University Of Vienna Research Articles

How does surgery influence female sexuality in patients with endometriosis compared to those with other benign gynecological conditions?

Endometriosis is a chronic, estrogen-dependent, benign condition, affecting 10-15% of women of reproductive age. It is associated with a prevalence of sexual dysfunction that is nearly twice as high as that seen in women with other benign gynecological conditions. Our study aimed to assess the effect of surgical intervention on sexual function, as measured by the FSFI (Female Sexual Function Index) score, in women with endometriosis compared to those with other benign gynecological conditions, both before and after surgery. A comparative analysis was conducted at the Medical University of Vienna from 2015 to 2020. The study included patients suspected of having endometriosis, fibroids, adnexal cysts, and/or infertility. Based on findings during surgery, patients were categorized into two groups: those with endometriosis (n = 64) and control patients (n = 38). All participants completed the FSFI questionnaire before surgery and again 8 to 18 weeks after the operation. No significant differences were observed in the preoperative FSFI scores between the endometriosis patients and the control group. Similarly, no significant differences were found between the two groups in postoperative scores. However, in women diagnosed with endometriosis, surgical removal of endometriotic lesions significantly increased their full-scale FSFI score, and resulted in a significant improvement in the areas "desire" and "satisfaction". Improvements were noted in all other areas as well, though they were not statistically significant. Our research indicates that the surgical removal of endometriotic lesions can lead to an improvement in sexual function, as measured by the FSFI, within 8 to 18 weeks post-surgery. This improvement was not observed in the control group, which underwent surgery for other benign gynecological issues.

Cilgavimab and tixagevimab as pre-exposure prophylaxis in vaccine non-responder kidney transplant recipients during a period of prevalent SARS-CoV-2 BA.2 and BA.4/5 variants—a prospective cohort study (RESCUE-TX)

The response to severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) vaccination is severely impaired in patients on maintenance immunosuppression after kidney transplantation. We conducted a prospective cohort study of 194 kidney transplant recipients (KTR) who exhibited no response to SARS-CoV-2 vaccinations (i.e., SARS-CoV-2 spike protein antibodies ≤264 U/mL) and had no prior documented infection. Patients received 300mg of cilgavimab/tixagevimab as SARS-CoV-2 pre-exposure prophylaxis (PrEP) between March 4, 2022, and May 3, 2022 and were contrasted to a matched cohort of 186 KTRs also without immunization again defined as SARS-CoV-2 spike protein antibodies ≤264 U/mL and no documented prior infection. The primary outcome was the serum kinetics of cilgavimab/tixagevimab, the secondary endpoints were time to SARS-CoV-2 breakthrough infection, severity of disease and variant specific live viral invitro neutralization tests of patient sera. Longitudinal serum level monitoring showed a half-life of 91 days for both antibodies (95% CI 86-95 days for cilgavimab and 85-96 days for tixagevimab) in KTRs. Invitro neutralization tests showed effectiveness against the BA.2 omicron subvariant but not BA.5. The cumulative incidence of SARS-CoV-2 infections until May 15, 2022, (BA.2 dominance) was 15/194 vs 36/186 in the PrEP and control group respectively (OR=0.35, 95% CI 0.18-0.66) but was not different thereafter (BA.4/5 dominance). The number of severe infections during the BA.2 period was lower in the prophylaxis than in the control group (OR=0.37, 95% CI 0.17-0.79). This study showed that SARS-CoV-2 PrEP with cilgavimab/tixagevimab demonstrated clinical effectiveness against variants that are neutralised (BA.2) but not against BA.4/5. This study was funded by the Medical University of Vienna and an unrestricted grant from AstraZeneca (ESR-21-21585).

THE FIRST WOMEN IN RESPONSIBLE POSITIONS IN THE MINISTRIES OF FOREIGN AFFAIRS OF POLAND AND UKRAINE (Kazimiera Iłłakowiczówna and Nadia Surowcowa)

The article shows the fate of the first women to hold responsible positions in the foreign ministries of Poland and Ukraine in the period of formation of the diplomatic services of both countries during the struggle of Ukrainians and Poles for the restoration of state independence in 1917-1921. At that time, diplomacy was a purely male field of activity. However, Kazimiera Iłłakowiczówna in Poland and Nadia Surowcowa in Ukraine have proven that women can work effectively in the diplomatic service. They were both fluent in several foreign languages, demonstrated creative approaches to solving complex problems, and fought for women's rights. Surowcova became the first woman in Ukrainian diplomacy to hold the position of head of an independent unit, the first spokesperson of the Ministry of Foreign Affairs, the first Ukrainian woman to defend her dissertation at the University of Vienna. Iłłakowiczówna proved the effectiveness of women in Polish diplomacy in various positions, she was the first to use the tools of public diplomacy during foreign trips with lectures on Poland and J. Piłsudski, she introduced diplomatic protocol in the Ministry of Military Affairs. Through their activities, both diplomats left important lessons of responsibility, professionalism, and creativity to future generations of women in diplomacy. The article concludes that these two unique women, despite extraordinary challenges, lived long and vibrant lives, went through fame, envy, oblivion and revival of memory, and became true legends - as diplomats and writer and journalist. Each of them found themselves in the diplomatic service by accident, but immediately realised their mission and pride in joining diplomacy as an important state institution in the days of its formation.

Aretrospective cross-sectional study on district-based socioeconomic status and prostate cancer diagnosis.

Socioeconomic disparities have been linked to delayed prostate cancer diagnosis and poorer outcomes in various countries. This study aims to evaluate the socioeconomic disparities in prostate cancer diagnostics in Vienna, Austria, by examining initial prostate-specific antigen values and age at diagnosis across different districts and nationalities. This retrospective study included 1356 prostate cancer patients treated at the Medical University of Vienna between 2012 and 2022. Influence of residential districts and nationalities of the patients on the initial prostate-specific antigen (iPSA) value and on the age at diagnosis were analyzed. Patient data, including iPSA values, residential districts, and nationalities, were retrieved from the hospital's internal documentation system. The information on average income of residential districts was obtained from the City of Vienna's municipality data. Nationalities were grouped into EU and non-EU categories. Statistical analyses, including linear regression and t‑tests, were performed to examine the relationship between iPSA values, age at diagnosis, and socioeconomic variables. Linear regression was used to analyze the relationship between district income and both iPSA values and age at diagnosis. The study found no significant differences in iPSA values and age at diagnosis between patients from higher income and lower income districts. Additionally, there were no significant differences among individual districts or between EU and non-EU nationals. The findings suggest that the Austrian healthcare system provides equitable access to prostate cancer diagnostics across different socioeconomic groups.

Dual hypothermic oxygenated machine perfusion of the liver reduces post transplant biliary complications - a retrospective cohort study.

Corroborating evidence for use of hypothermic oxygenated machine perfusion (HOPE) prior to orthotopic liver transplantation (OLT) suggests a beneficial effect in regards to biliary complications. Here, we aim to evaluate whether perfusion via portal vein alone (sHOPE) or via additional perfusion of the hepatic artery (dHOPE) have diverging impact on outcomes after OLT when compared to use of static cold storage (SCS). Consecutive patients undergoing OLT at Medical University of Vienna (2018 to 2023) were retrospectively analyzed. Donor organs were procured using SCS, or subjected to end-ischemic sHOPE or dHOPE. Severity of biliary complications was classified according to degree of therapeutic intervention (endoscopic retrograde cholangiopancreatography or surgical revision). 247 patients were included (69 SCS, 76 sHOPE, 102 dHOPE). Hospitalization was shorter for patients after HOPE (median in days: SCS=25 vs HOPE=20, P=0.019). Biliary complications were less frequent in patients after HOPE (SCS=37.7% vs HOPE=22.5%, P=0.015). A significantly lower incidence of surgical revisions for biliary complications was observed in the HOPE cohort (24.6% vs 11.8%, P=0.012). When evaluating outcome according to HOPE-modality, a significant reduction in biliary complications (P=0.006) and surgical revisions (P=0.002) was only observed in dHOPE patients in comparison to SCS. Further, only dHOPE was significantly associated with reduced need for surgical revision for biliary complications upon uni- and multivariable logistic regression (odds ratio=0.336, P=0.011). HOPE leads to a reduction of biliary complications and associated surgical revisions. This effect seems to be primarily associated with use of dHOPE, while both methods appear as feasible options for preconditioning of donor grafts prior to OLT.

Elevated fibrinogen-albumin ratio is an adverse prognostic factor for patients with primarily resected gastroesophageal adenocarcinoma

PurposeSerum fibrinogen and albumin play important roles in systemic inflammation and are implicated in tumor progression. The fibrinogen-to-albumin ratio (FAR) has shown a prognostic impact in several malignancies. This study aims to assess the prognostic value of the pretherapeutic FAR in patients with adenocarcinoma of the gastroesophageal junction (AEG) who underwent upfront resection.MethodsConsecutive patients who underwent surgical resection at the Department of Surgery at the Medical University of Vienna between 1992 and 2014 were included into this study. Optimal cut-off values were determined with the receiver-operating characteristic (ROC) curve, uni- and multivariate analyzes were calculated by the Cox proportional hazard regression model for overall survival (OS).ResultsAmong 135 included patients, the majority were male (79.26%), with a mean age of 66.53 years. Elevated FAR correlated significantly (p = 0.002) with shorter OS in univariate analysis, also confirmed as independent prognostic factor (p = 0.005) in multivariable analysis. The ROC curve of FAR (AUC = 0.744) outperformed fibrinogen (AUC = 0.738) and albumin (AUC = 0.378) in predicting OS for AEG patients.ConclusionThe FAR serves as an independent prognostic factor for OS in patients undergoing primarily resection for AEG. Given its routine availability and ease of calculation, FAR could help in diagnosis and treatment selection for AEG patients. Further validation studies are warranted to confirm these findings conclusively.

Prediction of Successful Liberation from Continuous Renal Replacement Therapy Using a Novel Biomarker in Patients with Acute Kidney Injury after Cardiac Surgery-An Observational Trial.

An acute kidney injury (AKI) is the most common complication following cardiac surgery, and can lead to the initiation of continuous renal replacement therapy (CRRT). However, there is still insufficient evidence for when patients should be liberated from CRRT. Proenkephalin A 119-159 (PENK) is a novel biomarker that reflects kidney function independently of other factors. This study investigated whether PENK could guide successful liberation from CRRT. Therefore, we performed a prospective, observational, single-center study at the Medical University of Vienna between July 2022 and May 2023, which included adult patients who underwent cardiac surgery for a cardiopulmonary bypass; patients on preoperative RRT were excluded. The PENK levels were measured at the time of AKI diagnosis and at the initiation of and liberation from CRRT, and were subsequently compared to determine whether the patients were successfully liberated from CRRT. We screened 61 patients with postoperative AKI; 20 patients experienced a progression of AKI requiring CRRT. The patients who were successfully liberated from CRRT had mean PENK levels of 113 ± 95.4 pmol/L, while the patients who were unsuccessfully liberated from CRRT had mean PENK levels of 290 ± 175 pmol/L (p = 0.018). For the prediction of the successful liberation from CRRT, we found an area under the curve of 0.798 (95% CI, 0.599-0.997) with an optimal threshold value of 126.7 pmol/L for PENK (Youden Index = 0.53, 95% CI, 0.10-0.76) at the time of CRRT liberation (sensitivity = 0.64, specificity = 0.89). In conclusion, PENK is a novel biomarker that has the potential to predict the successful liberation from CRRT for patients with AKI after cardiac surgery.

Presence of cholestasis and its impact on survival in SARS-CoV-2 associated acute respiratory distress syndrome.

Data on cholestasis and biliary injury in patients with COVID-19 are scarce. The primary aim of this study was to evaluate the prevalence of cholestasis and factors associated with its development and outcome in critically ill patients with COVID-19 associated acute respiratory distress syndrome (ARDS). In this retrospective exploratory study, COVID-19 patients with ARDS admitted to an intensive care unit (ICU) at the Medical University of Vienna were evaluated for the development of cholestasis defined as an alkaline phosphatase level of 1.67x upper limit of normal for at least three consecutive days. Simple and multiple logistic regression analysis was used to evaluate parameters associated with development of cholestasis and survival. Of 225 included patients 119 (53%) developed cholestasis during ICU stay. Patients with cholestasis had higher peak levels of alkaline phosphatase, gamma-glutamyl transferase, bilirubin and inflammation parameters. Factors independently associated with cholestasis were extracorporeal membrane oxygenation support, ketamine use, high levels of inflammation parameters and disease severity. Presence of cholestasis and peak ALP levels were independently associated with worse ICU and 6-month survival. Development of cholestasis is a common complication in critically ill COVID-19 patients and represents a negative prognostic marker for survival. It is associated with disease severity and specific treatment modalities of intensive care.

Fast Green FCF Improves Depiction of Extracellular Matrix in Ex Vivo Fluorescence Confocal Microscopy.

Rapid microscopic analysis of tissue is an essential diagnostic tool in oncological surgery. The gold standard for intraoperative histological tissue evaluation is frozen sections. However, frozen sections are prone to a variety of artefacts and require skilled staff and specialized lab equipment. A potential method for rapid intraoperative tissue evaluation that does not require fixation, freezing, or sectioning of the tissue is ex vivo fluorescence confocal microscopy (FCM). The visualization of the structurally important extracellular matrix (ECM) in conventional ex vivo FCM lags behind the standards of conventional histology. The objective of this study was to find a stain that would improve the depiction of the ECM to resemble FFPE H&E sections as closely as possible. Eleven different tissue stains were tested on 122 tissue samples submitted to the Department of Pathology at the Medical University of Vienna. This study was conducted on the RS-G4 Upright (Caliber I.D. Rochester, NY, USA, distributed in Europe by MAVIG GmbH, Munich, Germany). Fast Green FCF (FGFCF) in combination with acridine orange as a nuclear stain improved the visibility of the structural details of the ECM. Morphological details in FCM were equivalent or even superior to frozen sections in most analyzed categories. The addition of FGFCF to the conventional staining protocol improves the assessment of the ECM and analysis of fibrosis. The rapid staining protocol is compatible with an application in intraoperative microscopy.

Integrating palliative care into multiple myeloma management : Optimizing quality of life across the disease continuum.

Multiple myeloma (MM) poses significant challenges due to its complex symptomatology and evolving treatment landscape. While therapeutic advances have improved survival outcomes, holistic management of MM requires addressing the numerous physical and psychosocial needs of patients. Palliative care (PC) offers acomprehensive approach to symptom management and supportive care on aphysical, psychosocial and spiritual level; however, its role in MM remains underexplored. This retrospective single-center study examines the outcome of 22 MM patients admitted to the Division of Palliative Medicine at the Medical University of Vienna. We investigated reasons for admission, symptom severity, functional status, length of stay and overall survival. Most common reasons for palliative care unit (PCU) admission were nutritional problems (82%), fatigue (77%) and pain (68%). Median ECOG score at PCU admission was 3. The timepoint within the timeline of myeloma disease at which hospitalization took place varied greatly. Some patients were hospitalized shortly after diagnosis, other patients after many years of active disease and therapy. Median time from MM initial diagnosis to first PCU stay was 4.3years (range 0.6-23.8 years). The median length of hospital (PCU) stay was 11days (range 1-127days) and 45% of patients died during PCU hospitalization. The reduction in symptom burden as aresult of the inpatient stay in the PCU is reflected in the PERS2ON score, which was measured on the day of admission (median23 days, range 6-32days) and on the day of discharge (median16 days, range 7-20days). PC interventions effectively addressed the complex symptom burden experienced by patients with MM. Multidimensional approaches encompassing physical, psychological and social domains proved instrumental in optimizing quality of life. Integrating PC principles into MM management paradigms is essential to prioritize patient-centered care across the disease continuum.

Evaluation of PD-1 and interleukin-10-receptor expression by T lymphocytes in malignant and benign pleural effusions

PD-1 (programmed cell death protein-1)/PD-L1 (programmed cell death ligand 1) as well as IL-10 (interleukin-10)/IL-10R (interleukin-10 receptor) interactions play a major role in tumor immune evasion in various malignancies. Several studies investigated the expression of PD-1 on T lymphocytes in pleural effusions (PE) in patients with malignant diseases. However, results in malignant pleural effusions (MPE) compared to benign PE (BPE) are underreported. In this prospective study, 51 patients (median age 66 years, IQR 54–78, 47% male) with PE of malignant or benign origin at the Medical University of Vienna between March 2021 and November 2022 were enrolled and divided into three groups according to the cytological results (group 1: MPE [n = 24, 47%]; group 2: BPE in malignant disease [n = 22, 43%]; group 3: BPE in benign disease [n = 5, 10%]). In the cytological samples, T cells were analyzed for the expression of PD-1 and IL-10R via flow cytometry. In MPE, the proportion of PD-1+ T lymphocytes on CD4+ cells was significantly lower than in BPE (40.1 vs. 56.3 in group 1 vs. 3, p = 0.019). Moreover, a significantly lower expression of PD-1+ IL-10R+ CD8+ (9.6 vs. 35.2 in group 1 vs. 2, p = 0.016; 9.6 vs. 25.0 in group 1 vs. 3, p = 0.032) and a significantly higher expression of PD-1-IL-10R-CD8+ T lymphocytes (43.7 vs. 14.0 in group1 vs. 2, p = 0.045; 43.7 vs. 23.3 in group 1 vs. 3, p = 0.032) were observed in MPE when compared to BPE. The frequency of T cells expressing PD-1 and IL-10R on CD8+ T cells is significantly lower in MPE compared to BPE regardless of the underlying disease indicating a different microenvironment in PE driven by the presence of tumor cells. Our observation spotlights the possible involvement of PD-1 and IL-10R in MPE.

Outstanding Scientist I. Ya. Horbachevsky (dedicated to the 170th birth anniversary)

Ivan Yakovych Horbachevsky is one of the outstanding scientists of world science, whose activities span the middle of the 20th century. He, our compatriot, comes from the village Zarubyntsi, Ternopil region. The numerous scientific and governmental titles, ranks and awards that he was awarded confirm Ivan Horbachevsky’s global authority and popularity. He was elected honorary president of international scientific forums and congresses. He was also entrusted with the most difficult tasks in medicine and education. The scientist brought recognition to University of Vienna. He was elected a member (and later chairman) of the Royal Sanitary Council, given several high titles and appointed the first minister of health in Austria-Hungary. Ivan Horbachevsky’s scientific heritage includes more than 50 works published in German, Czech and Ukrainian languages (only 6 of them were in Ukrainian). He proposed the nomenclature of organic (1924–1926) and inorganic compounds (1939–1941), which formed the basis of the chemical substance classification and nomenclature. His nomenclature was implemented in Ukraine before World War II. Ivan Yakovych Horbachevsky was a candidate for the Nobel Prize in Physiology and Medicine in 1911. He lived for 67 years outside of his motherland, but he was closely connected with Ukraine, and did a lot for our state independence.

Gender differences in neurocognitive assessments: insights from apilot study with the International Neurocognitive Test Profile (INCP) digital battery.

The aging global population has led to an increase in the number of dementia diagnoses, with projections indicating acontinued upward trend. This demographic change presents profound challenges for patients, their families, and healthcare systems worldwide. Consequently, the demand for reliable and user-friendly screening tools that can detect dementia at early stages and monitor its progression is more critical than ever. The International Neurocognitive Test Profile (INCP), developed at the Medical University of Vienna, aims to address this need by offering adigital test battery for the early detection of dementia. This study forms apart of the INCP's ongoing development and evaluation, specifically investigating the influence of gender on test outcomes. Seventy participants, recruited through flyers at the Vienna General Hospital, completed the INCP assessment using tablets as part of the study. The effect of gender on performance across various INCP subtests was analyzed using Mann-WhitneyU tests. For further exploratory analysis, acorrelation matrix was calculated encompassing demographic variables (age and education), screening data, and all INCP subtests. The analysis revealed significant gender differences in two INCP subtests related to executive functions. Males outperformed females on the Figure Fluency Test (r = 0.30, indicating amoderate effect) and the Dice 2‑n Back Test (r = 0.29, indicating asmall effect). However, when correcting for multiple comparisons, no significant gender disparities were observed in the scores of the subtests. The identification of possible gender differences in specific subtests underscores the importance of considering gender as avariable in the further development and evaluation of the INCP. These findings offer valuable insights for the design and planning of future studies involving the INCP.

The chair of diseases of the eyes and urinary bladder in the university of Naples in XVIII century and the institution of autonomous university chairs of ophtalmology in Vienna and in Naples

In 1779, a chair entitled “Malattie degli occhi e della vescica urinaria” (“Eyes and Urinary Bladder diseases”) was established at the University of Naples and was assigned to Michele Troja, Enlightenment scientist, physician and surgeon. As in the case of Ophthalmology teaching, assigned to Joseph Barth, at the University of Vienna, also in Naples this was not recognized as an independent chair until later on, in Vienna with Joseph Beer and in Naples with Giovan Battista Quadri, a student of Beer. Michele Troja in 1780, gathered all his university lectures on eye diseases into a book that constituted an Ophthalmology text for students and physicians. This text, which today has considerable historical interest, was used for many years also after Troja's teaching ended.

Long-Term Follow-Up of the Quality of Life of Endometriosis Patients after Surgery: A Comparative Study.

Background/Objectives: This study investigated the long-term effects of the surgical removal of endometriotic lesions on quality of life in endometriosis patients. A sub-analysis explored different subtypes of endometriosis, hormonal influence, and the need for reoperation. Methods: The study was conducted at the Certified Endometriosis Center of the Medical University of Vienna. Included in the study were patients who had undergone the complete surgical removal of endometriotic lesions between 2014 and 2018. Patients were asked to complete the Endometriosis Health Profile-30 preoperatively, at the short-term follow-up (six to ten weeks postoperatively), and at the long-term follow-up (median of 48 months postoperatively). Results: A total of 87 patients completed the Endometriosis Health Profile-30 at the three time points. At the long-term follow-up, the reoperation rate was 8.0%. Significant improvements in the overall quality of life (p < 0.001; median decrease from 45.0 to 11.7) and in the categories of "pain", "control and powerlessness", "social support", "emotional well-being", and "self-image" at the long-term follow-up compared to preoperative values were observed (p-values < 0.01). The sub-analysis showed that patients with deep-infiltrating endometriosis (p < 0.001; median decrease from 49.2 to 10.0) and adenomyosis (p < 0.02; median decrease from 37.5 to 0.0) had the most pronounced long-term postsurgical benefits in terms of quality of life. Patients with (p < 0.001; median decrease from 45.0 to 1.7) and without (p < 0.001; median decrease from 45.42 to 12.5) hormonal influence showed significant improvements in overall quality of life compared to preoperative values. Patients without reoperation demonstrated improved long-term quality of life compared to the preoperative (p < 0.001; median decrease from 45.8 to 9.6) and short-term follow-up results (p < 0.005; median decrease from 19.2 to 9.6). Participants who underwent reoperation showed no improvement in quality of life at the long-term follow-up. Conclusions: The surgical removal of endometriotic lesions has a positive long-term impact on the quality of life, as measured by Endometriosis Health Profile-30.

Unveiling the Biography of Sigmund Freud With Pediatric Dentistry Insights.

Born in Freiberg, Moravia (now the Czech Republic), Austrian psychiatrist Sigmund Freud was the forerunner of psychoanalysis, a ground-breaking approach to understanding the human mind. Originally studying neurology at the University of Vienna, Freud soon became fascinated with the psychological origins of mental illness.He developed theories on repression, the unconscious mind, and the significance of dreams because he saw dreams as windows into hidden conflicts and impulses. Freud developed the theory and asserted that unconscious impulses, especially those related to sexuality, have a major impact on human conduct. Dream analysis and free association were among his innovative methods that helped modern psychotherapy come to pass. Though they were attacked and divisive, Freud's theories had a major impact on humanities, psychology, and psychiatry. His studies on the human mind challenged conventional wisdom and offered innovative insights into mental health. Freud's writings continue to inspire research and debate; his effect on popular and scholarly opinion attests to his ongoing legacy.

Strategies of Social Persuasion Against Hussitism

This contribution investigates the different strategies and methods of cultural and social persuasion against the Hussite reformation employed by an important member of the University of Vienna, Peter of Pirchenwart (d. 1436). During his career he used various oral and written means against the “new” heresy: sermons to the people, university lectures, theological commentaries, and short treatise. Different types of audiences were targeted in two cultural centres and key sites of anti-Hussite propaganda in the city of Vienna: the Faculty of Theology and St Stephen’s Church, both connected to the Ducal Court. Here I am going to discuss five unedited texts produced by him: the commentary on the Book IV of the Sentences; the biblical commentary on the Gospel of John, containing two anti-heretic sections, one of which is known to the catalogues under the eloquent title of De religione militari contra Hussitas; the short treatise Determinatio contra Hussitas; and two sermons delivered in 1423 and 1431. In these texts, the dimension of violence (both verbal and physical) is present as a recurring motif and substantial theme; one of Pirchenwart’s primary aims, in fact, is precisely to justify the extermination of heretics, without any form of negotiation or dialogue. Through these case studies I will highlight some of the ways in which the heresy was addressed locally (the city of Vienna), at the intersection of intellectual production and the construction of the collective imaginary.

A single-center retrospective comparison of pT1 substaging methods in bladder cancer.

Substaging of T1 urothelial cancer is associated with tumor progression and its reporting is recommended by international guidelines. However, it has not been integrated in risk stratification tools and there is no agreement on the best method to use for its reporting. We aimed to investigate the applicability, interobserver variability, and prognostic value of histological landmark based and micrometric (aggregate linear length of invasive carcinoma (ALLICA), microscopic vs. extensive system, Rete Oncologica Lombarda (ROL) system) substaging methods. A total of 79 patients with the primary diagnosis of T1 urothelial cancer treated with conventional transurethral resection and adjuvant BCG therapy between 2000 and 2020 at the Medical University of Vienna were included. The anatomical and metrical substaging systems were evaluated using agreement rate, Cohen's kappa, Kendall's tau, and Spearman rank correlation. Prognostic value for high-grade recurrence or T2 progression was evaluated in uni- and multivariable analysis. Applicability and reproducibility were good to moderate and varied between substaging methods. Obstacles are mainly due to fragmentation of samples. Anatomical substaging was associated with progression in univariable and multivariable analysis. In our cohort, we could only identify anatomical landmark-based substaging to be prognostic for T2 progression. A major obstacle for proper pathological assessment is fragmentation of samples due to operational procedure. Avoiding such fragmentation might improve reproducibility and significance of pathological T1 substaging of urothelial cancer.

Unraveling novel mutation patterns and morphological variations in two dalbavancin-resistant MRSA strains in Austria using whole genome sequencing and transmission electron microscopy

BackgroundThe increasing prevalence of methicillin-resistant Staphylococcus aureus (MRSA) strains resistant to non-beta-lactam antimicrobials poses a significant challenge in treating severe MRSA bloodstream infections. This study explores resistance development and mechanisms in MRSA isolates, especially after the first dalbavancin-resistant MRSA strain in our hospital in 2016.MethodsThis study investigated 55 MRSA bloodstream isolates (02/2015–02/2021) from the University Hospital of the Medical University of Vienna, Austria. The MICs of dalbavancin, linezolid, and daptomycin were assessed. Two isolates (16–33 and 19–362) resistant to dalbavancin were analyzed via whole-genome sequencing, with morphology evaluated using transmission electron microscopy (TEM).ResultsS.aureus BSI strain 19–362 had two novel missense mutations (p.I515M and p.A606D) in the pbp2 gene. Isolate 16–33 had a 534 bp deletion in the DHH domain of GdpP and a SNV in pbp2 (p.G146R). Both strains had mutations in the rpoB gene, but at different positions. TEM revealed significantly thicker cell walls in 16–33 (p < 0.05) compared to 19–362 and dalbavancin-susceptible strains. None of the MRSA isolates showed resistance to linezolid or daptomycin.ConclusionIn light of increasing vancomycin resistance reports, continuous surveillance is essential to comprehend the molecular mechanisms of resistance in alternative MRSA treatment options. In this work, two novel missense mutations (p.I515M and p.A606D) in the pbp2 gene were newly identified as possible causes of dalbavancin resistance.

Association of microaneurysms with retinal vascular alterations in patients with retinal vein occlusion

ObjectiveTo investigate the localization, distribution, and type of central microaneurysms (MAs) and their relationship with retinal vascular alterations in patients with retinal vein occlusion (RVO). MethodsIn this cross-sectional study, ultra-widefield color fundus photography (UWF-CF), standard and single-capture 65° widefield (WF) optical coherence tomography angiography (OCTA) were performed in consecutive patients with RVO treated at the Department of Ophthalmology and Optometry, Medical University of Vienna. UWF-CF, en face and B-Scans in 6 mm × 6 mm OCTA were examined for detection of MAs. Nonperfusion areas (NPA) and collateral vessels (CV) were evaluated on WF-OCTA, ghost vessels (GV), and tortuous vessels (TV) on UWF-CF. ResultsOne-hundred-and-twelve patients were included in the study, and data from 59 eyes of 59 patients with disease duration longer than 3 months, good image quality, and without relevant ocular comorbidities were eligible for statistical analysis. Fifty-six of 59 (94.9%) patients were previously treated with anti-vascular endothelial growth factor agents for macular edema, 31 of 59 (52.5%) patients presented with MAs in the central 6 mm and 60 MAs were found in total using multimodal imaging. There was no statistically significant difference in the greatest diameter of fluid-associated versus non-fluid-associated MAs (p = 0.53). Eyes with MAs were associated with CV, TV, and GV (χ2-test; p < 0.001, p = 0.0498, and p = 0.001). Median NPA was 27.3 mm2 (quartiles 1.3–62.8 mm2) in eyes with MAs and 0 mm2 (quartiles 0–36.2 mm2) in eyes without MAs (Mann-Whitney-U-test; p = 0.018). ConclusionMAs were associated with extensive NPA, the presence of CV, GV, and TV. There was no correlation between the diameter of the MA and the adjacent intraretinal fluid in our predominantly pretreated RVO study patients.