Wiener medizinische Wochenschrift
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The term "decompression illness (DCI)" is a disorder which arises from the presence of ectopic gas bubbles following decompression. Scuba diving poses the risk of two typically clinical syndromes: decompression sickness (DCS) and arterial gas embolism (AGE). DCS results from the formation of gas bubbles in the tissues of the body and in the blood due to rapid reduction of the environmental pressure. ⋯ Although the pathophysiological mechanisms of these two disorders are quite different, both of them lead to the same result: inert gas bubbles that may cause impairment of vital functions due to hypoxia. Recognizing the signs and symptoms of DCI is the first step of the therapy. The emergency treatment contains: basic life support, advanced life support--if necessary, horizontal positioning of the victim, administration of 100% normobaric oxygen via face mask or endotracheal tube, rehydration, rapid transportation to the nearest emergency department/hyperbaric facility for definitive treatment in order to prevent serious neurological sequelae.
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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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Wien Med Wochenschr · Jan 1999
Randomized Controlled Trial Multicenter Study Clinical TrialPAT--the Preventive Allergy Treatment Study design and preliminary results.
The Preventive Allergy Treatment Study, the PAT Study, is a European multi-center study. The end-point is to show in what capacity allergen specific subcutaneous immunotherapy can reduce the outcome of asthma in children with allergic rhinoconjunctivitis sensitized to birch and/or timothy pollen. Two hundred and ten children aged from 5 to 13 years were included in the study. ⋯ Preliminary data show that immunotherapy has been effective, it has been safe and statistically significantly less children in the actively treated group had asthmatic symptoms than children in the control group. Data have not been evaluated from all centers at the moment. The study is a prospective follow-up study, the patients' data will be evaluated next time in the year 2002.
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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[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.