Wiener medizinische Wochenschrift最新文献

Background: Epileptic seizures are a common manifestation of autoimmune encephalitis (AIE). Immunosuppression (IT) is an efficient therapeutic approach, particularly in AIE associated with antibodies against extracellular structures. The role of antiseizure medication (ASM) is less clear. However, it may be beneficial in disease refractory to IT or in chronic post-AIE epilepsy.

Methods: We conducted a systematic review assessing the PubMed and Cochrane databases to identify all reports on patients with epileptic seizures due to AIE in whom ASM was used and report it according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. We included case series (minimum 3 eligible patients), retrospective and prospective observational studies, and randomized controlled trials. The main outcome assessed was therapeutic efficacy of ASM. Secondary outcomes comprise number, type, and adverse effects of ASM. Descriptive statistics were used. The level of evidence was assessed according to the Centre for Evidence-Based Medicine.

Results: We screened a total of 3371 studies and included 30 (7 prospective, 23 retrospective). The reports cover a total of 708 patients, the majority (72.5%) suffering from AIE with antibodies against extracellular structures. Type of AIE, seizure frequency, and number and type of ASM used were heterogenous. While most patients profited from IT and/or ASM, the effect of ASM could rarely be isolated. Nine studies report on patients who received ASM monotherapy or were on ASM for a relevant length of time before IT initiation or after IT failure. One study reports a significant association between seizure freedom and use of sodium channel inhibitors. However, levels of evidence were generally low.

Conclusion: Few robust data exist on the particular efficacy of ASM in autoimmune epileptic seizures. While these patients generally seem to respond less well to ASM or surgical interventions, sodium channel blockers may have an additional benefit compared to other substances. However, levels of evidence are low and early IT remains the mainstay of AIE therapy. Future trials should address optimal ASM selection and dosing in AIE.

This historical account is a departure from the oblivion of the historical circumstances surrounding the introduction of the open method of wound healing by Vincenz Kern, a Viennese professor of surgery in 1809, and which is still used today in most surgical professions. Thanks are also due to the famous Medical University of Vienna from where Kern ultimately established numerous schools throughout Europe, including Croatia, as a then part of the great Austrian Empire.

A relationship between literature and medicine has existed since antiquity. A physician often appears in the literary genre of satire as the representative of medicine and is the object of the satire. The barely known humanistic author Johannes Gregor Macer Szepsius (ca. 1530-nach 1579) was a humanist who sharply criticized the work and behavior of physicians. We have read, translated and analyzed the satirical verses from his comprehensive poetical work De vera gloria, On the true glory, with respect to content, structure and sources. According to this, physicians are characterized by conceit, ignorance and laziness and therapeutic ineptitude. The comparison with other satirical works shows that much of that which he accuses physicians of is repeated in the history of medicine. Some places are similar to the proverbs from Walter's collection of proverbs from the Middle Ages and others are similar to the invectives of Petrarch. Macer also levels criticism against physicians in his poem about the family tree of his friend Anton Schneeberger that appears in Schneeberger's work De bona valetudine militum conservanda liber.

In 1573, Georg Henisch published a short pharmaceutical handbook, Enchiridion medicinae, which contains remedies for individual health problems, without making any further comments on the effects and method of use. However, this manual had a predecessor which was published in Paris in 1571 without mentioning the author. The text of both editions is practically identical, there are only minimal differences, but the second edition has been expanded to a foreword and final sections with some recipes. A comparison of the work with contemporary medical literature revealed that Enchiridion medicinae is a compilation of three works by other authors, De materia medicinali et compositione medicamentorum by G. Rondelet from 1556, a commentary by the French author Sebastien Coquillat Scipio on Galen's work Quos, quibus, quando purgare oporteat from 1553 and the book Lilium medicinae by Bernard de Gordon from 1550. Henisch probably acquired this compilation from 1571 as a young student in France, added some passages by Rendelet and passages from two others books, wrote a foreword which he signed with his name and published in Basel in 1573.

Croatia is a Central European and Mediterranean country with a long maritime border with Italy. Throughout history, it was not only goods but also knowledge and medical practices that were exchanged over its borders. Following archival sources, individual informal networks, professional publications, daily newspapers, and public lectures, we aimed to present main channels by which Croatian intellectuals embraced Lombroso's criminal anthropology at the end of the 19th and the beginning of the 20th centuries. We illuminated the fact that the adoption of Cesare Lombroso's concepts stimulated the joint engagement and communication of medical and legal realms in Croatia. Our analysis exposed the traces of Lombroso's ideas within the reform of the penal code, thus influencing forensic psychiatric practice. We showed how those ideas were translated into policy, politically exploited, and pitched into discussions employing rhetorical techniques, which led to the stigmatization of certain groups of people, particularly patients suffering from epilepsy. Our results also showed that, contrary to other countries that formed Austria-Hungary, the discussions about Lombroso's criminology waned in Croatia after the First World War. We believe that our results can close the gap on this topic, adding the evidence about the spread and influence of Lombroso's concepts within Austria-Hungary in the analyzed period.

Neurocritical care is a multidisciplinary field managing patients with a wide range of aliments. Specifically, neurotrauma is a rapidly growing field with increasing demands. The history of how neurotrauma management came to its current form has not been extensively explored before. Our review delves into the history, timeline, and noteworthy pioneers of neurotrauma-focused neurocritical care. We explore the historical development during early times, the 18th-20th centuries, and modern times, as well as warfare- and sports-related concussions. Research is ever growing in this budding field, with several promising innovations on the horizon.

X‑linked hypophosphatemia (XLH) is a phosphate wasting disorder. Typical serum constellations include low serum phosphate as well as high alkaline phosphatase (ALP) and fibroblast growth factor 23 (FGF-23 ) levels. Adult XLH patients usually suffer from (pseudo)fractures, enthesopathies, impaired mobility, and osteoarthritis. We report the case of a middle-aged woman with clinically mild disease, relatively balanced laboratory values, but bone non-healing of the femur post-surgery. Transiliac bone biopsy revealed pronounced osteomalacia and severe deterioration of bone microstructure. Due to the lack of XLH-typical symptoms, the patient was not substituted with calcitriol and phosphate in adulthood. Thus, laboratory findings and radiological examinations do not necessarily reflect bone metabolism in XLH. Bone biopsies should be considered in unclear cases or prior to surgery in adults with XLH.