Wiener Klinische Wochenschrift最新文献

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.

Introduction: Orchestra musicians frequently experience painful playing-related musculoskeletal disorders (PRMDs) yet often lack access to effective specialized treatment. This feasibility study aimed to establish proof-of-concept for a novel, multimodal treatment regimen and to explore potential diagnostic tools for PRMDs.

Methods: Musicians from the Orchestra Academy of the Vienna Philharmonic Orchestra participated in different interventions from a therapeutic and diagnostic protocol. The therapeutic part encompassed self-administered transcranial direct current stimulation (tDCS) sessions targeting the primary motor cortex with tailored physiotherapeutic exercises and psychological coaching. Separate diagnostic interventions included comprehensive physiotherapeutic and psychological assessments, pain questionnaires, and the acquisition of magnetic resonance imaging and 3D motion capture data. The feasibility of these methods was thoroughly evaluated through safety questionnaires, completion checklists, direct observation by the investigators, and detailed participant feedback.

Results: The therapeutic tDCS sessions with concurrent physiotherapeutic exercises were completed by 2 participants across all 10 scheduled sessions. Mild to moderate tingling/burning sensations during tDCS sessions were reported in 3 of 10 sessions (30%), and electrode connectivity issues occurred in 3 of 10 sessions (30%), which participants could resolve independently. All seven participants engaged in various diagnostic assessments. The novel pain assessment questionnaire was completed by four participants in under 5 min, with reported pain intensities ranging from 0-5 on a 0-10 scale, most frequently in the neck, wrist/hand, and upper and lower back. Functional magnetic resonance imaging during simulated instrument playing revealed discernible activation patterns, including bilateral primary motor cortex activation, and 3D motion capture provided detailed kinematic data from a violinist.

Discussion: This study provides initial evidence for the feasibility and safety of a combined treatment approach (tDCS, physiotherapy, psychological support) for musicians suffering from PRMDs. Furthermore, the results encourage further exploration of advanced imaging and motion capture techniques as potential diagnostic and monitoring tools. These findings support conducting a larger scale, randomized clinical trial to investigate the efficacy of these approaches.