Wiener medizinische Wochenschrift
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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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Systematic literature searches in bibliographic databases are an essential step in constructing systematic reviews and health technology assessments. The purpose of this kind of search is to identify as many relevant references on a given topic in electronic databases as possible. This article begins with describing the search process and continues with the basics of searching electronic databases. By delivering insight into the functionalities of databases and possibilities to search them (particularly PubMed), an understanding of potentials and weaknesses of systematic literature searches should be established.
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Wien Med Wochenschr · Jan 2008
Case Reports[Palliative therapy in bronchial carcinoma--implanted delivery system and ports].
This case report of a 54-year-old patient, with a metastasized non-small cell bronchial carcinoma, shows us the different ways in pain therapy alternatives. We report the possibility of using spinal delivery systems (especially epidural/intrathecal) in palliative therapy, if like in this case oral applicated opioids were not very successful. We discuss the advantages and disadvantages of this method and point out the possible side effects. Finally, we conclude that it has to be decided on a case per case basis, if this therapy is applicable or not.
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The successful treatment of acute postoperative pain remains a great challenge despite sufficient treatment concepts, including systemic and regional analgesia techniques. The efficacy of these strategies has been proved when they are adopted at the clinical conditions of the patient as well as at the requirements of the surgical procedure. The implementation of an acute pain service improves patient satisfaction and accelerates postoperative rehabilitation.