Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Aug 2021
ReviewTranscatheter treatment by valve-in-valve and valve-in-ring implantation for prosthetic tricuspid valve dysfunction.
Valve degeneration after surgical tricuspid valve replacement or repair is frequent and may require repeat replacement/repair. For high-risk patients, transcatheter valve-in-valve and valve-in-ring procedures have emerged as valuable treatment alternatives. Preprocedural transthoracic echocardiography is the method of choice to detect malfunction of the prosthesis including degenerative stenosis and/or regurgitation requiring reintervention. ⋯ Suitable transcatheter valves are the Edwards Sapien 3 and the Medtronic Melody valves. Differences in surgical prostheses or annuloplasty implants are important for device selection, height consideration and additional ballooning prior to or after implantation. Transesophageal echocardiography postimplantation is convenient for the assessment of transvalvular gradients or paravalvular leaks.
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Wien. Klin. Wochenschr. · Aug 2021
ReviewConsidering additive effects of polypharmacy : Analysis of adverse events in geriatric patients in long-term care facilities.
Potential additive effects of polypharmacy are rarely considered in adverse events of geriatric patients living in long-term care facilities. Our aim, therefore, was to identify adverse events in this setting and to assess plausible concomitant drug causes. ⋯ Patients in long-term facilities frequently suffer from many adverse events. Concomitantly administered drugs have to be frequently considered as plausible causes for adverse events. These additive effects of drugs should be more focused in patient care and research.
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Wien. Klin. Wochenschr. · Aug 2021
ReviewNew strategies in the management of valvular heart disease : A critical appraisal on the top 10 messages of the 2020 ACC/AHA guidelines for the management of patients with valvular heart disease.
The advent of transcatheter procedures for treatment of valvular heart disease has accelerated the pace of research in the diagnosis and treatment of heart valve disease. Rapid accumulation of novel knowledge in the field necessitates timely revisions of clinical guidelines. This paper comments on some important and novel issues addressed in the recently published American College of Cardiology/American Heart Association (ACC/AHA) guidelines.
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Wien. Klin. Wochenschr. · Jul 2021
ReviewImmunotherapy and vaccination against infectious diseases.
Due to the overuse of antibiotics, infections, in particular those caused by multidrug-resistant bacteria, are becoming more and more frequent. Despite the worldwide introduction of antibiotic therapy, vaccines and constant improvements in hygiene, the burden of multidrug-resistant bacterial infections is increasing and is expected to rise in the future. The development of monoclonal therapeutic antibodies and specific immunomodulatory drugs represent new treatment options in the fight against infectious diseases. This article provides a brief overview of recent advances in immunomodulatory therapy and other strategies in the treatment of infectious disease.
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Wien. Klin. Wochenschr. · May 2021
ReviewDevelopment of sustainable research excellence with a global perspective on infectious diseases: Centre de Recherches Médicales de Lambaréné (CERMEL), Gabon.
Medical research in sub-Saharan Africa is of high priority for societies to respond adequately to local health needs. Often enough it remains a challenge to build up capacity in infrastructure and human resources to highest international standards and to sustain this over mid-term to long-term periods due to difficulties in obtaining long-term institutional core funding, attracting highly qualified scientists for medical research and coping with ever changing structural and political environments. The Centre de Recherches Médicales de Lambaréné (CERMEL) serves as model for how to overcome such challenges and to continuously increase its impact on medical care in Central Africa and beyond. ⋯ Advancing bioethics in medical research in Africa and steadily improving its global networks and infrastructures, CERMEL serves as a reference centre for several international consortia. In close collaboration with national authorities, CERMEL has become one of the main training hubs for medical research in Central Africa. It is hoped that CERMEL and its leitmotiv "to improve medical care for local populations" will serve as an inspiration to other institutions in sub-Saharan Africa to further increase African capacity to advance medicine.