Wiener medizinische Wochenschrift
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Wien Med Wochenschr · Jan 1996
Review[Legal limits of assisted death: exemplified by amyotrophic lateral sclerosis].
The article discusses the question to what extent the physician may offer aid in dying to the terminally ill patient. The author comes to the conclusion that the withdrawal of artificial ventilation (after application of anesthesia) is allowed and even a physician's duty if the patient refuses further ventilation. Because the competent patient may refuse treatment at any time, a doctor's willful disregard of his patient's right to self-determination could also be regarded as battery [section 110 Penal Code).
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Wien Med Wochenschr · Jan 1996
[Methodology and problems in home monitoring of children with sleep-related respiratory disorders--perspectives].
In a pilot study we interviewed parents of 100 formerly home monitored infants about problems during the monitoring period. The duration of home monitoring was between 1 and 48 months (median 15 months). 95% of the parents reported false alarms. 66% of the infants had real alarms, in 50% of the infants interventions were necessary. 3% of the infants had to be resuscitated. Only 47% of the parents felt safe in the practice of resuscitation even though all parents had been trained before. Perspectives of improvement of home monitoring are discussed.
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Wien Med Wochenschr · Jan 1995
Randomized Controlled Trial Clinical Trial[Microinvasive, CT-controlled periradicular therapy in treatment of chronic intervertebral disk-induced functional disorders].
The disease of the spinal column is number 2 of common diseases world-wide and leads to high business- and commerce-related losses as well as to high expenses for the health care systems. An effective treatment of this disease is given by the microinvasive. CT controlled periradicular therapy (micro PRT). ⋯ After end of therapy, 83.3% (n = 30) had stopped the taking of analgesics and the neurologic deficit decreased significantly. Furthermore, significant reduction of prolapses could be observed at 60% of the patients in both study groups (n = 156). The CT scopic micro PRT with 40 mg Volon A leads to a significant improvement of pain and neurologic symptoms caused by chronical disk herniation.
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Wien Med Wochenschr · Jan 1995
Randomized Controlled Trial Clinical Trial[Therapy of Cheyne-Stokes respiration with nocturnal oxygen therapy].
Cheyne-Stokes respiration is common in patients with severe congestive heart failure and is associated with significant nocturnal oxygen desaturation and sleep disruption. The pathogenesis of Cheyne-Stokes respiration in patients with congestive heart failure has been well described and is related to prolonged circulation time between the lung and the carotid body mainly due to increased cardiac dimensions, reduced body stores of oxygen and carbon dioxide, disturbance of ventilation and respiratory control due to arousals and a relatively high hypercapnic ventilatory response. ⋯ In the following paper we describe a study designed to determine the impact of nasal nocturnal oxygen on Cheyne-Stokes respiration, sleep, peak oxygen consumption during bicycle exercise, cognitive function evaluated by the trailmaking test and daytime symptoms in patients with severe congestive heart failure. The study is designed as a randomized, cross-over, double-blind, placebo-controlled protocol on about 20 patients with a left ventricular ejection fraction < 35%.
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Wien Med Wochenschr · Jan 1995
Randomized Controlled Trial Clinical Trial[The European experience with megadose therapy and autologous bone marrow transplantation in solid tumors with poor prognosis Ewing sarcoma, germ cell tumors and brain tumors)].
Since 1984 a total of 2085 patients with solid tumors have been registered in the European Bone Marrow Transplantation Registry for Solid Tumors (EBMT-STR). The major aim of this registry is to supply data by retrospective analysis for the innovation of prospective, randomized studies. 104 Ewing's sarcoma patients received megatherapy followed by autologous bone marrow transplantation (MGT/ABMT). The 2-year overall survival was 31% in 14 patients with multifocal disease in first complete remission (CR1) and was 37% for 15 patients in second CR (CR2). (6 patients with local disease in CR1 have been excluded.) These results are better than observed under conventional dose chemotherapy. 67 patients were grafted with measurable disease showing a response rate of 72%. ⋯ Based on these results and a French randomized trial a prospective, randomized study is underway comparing MGT versus conventional chemotherapy in chemosensitive patients. 219 adults with malignant brain gliomas underwent a program consisting of surgery, MGT (BCNU in the majority)/ABMT and radiotherapy. The overall survival at 3 years was 12%, the median survival was 11 months after ABMT. Life quality after ABMT was good, but no major improvement in terms of prolonged survival was achieved.(ABSTRACT TRUNCATED AT 250 WORDS)