Wiener medizinische Wochenschrift最新文献

Background: The aim of this anatomical study was to evaluate the course of the extensor pollicis longus (EPL) tendon, its positional relationship to adjacent structures, and the resulting clinical relevance under consideration of various functional positions.

Materials and methods: Twenty upper extremities from ten adult human cadavers embalmed using Thiel's method were included in this study. The greatest possible movement/slippage of the EPL tendon, the angle at which the tendon wraps around Lister's tubercle, and its course across the extensor carpi radialis longus and brevis (ECRL and ECRB) were recorded and defined in all functional positions.

Results: Our findings demonstrate a high range of motion of the tendon in relation to clinically relevant structures.

Conclusion: Understanding the anatomical course of the EPL tendon, its potential extent of movement, and its resulting positional changes is essential for the diagnosis and surgical treatment of patients with complaints or injuries in the dorsoradial wrist region.

Background: Spinal cord injuries (SCIs) are a global concern, annually affecting hundreds of thousands of individuals. Among these cases, incomplete SCIs, allowing some muscle activity below the injury, pose unique challenges. This case study focuses on a 55-year-old male with a moderate incomplete SCI (AIS-D).

Case presentation: After initial treatments and pharmaceutical antispastic therapy, a novel intervention was introduced featuring the Standing Ovation gait exercise system (Standing Ovation GmbH, Hallwang, Austria). This individually tailored system, equipped with a rail system and seat-lifting unit, provided a secure environment for balance training. Over 14 training sessions spanning from October 13, 2021, to March 23, 2022, improvements in functional walking were observed.

Discussion and conclusion: Locomotor improvement in SCI rehabilitation is important; the potential of task-specific gait exercises with the Standing Ovation system in incomplete spinal cord injury seems to be a promising approach. Although promising, these findings call for further systematic studies with larger patient cohorts to strengthen their reliability. Ongoing research endeavors are essential to fully understand the benefits and limitations of this intervention in spinal cord injury rehabilitation.

Introduction: Non-specific low back pain (NLBP) is a common and clinically significant condition with substantial socioeconomic implications. Whole-body vibration therapy (WBVT) has shown effectiveness in improving pain and sensorimotor function (e.g., in osteoporosis) in previous studies. However, studies had heterogeneous settings. The aim of this study was to assess the effects of WBVT on pain, function, proprioception, and postural stability in patients with subacute and chronic NLBP.

Methods: A systematic literature search was conducted in the scientific databases PubMed, EMBASE, and PEDro (from inception until 17.05.2023). Only prospective controlled and uncontrolled studies were included. Outcome measures assessed were pain intensity, function (activities of daily living and physical function), proprioception, and postural stability.

Results: A total of 12 original articles (n = 821) were included in the analysis. Ten of the studies were randomized controlled trials, one study had a crossover design, and one study had a one-group pre-post study design. The studies compared WBVT vs. no intervention, WBVT vs. basic physical therapy, WBVT vs. core stabilization exercises with and without respiratory resistance, WBVT vs. lumbar extension exercises, and WBVT vs. whole body electromyostimulation training. The treatment approaches varied in terms of duration (2-18 weeks), frequency (2-3 times per week, two applications with a 2-week break), vibration frequency (5-30 Hz), type of exercises (WBVT with or without static or dynamic exercises), and vibration direction (horizontal and vertical). Significant pain reduction was observed in all 10 studies that investigated pain levels. Significant improvement in daily activity function was reported in five of the six studies that investigated daily function, while improvement in physical function was observed in all four studies that investigated physical function. Improvement in proprioception was reported in all three studies that investigated proprioception, and significant improvement in postural stability was observed in four out of six studies that investigated postural stability. No adverse events or side effects related to WBVT were reported.

Conclusion: The majority of the included studies demonstrated significant pain reduction, improvement in physical and daily functioning, and enhanced proprioception. Improvement in postural stability was less consistent. WBVT appears to be a safe and effective treatment modality for subacute and chronic NLBP when used within a multimodal approach. Future research should focus on standardized settings including assessment methods, treatment regimens, frequencies, and intensities.

Fragility fractures caused by osteoporosis, the most common metabolic bone disease, place a significant burden on affected individuals and impose substantial economic costs. A fragility fracture implies an imminent elevated risk for subsequent fractures, particularly in the short term. Therefore, osteoporosis must be addressed in the event of a sentinel fracture, if not already previously treated. Regardless of whether the fracture is treated conservatively or surgically, post-fracture care is particularly important. Early mobilization followed by fall risk assessment and the initiation of adequate bone-specific medication are essential milestones in preventing subsequent fractures. Monitoring patients increases adherence to bone-specific medication and fall prevention strategies. Comprehensive post-fracture care is important and should be performed by a multidisciplinary team. Coordinated care models, such as the fracture liaison service (FLS), have shown enhancements in the initiation of and adherence to secondary prevention of fragility fractures. Despite recommendations by several guidelines including that published by the Austrian Society for Bone and Mineral Research, only one fracture liaison service has been implemented in Austria.

Introduction: Non-specific low back pain is a common and clinically significant condition with substantial socioeconomic implications. Pulsed electromagnetic field (PEMF) therapy has shown benefits in pain reduction and improvement of physical function in patients with pain-associated disorders like osteoarthritis. However, studies had heterogeneous settings. The aim of this study was to assess the effects of PEMF on pain and function on patients with non-specific low back pain.

Methods: A systematic literature search of randomized controlled trials in PubMed, MEDLINE, EMBASE, Cochrane Library, and PEDro was performed (from inception until 15/5/2023). Outcome measures assessed pain and function.

Results: Nine randomized controlled trials with 420 participants (n = 420) were included. The studies compared PEMF vs. placebo-PEMF, PEMF and conventional physical therapy vs. conventional physical therapy alone, PEMF and conventional physical therapy vs. placebo-PEMF and conventional physical therapy, PEMF vs. high-intensity laser therapy (HILT) vs. conventional physical therapy, and osteopathic manipulative treatment (OMT) and PEMF vs. PEMF alone vs. placebo-PEMF vs. OMT alone. Five of the nine included studies showed statistically significant pain reduction and improvement in physical function in comparison to their control groups (p < 0.05). There was substantial heterogeneity among the groups of the study, with a wide range of duration (10-30 min), treatments per week (2-7/week), applied frequencies (3-50 Hz), and intensities (2mT-150mT). No serious adverse event had been reported in any study. The included studies showed solid methodological quality, with an overall score of 7.2 points according to the PEDro scale.

Conclusion: PEMF therapy seems to be a safe and beneficial treatment option for non-specific low back pain, particularly if used as an addition to conventional physical therapy modalities. Future research should focus on standardized settings including assessment methods, treatment regimens, frequencies, and intensities.

Objective: The aims of this study were to determine the incidence of macrosomic births over a 5-year period and to examine the childbirth complications for both mother and newborn.

Patients and methods: During the study period there were a total of 16,126 deliveries, of which 1905 were macrosomic fetuses (defined as those with a birthweight of 4000 g or more). Data on the course of pregnancy and childbirth were collected from existing maternal and peripartum medical records. Patients were divided into two groups: those who delivered vaginally and those who delivered by caesarean section. The groups were compared in terms of obstetric, fetal, and neonatal data as well as perinatal outcomes.

Results: We included 1905 women in the study, 1286 (67.5%) with vaginal delivery and 619 (32.4%) with caesarean section. Primiparous women more frequently delivered by caesarean section, whereas multiparous women more commonly delivered vaginally (p < 0.00001). Male fetuses were significantly more prevalent in both examined groups. Risk factors for fetal macrosomia, such as gestational diabetes, maternal obesity, pregnancy-induced hypertension, polyhydramnios, and multiparity, were significantly more prevalent in the group with caesarean section (p < 0.00001). Delivery complications such as dorsoposterior presentation of the fetal head; fetal asphyxia, dystocia, and cephalopelvic disproportion; and uterine rupture were statistically significantly more frequent with caesarean section CONCLUSION: Our data show that caesarean deliveries for fetal macrosomia were associated with more maternal and neonatal complications than vaginal deliveries.

Background: Tinea pseudoimbricata is a variant of tinea incognito, with multiple erythematous concentric rings (ring in a ring) and pruritus. Misuse of topical corticosteroids is a major exogenous factor.

Objective: We provide an overview of published cases and report the first case series from Romania.

Patients and methods: A narrative review of the literature was conducted in PubMed and amended by ResearchGate. A series of pediatric cases from Romania with clinical suspicion of tinea pseudoimbricata was investigated by clinical examination, KOH preparations of skin scrapings, and mycological culture when possible.

Results: We collected 137 cases of tinea pseudoimbricata from the literature and added a series of 5 pediatric patients from Romania. Oral treatment with fluconazole was effective in all of them. Worldwide, most reports came from India (86%), 3.5% were from other Asian countries, 3.5% were from the Americas, and 7% were from Europe. M. canis and T. mentagrophytes were identified in 2 patients from Romania. T. mentagrophytes, T. rubrum, and T. tonsurans are the dominant species worldwide, but molecular diagnostics were available for only a minor part of cases.

Conclusion: Tinea pseudoimbricata is most common in India. This is the first case series on tinea pseudoimbricata from Romania. Tinea pseudoimbricata is an emerging disease in Europe. Identification of fungi has rarely been done by molecular mycology. This may have caused an overestimation of T. mentagrophytes and an underestimation of T. indotineae.

Background: The prevalence of gastroesophageal reflux disease (GERD) in children is increasing in different societies. This study aims to investigate the value of mean platelet volume (MPV) for diagnosing esophagitis in children with GERD.

Methods: This cross-sectional study conducted at Amirkola Children's Hospital between 2022 and 2023 involved children aged 2 to 16 years diagnosed with GERD. The diagnosis was based on the GSQ-YC and GASP‑Q questionnaires. All patients underwent endoscopy, with a biopsy for pathology and a blood sample for MPV analysis. The data were then analyzed using SPSS software version 22 (IBM Corp., Armonk, NY, USA), with a significance level set at lower than 0.05.

Results: The frequency of esophagitis among 194 participants was 39.7%. The overall sensitivity and specificity of MPV for diagnosing esophagitis in children were 64.63% and 52.14%, respectively (area under the curve [AUC] = 0.59). In terms of gender, the overall sensitivity and specificity of the MPV were 85.00% and 32.65% in boys and 70.27% and 51.47% in girls (AUC = 0.58 and AUC = 0.61, respectively). In terms of age, the overall sensitivity and specificity of MPV in children under 12 years were 52.46% and 62.26% and in children older than 12 years 87.5% and 36.36% (AUC = 0.58 and AUC = 0.55, respectively).

Conclusion: In summary, the results of this study indicate that MPV is not a reliable method for diagnosing esophagitis in children with GERD.