Dożylna tromboliza w udarze niedokrwiennym mózgu

Leczenie trombolityczne przy użyciu rekombinowanego tkankowego aktywatora plazminogenu (rt-PA, recombinant tissue plasminogen activator) w ostrym udarze niedokrwiennym stosuje się od kilku lat. W randomizowanych, międzynarodowych badaniach klinicznych wykazano, że metoda ta jest skuteczna i bezpieczna, pod warunkiem przestrzegania procedur podawania leku, uwzględniania przeciwwskazań oraz zachowania reżimu 3-godzinnego okna czasowego. Być może prowadzone obecnie badania nad nowymi lekami trombolitycznymi (desmoteplazą) oraz metodami oceny niedokrwionego, ale nieobjętego martwicą obszaru mózgu (penumbry), pozwolą na poszerzenie przedziału czasowego i stosowanie tej metody u większej liczby chorych

Riedel’s thyroiditis — difficulties in differentiating from thyroid cancer

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Diagnosis and treatment of thyroid disorders in obese patients — what do we know?

Obesity-related changes in the composition of the body interfere with the proper functioning of the thyrotropic axis, leading to its disturbances and changes in the structure of the thyroid gland. Distinguishing what is related to obesity and what constitutes pathological changes is crucial for the proper treatment of patients. In this paper authors present a case of a patient with a diet-induced obesity, whose only abnormalities in thyroid assessment included an elevated level of thyroid stimulating hormone (TSH) and hypoechoic thyroid gland on ultrasound. Based on this clinical situation, we reviewed literature in order to establish rules regarding management of thyroid disorders in obese individuals. The most common obesity-related thyroid abnormality is an isolated increase of TSH, without clinical symptoms of hypothyroidism, defined as hyperthyrotropinaemia. In obese adults, autoimmune thyroid disease is found equally often as in the normal-weight population. Thyroid enlargement, increased risk of nodules, and decreased echogenicity, not related to autoimmunity, is frequent among obese individuals. Weight loss leads to the normalisation of TSH levels and thyroid echogenicity. Excessive weight can influence both the TSH level and ultrasound image of the thyroid gland; however, these findings can be reversed by weight reduction. Therefore, in asymptomatic obese patients elevated TSH should not be treated with thyroid hormone replacement

Accuracy of the European Thyroid Imaging Reporting and Data System (EU-TIRADS) in the valuation of thyroid nodule malignancy in reference to the post-surgery histological results

Purpose: To assess the clinical usefulness of the European Thyroid Imaging and Reporting Data System (EU-TIRADS) in the valuation of thyroid nodules malignancy in reference to post-surgery histological results. Material and methods: Pre-operative ultrasound was performed in consecutive patients admitted for thyroid surgery between June 2017 and January 2018. Thyroid nodules were classified according to EU-TIRADS to five groups: 1-5. At least one fine-needle aspiration biopsy (FNAB)/patient (dominant or suspected nodule) was performed in an outpatient clinic. The final diagnosis was based on the histological result. The percentage of cancers in each EU-TIRADS group was evaluated. Finally, sensitivity, specificity, accuracy, as well as positive and negative predictive values for malignancy were assessed. Results: Fifty-two patients with a total of 140 thyroid nodules (median: 3 nodules/thyroid [minimum-maximum: 1-6]) were enrolled in the study. Thyroid cancer was diagnosed in 0% (0/6) in EU-TIRADS 2; 0% (0/92) in EU-TIRADS 3; 5.9% (2/34) in EU-TIRADS 4, and 75% (6/8) in EU-TIRADS 5. In nodules assessed as EU-TIRADS ≥ 4 sensitivity, specificity, positive and negative predictive values for malignancy were, respectively: 75% (CI 95%: 40.7-93.5), 94.1% (CI 95%: 86.0-98.5), 75% (CI 95%: 40.7-93.5), and 94.1% (CI 95%: 86.0-98.5). Conclusions: EU-TIRADS is a valuable and simple tool for assessment of the risk of malignancy of thyroid nodules and demonstrates a high ultrasound correlation with histological post-surgery results. FNAB should be performed in all nodules assessed as EU-TIRADS ≥ 4, due to higher risk of malignancy

Development of design solutions for electric delivery vehicles with a GVM of 4.25 t

Van bodies are based on frame structures produced of aluminum alloy profiles. Searching for new directions in the development of vehicle bodies for newly designed eVans led to becoming focused on currently unused polymer composites in this area. The authors of the article designed a composite body for a delivery vehicle. They conducted detailed, numerical comparative analyses of the commercial body and the developed solution. The obtained results clearly confirmed the correctness of the formulated thesis about the possibility of designing bodies dedicated to electric vehicles made of structural composites

Development of a Recycling Process and Characterization of EVA, PVDF, and PET Polymers from End-of-Life PV Modules

Photovoltaic (PV) modules are highly efficient power generators associated with solar energy. The rapid growth of the PV industry will lead to a sharp increase in the waste generated from PV panels. However, electro-waste can be successfully used as a source of secondary materials. In this study, a unique procedure for recycling PV modules was developed. In the first stage, the aluminum frame and junction box, 18wt%. and 1wt%. of the module, respectively, were removed. The following stage was crucial, involving a mechanical–thermal method to remove the glass, which accounts for 70wt%. As a result, only 11wt%. of the initial mass of the PV was subjected to the next stage of chemical delamination, which reduced the amount of solvent used. Toluene was used to swell the ethylene vinyl acetate, EVA, and allow for the separation of the PV module. The effects of temperature and ultrasound on separation time were investigated. After the separation of silicon cells, metal ribbons, EVA, and the backsheet were obtained. The purity of the polymers was determined by FTIR and elemental analysis. Thermal properties were measured using DSC calorimetry to determine the basic parameters of the material