Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Oct 2017
Randomized Controlled Trial Comparative StudyListening to music during shock wave lithotripsy decreases anxiety, pain, and dissatisfaction : A randomized controlled study.
We analyzed the effects of music on pain, anxiety, and overall satisfaction in patients undergoing a shock wave lithotripsy (SWL) procedure. ⋯ Music can be an ideal adjunctive treatment modality for patients undergoing SWL treatment. It has the potential to enhance patient compliance and treatment satisfaction by reducing the procedure-related anxiety and pain perception.
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Wien. Klin. Wochenschr. · Sep 2017
Randomized Controlled Trial Comparative StudyAcetate-buffered crystalloid infusate versus infusion of 0.9% saline and hemodynamic stability in patients undergoing renal transplantation : Prospective, randomized, controlled trial.
Infusion therapy is one of the most frequently prescribed medications in hospitalized patients. Currently used crystalloid solutes have a variable composition and may therefore influence acid-base status, intracellular and extracellular water content and plasma electrolyte compositions and have a major impact on organ function and outcome. The aim of our study was to investigate whether use of acetate-based balanced crystalloids leads to better hemodynamic stability compared to 0.9% saline. ⋯ The use of an acetate-buffered, balanced infusion solution results in reduced need for use of catecholamines and cumulative catecholamine dose for hemodynamic support and in less occurrence of arterial hypotension in the perioperative period. Further research in the field is strongly encouraged.
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Wien. Klin. Wochenschr. · Sep 2017
Randomized Controlled Trial Comparative StudyRandomized controlled trial of induction at 38 weeks versus 40 weeks gestation on maternal and infant outcomes in women with insulin-controlled gestational diabetes.
To compare the impact of induction of labor at 38 weeks of gestation with the induction of labor at 40 weeks of gestation in women with insulin-treated gestational diabetes on maternal and fetal outcome. ⋯ In a cohort of women with insulin-treated gestational diabetes, induction of labor at 38 weeks did not significantly reduce the rate of large for gestational age newborns compared to induction at 40 weeks but seems to increase the rate of neonatal hypoglycemia.
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Wien. Klin. Wochenschr. · Dec 2016
Randomized Controlled Trial Multicenter StudyEvaluation of the pharmacoDYNAMIC effects of riociguat in subjects with pulmonary hypertension and heart failure with preserved ejection fraction : Study protocol for a randomized controlled trial.
The presence of pulmonary hypertension (PH) severely aggravates the clinical course of heart failure with preserved ejection fraction (HFPEF) resulting in substantial morbidity and mortality. So far, neither established heart failure therapies nor pulmonary vasodilators have proven to be effective for this condition. Riociguat (Adempas®, BAY 63-2521), a stimulator of soluble guanylate cyclase, is a novel pulmonary and systemic vasodilator that has been approved for the treatment of precapillary forms of PH. With regard to postcapillary PH, the DILATE-1 study was a multicenter, double-blind, randomized, placebo-controlled single-dose study in subjects with PH associated with HFPEF. Although there was no significant change in the primary outcome measure, peak decrease in mean pulmonary artery pressure with riociguat versus placebo, riociguat significantly increased stroke volume without changing heart rate, pulmonary artery wedge pressure, transpulmonary pressure gradient or pulmonary vascular resistance. The present study is designed to test the efficacy of long-term treatment with riociguat in patients with PH associated with HFPEF. ⋯ The DYNAMIC study is a randomized, double-blind, placebo-controlled, parallel-group, multicenter clinical phase IIb trial evaluating the efficacy, safety and kinetics of riociguat in PH-HFPEF patients. The drug will be given over 26 weeks to evaluate the effects of riociguat versus placebo. The primary efficacy variable will be the change from baseline in cardiac output at rest, measured by right heart catheter after 26 weeks of study drug treatment. Additional efficacy variables will be changes from baseline in further hemodynamic parameters, changes in left and right atrial area, right ventricular volume, as well as right ventricular ejection fraction measured by cardiac magnetic resonance imaging, and changes from baseline in World Health Organization (WHO) class and N‑terminal prohormone B‑type natriuretic peptide (NT-proBNP). The trial was registered on 25 August 2014 (EudraCT Number: 2014-003055-60; www.clinicaltrialsregister.eu ).
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Wien. Klin. Wochenschr. · Jul 2015
Randomized Controlled TrialVolatile anaesthetics and cardiac protection in abdominal surgery.
Clinical studies have shown that sevoflurane is cardio-protective in cardiac surgery patients, but this effect is doubtful in general surgery patients. This study has researched the influence of sevoflurane on the perioperative cardiac function and the incidence of cardiac ischaemic events in abdominal surgical patients. ⋯ Sevoflurane had no effect on the cardiac biomarkers Troponin I and BNP, and on the PiCCO parameters of cardiac function in abdominal surgical patients. Further research on the preconditioning effect of volatile anaesthetics in general surgical population should be concentrated on the population of patients with a high perioperative cardiac risk.