Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Dec 2024
ReviewNeuroprotective and neuroregenerative drugs after severe traumatic brain injury : A narrative review from a clinical perspective.
Traumatic brain injuries cause enormous individual and socioeconomic burdens. Survivors frequently struggle with motor handicaps as well as impaired cognition and emotion. In addition to the primary mechanical brain damage, complex secondary mechanisms are the main drivers of functional impairment. ⋯ By supporting the impaired mitochondrial energy supply, oxidative processes are inhibited and neuroregenerative processes, such as neurogenesis, angiogenesis and synaptogenesis are promoted by citicoline and cerebrolysin. First clinical evidence shows an improvement in cognitive and thymopsychic outcomes, underlined by own clinical experience combining different therapeutic approaches. Accordingly, adjuvant treatment with neuroprotective substances appears to be a promising option, although more randomized prospective studies are still needed.
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Isolated pulmonary valve endocarditis (IPE) is a rare form of infectious endocarditis. This article reports the case of a 49-year-old patient with IPE who was initially admitted with suspected cholecystitis. After vegetations were detected by transthoracic (TTE) and transesophageal echocardiography (TEE), antibiotic therapy in accordance with the antibiogram was primarily attempted; however, due to persistently elevated infection parameters and structural valve damage a pulmonary valve replacement was eventually performed.
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The curriculum for interventional cardiology outlines a structured training program for advanced training in interventional procedures. It specifies requirements for candidates, trainers, and centers. The curriculum specifically defines learning objectives, competence levels, and essential skills needed for on-duty shift in the catheterization laboratory. The program is based on the European Core Curriculum, tailored to Austrian healthcare needs, and aims to ensure high-quality care.
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Wien. Klin. Wochenschr. · Dec 2024
Our approach for out-of-center initiation of extracorporeal membrane oxygenation and subsequent interhospital transport.
Extracorporeal membrane oxygenation (ECMO) initiation at a non-ECMO-capable facility by specialized mobile teams aims for a stabilization prior to center admission, internationally referred to as ECMO retrieval. It is a recommended strategy to avoid primary interhospital transfer of compromised patients with a high risk of life-threatening incidents and potentially death. ⋯ Although recommendations for the initiation of ECMO retrieval programs exist, centers globally tailor their course of action to local individual needs and so do we. The purpose of this work is to portray the decision-tree-based protocol of the intensive care unit 13i2 (Department of Medicine I, Medical University of Vienna) with its operational standards for optimal patient selection and transport organization.