Wiener klinische Wochenschrift
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Based on several severe air pollution episodes, a temporal correlation between high concentrations of particulate matter (PM) and SO2 pollution and acute increases in respiratory and cardiopulmonary mortality had been established in Vienna for the 1970's. After air pollution had decreased in Austria in the 1980's--as documented by data on SO2, and total suspended particles (TSP)--no such associations between day-to-day changes of SO2 and TSP and mortality have been documented any more, however, traffic related pollutants like fine particles and NO2 remained a problem. Therefore, short term effects of PM on lung function, morbidity and mortality were investigated in Vienna, Linz, Graz and a rural control area. ⋯ In a prospective cohort study on 1630 dust-exposed and 1630 non dust-exposed workers matched for smoking we found an increase of lung cancer related to nonfibrous insoluble PM. Other studies were able to relate lung cancer to specific particles like those from diesel engines, and a large prospective study of the American Cancer Society was able to link lung cancer in the general population with long-term exposure to fine particles from combustion processes. All these recent epidemiological findings will have consequences for occupational and ambient air PM standards.
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Wien. Klin. Wochenschr. · Jan 2004
Comparative StudyClinical versus electrodiagnostic effectiveness of splinting in the conservative treatment of carpal-tunnel syndrome.
Splinting is known as one of the most effective non-aggressive treatments for carpal-tunnel syndrome (CTS). Early and accurate diagnosis of CTS is critical for effective non-surgical management. Nerve-conduction studies confirm the diagnosis of CTS with a high degree of sensitivity and specificity. Many patients report that their symptoms decrease after splinting; consequently, improved electrophysiological findings are expected. ⋯ Even though immobilization (wrist splint in neutral position) does not affect the common electrodiagnostic parameters in CTS diagnostics, it caused the disappearance of clinical symptoms in 75% of the patients. There is therefore a need for further research regarding the usefulness of repeated electrodiagnostic studies.
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Wien. Klin. Wochenschr. · Jan 2004
Comparative Study[Pulmonary function results in healthy subjects breathing through external stenoses compared to patients with airway obstruction].
We compared body plethysmographic data, flow-volume curves during spontaneous breathing, P0.1 and PETCO2 in healthy subjects breathing through external stenoses (ES) of varying magnitude to the results in patients suffering from chronic obstructive pulmonary disease (COPD). Inspiratory vital capacity (IVC) remained unchanged by experimental airway stenoses. IVC is mainly determined by the end-expiratory closure of the airways, which only weakly correlates with airway resistance in patients. ⋯ The well-known correlation between Rt and IGV is attributed to the end-expiratory closure of the airways during increased flow resistance and to "trapped air". It remains open, if and how the expiratory muscles act to overcome the increased resistance. With consideration of the underlying factors of the different lung function measures, the combination and the analysis of the correlation between different values may lead to far-reaching results in lung function testing.
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Wien. Klin. Wochenschr. · Jan 2004
Comparative StudyThe significance of thoracoscopic mechanical pleurodesis for the treatment of malignant pleural effusions.
Malignant pleural effusion (MPE) is a frequent and serious complication of numerous malignant tumors in the human organism. The patients are suffering from the primary disease, and the pleural effusion causes dyspnea, thus reducing the quality of their survival time. In our study we wished to establish the significance of thoracoscopic mechanical pleurodesis (TMP) as a new method for the resolution of this pathology, by comparing the results with those of thoracotomy with pleurectomy (TP) and thoracic drainage (TD). The main criterion for the effectiveness of each method was the absence of pleural effusion in a certain time interval. ⋯ TMP is an effective palliative method for the treatment of recurrent pleural effusions, with a minimum number of complications and a short period of hospitalization. After TMP there is significant improvement in respiratory functions, and for the patient it represents a relatively simple surgical procedure. TP is indicated in the treatment of tumors and subsequent MPE in the thoracic region, and TD is indicated in patients who are not suitable candidates for one of the palliative pleurodesis procedures, because of either their poor general condition or a trapped lung.
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Wien. Klin. Wochenschr. · Jan 2004
Case Reports[Bronchial asthmatic disease associated with tobacco dust--an occupational lung disease?].
Hypersensitivity to allergens in tobacco leaf as a cause of occupational asthma in workers of the tobacco manufacturing industry has been reported previously. We describe the case of a female employee working in a tobacco plant with asthmatic symptoms occurring at the working place. The symptoms described by the patient and the strong correlation to periods at work is highly suggestive for an occupational disease. The diagnosis of occupational bronchial asthma is supported by a positive skin test and bronchial provocation test with tobacco dust.