Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · May 2024
ReviewGene therapy: principles, challenges and use in clinical practice.
Gene therapy is an emerging topic in medicine. The first products have already been licensed in the European Union for the treatment of immune deficiency, spinal muscular atrophy, hemophilia, retinal dystrophy, a rare neurotransmitter disorder and some hematological cancers, while many more are being assessed in preclinical and clinical trials. ⋯ Gene therapy holds great promise for considerable improvement or even cure of genetic diseases with serious clinical consequences. However, a number of questions and issues need to be clarified to ensure broad accessibility of safe and efficacious products.
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Wien. Klin. Wochenschr. · May 2024
ReviewThe prevalence of presbyphagia in older adults: a systematic review and meta-analysis.
Presbyphagia is defined as structural, physiological and innervational alterations in the swallowing process as a result of aging and is considered to be involved in the etiology of dysphagia. This systematic review and meta-analysis aimed to estimate the prevalence of presbyphagia in older adults without disease-related dysphagia. ⋯ Although the pooled prevalence of presbyphagia in older adults was 17.3%, the lack of large representative studies limited the interpretation of these findings. In the future, further large studies that diagnose presbyphagia using standardized assessment tools would facilitate new avenues to reduce the risk of dysphagia in older adults.
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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
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.