Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Oct 2024
Case ReportsEsophageal perforation with near fatal mediastinitis secondary to Th3 fracture.
A 74-year-old male patient was referred with signs of sepsis 5 days after having been diagnosed with a rib fracture following a fall out of bed. Novel hypodensities were visible on thoracic X‑rays and laboratory tests revealed elevated inflammatory parameters. Subsequently performed thoracic computed tomography (CT) scan showed burst fracture of the 3rd thoracic vertebra, posttraumatic esophageal rupture at the same level and mediastinitis. ⋯ Up to the latest follow-up 41 months following injury, several endoscopic dilations with a bougie due to constrictions at the anastomosis have been performed. Similar to previous cases in the literature, esophageal injury was diagnosed delayed, with the patient already having developed severe complications. This extremely seldom injury should be suspected in young patients following high-energy trauma, but also in older patients after low-energy trauma but known degenerative changes of the vertebral column.
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Wien. Klin. Wochenschr. · Oct 2024
Austrian consensus statement on the diagnosis and management of hypertrophic cardiomyopathy.
Hypertrophic cardiomyopathy (HCM) is the most common inherited heart disease that is characterized by left ventricular hypertrophy unexplained by secondary causes. Based on international epidemiological data, around 20,000-40,000 patients are expected to be affected in Austria. Due to the wide variety of clinical and morphological manifestations the diagnosis can be difficult and the disease therefore often goes unrecognized. ⋯ Early and correct diagnosis, including genetic testing, is essential for comprehensive counselling of patients and their families and for effective treatment. The latter is especially true as an effective treatment of outflow tract obstruction has recently become available in the form of a first in class cardiac myosin ATPase inhibitor, as a noninvasive alternative to established septal reduction therapies. The aim of this Austrian consensus statement is to summarize the recommendations of international guidelines with respect to the genetic background, pathophysiology, diagnostics and management in the context of the Austrian healthcare system and resources, and to present them in easy to understand algorithms.
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Wien. Klin. Wochenschr. · Oct 2024
Historical ArticleThe establishment of orthopedics in Croatia : The role of Božidar Špišić (1879-1957) and his professional networks.
Božidar Špišić was a pioneer of Croatian orthopedics. In 1908 he founded the first private orthopedic clinic in the entire South Slav region. During the First World War he organized and headed the first orthopedic hospital for the rehabilitation and resocialization of wounded soldiers. ⋯ In this paper, we have reconstructed the transfer of knowledge and experiences between these prominent Austrian and German orthopedists and Božidar Špišić. We have paid special attention to the identification of those elements in Špišić's work that can be traced back to his mentor, teacher and lifelong colleague Adolf Lorenz, such as his treatment for congenital hip dislocation. We believe that the analysis of professional networks can shed additional light on the historiography of orthopedics, given that these influences did not manifest solely through the acquisition of specialized clinical knowledge but also through a profound influence on the core tenets of orthopedics as a discipline-its institutional organization and overall conservative approach.
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Wien. Klin. Wochenschr. · Oct 2024
[Position paper of the Austrian Society for Rheumatology and the Austrian Society for Pneumology on the diagnosis and treatment of sarcoidosis 2024].
In many cases sarcoidosis is a multisystemic disease that requires interdisciplinary medical cooperation in the diagnostics, treatment and medical care during follow-up. Due to the often chronic course, it is of utmost importance to include patients with their priorities and wishes at an early stage and extensively in disease management and to establish a shared decision making whenever possible. In the process of writing this joint position paper, the expert group on interstitial and orphan lung diseases of the Austrian Society for Pulmonology and the working group on rheumatological lung disorders of the Austrian Society for Rheumatology and Rehabilitation sought to include patient advocacy groups as well as experts for rare organ manifestations of sarcoidosis. This position paper is not only meant to reflect current scientific and clinical standards but should also focus the national expertise and by networking and exchange to be a first step to strengthen cooperation between stakeholders to ultimately improve care for patients with sarcoidosis.