Comment on "Quantum Time Crystals and Interacting Gauge Theories in Atomic Bose-Einstein Condensates"

In a recent Letter [Phys. Rev. Lett. 123, 250402], Öhberg and Wright describe a Bose-Einstein condensate trapped on a ring in the presence of the density-dependent gauge potential. It is claimed that the ground state of the system corresponds to a rotating chiral bright soliton and consequently it forms a genuine time crystal which minimizes its energy by performing periodic motion. We show that the energy of the chiral soliton in the laboratory frame is not correctly calculated in the Letter. The correct energy becomes minimal if the soliton does not move

Transfusion-related acute lung injury: A dangerous and underdiagnosed noncardiogenic pulmonary edema

Transfusion-related acute lung injury (TRALI) is one of the leading causes of death associatedwith transfusion of blood and blood components. The understanding of the etiology andpathophysiology of this syndrome has much improved during the last decades, neverthelessnumerous issues are still unresolved and symptomatic treatment remains the cornerstone ofmedical management. Consequently more attention is directed at primary as well as secondaryprevention. The awareness of the problem within the medical society is still unsatisfactorywhich results in a high number of unrecognized cases or of inaccurate diagnoses one of whichis cardiogenic pulmonary edema. The aim of this review is to make the TRALI syndrome morefamiliar to clinicians and to emphasize how signifi cant proper medical management is both forthe patients presenting TRALI symptoms as well as for future recipients of blood components

PCSK9 inhibitors : from discovery of a single mutation to a groundbreaking therapy of lipid disorders in one decade

Hypercholesterolemia is one of the main risk factors for coronary heart disease and significantly contributes to the high mortality associated with cardiovascular diseases. Statin therapy represents the gold standard in the reduction of low-density lipoprotein cholesterol concentration. Nevertheless, many patients still cannot achieve the recommended target levels, due to either inadequate effectiveness or intolerance of these drugs. Monoclonal antibodies that inhibit proprotein convertase subtilisin/kexin type 9 (PCSK9) have emerged as a promising option in lipid-lowering treatment. After confirmation of their efficacy and safety in clinical trials, evolocumab and alirocumab received approval from the US Food and Drug Administration (FDA) and European Medicines Agency (EMA) for introduction into clinical practice. In this review, we present a history of the development and mechanisms of action, as well as the results of the most important studies concerning PCSK9 inhibitors

Ostre poprzetoczeniowe uszkodzenie płuc u młodej kobiety z ciążą ektopową – opis przypadku i przegląd literatury

Background: Transfusion-related acute lung injury (TRALI) is a major cause of death associated with transfusion. Nevertheless it is still misdiagnosed and underreported. We present a case of this serious complication in order to make it more familiar to clinicians and indicate proper medical management, which is significant not only for the patients presenting TRALI symptoms but also for future recipients of blood components. Case presentation: A 32-year-old white woman with in-vitro fertilization in anamnesis was admitted to Department of Obstetrics and Gynecology because of abdominal pain. Ultrasonography examination revealed pathological mass in left adnexa. The patient underwent laparoscopic left salpingectomy. The following day she reported progressive pain in lower abdomen with signs of peritoneal irritation. Emergency laparotomy was performed and active bleeding from fallopian tube was stopped. Four units of red blood cells concentrate and six units of fresh frozen plasma were transfused. Within two hours of surgery acute respiratory distress symptoms occurred, bilateral infiltrates were found on chest X-ray. The patient responded to supportive treatment (oxygen therapy, dexamethasone, diuretics) and her state improved within 12 hours. Serological diagnostics revealed anti-HLA antibodies in one donor which reacted with patient’s granulocytes. Clinical picture and anti-leukocyte antibodies detected in blood component allowed to identify the immune-mediated TRALI. Conclusions: Transfusion-related acute lung injury is a life-threatening complication of transfusion which manifests as non-cardiogenic pulmonary edema. Each suspected case of this syndrome should be reported to blood center in order to confirm the diagnosis and implement preventive measures (exclusion of implicated donor from further blood donation).  Cel pracy: Ostre poprzetoczeniowe uszkodzenie płuc (TRALI) jest jedną z głównych przyczyn zgonów związanych z transfuzją składników krwi. Niemniej jednak powikłanie to pozostaje często nierozpoznawane lub niezgłaszane do odpowiednich ośrodków. W niniejszej pracy prezentujemy przypadek tego poważnego powikłania w celu przybliżenia jego obrazu klinicznego i wskazania prawidłowego postępowania, które jest nie tylko istotne dla pacjenta z objawami TRALI, ale także dla przyszłych biorców preparatów krwiopochodnych. Opis przypadku: 32-letnia kobieta rasy kaukaskiej z wywiadem zapłodnienia pozaustrojowego została przyjęta do Kliniki Położnictwa i Ginekologii z powodu bólu brzucha. Badanie ultrasonograficzne ujawniło obecność patologicznej masy w obrębie lewych przydatków macicy. Pacjentka przebyła lewostronną laparoskopową salpingektomię. Następnego dnia zgłosiła narastające dolegliwości bólowe w podbrzuszu z cechami podrażnienia otrzewnej. Przeprowadzono pilną laparotomię, w trakcie której zatamowano aktywne krwawienie z kikuta jajowodu. Pacjentce przetoczono 6 jednostek koncentratu krwinek czerwonych i 4 jednostki świeżo mrożonego osocza. Po 2 godzinach od operacji wystąpiły objawy ostrej niewydolności oddechowej a w rentgenogramie klatki piersiowej stwierdzono obustronne zacienienia. Zastosowano leczenie podtrzymujące: tlenoterapia bierna, deksametazon, diuretyki. Stan pacjentki uległ poprawie w ciągu 12 godzin. Diagnostyka serologiczna ujawniła u jednego dawcy krwi obecność przeciwciał anti-HLA reagujących z granulocytami pacjentki. Obraz kliniczny i przeciwciała antyleukocytarne wykryte w przetoczonym składniku krwi pozwoliły rozpoznać immunologiczną postać TRALI. Wnioski: Ostre poprzetoczeniowe uszkodzenie płuc jest zagrażającym życiu powikłaniem potransfuzyjnym, które manifestuje się jako niekardiogenny obrzęk płuc. Wszystkie przypadki z objawami wskazującymi na wystąpienie tego zespołu powinny być zgłaszane do Centrów Krwiodawstwa i Krwiolecznictwa celem potwierdzenia diagnozy i wdrożenia odpowiednich środków profilaktycznych (wyłączenie dawcy z przeciwciałami antyleukocytarnymi z dalszego oddawania krwi dla celów klinicznych).

Determinants of the circadian blood pressure pattern in hospitalized hypertensive patients

Background. Non-dipping hypertension might be associated with increased cardiovascular risk and multiple diseases. The aim of our study was to assess if there are parameters identified in 24-hour ECG-Holter monitoring (ECG-Holter), transthoracic echocardiography (TTE), ECG parameters or laboratory data that allow prediction of circadian blood pressure profile (CBPP). Material and methods. One hundred and three consecutive patients (male: 50.5%), who underwent 24-hour ambulatory BP measurement and ECG-Holter simultaneously were analyzed. We divided patients into 3 groups: dipping was defined as 10–20% (28.2%), non-dipping as < 10% (50.5%) fall in nocturnal BP and reverse-dipping as higher nocturnal than diurnal BP (21.4%). Additionally, we performed TTE and laboratory check-up in all patients. We built multivariable models for nocturnal fall in systolic BP (SBP) and CBPP. Results. Multivariable model based on clinical factors was: nocturnal fall in SBP (%) = [13.28 – 0.11 × age – 8.33 × (dilated cardiomyopathy) – 5.95 × PAD – 6.02 × a-adrenolytic]. Multivariable model based on laboratory, echocardiographic and electrocardiographic parameters was: nocturnal fall in SBP (%) = [–27.28 + 1.47 × hemoglobin – 0.14 × CK-MB + 0.14 × maximal heart rate]. Multivariable model for CBPP based on clinical factors included use of beta- or alpha-adrenolytics or torasemide. Conclusions. We proved that nocturnal fall in SBP and CBPP could be predicted based on ECG-Holter parameters, laboratory data and TTE results, as well as based on detailed medical history. These findings may have implications on care of patients with hypertension

Wady zastawkowe serca i różne profile dobowe ciśnienia tętniczego

Introduction. Valvular heart diseases (VHD) increase the risk of cardiovascular morbidity and mortality. Little is known about the correlation between circadian blood pressure profile (CBPP) and VHD. The study aimed to clarify the association between CBPP and VHD prevalence. Material and methods. 103 consecutive patients (male: 50.5%), who underwent 24-hour ambulatory blood pressure measurement (ABPM) and Holter electrocardiography simultaneously were analysed. Patients were divided into 3 groups: dipping was defined as 10–20% (28.2%), non-dipping as < 10% (50.5%) fall in nocturnal blood pressure (BP) and reverse-dipping as higher nocturnal than diurnal BP (21.4%). VHD was assessed by transthoracic echocardiography and described as mild, moderate or severe regurgitation or stenosis accordingly. Further, the severity of VHD, nocturnal fall pattern and ABPM features in all groups were compared. Results. The authors found no statistically significant association between severity of VHD and dipping status. The presented study showed some correlations between VHD severity and different ABPM parameters. Conclusions. Though severity of VHD did not influence dipping status obtained by ABPM, there were associations between VHD and ABPM outcomes. Further studies are needed.Wstęp. Wady zastawkowe serca (VHD) zwiększają ryzyko zachorowań i zgonów z przyczyn sercowo-naczyniowych. Niewiele wiadomo na temat zależności między profilem dobowym ciśnienia tętniczego (CBPP) a VHD. Celem tej pracy było wyjaśnienie związku między CBPP a VHD. Materiał i meody. Do badania włączono 103 kolejnych pacjentów (mężczyźni 50,5%), u których równocześnie wykonano całodobowy pomiar ciśnienia tętniczego (ABPM) i 24-godzinny zapis elektrokardiograficzny metodą Holtera. Podzielono ich na trzy grupy: dippers — zdefiniowanych jako osoby z ciśnieniem tętniczym (BP) w nocy o 10–20% niższym niż w ciągu dnia (28,2%), non-dippers — osoby ze spadkiem BP w nocy mniejszym niż 10% (50,5%), reverse-dippers — osoby z wyższymi wartościami BP w nocy niż w ciągu dnia (21,4%). Metodą echokardiografii przezklatkowej oceniano VHD jako małą, umiarkowaną lub ciężką. Następnie porównywano ciężkość VHD, CBPP i dane z ABPM we wszystkich grupach. Wyniki. Nie znaleziono istotnej statystycznie zależności między cięż kością VHD a CBPP. Zaobserwowano korelację między ciężkością VHD a niektórymi parametrami ocenianymi w trakcie ABPM. Wnioski. Choć ciężkość VHD nie wpływała na CBPP, to istnieją zależności między wynikami VHD i ABPM. Konieczne są dalsze badania

Indicators of the behavior of highly productive cows under the conditions of using feed stations

The purpose of this work was to study the influence of feed stations on behavioral indicators of high-yielding cows. The research was conducted at two farms of TDV “Terezine” (Kyiv region) with different options for feeding fodder: from a feed table and a feed table + at feed stations. On each farm, a group of unpregnant high-yielding cows of the Ukrainian black-spotted dairy breed (II lactation and older) with a daily productivity of 30 kg and above during the calving period (2–3 months of lactation) was formed. Using feed stations for concentrated feeds affected the daily behavior of high-yielding cows. With this option of feeding, lower values of the duration of walking and standing were observed (by 16.3 and 9.6 min), as well as a slightly longer duration of lying down rest – by 17.4 min. The total feeding duration was longer due to the consumption of concentrated feeds at feeding stations, which was 25.6 minutes. At both farms, the peak of daily foraging activity occurred at 08:00 and 18:00. On average, during the day, cows approached the feed table and ate feed 8.7 times (maximum 12, minimum 6). At the farm with concentrated fodder feeding at feed stations, the average hourly duration of fodder consumption from the feed table was slightly lower (by 1–8 min) than at the farm where cows were fed only with fodder mixtures. At the farm, with the use of feed stations, the values of the indices of comfort, use of stalls, and feeding were 3.14, 1.62, and 0.03 % higher compared to the option where cows were fed only with feed mixtures. This trend is explained by a slightly higher duration of rest and general feed consumption and, accordingly, a lower duration of walking and standing of animals. Somewhat lower values were for the index of standing, discomfort, and drunkenness, which were higher for feeding feed from the feed table – by 1.79, 0.04, and 0.008%, respectivel

Efficacy and tolerability of oral propafenone versus quinidine in the treatment of recent onset atrial fibrillation: A randomized, prospective study

Background: A prospective, randomized study was conducted to evaluate the efficacy and tolerability of oral propafenone and quinidine for the conversion of paroxysmal atrial fibrillation (AF). Methods: Eighty one consecutive patients (female/male 46/35; mean age 64.0 &#177; 11.6), admitted to hospital with AF lasting no longer than 48 hours, were randomized in terms of their pharmacological therapy. Forty three patients (55%) were randomly assigned to Group I and received propafenone 600 mg orally as the initial therapy, with an additional dose of 300 mg after eight hours, if the sinus rhythm had not been restored by then. Thirty eight patients (45%) (Group II) received 1 mg digoxin IV followed by an oral loading of quinidine (400 mg followed by 200 mg every two hours). Results: The conversion rate assessed after 24 hours was the same in both groups (Gr. I vs. Gr. II: 90.7 vs. 91.4%), with the same number of mild side effects (Gr. I vs. Gr. II: 37.2% vs. 45.7%). No life-threatening adverse events were reported. Propafenone achieved a higher efficacy rate during the first eight hours (83.3 vs. 54.3%; p = 0.01), with a significantly shorter time required to sinus rhythm recovery throughout the study period, with a median time of 165 min (95% confidence interval 120-278) vs. 360 min (95% confidence inerval 298-650; p < 0.05). There was some indication of greater effectiveness of propafenone than quinidine in early sinus rhythm restoration in patients with: no structural heart disease, in those with an AF duration shorter than 12 hours, and in patients with an ejection fraction > 55%. Conclusions: Although both drugs revealed the same effectiveness, the conversion to sinus rhythm in the group treated with propafenone was observed more quickly despite the longer paroxysmal AF episode duration