Wiener Klinische Wochenschrift最新文献

{"title":"Virtual reality for pain and anxiety reduction during venous puncture procedures : A within-subject clinical crossover study.","authors":"Andreas Rosenecker, Marco Amato, Isabel Geiger, Simon Winkler, Peter Willeit, Harald Schennach, Anita Siller","doi":"10.1007/s00508-026-02763-3","DOIUrl":"https://doi.org/10.1007/s00508-026-02763-3","url":null,"abstract":"<p><strong>Background: </strong>Venous puncture is a routine procedure in extracorporeal photopheresis (ECP) and may be associated with pain and anxiety. Virtual reality (VR) distraction has been shown to reduce distress in pediatric and acute settings. This study investigated if immersive VR can reduce pain and anxiety during venous puncture in ECP patients.</p><p><strong>Methods: </strong>A prospective, single-center clinical study with a within-subject crossover design was conducted at the University Hospital Innsbruck. A total of 21 adult patients underwent 2 consecutive ECP sessions, first with standard care and then with immersive VR distraction. Subjective pain and anxiety were assessed using numerical rating scales (NRS). The physiological parameters heart rate (HR), heart rate variability (HRV), respiratory rate (RR) and galvanic skin response were continuously monitored.</p><p><strong>Results: </strong>The NRS pain scores were significantly lower with VR compared to standard care with a median of 1.00 (interquartile range, IQR 0.00-2.00) in both conditions (p = 0.031). Without vs. with VR, 23.8% vs. 4.8% of patients rated their pain > 2 during puncture. The NRS anxiety scores were not significantly reduced with a median of 0.00 (0.00-1.00) without VR vs. 0.00 (0.00-0.00) with VR (p = 0.066). Without vs. with VR, 23.8% vs. 14.3% of patients rated their anxiety > 1 during puncture and 48% of patients preferred VR for future treatment, while 38% preferred standard care.</p><p><strong>Conclusion: </strong>The findings support the feasibility and potential benefit of VR as a supportive, nonpharmacological intervention, regarding pain reduction. Larger trials in more diverse patient populations are warranted to confirm these results.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843325","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":"The effects of the COVID-19 pandemic on acute and elective peripheral nerve surgery.","authors":"Eva Placheta-Györi, Oliver Bernhart, Elias Ludescher, Christine Radtke","doi":"10.1007/s00508-026-02757-1","DOIUrl":"https://doi.org/10.1007/s00508-026-02757-1","url":null,"abstract":"<p><strong>Objectives: </strong>Nerve injuries and regeneration after peripheral nerve surgery are time-sensitive, therefore longer waiting times and delayed treatment could impact patient management and functional results. This study aimed to investigate the effects of the COVID-19 pandemic on acute and elective peripheral nerve surgery during the strict first lockdown measures.</p><p><strong>Material and methods: </strong>In this retrospective study 352 patients who underwent peripheral nerve surgery in a university-based setting in an academic center during the COVID-19 lockdown (March 2020 to March 2021) were included. The pre-COVID-19 period of March 2018 to March 2019 served as a baseline for peripheral nerve procedures at the same department. Patient demographics, type of peripheral nerve lesion, affected peripheral nerves, operative treatment, postoperative complications and length of hospital stay were assessed. Acute indications and elective peripheral nerve surgery were assessed in 2 separate groups to evaluate influences of COVID-19 restrictions during the first lock-down period.</p><p><strong>Results: </strong>A total of 198 patients underwent peripheral nerve surgery during the pre-COVID-19 period compared to 154 patients during the COVID-19 period. The most common forms of surgery were peripheral nerve decompression procedures, which were significantly reduced during the COVID-19 period. While an overall reduction of peripheral nerve procedures was found, the proportion of posttraumatic reconstruction and nerve tumor surgery increased during the COVID-19 period.</p><p><strong>Conclusion: </strong>The measures taken during the COVID-19 period altered the number of elective peripheral nerve surgeries. While the overall number of patients treated was reduced, urgent cases were prioritized.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843073","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":"Trends in visual impairment among Austrian conscripts (1965-2003) after screening introduction : A retrospective, descriptive study.","authors":"Lorenz Wassermann, Clemens Vass, Philipp Ken Roberts, Thomas Neumayer, Lin Yang, Thomas Waldhoer","doi":"10.1007/s00508-026-02750-8","DOIUrl":"https://doi.org/10.1007/s00508-026-02750-8","url":null,"abstract":"<p><strong>Purpose: </strong>This retrospective descriptive study assesses the impact of Austria's pregnancy passport (Mutter-Kind-Pass, MKP) program, which was implemented in 1974, on best-corrected visual acuity (BCVA), with a particular focus on its potential role in reducing the prevalence of unilateral or bilateral visual impairment (UoBVI).</p><p><strong>Methods: </strong>As part of mandatory military service, Austrian males aged 17-19 years undergo standardized medical examinations, including BCVA assessment for amblyopia detection and service eligibility. This study analyzed BCVA data from 1,694,681 conscripts born between 1965 and 2003 using data from the Austrian military conscription database. The UoBVI was classified according to defined BCVA thresholds (in Snellen decimal).</p><p><strong>Results: </strong>Among the total cohort, 1,561,292 conscripts (98.0%) demonstrated a BCVA of ≥ 0.8 in both eyes. The overall prevalence of amblyopia decreased from an initial 4% to 1.5% in the period between 1965 and 2003. When comparing individuals born between 1965-1967 and 2001-2003, those achieving BCVA ≥ 0.8 in both eyes increased from 147,002 (96.6%) to 80,419 (98.4%). Those with BCVA < 0.8 in both eyes decreased from 1511 (1.0%) to 383 (0.5%); individuals with BCVA between 0.4-0.7 in 1 eye remained relatively stable at 1432 (0.9%) vs. 719 (0.9%); while those with BCVA ≤ 0.3 in 1 eye decreased markedly from 2459 (1.6%) to 237 (0.3%).</p><p><strong>Conclusion: </strong>The MKP program, through structured ocular screening during key periods of visual development, appears to significantly contribute to the reduction in UoBVI prevalence in Austria, most likely due to early detection and treatment of amblyopia. These findings underscore the value of early vision screening as a component of public health strategy.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843345","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":"Retropharyngeal abscess in a toddler : A rare cause of life-threatening airway obstruction with increasing incidence.","authors":"Gökhan Polat, Fatih Enes Çay, Furkan Akman","doi":"10.1007/s00508-026-02755-3","DOIUrl":"https://doi.org/10.1007/s00508-026-02755-3","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843082","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":"Organizing pneumonia mimicking metastatic tumor.","authors":"Minghui Zhang, Cong Huang","doi":"10.1007/s00508-026-02751-7","DOIUrl":"https://doi.org/10.1007/s00508-026-02751-7","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843120","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":"Postbiopsy hepatic hemorrhage due to an occult aberrant posterior sectoral hepatic artery.","authors":"Mustafa Yeşilyurt, Fahri Aydın","doi":"10.1007/s00508-026-02756-2","DOIUrl":"https://doi.org/10.1007/s00508-026-02756-2","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843093","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":"Hip joint infection by Prevotella denticola in rheumatoid arthritis : A case diagnosed with metagenomic sequencing.","authors":"Rong Zhu, Juan Zhang, Hai-Li Shen","doi":"10.1007/s00508-026-02752-6","DOIUrl":"https://doi.org/10.1007/s00508-026-02752-6","url":null,"abstract":"<p><strong>Background: </strong>Infection, as a complication of rheumatoid arthritis (RA), has attracted increasing attention from rheumatologists. Here, we present the first case of RA with hip joint infection, which was driven by infection with Prevotella denticola. Anaerobic bacterial infection was identified by metagenomic next-generation sequencing (mNGS).</p><p><strong>Methods: </strong>We describe the case of a 56-year-old woman with a history of RA who was admitted for intense hip joint pain and intermittent fever following long-term oral glucocorticoid (GC) treatment.</p><p><strong>Results: </strong>Although blood and hip joint effusion cultures for aerobic and anaerobic organisms were negative, we considered the possibility of a clinical diagnosis of hip joint infection; therefore, empirical antibiotic treatment was initiated but it was ineffective in this case. Prevotella denticola was identified by mNGS from the hip joint effusion obtained via ultrasound-guided puncture and the organism was resistant to the initial antimicrobial treatment. Finally, the adjustment of antimicrobial treatment led to successful treatment.</p><p><strong>Conclusion: </strong>Patients with RA have a significantly greater risk of infections than the general population; however, Prevotella denticola infection of the hip joint has not been previously reported. The combination of ultrasound-guided puncture and mNGS to accurately recognize and treat joint infection in patients with RA in a timely manner is necessary to prevent the development of complications, a strategy worthy of further clinical application.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783030","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":"Helicopter vs. ground transport: outcomes of out-of-hospital cardiac arrest patients with intra-arrest transport.","authors":"Florian Ettl, Matthias Pertl, Michael Poppe, Matthias Mueller, Ingrid Magnet, Christoph Schriefl, Luca Michael Kurz, Christian Schoergenhofer, Juergen Grafeneder","doi":"10.1007/s00508-026-02747-3","DOIUrl":"https://doi.org/10.1007/s00508-026-02747-3","url":null,"abstract":"<p><strong>Objective: </strong>Deciding to transport a patient intra-arrest is difficult. The effect of the mode of transportation, either helicopter emergency medical services (HEMS) or ground emergency medical services (GEMS) and its potential link to neurological outcomes has not yet been assessed.</p><p><strong>Methods: </strong>We performed a retrospective cohort study using data from our Cardiac Arrest Registry. Adult out-of-hospital cardiac arrest (OHCA) patients transported intra-arrest were included. Neurological outcome at 6 months, measured using the cerebral performance category (CPC 1-2: good, CPC 3-5: poor), served as the primary endpoint. Associations between mode of transport and prehospital time with neurological outcome were examined using univariable and multivariable logistic regression.</p><p><strong>Results: </strong>We included 639 patients of whom 533 (83%) were transported by GEMS and 106 (17%) by HEMS. Patients transported by HEMS were younger (median age 54 years vs. 58 years) and more frequently had witnessed arrest and a shockable initial rhythm (55% vs. 42%). Median prehospital time did not differ significantly between groups (HEMS: 62 min, GEMS: 58 min). In univariable and multivariable analyses, the transport mode was not associated with a favorable neurological outcome at 6 months (p > 0.4). Neurological outcome was independently associated with arrest-related factors, including age, witnessed arrest, initial rhythm and cumulative adrenaline dose.</p><p><strong>Conclusion: </strong>For patients undergoing intra-arrest transport, the mode of transport (HEMS vs. GEMS) was not significantly associated with neurological outcomes at 6 months. Neurological results appeared to be more influenced by arrest-related factors than by the transport method in this cohort.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782985","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":"Giant plexiform fibromyxoma of the esophagus.","authors":"Paul Swatek, Edin Ahmic, Iva Brcic, Iurii Mykoliuk, Anton Busau, Andrej Roj, Jörg Lindenmann","doi":"10.1007/s00508-026-02740-w","DOIUrl":"https://doi.org/10.1007/s00508-026-02740-w","url":null,"abstract":"<p><p>Plexiform fibromyxoma is a very rare gastrointestinal tumor, usually located in the stomach, predominantly in the antrum region. There are some cases reporting the tumor location in the small intestine, whereas originating from the esophagus has been described only twice up to now. This is the first report of a fast growing and symptomatic giant esophageal plexiform fibromyxoma requiring transthoracic esophagectomy and reconstruction by gastric pull-up.A 73-year-old patient was admitted with the clinical symptoms of dysphagia, chest pain, fever and weight loss for at least 2 months. A computed tomography (CT) scan revealed a giant mediastinal tumor measuring 11 × 7 × 7 cm with subsequent compression of the esophagus, the trachea and the heart. Endoscopy showed an ulcerated esophagus with signs of necrosis and obstruction of the esophageal lumen. A 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) scan detected a massive tracer uptake of this esophageal tumor suggesting malignancy.After discussion in the interdisciplinary tumor board transthoracic esophagectomy and reconstruction by gastric pull-up were performed. The patient fully recovered and was discharged on the 12th postoperative day. Contrary to the intraoperative frozen section indicating an esophageal sarcoma the final histopathological examination confirmed a giant esophageal plexiform fibromyxoma.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782908","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":"Comparison of sodium and potassium measurements in the emergency department by point-of-care vs. central laboratory testing : A retrospective analysis.","authors":"Svenja Ravioli, Annemarie Edenhofner, Christoph Schwarz, Susanne Oswald, Gregor Lindner","doi":"10.1007/s00508-026-02741-9","DOIUrl":"https://doi.org/10.1007/s00508-026-02741-9","url":null,"abstract":"<p><strong>Background: </strong>Point-of-care testing (POCT) using blood gas analyzers provides rapid results and can reduce diagnostic delays. Discrepancies between POCT and central laboratory (CL) measurements have been observed, particularly in patients with sodium disorders. This study evaluated the agreement between POCT and CL measurements for sodium and potassium in patients with hyponatremia, normonatremia and hypernatremia.</p><p><strong>Methods: </strong>In this retrospective single-center analysis, all paired measurements of sodium and potassium performed by POCT (Radiometer ABL 90 Flex Plus) and the CL (Roche Cobas Pro ISE) within ± 2 h between January and December 2024 were included. The correlation, Bland-Altman analysis, paired tests and intraclass correlation coefficients (ICC) were used to assess agreement. Regression analysis evaluated proportional bias and ANOVA tested differences among dysnatremic and normonatremic groups.</p><p><strong>Results: </strong>A total of 6404 paired sodium and 5622 paired potassium measurements were analyzed. Sodium was 140.3 mmol/L (SD 4.5) (POCT) and 137.8 mmol/L (SD 6.6) (CL), showing a mean difference of 2.4 mmol/L (SD 1.5). The correlation was significant (r = 0.583, p < 0.001) but ICC indicated poor agreement (0.473). The ANOVA demonstrated statistically significant differences between sodium groups (p = 0.007, effect size 0.002), indicating more pronounced deviations in hypernatremic patients. For potassium, the mean difference was 0.12 mmol/L (interquartile range, IQR 0.05-0.22 mmol/L) with good agreement (ICC = 0.85) but a significant proportional bias (p < 0.001). Clinically relevant deviations (> 4 mmol/L sodium or > 0.5 mmol/L potassium) occurred in 8.5% and 4.5% of cases, respectively.</p><p><strong>Conclusion: </strong>While potassium showed a very strong correlation and good agreement, sodium demonstrated only moderate correlation and poor agreement according to ICC criteria. Systematic and clinically relevant deviations were frequent, particularly in dysnatremic and dyskalemic patients.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677187","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}