Wiener medizinische Wochenschrift
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Wien Med Wochenschr · Jan 2001
Review[Radiological diagnosis of adult respiratory distress syndrome (ARDS)].
The bedside chest radiograph represents the imaging modality of choice for diagnosis and monitoring of adult respiratory distress syndrome (ARDS). Imaging findings are strongly influenced by means of mechanical ventilation therapy. ⋯ With CT, the understanding of the underlying pathophysiology and the effects of ventilation therapy (PEEP) could be improved. The role of CT in the clinical routine is still limited due to the high risk to transport patients with ARDS.
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Pain in the temporomandibular joint is often the result of internal derangement, other causes are traumatic, functional or inflammatory processes. Conventional radiography is indicated in case of suspected trauma or for specialised preoperative measurements to plan the treatment of various facial dysplasias. MRI and CT should be used in the context with the results of clinical investigation and of axiography to differentiate the various functional and morphological abnormalities of this joint.
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An acute abdomen may result from various diseases, with appendicitis, cholecystitis, pancreatitis, and obstruction of the small and the large bowel as the leading causes. The quality of diagnostic imaging has been improved within the last years especially by recent developments of cross-sectional imaging modalities. Sonography is an efficient modality for detecting cholecystitis and appendicitis. Spiral computed tomography is the modality of choice in case of suspected bowel obstruction or pancreatitis.
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Wien Med Wochenschr · Jan 2001
Review[Angiotensin II type-1 receptor antagonists and diabetes mellitus].
Arterial hypertension is a major risk factor for microangiopathic diabetic complications and associated with an increased cardiovascular morbidity and mortality. An intensified antihypertensive treatment reduces microangiopathic complications and cardiovascular morbidity and mortality in diabetic patients. Even in normotensive type 1 and type 2 diabetic patients, the treatment with ACE inhibitors may prevent the later development of diabetic nephropathy. ⋯ Further, it is unknown whether different phenotypes of the ACE gene (DD, II polymorphism) require different therapeutic options. In conclusion, treatment with angiotensin II receptor antagonists is well-tolerated and has no adverse effects on metabolic control in diabetic patients. The beneficial effect on microangiopathic complications however has to be proven in randomized long-term studies in direct comparison with ACE inhibitors, which were clearly shown to delay the development and progression of diabetic nephropathy.
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Wien Med Wochenschr · Jan 2001
Review Comparative Study[Antifungal prophylaxis in neutropenic patients].
During the last two decades the incidence of systemic fungal infections has been rising steadily. The prognosis of infected patients is often poor and the therapeutic strategies are limited. The prophylaxis of systemic fungal infections thus appears worthwhile. ⋯ Due its toxicity profile prophylactic amphotericin B should be used only for selected cases and in clinical studies. Nystatin can be used topically whenever topical amphotericin B is not well tolerated. All currently available prophylactic antimycotics bear the risk of either unsatisfactory effectiveness or severe toxicity.