Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Aug 2024
Efficacy and safety of intradetrusor abobotulinumtoxinA and incobotulinumtoxinA in women with overactive bladder and the value of local anesthesia: a randomized clinical study.
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. ⋯ 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.
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Wien. Klin. Wochenschr. · Aug 2024
PCSK9 inhibitors in real life-Cardiometabolic risk management in dyslipidemic patients in Vienna.
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. ⋯ 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.
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Wien. Klin. Wochenschr. · Aug 2024
Addressing healthcare vulnerabilities in nursing homes : Insights from human rights monitoring in two Austrian provinces.
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). ⋯ 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.
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Wien. Klin. Wochenschr. · Aug 2024
Healing chronic idiopathic eosinophilic pneumonia using mepolizumab alone without corticosteroids.
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. ⋯ 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.
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General practice/family medicine has recently been recognized as a medical discipline in Austria. This paper is a short report on the prevailing understanding of its goals and subjects, comparing the Austrian perception with international definitions. It comments on shortcomings and introduces an outline for the development of a revised professional theory. ⋯ Now it is the fragmentation that extensive specialization entails that gives a new meaning to generalist, contextual and patient-centered medicine. This change needs to be analyzed and understood. A description of the responsibilities, tasks and very specific methods unique to the discipline will be developed, which should enable the sensible, contemporary use of general practice/family medicine for the benefit of patients and the healthcare system.