Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Nov 2003
Review Comparative Study[Progress in the prevention of type 2 diabetes].
Type 2 diabetes mellitus is a major health problem associated with excess morbidity and mortality. Defects in the action and/or secretion of insulin are the two major abnormalities leading to development of glucose intolerance. Any intervention in the impaired glucose tolerance phase that reduces resistance to insulin or protects the beta-cells, or both, should prevent or delay progression to diabetes. ⋯ Remarkably, cardiovascular event rates, in particular myocardial infarction, were significantly reduced when acarbose was used instead of placebo in subjects with glucose intolerance. The ACE inhibitors captopril (CAPPP) or ramipril (HOPE) and the Angiotensin-II receptor antagonist losartan (LIFE) have been shown to reduce the appearance of diabetes by one third when given to patients with hypertension. Since many hypertensive patients are insulin-resistant and have an increased risk in developing type 2 diabetes, the protective effect of these classes of antihypertensive drugs might be explained by their antiinsulin-resistance effects.
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Wien. Klin. Wochenschr. · Nov 2003
Review Comparative StudyThe cumulative effects of Transcendental Meditation on cognitive function--a systematic review of randomised controlled trials.
It is claimed that regular practice of Transcendental Meditation (TM) improves cognitive function and increases intelligence. This systematic review assesses the evidence from randomised controlled trials for cumulative effects of TM on cognitive function. Searches were made of electronic databases and the collected papers and official websites of the TM organisation. ⋯ The other 6 trials recruited subjects with no specific interest in TM, and 5 of them used structured control procedures. The association observed between positive outcome, subject selection procedure and control procedure suggests that the large positive effects reported in 4 trials result from an expectation effect. The claim that TM has a specific and cumulative effect on cognitive function is not supported by the evidence from randomised controlled trials.
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Wien. Klin. Wochenschr. · Nov 2003
Review Comparative StudyThe cumulative effects of Transcendental Meditation on cognitive function--a systematic review of randomised controlled trials.
It is claimed that regular practice of Transcendental Meditation (TM) improves cognitive function and increases intelligence. This systematic review assesses the evidence from randomised controlled trials for cumulative effects of TM on cognitive function. Searches were made of electronic databases and the collected papers and official websites of the TM organisation. ⋯ The other 6 trials recruited subjects with no specific interest in TM, and 5 of them used structured control procedures. The association observed between positive outcome, subject selection procedure and control procedure suggests that the large positive effects reported in 4 trials result from an expectation effect. The claim that TM has a specific and cumulative effect on cognitive function is not supported by the evidence from randomised controlled trials.
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Wien. Klin. Wochenschr. · Sep 2003
Review Comparative Study[Sympathetic overactivity and the kidney].
Hypertension is present in the majority of patients with chronic renal failure and constitutes a major risk factor for the very high cardiovascular morbidity and mortality in this patient population. Furthermore hypertension is known to be a substantial progression factor in renal disease. In the past, it had been presumed that hypertension in chronic renal failure is due to enhanced sodium retention, chronic hypervolemia and increased activity of the renin-angiotensin-aldosterone-system. ⋯ The treatment goal in renal patients is to delay or even prevent progression of renal failure and to reduce the cardiovascular risk. Recent studies have investigated the respective impact of sympatholytic drugs, e.g. inhibitors of the renin-angiotensin-aldosterone-system, beta-blockers or I1-Imidazolin-receptor-agonists in fulfilling these aims. The present report will review experimental and clinical studies on the role of sympathetic overactivity in hypertension and chronic renal failure and possible new therapeutic options.
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Malignant hyperthermia is an autosomal dominant disorder of the skeletal muscle that predisposes affected individuals to a life-threatening hypermetabolic reaction in response to volatile anaesthetics and depolarizing muscle relaxants. The underlying heterogeneous genetic defects are mainly point mutations within the ryanodine receptor gene of the sarcoplasmic reticulum. Following the introduction of efficient diagnostic and therapeutic tools--the in vitro contracture test and intravenous treatment with dantrolene--a dramatic decline in mortality rates has been observed. The association of malignant hyperthermia-like reactions with other neuromuscular disorders requires the collaboration of several clinical disciplines to achieve a timely recognition of this still life-threatening disorder.