Wiener Klinische Wochenschrift最新文献

{"title":"Association between diabetes mellitus and diverticulosis: a cross-sectional analysis.","authors":"Andreas Völkerer, Georg Semmler, Maria Flamm, Mathias Ausserwinkler, Gabriele Koch, Paul Thöne, Sarah Wernly, Hannah Hofer, Elmar Aigner, Christian Datz, Bernhard Wernly","doi":"10.1007/s00508-025-02633-4","DOIUrl":"https://doi.org/10.1007/s00508-025-02633-4","url":null,"abstract":"<p><strong>Introduction: </strong>Diverticulosis is a multifactorial condition influenced by genetic, age-related and cardiometabolic factors. Given overlapping risk profiles, its association with diabetes mellitus remains of interest, although evidence is inconsistent.</p><p><strong>Methods: </strong>In a retrospective cohort study of 5924 asymptomatic individuals undergoing colorectal cancer screening in Austria, participants were stratified by glycemic status and assessed for diverticulosis via endoscopy. Incidence rate ratios (IRRs) were estimated using Poisson regression with robust standard errors, sequentially adjusting for demographic and cardiometabolic variables. Interaction and sensitivity analyses evaluated effect modification by age, sex, and metabolic parameters.</p><p><strong>Results: </strong>The prevalence of diverticulosis increased with diabetes status: lowest in participants without diabetes (29%), intermediate in prediabetes (41%), and highest in diabetes (46%; p < 0.001). In fully adjusted models, prediabetes remained moderately associated with diverticulosis (IRR: 1.10; 95% confidence interval, CI: 1.01-1.21; p = 0.034), while the association with diabetes was attenuated (IRR: 0.98; 95% CI: 0.86-1.11; p = 0.743). Right-sided diverticulosis showed a weak residual association with prediabetes (RRR: 1.62; p = 0.012) but not with diabetes. Associations were modified by age, sex, body mass index (BMI) and hypertension, with stronger effects observed in younger, female, non-obese, normotensive individuals.</p><p><strong>Conclusion: </strong>The association between (pre)diabetes and diverticulosis is largely attributable to shared metabolic risk factors. Observed signals for right-sided diverticulosis should be considered exploratory and hypothesis-generating, warranting further studies. Given the cross-sectional design, causality cannot be inferred and our findings should be interpreted as associations only.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Register and biobank on influence of assisted reproduction on pregnancy, maternal and neonatal outcome : A prospective multicenter medical data register and biobank.","authors":"Harald Zeisler, Florian Heinzl","doi":"10.1007/s00508-025-02626-3","DOIUrl":"https://doi.org/10.1007/s00508-025-02626-3","url":null,"abstract":"<p><strong>Background: </strong>Infertility affects 10-15% of couples worldwide. In Austria, the In Vitro Fertilization Fund supports assisted reproductive technology under specific conditions. While assisted reproductive technology is generally effective, its impact on pregnancy and neonatal outcomes remains under discussion.</p><p><strong>Methods: </strong>The Register and Biobank on the Influence of Assisted Reproduction on Pregnancy, Maternal and Neonatal Outcomes is a prospective multicenter register and biobank. It includes five in vitro fertilization centers and two obstetric departments in Vienna and Lower Austria. Standardized clinical and laboratory data are collected via electronic case report forms and pseudonymized using a unique code linking fertility and obstetric data. Recruitment started in 2022, and biobanking (blood, urine, placenta, and umbilical cord samples) was added in 2025.</p><p><strong>Results: </strong>By early 2025, complete data were available for 366 patients. Male infertility was the most frequent indication (231 cases), followed by tubal factor infertility, polycystic ovary syndrome, and endometriosis. The register enables linking of assisted reproductive technology procedures with detailed pregnancy and neonatal outcomes such as Apgar scores, delivery mode, and Neonatal Intensive Care Unit transfers.</p><p><strong>Conclusion: </strong>This register offers a unique real-world dataset connecting assisted reproductive technology treatment with maternal and neonatal outcomes. Continued recruitment will support hypothesis-driven research and improve assisted reproductive technology practices. It underlines the importance of high-quality, longitudinal data to understand potential assisted reproductive technology-related risks and guide future care.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to \"Comments on the impact of artificial intelligence on the adenoma detection rate: comparison between experienced, intermediate and trainee endoscopists' adenoma detection rate\".","authors":"Sebastian Bernhofer, Julian Prosenz, David Venturi, Andreas Maieron","doi":"10.1007/s00508-025-02641-4","DOIUrl":"https://doi.org/10.1007/s00508-025-02641-4","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calcified ears due to relapsing polychondritis.","authors":"Mustafa Yeşilyurt, Gökhan Polat","doi":"10.1007/s00508-025-02640-5","DOIUrl":"https://doi.org/10.1007/s00508-025-02640-5","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutcracker syndrome in an Alport family: a tricky case.","authors":"Sophie Henriette Schmidt, Diego Parada Rodriguez, Daniela Maria Allmer, Oliver Schlager, Sylvia Metz-Schimmerl, Franco Laccone, Alice Schmidt, Gere Sunder-Plassmann","doi":"10.1007/s00508-025-02629-0","DOIUrl":"https://doi.org/10.1007/s00508-025-02629-0","url":null,"abstract":"<p><p>Diagnosing nutcracker syndrome can be challenging, particularly when symptoms are suggestive of more common conditions. In such cases, the syndrome is often not considered as an initial differential diagnosis. We report the case of a 30-year-old woman with a history of microhematuria since childhood as well as previous episodes of macrohematuria, abdominal pain and urinary tract infections. As her mother, sister and other relatives are affected by Alport syndrome and chronic kidney disease, this was primarily suspected to be the cause of the symptoms; however, serum creatinine was within the normal range, albuminuria was absent and repeated genetic testing for the pathogenic COL4A5 variant inherited in her family was negative. Given the persistence of the symptoms, magnetic resonance angiography was performed, revealing findings consistent with symptomatic nutcracker syndrome. The patient declined interventional or surgical treatment. This case illustrates the diagnostic challenge of nutcracker syndrome, particularly when symptoms overlap with more common and reasonable conditions. It underscores the importance of considering vascular causes in patients with unexplained hematuria, even in the context of a family history of Alport syndrome.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In the shadow of the \"psychopharmacological revolution\": Malaria fever, insulin coma, cardiazol and electroconvulsive therapy at the Vienna Psychiatric University Clinic, 1951-1969.","authors":"Gernot Heiss","doi":"10.1007/s00508-025-02592-w","DOIUrl":"https://doi.org/10.1007/s00508-025-02592-w","url":null,"abstract":"<p><p>The study presents the results of a 2-year research project on the therapeutic practices in psychiatry at the University Clinic of Vienna under the leadership of Hans Hoff from 1951 to 1969. Hoff took over as Head of the Department of Psychiatry and Neurology shortly after his return to Vienna from whence he had had to flee after Austria's \"Anschluss\" (annexation) to Nazi Germany in 1938 because of his Jewish background. The focus of the investigation was on the extent, methods and justifications for the application of four highly invasive somatic treatments, which were developed during the interwar period and continued to be practiced at the Vienna Clinic during the years under study. These treatments included electroconvulsive therapy (ECT), cardiazol-induced convulsion therapy, insulin coma therapy and malaria fever therapy, the latter also used beyond its traditional application for neurosyphilitic conditions. The study analyzes the medical records of patients from the adult departments (aged 15 years and older) who were diagnosed with neurosyphilis, intellectual disabilities, schizophrenia, affective disorders, or psychopathy (a total of 14,919 patient records). Additionally, it examined how these therapies were discussed in professional publications from Austria, Switzerland, Germany, France, and Great Britain, and to what extent their application was considered state-of-the-art during the transition to new pharmacological treatments.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Recommendations for the Diagnosis and Treatment of Chronic Kidney Disease (CKD) by the Austrian Society of Nephrology].","authors":"Sara H Ksiazek, Martin Windpessl, Emanuel Zitt, Michael Rudnicki, Kathrin Eller, Christoph Schwarz, Marlies Antlanger, Sabine Schmaldienst, Daniel Cejka, Rainer Oberbauer, Alexander R Rosenkranz, Marcus D Säemann","doi":"10.1007/s00508-025-02590-y","DOIUrl":"10.1007/s00508-025-02590-y","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) affects over 800 million people worldwide, yet only about 6-10% of those affected are aware of their condition. Limited public awareness and insufficient structural measures in the healthcare system lead to the fact that CKD is frequently not diagnosed or diagnosed after a delay and therefore insufficiently treated. Current projections estimate that CKD could become the fifth leading cause of death worldwide by 2040, if timely and effective measures to increase awareness and early detection are not implemented. This article presents practice-oriented guidelines for the screening, diagnostics and treatment of CKD in Austria. It outlines for which risk groups screening is recommended and describes how physicians can diagnose and treat CKD across all medical specialties. A key aspect of these guidelines is the presentation of pharmacological treatment options that slow disease progression, with specific indications and practical clinical recommendations for their use. Furthermore, the recommendations address nationally defined referral criteria to nephrology specialists in Austria and discusses possible CKD-related complications along with appropriate treatment strategies.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":"137 Suppl 8","pages":"243-258"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical-Pathological Conference Series from the Medical University of Graz : Case No 183: A 57-year-old farmer with fever, cough, maculopapular rash and bicytopenia.","authors":"Elisabeth Fabian, Maximilian Gornicec, Nikolaus Kneidinger, Albert Wölfler, Florentine Moazedi-Fürst, Marijan Puseljic, Michael Fuchsjäger, Robert Krause, Guenter J Krejs","doi":"10.1007/s00508-025-02586-8","DOIUrl":"https://doi.org/10.1007/s00508-025-02586-8","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Was kommt nach CDK4/6-Inhibition? Perspektiven beim fortgeschrittenen Mammakarzinom.","authors":"Vanessa Castagnaviz, Anna Fenzl, Michael Gnant, Rupert Bartsch","doi":"10.1007/s00508-025-02622-7","DOIUrl":"https://doi.org/10.1007/s00508-025-02622-7","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Free fibula flap for secondary mandibular reconstruction after gunshot injuries in Tigray, northern Ethiopia : A 5-year review of microsurgical challenges and outcomes in a war zone.","authors":"Viktoria Koenig, Jakub Holoubek, Tomas Votruba, Julian Joestl, Tomas Kempny","doi":"10.1007/s00508-025-02615-6","DOIUrl":"https://doi.org/10.1007/s00508-025-02615-6","url":null,"abstract":"<p><strong>Background: </strong>Surgical care in Africa, particularly in conflict regions like Tigray, Ethiopia, faces unique challenges. Over 5 years a team of plastic and trauma surgeons conducted 5 humanitarian missions at Mekelle Referral University Hospital to reconstruct mandibular defects caused by shotgun injuries using free fibula flaps.</p><p><strong>Methods: </strong>This retrospective study analyzed 44 free fibula transfers performed between 2019 and 2023, with 33 cases involving mandibular reconstruction. Flaps were elevated using magnifying loupes; microscopes were employed when electricity was available. Postoperative flap monitoring and follow-up visits were conducted when feasible.</p><p><strong>Results: </strong>Of 33 mandibular reconstruction patients (3 females, 30 males; mean age 29.5 years), a microscope was available in only 28% of cases due to electricity interruptions. The mean surgery time was 532.7 min. The flap failure rate was 24% (8 of 33 cases), 8 microsurgical complications required intraoperative revision and 6 nonmicrosurgical complications (18%) were observed, primarily wound infections. Early outcomes varied: 21% had good results, 24% acceptable, 27% moderate, 24% no significant change and 3% worsened. Follow-up was incomplete; 29% of patients did not attend any postoperative visits.</p><p><strong>Conclusion: </strong>Microsurgical reconstruction in conflict-affected, resource-limited settings like Tigray is feasible but complicated by factors such as inconsistent electricity and loss to follow-up. Despite these challenges, acceptable complication and flap survival rates were achieved, highlighting the importance and feasibility of complex reconstructive surgery even under adverse conditions. Limitations include difficulties ensuring standardized operative environments and consistent long-term follow-up.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}