Wiener medizinische Wochenschrift
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Wien Med Wochenschr · Jan 1999
Review[Psychological treatment aspects of chronic pelvic pain in the woman].
Pelvic pain is one of the most frequent disorders in gynecological practice often without clinical evidence. There are many underlying factors which contribute to this disorder, psychological as well as somatic. In the Department of Obstetrics and Gynecology at the University Hospital Graz, the diagnosis of chronic pelvic pain patients includes a medical as well as a psychological evaluation. ⋯ Chronic pelvic pain is a complex syndrome where medical and psychological diagnostic evaluation is essential. Psychological interventions can be performed at an earlier stage, in order to prevent the pain from becoming a chronic problem. The presence of psychologists within the Gynecology Department may help to establish a multidisciplinary treatment for these patients.
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Recent lipid intervention studies led to the implementation of lipid lowering therapy in the cardiovascular risk management. These secondary as well as primary prevention studies share the effect of HMG-CoA-reductase inhibition. Despite varying product properties there seem to be no major differences in risk reduction between the drugs. ⋯ One could be surprised that the "intervention group" was not better, though representing the usual clinical procedere. Interestingly, borderline significant (p < 0.046 at a level of significance of p < 0.045), results were in favor for the drug treated group. Such data could, if confirmed in further investigations, change cardiovascular disease management to aggressive lipid lowering prior to or instead invasive management, especially in initial therapy of CVD and diabetes mellitus type II.
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Fibromyalgia is a chronic soft tissue pain syndrome characterized by the presence of widespread musculosceletal aching, tender points at characteristic sites, fatigue and poor sleep. Associated disorders are restless leg syndrome, irritable bowel syndrome, irritable bladder syndrome, cognitive dysfunction, cold intolerance, multiple sensitivities and dizziness. ⋯ The results demonstrate that sensory disorders processing at a central level are in part involved in fibromyalgia. These findings also influence the management of the disease with the tendency to a multidisciplinary therapeutical concept.
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Wien Med Wochenschr · Jan 1999
Review[Value of mistletoe lectin standardized mistletoe extract for evaluating antitumor properties].
It could be shown from several experiments that carbohydrate-binding mistletoe lectins represent the pharmacologically active constituents of mistletoe extracts. On the basis of these findings, it was possible to develop an extract preparation standardized with respect to the mistletoe lectin concentration. This drug is the first mistletoe preparation that fulfills the criteria of the guidelines for the development of drugs (1) regarding its quality and stability of the active ingredients under certain storage conditions. The quality of this preparation has also been shown in several animal models to demonstrate antitumoral potencies.
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Wien Med Wochenschr · Jan 1999
Review[Clinical value of electroconvulsive therapy in treatment of depression].
The electroconvulsive therapy (ECT), which provokes a generalized epileptic seizure by an electrical stimulus, was first administered in 1938 and performed without anesthesia during thirty years. Nowadays, ECT is carried out using brief anesthesia (preferably methohexital) and skeletal muscle relaxation (succinylcholine) to avoid fearful complications like bone and muscle fractures. ECT is a safe treatment without absolute contraindications; the treatment risk corresponds to the risk of general anesthesia. ⋯ Brief pulse stimulation, unilateral nondominant electrode placement and individual stimulus titration with respect to seizure threshold (EEG monitoring is required!) can minimize cognitive side effects. The apprehension that ECT could cause prolonged amnesia and structural brain damage has not been confirmed by the available scientific data. Modern brain imaging methods could elicit the until now unknown mode of action of ECT.