Wiener klinische Wochenschrift
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This study reports pheno- and genotypical analysis of 9 isolates of vancomycin-resistant enterococci (VRE) and 5 vancomycin-sensitive enterococci (VSE) in Austria: 5 E, faecium isolates of 4 patients (the sole patients demonstrating VRE at the University Hospital of Innsbruck in 1994 and 1995), 3 glycopeptide-sensitive isolates collected in Innsbruck in February 1996 for epidemiological analysis, and 6 enterococcus isolates from the University Hospitals of Vienna and Graz. The pheno- and genotypical analyses of all glycopeptide highly resistant E. faecium and E. faecalis isolates indicated the presence of VanA type resistance. One E. casseliflavus strain with intrinsic VanC-1 resistance showed a characteristic constitutive low-level resistance to vancomycin and susceptibility to teicoplanin. ⋯ The results of our study indicate that oral vancomycin administration to humans is a primary cause of VRE in Austrian hospitals. In Austria approximately 66 kg vancomycin, 20% of it given orally, are administered to patients per year. Approx. 18-20 tons Avotan (active ingredient Avoparcin-10%)/year were used in Austria; as of April 1, 1997 the use of this animal foodstuff supplement is prohibited by the European Commission.
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Wien. Klin. Wochenschr. · Apr 1997
Review[Intraoperative hypothermia: pathophysiology and clinical sequelae].
Both regional and general anesthesia markedly impair the normal precise regulation of core body temperature. Consequently, inadvertent perioperative hypothermia is common. ⋯ There is now convincing evidence that a typical degree of intraoperative hypothermia, say 2 degrees C, predisposes to numerous complications such as shivering, prolonged duration of action of several drugs, myocardial ischemia, coagulopathy and increased incidence of surgical wound infections, which alter patient outcome. Fortunately, effective methods such as convective warming are available for preventing hypothermia.
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Wien. Klin. Wochenschr. · Mar 1997
Review[Avalanche emergency. New aspects of the pathophysiology and therapy of buried avalanche victims].
A series of investigations on the pathophysiology and management of persons buried in an avalanche has been undertaken over the past few years in response to increased awareness of the importance of emergency medical treatment of avalanche victims and the fact that the high mortality rate has not decreased in spite of the improvement in rescue techniques. This paper is the very first review of the problems encountered in avalanche disasters. The developments over the past 20 years, in particular, are summarized and discussed. ⋯ Improvement of the technical developments for the avoidance of total burial (avalanche air bag) and optimization of the electronic location (transceiver) of buried skiers by uninjured companions are essential future requirements. Nonetheless, primary prevention remains of paramount importance in governing decision making by offpiste skiers. Correct assessment of the inherent risks according to the prevailing circumstances and strict adherence to safety rules take precedence over all other considerations.
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Wien. Klin. Wochenschr. · Mar 1997
Biography Historical Article["Coca-Koller" and hist friends. On the 140th birthday of the Vienna Jewish trio: Carl Koller (1857-1944), Sigmund Lustgarten (1857-1911) and Sigmund Freud (1856-1939)].
The lives of Carl Koller (1857-1944), Sigmund Lustgarten (1857-1911) and Sigmund Freud (1856-1939) are characterized by several interesting similarities. In their early achievements in medical research they were pathfinders of the first successful local anesthetic: cocaine. All three became later victims of antisemitism. Attention is paid to their personal relationship during their time in Vienna, on occasion of the 140th anniversary of their birth.
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Wien. Klin. Wochenschr. · Feb 1997
[Definition and evaluation of a documentation standard for intensive care medicine: the ASDI(Working Group for Standardization of a documentation system for Intensive care medicine) pilot project].
A comparison of data from different intensive care units (ICUs) needs standardized documentation. In this study the ASDI documentation standard for intensive care was tested in clinical practice. Goal of the study was to evaluate parameters and functionality required for a national, interdisciplinary documentation system for intensive care. ⋯ The ASDI data set fitted existing needs very closely. Only 7 out of 122 parameters (5.7%) were found to be superfluous and thus removed. Measures to reduce documentation effort to the default limits were a) a new, date orientated concept for manual recording, b) rede-sign of the user interface with new, user friendly data entry possibilities, and c) the integration of statistical analysis and reports in the documentation system. The revised data set represents a broad-based consensus, which seems to be well-suited as foundation for the national quality assurance program.