Wiener klinische Wochenschrift
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Better understanding of respiratory physiology and progress in ventilator technology have contributed to improved mortality and morbidity of premature neonates. Yet, pulmonary complications remain high and there is no consensus about the optimal regimen of mechanical ventilation. ⋯ However, our own results and the results from most surfactant studies show no significant reduction in the incidence of intraventricular haemorrhage. Thus, though mechanical ventilation and surfactant administration are milestones in neonatal therapeutic management, the problems encountered in very low birth weight neonates both with respect to mortality and morbidity have not been generally solved and underline the role of optimal perinatal management.
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Wien. Klin. Wochenschr. · Jan 1993
Association between neopterin and beta-2-microglobulin levels and HIV status in Romanian orphanage children.
Serologic markers of immune activation, neopterin and beta-2-microglobulin (B2M), have been shown to predict progressive human immunodeficiency virus type 1 (HIV-1) disease based on cohort studies in adults. Both parameters appear also to be valuable in distinguishing HIV-1 infants with progressive disease from asymptomatic infants and HIV-1 seronegative infants. In a cross-sectional study we examined the utility of neopterin and B2M testing in 135 infants of an orphanage in Romania, 69 of the infants (51%) were found to be HIV-1 antibody seropositive; 95% of the 135 infants were either hepatitis B virus (HBV) antigen or antibody seropositive. ⋯ Children with CDC stage P2 had only slightly higher neopterin and B2M values as compared to stage P1 (P = 0.04 and 0.08). Our study indicates that measurement of neopterin and B2M is useful to monitor HIV-1 infection, particularly in areas where laboratory facilities are limited. Both parameters continue to be associated with HIV-1 infection even when there is a high background rate of other infections.
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Wien. Klin. Wochenschr. · Jan 1993
[Tension headache--new evaluation of symptomatology based on International Headache Society diagnostic criteria].
This study presents the history and clinical findings in 80 patients suffering from tension-type headache diagnosed according to the criteria (group 2) proposed in 1988 by the Headache Classification Committee of the International Headache Society (IHS). The aim of this investigation was to evaluate the extent to which the symptomatology in our cases still corresponds with the clinical picture of tension headache described in the older literature. A positive family history of headache was obtained in 59% of the patients; mothers of headache patients were affected five times more often than fathers; a history of migraine was reported as frequently as tension-type headache in the families of the investigated patients. ⋯ Oral contraceptives influenced neither frequency nor intensity of headache attacks. Signs of depressive disorders were present in 28% of the female patients. The differences in symptomatology of tension-type headache between patients with episodic and chronic forms, between female and male patients, and also between younger and elderly patients are documented and have to be taken into account in the diagnostik evaluation of this condition.
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Wien. Klin. Wochenschr. · Jan 1993
[Prospective study of determining the value of D-dimer in diagnosing pulmonary embolism].
Pulmonary embolism (PE) is still misdiagnosed in a high proportion of cases. 107 patients admitted for suspected pulmonary embolism were studied prospectively to shed light on the value of ELISA-D-dimer and Latex-D-dimer. Pulmonary embolism was ruled out by negative perfusion scans in 66 patients (61.7%) and by angiography in 24 patients. 58% of the scans suggesting a high probability of PE were confirmed by angiography, but only 18% of the scans suggesting a low or intermediate probability of PE. ⋯ The positive predictive value was improved by ELISA-D-dimer in both groups to 75%. In order to augment the diagnostic efficacy in clinical practice the determination of Latex-D-dimer simultaneously with lung scanning is recommended.
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Wien. Klin. Wochenschr. · Jan 1993
[Hemorrhagic complications after tonsillectomy and adenoidectomy. Experiences with 7,743 operations in 14 years].
During 14 years the department of otolaryngology at Leoben performed 7743 tonsillectomies and/or adenoidectomies in children in cooperation with the department of pediatrics. 97 patients were treated for postoperative bleeding = 1.25%; one child died as a consequence of severe bleeding. The analysis of age, timing and severity of the bleeding includes 15 additional children whose surgery had been performed elsewhere. Only 7 of the 112 bleeding episodes occurred during the first 24 hours after surgery. ⋯ Because of severe blood loss, 18 patients received a blood transfusion. Despite pre- and postoperative coagulation tests no patient suffering from a coagulation disorder was identified. Neither the coagulation screening nor a 48 to 72 hour postoperative in hospital observation could prevent the risk of postoperative bleeding.