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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Autologous stem cell transplantation is an important option in the treatment of patients with multiple myeloma. 130 transplants using autologous marrow or peripheral stem cells were reported to the EBMT registry. The overall complete remission rate in evaluable patients was 48 percent. ⋯ Factors of importance for survival were the response to treatment before transplantation, the stage at diagnosis, and the number of chemotherapy treatment lines before transplantation. Further studies should compare autologous bone marrow transplantation to chemotherapy and allogeneic transplantation.
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Wien Med Wochenschr · Jan 1995
[Clinical diagnosis in sleep laboratory patients based on ICD-10, DSM-III-R and ICSD classification criteria].
For the diagnosis of sleep disorders, 3 different standardized classification systems are available: the International Statistical Classification of Diseases and Related Health Problems (ICD-10), the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R/DSM-IV) and the International Classification of Sleep Disorders (ICSD). These 3 classification schemata were comparatively evaluated in 50 sleep-disturbed patients who were admitted within 1 year to a non-specialized sleep laboratory for diagnostic evaluation and treatment. 17 female and 33 male sleep-disturbed patients, aged 54 +/- 12 years, were recorded polysomnographically in 3 subsequent nights (adaptation night, baseline/diagnosis night, treatment night) for measuring objective sleep quality. The subjective sleep quality as well as the subjective and objective awakening quality was assessed by means of rating scales, as well as psychometric and psychophysiological test battery. ⋯ Based on the DSM-III-R, 46% of the patients were diagnosed as insomnias based on another mental disorder, 38% as organic hypersomnias and 14% as parasomnias. Based on the ICSD Classification, sleep disorders associated with anxiety disorders were leading (30%), followed by sleep disorders based on affective disorders (16%), obstructive snoring (14%), primary snoring (8%) and sleep disorders based on neurological disorders (6%). While the broader ICD-10 and DSM-III-R diagnoses are syndrome-etiologically oriented and may be easily utilized by the practicing physician, the more narrowly defined, extensive, pathogenetically oriented polysomnographic features including ICSD diagnoses are suited better for the specialist.
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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.