Wiener Klinische Wochenschrift最新文献

{"title":"Michaelina Wautier's self-portrait-Iconodiagnostic and hermeneutic analysis of arthritis in a rediscovered Flemish painter.","authors":"Franz Kainberger, Josef S Smolen","doi":"10.1007/s00508-026-02828-3","DOIUrl":"https://doi.org/10.1007/s00508-026-02828-3","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224878","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":"Overtriage of a physician-staffed prehospital emergency resource in Austria : An exploratory retrospective analysis.","authors":"Konstantin Bräu, Florian Welte, Christoph Beywinkler, Christian Fohringer, Martin W Dünser, Harald Willschke, Helmut Trimmel","doi":"10.1007/s00508-026-02846-1","DOIUrl":"https://doi.org/10.1007/s00508-026-02846-1","url":null,"abstract":"<p><strong>Background: </strong>Appropriate emergency medical dispatch aims to balance rapid deployment of physician-staffed emergency medical services against unnecessary utilization of limited prehospital resources. Data on physician dispatch appropriateness in Austrian emergency medical services remain scarce. This study evaluated overtriage of a physician-staffed emergency medical response vehicle in Lower Austria.</p><p><strong>Patients and methods: </strong>This single-center retrospective study included all primary dispatches of a physician-staffed emergency medical response vehicle between January and December 2022. Dispatches were retrospectively classified as appropriately triaged or overtriaged based on predefined criteria. Secondary objectives were overtriage across the 10 most frequent dispatch codes and the association between priority level and dispatch appropriateness.</p><p><strong>Results: </strong>Overall, 3454 primary dispatches were analyzed and 2629 dispatches were classified as overtriage (76.1%; 95% confidence interval, CI 74.7-77.5%). Of these, 38.4% represented dispatches without patient contact and 37.7% were classified as low acuity overtriage, while only 23.9% (95% CI 22.5-25.3%) were retrospectively classified as appropriately triaged. The 10 most frequent dispatch codes accounted for 41.8% of all dispatches and demonstrated a combined overtriage rate of 77.1% (95% CI 74.8-79.2%). Priority level was not associated with physician dispatch appropriateness (ρ = -0.002, p = 0.92).</p><p><strong>Conclusion: </strong>In this study, over three quarters of physician-staffed emergency medical service dispatches did not meet the predefined retrospective criteria for physician involvement, although about half of these overtriaged cases were cancelled before physician-patient contact. Among cases with patient contact, 61% did not meet the predefined criteria for physician-level care. These findings highlight substantial potential to refine emergency physician-dispatch criteria.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196946","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":"Clinical-Pathological Conference Series from the Medical University of Graz : Case No 186: A 33-year-old plumber with fever and acute liver injury.","authors":"Elisabeth Fabian, Stefan Hatzl, Annkristin Heine, Robert Krause, Christine Beham-Schmid, Peter Fickert, Guenter J Krejs","doi":"10.1007/s00508-026-02815-8","DOIUrl":"https://doi.org/10.1007/s00508-026-02815-8","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184591","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":"50. Jahrestagung der Österreichischen Gesellschaft für Pneumologie & 10. Jahrestagung der Österreichischen Gesellschaft für Thoraxchirurgie.","authors":"","doi":"10.1007/s00508-026-02836-3","DOIUrl":"https://doi.org/10.1007/s00508-026-02836-3","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184550","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":"Prehospital recognition of sepsis is associated with earlier antibiotic administration in the emergency department : A retrospective cohort study.","authors":"L Romen, M Binder-Krieglstein, H Herkner, A Lipa, H Losert, C Schoergenhofer, M Schwameis, J Grafeneder","doi":"10.1007/s00508-026-02842-5","DOIUrl":"https://doi.org/10.1007/s00508-026-02842-5","url":null,"abstract":"<p><strong>Background: </strong>Early antibiotic administration is crucial in the treatment of sepsis. The impact of prehospital sepsis recognition remains unclear. We investigated whether an emergency medical services (EMS) suspicion of sepsis was associated with earlier antibiotic administration after patients arrived at the emergency department (ED).</p><p><strong>Methods: </strong>We conducted a retrospective, single-center observational cohort study involving adult patients (≥ 18 years) admitted via EMS between January 2022 and June 2025 with a sepsis diagnosis made in the ED. Prehospital sepsis recognition was defined as documentation of the term \"sepsis\" in the EMS protocol. The primary outcome was the percentage of patients who received antibiotic treatment within 1 h of ED admission. Logistic regression was used to adjust for age, sex, and illness severity (quick sequential organ failure assessment [qSOFA]).</p><p><strong>Results: </strong>We included 134 patients (43% female; mean age 71 ± 15 years). The EMS suspected sepsis in 30 patients (22%). Among these, 63.3% received antibiotics within 1 h of ED admission, compared with 19.2% of patients without an EMS suspicion (p < 0.001). The median time to antibiotic administration was shorter in the EMS suspected group (32.0 min, interquartile range, IQR 16.5-76.8 min versus 124.5 min, IQR 72.5-211.5 min; p < 0.001). Prehospital sepsis suspicion was independently associated with antibiotic administration within 1h (adjusted odds ratio, OR 5.77, 95% confidence interval, CI 2.14-16.4; p < 0.001).</p><p><strong>Conclusion: </strong>Prehospital recognition of sepsis by EMS was strongly associated with earlier antibiotic treatment after ED admission. This highlights the potential of systematic sepsis detection in prehospital settings.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184626","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":"Dynamic course and outcomes of acute-on-chronic liver failure in the intensive care unit : Insights from a real-world cohort.","authors":"Patrick Haselwanter, Max Oberweger, Marian Strunz, Petrus Aho, Lorenz Balcar, Georg Semmler, Benedikt Simbrunner, Bernhard Scheiner, Albert Friedrich Stättermayer, Marlene Riedl-Wewalka, Monika Schmid, Thomas Reiberger, Michael Trauner, Christian Zauner, Mathias Schneeweiss-Gleixner","doi":"10.1007/s00508-026-02829-2","DOIUrl":"https://doi.org/10.1007/s00508-026-02829-2","url":null,"abstract":"<p><strong>Background: </strong>Acute-on-chronic liver failure (ACLF) frequently requires intensive care unit (ICU) management, yet real-world data on dynamic disease course, organ support and mortality predictors in critically ill ACLF patients remain scarce.</p><p><strong>Methods: </strong>All ACLF patients admitted to a tertiary care hepatology ICU between 2013 and 2023 were analyzed in this retrospective single-center study for ACLF grade trajectories, organ support, and independent predictors of 90-day mortality.</p><p><strong>Results: </strong>Among 209 patients (228 admissions), 54.4% had ACLF grade 3 at ICU admission (median CLIF‑C ACLF 56). Most patients required vasopressors (86.8%), invasive mechanical ventilation (59.6%), and renal replacement therapy (53.5%). The ICU and 90-day survival were 56.1% and 34.2%, respectively. One third of the patients (33.3%) showed improvement in ACLF grade during the ICU stay, including grade 3 patients, indicating meaningful reversibility under comprehensive organ support. The CLIF‑C ACLF score (OR: 1.07, 95% CI: 1.03-1.11, p < 0.001) and the peak noradrenaline dose (OR: 13.5, 95% CI: 3.18-69.7, p < 0.001) were identified as independent predictors of 90-day mortality.</p><p><strong>Conclusion: </strong>Critically ill ACLF patients retain potential for partial recovery under full organ support, justifying ICU escalation even in grade 3 disease. Peak noradrenaline dose, alongside the established prognostic scores, provides a readily available parameter to guide individualized decision-making regarding full organ support or timely de-escalation.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184667","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":"[Perimenopause and postmenopause: acute diagnostic and therapeutic aspects for the DACH region : Consensus paper of the Austrian Society for Gynecology and Obstetrics (OEGGG), the German Society for Gynecology and Obstetrics (DGGG), the German Menopause Society (DMG) and the Swiss Society for Gynecology and Obstetrics (SGGG)].","authors":"Bettina Toth, Johannes Ott, Doris Maria Gruber, Gert Naumann, Susanna Weidlinger, Katrin Schaudig","doi":"10.1007/s00508-026-02832-7","DOIUrl":"https://doi.org/10.1007/s00508-026-02832-7","url":null,"abstract":"<p><p>There are currently approximately 13 million women in the DACH region who are in the perimenopause or postmenopause. This phase of life leads to relevant physical, psychological, and metabolic changes. Unfortunately, even now, many symptoms remain untreated, which has a major impact on women's quality of life and ability to work. Modern approaches to menopausal hormone therapy as well as nonhormonal treatment options, are designed to specifically improve the health and quality of life of affected women; however, these approaches are still underutilized. This DACH consensus paper reviews the currently available evidence, addresses risk factors, and provides specific recommendations for daily clinical practice.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171136","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":"Even short-term obesity leads to subclinical dysfunction of both ventricles in young individuals.","authors":"Karolina Angela Sieradzka Uchnar, Ingrid Schusterova, Stefan Toth, Ladislav Takac, Dominik Pella, Silvia Gurbalova, Tibor Poruban","doi":"10.1007/s00508-026-02835-4","DOIUrl":"https://doi.org/10.1007/s00508-026-02835-4","url":null,"abstract":"<p><strong>Objective: </strong>Obesity affects over 1.5 billion adults worldwide, necessitating early cardiovascular detection. We identified subclinical biventricular dysfunction in young overweight/obese individuals.</p><p><strong>Methods: </strong>In this prospective study (2023-2024), 60 participants were enrolled: 30 overweight/obese individuals (BMI ≥ 25 kg/m²) and 30 age-sex-matched controls. Conventional echocardiography, tissue Doppler imaging, and 2D speckle tracking strain analysis were performed. Stepwise multiple linear regression identified independent predictors of RWT, LV GLS, e' medial, RV S' and RV_FWLS, entering BMI, age, sex, blood pressure, heart rate, SPAP (RV_FWLS) and metabolic variables (obese group). Variables required p < 0.10 in univariate analysis.</p><p><strong>Results: </strong>Obese individuals showed LV remodeling: greater posterior (9.1 ± 1.2 vs. 8.1 ± 1.2 mm, p < 0.01) and septal wall thickness (10.1 ± 1.4 vs. 8.5 ± 1.3 mm, p < 0.001), LV mass index (76.6 ± 18.2 vs. 67.9 ± 14.6 g/m², p < 0.05), and RWT (0.39 ± 0.04 vs. 0.37 ± 0.06, p < 0.005). BMI independently predicted RWT (β = 0.42, p < 0.005). Despite preserved EF, LV GLS was impaired (-22.7 ± 6.1% vs. -23.4 ± 4.2%, p < 0.01). Reduced e' medial velocity (14.0 ± 2.7 vs. 15.3 ± 2.6 cm/s, p < 0.01) was predicted solely by BMI (β = -0.62, p < 0.0001). S' decreased (13.1 ± 1.7 vs. 14.2 ± 1.6 cm/s, p < 0.01). RV free wall strain (-20.9 ± 5.2% vs. -27.6 ± 4.1%, p < 0.001) and pulmonary systolic pressure (26.6 ± 5.8 vs. 22.7 ± 4.8 mm Hg, p < 0.01) were abnormal versus controls.</p><p><strong>Conclusion: </strong>Young overweight/obese individuals show early biventricular dysfunction, detectable particularly by speckle tracking, which may be more sensitive than conventional parameters and enable earlier prevention. Modest strain differences indicate long-term rather than immediate clinical relevance.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147405","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":"Severe alkalemia in the emergency department : Acid-base patterns, clinical presentation and short-term outcomes in hospitalized patients.","authors":"Philipp List, Gregor Lindner, Christoph Schwarz","doi":"10.1007/s00508-026-02840-7","DOIUrl":"https://doi.org/10.1007/s00508-026-02840-7","url":null,"abstract":"<p><strong>Introduction: </strong>Alkalemia is the most common acid-base disorder in hospitalized patients; however, data on patients with severe alkalemia admitted to the emergency department are limited. This study aimed to characterize the acid-base patterns of patients with severe alkalemia presenting to the emergency department and to describe the clinical presentation and short-term clinical outcomes of those requiring hospitalization.</p><p><strong>Patients, material and methods: </strong>We conducted a retrospective analysis of arterial and venous blood gas measurements and medical records of all adult nontrauma patients admitted to the emergency department of a tertiary university hospital in Austria with a pH> 7.55, between 1 June 2022, and 31 December 2023.</p><p><strong>Results: </strong>Among 215 patients with severe alkalemia, 84 (39%) required hospitalization. Acute respiratory alkalosis was the predominant acid-base disorder (57%), followed by mixed respiratory and metabolic alkalosis (35%), whereas isolated metabolic alkalosis was not observed. Detailed clinical data were available for 80 hospitalized patients. Pain (67%) and emesis (49%) were the most common presenting symptoms, while psychiatric disease was the most prevalent comorbidity (38%). Despite severe alkalemia, the disorder was documented as a diagnosis in only 4% of hospitalized patients. No in-hospital deaths occurred. Application of a published venous-to-arterial correction algorithm resulted in only minor changes in the classification of acid-base disorders.</p><p><strong>Conclusion: </strong>In contrast to previous reports from intensive care populations, patients with severe alkalemia requiring hospitalization had a clinically distinct phenotype and favorable short-term outcomes. Despite marked alkalemia, the condition was very rarely documented as a diagnosis, suggesting that severe alkalemia might be underrecognized in the emergency department.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138394","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":"Hospital seamless care beyond medication reconciliation: a 1-year evaluation in a Slovenian general hospital.","authors":"Urška Markoja, Alenka Kovačič","doi":"10.1007/s00508-026-02833-6","DOIUrl":"https://doi.org/10.1007/s00508-026-02833-6","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate a hospital seamless care service by characterizing medication discrepancies identified during medication reconciliation and documenting additional clinical pharmacy activities performed throughout hospitalization.</p><p><strong>Methods: </strong>A retrospective observational study was conducted at the General Hospital Murska Sobota, Slovenia. All hospital admissions in which the hospital seamless care service was completed between 1 January and 31 December 2025 were included. Patient characteristics, medication discrepancies identified at hospital admission and discharge, additional clinical pharmacy activities, discharge medication supply, and differences between medical and surgical departments were analyzed.</p><p><strong>Results: </strong>A total of 1813 seamless care episodes were included. At least one unintended medication discrepancy at hospital admission was identified in 391 episodes (21.6%), with medication omission being the most frequent discrepancy. At hospital discharge, the most common discrepancies were omitted medications in discharge summaries and missing prescriptions for newly initiated medications. Beyond medication reconciliation, at least one additional clinical pharmacy activity was documented in 341 episodes (18.8%). Seamless care episodes in medical departments included a significantly higher total number of clinical pharmacy activities within the seamless care service than those in surgical departments (p < 0.001). All prescribed discharge medications were supplied directly to patients in 439 seamless care episodes (24.2%).</p><p><strong>Conclusion: </strong>Medication reconciliation alone does not fully capture the scope of hospital seamless care. A substantial proportion of seamless care episodes involved additional clinical pharmacy activities throughout hospitalization. Comprehensive documentation of clinical pharmacy activities can provide a more complete evaluation of seamless care services and facilitate benchmarking across hospitals.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138422","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}