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Radiofrequency denervation has been established for many years as an important minimally invasive procedure for the treatment of chronic pain conditions. Positive experiences of many users for various indications are contrasted by a nonuniform evidence. With meticulous patient selection and correct assessment of the indications a longer term reduction of pain, a reduced need for analgesics and an improvement in the quality of life can be achieved. The aim of this interdisciplinary position paper is to present the value of radiofrequency denervation in the treatment of chronic pain. The summarized recommendations of the expert group are based on the available evidence and on the clinical experiences of Austrian centers that frequently implement the procedure. The position paper contains recommendations on patient selection and proven indications. We discribe safety aspects, complications, side effects and contraindications.

Despite many positive developments, postoperative pain and its treatment is still not always given the necessary attention. Severe pain after surgical procedures affects a significant proportion of patients. This very fact is not only detrimental to the immediate recovery process, but can also form the basis for the development of chronic pain conditions.An adequate and effective management of perioperative pain requires appropriate organizational structures. This multidisciplinary paper which was initiated by the Austrian Society for Anaesthesiology and Intensive Care and the Austrian Pain Society and developed together with numerous specialist and professional societies dealing with the subject aims at supporting the organization of perioperative pain management structures and to make best use of proven concepts. Additional recommendations describe specific interventions for selected types of intervention.

Background: The present guidelines ( http://leitlinien.net ) focus exclusively on cardiogenic shock due to myocardial infarction (infarction-related cardiogenic shock, ICS). The cardiological/cardiac surgical and the intensive care medicine strategies dealt with in these guidelines are essential to the successful treatment and survival of patients with ICS; however, both European and American guidelines on myocardial infarction and heart failure and also position papers on cardiogenic shock focused mainly on cardiological aspects., Methods: Evidence on the diagnosis, monitoring and treatment of ICS was collected and recommendations compiled in a nominal group process by delegates of the German Cardiac Society (DGK), the German Society for Medical Intensive Care Medicine and Emergency Medicine (DGIIN), the German Society for Thoracic and Cardiovascular Surgery (DGTHG), the German Society for Anaesthesiology and Intensive Care Medicine (DGAI), the Austrian Society for Internal and General Intensive Care Medicine (ÖGIAIM), the Austrian Cardiology Society (ÖKG), the German Society for Prevention and Rehabilitation of Cardiovascular Diseases (DGPR) and the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI), under the auspices of the Working Group of the Association of Medical Scientific Societies in Germany (AWMF). If only poor evidence on ICS was available, general study results on intensive care patients were inspected and presented in order to enable analogue conclusions., Results: A total of 95 recommendations, including 2 statements were compiled and based on these 7 algorithms with defined instructions on the course of treatment.

This paper briefly summarizes the late-breaking session "Pathology and COVID-19" that took place at the virtual congress of the German Society of Pathology on June 6, 2020. The lectures tackled a broad variety of aspects, including the German Registry for COVID-19 autopsies (DeRegCOVID), the detection methods of SARS-CoV‑2 in pathological material, the typical lung findings in severe COVID-19 cases, the distinct (micro)vascular changes and the cardiac and gastrointestinal involvement in COVID-19. In summary, in this first scientific meeting in German pathology on the COVID-19 pandemic, it became clear that pathologists in Germany, Austria and Switzerland have reacted very quickly to the pandemic and have established an autopsy program that has led to medically highly relevant findings.

When Adolf Hitler annexed Austria to the German Reich in 1938, the famous Jewish oral pathologist Bernhard Gottlieb was in great distress. The Viennese university teacher immediately lost his employment and teaching authority and was forced to emigrate.While Gottlieb's exceptional scientific position in oral pathology is well documented, the complex implications of his deprivation of rights and forced emigration in the Third Reich have so far received little attention. Against this background, the present contribution poses the question of the concrete effects of this drastic event on Gottlieb's life and work.In order to clarify this question, Gottlieb's career status, his scientific success up to 1938, the concrete background of his forced emigration, as well as the further course of his life and career in the USA (his immigration country) are scrutinized. In addition, the paper analyzes the extent to which Gottlieb was able to build on his professional career after 1945 and posthumously. The work is based on a thorough analysis of Gottlieb's academic career using archival sources and a re-analysis of the relevant research literature.The study concludes that Gottlieb suffered a severe setback after his emigration. Several reasons played a role. In particular, cultural and age-related adjustment problems, difficult local conditions, and scarce financial resources hampered the seamless continuation of Gottlieb's career in the USA. Only in the last two decades have efforts been made, particularly in the environment of the University of Vienna, to bring Bernhard Gottlieb and his scientific achievements back into collective memory.

During the last 20 years Austrian prehospital emergency medical services (EMS) have significantly improved. The structure and organization of Austrian EMS comply with European standards but training requirements for prehospital EMS physicians are insufficient when compared with other countries. Although some EMS systems follow the German or Swiss postgraduate training concepts, the legal requirements in Austria defining the scope of mandatory training for physicians in the prehospital setting are only minimal. Thus, besides board certification as a general practitioner or specialist of any discipline, the only formal requirement is a 1-week theoretical course comprising some manikin simulations. Experience in anesthesia or intensive care medicine is still not mandatory. The Austrian Society of Anesthesiology, Resuscitation and Intensive Care Medicine (ÖGARI) drafted a reform paper in 2009, which was adapted by the Austrian Chamber of Physicians, section of emergency medicine, and subsequently presented to the Austrian Ministry of Health. Due to the slowness of the legislation process, the relevant § 40 of the Austrian Physician 's Act is still unchanged. In the meantime, Austrian specialist training regulations were restructured in 2015 with significant consequences. Due to changes in the residency programs, board certification and subsequent full working permit becomes more difficult to obtain, thus further aggravating the shortage of emergency physicians in Austria. In order to counteract the threatening shortage of prehospital EMS physicians, the ÖGARI section of emergency medicine was requested by the Ministry of Health to develop a reasonable model for how physicians could be qualified and subsequently employed in EMS prior to full board certification. Presently, the Austrian Ministry of Health, the Chamber of Physicians and medical societies are in discussion on whether this approach might fit into the legal framework. This manuscript details the development and present status as well as key points of an ongoing discussion on how high-quality EMS care in Austria can be safeguarded in the future or could even make it impossible.

Background: Chronic pain is a widespread social problem. This paper reports on the care situation for patients with chronic pain in out-patient community settings in Austria., Materials and Methods: The study took the form of a telephone survey together with internet research. Every second out-patient pain service (from a total of 83) was contacted and 21 out of 42 agreed to participate., Results: The number of community-based physicians with a certificate in pain therapy as well as the number of out-patient pain services showed considerable regional variation. Partial or full interdisciplinary teams are a feature of approximately 50% of out-patient pain units and 76% of such services use guidelines according to their own estimation. Pain perception tends to be measured using pain rating scales rather than pain questionnaires. A wide range of treatments is offered either directly or via referral., Conclusions: Quality criteria relating to the structure of care established by the Austrian Society for Pain have only been partially implemented. Potential for improvement exists particularly with regards to the prevalence of pain-specific training, interdisciplinary teamwork and the measurement of outcomes.

This paper gives a comparative overview of the current clinical care of patients experiencing pain in the musculoskeletal system in Austria and in Germany. The questionnaire used in this study was modified from one used in a survey carried out in Germany in 2002. In our version we asked specifically about pain in the musculoskeletal system. In all 228 health care facilities were reviewed, 56.6% of which offer at least one option for pain therapy. In Austria, the majority of patients with pain in the musculoskeletal system are treated by specialists in the departments of anaesthesiology, internal medicine, and orthopaedics. In 17.4% of the clinics in Austria there are plans to extend the pain therapy they offer, but in over half of the hospitals that responded facilities for pain therapy are considered to be vulnerable. The study highlights a significant higher percentage of in-patient pain therapy services in Austria, while in Germany, in contrast, there are more outpatient options for pain therapy. The quality of pain therapy could by further improved by more intense cooperation between the inpatient and outpatient sectors and by the establishment of interdisciplinary and multimodal solutions.

Aim: The aim of the study presented in this paper is to find out how general practitioners evaluate their cancer patients' health, quality of life and type and extent of pain. In addition the study aims to get information about the training in pain therapy and palliative medicine., Methods: A representative sample of 440 of all Austrian general practitioners was interviewed via a standardized questionnaire. The consent for the questioning had been obtained by telephone., Results: The state of health and quality of life of the treated cancer patients are described as little satisfying and most unfavourably affected by the disease. The physicians suppose that the patients experience pain more intense than could be expected of them as endurable. Nevertheless the cancer patients appreciate pain therapy., Conclusion: As a result the medical training in pain therapy and palliative medicine should be improved. At the same time the future general practitioners should gain psychological competences, which would consequently provide them with a broad spectrum of treatment needed when dealing with pain patients (suffering from cancer).

This paper makes a summary on epidemiological and clinical experiences gained in Vienna since 1974 on the transmission of hepatitis B from mother to child (vertical hepatitis B transmission). 1. Hepatitis B and pregnancy: Whereas acute hepatitis B does not occur often in pregnant women, and HBs-antigen carrier status was found in 23 of 4,500 (0.52%) pregnant women examined prospectively. Three women were HBs-antigen positive, 18 were anti-HBe positive, and in no woman signs for an infection with delta-agent were found. These women are nearly always asymptomatic. About 2/3 have immigrated from the Balkans, Turkey and South-East Asia. While acute hepatitis B in the sense of an unspecific effect of the disease leads to an increased rate of premature births, neither a tendency to premature births nor to intrauterine dystrophia was found in HBs-antigen carriers--not even in infected children. 2. Frequency of vertical hepatitis B transmission: Prospectively, an infection of the children was found in three cases in pregnancies of 16 HBs-antigen carrier mothers. In mothers with positive HBe-antigen the risk was higher than in those with positive anti-HBe. But the latter may not be considered to be non-infectious in general: In an examination carried out retrospectively, 6 of 8 mothers examined were anti-HBe positive. Anti-HBe positive mothers of Westeuropean origin may also infect their children. It is known from American investigations that pregnant women suffering from acute hepatitis B in the third trimester of pregnancy or six weeks after delivery infect their children with hepatitis B in 66 to 100% of cases. 3. Mode of infection: The fact that most children demonstrate serological signs of infection only two to four months after birth justifies the assumption that the majority of children is infected perinatally, i.e. by ingestion or inoculation of infectious secretions of the mother, possibly also by maternofetal transfusions. Postnatal and in particular intrauterine infections are exceptions. The human milk is probably only important as source of infection if it is contaminated by bleeding rhagades. 4. Course of the disease in infected children: The following course of disease was observed prospectively and retrospectively: subclinical infection, acute hepatitis B, fulminant hepatitis B (including two cases in siblings), asymptomatic carrier status, chronic persistent hepatitis B, chronic aggressive hepatitis B. The course of infection in the child seems to be influenced by the HBe-antigen status of the mother: In children of anti-HBe positive mothers HBs-antigen elimination is a frequent occurrence during the course of infection.(ABSTRACT TRUNCATED AT 400 WORDS)