Wiener medizinische Wochenschrift
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Wien Med Wochenschr · Feb 2011
Review Comparative StudyNew anticoagulants: pharmacology and clinical studies.
The marketing of new anticoagulant drugs has led us to review the development of rivaroxaban and apixaban (oral anti-Xa drugs) and dabigatran (an oral thrombin inhibitor). The results are different in terms of efficacy and tolerance. ⋯ Though the results are favourable for these orally active drugs in the orthopaedic setting, it is clear that only cardiological applications will give a final green light for these products. The future will be fascinating in this regard.
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Wien Med Wochenschr · Jan 2011
Review Comparative Study[Pseudoprogression or pseudoresponse: a challenge for the diagnostic imaging in Glioblastoma multiforme].
This methodological paper on magnetic resonance tomography imaging recalls the assessment criteria on therapy response of Glioblastoma multiforme as defined by David Macdonald in 1990 that have remained State of the Art since their first publication. It defines the terms "pseudoprogression", "radiation induced necrosis" and "pseudoresponse". ⋯ Therefore, the assessment criteria have been recently updated with the newly proposed "RANO criteria (Response assessment in Neuro-Oncology)". Furthermore, the potential of additional information to conventional MR by MR perfusion, MR diffusion and MR spectroscopy is briefly discussed.
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Wien Med Wochenschr · Nov 2010
Review Comparative Study[Possibilities in oncoplastic and reconstructive surgery for patients with breast cancer].
Although systemic treatment strategies are improving continuously, breast surgery still plays a central role in the management of breast cancer. Because breast conserving therapy is feasible in more than two thirds of breast cancer patients, breast surgeons should be aware of the different oncoplastic techniques. The development of skin sparing techniques combined with immediate reconstruction provides good cosmetic results in many cases in which mastectomy is required. Therefore the reconstructive element should be offered and integrated in the therapy plan as soon as mastectomy is indicated.
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Wien Med Wochenschr · Sep 2010
ReviewChondrosis of the disc - risk factor for osteoporotic vertebral fractures (biomechanical analysis).
Based on biomechanical analysis, we present an until now unrecognised new view on pathological interactive relations in basic functional motor segments of the spine (vertebra - disc - vertebra), elevating the risk of osteoporotic vertebral fractures. They are classified as follows: 1. Degenerative alterations of intervertebral disc (chondrosis); 1a) decrease of intervertebral disc viscoelasticity; 1b) increase of compressive and tensile stress in the intervertebral disc. ⋯ Osteoporosis of vertebrae; 2a) decrease of vertebra elasticity and strength; 2b) phenomenon of local elevated compressive stress in the vertebra fracture site. In the vertebral body endplate infraction or fracture site develop a locus minoris of resistance and it contributes to the progression of breaking the vertebra and its whole compression by loading the spine with compressive force. With regard to the fact that above-mentioned risk factors are influenceable, we suggest preventive measures.
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Drugs have been widely associated with the development of delirium in the elderly and represent the most common reversible cause of this condition. This is of importance since successful treatment depends on identifying the reversible contributing factors. Medications with anticholinergic properties, tranquilizers, analgesics and narcotics are common causes of drug-induced delirium. This article provides practical approach to prevent and recognise this condition, reviews the underlying neurotransmitter imbalances and reconsiders age-related changes of pharmacological effects, which may contribute to the development of delirium.