Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Mar 2011
Review Meta AnalysisAre renal adverse effects of hydroxyethyl starches merely a consequence of their incorrect use?
Clinical studies such as VISEP-study, which show a negative outcome after the administration of hydroxyethyl starch (HES), are often criticized for an "incorrect" use of HES. It is argued that HES used in these studies differed from usual practice and that recommendations for maximal dosage, duration, and creatinine values were ignored, not enough "free water" was provided and more modern HES solutions should have been used. These comments imply that renal adverse events in clinical studies are the consequence of an inappropriate use of HES. We therefore searched for evidence whether these suggested measures are beneficial. ⋯ There is no evidence for the assumption that HES-associated renal impairment may be avoided by accompanying measures. Because HES use does not improve clinical outcome, the question arises whether it should be used at all in patients at risk.
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Wien. Klin. Wochenschr. · Oct 2010
Review[Bats and other reservoir hosts of Filoviridae. Danger of epidemic on the African continent?--a deductive literature analysis].
Ebola and Marburg virus, forming the Filoviridae family, cause hemorrhagic fever in countries of sub-Saharan Africa. These viral diseases are characterized by a sudden epidemic occurrence as well as a high lethality. Even though a reservoir host has not been approved yet, literature indicates the order of bats (Chiroptera) as a potential reservoir host. ⋯ Risk groups can be defined through chronological reprocessing and interpretation of existing epidemic-outbreaks on the African continent and the search for infection reasons of the index cases. The following risk factors for an infection with Ebola or Marburg virus must be put into consideration: Contact with and consumption of wild animal carcasses, sightseeing in caves as well as work in mines. The focus of this review is the demonstration of risk profiles and their exposure to Chiroptera and other potential reservoir hosts.
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Wien. Klin. Wochenschr. · Aug 2010
Review[Sedation and analgesia in intensive care: physiology and application].
Many therapeutic and diagnostic procedures in intensive care medicine are perceived as painful by most patients. As a consequence analgesia and sedation represent two of the main pillars in the treatment of the critically ill. Adaptation to the individual needs of the patients poses one of the biggest challenges that we are confronted with. ⋯ In the first part of this review we will discuss the physiology of sleep patterns and pain. Furthermore modes of action and side effects of the most common anesthetics and analgetics will be presented. Finally, the last part of the manuscript deals with the practical application of these therapeutics and their monitoring in intensive care medicine.
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Wien. Klin. Wochenschr. · May 2010
Review[Thirtieth anniversary of world health organization's world wide smallpox eradication].
This year in May, the World Health Assembly will celebrate the thirtieth anniversary of world wide Smallpox eradication. For this reason we report on this program's vertices.
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In Austria activities against smallpox started with variolation, the artificial infection with the smallpox virus, which bore the risk of contracting the disease. In 1800, Lower Austria was the first country in continental Europe to implement Edward Jenner's invention of vaccination with cowpox for mass vaccination. In the beginning vaccination was practised by inoculation from one human being to another. In this paper development of smallpox vaccination from the beginning to it's cessation in 1981 is described.