Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Jul 2024
ReviewGenetic relationship between rheumatoid arthritis and cardiovascular diseases : A systematic review of Mendelian randomization studies.
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. ⋯ 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.
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Wien. Klin. Wochenschr. · Jul 2024
Analysis of the impact of a university distance learning course on digitalization in medicine on students and healthcare professionals.
The public medical universities in Austria (educating 11,000 students) developed a joint public distance learning series in which clinicians discussed current digital lighthouse projects in their specialty. This study aims to examine the changes in attitude and knowledge of the participants before and after the lecture series to gain insights for future curriculum developments. ⋯ The study shows that the presentation and discussion of lighthouse projects improves understanding of digitalization in medicine but does not trigger a strong desire for additional further training.
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Wien. Klin. Wochenschr. · Jul 2024
Multicenter StudyProspective use of molecular minimal residual disease for risk stratification in children and adolescents with acute lymphoblastic leukemia : Long-term results of the AIEOP-BFM ALL 2000 trial in Austria.
Since 1979 Austrian children and adolescents with acute lymphoblastic leukemia (ALL) have been treated according to protocols of the Berlin-Frankfurt-Münster (BFM) study group. The Associazione Italiana di Ematologia e Oncologia Pediatrica and BFM (AIEOP-BFM) ALL 2000 study was designed to prospectively study patient stratification into three risk groups using minimal residual disease (MRD) on two time points during the patient's early disease course. The MRD levels were monitored by detection of clone-specific rearrangements of the immunoglobulin and T‑cell receptor genes applying a quantitative polymerase chain reaction-based technique. ⋯ Event-free survival for patients with precursor B‑cell and T‑cell ALL were 84 ± 2% (n = 521) and 84 ± 4% (n = 87; p = 0.460), respectively. The MRD assessment was feasible in 94% of the patients and allowed the definition of precursor B‑cell ALL patients with a low, intermediate or high risk of relapse even on top of clinically relevant subgroups. A similar finding with respect to MRD relevance in T‑ALL patients was not possible due to the small number of patients and events. Since this pivotal international AIEOP-BFM ALL 2000 trial, molecular response to treatment has been continuously used with additional refinements to stratify patients into different risk groups in all successive trials of the AIEOP-BFM ALL study group.
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Wien. Klin. Wochenschr. · Jul 2024
Revisiting the Epworth sleepiness scale : Is excessive daytime sleepiness still a valid screening tool for obstructive sleep apnea in a population at risk?
Obstructive sleep apnea (OSA) is a common medical problem with numerous comorbidities and high costs. Since the introduction of the Epworth sleepiness scale (ESS), excessive daytime sleepiness (EDS) has been considered the most common and prominent symptom of OSA. Aim of this study was to re-evaluate the ESS for detection of OSA in a population at risk compared to the gold standard overnight polysomnography (PSG). ⋯ It was found that excessive daytime sleepiness, measured by ESS, is not a valuable screening tool for OSA, especially when the test is negative. Other screening tests that involve additional parameters, beside daytime sleepiness alone, should be considered.
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Wien. Klin. Wochenschr. · Jul 2024
Editorial Case ReportsSummertime, wintertime, a biannual shift or what? : A polylemma!