Wiener klinische Wochenschrift
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Patients who are suspected of having acute appendicitis usually undergo surgery in order to avoid life-threatening complications such as perforation and peritonitis. However, acute appendicitis is difficult to distinguish from other sources of right-sided abdominal pain. The clinical picture is almost indistinguishable from appendiceal diverticulitis, which is a rare entity and remains a difficult diagnostic problem. ⋯ Every surgeon should be aware of the possibility of diverticulitis of the appendix in the operating room, even if this does not change the operative management. As diverticula of the cecum can be found as solitary lesions, as multiple lesions confined to the right colon, or as part of a generalized disease of the entire colon, postoperative barium enema examination may be useful.
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Wien. Klin. Wochenschr. · Jan 2004
Comparative StudyA review of civilian gunshot wounds to the head in northeast Slovenia: 1992 to 2002.
Surgical management of gunshot wounds to the head has remained a controversial issue. There are considerable regional differences in the causes of civilian gunshot wounds (GSW) to the head and various devices are used in different countries. The aim of our study was to review the demographic factors, treatment and outcome of patients with GSW to the head over the past 10 years at Maribor Teaching Hospital. ⋯ The results of our study support previous ones stating that patients with GSW to the head can benefit from aggressive treatment and still make satisfactory recoveries. Clearly, there are ethical dilemmas involved in withholding operative treatment from any individual. Guidelines dictating when to surgically intervene must be made.
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Wien. Klin. Wochenschr. · Jan 2004
Comparative StudyIncidence and outcome of rupture of the Achilles tendon.
We determined the incidence of complete rupture of the Achilles tendon in the Maribor region (273,609 inhabitants) between 1991 and 1996. During this period, 116 ruptures were treated at Maribor Teaching Hospital. The average incidence was 7 ruptures per 100,000 inhabitants, with a peak incidence of almost 9 per 100,000. ⋯ The mean AOFAS score was 96 points. The patients were subjectively very satisfied with their treatment in 88% of cases. Good functional results with a return to the usual pre-injury activities were achieved in 96% of patients.
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Based on several severe air pollution episodes, a temporal correlation between high concentrations of particulate matter (PM) and SO2 pollution and acute increases in respiratory and cardiopulmonary mortality had been established in Vienna for the 1970's. After air pollution had decreased in Austria in the 1980's--as documented by data on SO2, and total suspended particles (TSP)--no such associations between day-to-day changes of SO2 and TSP and mortality have been documented any more, however, traffic related pollutants like fine particles and NO2 remained a problem. Therefore, short term effects of PM on lung function, morbidity and mortality were investigated in Vienna, Linz, Graz and a rural control area. ⋯ In a prospective cohort study on 1630 dust-exposed and 1630 non dust-exposed workers matched for smoking we found an increase of lung cancer related to nonfibrous insoluble PM. Other studies were able to relate lung cancer to specific particles like those from diesel engines, and a large prospective study of the American Cancer Society was able to link lung cancer in the general population with long-term exposure to fine particles from combustion processes. All these recent epidemiological findings will have consequences for occupational and ambient air PM standards.
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Wien. Klin. Wochenschr. · Jan 2004
Comparative StudyClinical versus electrodiagnostic effectiveness of splinting in the conservative treatment of carpal-tunnel syndrome.
Splinting is known as one of the most effective non-aggressive treatments for carpal-tunnel syndrome (CTS). Early and accurate diagnosis of CTS is critical for effective non-surgical management. Nerve-conduction studies confirm the diagnosis of CTS with a high degree of sensitivity and specificity. Many patients report that their symptoms decrease after splinting; consequently, improved electrophysiological findings are expected. ⋯ Even though immobilization (wrist splint in neutral position) does not affect the common electrodiagnostic parameters in CTS diagnostics, it caused the disappearance of clinical symptoms in 75% of the patients. There is therefore a need for further research regarding the usefulness of repeated electrodiagnostic studies.