Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Jan 2009
Carbohydrate epitopes as a cause of cross-reactivity in patients allergic to Hymenoptera venom.
Among patients with allergy to insect stings, double positivity in tests for IgE antibodies specific to honey bee and wasp venoms is a frequent diagnostic problem. True double sensitization and possible cross-reactivity of venom hyaluronidases and with carbohydrate determinants must be considered in such patients. We studied the frequency of sensitization to carbohydrate determinants and the role of these in double positivity in tests for specific IgE antibodies. ⋯ The values of IgE specific for OSR pollen and MUXF3 in patients with primary sensitization to either honey bee venom or wasp venom were significantly higher than in patients with double sensitization. These results confirm that IgE antibodies against carbohydrates epitopes are a frequent cause of double positivity in tests for anti-venom IgE antibodies.
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Wien. Klin. Wochenschr. · Jan 2009
[Implementation of thrombolysis in acute stroke--10-year results of the Innsbruck stroke registry].
Randomized controlled trials have yielded evidence for the efficacy and safety of intravenous alteplase in the therapy of acute ischemic stroke. A large patient registry has recently confirmed the safe implementation of this therapy in the clinical routine setting. ⋯ Our data reinforce that intravenous thrombolysis is safe in the treatment of acute ischemic stroke in clinical routine setting. Establishment of modern stroke services and the implementation of structural operating procedures have contributed to an increase in the number of treated patients and a parallel decrease in door-to-needle time at our hospital. Widespread educational programs in the general community, introduction of optimized pre-hospital triage algorithms as well as the potential extension of the 3-hour window to 4.5 hours all are suitable measures to further extend the benefit of i.v. thrombolysis to large proportion of stroke patients.
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Wien. Klin. Wochenschr. · Jan 2009
Clinical TrialTreatment of inappropriate sinus tachycardia with ivabradine.
Inappropriate sinus tachycardia is most often treated with beta-blockers; in resistant cases, nonpharmacologic treatment has been attempted. Recent case reports have shown a favorable response to ivabradine in some patients. ⋯ The results of our study show that patients with inappropriate sinus tachycardia can be successfully treated with ivabradine.
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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.