Wiener Klinische Wochenschrift最新文献

{"title":"BillrothhausTV: Fortbildung, wann und wo Sie wollen.","authors":"","doi":"10.1007/s00508-026-02848-z","DOIUrl":"https://doi.org/10.1007/s00508-026-02848-z","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":"138 19-20","pages":"650"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196901","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":"A rare case of nephrotic syndrome and arterial thrombosis following long-term rifampicin therapy.","authors":"Satish Kumar Basattikoppalu Puttegowda, Pooja Anjanappa, Tejaswi Prithviraj Hadya Krishna, Yogendra Shrestha","doi":"10.1007/s00508-026-02736-6","DOIUrl":"10.1007/s00508-026-02736-6","url":null,"abstract":"<p><p>Although rifampicin is one of the main drugs in the treatment of tuberculosis, its potential for causing nephrotoxic reactions may lead to renal injury. In this paper, we present a 23-year-old man who was treated for pulmonary tuberculosis and who developed a nephrotoxic syndrome caused by rifampicin. This syndrome was defined by abdominal distension due to fluid retention, swelling in both legs, nephrotic range proteinuria and biopsy findings showing tubular atrophy and interstitial fibrosis. The nephrotoxicity developed after a prolonged, uninterrupted course of treatment with rifampicin. The patient was successfully treated for nephrotoxicity with corticosteroids, diuretics, albumin infusion and antihypertensive agents. We emphasize the need for clinicians to be aware of the risk of rifampicin nephrotoxicity, particularly in patients with pre-existing renal impairment.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"638-641"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147533309","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":"Austrian treatment algorithms 2025: CDK 4/6 inhibitors in the adjuvant therapy of HR+/HER2- early breast cancer.","authors":"Rupert Bartsch, Clemens Dormann, Daniel Egle, Simon P Gampenrieder, Gunda Pristauz-Telsnigg, Gabriel Rinnerthaler, Christian F Singer, Michael Gnant","doi":"10.1007/s00508-026-02726-8","DOIUrl":"10.1007/s00508-026-02726-8","url":null,"abstract":"<p><p>Hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) early breast cancer (eBC) represents the most common breast cancer subtype, with relevant recurrence risks despite optimal endocrine therapy (ET) and locoregional treatment. Long-term data from the Early Breast Cancer Trialists' Collaborative Group (EBCTCG) demonstrate that recurrence risk remains substantial, with outcomes strongly influenced by nodal burden, tumor size, and biological parameters.Advances in systemic therapy, including optimized endocrine strategies, chemotherapy, bone-modifying agents, PARP inhibitors for patients harboring germline BRCA 1/2-mutations, have significantly improved survival, yet recurrence remains a clinically relevant challenge, including for node-negative patients harboring additional biological risk features.The introduction of adjuvant CDK4/6 inhibitors represents an important therapeutic development. Abemaciclib (monarchE) has demonstrated sustained improvements in invasive disease-free survival (IDFS), distant relapse-free survival (DRFS), and a statistically significant overall survival (OS) benefit at 7 years. Ribociclib (NATALEE) demonstrated statistically significant IDFS improvement across a broader clinical risk spectrum, including selected node-negative disease.However, these advances must be considered in the context of distinct toxicity, treatment burden, and substantial additional healthcare system costs. Although emerging evidence supports treatment intensification with CDK4/6 inhibitors in certain settings, uncertainty persists regarding which patient subgroups derive sufficient benefit to justify routine use from both a clinical and health-economic perspective.Further clarification is expected from ongoing randomized studies and real-world evidence, as this paper aims to provide a structured, evidence-based overview of the current standard of knowledge and to support Austrian breast cancer specialists in navigating treatment decisions regarding adjuvant CDK4/6 inhibitor use.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"599-611"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147481956","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":"It's not always endocarditis: splinter hemorrhages in ANCA-associated vasculitis.","authors":"Werner Ribitsch, Alexandra Radler","doi":"10.1007/s00508-026-02734-8","DOIUrl":"10.1007/s00508-026-02734-8","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"645-646"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147487479","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":"An analysis of COVID-19 mortality regarding all Austrian political districts.","authors":"Stefanie Grötz, Martin Fieder, Harald Wilfing","doi":"10.1007/s00508-026-02728-6","DOIUrl":"10.1007/s00508-026-02728-6","url":null,"abstract":"<p><strong>Background: </strong>Coronavirus disease 2019 (COVID-19), first identified in Wuhan in 2019, rapidly escalated into a global pandemic. Austria reported its initial cases in February 2020, resulting in millions of infections and thousands of deaths. This study investigates COVID-19 mortality across Austrian districts, analyzing factors such as age, sex, immigrant background, household size, education and vaccination status.</p><p><strong>Methods: </strong>We analyzed data from the Austrian National Public Health Institute, comprising 4,591,739 confirmed cases and 20,123 deaths as of July 2022. We used a linear mixed model to examine whether individuals died from COVID-19. Furthermore, we created three interaction models: (i) vaccination status and consecutive month, (ii) age and consecutive month and (iii) sex and consecutive month. Additional linear models examined household size, education, and citizenship at the district level.</p><p><strong>Results: </strong>Our findings highlight several determinants of COVID-19 mortality in Austria. Advanced age significantly increases mortality risk, while vaccination is strongly protective. Female sex is also associated with reduced mortality. District of residence influences the case fatality ratio, with notable geographic variation. Larger household sizes correlate with increased infection risk. Districts with higher proportions of residents with tertiary education exhibit lower infection and mortality ratio. Districts with a greater percentage of non-Austrian citizens have lower case fatality ratio, likely reflecting a younger population demography.</p><p><strong>Conclusion: </strong>Key determinants of COVID-19 mortality include age, vaccination status, and sex. Districts with larger households experience higher infection ratios, while those with more highly educated residents have lower infection and mortality ratios. Districts with more non-Austrian citizens show lower case fatality ratios, likely due to younger populations. Further research into district-level age structures is warranted to refine these models. These findings underscore the importance of vaccination, particularly among older adults, and the need for accessible public health education to reduce infection and mortality ratio, especially in less-educated populations; however, district age structure (proportion of older individuals) substantially influences these associations.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"585-598"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515091","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":"Systematic evidence analysis of symptom modification in hip osteoarthritis following MSC-based interventions.","authors":"Paul Steiner, Theodor Seist, Lukas Moser, Johannes Neugebauer, Dietmar Dammerer, Stefan Nehrer, Markus Neubauer","doi":"10.1007/s00508-026-02820-x","DOIUrl":"https://doi.org/10.1007/s00508-026-02820-x","url":null,"abstract":"<p><strong>Background: </strong>Mesenchymal stromal/stem cell (MSC)-based interventions are increasingly used for hip osteoarthritis (HOA), although the products and supporting clinical evidence are heterogeneous. This systematic review evaluated symptom modification, safety, and methodological quality.</p><p><strong>Methods: </strong>PubMed/MEDLINE was searched on 1 August 2024 using MeSH and free-text terms. One author performed study screening, data extraction, and risk of bias assessment using the Downs and Black checklist and 9 studies comprising 307 patients were included. Because of clinical and methodological heterogeneity, results were synthesized descriptively; weighted outcome means were calculated only from studies reporting compatible baseline and follow-up values.</p><p><strong>Results: </strong>The interventions included culture-expanded MSCs, bone marrow concentrate, stromal vascular fraction, and micro-fragmented adipose tissue, with or without platelet-rich plasma. In contributing cohorts, VAS pain scores decreased from 6.7 to 3.7 (n = 58), WOMAC scores decreased from 35.4 to 18.5 (n = 49), and Harris hip scores increased from 40.8 to 62.8 (n = 76). These findings represent within-group changes rather than comparative treatment effects. Serious adverse events were uncommon, but reporting was incomplete and follow-up was generally limited.</p><p><strong>Conclusion: </strong>The use of MSC-based interventions was associated with encouraging short-term within-group improvements in pain and function; however, small samples, product heterogeneity, predominantly uncontrolled designs and limited safety reporting preclude conclusions regarding efficacy or structural disease modification. Adequately powered randomized controlled trials with standardized products and outcomes are required.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075429","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":"Sudden cardiac arrest in a young healthy man following kratom tea consumption: a case report and brief literature review.","authors":"Jonas Dunz, Mirco Janes, Armin Krösbacher, Regina Unterpertinger, Gabriel Putzer","doi":"10.1007/s00508-026-02826-5","DOIUrl":"https://doi.org/10.1007/s00508-026-02826-5","url":null,"abstract":"<p><p>We report the first case in Austria of cardiac arrest associated with isolated kratom intoxication in a young man, supported by toxicological blood analysis revealing markedly elevated mitragynine concentrations. Despite its perception as a low-risk substance, kratom can cause severe and potentially fatal adverse effects. This case highlights the need for increased clinical awareness, public education and further investigation of the cardiovascular safety of mitragynine.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031557","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":"Tumor-induced osteomalacia caused by fibroblast growth factor 23 excess : Delayed diagnosis resulting from overlooked hypophosphatemia-A  case report.","authors":"Seren Aksun, Nergis Basmaci, Mehmet Ayvaz, Deniz Pınar Baran, Kemal Kosemehmetoglu, Yahya Eryılmaz, Eser Lay Ergün, Alper Gürlek","doi":"10.1007/s00508-026-02821-w","DOIUrl":"https://doi.org/10.1007/s00508-026-02821-w","url":null,"abstract":"<p><p>Tumor-induced osteomalacia is a rare acquired disorder of phosphate metabolism caused by fibroblast growth factor (FGF)23-secreting mesenchymal tumors. We report the case of a 39-year-old man with a 3-year history of progressive musculoskeletal pain, in whom unrecognized hypophosphatemia led to misdiagnoses, including osteoporosis and inflammatory musculoskeletal disorders, and consequently, to inappropriate management. Biochemical evaluation revealed persistent hypophosphatemia, elevated alkaline phosphatase levels, secondary hyperparathyroidism, and markedly increased serum FGF23 levels. Gallium-68 DOTATATE positron emission tomography/computed tomography (PET/CT) identified a phosphaturic mesenchymal tumor located in the medial condyle of the right distal femur, which was subsequently confirmed histopathologically after surgical excision. Following surgery, serum phosphorus and FGF23 levels rapidly normalized, accompanied by significant clinical improvement. This case highlights unrecognized hypophosphatemia as a critical yet preventable cause of diagnostic delay and emphasizes the importance of routine serum phosphate assessment to avoid misdiagnosis and enable timely curative treatment.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026178","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":"Second victim experiences among Austrian nonphysician emergency medical services personnel : A cross-sectional analysis of symptom burden and associated factors.","authors":"Katharina Tscherny, Victoria Klemm, Herbert Huscsava, Stefan Dür, Eva Potura, Reinhard Strametz","doi":"10.1007/s00508-026-02819-4","DOIUrl":"https://doi.org/10.1007/s00508-026-02819-4","url":null,"abstract":"<p><strong>Background: </strong>Second victim experiences have been described across health professions but evidence for Austrian prehospital emergency medical services (EMS) remains limited. This study assessed the prevalence, key events and factors associated with high symptom burden among Austrian nonphysician emergency medical services personnel.</p><p><strong>Methods: </strong>We conducted a cross-sectional study within the Second Victims in German-speaking Countries (SeViD) research program using the standardized SeViD questionnaire among Austrian nonphysician EMS personnel. The SeViD-A4 denotes the fourth Austrian study within this program and does not refer to a separate questionnaire. Second victim status was recorded dichotomously and symptom burden was dichotomized for univariate analyses and multivariable binary logistic regression. The questionnaire included demographic and occupational variables, second victim experience, key event category, support after the key event, recovery, symptom reactions, support preferences and 10-item Big Five Inventory (BFI-10) personality dimensions.</p><p><strong>Results: </strong>A total of 1171 questionnaires were included and 60.1% of the respondents identified as second victims. Among participants with a second victim experience and valid key event data (n = 704), the most common key events were unexpected patient death or patient suicide (41.8%) and aggression by patients or relatives (18.8%). The multivariable complete case analysis included 698 participants, of whom 336 had high symptom burden. High symptom burden was associated with neuroticism (odds ratio, OR 1.44), openness (OR 1.21), patient volume per 100 additional patients per quarter (OR 1.14), professional compared with volunteer EMS work (OR 1.52), and lack of support despite seeking help (OR 5.98). Self-reported male gender was associated with lower odds of high symptom burden (OR 0.62).</p><p><strong>Conclusion: </strong>Second victim experiences were frequent in this nationwide Austrian convenience sample. High symptom burden was associated with individual, workload-related, employment-related and support-related factors. Low-threshold peer support and structured follow-up represent plausible organizational targets but their effectiveness requires prospective evaluation.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012430","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":"Healthy rural living: a misplaced optimism? : District-level agricultural index and Parkinson's disease risk in Austria.","authors":"A Santer, G Fülöp, A Langer, M Ludwig, H Cetin, F Zimprich, C Brücke, H Zach","doi":"10.1007/s00508-026-02817-6","DOIUrl":"https://doi.org/10.1007/s00508-026-02817-6","url":null,"abstract":"<p><strong>Background: </strong>Occupational exposure to pesticides is a well-established environmental risk factor for Parkinson's disease (PD). Living in agricultural regions has also been associated with PD risk, although evidence remains inconsistent. This study examines whether past district-level agricultural intensity is associated with current Parkinson's disease hospitalization prevalence across Austrian districts.</p><p><strong>Methods: </strong>We obtained district-level hospitalization prevalence data for individuals with a main or secondary diagnosis of PD from the Austrian national hospital discharge register for the years 2015-2023. Agricultural employment is quantified using an Agricultural Index (ACI), defined as the proportion of the working population employed in agriculture and forestry, derived from national population censuses conducted in 1981, 1991, and 2001. Associations between the cumulative ACI and cumulative PD hospitalization prevalence per region among the general population are assessed using Pearson correlation and linear regression analyses.</p><p><strong>Results: </strong>The cumulative ACI from 1981, 1991, and 2001 is significantly associated with PD hospitalization prevalence between 2015 and 2023 at the district level. In linear regression analysis, the cumulative ACI significantly predicts PD hospitalization prevalence (p = 0.01), explaining 6.8% of the variance (R² = 0.068).</p><p><strong>Conclusion: </strong>Austrian districts with historically higher agricultural employment and intensity exhibit higher contemporary hospitalization prevalences among individuals with Parkinson's disease (PD). These findings support existing evidence linking rural environments to increased PD risk and suggest that agricultural environmental exposures can affect not only agricultural workers but also the general population residing in highly agricultural regions.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012355","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}