Wiener Klinische Wochenschrift最新文献

{"title":"Complications of forgotten ureteral stents: stone encrustation and stent embedded in stone.","authors":"Gökhan Tonkaz, Duygu Erkal, Mehmet Tonkaz, Ahmet Yasin Yitik","doi":"10.1007/s00508-025-02513-x","DOIUrl":"10.1007/s00508-025-02513-x","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"317-318"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504636","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 causal relationship between hypothyroidism and rheumatoid arthritis, but not hyperthyroidism: evidence from the mendelian randomization study.","authors":"Mingyi Yang, Yani Su, Ke Xu, Pengfei Wen, Jianbin Guo, Zhi Yang, Lin Liu, Peng Xu","doi":"10.1007/s00508-024-02386-6","DOIUrl":"10.1007/s00508-024-02386-6","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the genetic level causal association among hyperthyroidism, hypothyroidism, and rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>We utilized the genome-wide association studies (GWAS) summary data for exposure (hyperthyroidism and hypothyroidism) and outcome (RA) from the IEU OpenGWAS database. We used two different sets of data (test cohort and validation cohort) for causal assessment of exposure and outcome. To establish a causal relationship between these conditions, we conducted a two-sample Mendelian randomization (MR) analysis. Subsequently, we evaluated the MR analysis results for heterogeneity, horizontal pleiotropy, and outliers, aiming to assess the validity and reliability of the findings. Moreover, we conducted additional analyses to examine the robustness of the MR results, including a \"Leave one out\" analysis and the MR robust adjusted profile score (MR-RAPS) method, ensuring the robustness and adherence to normal distribution assumptions.</p><p><strong>Results: </strong>The findings from the test cohort indicated that hyperthyroidism did not exhibit a genetic causal association with RA (P = 0.702, odds ratio [OR] 95% confidence interval [CI] = 1.021 [0.918-1.135]). Conversely, hypothyroidism displayed a positive genetic causal relationship with RA (P < 0.001, OR 95% CI = 1.239 [1.140-1.347]). The analysis results of the validation cohort are consistent with those of the test cohort. Notably, our MR analysis results demonstrated no evidence of heterogeneity, horizontal pleiotropy, or outliers. Furthermore, our MR analysis results remained unaffected by any single nucleotide polymorphism (SNP) and exhibited a normal distribution.</p><p><strong>Conclusion: </strong>The results of this study showed that hypothyroidism was positively correlated with RA, while hyperthyroidism was not causally correlated with RA. Hypothyroidism may as a risk factor of RA should be paid attention to in clinical work. Future studies are needed to further confirm this finding.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"279-290"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432947","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":"mitteilungen der gesellschaft der ärzte in wien.","authors":"","doi":"10.1007/s00508-025-02547-1","DOIUrl":"https://doi.org/10.1007/s00508-025-02547-1","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":"137 9-10","pages":"324"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080857","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":"Genetic relationship between rheumatoid arthritis and cardiovascular diseases : A systematic review of Mendelian randomization studies.","authors":"Mathias Ausserwinkler, Sophie Gensluckner, Andreas Voelkerer, Jens Thiel, Hans-Jörg Neumann, Maria Flamm, Christian Datz, Elmar Aigner, Bernhard Wernly","doi":"10.1007/s00508-024-02392-8","DOIUrl":"10.1007/s00508-024-02392-8","url":null,"abstract":"<p><strong>Objective: </strong>Rheumatoid arthritis (RA) is recognized as a chronic autoimmune disorder with systemic inflammation and joint damage. Its potential role as a risk factor for cardiovascular diseases (CVD) is increasingly noted. This review delves into the causal relationship between RA and CVD, with Mendelian randomization (MR) offering a genetic perspective.</p><p><strong>Methods: </strong>An extensive search was conducted in PubMed, Cochrane and Web of Science to identify MR studies addressing the RA-CVD link. Out of 530 studies, 9 met the inclusion criteria, which were rigorously assessed using a critical appraisal checklist. These were further stratified by a sensitivity analysis into categories reflecting the strength of their evidence, from not evaluable to robust.</p><p><strong>Results: </strong>From the nine included studies, eight supported a causal association between RA and an increased risk of CVD, specifically coronary artery disease (CAD) and one did not support a link between RA and heart failure. The results suggest that genetic factors associated with RA may contribute to an elevated risk for CVD. Chronic inflammation, prevalent in RA, emerges as a key mediator in this connection.</p><p><strong>Conclusion: </strong>The systematic review corroborates a genetic causal link between RA and CVD, as evidenced by eight of the nine MR studies reviewed. This suggests a need for integrated cardiovascular risk management in the treatment of RA patients. The findings advocate considering anti-inflammatory treatment that can reduce cardiovascular risk. The overarching evidence signifies a potential direction for new therapeutic strategies aimed at enhancing cardiovascular health in RA patients.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"272-278"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141767607","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":"25 years of lipid-lowering therapy: secular trends in therapy of coronary patients.","authors":"Magdalena Ratz, Johannes B Vogel, Heike Kührer, Christoph H Säly, Axel Mündlein, Alexander Vonbank, Arthur Mader, Peter Fraunberger, Andreas Leiherer, Heinz Drexel","doi":"10.1007/s00508-024-02365-x","DOIUrl":"10.1007/s00508-024-02365-x","url":null,"abstract":"<p><strong>Background and aim: </strong>Guidelines on dyslipidemia and lipid-lowering therapy (LLT) over the years recommend lower low-density lipoprotein cholesterol (LDL-C) goals by more intense therapy. Nevertheless, LDL‑C has increased in the general population. Real-world trends of LLT medication as well as of LDL‑C levels in cardiovascular high-risk patients are unclear.</p><p><strong>Methods: </strong>From 2158 patients who were referred for elective coronary angiography, lipid medication was analyzed at admission in three cardiovascular observational studies (OS) over the last 25 years: OS1: 1999-2000, OS2: 2005-2008 and OS3: 2022-2023. The three studies were performed at the same cardiology unit of a tertiary care hospital in Austria.</p><p><strong>Results: </strong>The proportion of patients without LLT significantly decreased from OS1 through OS2 to OS3 (49.4%, 45.6%, and 18.5%, respectively, p_trend < 0.001). Moreover, the percentage of patients under high-intensity statin treatment significantly increased from 0% to 5.1%, and 56.5% (p_trend < 0.001). Significantly more patients became treated by more than one compound (OS1: 1.8%, OS2: 1.6%, OS3: 31.2%; p_trend < 0.001). In the latest OS3, a trend to fixed-dose combination of statins with ezetimibe was observed. Mean LDL‑C levels decreased from 129 mg/dL over 127 mg/dL to 83 mg/dL, respectively (p_trend < 0.001). Of the patients on high-intensity therapy 34% met the recent ESC/EAS goals (LDL-C < 55 mg/dL), but only 3% on non-intense therapy.</p><p><strong>Conclusion: </strong>We conclude that during the observational period of a quarter of a century, treatment intensity increased and LDL‑C levels improved considerably. Guidelines apparently matter in this high-risk population and are considered by primary care physicians.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"297-306"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923366","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.","authors":"","doi":"10.1007/s00508-025-02550-6","DOIUrl":"https://doi.org/10.1007/s00508-025-02550-6","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":"137 9-10","pages":"321-322"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080861","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":"Ultrasound combined with radiographic localization assisting in emergency foreign body removal surgery.","authors":"Haibo Xie, Dianyi Zhang, Zhixin Liu, Bifeng Fu","doi":"10.1007/s00508-025-02511-z","DOIUrl":"10.1007/s00508-025-02511-z","url":null,"abstract":"<p><p>This case report presents a successful retrieval of a metallic foreign body located in the soft tissue of the patient's posterior thigh using a combination of ultrasound and radiography localization in an emergency setting. The combined use of ultrasound and radiography localization facilitated precise localization, reduced surgical trauma, decreased radiation exposure, and contributed to the rapid recovery of the patient.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"314-316"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658887","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":"PCSK9 inhibitors in real life-Cardiometabolic risk management in dyslipidemic patients in Vienna.","authors":"M Ferch, C Sert, P Fellinger, A Kautzky-Willer, Y Winhofer-Stöckl","doi":"10.1007/s00508-024-02402-9","DOIUrl":"10.1007/s00508-024-02402-9","url":null,"abstract":"<p><strong>Background: </strong>Proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors have emerged as important therapeutic options for patients unable to achieve the low-density lipoprotein cholesterol (LDL‑C) target or to tolerate alternative lipid-lowering agents. The aim of this study was to investigate the efficacy of PCSK9 inhibitor treatment in tertiary routine care, by determining the percentage of patients reaching individual LDL‑C target levels 1 year after treatment initiation.</p><p><strong>Patients and methods: </strong>Patients routinely started on PCSK9 inhibitors at our lipid clinic between 2017 and 2020 were retrospectively analyzed. Attainment of the LDL‑C target, utilization of follow-ups, cardiovascular events and effects on laboratory parameters were investigated.</p><p><strong>Results: </strong>In this study 347 patients were included, with the majority managed in secondary prevention (94.5%). The LDL‑C target was achieved by 44.9% after ca. 14 months, with differences between statin users and non-users (51.0% vs. 22.7%; p < 0.001). The median LDL‑C decreased from 126.00 mg/dL at baseline to 48 mg/dL (-61.6%; -77.00 mg/dL; p < 0.001) after ~2 months and to 60 mg/dL (-52.9%; -59.00 mg/dL; p < 0.001) after ~14 months. Median lipoprotein(a) levels decreased significantly from 184.0 nmol/L to 165.5 nmol/L (-25.9%; -25.5 nmol/L; p = 0.001) after ~2 months, whereas no effects on creatine kinase, amylase and lipase were detectable. Of the patients 15% utilized 4 follow-ups. The PCSK9 inhibitor intolerance occurred in 3.5% of patients.</p><p><strong>Conclusion: </strong>With the effect of LDL-lowering remaining constant over 14 months, PCSK9 inhibitor treatment showed effective and sustainable LDL‑C lowering in a majority of patients in secondary prevention, bringing them closer to the recommended LDL‑C goal, particularly those under concomitant statin medication. Treatment with PCSK9 inhibitors appears to be well-tolerated, confirming data from clinical trials in real life.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"307-313"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971988","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":"MUW researcher of the month.","authors":"","doi":"10.1007/s00508-025-02549-z","DOIUrl":"https://doi.org/10.1007/s00508-025-02549-z","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":"137 9-10","pages":"319-320"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080859","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":"Gene therapy: principles, challenges and use in clinical practice.","authors":"Cihan Ay, Andreas Reinisch","doi":"10.1007/s00508-024-02368-8","DOIUrl":"10.1007/s00508-024-02368-8","url":null,"abstract":"<p><strong>Introduction: </strong>Gene therapy is an emerging topic in medicine. The first products have already been licensed in the European Union for the treatment of immune deficiency, spinal muscular atrophy, hemophilia, retinal dystrophy, a rare neurotransmitter disorder and some hematological cancers, while many more are being assessed in preclinical and clinical trials.</p><p><strong>Objective: </strong>The purpose of this review is to provide an overview of the core principles of gene therapy along with information on challenges and risks. Benefits, adverse effects and potential risks are illustrated based on the examples of hemophilia and spinal muscular atrophy.</p><p><strong>Results: </strong>At present, in-vitro and in-vivo gene addition or gene augmentation is the most commonly established type of gene therapy. More recently, more sophisticated and precise approaches such as in situ gene editing have moved into focus. However, all types of gene therapy require long-term observation of treated patients to ensure safety, efficacy, predictability and durability. Important safety concerns include immune reactions to the vector, the foreign DNA or the new protein resulting from gene therapy, and a remaining low cancer risk based on insertional mutagenesis. Ethical and regulatory issues need to be addressed, and new reimbursement models are called for to ease the financial burden that this new treatment poses for the health care system.</p><p><strong>Conclusion: </strong>Gene therapy holds great promise for considerable improvement or even cure of genetic diseases with serious clinical consequences. However, a number of questions and issues need to be clarified to ensure broad accessibility of safe and efficacious products.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"261-271"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860328","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}