Wiener Klinische Wochenschrift最新文献

{"title":"Analysis of potential health impacts of road and rail traffic noise, using noise at residential locations in Austria as an example.","authors":"Markus Hamik, Stefanie Schindler, Hanns Moshammer","doi":"10.1007/s00508-025-02609-4","DOIUrl":"https://doi.org/10.1007/s00508-025-02609-4","url":null,"abstract":"<p><strong>Background: </strong>Environmental noise, particularly from road and railway traffic, has been identified as a significant public health concern. The World Health Organization (WHO) has highlighted the adverse effects of noise exposure on cardiovascular health, including ischemic heart disease (IHD). Despite the European Union's regulations on air pollution, there are no mandatory limits for environmental noise exposure, necessitating further investigation into its health impacts.</p><p><strong>Methods: </strong>Noise exposure data were obtained from strategic noise maps and linked to Geographic Information System (GIS) data of Austrian buildings. Mortality data covering 5 years (1 Nov 2016 - 31 Oct 2021) were analyzed using Poisson regressions to evaluate the association between noise exposure at residential locations and mortality, specifically focusing on IHD. The analysis adjusted for age, sex, and noise bands, with sensitivity analyses to assess the robustness of the findings.</p><p><strong>Results: </strong>The study included 37,066,299 individuals, with 372,638 deaths recorded over 5 years. Higher noise bands were associated with increased incidence rate ratios (IRR) for IHD and all-cause mortality. The IRR for IHD increased by approximately 3% per 5 dB increase in noise levels. Sensitivity analyses confirmed the robustness of these findings, with stronger effects observed for railway traffic noise compared to road traffic noise.</p><p><strong>Conclusion: </strong>The findings underscore the significant health impacts of transportation noise, particularly on cardiovascular mortality. These results support the need for stricter noise regulations and comprehensive health impact assessments to mitigate the adverse effects of environmental noise exposure in Austria.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001436","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":"Resources of Austrian hospital-based departments of neurology and psychiatry for new amyloid-antibody therapies in early Alzheimer dementia : A survey of the Austrian Alzheimer Society.","authors":"Gerhard Ransmayr, Edith Eicher, Jürgen Mraczansky, Eirini Braoudaki, Michaela Defrancesco, Walter Struhal, Christian Bancher, Peter Dal-Bianco, Josef Marksteiner, Reinhold Schmidt, Elisabeth Stögmann","doi":"10.1007/s00508-025-02608-5","DOIUrl":"https://doi.org/10.1007/s00508-025-02608-5","url":null,"abstract":"<p><strong>Background: </strong>Disease-modifying therapies with amyloid-antibodies will soon be available for patients with early Alzheimer's disease, which necessitates diagnostic and therapeutic resources in hospital and outpatient settings.</p><p><strong>Methods: </strong>The Austrian Alzheimer Society developed an online questionnaire to survey Austrian hospital-based departments of neurology and psychiatry regarding resources for amyloid-antibody therapies.</p><p><strong>Results: </strong>Between May and October 2023, 30 out of 41 neurology (73%) and 12 out of 33 psychiatry departments (36%) responded. The number of first examinations per year and center ranges between 0 in centers accepting only secondary referrals and 500, median 100. Of the patients 30% (median; range 0-80%) achieve a mini-mental state examination sum score ≥ 22 constituting an early disease stage. First visits comprise medical history, clinical examination, routine blood sampling and neurocognitive screening in 90-100% of patients, magnetic resonance imaging in 90% (median; range 10-100%), amyloid-PET in 5% (0-70%), cerebrospinal fluid analysis (Aß42, Aß40, tau, phospho-tau) in 25% (0-90%) and Apo‑E testing in 2.5% (0-100%). To assess the amyloid status 18 centers (44%) prefer amyloid-PET to lumbar puncture, 20 (49%) vice versa and 15 centers intend to offer amyloid-antibody therapy. Differences between centers and federal states were observed regarding hospital-based resources for amyloid-antibody therapies. A substantial need exists for early dementia diagnosis, medical, neuropsychological, nursing and administrative resources, adequate space, access to amyloid-PET and MRI. All centers highlighted the need for structured patient pathways and multidisciplinary care networks, including neurologists, psychiatrists, radiologists, neuropsychologists operating in clinical practice, rehabilitation and dementia care settings.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001454","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":"Effectiveness of controlled-expansion transjugular intrahepatic portosystemic shunt (CX-TIPS) in an interdisciplinary setting at a large tertiary center.","authors":"Marlene Hintersteininger, Julia Kappel, Theresa Müllner-Buscics, Susanna Riegler, Nina Dominik, Georg Kramer, Christian Sebesta, Paul Thöne, Albert Friedrich Stättermayer, Lukas Reider, Maria Schoder, Catharina Klausenitz, Raoul Varga, Fredrik Waneck, Michael Trauner, Mattias Mandorfer, Thomas Reiberger, Lukas Hartl","doi":"10.1007/s00508-025-02606-7","DOIUrl":"https://doi.org/10.1007/s00508-025-02606-7","url":null,"abstract":"<p><strong>Introduction: </strong>The use of controlled-expansion transjugular intrahepatic portosystemic shunt (CX-TIPS) effectively controls portal hypertension (PH)-related complications while reducing risks related to fully expanded stents. We evaluated the effectiveness of CX-TIPS in a large Viennese patient cohort.</p><p><strong>Method: </strong>We assessed the number of patients evaluated for CX-TIPS placement by interdisciplinary discussion at the Medical University of Vienna and included all patients from the prospective AUTIPS registry undergoing CX-TIPS placement between June 2018 - December 2024. After clinical and laboratory characterization at baseline, patients were followed up for clinical events.</p><p><strong>Results: </strong>Overall, 200 patients underwent interdisciplinary evaluation for CX-TIPS. In 62.5% CX-TIPS was recommended and 82.4% of these patients underwent CX-TIPS placement. Among 103 patients with CX-TIPS placement between June 2018 - December 2024 (median age 57 years, 67.0% male, median MELD 11), the primary indication for CX-TIPS implantation was ascites (65.0%). The median portal pressure gradient decreased from 18 mm Hg to 8 mm Hg after CX-TIPS. Underdilated CX-TIPS placement was performed in 13.6% (n = 14) of patients and portal vein recanalization (PVR-TIPS) was performed in 4 patients. During a median follow-up time of 13.5 months, 30.1% of patients experienced hepatic encephalopathy and 5.8% cardiac decompensation. Kaplan-Meier survival analyses revealed 1‑year and 3‑year transplant-free survival rates of 78.0% and 74.7%, respectively.</p><p><strong>Conclusion: </strong>Implementation of interdisciplinary case discussions and the use of CX-TIPS enable personalized medicine in patients with cirrhosis. Underdilation of CX-TIPS should be considered in patients at high risk for complications.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993775","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":"Isolated neurogenic dysphagia in vertebral artery compression syndrome.","authors":"Ivana Vachalova, Matthias Dollinger, Florian Rauer, Josef G Heckmann","doi":"10.1007/s00508-025-02611-w","DOIUrl":"https://doi.org/10.1007/s00508-025-02611-w","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993749","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":"Comment on \"Health risk factors in different educational groups and their association to Barrett's esophagus\".","authors":"Prajnasini Satapathy, Rachana Mehta, Ranjana Sah","doi":"10.1007/s00508-025-02613-8","DOIUrl":"https://doi.org/10.1007/s00508-025-02613-8","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993726","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":"Gentian root bitters for the rapid suppression of post-propofol singultus: a case report.","authors":"Christian J Wiedermann, Maximilian Scheer, Armin Pycha","doi":"10.1007/s00508-025-02607-6","DOIUrl":"https://doi.org/10.1007/s00508-025-02607-6","url":null,"abstract":"<p><p>Persistent singultus (hiccups) can be distressing and challenging to manage in the postoperative setting. While pharmacological interventions such as metoclopramide are commonly used, their effectiveness is often limited. Gentian root (Gentiana lutea) contains intensely bitter secoiridoid compounds known to stimulate vagally mediated reflexes and has a long history of use for digestive complaints. We report a case of a 70-year-old male who developed persistent hiccups following minor urologic surgery under propofol anesthesia. The hiccups were unresponsive to metoclopramide. The patient then self-administered a small amount (~20 mL) of traditional gentian schnapps, resulting in complete cessation of hiccups within 1 min. The effect was reproducible upon two subsequent recurrences later the same day. No further episodes occurred after the third administration. This case raises the hypothesis that bitter taste receptor activation in the oropharyngeal and gastrointestinal tract may modulate the hiccup reflex arc. While spontaneous resolution or the effect of alcohol cannot be excluded, the rapid and reproducible response suggests a possible therapeutic role for bitter-tasting botanical preparations in functional singultus.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971508","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":"Thirty years of high-voltage injuries: comparative analysis of train surfing and work-related cases with a focus on trauma-associated diagnoses.","authors":"V Koenig, A Fochtmann-Frana, P Tratnig-Frankl, M Monai, J Joestl","doi":"10.1007/s00508-025-02591-x","DOIUrl":"https://doi.org/10.1007/s00508-025-02591-x","url":null,"abstract":"<p><strong>Introduction: </strong>High-voltage electrical injuries from train surfing pose a unique challenge, often involving severe burns and multisystem trauma. This study retrospectively analyzed train surfing injuries over 30 years, with a focus on trauma-associated diagnoses and comparing them to work-related high-voltage injuries.</p><p><strong>Methods: </strong>A retrospective review of 87 high-voltage injury cases was conducted, including 30 train surfing and 57 work-related cases. Demographics, injury patterns, injury time, intensive care unit (ICU) stays, surgical interventions, Glasgow Coma Scale (GCS) scores, accident timing and trauma scores (Abbreviated Burn Severity Index (ABSI), Injury Severity Score (ISS), Abbreviated Injury Scale (AIS), National Advisory Committee for Aeronautics Score (NACA), Glasgow Outcome Scale (GOS)) were analyzed.</p><p><strong>Results: </strong>Train surfers were significantly younger (20.6 years vs. 36.0 years, p < 0.001) and sustained more severe burns (Total Body Surface Area (TBSA): 46.5% vs. 20.8%, p < 0.001). The ABSI (7.1 vs. 5.1, p < 0.01) and ISS (25.0 vs. 12.0, p < 0.001) were higher in train surfers, reflecting greater injury severity. The ICU stays were longer (56.1 days vs. 15.8 days, p < 0.001) and fasciotomies (86.7% vs. 53.0%, p < 0.01) and amputations (56.7% vs. 17.5%, p < 0.001) were more frequent. Train surfers exhibited worse metabolic parameters (base excess -4.49 vs. -0.7 mmol/L, p < 0.001; lactate 3.2 vs. 2.6 mmol/L, p < 0.05) and higher AIS scores for head and thoracic trauma. The GCS at the accident site was lower in train surfers (11.1 vs. 13.0, p = 0.10), indicating more severe initial impairment. Accidents predominantly occurred at night (69.9% of train surfing cases vs. 3.5% of work-related cases, p < 0.001). Mortality was significantly higher in the train surfing group (20.0% vs. 3.2%, p < 0.01).</p><p><strong>Conclusion: </strong>Train surfing injuries involve extensive burns, severe multisystem trauma, and a higher surgical burden compared to work-related injuries. Their distinct injury patterns necessitate targeted prevention and specialized trauma care.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971525","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":"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":"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":"563-570"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","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":"Multifocal white plaques on the tongue: isolated oral manifestation of secondary syphilis.","authors":"Yuri de Lima Medeiros, Maria Emília Mota, Daniel Amaral Alves Marlière","doi":"10.1007/s00508-025-02515-9","DOIUrl":"10.1007/s00508-025-02515-9","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"587-588"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543818","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":"Retraction Note to: Hydroxyethylstärke (HES).","authors":"Joachim Boldt","doi":"10.1007/s00508-025-02571-1","DOIUrl":"10.1007/s00508-025-02571-1","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"595"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545113","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}