Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Mar 2024
Letter ReviewHomeopathy-A lively relic of the prescientific era.
Homeopathy was first postulated by the German physician Samuel Hahnemann in 1796 and 220 years later homeopathy is the most popular and widespread alternative medicine. Partly, it is also part of the national healthcare and insurance systems but homeopathy is not without controversy within the medical and healthcare community. Its implausible basic assumptions, some of which contradict natural laws, do not lead us to expect that its remedies have any specific effect. ⋯ The medical irrelevance of the sham method of homeopathy has been proven with more than sufficient probability [2]. As a major testimonial, the statement "Homeopathic products and practices" of the European (EASAC 2017) can be regarded. The primary aim of this brief report is therefore not to take another look at homeopathy from a medical scientific perspective, but rather focus attention on the implications of the still continuous and largely uncritically accepted existence of this method in medical practice, in the medical scientific sphere and in the judgement of the general public.
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Wien. Klin. Wochenschr. · Jan 2024
ReviewThe three pillars in treating antibody-mediated encephalitis.
The rapid initiation of immunotherapy has a decisive impact on the course of the disease in patients with antibody-mediated encephalitis (AE). The importance of treating AE with antiseizure medication and antipsychotics is discussed controversially; however, standardized procedures should be ensured, especially for the initiation of treatment in severe disease. Recommendations and guidelines for further interventions in refractory courses are needed. In this review, we contrast the three mainstays of treatment options in patients with AE and attempt to highlight the importance of 1) antiseizure therapy, 2) antipsychotic therapy, and 3) immunotherapy/tumor resection from today's perspective.
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Wien. Klin. Wochenschr. · Dec 2023
ReviewSex differences in the management and outcome of acute coronary syndrome-Still an issue of equal treatment?
Significant sex-specific differences were described in the presentation, management and outcome of acute coronary syndrom (ACS) patients. Female ACS patients more often presented with noncardiac symptoms, which lead to significant time delays between symptom onset and treatment. Furthermore, multiple studies from various countries described that women with ACS were less likely to receive the medical or reperfusion therapy recommended by the respective guidelines, resulting in higher in-hospital mortality rates. The treating physicians and the patients need to be more aware of the described differences to ensure the best possible medical care for ACS patients, irrespective of sex.
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Wien. Klin. Wochenschr. · Dec 2023
ReviewHypertensive response to exercise, hypertension and heart failure with preserved ejection fraction (HFpEF)-a continuum of disease?
Heart failure with preserved ejection fraction (HFpEF) has been shown to be a long-term consequence of uncontrolled arterial hypertension (aHT). Other than that, hypertensive response to exercise (HRE) precedes aHT. We aim to evaluate the available evidence for a continuum of HRE, aHT and HFpEF. ⋯ The literature search revealed suggestive data on a connection of HRE, aHT and HFpEF. HRE seems to be an independent risk factor for aHT and aHT in turn is one of the main risk factors for HFpEF. However, further research is needed to improve our knowledge of a possible continuum of disease.
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Wien. Klin. Wochenschr. · Dec 2023
ReviewUltrasound utilization for implantation of cardiac implantable electronic devices.
Ultrasound (US) guidance for implantation of cardiac implantable electronic devices (CIED) is currently not routine practice. This article sought to review published data on the use of ultrasound in each of the major surgical steps involved in implantation of CIEDs, including achieving anesthesia, obtaining venous access and implantation of leads. A literature review was performed, revealing a total of 20 peer-reviewed studies that assessed US guidance for CIED implantation; 3 of these were randomized trials while the remainder were mostly feasibility studies. The available data suggest that ultrasound can be useful in guiding implantation of CIEDs, with a trend towards less complication rates; however, more high-quality studies that compare US guidance to traditional techniques in CIED implantation are required.