Wiener Klinische Wochenschrift最新文献

{"title":"Extremity preservation in traumatic and nontraumatic lower extremity defects.","authors":"Anna Fast, Eva Placheta-Györi, Thomas Rath, Christine Radtke","doi":"10.1007/s00508-025-02585-9","DOIUrl":"https://doi.org/10.1007/s00508-025-02585-9","url":null,"abstract":"<p><strong>Background: </strong>Indications for reconstruction of the lower extremity range from posttraumatic defects to infections and tumors. Despite advancements in plastic surgery, flap surgery still poses a challenge. In this retrospective study local flap surgeries and microsurgical free flaps were assessed. Postoperative complications and limb preservation were analyzed.</p><p><strong>Methods: </strong>This retrospective study included 187 patients who were treated at a university-affiliated tertiary care hospital. Defects were of traumatic (29.4%) and nontraumatic (70.6%) etiology. Limb preservation was determined during a 12-month follow-up period. Patient characteristics, flap selection and postoperative flap-associated complications were collected.</p><p><strong>Results: </strong>The patient population included 107 men (57.2%) and 80 women (42.8%), 104 (55.6%) free flaps and 83 (44.4%) local flaps were performed. In the free flap group latissimus dorsi and gracilis flaps were most commonly performed. The most common surgeries in the local flap group were gastrocnemius, soleus and plantaris medialis muscle flaps. The overall limb preservation rate was 92.5% with no significant difference between the two groups.</p><p><strong>Conclusion: </strong>Both methods enable reconstruction of complex lower extremity wounds and enable limb preservation in many cases. The type of flap is selected based on the anatomical location of the defect, defect size and patient factors.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875467","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":"When rash challenges treatment: reintroducing cystic fibrosis modulator therapy safely.","authors":"T Vukić Bilić, M Alebić, M Banić, D Darapi, R Likić, M Ganza, D Rnjak, D Tješić-Drinković, A Vukić Dugac","doi":"10.1007/s00508-025-02583-x","DOIUrl":"https://doi.org/10.1007/s00508-025-02583-x","url":null,"abstract":"<p><p>Various adverse reactions to elexacaftor/tezacaftor/ivacaftor (ETI) therapy have been documented in the literature. Here, we present the first reported case in Croatia of severe rash following ETI therapy in a 19-year-old female cystic fibrosis (CF) patient. There were two attempts to introduce ETI therapy, spaced two months apart, both of which resulted in diffuse maculopapular rash, in the second attempt, the rash appeared on the same day as re-initiation. Given the clinical benefits of ETI treatment, andinspired by several case reports on drug desensitization, in July 2023, we started the patient on a modified 3-day-tolerance induction protocol which was successful.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875468","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":"Could alpha-gal syndrome be the cause of southern tick-associated rash illness (STARI)? : A simple study could answer that question.","authors":"Gary P Wormser, Akira Shishido","doi":"10.1007/s00508-025-02584-w","DOIUrl":"https://doi.org/10.1007/s00508-025-02584-w","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817647","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":"Comments on \"The impact of artificial intelligence on the adenoma detection rate: comparison between experienced, intermediate and trainee endoscopists' adenoma detection rate\".","authors":"Wenjia Guo, Yi Chen","doi":"10.1007/s00508-025-02596-6","DOIUrl":"https://doi.org/10.1007/s00508-025-02596-6","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800424","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":"Hypovolemic shock due to massive subcutaneous hemorrhage in a patient with musculocontractural Ehlers-Danlos syndrome (mcEDS).","authors":"R Laggner, S Payr, L Adam, D Baron, L Zak","doi":"10.1007/s00508-025-02577-9","DOIUrl":"https://doi.org/10.1007/s00508-025-02577-9","url":null,"abstract":"<p><p>Musculocontractural Ehlers-Danlos syndrome (mcEDS) is a rare autosomal recessive connective tissue disorder characterized by fragility of skin, vasculature and musculoskeletal structures. We report a case of a young male with CHST14(Carbohydrate sulfotransferase 14)-related mcEDS who developed a massive subcutaneous hematoma following minor trauma, necessitating surgical evacuation. This case highlights the potential for life-threatening bleeding complications in mcEDS and underscores the importance of early recognition and multidisciplinary management.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785445","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":"Was kommt nach CDK4/6-Inhibition? Perspektiven beim fortgeschrittenen Mammakarzinom.","authors":"Vanessa Castagnaviz, Anna Fenzl, Michael Gnant, Rupert Bartsch","doi":"10.1007/s00508-025-02582-y","DOIUrl":"10.1007/s00508-025-02582-y","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"219-232"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754583","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":"Correction to: Diagnosis and treatment of iron deficiency in chronic heart failure.","authors":"Moritz Messner, Gerhard Pölzl, Christopher Adlbrecht, Johann Altenberger, Johann Auer, Robert Berent, Jakob Dörler, Marc-Michael Zaruba, Christian Ebner, Friedrich Fruhwald, Martin Hülsmann, Deddo Mörtl, Peter P Rainer, Anna Rab, Thomas Weber, Rudolf Berger","doi":"10.1007/s00508-025-02576-w","DOIUrl":"https://doi.org/10.1007/s00508-025-02576-w","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761561","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":"Acute myeloid leukemia in the next-generation sequencing era : Real-world data from an Austrian tertiary cancer care center.","authors":"Sonja Wurm, Michael Waltersdorfer, Simone Loindl, Jennifer M Moritz, Sereina A Herzog, Gerhard Bachmaier, Andrea Berghold, Karl Kashofer, Christine Beham-Schmid, Gerald Hoefler, Hildegard T Greinix, Albert Wölfler, Andreas Reinisch, Heinz Sill, Armin Zebisch","doi":"10.1007/s00508-024-02463-w","DOIUrl":"10.1007/s00508-024-02463-w","url":null,"abstract":"<p><strong>Background: </strong>Next-generation sequencing (NGS) has recently entered routine acute myeloid leukemia (AML) diagnostics. It is paramount for AML risk stratification and identification of molecular therapeutic targets. Most NGS feasibility and results data are derived from controlled clinical intervention trials (CCIT). We aimed to validate these data in a real-world setting.</p><p><strong>Patients, materials and methods: </strong>This study retrospectively analyzed 447 AML patients treated at an Austrian tertiary cancer care center. A total of 284 out of the 447 cases were treated between 2013-2023 when NGS was locally available for the clinical routine.</p><p><strong>Results: </strong>The NGS was successfully performed from bone marrow biopsies and aspirates, with processing times decreasing from 22 days in 2013/2014 to 10 days in 2022. Molecular therapeutic target(s) were identified by NGS in 107/284 (38%) cases and enabled risk stratification in 10 cases where conventional karyotyping failed. Concerning molecular landscape, TET2 (27%), FLT3 (25%), DNMT3A (23%), and NPM1 (23%) were most frequently mutated. Comparing older and younger patients (cut-off 70 years) showed enrichment in older people for mutations affecting DNA methylation (72% vs. 45%; P < 0.001) and the spliceosome (28% vs. 11%; P = 0.006) and more cellular signaling mutations in younger patients (61% vs. 46%; P = 0.022). Treatment outcomes corroborated a significant survival benefit in the recent NGS era and patients treated with novel/molecularly targeted drugs. Ultimately, biospecimens of these patients are stored within a leukemia biobank, generating a valuable tool for translational science.</p><p><strong>Conclusion: </strong>Our study validates data from CCIT and supports their relevance for treatment decisions in a real-world setting. Moreover, they demonstrate the feasibility and benefits of NGS within a routine clinical setting.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"504-516"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628790","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":"Lungenfunktion in Theorie und Praxis.","authors":"","doi":"10.1007/s00508-025-02587-7","DOIUrl":"https://doi.org/10.1007/s00508-025-02587-7","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":"137 15-16","pages":"534"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971532","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":"Efficacy and safety of intradetrusor abobotulinumtoxinA and incobotulinumtoxinA in women with overactive bladder and the value of local anesthesia: a randomized clinical study.","authors":"Niko Kavcic, Andrej Avsenak, Jan Zmazek, Tamara Serdinsek, Igor But","doi":"10.1007/s00508-024-02412-7","DOIUrl":"10.1007/s00508-024-02412-7","url":null,"abstract":"<p><strong>Background: </strong>A non-inferiority clinical study evaluated the efficacy and safety of abobotulinumtoxinA vs. incobotulinumtoxinA intradetrusor injections in women with overactive bladder and urge urinary incontinence. Also, the effect of local anesthesia on the pain level of the procedure was assessed.</p><p><strong>Methods: </strong>Patients were randomized to receive 20 intradetrusor injections of either 300 U abobotulinumtoxinA or 100 U incobotulinumtoxinA. They were further randomized to receive either local anesthesia (40 ml 1% lidocaine solution) or placebo before botulinum toxin injection. Before the procedure and 4 months after the procedure each patient reported urinary incontinence episodes, frequency, nocturia, completed the Urogenital Distress Inventory (UDI-6) score, Incontinence Impact Questionnaire (IIQ-7), and Incontinence Quality of Life (I-QOL) questionnaire. Each patient completed a patient satisfaction survey 4 months after the procedure. During the procedure, the patients graded the pain intensity of every injection on a visual analog scale (VAS). The total score of each questionnaire was considered.</p><p><strong>Results: </strong>A total of 54 patients with a mean age of 66 ± 13 (SD) years completed the study. Total scores of UDI‑6, IIQ‑7, I‑QOL, patient satisfaction, urinary incontinence episodes, frequency, nocturia and VAS questionnaires did not show differences between the abobotulinumtoxinA (n = 26) or incobotulinumtoxinA (n = 28) group. Urinary retention requiring catheterization was noted in five patients. The VAS and patient satisfaction questionnaire values did not show significant differences between the group receiving bladder instillation with lidocaine solution (n = 28) or the group receiving placebo (n = 26).</p><p><strong>Conclusion: </strong>In women with overactive bladder and urge urinary incontinence where conservative treatment failed, abobotulinumtoxinA vs. incobotulinumtoxinA intradetrusor injections showed comparable results regarding improved clinical outcome and patient satisfaction. Local anesthesia before the procedure did not reduce the pain level in comparison with the placebo.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":"470-478"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047279","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}