discussed. ⋯ Drugs with a serotonergic function, e.g. serotonin-reuptake-inhibitors (SSRI), have demonstrated significant results in the treatment of bulimia nervosa and eating disorders with comorbid depression. In clinical practice "treatment packages" are offered because of the complexity of the disorders. The paper also deals with medical complications of eating disorders, motivational interviewing in anorexia nervosa and treatment with self-help manuals in bulimia nervosa.