Wiener medizinische Wochenschrift
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Wien Med Wochenschr · Jan 2008
Review Comparative Study[Opioid-induced bowel dysfunction: a literature analysis on pathophysiology and treatment].
Bowel dysfunction is a frequent and serious side effect of opioid analgetics. In spite of its common occurrence, in the course of clinical routine, it is frequently ignored or underestimated. Authors of the analysed literature widely agree that a prophylactic and routine pharmacotherapy is necessary. ⋯ Effective abatement of opioid-induced obstipation by opioid antagonists has been proven in numerous studies. However, the loss of analgesia and opioid withdrawal symptoms were described as adverse effects. Development of quaternary opioid antagonists such as methylnaltrexone was allowed for mitigating these adverse effects.
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Wien Med Wochenschr · Jan 2008
Comparative Study[Therapeutic hypothermia after cardiopulmonary resuscitation - pro and con].
After successful cardiopulmonary resuscitation (CPR), mild therapeutic hypothermia remains the only intervention with a fair evidence of improving outcomes. Randomized controlled trials reported a clinically important benefit, at least for selected victims of cardiac arrest. ⋯ Among those delivering acute and intensive care, three of four remain sceptical or do not use therapeutic hypothermia. Is this reluctance justified?
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Wien Med Wochenschr · Jan 2008
Review[Biologics in the early treatment of ankylosing spondylitis and related forms of spondyloarthritis].
New pathogenetic insights have identified the key role of TNF-alpha in inflammatory rheumatic diseases and have revolutionized the therapy of spondyloarthritides. TNF-alpha-antagonists specifically inhibit the pro-inflammatory effects of TNF-alpha. Clinical studies with infliximab (Remicade), Etanercept (Enbrel) or Adalimumab (Humira) in ankylosing spondylitis or related diseases demonstrate superior efficacy to conventional drugs like non-steroidal antirheumatic drugs or traditional disease modifying antirheumatic drugs.
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Delirium is a common complication in palliative care of preterminally or terminally ill cancer patients. Based on a case report of a delirious male patient with cerebral metastasis, typical manifestations, etiologies, risk factors and possible therapies of palliative delirium will be reviewed. Furthermore, difficult therapeutic decisions with regard to the use of corticosteroids, fentanyl and parenteral rehydration therapy will be discussed.
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Systematic literature searches in bibliographic databases are an essential step in constructing systematic reviews and health technology assessments. The purpose of this kind of search is to identify as many relevant references on a given topic in electronic databases as possible. This article begins with describing the search process and continues with the basics of searching electronic databases. By delivering insight into the functionalities of databases and possibilities to search them (particularly PubMed), an understanding of potentials and weaknesses of systematic literature searches should be established.