Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Jun 2004
Comparative Study Clinical Trial Controlled Clinical TrialIncrease of serum triiodothyronine concentration in soldiers with combat-related chronic post-traumatic stress disorder with or without alcohol dependence.
Post-traumatic stress disorder (PTSD) is a relatively new psychiatric disorder with three clusters of symptoms: trauma re-experiencing, avoidance, and increased arousal. The condition develops after a person sees, is involved in, or hears of an extreme traumatic stressor such as war, torture, natural catastrophe, assault, rape, or serious accident. PTSD is also often comorbid with other psychiatric disorders, especially with alcohol dependence. Several hormonal alterations have been reported in veterans with combat-related PTSD, including elevations in certain thyroid hormones, e.g., total T3; however, previous studies have not controlled for alcohol dependence, a common comorbid psychiatric disorder in this population. ⋯ Elevated concentrations of serum TT3 are associated with combat-related PTSD, regardless of its comorbidity with alcohol dependence, and also with the number of traumatic events and symptoms of increased arousal. Given that current pharmacotherapy for PTSD is inadequate, reduction of TT3 may be a new strategy for pharmacologic intervention that could contribute to more effective treatment of this disorder.
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Wien. Klin. Wochenschr. · Jun 2004
Epidemiology and outcome of pediatric trauma treated by an emergency-physician-staffed advanced life-support unit.
The aim of this study was to describe the epidemiology and outcome of pediatric trauma in the setting of an emergency-physician-staffed mobile advanced life support (ALS) unit serving a predominantly urban area in Austria. ⋯ Because the frequency of pediatric trauma is so low, ALS units may not gain adequate experience in the management of (severe) pediatric trauma, thus rendering regular training of paramount importance.
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Wien. Klin. Wochenschr. · May 2004
Randomized Controlled Trial Comparative Study Clinical TrialHuman albumin and starch administration in critically ill patients: a prospective randomized clinical trial.
To determine whether intravenous infusion of either human albumin or hydroxyethyl-starch (HES) in hypo-albuminemic critically ill may lead to an increase in colloid osmotic pressure and to a better clinical outcome, i.e. lower mortality and fewer complications, compared to fluid replacement with normal saline. ⋯ Raising colloid osmotic pressure with human albumin in hypoalbuminemic patients is not associated with improvement of the clinical outcome.
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Wien. Klin. Wochenschr. · May 2004
High-dosage continuous amiodarone therapy to treat new-onset supraventricular tachyarrhythmias in surgical intensive care patients: an observational study.
New-onset supraventricular tachyarrhythmias (SVTA) are a complication contributing significantly to morbidity and mortality in surgical intensive care unit (SICU) patients. Although only few data on efficiency can be found in the literature, class III antiarrhythmics have become popular in the treatment of SVTA in critically ill patients. ⋯ High-dosage continuous amiodarone infusion during a period of 48 hours resulted in restoration of SR in 75% of SICU patients with new-onset SVTA and moderate to severe multiple-organ dysfunction syndrome. A significant improvement in cardiocirculatory function was more pronounced in responders but could be demonstrated irrespective of restoration of sinus rhythm in all patients. Apart from a possibly amiodarone-mediated increase in concentrations of creatinine and bilirubin, no major drug-related adverse effects occurred during the observation period.