Wiener Klinische Wochenschrift最新文献

{"title":"Austrian Society of Gastroenterology and Hepatology (ÖGGH) consensus on primary biliary cholangitis.","authors":"Emina Halilbasic, Elisabeth Tatscher, Elmar Aigner, Lukas Burghart, Ivo Graziadei, Stephanie Hametner-Schreil, Benedikt Silvester Hofer, Harald Hofer, Andreas Maieron, Mattias Mandorfer, Markus Peck-Radosavljevic, Benedikt Schaefer, Wolfgang Sieghart, Martin Stradner, Stefan Traussnigg, Martin Wagner, Heinz Zoller, Peter Fickert, Michael Trauner","doi":"10.1007/s00508-026-02798-6","DOIUrl":"10.1007/s00508-026-02798-6","url":null,"abstract":"<p><p>This consensus document of the Austrian Society of Gastroenterology and Hepatology (ÖGGH) is intended to provide practical guidance for the management of individuals with primary biliary cholangitis (PBC).PBC is a chronic inflammatory, autoimmune-mediated disease of the intrahepatic bile ducts that can lead to fibrosis and ultimately cirrhosis. Middle-aged women are significantly more frequently affected than men. The pathogenesis is currently not fully understood. Based on the presence of disease-specific autoantibodies, it is classified as an autoimmune liver disease, although a combination of genetic predisposition and environmental factors contribute to disease development and progression.The diagnosis of PBC is based on a cholestatic enzyme pattern together with the presence of anti-mitochondrial antibodies (AMA) or PBC-specific anti-nuclear antibodies (sp100, gp210). A liver biopsy is rarely required to establish the diagnosis; exceptions are the suspicion of a PBC autoimmune hepatitis (AIH) variant syndrome or the absence of the abovementioned antibodies.The therapeutic goal is to reduce cholestatic injury thereby preventing disease progression and to reduce symptoms. Approximately 60-70% of patients achieve clinical and biochemical remission with first-line treatment, i.e., ursodeoxycholic acid (UDCA). Recently, the therapeutic paradigm has shifted from achieving certain predefined response criteria to a normalization of alkaline phosphatase (ALP) together with a low-normal bilirubin level, as the latter was linked to improved outcomes in some subgroups. For patients who do not sufficiently respond to UDCA, the newly approved peroxisome proliferator-activated receptor (PPAR) agonists elafibranor and seladelpar, as well as bezafibrate (off-label use), should be used as a combination treatment with UDCA. In patients with decompensated cirrhosis, liver transplantation has been associated with good long-term outcomes, albeit disease recurrence occurs in up to 50% by 15 years.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"831-858"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13601090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920992","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":"\"Lunge digital\".","authors":"","doi":"10.1007/s00508-026-02823-8","DOIUrl":"https://doi.org/10.1007/s00508-026-02823-8","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":"138 17-18","pages":"583"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991497","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":"MUW researcher of the month: Prof. Dr. Marco Hein.","authors":"","doi":"10.1007/s00508-026-02824-7","DOIUrl":"https://doi.org/10.1007/s00508-026-02824-7","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":"138 17-18","pages":"581-582"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991479","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":"Short-term clinical, functional and MRI findings after hamstring allograft vs. autograft ACL reconstruction : A pilot randomized controlled trial.","authors":"Paul Ruckenstuhl, Amir Koutp, Tobias Oswald, Stefan Fischerauer, Andreas Leithner, Matthias Groell, Patrick Sadoghi, Gerald Gruber, Gerwin A Bernhardt","doi":"10.1007/s00508-026-02805-w","DOIUrl":"https://doi.org/10.1007/s00508-026-02805-w","url":null,"abstract":"<p><strong>Purpose: </strong>Graft choice in primary anterior cruciate ligament (ACL) reconstruction remains controversial. While hamstring autografts are common, allografts offer advantages such as no donor site morbidity and reduced operation time. This study aimed to compare the clinical, functional and health-related quality of life (HRQOL) outcomes of hamstring allografts vs. autografts in primary ACL reconstruction.</p><p><strong>Methods: </strong>In this single-center randomized controlled trial, patients undergoing primary ACL reconstruction were randomized to receive either a hamstring allograft or autograft. Clinical evaluation and patient-reported outcome measures (PROMs), including the International Knee Documentation Committee (IKDC), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Short Form (SF)-36 Health survey, were collected preoperatively and at multiple follow-ups to 12 months. Operation time and postoperative magnetic resonance imaging (MRI) scans at 12 months were also analyzed.</p><p><strong>Results: </strong>The final cohort included 25 patients (13 allograft, 12 autograft). At 12 months, no statistically significant differences between groups were detected for any PROM. Mean IKDC scores were 83.0 ± 7.2 in the allograft group and 87.2 ± 5.0 in the autograft group (p = 0.12). Both groups demonstrated improvement in patient-reported functional outcomes; however, objective instrumented laxity testing was not performed. Mean operation time was significantly shorter for the allograft group (61.6 ± 11.4 min) compared to the autograft group (83.0 ± 13.6 min; p < 0.001).</p><p><strong>Conclusion: </strong>In this small pilot randomized cohort of patients aged 27 years and older, no statistically significant short-term differences in PROMs were detected between hamstring allograft and autograft ACL reconstruction at 12 months. Allograft use was associated with significantly shorter operative time. These findings should be interpreted cautiously because the study was not powered to demonstrate equivalence or noninferiority and longer term follow-up with objective laxity testing is required to assess graft durability and stability.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876093","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 reduction in conservative treatment of boxer fractures : A retrospective study of 115 patients.","authors":"Paul Lennart Hoppe, Margarete Maria Steiner, Laura Maria Kurz, Thomas Haider, Stefan Hajdu, Gerhild Thalhammer","doi":"10.1007/s00508-026-02711-1","DOIUrl":"10.1007/s00508-026-02711-1","url":null,"abstract":"<p><strong>Purpose: </strong>Subcapital fractures of the fifth metacarpal bone are one of the most common fractures of the hand. Surgical and conservative treatment is possible but the respective indications remain controversial. Closed reduction and cast retention are commonly performed for these fractures but their effectiveness in fracture retention is unclear. Therefore, the aim of this study was to evaluate the efficacy of closed reduction with consecutive below-elbow casting and finger splinting.</p><p><strong>Methods: </strong>Radiographs of 115 patients with a subcapital fracture of the fifth metacarpal bone at an academic level 1 trauma center were retrospectively reviewed and volar angulation was assessed at initial presentation, after reduction and at the end of treatment.</p><p><strong>Results: </strong>The patients mean age was 32 years (IQR 25-37 years) and 93% were male (n = 107). Cast immobilization was 4 weeks in all cases. Volar angulation at initial presentation was 49.9° ± 11°. After reduction an angle of 40.9° ± 9.2°was observed. After cast removal, an angulation of 42.4° ± 9.9° was observed. A repeated measures ANOVA with a Huynh-Feldt correction showed that the difference in mean fracture angulation was statistically significant.</p><p><strong>Conclusion: </strong>This study indicates that improved fracture angulation can be maintained with closed reduction and retention in a below-elbow cast with finger splinting. Further studies have to be conducted to investigate whether improved fracture angulation results in more favorable clinical outcomes.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"568-574"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214352","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":"Single odor identification in subjective cognitive decline, mild cognitive impairment and Alzheimer's dementia.","authors":"Abdallah Tasnim, Johann Lehrner","doi":"10.1007/s00508-026-02721-z","DOIUrl":"10.1007/s00508-026-02721-z","url":null,"abstract":"<p><strong>Background: </strong>Olfactory dysfunction is an early biomarker of Alzheimer's dementia (AD) and cognitive impairments. This study examines odor-specific olfactory deficits across cognitive impairment stages using the Sniffin' Sticks Odor Identification Test (SS-OIT).</p><p><strong>Objective: </strong>To assess the discriminative validity of specific odors in differentiating subjective cognitive decline (SCD), non-amnestic mild cognitive impairment (naMCI), amnestic mild cognitive impairment (aMCI), and AD from healthy controls (HC). Additionally, the influences of age, gender, verbal intelligence and depression on olfactory performance were analyzed. Participants were also grouped into an AD versus non-AD category (comprising SCD, naMCI, and aMCI) for logistic regression analyses.</p><p><strong>Methods: </strong>A retrospective analysis at the Department of Neurology of the Medical University of Vienna included 737 participants aged 50 years and older. Olfactory identification was assessed using the 16-item Sniffin' Sticks odor identification test. The discriminative power of specific odors was evaluated for distinguishing AD from non-AD groups. Bonferroni corrections were applied to adjust for multiple comparisons, which increases the stringency of statistical significance across the 16 odors tested.</p><p><strong>Results: </strong>Significant differences in odor identification were observed across diagnostic groups. The AD patients exhibited the most pronounced deficits, particularly in recognizing clove, rose and aniseed. Age negatively correlated with olfactory performance, while higher verbal intelligence was a protective factor. Key odors differentiated AD from non-AD groups, highlighting the diagnostic potential of olfactory testing.</p><p><strong>Conclusion: </strong>Odor-specific olfactory deficits serve as early indicators of cognitive decline. The Sniffin' Sticks test, particularly key odors, may aid early detection and differentiation of cognitive impairments. Accounting for covariates enhances the diagnostic accuracy. Future research should aim to refine olfactory testing protocols and assess their clinical utility in broader populations.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"545-557"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391439","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":"Emergency physician attended calls that could have been covered by advanced emergency medical technicians in Austria : Results of the Austrian Emergency Day 2025 audit.","authors":"Helmut Trimmel, Romana Erblich, Christian Anzur, Stefan Dressler-Stross, Wolfgang Voelckel, Mario Krammel, Armin Krösbacher, Berndt Schreiner, Christian Fohringer, Markus Gschanes, Gerhard Prause, Martin W Dünser","doi":"10.1007/s00508-026-02722-y","DOIUrl":"10.1007/s00508-026-02722-y","url":null,"abstract":"<p><strong>Background: </strong>Emergency physician-staffed emergency medical services (EMS) in Austria frequently attend low priority calls, raising concerns about over-triage and future workforce sustainability.</p><p><strong>Objective: </strong>To quantify the proportion of emergency physician-attended calls that could have been managed by advanced emergency medical technicians (AEMT), with or without telemedical physician support, and evaluate current AEMT practice and training needs.</p><p><strong>Methods: </strong>This prospective, nationwide audit collected data from public physician-staffed EMS in Austria over a 24‑h period. Emergency physicians documented call characteristics, NACA (National Advisory Committee for Aeronautics) severity scores, AEMT presence, actual and potential EMT or AEMT interventions, accuracy of severity assessment and their judgement regarding the necessity of on-scene physician involvement.</p><p><strong>Results: </strong>Out of 149 physician-staffed EMS, 88 (59.1%) participated recording 313 calls and 273 emergency calls, 25 interhospital transfers and 15 telemedical emergency physician consultations were included. Emergency physicians assessed that 53.4% (95% confidence interval, CI 46.8-60.0%) of emergency calls and 48.0% (95% CI 28.4-67.6%) of interhospital transfers could have been managed by AEMTs. Approximately one third of these would have required telemedical physician support. The AEMTs arrived on the scene before emergency physicians in 75.1% of emergency calls and correctly assessed disease severity in 88.4% of cases and one or more additional interventions could have been set by AEMTs before emergency physician arrival in 48.0% of emergency calls. Most physicians supported expanding AEMT competencies and telemedical physician services.</p><p><strong>Conclusion: </strong>The results of this nationwide audit suggest that more than half of emergency calls and interhospital transfers attended by emergency physicians in Austria could have been managed by AEMTs with or without telemedical emergency physician support.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"558-567"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147356852","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":"[Consensus recommendation of the Austrian Society of Cardiology: anatomy, pathophysiology, diagnosis and treatment of arrhythmias in adult patients with congenital heart disease].","authors":"Barbara Wichert-Schmitt, Stefan Kurath-Koller, Lore Schrutka, Johannes Mair, Hermann Blessberger, Karim Saleh, Georgios Kollias, Stefan Stojkovic, Tomaz Podnar, Ante Burmas, Daniel Scherr, Christoph Schukro","doi":"10.1007/s00508-026-02801-0","DOIUrl":"10.1007/s00508-026-02801-0","url":null,"abstract":"<p><p>This consensus recommendation of the Working Group for Congenital and Acquired Heart Disease and the Working Group for Rhythmology of the Austrian Society of Cardiology (ÖKG) describes the pathophysiological foundations, clinical presentation, diagnosis and treatment of arrhythmias in adult patients with congenital heart defects. It also illuminates malformation-specific aspects with respect to the anatomy, typical corrective interventions, risk of arrhythmia and treatment.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"805-829"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907329","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 case of bilateral multicystic encephalomalacia secondary to neonatal hypoglycemia in a 6-month-old girl.","authors":"Gökhan Polat, Furkan Akman, Fatih Enes Çay","doi":"10.1007/s00508-026-02715-x","DOIUrl":"10.1007/s00508-026-02715-x","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"578-580"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345249","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":"Evolving landscape of glioblastoma research : A 75-year bibliometric study on survival, treatment and gender in authorship.","authors":"Jana Breu, Bernhard Baumann, Jason K Sa, Anna Sophie Berghoff, Matthias Preusser, Karl-Heinz Nenning, Adelheid Woehrer","doi":"10.1007/s00508-026-02725-9","DOIUrl":"10.1007/s00508-026-02725-9","url":null,"abstract":"<p><strong>Background: </strong>Glioblastoma is the most aggressive type of brain tumor. Here, we examine the evolution of glioblastoma treatment and survival across different study types over nearly a century. Furthermore, we map the landscape of glioblastoma research to track the potential influence of publication bias on perceived progress and assess sex disparities in authorship across time, study type and geographic region.</p><p><strong>Methods: </strong>We analyzed a comprehensive dataset of glioblastoma research published from 1947-2022. A manual review of 19,668 articles yielded 2232 articles passing the inclusion criteria.</p><p><strong>Results: </strong>Overall, we observed an increased median overall survival (OS, slope = 0.16 months per year, Pearson's r = 0.23, p = 1.65e-44) for all study types. Nevertheless, reported survival outcomes varied by treatment modality. Only tumor treating fields (fitted median OS from 14.5 to 21.4 months, slope = 0.53 months per year) showed a stronger increase in positive outcomes than radiotherapy with concomitant and adjuvant temozolomide (fitted median overall survival from 12.0 to 20.0 months, slope = 0.31 months per year). Despite making up only 5.6% of all studies, randomized controlled trials had the highest cumulative impact factor and citation count and US-based researchers dominated across all study types (33.9%). Women continued to be underrepresented, particularly as last authors (25.2% female first, 18.5% female last).</p><p><strong>Conclusion: </strong>The 75 years of reported survival of patients with glioblastoma document a slow increase in overall survival. While research by women as first authors shows an upward trend, gender inequality persists, particularly in the last authorship.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"533-544"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436154","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}