Wiener klinische Wochenschrift
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Prolongation of the ventricular repolarisation manifests itself as a prolongation of the QT intervall on the surface ECG and represents a major risk for a special form of ventricular tachycardia called "torsades de pointes". Torsades de pointes are often self limited and are associated with palpitations, dizziness or syncope. Degeneration into ventricular fibrillation and sudden cardiac death can occur. ⋯ Repeated ECG controls during therapy with QT prolonging drugs are mandatory, especially when drug doses are changed, additional drugs are prescribed, or in case of vomiting and diarrhea. QT prolongation in individual medical therapy is not always predictable. Therefore, updated lists of drugs with the potential of QT prolongation are available on the Internet (e.g. www.qtdrugs.org ).
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Wien. Klin. Wochenschr. · Jan 2008
ReviewThe European surveillance activities EARSS and ESAC in the context of ABS International.
Development of resistance obstructs the successful use of antimicrobial drugs, since shortly after each and every introduction of a new antibiotic resistant pathogens have emerged. The hope of being able to reverse or at least slow down the occurrence of antibiotic resistance has led to a number of actions and initiatives. ⋯ The data generated by EARSS and ESAC are an essential prerequisite for targeted interventions to cope with the problem of antibiotic resistance. The project ABS International constitutes an impressive initiative to optimize the situation in hospitals in nine European member states.
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Wien. Klin. Wochenschr. · Jan 2008
Comparative StudyDifferences in critical care practice between an industrialized and a developing country.
Few data are available on intensive care unit (ICU) patient populations and critical care medicine practices in developing countries. ⋯ Patient characteristics and ICU practices varied significantly between the two ICUs. Mortality was substantially greater at MonICU, particularly among patients suffering from multiple-organ dysfunction. Strategies to improve the care of critically ill patients at MonICU should address both system- and staff-related problems, improve acceptance of the ICU service among physicians of other disciplines and upgrade the training of ICU staff.
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Wien. Klin. Wochenschr. · Jan 2008
Randomized Controlled Trial[Efficacy of glycopyrronium bromide and scopolamine hydrobromide in patients with death rattle: a randomized controlled study].
Death rattle is an extremely distressing symptom for the dying patient and for his environment. The aim of this study was to assess the efficacy of glycopyrronium bromide as compared with scopolamine hydrobromide in alleviating death rattle in terminal cancer patients with cognitive impairment. ⋯ Glycopyrronium bromide given in a dose of 0,4 mg every six hours demonstrated a significant reduction of death rattle compared to scopolamine hydrobromide. Concerning side effects (restlessness, expressions of pain) there was no difference between both substances.
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Wien. Klin. Wochenschr. · Jan 2008
ReviewAntibiotic stewardship through the EU project "ABS International".
The increasing problem of antimicrobial resistance requires implementation of antibiotic stewardship (ABS) programs. The project "ABS International--implementing antibiotic strategies for appropriate use of antibiotics in hospitals in member states of the European Union" was started in September 2006 in Austria, Belgium, the Czech Republic, Germany, Hungary, Italy, Poland, Slovenia and Slovakia. ⋯ Specific ABS tools are being implemented in up to five healthcare facilities in each country. Although ABS International clearly focuses on healthcare institutions, future antimicrobial stewardship programs must also cover public education and antibiotic prescribing in primary care.