Wiener Klinische Wochenschrift最新文献

{"title":"Regarding Gampenrieder et al., A comparison of breast cancer incidence and cancer stages before and after the introduction of the Austrian national breast cancer screening program in the federal state of Salzburg.","authors":"Pascal A T Baltzer, Paola Clauser","doi":"10.1007/s00508-025-02555-1","DOIUrl":"https://doi.org/10.1007/s00508-025-02555-1","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295045","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 \"Fake smoke, real fire: a retrospective single-center analysis of the underestimated risk of e-cigarette explosions and the typical burn patterns\".","authors":"Renu Sah, Ankita Mathur","doi":"10.1007/s00508-025-02562-2","DOIUrl":"https://doi.org/10.1007/s00508-025-02562-2","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295044","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":"Exploratory study on the self-perceived knowledge and care competence of general practitioners in managing patients with overweight and obesity in Austria.","authors":"Sabine Fritzenwallner, Maria Flamm, Hans-Peter Wiesinger, Dagmar Schaffler-Schaden","doi":"10.1007/s00508-025-02545-3","DOIUrl":"https://doi.org/10.1007/s00508-025-02545-3","url":null,"abstract":"<p><strong>Objectives: </strong>Obesity is a chronic, multifactorial disease that is often described as an epidemic or pandemic of the 21st century. General practitioners (GPs) play a crucial role in managing it, yet multiple barriers hinder effective care. This study explores Austrian GPs' experiences in obesity management, their self-assessed knowledge and care competencies, and the perceived barriers to optimal treatment.</p><p><strong>Methods: </strong>A quantitative online survey was conducted among GPs in October and November 2023. The questionnaire covered prevention, treatment, barriers, and experiences in managing overweight and obesity in primary care.</p><p><strong>Results: </strong>In all, 59 GPs (56% female) completed the survey. Nearly all recognized obesity as a chronic disease and felt responsible for its management, but almost half considered their training insufficient. While 80% acknowledged the need for multimodal therapy programs, awareness of available healthcare services was low. The most significant barrier to effective obesity care from the GP's point of view was a lack of patient motivation. Female GPs were more likely to screen for dietary habits and physical activity, refer patients to specialized care, and request additional resources, whereas male GPs were more likely to prescribe pharmacotherapy. More experienced GPs felt better trained but were less likely to seek treatment guidelines. Regional and practice-setting differences influenced attitudes and referral patterns. GPs with private insurance contracts felt best trained and were least likely to request additional support.</p><p><strong>Conclusion: </strong>The survey revealed considerable uncertainty among GPs regarding the management of overweight and obesity. These findings highlight the need for targeted interventions to improve patient care and enhance GPs' training in obesity management.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267409","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":"Evaluating physicians' knowledge of assisted suicide and palliative sedation therapy in Austria : An exploratory survey study.","authors":"Lukas Fischer, Nguyen-Son Le, Stefanie Kirchner, Angelika Feichtner, Angelina Falkner, Eva Katharina Masel, Jan Gärtner, Dietmar Weixler, Gudrun Kreye","doi":"10.1007/s00508-025-02509-7","DOIUrl":"10.1007/s00508-025-02509-7","url":null,"abstract":"<p><strong>Background: </strong>Since January 2022, assisted suicide (AS) has been legal in Austria under specific conditions, allowing medical AS for individuals with incurable, life-ending diseases or severe, enduring illnesses that significantly impact their lives. Palliative sedation therapy (PST) involves the controlled use of drugs to induce unconsciousness and alleviate otherwise untreatable suffering. This study evaluates Austrian physicians' knowledge of AS and PST, comparing the knowledge levels of palliative care (PC) and non-PC physicians.</p><p><strong>Methods: </strong>In this explorative study, an online survey was distributed primarily to physicians in Lower Austria through the State Healthcare Agency Lower Austria (Landesgesundheitsagentur Niederösterreich, LGA) and to PC physicians across Austria via the Austrian Association for Palliative Care (Österreichische Palliativgesellschaft, OPG). Questions in this survey focused on basic knowledge of the principles of AS and PST. Participants included physicians who have expertise in PC and physicians from other medical specialties.</p><p><strong>Results: </strong>In this study, 223 physicians completed the survey. The PC physicians displayed significantly more specialized training, with 74.2% holding a PC diploma compared to 17.9% of non-PC physicians (p < 0.001). Regarding PST, PC physicians were more likely to follow guidelines, using midazolam (97.8% vs. 77.6%, p < 0.001), propofol (56.2% vs. 38.1%, p = 0.009), and levomepromazine (23.6% vs. 11.2%, p = 0.016). In AS, PC physicians emphasized the decision-making capacity more frequently (p = 0.006) and were better informed about the legal requirements.</p><p><strong>Conclusion: </strong>Overall, Austrian physicians demonstrate insufficient knowledge of AS and PST, underlining the need for enhanced education on PC principles to ensure informed practice post-AS legalization. Nonetheless, PC physicians in Austria demonstrate superior adherence to guidelines in managing life-limiting conditions, PST and AS compared to non-PC physicians, highlighting the importance of specialized PC education.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"357-367"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543816","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":"Associations of malnutrition factors with dysphagia mediated by ADL among nursing home residents.","authors":"Kotomi Sakai, Shoji Kinoshita, Hidetaka Wakabayashi, Tokiko Isowa, Haruka Tohara, Ryosuke Yanagida, Ryo Momosaki","doi":"10.1007/s00508-024-02488-1","DOIUrl":"10.1007/s00508-024-02488-1","url":null,"abstract":"<p><strong>Objective: </strong>The potential link between malnutrition and dysphagia along with its underlying mechanisms remains unknown. This study aimed to investigate the association between malnutrition factors and dysphagia mediated by a decline in activities of daily living (ADL) among nursing home residents.</p><p><strong>Methods: </strong>This cross-sectional study used data from 705 nursing home residents. The primary factors were risk of malnutrition and dysphagia. A body mass index (BMI) of < 18.5 and insufficient energy and protein intakes were also collected as factors related to malnutrition. The causal mediation analysis was used with malnutrition factors as the exposure, dysphagia as the outcome, and ADL as the mediation factor.</p><p><strong>Results: </strong>In total, 391 residents (55.5%) were at risk of malnutrition and 451 residents (64.0%) had dysphagia. The average causal mediation effect (ACME) of risk of malnutrition on dysphagia was 0.07 (95% confidence interval, C, 0.07-0.08), and the ACME of BMI < 18.5 was 0.05 (95% CI 0.04-0.05, P < 0.001 for both). For insufficient nutritional intake, the ACME of low energy intake was 0.07 (95% CI 0.07-0.07), and the ACME of low protein intake was 0.03 (95% CI 0.02-0.04, P < 0.001 for both). The total effects of all these exposures on dysphagia were significant (P = 0.002 for low protein intake and P < 0.001 for the others).</p><p><strong>Conclusion: </strong>Malnutrition factors were associated with dysphagia, mediated by a decline in ADL among nursing home residents. The results of this study suggest the importance of nutritional management along with approaches to ADL to prevent dysphagia.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"377-383"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877710","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":"Addressing healthcare vulnerabilities in nursing homes : Insights from human rights monitoring in two Austrian provinces.","authors":"Arkadiusz Komorowski, Theresa Rahel Demmer, Marianne Auer, Marianne Schulze, Gabriele Fischer","doi":"10.1007/s00508-024-02409-2","DOIUrl":"10.1007/s00508-024-02409-2","url":null,"abstract":"<p><strong>Background: </strong>Current demographic changes bear challenges for national care systems due to higher life expectancy of older citizens. Largely cut off from society, nursing home residents are at risk for violence, neglect, and other potential human rights violations. This study aimed to investigate healthcare vulnerabilities in nursing homes and evaluate the Austrian National Preventive Mechanism (NPM).</p><p><strong>Methods: </strong>Between 2017 and 2019, 55 monitoring visits were conducted in 32 nursing homes. Study outcomes from two Austrian provinces included data on infrastructure, occupancy, staffing, resident's demographics and medical conditions, as well as measures related to the functioning of the NPM.</p><p><strong>Results: </strong>Accessibility with mobility aids was sufficient in 87%, but assistance for persons with visual or hearing impairments solely in 20-40% of the institutions. An understaffing with nursing assistants (-5.2 full-time equivalents in Carinthia) and home helpers (-1.6 in Carinthia and Styria) was present. Less than 20% of the personnel received advanced training related to dementia and neuropsychiatric care. While 50% of the residents were diagnosed with a psychiatric disorder, approximately 36% received support from an appointed legal guardian. Of the monitoring visits 58.1% were conducted due to anonymous complaints and urgent referrals. The median processing times of the NPM and the provincial governments exceeded 250 days.</p><p><strong>Conclusion: </strong>Human rights monitoring reveals critical aspects in nursing home care, including insufficient accessibility, understaffing and inadequate training. Although the authorities' handling times hinder prompt responses, the NPM may foster systemic improvements and accountability within nursing homes.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"368-376"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914142","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":"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":"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":"325-334"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176912/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of a nurse-led intervention on number of falls and acceptance of disability in patients with Parkinson's disease.","authors":"Yanli Cheng, Zishuang Liu, Na Zhang","doi":"10.1007/s00508-025-02518-6","DOIUrl":"10.1007/s00508-025-02518-6","url":null,"abstract":"<p><strong>Background: </strong>Falling is one of the possible complications of Parkinson's disease (PD). Also, Parkinson's patients become disabled due to the gradual progression of the disease; however, acceptance of the disability (AOD) can help in managing the illness. The aim of this study was to evaluate the effect of a nurse-led intervention on the prevention of falls and AOD in patients with PD.</p><p><strong>Methods: </strong>In this study 240 patients over 60 years of age were selected from specialized clinics and randomly divided into 2 experimental and control groups. Both groups received their usual care; however, the experimental group also received a separate nurse-led intervention twice a month for 6 months. The number of falls and the AOD were measured (using a modified Chinese version of the AOD scale).</p><p><strong>Results: </strong>During the 6‑month follow-up, falls in the control group were more than the experimental group (165 vs. 92 falls). The AOD of the experimental group had increased significantly in the postintervention period and the 6‑month follow-up compared to the preintervention (from 60.4 ± 19.25 preintervention to 65.125 ± 18.52 postintervention and 65.433 ± 18.30 in follow-up, p < 0.05). Also, the AOD of the experimental group was significantly higher than the control group in the two time periods of postintervention and follow-up (postintervention: 65.125 ± 18.52 in experimental group and 58.78 ± 19.32 in control group; follow up: 65.433 ± 18.30 in experimental group and 57.52 ± 18.97 in control group, p < 0.05).</p><p><strong>Conclusion: </strong>The nurse-led intervention can be an effective noninvasive method to reduce the number of falls and increase the AOD in patients with PD.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"384-389"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568338","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":"Use of ¹⁷⁷Lu prostate-specific membrane antigen therapy in metastatic castration-resistant prostate cancer : Joint statement of the Austrian Society of Nuclear Medicine and Theranostics and the Austrian Society of Urology and Andrology.","authors":"Siroos Mirzaei, Gregor Schweighofer-Zwink, Heidemarie Ofner, Jasmin Bektic, Harun Fajkovic, Eisabeth von Guggenberg, Anton Ponholzer, Gero Kramer, Lukas Lusuardi, Michael Gabriel, Tatjana Traub-Weidinger, Marcus Hacker, Shahrokh F Shariat","doi":"10.1007/s00508-025-02544-4","DOIUrl":"10.1007/s00508-025-02544-4","url":null,"abstract":"<p><p>Prostate cancer (PCa) remains a leading cause of cancer-related morbidity and mortality in men. Over the past decades, the incidence has risen in all age groups. Prostate-specific membrane antigen (PSMA)-based theranostics, which involve the use of PSMA-targeting radiopharmaceuticals for both diagnostic imaging and therapeutic applications, have become integral in the management of patients with metastatic castration-resistant prostate cancer (mCRPC). The field has witnessed a substantial and continuously expanding body of scientific literature, encompassing case reports, original research, systematic reviews and also clinical guidelines. The objective of this joint statement is to enhance awareness of PSMA theranostics and underscore their critical role in contemporary precision oncology. We aim to provide a comprehensive yet practical perspective on the current landscape of PSMA-based diagnostic and therapeutic modalities, offering a consensus-driven approach to their clinical application.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":"137 Suppl 4","pages":"157-166"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217109","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":"Integrating palliative care into multiple myeloma management : Optimizing quality of life across the disease continuum.","authors":"Lina Rüsing, Christina Brunbauer, Clara Sophie Michel, Claudia Wenzel, Philipp Bauer, Lea Vospernik, Julia Rabensteiner, Feroniki Adamidis, Joachim Baer, Franziska Ecker, Lea Kum, Hermine Agis, Eva Katharina Masel, Maria Theresa Krauth","doi":"10.1007/s00508-024-02447-w","DOIUrl":"10.1007/s00508-024-02447-w","url":null,"abstract":"<p><strong>Background: </strong>Multiple myeloma (MM) poses significant challenges due to its complex symptomatology and evolving treatment landscape. While therapeutic advances have improved survival outcomes, holistic management of MM requires addressing the numerous physical and psychosocial needs of patients. Palliative care (PC) offers a comprehensive approach to symptom management and supportive care on a physical, psychosocial and spiritual level; however, its role in MM remains underexplored.</p><p><strong>Methods: </strong>This retrospective single-center study examines the outcome of 22 MM patients admitted to the Division of Palliative Medicine at the Medical University of Vienna. We investigated reasons for admission, symptom severity, functional status, length of stay and overall survival.</p><p><strong>Results: </strong>Most common reasons for palliative care unit (PCU) admission were nutritional problems (82%), fatigue (77%) and pain (68%). Median ECOG score at PCU admission was 3. The timepoint within the timeline of myeloma disease at which hospitalization took place varied greatly. Some patients were hospitalized shortly after diagnosis, other patients after many years of active disease and therapy. Median time from MM initial diagnosis to first PCU stay was 4.3 years (range 0.6-23.8 years). The median length of hospital (PCU) stay was 11 days (range 1-127days) and 45% of patients died during PCU hospitalization. The reduction in symptom burden as a result of the inpatient stay in the PCU is reflected in the PERS²ON score, which was measured on the day of admission (median 23 days, range 6-32 days) and on the day of discharge (median 16 days, range 7-20 days).</p><p><strong>Conclusion: </strong>PC interventions effectively addressed the complex symptom burden experienced by patients with MM. Multidimensional approaches encompassing physical, psychological and social domains proved instrumental in optimizing quality of life. Integrating PC principles into MM management paradigms is essential to prioritize patient-centered care across the disease continuum.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"351-356"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355297","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}