Wiener klinische Wochenschrift
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A positive relationship between patient volume and outcome has been demonstrated for a variety of clinical conditions and procedures, but the evidence is sparse for critically ill patients. ⋯ Our results provide evidence for a relationship between patient volume and outcome in critically ill patients. Besides the total number of patients, diagnostic variability plays an important role. The relationship between volume and outcome seems, however, to be complex and to be influenced by other variables, such as workload of nursing staff.
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Wien. Klin. Wochenschr. · Jan 2009
Atrial fibrillation is an independent determinant of increased NT-proBNP levels in outpatients with signs and symptoms of heart failure.
N-terminal pro-B-type natriuretic peptide (NT-proBNP) is increasingly used in the diagnosis and prognostic assessment of heart failure; however, the possible influence of atrial fibrillation on BNP is still a matter of controversy. We assessed the influence of atrial fibrillation on NT-proBNP levels in outpatients with signs and symptoms of heart failure. ⋯ Atrial fibrillation is an independent determinant of increased NT-proBNP levels. This association should be taken into account when NT-proBNP levels are used in the diagnosis of heart failure in patients with atrial fibrillation.
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Wien. Klin. Wochenschr. · Jan 2009
Case ReportsChicken-bone perforation of a sigmoid colon diverticulum into the right groin and subsequent phlegmonous inflammation of the abdominal wall.
Colonic diverticula are frequent in western countries and approximately 80% of patients who develop diverticulitis are elderly. The sigmoid and descending colon are most commonly involved. Clinical manifestations range from asymptomatic diverticula to life-threatening complications such as diverticulum perforation and subsequent peritonitis. ⋯ A Hartmann's procedure with necrectomy of the abdominal wall was performed. Histopathologic examination revealed an ingested chicken bone perforating the diverticulum. When diverticulitis or diverticular abscess is suspected in an elderly patient, foreign body impaction or perforation should be considered as a possible cause.
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Wien. Klin. Wochenschr. · Jan 2009
Randomized Controlled Trial Comparative StudyCardiopulmonary resuscitation and the 2005 universal algorithm: has the quality of CPR improved?
Chest compressions are crucial in cardiopulmonary resuscitation (CPR), although the optimal number, rate and sequence are unknown. The 2005 CPR guidelines of the European Resuscitation Council (ERC) brought major changes to the basic life support algorithm. One of the major aims of the ERC was to decrease hands-off time in order to improve perfusion of the coronary vessels and the brain. Using a manikin model of basic life support in simulated cardiac arrest, we compared hands-off time and total number of chest compressions according to the guidelines of 2000 and those of 2005. ⋯ In this manikin setting, both hands-off time and the total number of chest compressions improved with basic life support performed according to the ERC guidelines of 2005.
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Wien. Klin. Wochenschr. · Jan 2009
Review[Evidence-based cosmetics: concepts and applications in photoaging of the skin and xerosis].
As well as for topically used dermatological agents, studies performed according to the rules of evidence-based medicine (EBM) are also needed for cosmetics. Although the concept of evidence-based cosmetics has been only partly developed so far, there are some agents and preparations available that can be considered as evidence-based. In this paper we present data from several studies that claim to have examined and demonstrated the efficacy of cosmetic preparations for the management of solar damage and aging skin as well as lentigo and melanosis according to EBM criteria. ⋯ However, the lack of controlled studies confirming the efficacy of dermocosmetic products as well as the superiority of the preparation incorporating the active agent over the corresponding base is a problem yet to be solved. Undoubtedly, the efficacy and the sustainability of the achieved effects have to be examined and proven accordingly to EBM criteria in further active cosmetic agents. Moreover, generally accepted guidelines for the examination of efficacy and tolerability of dermocosmetics have to be developed.