{"title":"Advances in clinical gerontology: from healthy longevity to prevention of care needs.","authors":"Thomas E Dorner","doi":"10.1007/s00508-024-02413-6","DOIUrl":"10.1007/s00508-024-02413-6","url":null,"abstract":"","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018857","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":"The Viennese dissection course-A model for Habsburg medical teaching (1787-1848).","authors":"Sophia Bauer, Leo Schaukal, Wolfgang J Weninger","doi":"10.1007/s00508-024-02433-2","DOIUrl":"https://doi.org/10.1007/s00508-024-02433-2","url":null,"abstract":"<p><p>This article delves into the beginnings of the dissection course, a teaching practice which today is still in place in Vienna and continues to shape future medical practitioners. Based on a comparison of different historical sources the article shows that the Viennese tradition of a dissection course dates back to the 1780s and the initiative of the anatomist Joseph Barth to build a dissection institute and to implement a dissection course, two endeavors that coincided with Joseph II's reform ideas regarding a practically orientated medical and surgical education and a Europe-wide practice turn. Additionally, this paper shows the role of the Viennese dissection course as model for other Habsburg universities and, thus, explains the similarities of today's dissection courses in different former Habsburg universities.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112641","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}
Ahmet Burak Dirim, Nazrin Namazova, Merve Guzel Dirim, Ozgur Akin Oto, Ayse Serra Artan, Ozge Hurdogan, Yasemin Ozluk, Halil Yazici
{"title":"Baseline systemic inflammatory indices and clinicopathological features to predict the outcome of acute tubulointerstitial nephritis : A single-center retrospective study.","authors":"Ahmet Burak Dirim, Nazrin Namazova, Merve Guzel Dirim, Ozgur Akin Oto, Ayse Serra Artan, Ozge Hurdogan, Yasemin Ozluk, Halil Yazici","doi":"10.1007/s00508-024-02417-2","DOIUrl":"https://doi.org/10.1007/s00508-024-02417-2","url":null,"abstract":"<p><strong>Background: </strong>Acute tubulointerstitial nephritis (AIN) is an immune-mediated disorder that can cause acute kidney injury (AKI). We aimed to investigate the characteristics of patients with AIN and predictive factors for treatment response.</p><p><strong>Material and methods: </strong>In this study, thirty-one patients diagnosed with AIN on kidney biopsy between 2006 and 2021 were included. Baseline clinical, histopathological, and laboratory findings, including complete blood count (CBC), creatinine, erythrocyte sedimentation rate, C‑reactive protein, C3, C4, systemic immune inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and urinalysis were evaluated. Treatment response, mortality, and creatinine levels at the time of last follow-up were also noted.</p><p><strong>Results: </strong>The median age was 46 years and 80.6% were female. Median baseline creatinine and proteinuria levels were 4.1 mg/dL and 0.84 gram/day. The median follow-up period was 14 months and 93.5% received immunosuppressives. End-stage kidney disease (ESKD) developed in five patients (16.1%). Renal recovery (creatinine < 1.4 mg/dL) was observed in 17 patients (54.8%). Higher degrees of interstitial fibrosis, tubular atrophy, granuloma formation, global glomerulosclerosis, and higher baseline hemoglobin levels, in addition to a longer interval between first symptom to initiation of immunosuppressives were associated with renal nonrecovery, statistically. Also, patients who progressed to ESKD had higher baseline hemoglobin (p = 0.033) and lymphocyte (p = 0.044) and lower PLR levels (p = 0.016), as well as higher degrees of global glomerulosclerosis (p = 0.014), interstitial fibrosis (p = 0.042), and tubular atrophy (p = 0.030).</p><p><strong>Conclusion: </strong>Treatment response rates are low for AIN, which may lead to ESKD. Besides chronicity in histopathology specimens, higher baseline hemoglobin levels and lower platelet-to-lymphocyte ratio might be prognostic. Further studies should be conducted on new markers for AIN.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074089","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}
Emre Söylemez, Mehmet Dağ, Abdulkadir Ilgaz, Bekir Korkmaz, Ümit Topçuoğlu, Ahmet Düha Koç, Serdar Ensari
{"title":"Excessive smartphone use increases self-reported auditory and vestibular symptoms.","authors":"Emre Söylemez, Mehmet Dağ, Abdulkadir Ilgaz, Bekir Korkmaz, Ümit Topçuoğlu, Ahmet Düha Koç, Serdar Ensari","doi":"10.1007/s00508-024-02418-1","DOIUrl":"https://doi.org/10.1007/s00508-024-02418-1","url":null,"abstract":"<p><strong>Background: </strong>With widespread smartphone use, there is growing concern about their potential impact on human health.</p><p><strong>Objective: </strong>The effects of smartphone use on self-reported hearing ability, tinnitus, balance, falls, and anxiety level were investigated in this study.</p><p><strong>Methods: </strong>This study included 682 participants who were divided into 2 groups: a high smartphone use (HSU) group and a low smartphone use (LSU) group. Both groups were evaluated for hearing ability using the Amsterdam inventory for auditory disability and handicap; balance status using the vertigo, dizziness, imbalance symptom scale; anxiety status using the Beck anxiety index; and fall and tinnitus status using the visual analog scale.</p><p><strong>Results: </strong>The HSU group showed significantly worse hearing ability, tinnitus, balance, falling, and anxiety status results than the LSU group (p < 0.001). There was a positive correlation between smartphone addiction severity and auditory impairment, tinnitus, risk of falling, and anxiety, as well as a negative correlation with balance score (p < 0.001).</p><p><strong>Conclusion: </strong>The findings suggest that individuals with excessive smartphone use are more likely to experience hearing, tinnitus, balance, falling, and anxiety problems than those who use smartphones less frequently. Excessive smartphone use may be considered a potential risk factor for these problems.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037083","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}
Niko Kavcic, Andrej Avsenak, Jan Zmazek, Tamara Serdinsek, Igor But
{"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":"https://doi.org/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":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sonja Valsky, David Mutschlechner, Dominik Wiedemann, Thomas Gremmel
{"title":"Isolated pulmonary valve endocarditis.","authors":"Sonja Valsky, David Mutschlechner, Dominik Wiedemann, Thomas Gremmel","doi":"10.1007/s00508-024-02416-3","DOIUrl":"https://doi.org/10.1007/s00508-024-02416-3","url":null,"abstract":"<p><p>Isolated pulmonary valve endocarditis (IPE) is a rare form of infectious endocarditis. This article reports the case of a 49-year-old patient with IPE who was initially admitted with suspected cholecystitis. After vegetations were detected by transthoracic (TTE) and transesophageal echocardiography (TEE), antibiotic therapy in accordance with the antibiogram was primarily attempted; however, due to persistently elevated infection parameters and structural valve damage a pulmonary valve replacement was eventually performed.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047280","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}
M Ferch, C Sert, P Fellinger, A Kautzky-Willer, Y Winhofer-Stöckl
{"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":"https://doi.org/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":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Addressing healthcare vulnerabilities in nursing homes : Insights from human rights monitoring in two Austrian provinces.","authors":"Arkadiusz Komorowski, Theresa Rahel Demmer, Marianne Auer, Marianne Schulze, Gabriele Fischer","doi":"10.1007/s00508-024-02409-2","DOIUrl":"https://doi.org/10.1007/s00508-024-02409-2","url":null,"abstract":"<p><strong>Background: </strong>Current demographic changes bear challenges for national care systems due to higher life expectancy of older citizens. Largely cut off from society, nursing home residents are at risk for violence, neglect, and other potential human rights violations. This study aimed to investigate healthcare vulnerabilities in nursing homes and evaluate the Austrian National Preventive Mechanism (NPM).</p><p><strong>Methods: </strong>Between 2017 and 2019, 55 monitoring visits were conducted in 32 nursing homes. Study outcomes from two Austrian provinces included data on infrastructure, occupancy, staffing, resident's demographics and medical conditions, as well as measures related to the functioning of the NPM.</p><p><strong>Results: </strong>Accessibility with mobility aids was sufficient in 87%, but assistance for persons with visual or hearing impairments solely in 20-40% of the institutions. An understaffing with nursing assistants (-5.2 full-time equivalents in Carinthia) and home helpers (-1.6 in Carinthia and Styria) was present. Less than 20% of the personnel received advanced training related to dementia and neuropsychiatric care. While 50% of the residents were diagnosed with a psychiatric disorder, approximately 36% received support from an appointed legal guardian. Of the monitoring visits 58.1% were conducted due to anonymous complaints and urgent referrals. The median processing times of the NPM and the provincial governments exceeded 250 days.</p><p><strong>Conclusion: </strong>Human rights monitoring reveals critical aspects in nursing home care, including insufficient accessibility, understaffing and inadequate training. Although the authorities' handling times hinder prompt responses, the NPM may foster systemic improvements and accountability within nursing homes.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914142","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}
Katharina Moritz, Carolina Amelunxen, Michael Bergmann, Florian Vafai-Tabrizi, Georg-Christian Funk
{"title":"Healing chronic idiopathic eosinophilic pneumonia using mepolizumab alone without corticosteroids.","authors":"Katharina Moritz, Carolina Amelunxen, Michael Bergmann, Florian Vafai-Tabrizi, Georg-Christian Funk","doi":"10.1007/s00508-024-02406-5","DOIUrl":"https://doi.org/10.1007/s00508-024-02406-5","url":null,"abstract":"<p><p>While glucocorticoids remain the standard first-line treatment for chronic idiopathic eosinophilic pneumonia (CIEP), the long-term use is marred by significant side effects. This case study explores the effectiveness of mepolizumab, an anti-interleukin‑5 (IL-5) monoclonal antibody, as a novel corticosteroid-free alternative in treating CIEP. A 50-year-old woman presented with a 3-week history of progressive shortness of breath, dry cough and night sweats. The blood tests showed eosinophilia, and chest radiography identified lung consolidations. The CIEP was confirmed, ruling out other conditions through a detailed clinical and bronchoscopic work-up. The patient declined to be treated with systemic glucocorticoids. Treatment with mepolizumab was remarkable for effectively resolving symptoms and improving radiological findings without any prior or concurrent glucocorticoid therapy. Notably, the patient remained relapse-free over a 2-year follow-up, underscoring mepolizumab's efficacy as a corticosteroid-free treatment for CIEP. This case study calls for further research into anti-IL‑5 treatment of rare respiratory conditions.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903070","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":"Balint groups' possible role in self-care and job satisfaction of general practitioners-A qualitative study.","authors":"Karina Schweiger, Benedikt Hofbaur, Susanne Rabady","doi":"10.1007/s00508-024-02404-7","DOIUrl":"https://doi.org/10.1007/s00508-024-02404-7","url":null,"abstract":"<p><strong>Background: </strong>Concerns are growing when it comes to the shortage of primary care physicians, therefore it seems necessary to take a closer look at job satisfaction and self-care as one of many influences on career choice. A higher job satisfaction reduces the risk to experience burnout and job-related stress and in addition it will contribute to staying in the profession. The objective of this study is to investigate the impact of regular participation in Balint groups on job satisfaction and self-care among general practitioners.</p><p><strong>Methods: </strong>Descriptive qualitative study with semi-structured expert interviews of 7 general practitioners. Thematical analysis of data and narrative summary.</p><p><strong>Results: </strong>A total of 402 coded segments were categorized into 8 main themes and 39 subthemes. Interviewees emphasized changes in self-care and job satisfaction as a result of Balint work and mentioned Balint work as a burnout prophylaxis for themselves. Competences that were learnt or improved through Balint work were described as well as aspects such as feedback and connection with colleagues or professional challenges and difficulties.</p><p><strong>Conclusion: </strong>The results of the study give rise to the assumption that regular participation in Balint groups might help to improve self-care, resilience, and contribute to job satisfaction. Further research is needed before a general recommendation can be made. Many positive aspects were described by the experts, while no harmful negative influences of Balint work were identified.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894425","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}