[Medical continuity in the supply psychiatry before and after implementation of the new working hours act based on the example of the psychiatric department in the Danube hospital Vienna]. / Ärztliche Kontinuität in der Versorgungspsychiatrie vor und nach Einführung des Arbeitszeitgesetzes-Neu am Beispiel der psychiatrischen Abteilung des Donauspitals in Wien.

A successful and sustainable treatment of psychiatric patients is based on intensive relationship work. After the introduction of the new Working Hours Act the standards of evidence-based treatment are endangered. Using the data of the official working schedule of the Psychiatric Department of the Danube hospital in Vienna, before and after the introduction of the new Working Hours Act, we demonstrate a significant decrease of the medical consistency of the patient-related doctors. New approaches must be considered in order to solve this problem of quality.

Influence of intravenous administration of the antipsychotic drug benperidol on the QT interval.

A group effect is generally assumed regarding the prolongation of the QT interval through butyrophenone antipsychotics like haloperidol. Consequently intravenous administration of benperidol is seen critically notwithstanding sparse evidence; thus benperidol and haloperidol were compared regarding their cardiac risk of prolonging the QT interval when administered intravenously for acute sedation of psychotic patients. The QT interval was measured by a 12-lead ECG. For the correction of QT values Bazett's formula was used. The resulting QTc intervals of the benperidol and the haloperidol group were compared using Mann-Whitney U-test. Our data provide statistical evidence for benperidol being less prone to cause QTc prolongation than haloperidol (p = 0.049). The results of our study indicate a more favourable risk profile of benperidol compared to haloperidol regarding QTc prolongation when administered intravenously.

[Manpower requirements for medical doctors in psychiatric departments of community hospitals--bottom-up calculation for the psychiatric department of Donauspital in Vienna]. / Ärztlicher Personalbedarf in der Versorgungspsychiatrie--eine "Bottom-Up" Personalbedarfsberechnung am Beispiel der Psychiatrischen Abteilung des Donauspitals in Wien.

BACKGROUND: Clinical psychiatry changed dramatically in the past 30 years. Clinical challenges are very different from those in old mental hospitals. Psychotherapy and sociotherapy are effective but very time-consuming parts of treatments of nearly every psychiatric disorder. Planning of staff resources based on the German "Psychiatrie Personalverordnung" does not match with modern quality requirements. As a result, the standards of evidence-based treatment cannot be offered to severely mentally ill inpatients. METHODS: We carried out a buttom-up calculation of medical staffing for the concrete patients considering diagnosis, and length of stay of the psychiatric department of the Danube hospital in Vienna 2013 and 2014. This is an 80 bed unit responsible for an area of 250,000 inhabitants, providing about 1100 admissions each year. RESULTS: The calculated yearly sum of working hours for medical doctors in the particular department was 39,527. When considering a net working-time of 80%, the actual number of medical staff should be at least doubled to allow psychiatric treatment according to current guidelines. CONCLUSIONS: Severely ill psychiatric patients seem to be undertreated because of low staffing of psychiatric departments.

Ocular blood flow and systemic blood pressure in patients with primary open-angle glaucoma and ocular hypertension.

PURPOSE: There is evidence that altered optic nerve head (ONH) blood flow may play a role in the development and progression of glaucoma. In the present study, the baseline characteristics were examined in a study population participating in a clinical trial in which the ocular hemodynamic effects of timolol and dorzolamide were compared. METHODS: One hundred forty patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT) were included in this trial and their baseline parameters compared with those of a group of 102 age-matched control subjects. Scanning laser Doppler flowmetry was used to measure blood flow in the temporal neuroretinal rim and the cup of the ONH. Pulsatile choroidal blood flow was assessed by laser interferometric measurement of fundus pulsation amplitude. In addition, hemodynamic parameters and mean arterial pressure were calculated in both groups. RESULTS: All ocular hemodynamic parameters were significantly lower in the POAG/OHT group compared with the healthy control group (P < 0.001 each). In addition, a significant positive correlation between laser Doppler flowmetry readings and mean arterial pressure was observed in patients with glaucoma but not in healthy control subjects. Likewise, the correlation coefficient between fundus pulsation amplitude and mean arterial pressure was higher in patients with glaucoma than in healthy control subjects. CONCLUSIONS: The present study indicates reduced ONH and choroidal blood flow and an abnormal association between blood pressure and ocular perfusion in patients with primary open-angle glaucoma or ocular hypertension, independent of topical antiglaucoma medication. Hence, vascular dysregulation appears to be an early manifestation in glaucoma that is not caused by pharmacologic intervention.