Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Apr 2024
ReviewPerspectives in treatment-resistant depression: esketamine and electroconvulsive therapy.
Modern electroconvulsive therapy (ECT) and the approval of nasal esketamine for clinical use have significantly improved the approach to treatment-resistant depression (TRD), which is defined as non-response to at least two different courses of antidepressants with verified adherence to treatment, adequate dosage, and duration of treatment. The goal of this literature review is to present the newest evidence regarding efficacy and safety. Furthermore, we aim to provide an overview of future perspectives in this field of research, for example, regarding structural and molecular effects. ⋯ The decision-making process between esketamine nasal spray or ECT should include the assessment of contraindications, age, severity of disease, presence of psychotic symptoms, patient preference and treatment accessibility. We conclude that both treatment options are highly effective in TRD. If both are indicated, pragmatically esketamine will be chosen before ECT; however, ECT studies in ketamine non-responders are missing.
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Wien. Klin. Wochenschr. · Apr 2024
ReviewHistory of surgery at the University of Vienna : The three surgical schools.
There are several publications on the history of surgery at the University of Vienna. None of these publications, however, sought to group the rich history of surgery in Vienna into distinct "surgical schools" of which, upon closer inspection, only 3 have emerged over the last 250 years. ⋯ Each of these schools is unique in that it maintained a degree of coherence, as knowledge, methodology and scientific focus were passed down in a chain of succession. These three schools also significantly influenced the rest of surgery in Vienna because most of the department chairs at the Vienna city hospitals or private hospitals were trained in one of these three schools.
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A complete review of the development of neonatology in the last 40 years would probably require a compendium with several volumes, to bring to view the remarkable improvements in survival rates and neurodevelopmental outcomes of ill babies in Austria, most industrial countries and to some extent worldwide. The challenge I had to solve here was to integrate my own contributions to the field of neonatology during this period and particularly the contributions of my team from the Division of Neonatology and Pediatric Intensive Care Medicine, Department of Pediatrics and Adolescence Medicine, Medical University Vienna where I was working first as an intern and resident and later had the privilege to become head of department. ⋯ As we look ahead it is imperative to build upon the progress made, harnessing the power of science and technology to further improve the survival and quality of life for preterm infants in Austria and worldwide. At the same time, neonatology must continue to prioritize ethical reflection and education, fostering a culture of integrity, interdisciplinary collaboration, and the development of guidelines and protocols that uphold ethical standards while addressing the evolving needs and complexities of neonatal medicine.
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Wien. Klin. Wochenschr. · Apr 2024
Erwin Deutsch, the Eppinger Clinic and the legacy of the Second Vienna School of Medicine-Continuities of a career.
Erwin Deutsch (1917-1992) was an outstanding representative of Austrian internal medicine after World War II. Little is known about his early biography. Considered a "Jewish half-breed" under Nazi racial laws, he was subjected to harassment during his training. ⋯ Erwin Deutsch significantly contributed to continuity by vehemently calling for the unity of internal medicine after 1945, as it had been practiced in Vienna since the nineteenth century. Discrimination as a "Jewish half-breed" played a paradoxical role in this context-it delayed the start of his independent academic activity and increased his personal dependence on Eppinger; at the same time it spared him military service and enabled him to start his career after 1945 unaffected by denazification measures. Based on unpublished archival material, interviews with contemporary witnesses, and Deutsch's medical publications, this article is the first to offer an account of his early career, from his graduation in 1940, his time at the Eppinger Clinic, compulsory service in Germany during the war and the beginning of his scientific work to his appointment as Ernst Lauda's successor as director of the 1st Medical Clinic in Vienna.
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In view of the recent revival of interest in circadian biology and circadian epidemiology at the Medical University of Vienna, it seems appropriate to highlight the rich and pioneering history of circadian research in Austria. Among the forefathers of circadian research in Vienna are Otto Marburg (1874-1948), who discovered important elements of the pineal gland physiology, Robert Hofstätter (1883-1970), who used pineal gland extract in obstetrics/gynecology, and Paul Engel (1907-1997), who discovered that the pineal gland was controlled by light. More recently, Vera Lapin (1920-2007) showed that surgical removal of the pineal gland increased tumor growth, while Franz Waldhauser (*1946) investigated melatonin in conjunction with night work. ⋯ Furthermore, Vienna-born Erhard Haus (1926-2013) pioneered the discovery of the role and importance of melatonin in relation to numerous diseases. This rich pioneering contribution of scientists in Vienna or with roots in Vienna is continued today by a new generation of chronobiologists, epidemiologists and clinicians in Vienna whose new insights contribute to the rapidly developing field of circadian rhythms research. Current topics and contributions relate to the impact of circadian rhythm disruption on health, and the application of chronotherapeutic approaches in clinical and preventive settings.