Ameos Klinikum Inntal

Carbon monoxide (CO) can occur in numerous situations and ambient conditions, such as fire smoke, indoor fireplaces, silos containing large quantities of wood pellets, engine exhaust fumes, and when using hookahs.Symptoms of CO poisoning are nonspecific and can range from dizziness, headache, and angina pectoris to unconsciousness and death.This guideline presents the current state of knowledge and national recommendations on the diagnosis and treatment of patients with CO poisoning.The diagnosis of CO poisoning is based on clinical symptoms and proven or probable exposure to CO. Negative carboxyhemoglobin (COHb) levels should not rule out CO poisoning if the history and symptoms are consistent with this phenomenon. Reduced oxygen-carrying capacity, impairment of the cellular respiratory chain, and immunomodulatory processes may result in myocardial and central nervous tissue damage even after a reduction in COHb.If CO poisoning is suspected, 100% oxygen breathing should be immediately initiated in the prehospital setting.Clinical symptoms do not correlate with COHb elimination from the blood; therefore, COHb monitoring alone is unsuitable for treatment management. Especially in the absence of improvement despite treatment, a reevaluation for other possible differential diagnoses ought to be performed.Evidence regarding the benefit of hyperbaric oxygen therapy (HBOT) is scant and the subject of controversy due to the heterogeneity of studies.If required, HBOT should be initiated within 6 h.All patients with CO poisoning should be informed about the risk of delayed neurological sequelae (DNS).

The direct and indirect application of force can lead to isolated fractures in the area of ??the temporal bone. Very often these injuries arise in the context of traffic accidents, Brutality, falls or bicycle accidents. In Europe, injuries from projectiles rather to play a Subordinate role.

In otorhinolaryngological patients suffering from acute and chronic vestibular symptoms, beside peripheral vestibular disorders, central vestibular origins should also be considered possible. Downbeatnystagm is often displayed as a central vestibular lesion.

Das Susac Syndrom ist eine seltene Vaskulopathie, die durch eine Autoimmunreaktion gegen endotheliale oder intramurale Strukturen kleiner Arterien in Innenohr, Retina und Hirn ausgelöst wird. Betroffen sind überwiegend junge Frauen. Charakteristisch ist eine Trias aus sensorineuraler Schwerhörigkeit, Sehstörungen und neurologischen Defiziten. Tinnitus und Schwindel können ebenfalls auftreten. Wichtigste Differenzialdiagnose ist die Multiple Sklerose. Die unverzügliche Einleitung einer immunsuppressiven Therapie ist essentiell, um ein Fortschreiten der Erkrankung zu vermeiden. Weltweit sind ca. 300 Fälle beschrieben, wobei von einer deutlich höheren Dunkelziffer auszugehen ist. Durch ihre vielfältige Symptomatik und variable Ausprägung stellt diese Autoimmunerkrankung eine interdisziplinäre Herausforderung dar. Die Diagnose kann oft nur durch eine enge Zusammenarbeit von HNO, Neurologie und Ophthalmologie gestellt werden.

The aim of this study was to compare the efficacy of topiramate versus a placebo in the treatment of adiposity in women undergoing olanzapine therapy. We also assessed changes health-related quality of life, the patient's actual state of health, and psychologic impairments. The 10-week, random, double-blind, placebo-controlled study included 43 women who had been treated with olanzapine (mean dose 7.8 +/- 3.6 in the topiramate group and 7.2 +/- 3.1 in the placebo group) and had gained weight as a side effect. The subjects were randomly assigned to topiramate (n = 25) or a placebo (n = 18). Primary outcome measures were weight checks and self-reported changes on the scales of the SF-36 Health Survey, Bf-S Scale of Well-Being, and the Adjective Checklist EWL-60-S. Weight loss was observed and was significantly more pronounced in the topiramate-treated group (difference in weight loss between the 2 groups: 5.6 kg, 95% CI = -8.5, -3.0, P < 0.001). In comparison with the placebo group, significant changes on 7 (7/8) scales of SF-36 Health Survey (all P < 0.001), on all 6 scales of the EWL-60-S, and on the Bf-S were observed in the topiramate-treated subjects after 10 weeks. All patients tolerated topiramate well. Topiramate appears to be a safe and effective agent in the treatment of weight gain that occurred during olanzapine treatment. Significantly positive changes in health-related quality of life, the patient's actual state of health, and psychologic impairments were observed.

Whether the primary motivation for entering therapy significantly influences the results of inpatient psychotherapeutic treatment is subject to debate. The purpose of this study was to examine this question in women with generalized anxiety disorder. The monitored results from 54 female inpatients (29 who were highly motivated to enter therapy and 25 who were minimally motivated) were compared. The questionnaire for measuring psychotherapy motivation (FMP), the symptom checklist (SCL-90-R) and the questionnaire for measuring change of experience and behavior (VEV) were used to assess motivation and results of treatment. The patients were tested at admission and after the fourth and sixth weeks of therapy, at which time the patients with high primary motivation showed a significantly more marked reduction of anxiety symptoms (SCL-90-R, P < 0.01). These patients also had better test results on the VEV (P < 0.01). However, both quantitative and qualitative improvements in motivation for therapy were observed among the less motivated patients, and this improvement did not differ from that of the highly motivated group on most scales of the FMP (P < 0.05 to P = 0.43). Highly motivated patients with generalized anxiety disorder can profit significantly more from inpatient psychosomatic treatment than those who have less primary motivation. However, less motivated patients can show significant positive changes in developing motivation for therapy, as well as in the final results of treatment. Establishing and developing motivation prior to hospitalization might contribute to more efficient and cost-effective clinical treatment.

Treatments for aggression are based on the underlying causes and may combine pharmacological and environmental or psychotherapeutic measures. The aim of this study was to determine the effectiveness of family psychotherapy as a monotherapy for anger in female youth. Female youth from a randomized sample (381 families) were interviewed over the telephone. Those from 36 of the families complained of subjectively increased aggression owing to conflict at home. A total of 13 of these families were randomly selected and took part in a family therapy programme for 6 months. The control group comprised 12 families. The responder rate was 92.6%. Aggression and change in aggression were measured using the State-Trait Anger Expression Inventory (STAXI). In comparison with the control group, significant changes on all five scales of STAXI (State-Anger, Trait-Anger, Anger-In, Anger-Out, Anger-Control) were observed after 6 months in the treated subjects (differences in change between the two groups were between 5.7% and 28.6%). The results of this study show that ambulant family therapy appears to be a safe and effective method in the treatment of anger in aggressive female youth.