Acta medica Austriaca
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Acta medica Austriaca · Jan 1992
Review Clinical Trial Controlled Clinical Trial[Management of patients with traveler's diarrhea].
Traveler's diarrhea starts 5 to 15 days after arrival with 3 or more watery bowel movements daily in 4 to more than 50% of travelers depending on geographical regions. Enterotoxin producing strains of E. coli are isolated in 20 to 50% of patients, followed by shigella, salmonella, campylobacter and vibrio spp. Rarely giardia lamblia, entamoeba histolytica and cryptosporidia are causative organisms. ⋯ Cotrimoxazole and aminopenicillins are loosing efficacy because of growing resistance. The minimal. In a double blind placebo controlled trial with 500 mg ciprofloxacin b.i.d. for 5 days we were able to demonstrate a significant clinical and bacteriologic effect in 132 patients with salmonellosis and campylobacteriosis.
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Critically ill patients with intracerebral hemorrhage require immediate treatment in an intensive care unit. In the acute phase of the disease the patients are endangered from increased intracerebral pressure, respiratory disorders (aspiration!) and hypertension. An adequate intensive care management consisting of sedation, analgesia, intubation and mechanical ventilation, correct body positioning and treatment of hypertension is of decisive importance for the prognosis of these patients. The aim of this report is to discuss the most important therapeutic strategies and arising problems in the course of intracerebral hemorrhage.
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Transcranial Doppler sonography (TCD) enables measurement of blood flow velocities in the basal intracerebral vessels. The most important applications of TCD in the ICU are the diagnosis and monitoring of vasospasms caused by subarachnoid hemorrhage after rupture of an aneurysm. ⋯ TCD lends itself as a valuable non invasive bedside-monitoring tool, which enables continuous or intermittent monitoring of intracerebral hemodynamics without strain for the patients. Disadvantages to be mentioned are the dependence of experienced examiners and the long lasting training phase required to achieve the requisite experience.