Placental Protein 13 (PP13) is a galectin expressed by the syncytiotrophoblast. Women who subsequently develop preterm preeclampsia have low first trimester maternal serum PP13 concentrations. This study revealed that third trimester maternal serum PP13 concentration increased with gestational age in normal pregnancies (p<0.0001), and it was significantly higher in women presenting with preterm preeclampsia (p=0.02) and HELLP syndrome (p=0.01) than in preterm controls. Conversely, placental PP13 mRNA (p=0.03) and protein, as well as cytoplasmic PP13 staining of the syncytiotrophoblast (p<0.05) was decreased in these pathological pregnancies compared to controls. No differences in placental expression and serum concentrations of PP13 were found at term between patients with preeclampsia and control women. In contrast, the immunoreactivity of the syncytiotrophoblast microvillous membrane was stronger in both term and preterm preeclampsia and HELLP syndrome than in controls. Moreover, large syncytial cytoplasm protrusions, membrane blebs and shed microparticles strongly stained for PP13 in preeclampsia and HELLP syndrome. In conclusion, parallel to its decreased placental expression, an augmented membrane shedding of PP13 contributes to the increased third trimester maternal serum PP13 concentrations in women with preterm preeclampsia and HELLP syndrome.

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Insufficient invasion of the spiral arteries by trophoblast cells is associated with the etiology of pre-eclampsia, the syndrome of hemolysis, elevated liver enzymes and low platelet counts (HELLP) and pre-eclampsia-associated intrauterine growth restriction (IUGR). Mannose-binding lectin (MBL) is a component of the innate immune system. MBL-mediated activation of the complement cascade is an important event in the destruction of invading trophoblasts. The gene coding for MBL is polymorphic, and variant alleles result in greatly reduced circulating MBL levels. The aim of this study was to test the association between an MBL polymorphism and pre-eclampsia, HELLP syndrome and IUGR. DNA was extracted from buccal swabs of 51 women with pre-eclampsia, 81 women with HELLP syndrome and 184 healthy pregnant controls. Aliquots were tested for a single nucleotide MBL gene polymorphism at codon 54 by PCR and endonuclease digestion. Homozygosity for the wild-type allele was more frequent in patients with pre-eclampsia (P = 0.04) and HELLP syndrome (P = 0.02) when compared with controls. The presence of the variant allele was more prevalent among controls than in women with pre-eclampsia (P = 0.02) or HELLP syndrome (P = 0.028). Twenty-two (55%) patients with pre-eclampsia and 43 (53%) women with HELLP syndrome delivered an IUGR neonate. MBL-54 heterozygosity was more frequent in controls (27.2%) than in pre-eclamptic women (4.5%, P = 0.025) and those with HELLP syndrome (11.7%, P = 0.05) who delivered an IUGR neonate. Genotype frequencies of neonates born to mothers in all study groups were similar. Carriage of the MBL codon 54 polymorphism protects against pre-eclampsia, HELLP syndrome and IUGR and implies that an MBL-mediated event might be involved in the pathogenesis of these disorders.

The localization and severity of endometriotic lesions and adhesions, as described using the #Enzian classification for endometriosis, can be diagnosed accurately on preoperative ultrasound. What are the clinical implications of this work?The recently updated #Enzian classification can be applied accurately both at preoperative ultrasound examination and during surgical resection of endometriosis, thereby enabling the use of uniform terminology for describing endometriosis.

Early maternal separation is a particularly stressful experience. Current models of nightmare production emphasize negative emotionality as having a central role in determining dream affect. Our aim is to test the hypothesis that persons who experienced early maternal separation (before one year of age and lasting at least one month) report more frequent nightmare experiences and bad dreams as adults. In the frame of the Hungarostudy Epidemiological Panel, 5020 subjects were interviewed. Significant associations were found between early maternal separation and both frequent nightmare experience in adulthood and increased frequency of oppressive and bad dreams. Current depression scores fully mediated the association between early separation and nightmares, but not the association between early separation and negative dream affect. We interpret these findings as a trait-like enhancement of negative emotionality in adults who experienced early maternal separation. This enhancement influences the content of dreams and, when it takes the form of depression, also influences the frequency of nightmares.

BNP levels were significantly higher in EOP than in LOP patients. The cut-off value <24.5 pg/mL seems to be a powerful discriminative indicator excluding preeclampsia. The amount of proteinuria and total protein levels correlate with the elevation of the BNP levels. In EOP the extent of proteinuria is higher than in the LOP.

Vital exhaustion and depressive symptomatology showed a different pattern in their relationship with CVD incidence, with vital exhaustion being the more robust predictor. These results suggest that the 2 constructs are not identical and that vital exhaustion deserves consideration when planning and implementing interventions to reduce CVD risk. (PsycINFO Database Record