Acta medica Austriaca
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Acta medica Austriaca · Jan 1993
Review[Value of interferon-alpha in treatment of chronic myeloid leukemia].
In 1983 Talpaz et al. (43) for the first time demonstrated the efficacy of interferon-alpha (IFN-alpha) for the treatment of patients with chronic myelogenous leukemia (CML). This observation has been confirmed by several study groups in the consecutive years. An overview over the 7 largest trials including more than 400 patients reveals response rates (partial and complete hematological remissions) of 55 to 91%. ⋯ The following factors influence the response to IFN-alpha in patients with CML: phase and duration of the disease, several well defined risk factors, and IFN-dose. Currently available data are strongly suggestive for a survival benefit of patients with cytogenetic remissions, although definitive prove by phase-III trials is lacking. Actual studies focus on combinations of IFN-alpha and cytostatics, e.g. low-dose cytosine arabinoside.
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The task of the cardiorespiratory system is to deliver enough oxygen to meet the metabolic requirements of the body. Of all metabolic substrates, oxygen has the highest percentage of extraction and oxygen reserves are exhausted within a few minutes. Arterial oxygen content and cardiac output are the determinants of oxygen delivery (DO2). ⋯ Therefore these parameters can easily be replaced by SvO2 for clinical purposes. Continuous real time in-vivo control of SvO2 has now become possible using commercially available devices with fiberoptic catheters. Pathophysiological changes in the O2-supply-to-demand-ratio as well as effects of ongoing therapy can be determined at the bedside.
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Acta medica Austriaca · Jan 1993
[Successful intubation with the Combitube of two patients with bull neck].
Endotracheal intubation is without doubt the optimal method for emergency airway management. Rapid intubation and effective ventilation are the major aims during cardiopulmonary resuscitation. ⋯ The patients could be oxygenated and ventilated adequately with the Combitube. This case report shows that the Combitube may be a valuable tool for emergency intubation in difficult situations.
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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.