Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Jan 1994
Review[The value of metformin in therapy of type 2 diabetes: effect on insulin resistance, diabetic control and cardiovascular risk factors].
In this review article recently published controlled clinical studies of metformin treatment in type-2 diabetic patients are summarized. Several studies demonstrate that body weight decreases and insulin resistance improves--as evaluated by peripheral glucose utilisation--under metformin treatment. HbA1c is lowered by approximately 20% (absolute decrease of HbA1c: 1.0%-1.5%). Since plasma lipid values and plasminogen-activator-inhibitor (PAI-1) concentrations are also lowered under metformin therapy, it currently represents the treatment of choice for the obese group of type-2 diabetic patients.
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Wien. Klin. Wochenschr. · Jan 1994
[Innsbruck results of bone marrow transplantation in treatment of hematologic neoplasms and solid tumors].
87 patients underwent bone marrow transplantation (BMT) in Innsbruck between 1983 and 1992. 81 patients were suffering from hematologic malignancies and severe aplastic anemia and six patients had advanced solid tumours/sarcoma. 56% of the patients undergoing HLA-identical sibling BMT were in an advanced or refractory stage of disease at the time of BMT. 19 patients underwent autologous BMT and 5 patients received a graft from an HLA-matched unrelated donor. Patients were treated with standard conditioning regimens according to the underlying disease. Cyclosporine A (CsA) was given prophylactically against graft-versus-host disease (GVHD) either alone or in combination with methotrexate. ⋯ Probability of survival for lymphoma patients was 60%. Acute GVHD > grade II developed in 35% of patients undergoing HLA-identical sibling BMT (46% in the high-risk group vs. 21% in the standard-risk group). Main causes of death in the high-risk group were relapse (31%), severe bacterial or fungal infections (17%), interstitial pneumonia (11%) and acute GVHD (6%).
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Wien. Klin. Wochenschr. · Jan 1994
Comparative Study[Synergistic cytotoxic effects of chemotherapy in colon tumor cells by simultaneous inhibition of de novo and salvage energy metabolism pathways].
The success of chemotherapy of colon tumours is currently limited. We have therefore used the human colon tumour cell line HT-29 to evaluate the cytotoxic effects of various drug combinations. Trimidox (3,4,5-trihydroxybenzamidoxime), a recently patented inhibitor of ribonucleotide reductase was combined with cytosinearabinoside (Ara-C) or 2',2'-difluorodeoxycytidine (DFDC) in order to inhibit both pyrimidine de novo and salvage pathways. ⋯ Synergistic cytotoxic effects were observed under these conditions too. When cells were treated with 10 microM tiazofurin and 400 microM or 800 microM allopurinol the number of colonies decreased to 69% and 27%, respectively, of the values calculated for additive effects. Our data suggest these drug combinations to be promising options in the treatment of human colon cancer.
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Wien. Klin. Wochenschr. · Jan 1994
Case Reports[Life-threatening caffeine poisoning by using coffee as a psychoactive drug].
A 27 year-old deeply unconscious male patient with shallow spontaneous respiration was admitted to hospital following an epileptoid convulsion with a tentative diagnosis of cerebral trauma. On admission he was noted to have hyperpyrexia, tachycardia and hypertension. The clinical and laboratory findings pointed to intoxication. ⋯ The clinical picture was consistent with the expected signs of caffeine intoxication whereby the central effects of the substance remain to be clarified. This appears to be the first report of caffeine misused in this manner. In cases of intoxication with convulsions of uncertain aetiology, caffeine poisoning should be considered in the differential diagnosis.
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Wien. Klin. Wochenschr. · Jan 1994
[Emergency management of ruptured/dissecting aortic aneurysm--diagnosis and therapeutic strategies].
Between December 1991 and January 1994 fifteen patients with a ruptured abdominal aortic aneurysm and seven patients with a dissecting aortic aneurysm were treated in our emergency department. Dissection/rupture of an aortic aneurysm is still a dramatic event with poor outcome, whereby survival depends largely on early diagnosis. In most cases the diagnosis can be made with reasonable assurance by history taking and physical examination. ⋯ The largest delay in commencing therapy is caused by patients' hesitation to call the Emergency Medical Service. Chest X-ray, echocardiography and abdominal sonography are of high diagnostic value, computed tomography confirms the diagnosis in most cases. Our Emergency Department provides the facilities for rapid diagnosis and interdisciplinary preoperative management of dissecting/ruptured aortic aneurysms.