Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Nov 2022
Letter ReviewRecurrent gestational diabetes : Breaking the transgenerational cycle with lifestyle modification.
This literature review is aimed at examining the benefits of lifestyle modifications in preventing recurrent gestational diabetes (GDM). Worldwide GDM affects approximately 16.2% of all pregnancies with significant maternal, fetal and neonatal complications. Almost two thirds of pregnant women with GDM will develop type 2 diabetes mellitus (T2DM) in the years following pregnancy. The proportion of women affected by GDM is on the rise and reflects increasing trends in T2DM as well as adult and childhood obesity. ⋯ This review provides an overview of the literature to date, discusses different targeted approaches and how these interventions can optimise their benefits, and where further research is required.
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Borrelial lymphocytoma is a rare cutaneous manifestation of early localized European Lyme borreliosis. It manifests as a nodule or plaque with a diameter of up to a few centimeters. The lesion is, as a rule, solitary. ⋯ Posttreatment duration of a borrelial lymphocytoma is positively associated with the pretreatment duration of the lesion and with patient age, while treatment failure is associated with the clinical signs of disseminated Lyme borreliosis at presentation. Substantial improvements in knowledge on borrelial lymphocytoma and laboratory diagnostics in recent decades have contributed to earlier diagnosis and treatment. Consequently, borrelial lymphocytoma is usually a mild disease with a good prognosis.
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Wien. Klin. Wochenschr. · Aug 2022
ReviewAssessment of personality functioning in psychosomatic medicine.
Personality functioning, also referred to as structural integration, describes basic emotion-related perception and regulation capacities directed towards the self and others. Patients with impairments of personality functioning experience difficulties in self-regulation and interpersonal relations. Although personality functioning has become increasingly important in psychotherapeutic and psychiatric diagnoses and treatment planning, there is little systematic evidence on the role of personality functioning in patients with chronic and somatic diseases. This article reviews empirical studies using standardized assessments of personality functioning in patients with chronic and somatic diseases and discusses the role of personality structure in psychosomatic medicine. ⋯ The review suggests a systematic link between personality functioning and health behavior in patients with chronic diseases that relate to self-regulation and coping strategies. These findings underline the importance of assessing personality functioning for diagnostics and treatment planning in psychosomatic medicine. Finally, an assessment of personality functioning could be helpful in choosing specific psychotherapeutic treatment strategies; however, more empirical studies are needed to comprehensively prove these assumptions.
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Wien. Klin. Wochenschr. · Jul 2022
ReviewUpdate of the mechanism and characteristics of tuberculosis in chronic kidney disease : Review article.
The risk of tuberculosis (TB) is significantly increased in patients with chronic kidney disease (CKD), which is closely related to hyperparathyroidism, malnutrition and oxidative stress as well as immune deficiency in patients with end-stage renal disease (ESRD). Vitamin D deficiency and gender bias are independent risk factors. In the TB screening and diagnosis test of CKD, interferon-gamma release assays (IGRA), including T‑SPOT. ⋯ For CKD patients with TB, the choice and dosage of anti-TB drugs need to be reconsidered. Weekly treatment with rifapentin (RFT) and isoniazid (INH) for 3 months is an effective treatment for latent tuberculosis infection (LTBI) in hemodialysis (HD) patients. Therefore, in this review we discuss CKD and TB, its pathogenesis, clinical features, diagnosis and treatment advancements.
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Wien. Klin. Wochenschr. · Jun 2022
ReviewEffects of pulsed electromagnetic field therapy on outcomes associated with osteoarthritis : A systematic review of systematic reviews.
Osteoarthritis (OA) is a chronic degenerative disease of multiple joints with a rising prevalence. Pulsed electromagnetic field (PEMF) therapy may provide a cost-effective, noninvasive, and safe therapeutic modality with growing popularity and use in physical medicine and rehabilitation. The purpose of this study was to synthesize the current knowledge on the use of PEMF in OA. ⋯ The PEMF therapy appears to be effective in the short term to relieve pain and improve function in patients with OA. The existing studies used very heterogeneous treatment schemes, mostly with low sample sizes and suboptimal study designs, from which no sufficient proof of efficacy can be derived. A catalogue of measures to improve the quality of future studies has been drawn up.