Wiener Klinische Wochenschrift最新文献_第4页

"Lunge vernetzt". "联系" .肺

IF 1.9 4区医学

Wiener Klinische Wochenschrift Pub Date : 2025-06-01 DOI: 10.1007/s00508-025-02556-0

引用次数: 0

Symptom tracking made simple? Observational data on the clinical use of the PERS²ON score in cancer patients receiving palliative care. 症状跟踪变得简单了吗？在接受姑息治疗的癌症患者中使用PERS2ON评分的临床观察数据。

IF 1.9 4区医学

Wiener Klinische Wochenschrift Pub Date : 2025-06-01 Epub Date: 2025-05-31 DOI: 10.1007/s00508-025-02553-3

Katharina Tscherny, Juergen Grafeneder, Bettina Wandl, Maximilian Niederer, Martina Haider, Eva Katharina Masel, Dominik Roth, Alexander Egger

{"title":"Symptom tracking made simple? Observational data on the clinical use of the PERS2ON score in cancer patients receiving palliative care.","authors":"Katharina Tscherny, Juergen Grafeneder, Bettina Wandl, Maximilian Niederer, Martina Haider, Eva Katharina Masel, Dominik Roth, Alexander Egger","doi":"10.1007/s00508-025-02553-3","DOIUrl":"10.1007/s00508-025-02553-3","url":null,"abstract":"Context: A standardized assessment of symptoms is essential for individualized palliative care (PC). While numerous tools exist, many are too complex for daily clinical use.Objective: The PERS2ON score was developed as a brief and practical tool to assess symptom burden in PC. This study aimed to evaluate its feasibility in a rural hospital setting, although it did not include formal feasibility metrics such as recruitment or adherence rates.Methods: Patients admitted to the palliative care unit of a rural hospital were assessed using the PERS2ON score, which includes seven items: pain, eating, rehabilitation, social situation, suffering, oxygen/dyspnea, and nausea/emesis. Each item is scored from 0 to 10, with higher scores indicating greater burden. Assessments were conducted on admission, after 7 days, and at discharge. Symptom scores were analyzed for change over time.Results: Of 60 admitted patients, 40 met the inclusion criteria. Reassessment was possible in 35 patients after 7 days and in 31 patients at discharge. The mean PERS2ON score decreased from 28 (SD 12) on admission to 21 (SD 11) after 7 days (difference: 7, 95% confidence interval, CI: 3-11, p = 0.002), and to 17 (SD 10) at discharge (difference: 11, 95% CI: 6-15, p < 0.001).Conclusion: The PERS2ON score was feasible to implement and enabled consistent symptom monitoring. Its use may support structured clinical assessment and targeted symptom management even in smaller or rural palliative care units.","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"335-341"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192322","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}

引用次数: 0

Behavioral recommendations following gynecological surgery. 妇科手术后的行为建议。

IF 1.9 4区医学

Wiener Klinische Wochenschrift Pub Date : 2025-05-30 DOI: 10.1007/s00508-025-02548-0

Felix Hofbauer, Laura Strobel, Christian Marth, Andreas Widschwendter

{"title":"Behavioral recommendations following gynecological surgery.","authors":"Felix Hofbauer, Laura Strobel, Christian Marth, Andreas Widschwendter","doi":"10.1007/s00508-025-02548-0","DOIUrl":"https://doi.org/10.1007/s00508-025-02548-0","url":null,"abstract":"Background: Postoperative care is critical for recovery after gynecological procedures. Yet, the absence of consistent guidelines often leaves patients uncertain, potentially hindering healing. This study aimed to assess behavioral recommendations provided by Austrian gynecologists and hospitals to inform the development of standardised postoperative guidance.Patients and methodology: Between December 2023 and April 2024, questionnaires were sent to 118 gynecologists and 79 hospitals, covering postoperative advice for hysteroscopy, large loop excision of the transformation zone (LLETZ) conisation, tension-free vaginal tape (TVT), laparoscopy, hysterectomy, and caesarean section. Topics included duration of sick leave, follow-up, bathing, tampon use, sexual activity, sports, and lifting restrictions.Results: Responses were received from 54 gynecologists (46%) and 49 clinics (62%). Clinics tended to recommend more restrictive measures than specialists, particularly for LLETZ, TVT, and laparoscopy, while advice aligned for hysterectomy and caesarean section. Notably, for LLETZ conisation, specialists advised 2-4 weeks of rest, whereas clinics recommended 1-2 weeks (p < 0.05). For hysterectomy and caesarean section, both groups advised 4-6 weeks of recovery, with restrictions on weight lifting, sexual activity, and sports. Variability was also seen in the basis for recommendations: 41% of specialists relied on personal experience, while 41% of clinics cited current evidence.Conclusion: This study highlights significant heterogeneity in postoperative advice across Austria and underscores the need for evidence-based, standardised guidelines to improve the quality and consistency of care in gynecology.","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188140","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}

引用次数: 0

Acute liver failure in patients admitted to the intensive care unit-a Viennese retrospective single-center analysis. 重症监护病房住院患者的急性肝衰竭——维也纳回顾性单中心分析

IF 1.9 4区医学

Wiener Klinische Wochenschrift Pub Date : 2025-05-26 DOI: 10.1007/s00508-025-02539-1

Patrick Haselwanter, Seanna Fairfield, Marlene Riedl-Wewalka, Monika Schmid, Albert Friedrich Stättermayer, Thomas Reiberger, Michael Trauner, Christian Zauner, Mathias Schneeweiss-Gleixner

{"title":"Acute liver failure in patients admitted to the intensive care unit-a Viennese retrospective single-center analysis.","authors":"Patrick Haselwanter, Seanna Fairfield, Marlene Riedl-Wewalka, Monika Schmid, Albert Friedrich Stättermayer, Thomas Reiberger, Michael Trauner, Christian Zauner, Mathias Schneeweiss-Gleixner","doi":"10.1007/s00508-025-02539-1","DOIUrl":"https://doi.org/10.1007/s00508-025-02539-1","url":null,"abstract":"Background: Acute liver failure (ALF) is characterized by a rapid deterioration of liver function and a high mortality without transplantation depending on etiology and onset. Immediate transfer to a dedicated intensive care unit (ICU) and evaluation for high-urgency liver transplantation (HU-LTx) is recommended to maximize chances of survival. Data on ALF epidemiology are limited, particularly for Central Europe.Methods: This retrospective single-center study included all ALF patients admitted to the ICU of the Department of Gastroenterology and Hepatology at the Vienna General Hospital between 2012 and 2024.Results: Overall, 31 patients (median age of 44 [interquartile range, IQR 32-56] years, 20 [65%] female) were included. The primary causes of ALF were viral infections (n = 8; 26%), autoimmune hepatitis (n = 5; 16%), drug-induced liver injury (DILI; n = 3; 10%), and Wilson's disease (n = 4; 13%), while in 8 patients (26%) no cause was identified. Median length of ICU stay was 12 (IQR 4-21) days, with mean sequential organ failure assessment (SOFA) and simplified acute physiology score II (SAPS II) scores of 10.55 ± 4.56 and 40.97 ± 14.84. Overall ICU survival was 61% (n = 19). Non-HU-LTx patients (n = 18) had an ICU survival of 44%. HU-LTx was performed in 13 patients (42%), with 12 patients (92%) surviving 28 days. The 6‑month overall survival of HU-LTx patients was 85%.Conclusion: The diverse causes of ALF in Central Europe include most commonly viral infections, autoimmune hepatitis, and DILI. HU-LTx was required and performed in almost half of patients and was associated with favorable survival rates, underscoring the importance of ICU management and early transfer to liver transplantation centers in the management of ALF.","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152070","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}

引用次数: 0

Completely ulcerated infantile hemangioma: a diagnostic challenge. 完全溃烂的婴儿血管瘤：一个诊断挑战。

IF 1.9 4区医学

Wiener Klinische Wochenschrift Pub Date : 2025-05-22 DOI: 10.1007/s00508-025-02543-5

Elias Marquart, Doris Weiss, Klaudija Batinic, Thomas Wiesner, Johannes Rohrbeck, Tamara Arnoldner, Wolfgang Weninger, Tamar Kinaciyan

引用次数: 0

No increase of biopsy rates despite high rates of probable eosinophilic esophagitis in patients with esophageal food impaction. 尽管食道食物嵌塞患者可能存在嗜酸性粒细胞性食管炎，但活检率并未增加。

IF 1.9 4区医学

Wiener Klinische Wochenschrift Pub Date : 2025-05-21 DOI: 10.1007/s00508-025-02542-6

Lukas Neumann, Rafael Brader, Lili Kazemi-Shirazi, Michael Trauner, Christian Primas, Karin Wisniowski, Jurij Maurer, Hansjörg Schlager, Jagoda Pokryszka, Clemens Dejaco, Walter Reinisch, Gottfried Novacek, Philipp Schreiner

{"title":"No increase of biopsy rates despite high rates of probable eosinophilic esophagitis in patients with esophageal food impaction.","authors":"Lukas Neumann, Rafael Brader, Lili Kazemi-Shirazi, Michael Trauner, Christian Primas, Karin Wisniowski, Jurij Maurer, Hansjörg Schlager, Jagoda Pokryszka, Clemens Dejaco, Walter Reinisch, Gottfried Novacek, Philipp Schreiner","doi":"10.1007/s00508-025-02542-6","DOIUrl":"https://doi.org/10.1007/s00508-025-02542-6","url":null,"abstract":"Introduction: Eosinophilic esophagitis (EoE) is one of the main causes of esophageal food impaction (EFI). Since only few endoscopists take biopsies during the emergency endoscopy at EFI presentation, as is recommended by current guidelines, a high number of patients will not have a proper diagnosis after EFI. Hence, we investigated the change of biopsy rates and the etiology of EFI over 11 years.Methods: All patients presenting at the emergency department (ED) of a tertiary center with an EFI who underwent esophagogastroduodenoscopy (EGD) between 2013 and 2023 were included. Clinical and endoscopic variables were analyzed retrospectively. We performed a binary logistic regression model to predict biopsy performance.Results: A total of 180 EFI cases (67% male, median age 57 years) were recorded between 2013 and 2023. Overall, esophageal biopsies were taken only in 18% without any increase over time. In patients ≥ 50 years of age (n = 108), the etiology remained unknown in half of patients (48%), followed by gastroesophageal reflux disease (GERD; 23%) and EoE (18%). However, in patients < 50 years of age, EoE was the main suspected etiology in 69% of cases. Biopsies were obtained in only 18% of all patients with suspected EoE. Age, gender, and the year of EFI were not associated with biopsy performance. However, the probability of biopsy increased by a factor of 4.03 in the presence of suspected EoE by the endoscopist.Conclusion: Despite an increasing awareness of EoE, the biopsy rate in EFI is rather low. Routine biopsies should be taken to shorten diagnostic delay.","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120914","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}

引用次数: 0

Structural quality criteria of emergency departments in Vienna. 维也纳急诊科结构质量标准。

IF 1.9 4区医学

Wiener Klinische Wochenschrift Pub Date : 2025-05-19 DOI: 10.1007/s00508-025-02541-7

Harald Herkner, Alexandra J Lipa, Philip Eisenburger, Wilhelm Behringer, Alexander Spiel, Sonja Mahrer, Moritz Haugk, Rainer Thell, Marie-Kathrin Breyer, Nicole Biber, Edith Doberer, Anna Kreil, Michael Schwameis

{"title":"Structural quality criteria of emergency departments in Vienna.","authors":"Harald Herkner, Alexandra J Lipa, Philip Eisenburger, Wilhelm Behringer, Alexander Spiel, Sonja Mahrer, Moritz Haugk, Rainer Thell, Marie-Kathrin Breyer, Nicole Biber, Edith Doberer, Anna Kreil, Michael Schwameis","doi":"10.1007/s00508-025-02541-7","DOIUrl":"https://doi.org/10.1007/s00508-025-02541-7","url":null,"abstract":"Background: In 2020, the Austrian Association of Emergency Medicine proposed structural quality criteria for in-hospital emergency care in Austria. However, it has not yet been assessed how these criteria apply to existing emergency departments.Methods: All in-hospital emergency departments across Vienna were surveyed using a structured assessment based on published proposed structural quality criteria. A total of 54 criteria were analysed, each rated on a scale of 3 (comprehensive care), 2 (standard care), 1 (basic care), or 0 (not met).Results: Among 16 hospitals, we identified 10 emergency departments. The scores ranged from 87 points (54%) to 151 points (95%). None of the departments met all structural quality criteria. Overall, across all emergency departments, 69% of the criteria aligned with comprehensive care, 7% with standard care and 3% with basic care, while 21% of the criteria were not met at all.Conclusions: A set of proposed structural quality criteria for emergency departments could be quantitatively assessed. While the published criteria and the observed infrastructure are largely consistent, there is significant potential for improvement in both the definition of the criteria and the criteria per se. The extent to which these structural quality criteria are useful for assessing the classification of tiered care models requires further studies in different regions.","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095275","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}

引用次数: 0

Inadequate pediatric reference ranges impede the diagnosis of X-linked hypophosphatemia and hypophosphatasia in Austria. 在奥地利，不充分的儿科参考范围阻碍了x连锁低磷血症和低磷血症的诊断。

IF 1.9 4区医学

Wiener Klinische Wochenschrift Pub Date : 2025-05-19 DOI: 10.1007/s00508-025-02546-2

Jojo Steininger, Magdalena Jablonska, Susanne Sagmeister, Gabriel Mindler, Adalbert Raimann

{"title":"Inadequate pediatric reference ranges impede the diagnosis of X-linked hypophosphatemia and hypophosphatasia in Austria.","authors":"Jojo Steininger, Magdalena Jablonska, Susanne Sagmeister, Gabriel Mindler, Adalbert Raimann","doi":"10.1007/s00508-025-02546-2","DOIUrl":"https://doi.org/10.1007/s00508-025-02546-2","url":null,"abstract":"Background: Accurate diagnosis of many pediatric disorders relies on age-specific laboratory reference ranges. This is particularly important for rare disorders such as X‑linked hypophosphatemia (XLH) and hypophosphatasia (HPP), which present with decreases in serum phosphate and alkaline phosphatase (ALP), respectively.Objective: This study evaluated the use of pediatric reference ranges among Austrian medical laboratories.Methods: A comprehensive list of all extramural clinical laboratories was compiled. A standardized serum sample with pathological values for a 4-year-old child was dispatched to 26 extramural laboratories. The returned absolute and stated reference values were assessed and analyzed.Results: Of 22 responding laboratories, 18.2% used appropriate pediatric reference ranges for serum phosphate and 40.9% for ALP. In total, 54.5 and 36.4% of laboratories identified the sample as normal for serum phosphate or ALP, respectively.Conclusion: Despite accurate absolute value measurements, the majority of laboratories failed to identify the test sample as pathologic. In a real-world setting, the results obtained could lead to significant diagnostic delays and missed diagnoses in pediatric patients. The lack of regulatory requirements for pediatric-specific reference ranges in Austria and most European countries contributes to this problem. The study highlights the need for standardization and mandatory implementation of pediatric reference ranges to improve diagnostic accuracy for rare pediatric disorders across Europe.","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095273","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}

引用次数: 0

Wild-type transthyretin cardiac amyloidosis mimicking hypertrophic obstructive cardiomyopathy : A case report. 模拟肥厚性阻塞性心肌病的野生型转甲状腺素型心脏淀粉样变1例报告。

IF 1.9 4区医学

Wiener Klinische Wochenschrift Pub Date : 2025-05-13 DOI: 10.1007/s00508-025-02540-8

Nikol Kubinova, Tomas Paleček, Marek Mika, Radek Jaksa, Ales Linhart

{"title":"Wild-type transthyretin cardiac amyloidosis mimicking hypertrophic obstructive cardiomyopathy : A case report.","authors":"Nikol Kubinova, Tomas Paleček, Marek Mika, Radek Jaksa, Ales Linhart","doi":"10.1007/s00508-025-02540-8","DOIUrl":"https://doi.org/10.1007/s00508-025-02540-8","url":null,"abstract":"Background: Wild-type transthyretin cardiac amyloidosis (ATTRwt CA) is increasingly recognized as an important cause of heart failure and arrhythmias in older people. There are several clinical, echocardiographic, electrocardiographic (ECG) and laboratory features that increase the suspicion for ATTRwt CA. Presentation and phenotype can, however, be associated with atypical findings making it difficult to make a correct diagnosis. A 65-year-old man was admitted for an acute coronary syndrome. Echocardiography revealed diffuse concentric left ventricular (LV) thickening. Because of a history of bilateral carpal tunnel syndrome and polyneuropathy, the patient underwent dedicated laboratory testing and diphosphonate scintigraphy the results of which were suggestive of transthyretin cardiac amyloidosis. Also, a dynamic LV outflow tract obstruction due to the systolic anterior motion of the anterior mitral valve was noted on echocardiography during the initial investigations. Genetic testing for hypertrophic cardiomyopathy was negative. Seeking a conclusive diagnosis, endomyocardial biopsy was performed. This confirmed the diagnosis of ATTRwt CA.Discussion: The presence of dynamic LV outflow tract obstruction is typically seen in patients with sarcomeric hypertrophic cardiomyopathy. It can be rarely seen also in individuals with cardiac amyloidosis, including ATTR-wt CA. The presence of so-called red flags in patients' history, physical examination, laboratory test, ECG and imaging should raise suspicion for other etiologies of LV wall thickening than hypertrophic cardiomyopathy. Although noninvasive diagnosis of ATTRwt CA is possible in most patients, endomyocardial biopsy remains necessary in cases with diagnostic ambiguity.","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001501","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}

引用次数: 0

Highlights aus unserem Fortbildungsprogramm. 我们的培训计划。

IF 1.9 4区医学

Wiener Klinische Wochenschrift Pub Date : 2025-05-01 DOI: 10.1007/s00508-025-02538-2

引用次数: 0