Wiener medizinische Wochenschrift
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Wien Med Wochenschr · Oct 2013
Review[Procedural organisation: surgical and anaesthesiological management in hip fractures].
In patients with hip fractures, in order to reduce the high number of general complications and those associated with the specific treatment, the functional loss and cognitive impairment, implementation of co-ordinated, multidisciplinary treatment pathways, and rehabilitation, is mandatory. The imminent treatment of proximal femoral fracture consists of major orthopaedic surgery in most cases (total or partial hip arthroplasty, osteosynthesis). After the diagnosis of a hip fracture, an adequate pain medication should be initiated. ⋯ Medical abnormalities should be optimized within 24 to 48 h, or an increased perioperative risk due to comorbidities has to be accepted. The timing and the course of further preoperative diagnostic examinations and therapeutic interventions should be co-ordinated between the involved medical disciplines. After the operation a structured screening for delirium should be initiated and further evaluation of patient's nutrition, fall-associated medication, living conditions and osteoporosis treatment has to be performed.
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Wien Med Wochenschr · Aug 2012
Review Comparative Study[Transcatheter aortic valve replacement: when should it be used in aortic stenosis?].
30% of patients with significant aortic stenosis are not considered for operative aortic valve replacement because of the high perioperative risk. An alternative catheter based option for these patients is the transcatheter aortic valve replacement (TAVI). In general, there are two approaches for TAVI: transfemoral and transapical. ⋯ First clinical trials in a high-risk population show a promising outcome. Therefore TAVI offers a reasonable therapy option for patients with high perioperative risk. Further long-term clinical trials are still pending.
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Wien Med Wochenschr · Jul 2011
Review Comparative Study[Actual state and perspectives of e-health in Austria and international--an overview].
eHealth will influence the development of the Austrian health and social care significantly. The main part will be the implementation of an electronic health record. There are many hospital and outpatient information systems already implemented and the challenge is to enable a patient-centered communication of all health care providers by defining technical standards and the organizational and legal framework. ⋯ Also, companies offering information systems have to improve the usability of their systems. One very important application is the filtering of relevant information according to a user profile and the optimal presentation in tables and graphs. The stepwise modular implementation and the use of international standards can be considered as a very positive approach to eHealth in Austria.
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Wien Med Wochenschr · Apr 2011
ReviewThe role of vasopressin and terlipressin in catecholamine-resistant shock and cardio-circulatory arrest in children: review of the literature.
Arginine-vasopressin (AVP) and terlipressin (TP) are used as rescue drugs for states of shock and cardio-circulatory failure. ⋯ No firm recommendations on the use of AVP/TP in children with severe forms of cardio-circulatory failure can be issued.
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Wien Med Wochenschr · Apr 2011
ReviewThe role of milrinone in children with cardiovascular compromise: review of the literature.
Cardiovascular instability is a common complication in children after cardiac surgery and in various forms of shock. ⋯ There are a limited number of RCTs in children that suggest a beneficial effect of milrinone in the optimization of cardiovascular function after cardiac surgery and in septic shock.