Wiener medizinische Wochenschrift最新文献

{"title":"[Assessment of the importance of neuropediatric diagnostics in the initial clarification of autism].","authors":"Sarah Ruffing, Christine Ullrich, Marina Flotats-Bastardas, Martin Poryo, Sascha Meyer","doi":"10.1007/s10354-023-01012-w","DOIUrl":"10.1007/s10354-023-01012-w","url":null,"abstract":"<p><strong>Background: </strong>The diagnostics of autism spectrum disorder is complex due to missing biological markers and numerous comorbidities. The aim was to assess the role of neuropediatric diagnostics and to develop a standard operating procedure for a targeted assessment.</p><p><strong>Method: </strong>All patients presenting to the neuropediatric outpatient clinic at Saarland University Hospital between April 2014 and December 2017 with ICD code F84 pervasive developmental disorders were included.</p><p><strong>Results: </strong>A total of 82 patients were included (male 78%, female 22%; mean age 5.9 ± 2.9 years, range 2-16 years). The most frequent examination was electroencephalography (EEG) (74/82; 90.2%) with pathological findings in 33.8% (25/74). Based on the history and/or EEG epilepsy was diagnosed in 19.5% (16/82). Magnetic resonance imaging (MRI) was performed in 49/82 (59.8%) patients, 22/49 (44.9%) showed at least 1 cerebral abnormality and definite pathologies could be detected in 63.6% (14/22). A metabolic diagnostic work-up was performed in 44/82 (53.7%) cases and in 5/44 (11.4%) it resulted in a diagnosis or suspicion of a metabolic disease. Genetic testing results were available in 29/82 (35.4%) children and 12/29 (41.4%) showed abnormal results. Delay in motor development was more frequently associated with comorbidities, EEG abnormalities, epilepsy and abnormalities in metabolic and genetic testing.</p><p><strong>Conclusion: </strong>Neuropediatric examination in cases of suspected autism should include a detailed history, a thorough neurological examination and an EEG. An MRI, comprehensive metabolic and genetic testing are only recommended if clinically indicated.</p>","PeriodicalId":23882,"journal":{"name":"Wiener medizinische Wochenschrift","volume":" ","pages":"231-241"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11347487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9406764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dilatative fetal cardiomyopathy followed by a mirror syndrome.","authors":"Antonio Ivan Miletić, Feodora Stipoljev, Ana Vičić, Alan Šerman, Ivanka Bekavac Vlatković","doi":"10.1007/s10354-024-01041-z","DOIUrl":"10.1007/s10354-024-01041-z","url":null,"abstract":"<p><p>Mirror syndrome (Ballantyne syndrome) is a rare condition characterized by maternal edema, which often affects the lungs. It mirrors the image of fetal and placental edema; therefore, it is also called triple edema. We present the case of a 37-year-old secundigravida, referred to our clinic at 26 weeks of a pregnancy complicated by fetal dilatative restrictive cardiomyopathy and hydrops, placentomegaly, new-onset dyspnea, and maternal calf edema. Due to worsening mirror syndrome, preterm labor was induced. Labor was complicated, with soft tissue dystocia, stillbirth, and postpartum hemorrhage. The first pregnancy was also complicated by fetal right ventricular noncompaction dilatative cardiomyopathy. A eutrophic male child was born vaginally at term and died due to deterioration of the cardiac disease in the third year of life. Next-generation sequencing panel for pediatric cardiology was performed in the deceased child and parents. Two gene variants were recorded: MYOM1: c.770_771delCA (p.Thr257fs) and TPM1: c.814G>A (p.Glu272Lys). Both variants were classified as variants of uncertain significance. This case emphasizes the importance of antenatal counseling, the timing of labor induction, appropriate management of possible complications such as postpartum hemorrhage and soft tissue dystocia, and the interpretation of placental biomarkers in the context of mirror syndrome. Finally, it contributes to understanding the clinical significance of the MYOM1 and TPM1 gene variants.</p>","PeriodicalId":23882,"journal":{"name":"Wiener medizinische Wochenschrift","volume":" ","pages":"213-216"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and epidemiologic characteristics of hospitalized oncological patients with hypercalcemia: a longitudinal, multicenter study.","authors":"Guillermo Ropero-Luis, Jaime Sanz-Cánovas, Almudena López-Sampalo, Alberto Ruiz-Cantero, Ricardo Gómez-Huelgas","doi":"10.1007/s10354-024-01051-x","DOIUrl":"10.1007/s10354-024-01051-x","url":null,"abstract":"<p><strong>Background: </strong>There are few studies that have analyzed the characteristics of hypercalcemia in hospitalized oncological patients. Our objectives were to describe the clinical characteristics of hospitalized patients with paraneoplastic hypercalcemia and to identify prognostic variables for mortality.</p><p><strong>Methods: </strong>This was an observational, longitudinal, retrospective, and bicentric study. It included adult patients admitted to two hospitals in Málaga, Spain (2014-2018). The minimum follow-up period was 2 years or until death.</p><p><strong>Results: </strong>A total of 154 patients were included; the majority (71.4%) were admitted to the internal medicine department. The median follow-up was 3.5 weeks (interquartile range [IQR] 1.1-11.5). The mean (standard deviation) age was 67.6 (12.3) years, with a predominance of males (58.4%). The median (IQR) serum calcium at admission was 13.2 (11.8-14.6) mg/dl. The most common neoplasms were pulmonary (27.3%), hematologic (23.4%), urological (13%), and breast (12.3%). Furthermore, 56.5% of cases had a known history of neoplasia at the time of diagnosis. The parathyroid hormone (PTH) level was determined in 24%; of these, 10.8% had elevated levels. In all, 95.5% of patients died during follow-up. The median survival was 3.4 weeks (95% confidence interval 2.6-4.3). Factors associated with higher mortality were age, serum calcium at admission, previous history of neoplasia, etiology other than multiple myeloma, and noncorrection of hypercalcemia.</p><p><strong>Conclusions: </strong>In hospitalized patients, paraneoplastic hypercalcemia was associated with high short-term mortality. Several factors associated with a worse prognosis were identified in these patients.</p>","PeriodicalId":23882,"journal":{"name":"Wiener medizinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application value of an artificial intelligence-based diagnosis and recognition system in gastroscopy training for graduate students in gastroenterology: a preliminary study.","authors":"Peng An, Zhongqiu Wang","doi":"10.1007/s10354-023-01020-w","DOIUrl":"10.1007/s10354-023-01020-w","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to discuss the application value of an artificial intelligence-based diagnosis and recognition system (AIDRS) in the teaching activities for Bachelor of Medicine and Bachelor of Surgery (MBBS) in China. The learning performance of graduate students in gastroenterology during gastroscopy training with and without AIDRS was assessed.</p><p><strong>Methods: </strong>The study recruited 32 graduate students of the gastroenterology program at Jiangsu province hospital of Chinese medicine and Xiangyang No. 1 People's Hospital from March 2018 to March 2022 and randomly divided them into AIDRS (n = 16) and non-AIDRS (n = 16) groups. The AIDRS software was used for real-time monitoring of blind spots of gastroscopy to aid in lesion diagnosis and recognition in the AIDRS group. Only a conventional gastroscopic procedure was implemented in the non-AIDRS group. The final performance score, success rate of gastroscopy, lesion detection rate, and pain score of patients were compared between the two groups during gastroscopy. A self-prepared teaching and learning satisfaction questionnaire was administered to the two groups of students.</p><p><strong>Results: </strong>The AIDRS group had a higher final performance score (92.60 ± 2.83 vs. 89.21 ± 3.57, t = 2.98, P < 0.05), a higher success rate of gastroscopy (448/480 vs. 417/480, χ² = 11.23, P < 0.05), and a higher detection rate of lesions (51/52 vs. 41/53, χ² = 8.56, P < 0.05) compared with the non-AIDRS group. The pain scores of patients were lower in the AIDRS group than in the non-AIDRS group (3.40 [2.23, 3.98] vs. 4.45 [3.72, 4.75], Z = 3.04, P < 0.05). Besides, the average time for gastroscopy was lower in the AIDRS group than in the non-AIDRS group (7.15 ± 1.24 vs. 8.21 ± 1.26, t = 2.38, P = 0.02). The overall satisfaction level with the teaching program was higher in the AIDRS group (43.51 ± 2.29 vs. 40.93 ± 2.07, t = 3.33, P < 0.05).</p><p><strong>Conclusion: </strong>In the context of medicine-education cooperation, AIDRS offered valuable assistance in gastroscopy training and increased the success rate of gastroscopy and teaching and learning satisfaction. AIDRS is worthy of wider-scale promotion.</p>","PeriodicalId":23882,"journal":{"name":"Wiener medizinische Wochenschrift","volume":" ","pages":"173-180"},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10542763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Education of non-medical practitioners in Germany-an analysis of course subjects of specialized schools.","authors":"Lea Hoffmeister, Jutta Huebner, Christian Keinki, Karsten Muenstedt","doi":"10.1007/s10354-021-00896-w","DOIUrl":"10.1007/s10354-021-00896-w","url":null,"abstract":"<p><p>In Germany, non-medical practitioners (NMPs; in German: Heilpraktiker) offer a broad range of complementary and alternative (CAM) methods. Our aim was to characterize schools for NMPs in Germany in terms of basic (medical) training and advanced education. We found 165 schools for NMPs in a systematic web-based search. As the medical board examination NMPs must take before building a practice exclusively tests their knowledge in conventional medicine, schools hardly include training in CAM methods. Only few schools offered education on CAM methods in their NMP training. Although NMP associations framed requirements for NMP education, 83.0% (137/165) of schools did not meet these requirements. Patients and physicians should be aware of the lack of training and consequent risks, such as harm to the body, delay of necessary treatment, and interaction with conventional drugs. Disestablishing the profession of NMPs might be a reasonable step.</p>","PeriodicalId":23882,"journal":{"name":"Wiener medizinische Wochenschrift","volume":" ","pages":"189-197"},"PeriodicalIF":0.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39598188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare non-serous fallopian tube cancers: institutional experience and literature review.","authors":"Dmitrii Sumtsov, Georgyi Sumtsov, Nataliia Hyriavenko, Mykola Lyndin, Kateryna Sikora, Nataliia Kalashnik, Svitlana Smiian, Igor Gladchuk","doi":"10.1007/s10354-023-01027-3","DOIUrl":"10.1007/s10354-023-01027-3","url":null,"abstract":"<p><strong>Introduction: </strong>We reviewed 63 reports from the literature on rare non-serous tumors of the fallopian tubes and carried out a comparative analysis of clinical manifestations and diagnostic methods. We also report our observations from patients with these tumors.</p><p><strong>Materials and methods: </strong>Of 157 patients with primary fallopian tube cancer (FTC) treated in our regional oncological hospital between 1970 and 2020, there were nine (6%) cases of rare non-serous cancers, including one case each of choriocarcinoma, carcinosarcoma, and neuroendocrine tumor, and two cases each of non-keratinizing squamous cell carcinoma, mucinous adenocarcinoma, and clear cell adenocarcinoma.</p><p><strong>Results: </strong>For carcinosarcoma and squamous cell, clear cell, and transitional cell carcinomas, clinical history, patient age, and clinical manifestations were similar to the main group of FTCs. Choriocarcinoma differed significantly from other cancers of the fallopian tubes in terms of patient age and clinical course. Mucinous adenocarcinoma, mesothelioma, and borderline tumors, with rare exceptions, were almost always asymptomatic and were found only incidentally during surgery. Choriocarcinoma and carcinosarcoma had an aggressive course, while squamous cell, transitional cell, clear cell, and mucinous carcinomas were less aggressive. Since most rare non-serous tumors have a similar disease course to typical FTCs and there is a lack of appropriate treatment protocols for rare tumors, treatment options developed for ovarian tumors and FTC are justified for these tumors.</p><p><strong>Conclusion: </strong>Rare non-serous malignant fallopian tube tumors are very similar to serous and endometrioid FTC in terms of clinical manifestations and diagnosis.</p>","PeriodicalId":23882,"journal":{"name":"Wiener medizinische Wochenschrift","volume":" ","pages":"199-207"},"PeriodicalIF":0.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138446414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significance of plasma relaxin-2 levels in patients with primary hypertension and type 2 diabetes mellitus.","authors":"Olena Pankova, Oleksii Korzh","doi":"10.1007/s10354-024-01035-x","DOIUrl":"10.1007/s10354-024-01035-x","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate plasma relaxin‑2 (RLN-2) levels in patients with arterial hypertension (AH) and their relationships with clinical and laboratory parameters.</p><p><strong>Methods: </strong>The study involved 106 hypertensive patients, including 55 with type 2 diabetes mellitus (T2DM), and 30 control subjects. Plasma RLN-2 levels were measured using an enzyme-linked immunosorbent assay kit.</p><p><strong>Results: </strong>RLN-2 levels were reduced in patients with AH compared to healthy volunteers (p < 0.001), and hypertensive patients with T2DM had lower RLN-2 levels than those without impaired glucose metabolism (p < 0.001). RLN‑2 was negatively correlated with systolic blood pressure (SBP) (p < 0.001) and anthropometric parameters such as body mass index (BMI; p = 0.027), neck (p = 0.045) and waist (p = 0.003) circumferences, and waist-to-hip ratio (p = 0.011). RLN‑2 also had inverse associations with uric acid levels (p = 0.019) and lipid profile parameters, particularly triglycerides (p < 0.001) and non-HDL-C/HDL‑C (p < 0.001), and a positive relationship with HDL‑C (p < 0.001). RLN‑2 was negatively associated with glucose (p < 0.001), insulin (p = 0.043), HbA1c (p < 0.001), and HOMA-IR index (p < 0.001). Univariate binary logistic regression identified RLN‑2 as a significant predictor of impaired glucose metabolism (p < 0.001).</p><p><strong>Conclusions: </strong>Decreased RLN-2 levels in patients with AH and T2DM and established relationships of RLN‑2 with SBP and parameters of glucose metabolism and lipid profile suggest a diagnostic role of RLN‑2 as a biomarker for AH with T2DM.</p>","PeriodicalId":23882,"journal":{"name":"Wiener medizinische Wochenschrift","volume":" ","pages":"161-172"},"PeriodicalIF":0.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of appropriate emergency department utilization and verbal communication on physicians' (dis)satisfaction with doctor-patient interactions with special consideration of migrational backgrounds.","authors":"Anna Rahel Pötter, Odile Sauzet, Theda Borde, Baharan Naghavi, Oliver Razum, Jalid Sehouli, Rajan Somasundaram, Hendrike Stein, Matthias David","doi":"10.1007/s10354-022-00948-9","DOIUrl":"10.1007/s10354-022-00948-9","url":null,"abstract":"<p><p>In recent years, utilization of emergency departments (EDs) has increased continuously, both in Germany and internationally. Inappropriate use of EDs is believed to be partly responsible for this trend. The topic of doctor-patient interaction (DPI) has received little attention in research. However, successful DPI is not only important for adherence and treatment success, but also for the satisfaction of medical staff. This non-interventionl cross-sectional study attempts to identify factors influencing physicians' satisfaction with DPIs, with a particular focus on the appropriate utilization of EDs and verbal communication. We carried out tripartite data collection in three EDs of major referral hospitals in Berlin between July 2017 and July 2018. Migration experience, communication and language problems, level of education, and a large gap between physicians' and patients' perceived urgency regarding the utilization of EDs influence the quality of the doctor-patient relationships and interactions.</p>","PeriodicalId":23882,"journal":{"name":"Wiener medizinische Wochenschrift","volume":" ","pages":"140-148"},"PeriodicalIF":0.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9294758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10253329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative anxiety after face-to-face patient assessment versus preanaesthesia telemedicine (PANTEM) in adults: a randomised clinical trial.","authors":"Georg Gibas, Martin Liebisch, Christiane Eichenberg, Vincent T Krenn, Aria Sallakhi, Salah E Benhebesse, Sibylle Kietaibl","doi":"10.1007/s10354-022-00937-y","DOIUrl":"10.1007/s10354-022-00937-y","url":null,"abstract":"<p><p>Preanaesthesia consultation is performed to assess and optimise patient-specific risk factors before surgery, to inform patients about anaesthesia techniques and to obtain consent. Aside from face-to-face visits, telephone consultation is increasingly being used clinically. Concentration on the content and avoidance of confounding factors could lead to improved patient preparation. We hypothesised that patients receiving a telemedical intervention have less anxiety. Patients scheduled for elective surgery were randomised into two groups according to the consultation performed face-to-face (FTF) or via telephone (TEL). Before consultation (< 48 h) and 1-2 h prior to surgery, both groups had to fill in the State-Trait Anxiety Inventory (STAI). A total of 271 patients were randomised and 130 were analysed. There were no significant intergroup differences in mean state anxiety (STAI-S) before and after the intervention. Patients' positive feedback on telemedical consultation urges future studies on its effect on satisfaction and quality of life.</p>","PeriodicalId":23882,"journal":{"name":"Wiener medizinische Wochenschrift","volume":"1 1","pages":"133-139"},"PeriodicalIF":0.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41981936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[\"He does not know it yet\"-Triadic communication and its pitfalls exemplified by an oncological ward round consultation].","authors":"Bettina Baldt","doi":"10.1007/s10354-022-00924-3","DOIUrl":"10.1007/s10354-022-00924-3","url":null,"abstract":"<p><p>Medical communication is an effective instrument for the medical practice. Due to the low status that medical communication still has within medicine and medical education, many physicians do not know how to use this instrument professionally. Using medical communication in a way that patients are well informed and involved is a prerequisite for them to make self-determined decisions. In this paper I analyze a consultation in an oncology ward to show the pitfalls of medical communication, especially in triadic communication, based on a case study to work out suggestions for optimization from the transcript. Mistakes in conducting conversations, which can be recognized as such in theory, unfortunately still happen in practice, which is why this case study is intended as an invitation to critically reflect on one's own conduct of conversations. The conclusion contains suggestions for the preparation as well as the conduct of the consultation during medical rounds.</p>","PeriodicalId":23882,"journal":{"name":"Wiener medizinische Wochenschrift","volume":"1 1","pages":"153-160"},"PeriodicalIF":0.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11060969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51977870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}