Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Oct 2024
Austrian consensus statement on the diagnosis and management of hypertrophic cardiomyopathy.
Hypertrophic cardiomyopathy (HCM) is the most common inherited heart disease that is characterized by left ventricular hypertrophy unexplained by secondary causes. Based on international epidemiological data, around 20,000-40,000 patients are expected to be affected in Austria. Due to the wide variety of clinical and morphological manifestations the diagnosis can be difficult and the disease therefore often goes unrecognized. ⋯ Early and correct diagnosis, including genetic testing, is essential for comprehensive counselling of patients and their families and for effective treatment. The latter is especially true as an effective treatment of outflow tract obstruction has recently become available in the form of a first in class cardiac myosin ATPase inhibitor, as a noninvasive alternative to established septal reduction therapies. The aim of this Austrian consensus statement is to summarize the recommendations of international guidelines with respect to the genetic background, pathophysiology, diagnostics and management in the context of the Austrian healthcare system and resources, and to present them in easy to understand algorithms.
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Wien. Klin. Wochenschr. · Oct 2024
Train Climbing-A new old trend in adolescents: Treatment of high voltage injuries and planning of a pilot project to raise awareness.
An increasing number of high voltage electric burn injuries in a typically younger patient collective of train surfers and climbers at our level I center for burns was recognized. The purpose of this study was a retrospective data evaluation and as a consequence the implementation of an awareness program against train surfing. ⋯ This study highlighted the severity of injuries, with a mean TBSA of 41.42% and a mortality rate of 14.29% among the study population. Train climbing and surfing patients presented with severe injuries and fatal long-term consequences. A pilot project involving several stakeholders was initiated in order to raise awareness of the dangers of electric arcs and the risk involved.
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Wien. Klin. Wochenschr. · Oct 2024
Case ReportsEsophageal perforation with near fatal mediastinitis secondary to Th3 fracture.
A 74-year-old male patient was referred with signs of sepsis 5 days after having been diagnosed with a rib fracture following a fall out of bed. Novel hypodensities were visible on thoracic X‑rays and laboratory tests revealed elevated inflammatory parameters. Subsequently performed thoracic computed tomography (CT) scan showed burst fracture of the 3rd thoracic vertebra, posttraumatic esophageal rupture at the same level and mediastinitis. ⋯ Up to the latest follow-up 41 months following injury, several endoscopic dilations with a bougie due to constrictions at the anastomosis have been performed. Similar to previous cases in the literature, esophageal injury was diagnosed delayed, with the patient already having developed severe complications. This extremely seldom injury should be suspected in young patients following high-energy trauma, but also in older patients after low-energy trauma but known degenerative changes of the vertebral column.
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Wien. Klin. Wochenschr. · Oct 2024
Health literacy in physical trauma patients : Evaluation of the general understanding of patients in an outpatient clinic using the German Short Test of Functional Health Literacy.
Health literacy (HL) refers to the ability to understand and process information provided by the healthcare system and depends on various factors, such as language comprehension, education, and social environment. Low HL was recently associated with increased readmission, morbidity, and mortality. Little is known about HL levels in physical trauma patients. The aim of this study was to determine general HL in physical trauma patients in an outpatient setting and to evaluate possible differences based on demographic characteristics. ⋯ In this study, included outpatient trauma patients demonstrated an overall adequate understanding of healthcare related information. Age, sociodemographic background, and/or educational status did not influence performance, which leads to the question as to whether the German version of the S‑TOFHLA is valid to representatively measure HL in these patients. Furthermore, regarding the obvious shortcomings of the S‑TOFHLA, the education standard of the respective population should be taken into consideration when choosing an appropriate testing tool.
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Wien. Klin. Wochenschr. · Oct 2024
Historical ArticleThe establishment of orthopedics in Croatia : The role of Božidar Špišić (1879-1957) and his professional networks.
Božidar Špišić was a pioneer of Croatian orthopedics. In 1908 he founded the first private orthopedic clinic in the entire South Slav region. During the First World War he organized and headed the first orthopedic hospital for the rehabilitation and resocialization of wounded soldiers. ⋯ In this paper, we have reconstructed the transfer of knowledge and experiences between these prominent Austrian and German orthopedists and Božidar Špišić. We have paid special attention to the identification of those elements in Špišić's work that can be traced back to his mentor, teacher and lifelong colleague Adolf Lorenz, such as his treatment for congenital hip dislocation. We believe that the analysis of professional networks can shed additional light on the historiography of orthopedics, given that these influences did not manifest solely through the acquisition of specialized clinical knowledge but also through a profound influence on the core tenets of orthopedics as a discipline-its institutional organization and overall conservative approach.