Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Jan 1991
Comparative Study[Infections in the neutropenic phase following bone marrow transplantation: comparison of laminar airflow isolation with conventional isolation].
From May 1978 to September 1989 45 patients underwent 25 allogeneic and 21 autologous bone marrow transplantations (BMT) and 1 peripheral stem cell transplantation for the following indications: severe aplastic anemia (n = 4), hematological malignancies (n = 28), malignant solid tumours (n = 12) and sideroblastic anemia (n = 1). The first group of 20 patients was isolated in a conventional hospital room, while management of the aplastic phase in the second group of 25 patients was performed in a laminar air flow (LAF) unit. ⋯ Despite the fact that the septic morbidity was lower in the LAF group, mortality during the neutropenic period (15% in group I versus 16% in group II) was unaffected and survival rate (45% in group I versus 36% in group II) did not improve. We conclude that LAF protection will only have a positive impact on survival rate if the incidence of non-infectious complications of BMT, such as organ toxicity or graft-versus-host disease, is likewise reduced.
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Wien. Klin. Wochenschr. · Aug 1990
[Percutaneous cannulation of the radial artery in severely ill premature and newborn infants].
Cannulation of the radial artery is an easy and safe alternative to the usual procedure of catheterization of the umbilical artery to secure blood for gas sampling and for monitoring blood pressure in critically ill neonates. The use of a fiberoptic light source further improves the success of percutaneous radial artery cannulation. We performed this procedure in 264 critically ill babies and it was successful in 211 (80%). ⋯ No case of bacterial infection due to cannulation was observed. No neurological disturbance in hand or finger function was found on follow up after one year. In conclusion, this method is safe, easy to handle, has less complications and several advantages over previous methods.
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Wien. Klin. Wochenschr. · Jun 1990
[Compulsory admission and detention at psychiatric hospitals in Tirol--a frequency analysis of 11 years].
Freedom and compulsion are burning questions in psychiatry, and often unsatisfactorily resolved. In this paper general aspects are discussed in the light of data obtained at the Innsbruck University Department of Psychiatry and the Mental State Hospital of Hall in Tyrol. From 1976 to 1986 364 (1.99%) patients required compulsory admission following certification by police (or civil service) doctors out of 18,207 admissions to the University Department of Psychiatry over this 11-year period. ⋯ Most frequent reasons for compulsory admission were alcohol-related psychiatric diseases in men and endogenous psychoses in women. The data collected at the University Department are compared with the situation in the Mental State Hospital of Hall in Tyrol. Results are discussed in the light of recent literature.
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Wien. Klin. Wochenschr. · May 1990
Randomized Controlled Trial Clinical Trial[Comparison of an oxygen-conserving module "Oxytron" and the reservoir cannula "Oxymizer Pendant" with continuous oxygen administration via nasal prong in hypoxemic patients].
High costs involved in administering continuous long-term oxygen therapy to patients with chronic lung diseases and limited portability of oxygen sources stimulated research into and development of oxygen conserving devices. Oxytron (Weinmann, Hamburg) is a new electronic demand oxygen delivery system which limits oxygen flow to the early phase of inspiration. The reservoir cannula Oxymizer Pendant (Chad-Therapeutics Inc.) is a nasal prong system incorporating a pendant reservoir which stores oxygen during expiration and delivers it as a bolus at the onset of inspiration. ⋯ With the reservoir cannula oxygen saving was most evident at low oxygen flows: 29.3, 19.4 and 4.7% less oxygen was required than with continuous flow at 2, 3 and 41/min. Individual patient acceptance of various drug delivery systems and response to therapy should be considered when prescribing home oxygen therapy. The use of oxygen saving techniques could result in a substantial cost saving and greater mobility may help to improve compliance in patients requiring continuous oxygen therapy.