Wiener medizinische Wochenschrift
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Wien Med Wochenschr · Jun 1989
[Street noise and sleep: whole night somnopolygraphic, psychometric and psychophysiologic studies in comparison with normal data].
In 3 sleep-laboratory studies the effects of nocturnal traffic noise on the sleep of young (1st study: mean age 25 years, n = 10) and elderly (2nd study: mean age 62 years, n = 10) healthy subjects as well as adaptation phenomena (3rd study: one week in young volunteers, n = 10) were investigated. Objective sleep quality was evaluated for baseline- and traffic noise-conditions by means of somnopolygraphic all-night recordings between 22:30 ("lights out") and 6:00 ("buzzer") in the sleep-laboratory. In the morning sleep- and awakening quality were measured by a self-rating scale and psychometric and psychophysiological tests. ⋯ Objective awakening quality was unaffected. In the course of a one-week nocturnal traffic noise, we observed an increase of S 4 and a decrease of S 3. The last 3 nights revealed a significant improvement in subjective sleep quality, suggesting adaptive phenomena.(ABSTRACT TRUNCATED AT 250 WORDS)
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Wien Med Wochenschr · Jul 1988
Review[Adjuvant chemotherapy in cancers of the gastrointestinal tract (GIT)].
A critical review of adjuvant therapies of gastrointestinal tumors shows that this is a field of active clinical investigation. Unfortunately the results that have been achieved until now have not fulfilled the expectations. Neoadjuvant therapies of squamous cell carcinomas of the esophagus and the anus in many cases lead to pathologically documented complete remissions. ⋯ The results of adjuvant chemotherapy in rectal cancer after radiotherapy or radiochemotherapy are easier to judge. They show that some patients profit from adjuvant therapy. But the most efficient combinations and the role of newer modalities remain to be elucidated (Fig. 8 a-8c).
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Nowadays, in almost all cases of clinical death, there is at least a remote chance of resuscitation, of restoring breathing and circulation by means of modern methods of cardiopulmonary resuscitation. Statistically, there are more cases of cardiocirculatory arrest due to an internal cause than to a traumatic cause. Just as medical activity in general, resuscitation is increasingly discussed in its legal and ethical aspects. ⋯ Over the past years, resuscitation measures within the complex of the procurement of death have repeatedly been put up for discussion. Examples from US judicature may help to define the problem more clearly and also to offer solutions for similar cases. Such decisions should essentially be guided by the consideration of the presumed will of the patient who no longer is in a position to exercise the right of self-determination.
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Under the heading "acute diseases of the external genital organs" affections of the scrotal contents and the penis (without urethra) demanding immediate therapy are summarized. Crucial is the differential diagnosis epididymitis vs. torsion of the spermatic cord for an error may have very serious consequences for the patient as well as for the physician undertaking primary care. As to the other acute diseases of the scrotal contents the increasingly important role of scrotal sonography is stressed. Among the relatively rare acute affections of the penis traumatic rupture of the corpus cavernosum and priapism of various origin deserve particular interest because delayed wrong treatment may lead to loss of erectile potency.
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Wien Med Wochenschr · May 1987
[Specific therapy of acute benzodiazepine poisoning using flumazenil (Ro 15-1788)].
In 20 patients with coma (grade 4: n = 7, grade 3: n = 8, grade 2: n = 2, grade 1: n = 3) due to benzodiazepine intoxication, solely or combined with alcohol or other psychoactive drugs, the effect of a specific benzodiazepine antagonist, Flumazenil (Ro 15-1788), was evaluated. In terms of coma depth, 80% of the patients responded to application of 1.96 mg Flumazenil as a mean with immediate awakening or improvement of at least two steps in coma grading. ⋯ Agitation and generalized convulsions, each observed in 1 patient, presumably were due to an acute benzodiazepine-withdrawal rather than an intrinsic side effect of the antagonist. In conclusion, Flumazenil proved to be a potent antagonist of benzodiazepines in patients with severe coma and even may serve as a valuable diagnostic in cases of suspected benzodiazepine intoxication.