Wiener medizinische Wochenschrift
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Wien Med Wochenschr · Jan 2008
Review Comparative StudyThe neonatal coagulation system and the vitamin K deficiency bleeding - a mini review.
Coagulation factors do not cross the placental barrier but are synthesized independently by the conceptus. At birth, activities of the vitamin K dependent factors II, VII, IX, and X and the concentrations of the contact factors XI and XII are reduced to about 50% of normal adult values. The levels of the factors V, VIII, XIII, and fibrinogen are similar to adult values. ⋯ Subsequently, the actual schedule of vitamin K prophylaxis as recommended by the "Osterreichische Gesellschaft für Kinder- und Jugendheilkunde" is given as follows: i) the oral treatment of healthy full-term babies and orally fed preterm babies, ii) the parenteral treatment of small preterm and sick full-term babies, and iii) the treatment of mothers under medication with enzyme-inducing drugs with vitamin K during the last 15-30 days of pregnancy. The regimes of prophylactic vitamin K treatment of different countries are also given. Finally, the therapeutic use of vitamin K is addressed; the potential use of fresh-frozen plasma, prothrombin complex preparations, and recombinant factor VIIa is discussed.
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Wien Med Wochenschr · Jan 2008
Multicenter Study Comparative StudyEarly Austrian multicenter experience with palonosetron as antiemetic treatment for patients undergoing highly or moderately emetogenic chemotherapy.
Palonosetron is a new generation 5-HT3-receptor antagonist with a significantly prolonged half-life and a once-a-day administration compared to the conventional setrons. To evaluate the antiemetic efficacy of palonosetron in the daily hospital practice setting, a postmarketing study was carried out in Austria. ⋯ Palonosetron resulted in high antiemetic efficacy in this study. Female gender and age < or = 50 years should be particularly considered when the antiemetic regimen is selected.
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Wien Med Wochenschr · Jan 2008
Review Comparative Study[Opioid-induced bowel dysfunction: a literature analysis on pathophysiology and treatment].
Bowel dysfunction is a frequent and serious side effect of opioid analgetics. In spite of its common occurrence, in the course of clinical routine, it is frequently ignored or underestimated. Authors of the analysed literature widely agree that a prophylactic and routine pharmacotherapy is necessary. ⋯ Effective abatement of opioid-induced obstipation by opioid antagonists has been proven in numerous studies. However, the loss of analgesia and opioid withdrawal symptoms were described as adverse effects. Development of quaternary opioid antagonists such as methylnaltrexone was allowed for mitigating these adverse effects.
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Wien Med Wochenschr · Jan 2008
Comparative Study[Therapeutic hypothermia after cardiopulmonary resuscitation - pro and con].
After successful cardiopulmonary resuscitation (CPR), mild therapeutic hypothermia remains the only intervention with a fair evidence of improving outcomes. Randomized controlled trials reported a clinically important benefit, at least for selected victims of cardiac arrest. ⋯ Among those delivering acute and intensive care, three of four remain sceptical or do not use therapeutic hypothermia. Is this reluctance justified?
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Severe pain caused by multiple metastases in bones in a pediatric patient suffering from rhabdomyosarcoma, a solid tumor of childhood, made palliative sedation therapy after developing metastases in lung necessary. The premises for this therapy, the difference in the choice of drugs compared to adults and psychology of the dying child are discussed.