Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Jan 1994
[Insulin-dependent diabetes mellitus:"EURODIAB IDDM Complications Study"--results from the Vienna center].
The EURODIAB IDDM complications study is a multicenter clinical study for evaluation of the prevalence of microvascular, macrovascular and acute metabolic complications in randomly selected samples of insulin-dependent diabetic patients attending 31 European diabetes centers. A total of 3250 patients were studied (mean age: 32.7 +/- 10 years, mean duration of diabetes: 14.7 +/- 9.3 years) by standardized, validated methods. The third medical department of the Vienna-Lainz hospital participated from Austria. 122 patients, age: 34.9 +/- 9.9 years, duration of diabetes: 16 +/- 10 years were recruited from this center. ⋯ Important associations of raised blood pressure (frequency in all centers: 8-41%, Vienna: 29%) with renal disease and retinopathy have implications for the initiation of preventive measures. The data on diabetic complications obtained from the EURODIAB study permit a comparison between the different European centers and emphasize the need for implementation of the St. Vincent recommendations.
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Wien. Klin. Wochenschr. · Jan 1994
[Prevalence of cardiac autonomic neuropathies in uremia and diabetes mellitus].
In the absence of relevant data, the prevalence of cardiac autonomic neuropathy was investigated in patients with diabetes mellitus or uremia due to other causes and diabetic patients with endstage renal failure. 117 patients (40 on a dialysis program without diabetes, 32 with diabetes mellitus type 1 but no nephropathy, 16 type 1 and 13 type 2 diabetic uremic patients, 16 diabetic patients with a kidney graft) and 25 healthy control subjects underwent assessment of the cardiorespiratory reflexes. The evaluation of parasympathetic damage was of particular interest. Definite parasympathetic dysfunction was detected in 32% of the non-diabetic uremic and in 19% of the non-uremic type 1 diabetic patients. Furthermore, 88% of type 1 and 77% of type 2 diabetic patients on dialysis and 75% of diabetic patients after kidney transplantation had evidence of autonomic neuropathy.
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Wien. Klin. Wochenschr. · Jan 1993
Case Reports[Pain syndromes of the tibial nerve at the leg-foot transition].
The prognosis of surgical treatment of the tarsal tunnel syndrome (TTS) with regard to total pain relief is worse than following surgery of the carpal tunnel syndrome. In TTS, additional static factors play a role. The indication for surgery, therefore, is made with utmost reluctance. ⋯ Three such patients are reported. This pain syndrome is caused and increased by recurrent fibrosis of the nerve bed, eventually including the integument and inducing entrapment neuropathy by the contracted dermal covering. Surgical resolution of this problem is transplantation of soft tissues to surround the nerve and skin grafting to augment the covering dermal layer.
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Wien. Klin. Wochenschr. · Jan 1993
[Value of surgery in treatment of complicated gastroduodenal ulcer].
The surgical procedure in acute complications of gastroduodenal ulcers is examined with regard to risk factors and mortality. Emergency admissions to an Austrian district hospital between 1. 1. 1984 and 31. 8. 1992 for peptic ulcer are retrospectively analyzed. 293 patients were admitted with a history of bleeding ulcers. Endoscopic haemostasis was achieved in 91 of 130 (70%) patients with active haemorrhage (Forrest Ia, Ib). ⋯ Postoperative mortality was 9.1% (5/55) for bleeding peptic ulcers and 6.1% (2/33) for perforated ulcers. Furthermore, mortality was zero in patients younger than 60 years (0/44), but 15.9% (7/44) in patients older than 60 years. Distal gastric resection was chosen as standard procedure for emergency operations.