Wiener klinische Wochenschrift
-
Wien. Klin. Wochenschr. · Jan 1994
Review["Small volume resuscitation"--does it open new possibilities in the treatment of hypovolemic shock?].
Hypertonic-hyperoncotic solutions are a supplementation to conventional fluid regimens in the management of hypovolemia due to trauma, hemorrhage and shock. In this review the possible modes of action of these solutions are discussed and their efficacy both in experimental and clinical settings is presented. Possible side effects, such as hypernatremia and possible problems in the presence of increased intracranial pressure, following administration of hypertonic-hyperoncotic solutions are discussed, as well as the reaction of normovolemic patients to such infusions.
-
Wien. Klin. Wochenschr. · Jan 1994
Review[Bronchial cancer--development, diagnosis, therapy, prognosis].
Lung cancer is the most frequent cause of death from cancer in men. In addition its prevalence among women is currently rapidly increasing. Main risk factors are smoking, exposure to asbestos and genetic factors. ⋯ In small cell lung cancer the probability of 5-year survival is about 10% for patients with limited disease and less than 1% for patients with extended disease. Although surgery plays a role in stage I to stage IIIA, chemotherapy remains the most important mode of therapy in small cell lung cancer. In stages I to IIIA, however, combined treatment modalities might improve outcome of the patients with small cell lung cancer.
-
In spontaneous breathing intrathoracic pressure alternates between positive and negative in a biphasic sequential pattern. By contrast, during mechanical ventilation (IPPV, CPPV) the intrathoracic pressure remains above atmospheric all the time. ⋯ In order to minimize these deleterious effects of positive pressure ventilation it is essential to keep the procedure as short and little invasive as possible. The following strategy enables this goal to be brought closer: 1) early commencement of ventilation; 2) optimal adjustment of artificial ventilation to the individual needs of the patient, 3) early weaning from assisted ventilation through augmented rather than controlled modes of ventilation: 4) kinetic therapy (systematic changing of the patient's position) with the back up of the requisite thoracic CT scan findings; 5) reduction of the invasiveness of the procedure in order to ensure early commencement of spontaneous respiration.
-
Seasonal changes in human behavior have been recognized since ancient times. Starting in 1980 systematic research has been carried out by Rosenthal et al. (1984), who described and characterized a psychopathological and clinical syndrome which is linked to fall/winter and shows remission in spring/summer and which was termed seasonal affective disorder (SAD). ⋯ The efficacy of light therapy with bright, fluorescent, full-spectrum light has been widely demonstrated for treatment of fall/winter SAD. In addition, treatment with selective serotonin reuptake inhibitors appears to be successful in this condition.
-
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.