Wiener medizinische Wochenschrift最新文献

Background: Art in patient rooms can have positive effects on wellbeing and clinical outcomes. Patients' art preferences may differ from the preferences of medical providers. In this study, chronic pain and palliative care patients' preferences regarding art in patient rooms were compared with physicians' preferences.

Methods: From a selection of abstract art photographs by artists of the Muthesius University of Fine Arts and Design, Kiel, and figurative paintings from the Kunsthalle zu Kiel, 79 physicians and 79 chronic pain patients were asked to choose a picture. The physicians were also asked which picture they would choose for their patients. Furthermore, 79 palliative care patients were investigated to compare their choices with those of pain patients and physicians.

Results: Both patient groups preferred figurative art more often than did physicians for their patients. Among palliative care patients, 65% chose figurative art, while only 42% of physicians did (p < 0.0001). Similarly, 67% of chronic pain patients preferred figurative art, in contrast to 42% of physicians (p = 0.0002). The incidence of physicians' art choices for figurative art in patient rooms and for themselves as patients differed significantly (42 vs. 58, p = 0.013). Views with natural elements were preferred by physicians for patients and themselves (49 vs. 30 and 44 vs. 35), by palliative care patients (41 vs. 38), and by chronic pain patients (54 vs. 25).

Conclusion: Patients' art preferences differ significantly from physicians' art preferences.

Background: Despite extensive diagnostic efforts, the etiology of stroke remains unclear in up to 30% of patients. Mechanical thrombectomy (MT) potentially enhances etiological determination by (immuno)histological analysis of retrieved thrombotic material.

Methods: In this monocentric exploratory study, clots from 200 patients undergoing MT were investigated by hematoxylin and eosin, CD3, and CD45 staining. Semiquantitative and computer-based image analysis defined the histological composition and relative fractions of immunohistochemically stained areas. First, we correlated these results with strokes of known etiology. Subsequently, clots of unknown source were characterized with regard to their (immuno)histological profile to attempt etiological classification.

Results: Samples from 198 patients were accessible for analysis. Fibrin-/platelet-rich histology appeared in 45 (23%), erythrocyte-rich in 18 (9%), and mixed histology in 123 (62%) patients. Etiology was classified as cardioembolic in 87 (44%), arterioembolic in 37 (19%), and as cryptogenic stroke (CS) in 26 (13%) cases. 20 (23%) patients with cardioembolic stroke and 5 (14%) patients with arterioembolic stroke had fibrin-/platelet-rich clots. 8 (22%) patients with arterioembolic stroke and 1 (1%) patient with cardioembolic stroke had erythrocyte-rich clots. In CS, cardioembolic clot features appeared more than twice as often as arterioembolic clot features. Whereas the association between histology and etiology was significant (p = 0.0057), CD3/CD45 staining did not correlate.

Conclusion: A significant association between histology and etiology was observed, with the proportion of erythrocyte-rich thrombi being largest among arterioembolic strokes and the proportion of fibrin-/platelet-rich thrombi highest among cardioembolic strokes. A high number of clots from CS presented histological features of cardioembolic clots. Thus, patients with CS and fibrin-/platelet-rich clots particularly require long-term cardiac rhythm monitoring and may benefit from oral anticoagulation.

Background: Social media is a significant source of information on health-related topics and neurodevelopmental disorders such as autism spectrum disorder (ASD). The public perception of ASD, as reflected on social media, can raise awareness but also increase stigma. This study examined ASD portrayal on TikTok, focusing on neurodiversity, content themes, creator identities, and the depiction of autistic individuals.

Materials and methods: This exploratory study analyzed 100 TikTok videos: the 50 most-watched for #autism and the 50 most-watched for both #autism and #neurodiversity. The study reviewed metadata and content using publicly available data.

Results: Videos from the #autism sample encompassed 97% of all views and primarily portrayed entertaining content. Neurodiversity videos were more educational and less popular. Creators and portrayed individuals were primarily white. Adult autistic individuals are more ferequently represented in the #neurodiversity sample (30%), but children sill appear frequently (30% in the # neurodiversity and 38% in the #autism sample). Healthcare professionals (HCPs) were absent in the autism sample but appeared in 32% of neurodiversity videos.

Conclusion: The portrayal of ASD differed widely in both samples. Both samples underrepresented ethnic minorities. As TikTok shapes public perception of ASD, HCPs should be aware of trending ASD-related content on TikTok in order to be able to combat misinformation.

Dystonia is a complex neurological disorder characterized by involuntary muscle contractions, abnormal postures, and repetitive movements, which can lead to significant functional impairment and reduced quality of life. The disorder's pathophysiology involves a range of factors including genetic mutations, neurochemical imbalances, and structural abnormalities in the brain. Acupuncture has emerged as a promising complementary treatment for various types of dystonia, including post-stroke, cerebral palsy (CP)-related, limb, and cervical dystonia, as well as other hyperkinetic movement disorders. Clinical studies indicate that acupuncture may help to alleviate symptoms, decrease muscle spasticity, and improve overall patient outcomes. However, the effectiveness of acupuncture can vary depending on the specific type and severity of dystonia, with some studies reporting significant improvements, while others show more modest results. The variability in treatment response highlights the need for more robust research to better understand the mechanisms underlying acupuncture's effects and to develop standardized treatment protocols. The aim of this review is to provide a comprehensive overview of dystonia's pathophysiology and to assess the current evidence on the role of acupuncture in its treatment, identifying areas in which further research is needed to optimize therapeutic approaches.

Diabetic retinopathy (DR), the prevalence of which continues to rise, is one of the most common causes of vision loss worldwide. Experimental and clinical research in recent years has contributed to a better understanding of the pathogenesis of DR, which is complex and results from many interrelated processes leading to abnormal permeability and occlusion of the retinal vasculature, with ischemia and subsequent neovascularization. According to the absence or presence of neovascularization, DR is divided into two main forms: nonproliferative and proliferative DR. From nonproliferative to proliferative disease, diabetic macular edema (DME) can develop anywhere along the spectrum. As the majority of diabetics have no ophthalmologic symptoms, screening plays an important role in preventing the development of retinal disease. Specific treatment options beyond metabolic risk factor control, including intravitreal administration of anti-vascular endothelial growth factor (VEGF) agents or corticosteroids, laser photocoagulation, and vitreous surgery, are effective approaches for ocular diabetic complications.

Given how the diagnosis and management of many ocular and, most specifically, retinal diseases heavily rely on various imaging modalities, the introduction of artificial intelligence (AI) into this field has been a logical, inevitable, and successful development in recent decades. The field of retinal diseases has practically become a showcase for the use of AI in medicine. In this article, after providing a short overview of the most relevant retinal diseases and their socioeconomic impact, we highlight various aspects of how AI can be applied in research, diagnosis, and disease management and how this is expected to alter patient flows, affecting also health care professionals beyond ophthalmologists.

The healthcare sector, responsible for approximately 4-5% of global carbon dioxide equivalent (CO₂eq) emissions, significantly impacts the environment due to its high energy consumption and waste generation. As a specialty, ophthalmology has a disproportionately large environmental impact because of the high annual volume of ophthalmic surgeries. In recent years, significant organized efforts have focused on reducing ophthalmology's carbon footprint while maintaining quality patient care. As one example, EyeSustain is a coalition of 50 global ophthalmology societies collaborating to advance sustainability in the delivery of eye care through education, research, and advocacy. Education and advocacy are critical to raising awareness and promoting the implementation of sustainable practices among physicians. Many of these practices can and should be applied throughout the broader healthcare system, and EyeSustain is a model of how other specialties can organize education and advocacy efforts through medical societies. We review current initiatives, advocacy efforts, and waste-reduction strategies aimed at reducing the environmental footprint of ophthalmic procedures.

Intravitreal injections have revolutionized the treatment of various sight-threatening diseases of the posterior segment of the eye. Initially explored for treatment of bacterial endophthalmitis, intravitreal injections rapidly expanded to combat retinal vascular disease in particular. Especially anti-vascular endothelial growth factor agents have emerged as a cornerstone of intravitreal therapy, targeting neovascular age-related macular degeneration and diabetic macular edema as important examples. Advances continue, with novel therapies such as complement inhibitors now available as treatment for geographic atrophy secondary to non-neovascular age-related macular degeneration, offering hope for a previously untreatable condition. Pioneering approaches such as the port delivery system and intravitreal gene therapy aim to improve treatment efficacy while minimizing patient burden. Despite notable successes, challenges for intravitreal therapies persist, including ocular and systemic complications and high treatment burden. Future research endeavors aim to address these challenges and enhance treatment outcomes. This comprehensive review critically evaluates the efficacy, safety, and cost-effectiveness of intravitreal injections, delving into emerging trends and future directions.

Retinal detachments are ophthalmic emergencies given their potential to become a permanently blinding disorder if left untreated. This review will outline the history, pathogenesis, clinical presentation, and current and future management of retinal detachments.