Wiener Klinische Wochenschrift最新文献

{"title":"Cystic fibrosis care today-a narrative review based on views of experts, patients and the public.","authors":"Florian Singer, Anja Maria Schaffer, Michaela Auer, Jakob Auer, Jasmin Pansy, Vanessa Stadlbauer, Ernst Eber","doi":"10.1007/s00508-026-02739-3","DOIUrl":"https://doi.org/10.1007/s00508-026-02739-3","url":null,"abstract":"<p><p>Cystic fibrosis (CF) is one of the most common rare, genetic diseases. Newly available, highly effective modulator therapy (HEMT) improves many domains of CF pathophysiology. Thereby, HEMT challenges current standards of care and prediction models of disease outcomes.We established a public patient involvement (PPI) group including experts and caregivers of children with CF and collated a narrative review on CF management. This review is based on the views of healthcare professionals and caregivers and summarizes important features of the disease, prevention and treatment which are currently considered relevant for caregivers and Austrian healthcare settings.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639901","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":"Superior thyroid cornu syndrome: a rare cause of dysphagia.","authors":"Vineeth Sasikumar, Satvinder Singh Bakshi, Seepana Ramesh, Soumyajit Das","doi":"10.1007/s00508-026-02743-7","DOIUrl":"https://doi.org/10.1007/s00508-026-02743-7","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634441","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":"Bone metabolism in primary hyperparathyroidism.","authors":"Katharina Kerschan-Schindl, Katharina Gelles, Maria Butylina, Richard Crevenna, Peter Pietschmann","doi":"10.1007/s00508-025-02670-z","DOIUrl":"10.1007/s00508-025-02670-z","url":null,"abstract":"<p><p>Primary hyperparathyroidism is a frequent endocrine disorder that affects various organ systems. In this review we present and discuss alterations of bone metabolism in primary hyperparathyroidism. Excessive secretion of parathyroid hormone results in increased bone remodelling with an excess of bone resorption. Consequently, bone mineral density declines, bone quality is compromised and fracture risk increases.Successful surgery for hyperparathyroidism results in a normalization of bone turnover and a decrease of fracture risk. Osteitis fibrosa cystica, a severe bone manifestation of hyperparathyroidism, is observed rarely today.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"217-224"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13099684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145655789","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":"Primary hyperparathyroidism: targeted, focused exploration with \"selective\" parathyroidectomy : Minimally invasive open vs. minimally invasive video-assisted vs. endoscopic approach.","authors":"Lindsay Hargitai, Philipp Riss, Christian Scheuba","doi":"10.1007/s00508-026-02703-1","DOIUrl":"10.1007/s00508-026-02703-1","url":null,"abstract":"<p><p>Sporadic primary hyperparathyroidism is most commonly caused by a single parathyroid adenoma. Traditionally, bilateral neck exploration with assessment of all four glands was the gold standard, achieving cure rates up to 98%. This approach has largely been replaced by limited exploration (LE), in which a prelocalized hyperfunctioning gland is selectively removed using a small open, video-assisted, or endoscopic approach.Successful LE relies on accurate preoperative localization of single-gland disease. First-line imaging consists of high-resolution ultrasound combined with 99mTc-sestamibi scintigraphy with single-Photon Emission Computerized Tomograph (SPECT/CT). When results are negative or discordant, 18F-choline PET/CT is recommended, significantly improving localization and enabling targeted surgery..Because multiglandular disease cannot be definitively excluded preoperatively, intraoperative parathyroid hormone (IOPTH) monitoring has become an important adjunct. IOPTH confirms complete excision of hyperfunctioning tissue and aids detection of additional abnormal glands. Several interpretive criteria exist, including Miami, Vienna, Halle, and Rome, with Miami and Vienna most commonly used. Although routine IOPTH use in concordantly localized single-gland disease remains debated, evidence suggests it reduces persistent disease and reoperation rates, particularly when imaging is inconclusive.Endoscopic, extracervical, and robotic approaches offer superior cosmetic outcomes but involve greater dissection, higher costs, and increased technical demands, limiting widespread use. Overall, advances in imaging and intraoperative adjuncts have enabled minimally invasive parathyroidectomy to replace bilateral exploration while maintaining excellent long-term outcomes.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"241-251"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107525","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":"Neuropsychiatric manifestations of primary hyperparathyroidism.","authors":"Marco Mairinger, Godber Mathis Godbersen, Siegfried Kasper","doi":"10.1007/s00508-025-02688-3","DOIUrl":"10.1007/s00508-025-02688-3","url":null,"abstract":"<p><p>Neuropsychiatric manifestations occur in about 25% of patients with primary hyperparathyroidism (PHPT). Symptoms can range from depression, anxiety, fatigue or cognitive dysfunction which are commonly observed to more seldomly revealed states of mania, delirium or psychosis which warrant psychiatric intervention. The underlying pathophysiology is likely multifactorial, potentially explained by elevated parathormone and hypercalcemia, with subsequent direct and indirect effects on monoamine neurotransmission and neuroinflammation via monoamine oxidase, tyrosine hydroxylase, sodium-potassium adenosine triphosphatase transporter and interleukin‑6.This review aims to (1) give an overview of the hypothesized pathophysiologic understanding regarding neuropsychiatric manifestations, (2) to summarize the most common neuropsychiatric symptoms and (3) to equip clinicians with recommendations for evidence-based tools to detect neuropsychiatric symptoms effectively.Psychometric questionnaires depicting psychiatric symptom burden across PHPT research are highlighted. Cut-off values for psychiatric screening purposes and hypothesized cut-off values in PHPT research to indicate parathyroidectomy are provided. A practical approach on how screening for neuropsychiatric symptoms in PHPT might be implemented in routine clinical practice is outlined.Parathyroidectomy is recognized to alleviate neuropsychiatric symptoms in PHPT, with increasing evidence showing persistent improvements in symptoms of depression, anxiety, fatigue and cognitive dysfunction. Clinical practice guidelines still diverge on whether neuropsychiatric manifestations in PHPT warrant parathyroid surgery. A symptom-based treatment approach is recommended alongside evaluating surgical intervention.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"232-240"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13099673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935284","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":"Hyperparathyroidism: then and now.","authors":"Bruno Niederle","doi":"10.1007/s00508-026-02738-4","DOIUrl":"https://doi.org/10.1007/s00508-026-02738-4","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":"138 7-8","pages":"197-198"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783041","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":"[Consensus statement of the Austrian Society for Rheumatology and Rehabilitation on the management of increased cardiovascular risk in rheumatoid arthritis, psoriatic arthritis and spondyloarthritis].","authors":"Boris Lindner, Mathias Ausserwinkler, Christina Siess, Kai Ammerer, Monika Esposito, Josef Hermann, Rainer Hintenberger, Matthias Komposch, Lukas Lanser, Helga Lechner-Radner, Caroline Peter, Gersina Rega-Kaun, David Reinhart-Mikocki, Simon Schedl, Michaela Stögerer-Lanzenberger, Jens Thiel, Alexander Niessner","doi":"10.1007/s00508-026-02718-8","DOIUrl":"10.1007/s00508-026-02718-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Chronic inflammatory rheumatic diseases are associated with an increased risk of cardiovascular diseases (CVD), which significantly contribute to an increased morbidity and mortality. Although international recommendations exist, disease-specific and pragmatic guidance for the routine clinical practice are lacking due to heterogeneous evidence and incompletely understood pathophysiological mechanisms of cardiovascular events.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aim was to develop an expert consensus providing practical recommendations for the prevention, screening and management of the increased cardiovascular risk in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and spondyloarthritis (SpA).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Between 2023 and 2025 a multidisciplinary panel of 21 experts (rheumatology, cardiology, radiology, nephrology and endocrinology) convened under the Working Group \"Rheumatism and Heart\" of the Austrian Society for Rheumatology and Rehabilitation. A structured workflow was developed through iterative meetings and refined using a Delphi process. A total of 50 statements were rated on a 10-point Likert scale; all achieved &gt; 90% level of agreement after revision. The final consensus was consolidated into a structured clinical workflow.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The panel proposes a three-phase cardiovascular care model. Phase 1 (initial diagnosis of a rheumatic disease) emphasizes rapid achievement of remission, consideration of cardiovascular effects of antirheumatic treatment and early lifestyle counselling. The cardiovascular profiles of antirheumatic drugs are summarized in a heat map. Phase 2 (rheumatic disease with low disease activity or in remission) focuses on systematic cardiovascular risk screening from age ≥ 40 years using SCORE2 or SCORE2-OP, with a disease-specific multiplication factor of 1.5 for RA, PsA and radiographic axial SpA. Patients are stratified into risk categories defined by the European Society of Cardiology (ESC), with defined upgrade criteria. Phase 3 (advanced diagnostics and primary prevention) links risk categories to low-density lipoprotein (LDL)-cholesterol targets and tailored diagnostics aiming for early detection of atherosclerosis, arrhythmias and heart failure. In cases of a low risk for atherosclerosis blood pressure monitoring should be performed, at moderate risk additional carotid ultrasound and at high or very high risk an additional electrocardiography (ECG). To screen for heart failure a liberal amino-terminal pro-brain natriuretic peptide (NT-proBNP) measurement is recommended and in cases of elevated results or specific questions selective echocardiography is recommended. Opportunistic screening through pulse palpation is also recommended for patients at increased risk of atrial fibrillation. The ECG or electronic devices can provide evidence of arrhythmias and conduction abnormalities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Th","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":"138 Suppl 3","pages":"49-69"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13046651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595259","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":"Wenn Zeit Spuren verwischt: Genaue Dokumentation bei Gewaltverletzungen ist entscheidend.","authors":"","doi":"10.1007/s00508-026-02742-8","DOIUrl":"https://doi.org/10.1007/s00508-026-02742-8","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":"138 7-8","pages":"255"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782998","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":"Effect of parathyroidectomy on stone recurrence in primary hyperparathyroidism : A systematic review.","authors":"Victoria Jahrreiss, Ozan Yurdakul, Julian Veser, Christian Seitz","doi":"10.1007/s00508-026-02733-9","DOIUrl":"10.1007/s00508-026-02733-9","url":null,"abstract":"<p><strong>Background: </strong>Primary hyperparathyroidism (pHPT) is infrequently associated with calcium-containing kidney stones, despite hypercalciuria. Parathyroidectomy (PTX) is the only curative treatment of the metabolic disorder and is indirectly regarded as prophylaxis of recurrence of stone formation. The aim of the systematic review was to evaluate the impact of PTX on stone recurrence and to identify possible predictors of recurrent stone formation.</p><p><strong>Methods: </strong>Following PRISMA guidelines, a systematic PubMed search was conducted through April 2025. Eligible studies including adults with successfully surgically treated pHPT, documented nephrolithiasis and a follow-up of at least 12 months were analyzed.</p><p><strong>Results: </strong>A total of 13 studies (2 prospective cohorts, 10 retrospective cohorts, 1 randomized controlled trial, RCT) comprising more than 8000 patients met the inclusion criteria. After PTX, recurrence rates in prospective studies ranged from 0-30% among stone formers, while retrospective series showed a wider range (between 0% and 58%). Registry data indicated that in patients with a history of nephrolithiasis, the recurrence risk seems higher shortly after PTX compared with conservative management of pHPT but decreases substantially with each subsequent year. In patients without a stone history, de novo stone formation was rare; in the RCT, recurrence occurred in 0% after PTX versus 4% under observation. Consistent predictors of recurrence included persistent hypercalciuria, multiple preoperative stone episodes, hypocitraturia, elevated body mass index, and male sex.</p><p><strong>Conclusion: </strong>The use of PTX significantly reduces the long-term risk of stone recurrence but does not eliminate it entirely. In patients with a history of nephrolithiasis, short-term risk may be elevated after PTX but declines markedly over time. Individualized follow-up including regular assessment of serum calcium, parathyroid hormone, renal function, and 24‑h urinary parameters, together with preventive measures where indicated, such as adequate fluid intake, dietary counselling, potassium citrate or thiazide therapy, is recommended, particularly in patients with persistent risk factors. Decisions regarding surgical treatment of existing kidney stones should be individualized based on stone size, location, symptoms, infection risk as well as the overall patient risk profile and life expectancy.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"225-231"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515126","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":"Hyperparathyroidism: historical milestones and modern therapeutic strategies.","authors":"Bruno Niederle, Martin B Niederle","doi":"10.1007/s00508-026-02737-5","DOIUrl":"10.1007/s00508-026-02737-5","url":null,"abstract":"<p><p>The Viennese Medical School was at the forefront of the clinical understanding of the relationship between parathyroid and bone metabolism. A century ago, F. Mandl (1925) and E. Gold (1927) described two patients clinically (osteitis fibrosa cystica) and biochemically (hypercalcemia, hypercalciuria) with a disease which Gold had already termed (primary) hyperparathyroidism (PHPT) in 1928. The two patients were successfully treated by removing one enlarged parathyroid gland each. After the clinical and biochemical diagnosis was confirmed, surgery was recommended. In 1933, Mandl summarized his rules postulating bilateral cervical exploration, i.e. the macroscopic assessment of all four glands. Only enlarged glands should be removed. Until the beginning of the 1990s, in the hands of highly experienced endocrine surgeons, bilateral neck exploration was the undisputed method of choice (gold standard) with a high postoperative success rate (normocalcemia: 98-99%). Sporadic PHPT is predominantly caused by one hyperactive parathyroid gland. The development of reliable imaging techniques in combination with intraoperative parathyroid hormone (PTH) monitoring to verify the completeness of parathyroid tissue resection led to a change in surgical strategy from extended to limited explorations. The targeted (focused) exposure of the prelocated enlarged gland with the aim to reduce surgical trauma, yet resulting in the same high cure rates, was introduced. For targeted exploration, various endoscopic techniques, cervical or remote access (i.e. skin incision outside the neck), have become available. The more direct the access, the less invasive is the dissection. Surgical techniques minimizing trauma and followed by less pain should be favored. Therefore, the direct open (mini-incision) technique with short neck incision seems to be the new gold standard.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"199-216"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13099686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515151","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}