Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Sep 2012
Randomized Controlled TrialEffectiveness of the Austrian disease management programme "Therapie Aktiv" for type 2 diabetes regarding the improvement of metabolic control, risk profile and guideline adherence: 2 years of follow up.
We evaluated the disease management programme (DMP) "Therapie Aktiv" for diabetes mellitus type 2 during the first year of implementation in a cluster-randomised controlled trial (RCT), which revealed an improvement of process quality, but only insignificant effects on HbA1c. To further analyse the effects of the DMP we followed up participants of the RCT for another year. ⋯ The DMP clearly enhances process quality. Furthermore, the DMP yields a reduction of HbA1c within groups after 2 years, but significance is lost in between-group analysis. We conclude that the DMP has only a minor effect on metabolic control.
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Wien. Klin. Wochenschr. · Sep 2012
Acute health problems in African refugees: ten years' experience in a Swiss emergency department.
Over the last two decades, the total number of applications from Africans for asylum in the countries of the European Union has increased from 578,000 to more than 2.9 million. About 20 % (7,196/36,100) of the asylum seekers in Switzerland originate from Africa. The disease profile of African asylum seekers is remarkably different from that of the native population in the country of application. We have therefore conducted an analysis of African asylum seekers presenting themselves to our emergency department. ⋯ The causes of presentation are manifold, including internal medical problems and injuries. Admissions for psychiatric problems are increasing. Establishing simple screening scores for somatization should be a key priority in providing more focused treatment in emergency departments.
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Wien. Klin. Wochenschr. · Sep 2012
Case ReportsNeoadjuvant radiotherapy of head and neck carcinoma: an obstacle for plastic reconstruction?
Head and neck carcinomas often are at an advanced stage at the time of diagnosis and therefore frequently primarily hardly operable. A downstaging achieved by neoadjuvant radiotherapy can facilitate a radical tumor resection. Because of radiogenic tissue alterations like scarring and impairment of blood supply, elaborate operations, such as microsurgical reconstructions, are aggravated to a degree, and most surgeons consider them impossible. ⋯ An anastomosis venous thrombose in one patient and a wound dehiscence in another required revision. In the end, a satisfactory result could be achieved in all the patients. Sophisticated reconstructions in irritated patients with ENT carcinoma are challenging; therefore, efficient interdisciplinary cooperation can overcome this obstacle.
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Wien. Klin. Wochenschr. · Sep 2012
Health-related quality of life of long-term survivors of intensive care: changes after intensive care treatment. Experience of an Austrian intensive care unit.
The aim of the study was to determine if health-related quality of life of long-term survivors changes 24 months after intensive care treatment compared to the quality of life before admission. ⋯ In the interviewed population the total score of health-related quality of life did not change after intensive care treatment. Surprisingly, emotional state improved significantly although physical performance decreased. Quality of life after ICU discharge was predominantly influenced by preadmission quality of life. However, these results are not reflective of all ICU survivors.