Raimund Lunzer, Georg Delle-Karth, Markus Zeitlinger, Marlene Prager, Lena Maria Pracher
{"title":"[Colchicine-Phoenix from the ashes].","authors":"Raimund Lunzer, Georg Delle-Karth, Markus Zeitlinger, Marlene Prager, Lena Maria Pracher","doi":"10.1007/s00508-024-02490-7","DOIUrl":"https://doi.org/10.1007/s00508-024-02490-7","url":null,"abstract":"<p><p>Colchicine is an anti-inflammatory herbal medicine with a history stretching back thousands of years. It is a cornerstone in the acute and prophylactic treatment of gout and has secured a permanent place in the standard pharmacological repertoire for familial Mediterranean fever, pericarditis, neutrophilic dermatoses, Behçet's disease and severe aphthous ulcers refractory to oral treatment. The US Food and Drug Administration (FDA) has recently approved colchicine to reduce the risk of myocardial infarction, stroke, coronary revascularization and cardiovascular death in adult patients with established atherosclerotic disease or with multiple risk factors for cardiovascular diseases. The recommendation level for cardiovascular prophylaxis was raised from IIb to IIa in the current European Society of Cardiology (ESC) guidelines from 2024. Clinical studies in recent years also demonstrated an effect for acute coronary syndrome and atrial fibrillation. This review article highlights the efficacy and safety profile of colchicine and provides insights into recent and potential future evidence-based fields of application.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":"137 Suppl 1","pages":"1-33"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256545","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}
Ayse Serra Artan, Safak Mirioglu, Elif Ünal, Vafa Suleymanova, Ozgur Akin Oto, Savas Ozturk, Halil Yazici, Tuğba Saraç Sivrikoz, Aydin Turkmen
{"title":"Maternal and neonatal outcomes in kidney transplant recipients: a single-center observational study.","authors":"Ayse Serra Artan, Safak Mirioglu, Elif Ünal, Vafa Suleymanova, Ozgur Akin Oto, Savas Ozturk, Halil Yazici, Tuğba Saraç Sivrikoz, Aydin Turkmen","doi":"10.1007/s00508-024-02425-2","DOIUrl":"10.1007/s00508-024-02425-2","url":null,"abstract":"<p><strong>Objective: </strong>Pregnancy poses a high risk for adverse maternal and neonatal outcomes in kidney transplant recipients (KTRs), and data on long-term allograft functions compared to the healthy population are still limited. Therefore, we aimed to conduct a comparative analysis of maternal and neonatal outcomes in KTRs.</p><p><strong>Subject and methods: </strong>In this retrospective single-center study, KTRs who experienced pregnancy after transplantation were evaluated in comparison with an age-matched non-transplanted control group. Maternal outcomes included obstetric complications (preeclampsia, peripartum hemorrhage, duration of maternal hospitalization) and a composite kidney outcome for KTRs defined as progression to graft failure necessitating dialysis or retransplantation or doubling of serum creatinine at the end of follow-up. Neonatal outcomes were gestational age, preterm birth, newborn mortality, admittance to the neonatal intensive care unit (NICU), Apgar scores, and birth weight.</p><p><strong>Results: </strong>In 53 KTRs, 68 pregnancies occurred. Preeclampsia (p < 0.001) and preterm birth (p = 0.003) were significantly higher in KTRs. The KTR pregnancies had lower mean birth weights (p = 0.001) and longer durations of maternal hospitalization (p = 0.001). Neonatal mortality, NICU admissions, peripartum hemorrhage rates, and Apgar scores were similar between groups. Follow-up for a median of 105 months after the index birth showed higher serum creatinine levels at postpartum visits (p < 0.001) and at the last follow-up (p = 0.001) compared to baseline. Of the KTRs 6 (11.3%) experienced composite kidney outcomes, including 5 patients with graft failure and 1 with a doubling of serum creatinine.</p><p><strong>Conclusion: </strong>The KTRs exhibit comparable neonatal mortality and NICU admission rates but have higher rates of preeclampsia and preterm birth. Importantly, graft functions worsen significantly during postpartum follow-up.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"89-97"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133957","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":"Surgical and oncological outcome after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal mesothelioma : A retrospective single center experience.","authors":"Muhammad Safwan, Ishwa Shakir, Saman Naz","doi":"10.1007/s00508-024-02493-4","DOIUrl":"https://doi.org/10.1007/s00508-024-02493-4","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012541","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}
Fabian Ruttinger, Christoph Schwarz, Georg-Christian Funk, Gregor Lindner, Roland Edlinger, Martin Auinger, Thomas Stulnig
{"title":"Predictors of 7-day mortality in critically ill patients with hyperglycemic crisis : A single center retrospective analysis.","authors":"Fabian Ruttinger, Christoph Schwarz, Georg-Christian Funk, Gregor Lindner, Roland Edlinger, Martin Auinger, Thomas Stulnig","doi":"10.1007/s00508-024-02489-0","DOIUrl":"https://doi.org/10.1007/s00508-024-02489-0","url":null,"abstract":"<p><strong>Aim/hypothesis: </strong>The main aim of the study was to identify point of care available laboratory and clinical predictors of 7‑day mortality in critically ill patients with a hyperglycemic crisis.</p><p><strong>Methods: </strong>A retrospective study of 990 patients with the first hospitalization due to hyperglycemia was performed. Patients were classified as having diabetic ketoacidosis (DKA) or being in a hyperosmolar hyperglycemic state (HHS) according to the recommendations of the American Diabetes Association (ADA). Patients not fulfilling the ADA criteria for DKA or HHS were summarized in a third group (unclassifiable hyperglycemia, UCH). The primary outcome was 7‑day mortality, potentially relevant factors were analyzed as secondary outcomes.</p><p><strong>Results: </strong>Overall, the 7‑day mortality was 7.5%, with no significant differences between DKA (7.8%), HHS (14.5%) and UCH (6.1%). Blood lactate levels were significantly higher in nonsurvivors than survivors in all three groups (mean level of 6.3 mmol/l vs. 3.4 mmol/l in DKA, 5.3 mmol/l vs. 3.1 mmol/l in HHS, 5 mmol/l vs. 2.5 mmol/l in UCH). Measured and calculated osmolality were significantly higher in nonsurvivors in the DKA group (measured osmolality 359 mosmol/kg vs. 338 mosmol/kg, calculated osmolality 315 mosmol/kg vs. 305 mosmol/kg) and patients with UCH (354 mosmol/kg vs. 325 mosmol/kg; 315 mosmol/kg vs. 298 mosmol/kg) but not in patients with HHS. Survival analysis for the DKA group showed no significant differences in 7‑day mortality when patients were compared by the ADA criteria of severity (severe, moderate, or mild). Patients with elevated calculated osmolality (> 320 mosmol/kg) and lactate (> 4 mmol/l) had the lowest 7‑day survival rate (66.7%).</p><p><strong>Conclusion/interpretation: </strong>Our data showed that elevated lactate levels were associated with higher mortality in all types of hyperglycemic crises.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984549","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 memoriam Univ.-Prof. Dr. Fritz Sterz (1956-2024) : A life dedicated to saving lives.","authors":"Wilhelm Behringer","doi":"10.1007/s00508-024-02495-2","DOIUrl":"https://doi.org/10.1007/s00508-024-02495-2","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955954","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}
Anna Kitta, Sarah Winsauer, Sal Marx, Lea Kum, Feroniki Adamidis, Franziska Ecker, Jessica Stöger, Eva Katharina Masel
{"title":"A comic that explains palliative care: how patients experience comic-based educational material.","authors":"Anna Kitta, Sarah Winsauer, Sal Marx, Lea Kum, Feroniki Adamidis, Franziska Ecker, Jessica Stöger, Eva Katharina Masel","doi":"10.1007/s00508-024-02480-9","DOIUrl":"https://doi.org/10.1007/s00508-024-02480-9","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to create a patient-centered comic on palliative care with and for patients admitted to a palliative care unit and to examine their experiences of graphic educational material.</p><p><strong>Methods: </strong>This study employed a qualitative methodology using semi-structured interviews with advanced cancer patients admitted to the palliative care unit of the Medical University of Vienna. The data were analyzed using thematic analysis with the assistance of the MAXQDA software.</p><p><strong>Results: </strong>In the first phase of the comic creation 6 interviews were conducted and 15 additional interviews in the second phase, all of which examined patients' reactions to the comic. The findings revealed three themes: 1) patients' experiences with and understanding of graphics about palliative care, 2) patients' perceptions of the possibilities for use of the comic and 3) how the visual material facilitated access to the patients' shared imagination and interpretations. The medium generated curiosity, participation, and positive reactions. Patients were inclined to be involved in patient-centered educational material that enabled an entry into conversations and connection, giving access to feelings and associations of patients.</p><p><strong>Conclusion: </strong>The results of the present study offer insights into mostly positive reactions of patients when presented with a comic about palliative care. The study showed how illustrated educational information led to deepened conversation among the interviewer and the patients, offering insights into their experiences and imagination.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955950","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}
Dorian Hirschmann, Danial Nasiri, Christian Joachim Entenmann, Christine Haberler, Thomas Roetzer, Christian Dorfer, Matthias Millesi
{"title":"Is location more determining than WHO grade for long-term clinical outcome in patients with meningioma in the first two decades of life?","authors":"Dorian Hirschmann, Danial Nasiri, Christian Joachim Entenmann, Christine Haberler, Thomas Roetzer, Christian Dorfer, Matthias Millesi","doi":"10.1007/s00508-024-02382-w","DOIUrl":"10.1007/s00508-024-02382-w","url":null,"abstract":"<p><strong>Objective: </strong>To identify factors for tumor relapse and poor outcome in patients with meningiomas in the first two decades of life.</p><p><strong>Methods: </strong>All patients ≤ 21 years of age who underwent resection of a meningioma at the department of neurosurgery, Medical University of Vienna between 1989 and 2022 were included in this retrospective study. Clinical and radiological data were extracted from the medical records. Outcome and tumor relapse were analyzed for tumor location, histological findings and extent of resection.</p><p><strong>Results: </strong>In this study 18 patients were included, 6 meningiomas were located in the skull base, 5 in the convexity and 7 in other locations including intraventricular and spine (2 patients each), falx, intraparenchymal and optic nerve sheath. Most frequent symptoms were seizures and cranial nerve palsy. In total 56% of the meningiomas were World Health organization (WHO) grade 1, 39% grade 2 and 5% grade 3. Gross total resection was achieved in 67%. The overall relapse rate was 61% and 50% underwent repeat surgery. All patients with convexity meningiomas became seizure free and had a favorable outcome. Relapse and clinical outcome were independent of WHO grade among the whole cohort but the outcome significantly depended on the WHO grade when patients with skull base meningiomas were analyzed as a subgroup. The relapse rate was significantly higher in cases of skull base location (100% vs. 42%, p = 0.038) and after subtotal resection (100% vs. 42%, p = 0.038). Clinical outcome was also significantly worse and the rate of complications was higher in patients with skull base meningiomas.</p><p><strong>Conclusion: </strong>Patients with convexity meningiomas in the first two decades of life have a good outcome due to high chance of gross total resection. Patients with skull base meningioma are at high risk of relapse and poor outcome, particularly those with WHO grades 2 and 3. Subtotal resection in patients with skull base location is probably the main reason for this difference.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"21-30"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141180917","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":"MUW researcher of the month.","authors":"","doi":"10.1007/s00508-024-02494-3","DOIUrl":"https://doi.org/10.1007/s00508-024-02494-3","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":"137 1-2","pages":"64-65"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012460","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}
Reinhard Told, Adrian Reumueller, Judith Kreminger, Birgit Lackner, Andreas Kuchar, Ursula Schmidt-Erfurth, Roman Dunavoelgyi
{"title":"Long-term results after surgical basal cell carcinoma excision in the eyelid region: revisited.","authors":"Reinhard Told, Adrian Reumueller, Judith Kreminger, Birgit Lackner, Andreas Kuchar, Ursula Schmidt-Erfurth, Roman Dunavoelgyi","doi":"10.1007/s00508-024-02333-5","DOIUrl":"10.1007/s00508-024-02333-5","url":null,"abstract":"<p><p>The aim of the study was to readdress basal cell carcinoma (BCC) in the periocular region to prove the efficacy of histologically controlled surgical treatment and to identify high-risk characteristics.Retrospective analysis of 451 microscopically controlled BCC excisions in the periocular region. Tumor location, tumor size, AJCC 7 classification, and histological results were recorded. The same procedure was followed for recurrences.A recurrence rate of 5.0% was observed after the first microscopically controlled excision. Recurrent BCCs show a shift from nodular to sclerosing BCC as the primary histological type as well as a change in primary location from lower eyelid to medial canthus. The frequency of BCC with deep extension increased from 7.3% to 24.7%, and 57.1% after the second and third operations, respectively. The recurrence rate increased to 9.5% and 42.9%, after the second and third operations, respectively.In conclusion, we are facing the same challenges in surgical BCC treatment as 30 years ago. The distribution of periocular BCC location, histologic subtype and recurrence rates mirror the literature und the general consensus. The recurrence rate increases with every operation needed. Sclerosing BCCs with deep extension at the medial canthus bear the greatest risk for recurrence. In such cases, centers of expertise should be consulted and additional treatment options should be considered.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"7-12"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139724212","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}