Wiener klinische Wochenschrift
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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.
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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
Comparing stress levels in children aged 2-8 years and in their accompanying parents during first-time versus repeated voiding cystourethrograms.
Invasive procedures such as voiding cystourethrograms (VCUGs) cause distress in both children and their accompanying parents. The main purpose of this study was to examine whether stress levels in children and their parents differ during first-time and repeated VCUGs. The second objective was to examine the relationship between parental behavior (behavior promoting child coping and behavior promoting child distress), parental stress levels and child distress in first-time versus repeated VCUGs. ⋯ Repeated VCUGs and first-time VCUGs are both highly distressing procedures for children. Even though parental stress levels are lower during repeated VCUGs, spontaneous parental behavior proves to be ineffective or even counterproductive in reducing the child's distress. Further research into efficient counseling and training methods for parents and children undergoing VCUGs is required.
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Wien. Klin. Wochenschr. · Jan 2008
Abnormal pulmonary arterial pressure limits exercise capacity in patients with COPD.
Pulmonary hypertension (PH) is common in patients with chronic obstructive pulmonary disease (COPD). Mean pulmonary artery pressure (mPAP) is often only slightly elevated at rest but is increased by exercise. The purpose of this study was to determine whether abnormal pulmonary artery pressure impairs exercise capacity in patients with COPD. ⋯ In patients with COPD, abnormal pulmonary artery pressure impairs gas exchange, decreases maximum oxygen uptake during exercise and impairs exercise capacity.