Emotionale Reiz-Bewertung bei PatientInnen mit Mild Cognitive Impairment (MCI)

Die Untersuchung der affektiven Reaktion auf olfaktorische und visuelle Reize bei Patienten mit Mild Cognitive Impairment (MCI) hatte zum Ziel, aufzuklären, ob sich dieses Patientengut beziehungsweise die Subtypen amnestisch, non-amnestisch und subjektiv hinsichtlich Defizite in der Valenz-/ Arousal-Bewertung charakterisieren. Des Weiteren war von Interesse ob abweichende Reizbewertungen modalitätsspezifisch sind und ob sie mit der kognitiven Leistungsfähigkeit korrelieren. Es wurden 89 MCI-Patienten untereinander sowie mit 138 altersgleichen Kontrollen verglichen. Die Teilnehmer hatten zur Aufgabe, ihre emotionale Reaktion auf 16 Geruchsstoffe (Sniffin´ Sticks) und 83 IAPS-Bildern anhand dem Self-Assement-Manikin (SAM) zu beurteilen. Um den kognitiven Status zu erheben, kamen die Mini-Mental-State-Examination (MMSE) sowie die Neuropsychologische Testbatterie Vienna (NTBV) zum Einsatz. Die statistische Auswertung erfolgte mittels ANCOVAs, MANCOVAs sowie anhand Korrelationsberechnungen. MCI-Patienten stuften das Arousal von positiven, neutralen und negativen IAPS-Bildern niedriger ein als die Kontrollgruppe. Hinsichtlich der Subgruppen konnten Differenzen zwischen der amnestischen und der subjektiven MCI gefunden werden. Dies betraf sowohl die negative Valenz- als auch die Arousal-Bewertung. Diese Differenzen zeigten sich zum Teil von der Reizmodalität abhängig. Abschließend konnten signifikante Korrelationen zwischen der Arousal-Bewertung und dem Gedächtnis (episodisch und semantisch) einerseits, sowie zwischen der Arousal-Beurteilung und den Leistungen im MMSE andererseits, gefunden werden.Background: Mild cognitive impairment (MCI) is a clinical diagnosis in which deficits in cognitive functions are evident but not of sufficient severity to warrant a diagnosis of dementia (Peterson et al., 2005). Earlier to cognitive impairments, emotional deficits occur in patients with MCI (Teng, 2007). However, this issue has been underexplored. Objectives: Thus, the aim of the study was to examine whether emotional deficits are present in MCI/ MCI-subtypes in regard to the evaluation on the two dimensions valence (pleasure-unpleasure) and arousal (excited-calm). Secondly, it was examined if these deficits are stimuli dependent (visual versus olfactory). Finally, it was investigated if there is an association between emotional and cognitive deficits. Design: Case-control study. Setting: Department of Neurology of the General Hospital (Vienna). Patients: 89 patients with MCI (amnestic, non-amnestic, subjective) and 138 controls were included. Measurements: Information about the emotional evaluation was obtained from the International Affective Picture System (IAPS), the Sniffin´ Sticks and the Self-Assessment-Manikin (SAM). The Neuropsychological Test Battery Vienna (NTBV) and the Mini-Mental-State-Examination were used to measure the cognitive status. Statistical analysis: ANCOVAs, MANCOVAS and correlations have been carried out. Results: MCI patients responded with less arousal to positive, neutral and negative IAPS-pictures than controls. Moreover group differences (amnestic, subjective) could be found for both the negative valence and arousal dimension. These effects varied with the stimulus modality for the first mentioned. Lastly, significant correlations could be found between the arousal dimension and the episodic as well as the semantic memory on the one hand, and the arousal dimension and the performances in the MMSE on the other hand

Operating during pregnancy: A needs assessment among surgical residents in Austria

In Austria, female physicians must immediately disrupt their surgical training as soon as their pregnancy is announced. In Germany, surveys on the topic of “female surgeons performing surgery during pregnancy” led to a reform of the German Maternity Protection Act, which came into force on January 1, 2018, and allows female physicians to perform risk-adapted surgery during pregnancy at their own request. However, in Austria, such reform is still pending. The study aimed i) to assess the current situation of how pregnant female surgeons handle their training under the actual restrictive legislature in Austria, especially in context of operative activity, and ii) to identify needs for improvements. Therefore, a nation-wide online survey, initiated by the Austrian Society for Gynecology and Obstetrics and the Young Forum of the Austrian Society of Gynecology and Obstetrics, was performed from June 1 to December 24, 2021, among employed physicians working in surgical specialties. To conduct a general needs assessment, the questionnaire was made available to both female and male physicians in all positions. In total, 503 physicians participated in the survey, of which 70.4% (n = 354) were women and 29.6% (n = 149) were men. The majority of the women (61.3%) were undergoing residency training at the time of their pregnancy. The announcement of the pregnancy to the supervisor(s) occurred on average in the 13th week of gestation (week 2–40). Before that, pregnant female physicians spent an average of 10 h per trimester (first trimester: 0–120 h; second trimester: 0–100 h) in the operating room. The main reason for women to continue surgical activity despite their (yet unreported) pregnancy was “own request”. 93% (n = 469) of the participants explicitly wished to be able to perform surgical activities in a safe setting during pregnancy. This response was independent of gender (p = 0.217), age (p = 0.083), specialty (p = 0.351), professional position (p = 0.619), and previous pregnancy (p = 0.142). In conclusion, there is an urgent need to offer female surgeons the possibility of continuing surgical activities during pregnancy. This handling would significantly increase the career opportunities for women who want to build up both a successful career and a family life

The Prognostic Value of Angiogenic Markers in Twin Pregnancies to Predict Delivery Due to Maternal Complications of Preeclampsia

The sFlt-1 (soluble fms-like tyrosine kinase-1), PlGF (placental growth factor), and their ratio are useful for predicting delivery because of preeclampsia in singleton pregnancies. Evidence on the utility of sFlt-1/PlGF ratio in twin pregnancies is lacking. We aimed to evaluate the predictive value of sFlt-1/PlGF ratio for delivery because of preeclampsia in twins. A retrospective data analysis of 164 twin pregnancies with suspected preeclampsia was performed. The sFlt-1/PlGF ratio, which was known to clinicians, was significantly higher in women who delivered within 1 and 2 weeks compared with those who did not (median: 98.9 and 84.2 versus 23.5 pg/mL, respectively;P0.100 for interaction). The area under the curve values of sFlt-1/PlGF were significantly higher than for PlGF alone (mean 0.88 and 0.88 versus 0.81 and 0.80) for predicting delivery because of preeclampsia within 1 and 2 weeks of blood sampling (P=0.055 and 0.001, respectively). sFlt-1/PlGF ratio lower than 38 was able to rule-out delivery within 1 and 2 weeks with a negative predictive value of 98.8% and 96.4% for delivery because of preeclampsia within 1 and 2 weeks, respectively. A cutoff of 38 is applicable for ruling out delivery because of preeclampsia in twin pregnancies

The Prognostic Value of Angiogenic Markers in Twin Pregnancies to Predict Delivery Due to Maternal Complications of Preeclampsia

The sFlt-1 (soluble fms-like tyrosine kinase-1), PlGF (placental growth factor), and their ratio are useful for predicting delivery because of preeclampsia in singleton pregnancies. Evidence on the utility of sFlt-1/PlGF ratio in twin pregnancies is lacking. We aimed to evaluate the predictive value of sFlt-1/PlGF ratio for delivery because of preeclampsia in twins. A retrospective data analysis of 164 twin pregnancies with suspected preeclampsia was performed. The sFlt-1/PlGF ratio, which was known to clinicians, was significantly higher in women who delivered within 1 and 2 weeks compared with those who did not (median: 98.9 and 84.2 versus 23.5 pg/mL, respectively;P0.100 for interaction). The area under the curve values of sFlt-1/PlGF were significantly higher than for PlGF alone (mean 0.88 and 0.88 versus 0.81 and 0.80) for predicting delivery because of preeclampsia within 1 and 2 weeks of blood sampling (P=0.055 and 0.001, respectively). sFlt-1/PlGF ratio lower than 38 was able to rule-out delivery within 1 and 2 weeks with a negative predictive value of 98.8% and 96.4% for delivery because of preeclampsia within 1 and 2 weeks, respectively. A cutoff of 38 is applicable for ruling out delivery because of preeclampsia in twin pregnancies

Scientific Reports / Pregnancy-associated diamine oxidase originates from extravillous trophoblasts and is decreased in early-onset preeclampsia

Human extravillous trophoblast (EVT) invasion of the pregnant uterus constitutes a pivotal event for the establishment of the maternal-fetal interface. Compromised EVT function manifesting in inadequate arterial remodeling is associated with the severe pregnancy disorder early-onset preeclampsia (eoPE). Recent studies suggest that EVTs invade the entire uterine vasculature including arteries, veins and lymphatics in the first trimester of pregnancy. We therefore hypothesized that EVT-derived factors accumulate in the circulation of pregnant women early in gestation and may serve to predict eoPE. In contrast to published literature, we demonstrate that placenta-associated diamine oxidase (DAO) is not expressed by maternal decidual cells but solely by EVTs, especially when in close proximity to decidual vessels. Cultures of primary EVTs express and secret large amounts of bioactive DAO. ELISA measurements indicate a pregnancy-specific rise in maternal DAO plasma levels around gestational week (GW) 7 coinciding with vascular invasion of EVTs. Strikingly, DAO levels from eoPE cases were significantly lower (40%) compared to controls in the first trimester of pregnancy but revealed no difference at mid gestation. Furthermore, DAO-containing pregnancy plasma rapidly inactivates pathophysiologically relevant histamine levels. This study represents the first proof of concept suggesting EVT-specific signatures as diagnostic targets for the prediction of eoPE.(VLID)464142

Abstracts of the 6th FECS Conference 1998 Lectures

International audienc