Wiener medizinische Wochenschrift
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Wien Med Wochenschr · Jan 2008
Review Comparative Study[Minimizing perioperative risk - an interdisciplinary effort].
Physicians involved in perioperative care have to face new challenges because of the continuing aging of the population and medical progress, which facilitates even more invasive surgery. The risk of surgical procedures is elevated in patients with cardiac co-morbidity necessitating an optimization of both clinical condition and preoperative therapy of these patients. ⋯ Physicians should start beforehand the interdisciplinary preparation of surgical patients as out-patients and should continue this approach during the stay in hospital. In this review, we describe the major perioperative cardiac, pulmonary and vascular risks for physicians involved in the treatment of surgical patients.
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Wien Med Wochenschr · Jan 2008
Review[Biologics in the early treatment of ankylosing spondylitis and related forms of spondyloarthritis].
New pathogenetic insights have identified the key role of TNF-alpha in inflammatory rheumatic diseases and have revolutionized the therapy of spondyloarthritides. TNF-alpha-antagonists specifically inhibit the pro-inflammatory effects of TNF-alpha. Clinical studies with infliximab (Remicade), Etanercept (Enbrel) or Adalimumab (Humira) in ankylosing spondylitis or related diseases demonstrate superior efficacy to conventional drugs like non-steroidal antirheumatic drugs or traditional disease modifying antirheumatic drugs.
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Wien Med Wochenschr · Jan 2008
Comparative Study[Standard operating procedures and operating room management: Improvement of patient safety and the efficiency of processes].
Financial pressures have led the way more efficiency in health care management. To decrease hospital costs a more proficient use of personal resources is required. The drive to increase efficiency with the concomitant increase in workload can cause a reduction in quality of patient care and of patient security. ⋯ OR management can control an efficient workflow and generate data concerning performance, costs and quality. SOPs lead to a standardisation of workflow in the OR and in patient treatment modalities. This guaranties a high quality in patient care and more safety despite an increase in work-load.
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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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This article about cohort studies is part of a methods series about study designs and their critical evaluation by the Ludwig Boltzmann Institute for Health Technology assessment. This article aims to describe the theoretical concept of cohort studies and their typical characteristics. Furthermore, it strives to highlight advantages and disadvantages of this study type and to make suggestions for the critical evaluation of the significance and validity of cohort studies. ⋯ Problems of blurring results by selection bias and confounding are also discussed. Cohort studies are applied in situations where the effects of environmental exposures are measured and rare side effects are identified but randomised controlled studies did not show significant results because of limitations. They are also used to assess the incidence of a disease or a condition.