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Clinical cases of 'staggering disease', a nonsuppurative encephalomyelitis associated with gait abnormalities in cats, have been documented for decades in Sweden. In Austria, an increased incidence was observed in the 1990s. Only recently, rustrela virus (RusV) was identified as the causative agent of this clinicopathologic disease entity. In this retrospective study, we analyzed a total of 23 brain and spinal cord samples from Austrian cats with the pathohistological diagnosis of nonsuppurative encephalomyelitis and clinical signs consistent with staggering disease from 1994 to 2016 using reverse transcription real-time polymerase chain reaction (RT-qPCR) and in situ hybridization. We were able to detect RusV nucleic acids in seven of the examined samples. Borna disease virus 1 (BoDV-1) could be excluded in all cases via immunohistochemistry and RT-qPCR. This study confirms that RusV has been a relevant etiological agent of nonsuppurative encephalomyelitis of cats in a geographically and temporally limited disease cluster in Austria, mainly in the 1990s. The geographic distribution of the positive samples in this study is consistent with earlier reports on 'staggering disease' in Austria. Further studies are necessary to confirm the reservoir host of 'staggering disease' in Austria, as well as investigations on the disappearance of this disease and its possible zoonotic potential. [ABSTRACT FROM AUTHOR]

'Staggering disease' is a neurological disease entity considered a threat to European domestic cats (Felis catus) for almost five decades. However, its aetiology has remained obscure. Rustrela virus (RusV), a relative of rubella virus, has recently been shown to be associated with encephalitis in a broad range of mammalian hosts. Here, we report the detection of RusV RNA and antigen by metagenomic sequencing, RT-qPCR, in-situ hybridization and immunohistochemistry in brain tissues of 27 out of 29 cats with non-suppurative meningoencephalomyelitis and clinical signs compatible with'staggering disease' from Sweden, Austria, and Germany, but not in non-affected control cats. Screening of possible reservoir hosts in Sweden revealed RusV infection in wood mice (Apodemus sylvaticus). Our work indicates that RusV is the long-sought cause of feline 'staggering disease'. Given its reported broad host spectrum and considerable geographic range, RusV may be the aetiological agent of neuropathologies in further mammals, possibly even including humans. Rustrela virus (RusV) was detected in the brains of 27 out of 29 domestic cats with 'staggering disease', but not of 29 control cats. This suggests RusV as the long-sought causative agent of 'staggering disease', which had been obscure for 50 years. [ABSTRACT FROM AUTHOR]

Simple Summary: There are many causes of mortality in free-living songbirds, and, usually, the general public is not particularly interested in these issues. Only when large numbers of dead birds are observed within small geographic areas and within a short period of time is some public attention focused on these phenomena. In this study, we investigated episodes of mass mortality of songbirds, especially in greenfinches all over Austria, which occurred between 2012 and 2020. We noticed that all of these losses were caused by a particular protozoal parasite (Trichomonas (T.) gallinae) which induced severe inflammation of the upper digestive tract and subsequently death due to starvation. We were able to establish clear links with almost identical disease outbreaks in other countries and thus trace the path of the pathogen through Europe. It could be shown that T. gallinae has spread over the whole of Austria in recent years and occurred in many different songbird species, with a preference for greenfinches, leading to a significant decline in the population of this bird species. Since most birds are presumably infected at feeding sites, hygiene conditions and the correct selection of feeders play an important role in the prevention of disease. In the early summer of 2012, sudden mass mortality among songbirds, particularly in greenfinches (Chloris chloris, syn: Carduelis chloris) was observed in Austria, which was caused by the protozoan parasite Trichomonas gallinae. This pathogen induced fibrinonecrotic ingluvitis and/or esophagitis, leading to impairment of food intake and ultimately death due to starvation. The pathogen was successfully detected within the lesions by polymerase chain reaction (PCR) and chromogenic in situ hybridization. The epizootic resulted in a significant decline in the Austrian greenfinch population. Continuing passive surveillance in the subsequent years (2013–2020) revealed that the condition occurred each year and was present in the entire country. Genetic characterization of the pathogen showed the presence of an identical strain irrespective of geographical location, bird species, and year. [ABSTRACT FROM AUTHOR]

Background: Eight different PCV2 genotypes with varying prevalence and clinical impact have been described so far. PCV2 infection is still widespread among the vaccinated population and several experimental studies have clearly demonstrated that there is no induction of a 100% cross-protective immunity between the PCV2 genotypes. Hence, PCV2a-based vaccines may be ineffective. In this longitudinal study, the PCV2 genotype and haplotype evolution in Austria in the years 2002 to 2017 was investigated by phylogenetic analysis of 462 bp-long sequences of the capsid protein gene (ORF2). The obtained findings may be of practical relevance for the future development of vaccination strategies. Results: One hundred thirty four of a total of 161 formalin-fixed and paraffin wax-embedded samples could be sequenced successfully. There was no significant influence of storage time on sequencing success or quality. PCV2a (8.2%), PCV2b (77.6%), PCV2d (13.4%), and PCV2g (0.8%) were found. PCV2d was first detected as early as in 2004. PCV2g was described once in 2009. Both global PCV2 genotype shifts were observed. PCV2a occurred with a low prevalence during the first study years only in samples from non-vaccinated swine herds and was gradually replaced by PCV2b until 2011. PCV2b was the most prevalent genotype over the whole study period and was detected in samples from vaccinated and non-vaccinated herds. During the last two study years, the prevalence of PCV2d increased, although at this point almost all herds were vaccinated. The haplotype diversity was high, but the nucleotide diversity was low. Especially for genotype PCV2b, an increase in haplotype diversity could be described during the first study years. Conclusion: Extensive PCV2a-derived vaccination resulted in a reduction of prevalence and in a stabilization of genotype PCV2a, whereas genotypes PCV2b and PCV2d evolved as a consequence of natural and vaccination-induced selection. An ongoing virus circulation may be the result of reduced vaccine-induced protection. [ABSTRACT FROM AUTHOR]

Native European passerine birds are frequently clinically inapparent carriers of haemosporidian parasites of the genus Plasmodium. Clinical disease and death are only exceptionally reported. In the present study, tissue samples of 233 wild passerine birds found dead in Eastern Austria were examined by in situ hybridization (ISH) and partial cytochrome B gene sequence analysis for the presence, abundance and taxonomic assignment of Plasmodium spp. In 34 cases (14.6 %), ISH yielded a positive result with large numbers of developmental stages in different cell types of the spleen, liver, brain and lung. The abundance of the tissue stages, which was comparable to fatal cases of avian malaria in penguins, suggested a major contribution to the cause of death. Genetic analysis revealed infections with representatives of three different valid species of Plasmodium, Plasmodium elongatum, Plasmodium lutzi and Plasmodium vaughani. Genetically identical parasite lineages had been found in a previous study in penguins kept in the Vienna zoo, providing evidence for the role of wild birds as reservoir hosts. Further, this study provides evidence that several species of Plasmodium are able to abundantly proliferate in endemic wild birds ultimately resulting in mortalities. [ABSTRACT FROM AUTHOR]

Abstract.  Navigation alters the ecology of large inland waterways via engineering and more directly by emission of hazardous substances and wave wash. We investigated the potential effects of the latter on the early life history stages of riverine fish, which have their nursery zones generally located in shallow areas with low current and higher water temperatures. Ship induced wave wash causes the following impacts on fish during their early life history stages: i) short-term dislocation of suitable larval and juvenile fish habitats due to wake and splash; ii) water velocities during ship passages frequently exceed maximum swimming performances of 0+fish; and iii) suspended solids concentrations in the inshore habitats increase dramatically and limit the foraging efficiency of young of the year fish (YOY). In situ conditions during ship passages were investigated in three different inshore zones of the Austrian Danube with respect to wake and splash patterns, changes in water velocity and turbidity. These navigation induced conditions in the main nursery zones of riverine fish were set in comparison to results on swimming performances and capacities of larval and juvenile fish obtained in experimental studies. Engineering in large river systems in Europe and USA has resulted in a strong reduction of natural shoreline structures. Within this altered situation, navigation induced wave wash has a strong and cumulative effect on riverine fish recruitment and, hence, contributes to the general ongoing decline of native fish stocks in inland waterways. These aspects require particular consideration in river restoration programs to mitigate the effects of navigation, especially with respect to the intended expansion of European water ways within EC projects like TEN-T and NAIADES. [ABSTRACT FROM AUTHOR]

Key message: Autumn and spring frost events caused wide variation in the survival of juvenile Douglas-fir in Austrian forest sites located in the transition zone from Atlantic to continental climate. Survival rate can be optimized by planting provenances originating from an altitudinal belt of 500–1400 m in North America. Neither the variety nor the climate of origin of planted Douglas-fir provenances influence its response to frost events. Context: Understanding the risks of frost during late spring and early autumn is crucial for planting non-native Douglas-fir (Pseudotsuga menziesii [Mirbel] Franco) as an alternative tree species under climate change in Europe. Aims: We investigate the role of early and late frost events on the survival of juvenile Douglas-fir and tested whether survival depends on seed origin. Methods: With data from 19 provenance trials across Austria, we modeled the effects of early and late frost events on juvenile survival rate, accounting for random variations due to site condition and provenance origin. Results: Wide variations (37–93%) in the juvenile survival rate of Douglas-fir were mainly driven by early and late frost events (daily Tmin < 0 °C), summer drought, and continentality. Juvenile survival declined with an increasing number of frost events within the observation period and prevailing warm spells preceding the frost events. The seed origin of the tested provenances had a minor effect and was related to the altitude, but not to the variety or the climate of provenance origin. Conclusion: For planting Douglas-fir in the transition zone from Atlantic to continental climates, typical in Austrian forests, the local site conditions and the probability of the occurrence of early and late frosts should be considered, while provenance selection should rather focus on productivity. [ABSTRACT FROM AUTHOR]

Simple Summary: An emerging body of science has linked dog ownership with a better quality of life in their owners. However, there is limited information on the potential health benefits of guide dog ownership in blind people. This study sought to shed light on quality of life, annual medical costs, and attitudes towards the human–guide dog relationship in an Austrian population of 36 blind people with and without a guide dog. No significant differences in quality of life by means of a standardized questionnaire were found. Still, guide dog owners were more likely to regard a guide dog as a family member and to believe that guide dogs can increase their independency and, furthermore, have a positive effect on their health. Lower annual medical costs in guide dogs' owners were reported on a non-significant level, as only few people provided the required information. These findings indicate that the attitude towards guide dog ownership varies between blind people with and without a guide dog. Further research into this topic is warranted. Blindness has previously been associated with impaired quality of life (QOL). Guide dogs may not only support blind people in their independency, but also facilitate social relationships and overall health. This study sought to investigate whether blind people from Austria with a guide dog, when compared with blind people without a guide dog, differ in their QOL, annual medical costs, and attitudes towards the human–guide dog relationship. Participants (n = 36) filled out an online accessible questionnaire that consisted of the World Health Organization (WHO)QOL-BREF and additional self-designed questions. Guide dog ownership was not associated with a better QOL. However, yearly medical cost expenditures were descriptively lower in guide dog owners, who were also more likely to believe that guide dogs can increase their independency and exert positive effects on health. Moreover, guide dog owners more likely considered a guide dog as a family member than non-guide dog owners. Although within the framework of this study, owning a guide dog was not significantly associated with increased QOL, some differences between the groups regarding health beliefs, attitude towards the dog, and relationship with the dog were identified. Accounting for the emerging prevalence of visual impairment, further research into this topic is warranted. [ABSTRACT FROM AUTHOR]

Project "Chemical analysis, risk assessment and elimination of selected cytostatic agents from hospital waste water", performed at the University Hospital (AKH) Vienna. Methods Drugs: 5-fluorouracil, doxorubicin, epirubicin, daunorubicin, cisplatin, carboplatin, oxaliplatin. Model calculation: Minimum, maximum annual average concentrations and cumulative amount in hospital sewage were calculated. Parameters: drug, water consumption in the oncologic in-patient treatment ward, renal human excretion rate. Chemical analysis: platinum compounds: ICP-MS (speciation analysis by on-line coupling of HPLC to ICP-MS), limits of detection: cisplatin (0.09 µg/l), carboplatin (0.1 µg/l), oxaliplatin (0.15 µg/l). Anthracyclines: solid phase extraction, HPLC and fluorescence detection (FLD), limits of detection: doxorubicin (0.05 µg/l), daunorubicin (0.06 µg/l). 5-Fluorouracil: solid phase extraction, capillary electrophoresis, limit of detection 1.7 µg/l. Chemical monitoring: waste water samples: effluent of (a) the total hospital (TH), (b) the oncological ward (OW), collected before dilution in the Vienna sewer system for a total period of 98 days. Results Pt concentrations ranged from 3.2 to 266 µg/l; estimates revealed that about one third of the administered drugs was detected in the waste water of the oncologic ward. 5-Fluorouracil was detected in waste water up to 124 µg/l, doxorubicin up to 1.35 µg/l. The concentrations determined chemically agreed with the predictions based upon model calculations. [ABSTRACT FROM AUTHOR]

Background: Early biliary complications (EBC) constitute a burden after pediatric liver transplantation frequently requiring immediate therapy. We aimed to assess the impact of EBC on short- and long-term patient and graft survival as well as post-transplant morbidity., Methods: We analyzed 121 pediatric liver transplantations performed between 1984 and 2019 at the Medical University of Innsbruck for the occurrence of early (<90 days) biliary complications and investigated the influence of EBC on patient and graft survival., Results: Early biliary complications occurred in 30 (24.8%) out of the 121 pediatric liver transplant recipients. Patient survival at 15 years (89.2% vs. 84.2%, p = .65) and all-cause (82.5% vs. 74.0%) and death-censored graft survival (82.5% vs. 75.1%, p = .71) at 10 years were similar between the EBC and the non-EBC group. The EBC group had a significantly longer ICU (25 vs. 16 days, p < .001) and initial hospital stay (64 vs. 42 days, p = .002). Livers of patients with EBC were characterized by multiple bile ducts (33.3% vs. 13.2%, p = .027), and patients with EBC had a higher risk to develop late biliary complications (OR 2.821 [95% CI 1.049-7.587], p = .044) and bowel obstruction/perforation (OR 4.388 [95% CI 1.503-12.812], p = .007)., Conclusion: Early biliary complications after pediatric liver transplantation is frequent. The occurrence of EBC significantly increased post-transplant morbidity without affecting mortality. Multiple bile ducts were the only risk factor for the development of EBC in our cohort., (© 2021 The Authors. Pediatric Transplantation published by Wiley Periodicals LLC.)

Background: Sarcopenia is an established risk factor predicting survival in chronically ill and trauma patients. We herein examine the assessment and clinical implication of sarcopenia in liver transplantation (LT)., Methods: Computerized tomography scans from 172 patients waitlisted for LT were analyzed by applying 6 morphometric muscle scores, including 2 density indices (psoas density [PD] and skeletal muscle density [SMD]) and 4 scores based on muscle area (total psoas area, psoas muscle index, skeletal muscle area, and skeletal muscle index)., Results: The prevalence of sarcopenia in our cohort ranged from 7.0% to 37.8%, depending on the score applied. Only sarcopenia as defined by the density indices PD and SMD (but not total psoas area, psoas muscle index, skeletal muscle area, or skeletal muscle index) revealed clinical relevance since it correlates significantly with postoperative complications (≥Grade III, Clavien-Dindo classification) and sepsis. Furthermore, sarcopenia predicted inferior patient and graft survival, with low muscle density (PD: <38.5 HU or SMD: <30 HU) representing an independent risk factor in a multivariate regression model (P < 0.05). Importantly, the widely used Eurotransplant donor risk index had a predictive value in nonsarcopenic patients but failed to predict graft survival in patients with sarcopenia., Conclusions: Sarcopenia revealed by low muscle density correlates with major complications following LT and acts as an independent predictor for patient and graft survival. Therefore, the application of a simple computerized tomography-morphologic index can refine an individual recipient's risk estimate in a personalized approach to transplantation.

The International Society of Vascularized Composite Allotransplantation held its 13th congress "Defining Success" in October 2017 in Salzburg, Austria. A total of 122 delegates from 22 countries representing 5 continents attended the conference. The theme strived to provide pathways to accomplish best possible outcomes in this unique and multifaceted field of transplantation. "Ignite talks," a new feature introduced for the first time at the Salzburg meeting served as key elements for productive discussions on both congress days. The "ignitors" had been selected as experts from Europe, the Americas and Asia in vascularized composite allotransplantation and neighboring disciplines and provided a global perspective of their topic. Posttransplant treatment regimens, including the most burdensome side effects of immunosuppressants in addition to novel and future therapeutic options were discussed in depth. An additional ethics symposium summarized and advanced topics that had been discussed during the first international workshop on bioethical challenges in reconstructive transplantation held earlier in 2017.

Objective: To describe the evolution of pancreas transplantation from 1979 to 2011. The aim was to examine factors influencing long-term patient and graft survival, surgical methods, and risk factors influencing organ performance after transplantation., Background: Pancreas transplantation has become the therapy of choice for patients suffering insulin-dependent diabetes and end stage renal failure., Methods: Retrospective analysis of 509 consecutive pancreas transplants (442 simultaneous pancreas and kidney [SPK], 20 pancreas transplanted alone [PTA], and 47 pancreas transplanted after kidney [PAK]), performed at the University Hospital Innsbruck. The data were statistically analyzed using the Kaplan-Meier method and log-rank test., Results: After overcoming initial immunological and technical problems between 1979 and 1988 (5-year pancreas graft survival rate, 29.7%), pancreas transplantation evolved during the second decade (1989-1996; 5-year pancreas graft survival rate, 42.2%). Technical changes, optimized immunosuppression, careful pretransplant evaluation, and improved graft monitoring have become standard in the last decade and result in excellent 5-year patient (94.3%), kidney (89.4%), and pancreas (81.5%) graft survival. Five-year graft survival was superior in SPK (68.8%) compared with PAK (62.5%) and PTA (16.4%). SPK retransplantation can be carried out safely with 5-year patient (87.5%) and pancreas graft (75.0%) survival. Overall 5-year patient survival after loss of the first pancreas graft is significantly better in patients who underwent retransplantation (89.4% vs. 67.9%, P = 0.001). Long-term pancreas graft survival is independent of donor body mass index, sex, and cause of death, anastomosis time and the number of human leukocyte antigen (HLA) mismatches, recipient age, body mass index, sex, current panel reactive antibodies, and waiting time. Significant risk factors for reduced graft survival are cold ischemia time and donor age., Conclusions: During the last 32 years, many problems in pancreas transplantation have been overcome and it may currently represent the therapeutic gold standard for some patients with diabetes and end stage renal failure.

Standardized psychological assessment of candidates for reconstructive hand transplantation (RHT) is a new approach in transplantation medicine. Currently, international guidelines and standardized criteria for the evaluation are not established. Patients suffering from the loss of a hand or an upper extremity have to cope with multiple challenges. For a selected group of patients, RHT represents an option for restoring natural function and for regaining daily living independence. The identification of at-risk patients and those requiring ongoing counseling due to poor coping or limited psychological resources are the primary focus of the psychological assessment. We have developed the 'Innsbruck Psychological Screening Program for Reconstructive Transplantation (iRT-PSP)' which utilizes a semi-structured interview and standardized psychological screening procedures and continuous follow-up ratings. Between January 2011 and October 2011, four candidates were evaluated using the iRT-PSP. Psychological impairments including social withdrawal, embarrassment, reduced self-esteem, and a depressive coping style were identified and poor quality of life was reported. The motivation for transplantation was diverse, depending on many factors such as bi- or unilateral impairment, native or accidental loss of hand, and social integration., (© 2012 The Authors. Transplant International © 2012 European Society for Organ Transplantation.)

Background: Obesity is increasingly impacting the overall health status and the global costs for health care. The increase in body mass index (BMI) is also observed in kidney allograft recipients and deceased organ donors., Methods: In a retrospective single-center study, we analyzed 1132 deceased donor kidney grafts, transplanted at our institution between 2000 and 2009 for recipient and donor BMI and its correlation with delayed graft function (DGF). Recipients/donors were classified according to their BMI (<18.5, 18.5-24.9, 25-29.9, and >30 kg/m(2)). DGF was defined as requirement for one dialysis within the first week after transplantation., Results: Overall DGF rate was 32.4%, mean recipient BMI was 23.64 ± 3.75 kg/m(2), and mean donor BMI was 24.69 ± 3.44 kg/m(2). DGF rate was 25.2%, 29.8%, 40.9%, and 52.6% in recipients with BMI less than 18.5, 18.5 to 24.9, 25 to 29.9, and more than 30 kg/m, respectively (P<0.0001). Donor BMI less than 18.5, 18.5 to 24.9, 25 to 29.9, more than 30 kg/m(2) resulted in a DGF rate of 22.5%, 31.0%, 37.3%, and 51.2% (P < 0.0001). Multivariate analysis revealed recipient BMI and dialysis duration as independent risk factors for DGF. DGF results in inferior 1- and 5-year graft and patient survival., Conclusion: Recipient and donor BMI correlate with the incidence of DGF. Awareness thereof should have an impact on peri- and posttransplant measures in renal transplant recipients.

Patients who have lost a hand or upper extremity face many challenges in everyday life. For some patients, reconstructive hand transplantation represents a reasonable option for anatomic reconstruction, restoring prehensile function with sensation and allowing them to regain daily living independence. The first clinical case of bilateral hand transplantation at University Hospital Innsbruck was realized on March 17th, 2000. A decade later, a total of 7 hands and forearms were transplanted in 4 patients. This article review the clinical courses of 3 bilateral hand transplant recipients and highlights psychological aspects on reconstructive hand transplantation with special regard to unilateral/bilateral transplantation., (Copyright © 2011 Elsevier Inc. All rights reserved.)