Wiener Klinische Wochenschrift最新文献

Background: High-voltage electrical injuries (HVEI) and thermal burns are both classified as severe burn trauma, yet their clinical impact differs markedly. The HVEIs cause deep tissue destruction and systemic complications that are often underestimated in severity by conventional burn indices such as TBSA (Total Body Surface Area) and ABSI (Abbreviated Burn Severity Index).

Methods: A retrospective cohort analysis was performed on 1515 burn patients treated between 1994 and 2024. After exclusions 1489 patients were evaluated, including 92 with HVEI and 1397 with thermal burns. The demographics, burn size, ABSI, intensive care unit (ICU) stay and surgical procedures were analyzed using nonparametric tests.

Results: Across the cohort, the mean number of operations was 3.56 (median 3). The HVEI patients required significantly more procedures than thermally injured patients (mean 5.01 vs. 3.49; p < 0.001). Burn size (p < 0.001), ABSI (p < 0.001) and ICU stay (p < 0.001) were all significantly associated with the number of operations. No sex-related differences were observed (p = 0.67).

Conclusion: The HVEIs impose a disproportionately high surgical and intensive care burden compared to thermal burns. These findings highlight the limitations of current severity scores and emphasize the need for early recognition, repeated surgical management and tailored interdisciplinary care in patients with electrical trauma.

Objective: Despite Austria's highly ranked healthcare system, health literacy (HL) is lower than in other European countries, with Vienna falling below the national average in life expectancy and healthy life years. Following the 2016 WHO Strategy for Women's Health and Well-being, Austria introduced a Women's Health Action Plan in 2017, which highlighted a major lack of information about women's reproductive health. To date, data on reproductive health knowledge (RHK) and behavior (RHKB), and their relationship with HL remain scarce. The study aimed to examine these relationships among women in Vienna.

Methods: An online cross-sectional survey was conducted in 2023 among women of reproductive age (18-49 years) in Vienna. Collected data included information about sociodemographic characteristics, HL (HLS19-Q12-AT), RHK and RHKB (0-100% scale). Associations between RHK/RHKB and HL, alongside sociodemographic characteristics were examined using linear regression analyses.

Results: Among 386 participating women 41% had limited HL. Mean scores were 71% (SD = 21) for HL, 74% (SD = 16) for RHK, and 78% (SD = 14) for RHKB. The highest rate of incorrect responses concerned egg cell lifespan (61%), human papillomavirus (HPV) consequences (49%) and fertility age (40%). In univariate analyses RHK and RHKB were positively associated with older age and partnership and negatively associated with inadequate HL and certain religious affiliations. The RHKB was further associated with university education and parenthood. Multivariate analyses confirmed age and religion as significant factors.

Conclusion: Our study identified RHK gaps among women in Vienna, showed associations between RHKB and HL and highlighted the importance of information sources. Findings underline the need for targeted interventions to improve reproductive HL.

Musculocontractural Ehlers-Danlos syndrome (mcEDS) is a rare autosomal recessive connective tissue disorder characterized by fragility of skin, vasculature and musculoskeletal structures. We report a case of a young male with CHST14(Carbohydrate sulfotransferase 14)-related mcEDS who developed a massive subcutaneous hematoma following minor trauma, necessitating surgical evacuation. This case highlights the potential for life-threatening bleeding complications in mcEDS and underscores the importance of early recognition and multidisciplinary management.

Background: Artificial intelligence (AI) is a promising tool to achieve a high adenoma detection rate (ADR). The aim of this study is to evaluate the impact of a computer-aided detection (CADe) device on the ADRs of endoscopists with different levels of expertise.

Methods: Data were collected from patients who underwent colonoscopy with CADe within a 12-month period. Endoscopists were divided into three groups, a trainee group (< 500 colonoscopies), an intermediate group (500-1000 colonoscopies) and an expert group (> 2000 colonoscopies). Endoscopists with the same definition of experience without CADe support served as the control cohort. For the differences in ADR between the groups a 2-sided 95% confidence interval (CI) and odds ratios (OR) were calculated.

Results: In this study 335 patients (155 females, 177 males) with a mean age 62.1 years (SD ± 16.2 years) were included in the CADe cohort. In this cohort 508 polyps were resected. The ADRs for the groups and control groups (without CADe) were as follows: 42.9% (95% CI: 28.5-57.2%) and 21.5% (95% CI: 11.3-31.8%) in the trainee group, 41.3% (95% CI: 33.5-49.0%) and 36.8% (95% CI: 27.9-45.6%) in the intermediate group and 39.8% (95% CI: 30.9-48.8%) and 33.3% (95% CI: 26.3-40.4%) in the expert group. There were no significant differences among the CADe groups when trainees were compared to experts (p = 0.72, OR 1.13, 95% CI: 0.58-2.16) or when intermediate endoscopists were compared to experts (p = 0.81, OR 1.06, 95% CI: 0.65-1.74).

Conclusion: The use of AI appears to provide an opportunity to match the ADR-based quality of colonoscopy at an early stage of endoscopy training with experts.

Background: Genital infections caused by Mycoplasma hominis and Ureaplasma urealyticum are increasingly linked to female infertility, yet their epidemiology and resistance patterns remain poorly characterized in low-resource settings.

Objective: This study aimed to determine the prevalence, antimicrobial resistance (AMR) profiles, and risk factors of M. hominis and U. urealyticum infections among infertile women in Akbou, Algeria.

Methods: In this cross-sectional analysis (February-July 2024), cervicovaginal swabs from 79 infertile women were tested using the MYCOFAST® RevolutioN 2 system. Demographic, clinical, and reproductive data were collected via structured questionnaires. Statistical analyses included χ²-testsand logistic regression.

Results: The overall infection prevalence was 37.9% (n = 30), with U. urealyticum (17.7%), M. hominis (13.9%), and co-infections (6.3%) predominating. Infections peaked in women aged 31-35 years (63.3%). Resistance to tetracycline was high (U. urealyticum: 71.4%; M. hominis: 54.5%), while doxycycline and clindamycin retained full efficacy. Significant risk factors included prior abortion (adjusted odds ratio, OR = 4.2, p < 0.001), STI history (OR = 3.8, p < 0.001), and artificial insemination (OR = 2.9, p = 0.018).

Conclusion: The high prevalence of genital Mycoplasma infections and emerging AMR in Algeria underscores the need for routine screening, updated treatment guidelines, and targeted antimicrobial stewardship programs to safeguard reproductive health.

Objective: The aim of the study was to investigate the efficacy of autologous concentrated growth factors (aCGF) in the treatment and healing of cystic lesions of the jaw.

Material and methods: In this prospective randomized intervention study 138 patients were enrolled, with 68 patients undergoing cystectomy alone and 70 patients undergoing cystectomy with defect filling using autologous concentrated growth factors. Bone healing was volumetrically measured using cone beam computed tomography (CBCT) at 6 and 12 months postoperatively. Clinical follow-ups were conducted 14 days, 1 month, 3 months, 6 months, and 12 months after the treatment.

Results: In both groups, almost complete bone healing occurred, with no significant differences observed between the two groups (P =0.484). In the aCGF group there was a trend towards a reduction in wound healing disturbances after 14 days, although this reduction was not statistically significant (P =0.071).

Conclusion: The use of aCGF following cystectomy does not show radiologically measurable significantly improved bone healing; however, a tendency towards improved wound healing compared to cystectomy without any filling materials could be observed in the initial healing period.

Introduction: General health risk factors may vary significantly across different education groups. These disparities in lifestyle choices can contribute to the development of chronic conditions, including gastrointestinal disorders. Barrett's esophagus (BE), a premalignant condition associated with increased risk of esophageal cancer, may be influenced by these social determinants of health. This work explores how education status shapes the prevalence of BE, considering how key health risk factors in different education groups impact the development of the condition.

Methods: We analyzed data from a cohort of 5160 Austrian individuals who underwent esophagogastroduodenoscopy (EGD) and screening colonoscopy. Participants were categorized into three education groups: low (n = 1933), medium (n = 2780), and high (n = 447). The distribution of risk factors across education groups was observed and the prevalence of BE (including any BE and dysplastic BE) was assessed using univariate and multivariable regression analyses, adjusting for potential confounders such as age, sex, metabolic syndrome, smoking, alcohol consumption, reflux severity, hiatal hernia and proton pump inhibitor intake.

Results: General health risk factors, such as metabolic syndrome, alcohol consumption, gastroesophageal reflux and smoking are more prevalent in lower education groups, contributing to a higher burden of chronic diseases. The prevalence of histologically confirmed Barrett's esophagus was low across all education levels, showing no significant differences (p = 0.90). Nondysplastic BE was present in 1% of participants, with similar rates across the low, medium and high education groups (1% each). Only one case of high-grade dysplasia (HGD) was found in the medium education group. In the unadjusted analysis no significant link was found between education level and Barrett's esophagus. Compared to those with lower education, the odds were 1.25 (95% confidence interval, CI: 0.71-2.19, p = 0.443) for medium and 0.91 (95% CI: 0.31-2.69, p = 0.864) for high education. In the fully controlled model, accounting for age, sex, metabolic syndrome, smoking, alcohol consumption, reflux severity, hiatal hernia, and proton pump inhibitor use, the association remained nonsignificant, with odds ratios of 1.15 (95% CI: 0.55-2.40, p = 0.719) for medium and 1.01 (95% CI: 0.30-3.36, p = 0.986) for high education.

Conclusion: Our study indicates that education level is associated with the distribution of general risk factors, but it is not a key factor in Barrett's esophagus risk in an asymptomatic screening population. Although education impacts health outcomes in many conditions, its influence on BE seems minimal. Future research should explore broader socioeconomic factors, such as income, occupation and healthcare access for a better understanding of the BE risk and detection disparities.