Reasons for reoperation of patients undergoing surgical evacuation of an acute subdural hematoma – case raport and review of literature

Background: We are presenting a case and as well as its analyzis regarding subdural hematoma reoperations. Case description: A 48-year-old patient after head trauma operated on due to diagnosed right-sided subdural hematoma. On the second day of hospitalization he developed epidural hematoma at the operation site, which reuired second surgery. Conclusion: Early detection and prompt treatment may improve the poor outcome in this group of patients. The choice between craniotomy and craniectomy and additional risk factors as ASA and antiplatelet intake as well as age and alcohol abuse have unverified importance in the context of reoperation

Ticagrelor effectively inhibits platelet aggregation in comatose survivors of cardiac arrest undergoing primary percutaneous coronary intervention treated with mild therapeutic hypothermia

Background: Mild therapeutic hypothermia (MTH) is believed to reduce the effectiveness of antiplatelet drugs. Effective dual-antiplatelet therapy after percutaneous coronary intervention (PCI) is mandatory to avoid acute stent thrombosis (ST). The effectiveness of ticagrelor in MTH-treated out-of-hospital cardiac arrest (OHCA) survivors is still a matter of debate. The aim of the study was to evaluate the impact of MTH on the platelet-inhibitory effect of ticagrelor in comatose survivors of OHCA treated with primary PCI. Methods: Eighteen comatose survivors of OHCA with acute coronary syndrome undergoing immediate PCI treated with MTH were compared with 14 patients with uncomplicated primary myocardial infarction after PCI, matched for gender and age, in a prospective, single-center, observational study. Platelet aggregation was evaluated using VerifyNow P2Y12 point-of-care testing at 3 time points: admission (T0), during MTH (T1), and 48–72 h after rewarming (T2). Results: Ticagrelor effectively inhibits platelet aggregation in OHCA patients subjected to MTH and in all patients in the control group. The effectiveness of ticagrelor did not differ between the MTH group and the control group (p = 0.581). In 2 cases in the MTH population, the platelet response to ticagrelor was inadequate, and in one of them it remained insufficient during the re-warming phase. There was no stent thrombosis in these patients. Conclusions: The present study confirmed the effectiveness of ticagrelor to inhibit platelets in myocardial infarction patients after OHCA treated with primary PCI undergoing hypothermia. The use of cooling was not associated with an increased risk of stent thrombosis

Mechanical thrombectomy in acute stroke – Five years of experience in Poland

Objectives Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. Methods and results We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. Results Most of the CSCs (74%) were founded at University Hospitals and most (65.2%) work round the clock. In 78.3% of them, the working teams are composed of neurologists and neuro-radiologists. All CSCs perform CT and angio-CT before MT. In total 586 patients were subjected to MT and data from 531 of them were analyzed. Mean time laps from stroke onset to groin puncture was 250±99min. 90.3% of the studied patients had MT within 6h from stroke onset; 59.3% of them were treated with IV rt-PA prior to MT; 15.1% had IA rt-PA during MT and 4.7% – emergent stenting of a large vessel. M1 of MCA was occluded in 47.8% of cases. The Solitaire device was used in 53% of cases. Successful recanalization (TICI2b–TICI3) was achieved in 64.6% of cases and 53.4% of patients did not experience hemorrhagic transformation. Clinical improvement on discharge was noticed in 53.7% of cases, futile recanalization – in 30.7%, mRS of 0–2 – in 31.4% and mRS of 6 in 22% of cases. Conclusion Our results can help harmonize standards for MT in Poland according to international guidelines

Determining the Number of Measurements and Bootstrap Samples Required to Estimate of Long-Term Noise Indicators

The minimum size of the bootstrap algorithm input parameters have been determined for estimation of long-term indicators of road traffic noise. Two independent simulation experiments have been performed for that purpose. The first experiment served to determine the impact of original random sample size, and the second to determine the impact of number of the bootstrap replications on the accuracy and uncertainty of estimation of long-term noise indicators. The inference has been carried out based on results of non-parametric statistical test at significance level α = 0:05. The simulation experiments have shown that estimation of long-term noise indicators with uncertainty below ±1 dB(A) requires all-day noise measurements during three randomly selected days during the year in a dense urban development. The maximum size of original random sample should not exceed n = 50 elements. The minimum number of bootstrap replications necessary for estimation should be B = 5000. The data used to the simulation experiments and carry out the analysis were results of continuous monitoring of road traffic noise recorded in 2009 in one of the main arteries of Krakow in Poland

Estymacja niepewności wskaźników zagrożeń hałasowych środowiska rozprawa doktorska /

Praca doktorska. Akademia Górniczo-Hutnicza im. Stanisława Staszica (Kraków), 2011.Zawiera bibliogr.Dostępna także w wersji drukowanej.Tryb dostępu: Internet.Wskaźniki oceny zagrożeń hałasowych środowiska, niepewność pomiarów, źródła błędów w procesie pomiarowym, zasady wyznaczania niepewności pomiarów, wyznaczanie niepewności standardowej typu A, wyznaczanie niepewności standardowej typu B, estymacja wartości oczekiwanej, niepewności standardowej typu A długookresowych wskaźników oceny zagrożeń hałasowych środowiska, podejście klasyczne, nieklasyczne, nieklasyczne metody statystyczne, ich zastosowanie do estymacji parametrów rozkładu, estymacja nieparametryczna, estymator jądrowy, estymacja wartości oczekiwanej, odchylenia standardowego, techniki ponownego losowania, metoda bootstrap, estymacja wartości oczekiwanej, błędu standardowego, estymacja bayesowska, metody numeryczne stosowane we wnioskowaniu bayesowskim, estymacja wartości oczekiwanej, odchylenia standardowego, algorytmy nieklasycznych metod statystycznych do estymacji wartości oczekiwanej i niepewności standardowej typu A długookresowych wskaźników oceny zagrożeń hałasowych środowiska, estymacja jądrowa, zastosowanie w warunkach praktycznych algorytmów do estymacji wartości oczekiwanej, niepewności standardowej typu A długookresowych wskaźników oceny zagrożeń hałasowych środowiska, system ciągłego monitoringu hałasu, materiał badawcz

Serum Level of MMP-3 and MMP-9 in Patients with Diabetes Mellitus Type 2 Infected with Epstein-Barr Virus

Diabetes mellitus type 2 (DM2) has recently become one of the most important health problems in the world. Patients with DM2 with long-term glycaemia are more likely to become infected than the healthy population. Matrix metalloproteinases (MMPs) play a key role in tissue remodeling during various physiological processes. However, it has been reported that certain MMPs are overexpressed during the development of various human diseases. In this study, we analyzed the levels of MMP-3 and MMP-9 in the serum of DM2 patients with and without Epstein-Barr virus (EBV) infection. The study included 115 patients with DM2 hospitalized in the Internal Ward of the Masovian Specialist Hospital in Radom, Poland, who were divided into two groups: EBV-positive and EBV-negative. The levels of MMP-3 and MMP-9 were tested in the serum of patients using the ELISA method, while the presence of EBV in saliva was tested by polymerase chain reaction (PCR). The presented studies showed a significant difference in the concentration of both MMPs in diabetic patients additionally infected with EBV compared to the group of non-infected individuals. It seems that MMPs may be useful biomarkers in the diagnosis, prognosis, and monitoring of diabetes associated with EBV infection

Serum and Tissue Level of TLR9 in EBV-Associated Oropharyngeal Cancer

The Epstein–Barr virus (EBV) is associated with the development of various epithelial malignancies including cancer in the head and neck region. Several studies have shown that Toll-like receptors (TLRs) are required for an innate immune response to infection with human DNA viruses, e.g., EBV. During viral infections, TLR response may influence the transformation to malignancy. The aim of the study was to assess TLR9 serum and tissue level in EBV(+) and EBV(−) oropharyngeal cancer patients. The study involved 78 patients: 42 EBV(+) and 36 EBV(−). EBV DNA was detected in fresh frozen tumor tissue. TLR9 level was measured in homogenate of tumor tissue and in serum. Moreover, in serum samples IL-10, VEGF, TGFβ, TNFα and antibodies against EBV were detected using ELISA test. TLR9 level was significantly lower in EBV(+) patients, both in tissue and serum, while EBVCA, EBNA and VEGF level was statistically higher in EBV(+) patients. An increase in EBVCA and EBNA antibodies titer was correlated with a TLR9 level decrease. TLR9 level was higher in poorly-differentiated tumors (G3), in tumor of larger dimensions (T3-T4) and with lymph nodes involvement (N3-N4) but without statistical significance. High levels of anti-EA antibodies in the majority of EBV(+) patients may point to the reactivation of EBV infection

Experimental Verification of Windshields in the Measurement of Low Frequency Noise from Wind Turbines

Measuring noise from wind turbines is a problematic metrological task due to the significant interference caused by the wind, especially in the low-frequency range. In the audible band, especially A-weighted, the impact of interference from wind is considerably less than in the low-frequency and infrasound bands. In the audible band, especially the A-weighted curve, the impact of interference from wind is significantly less than in the low-frequency and infrasound bands. For this reason, methods are still being sought to reduce interference from wind in the lowest frequency bands effectively. Experimental tests within the scope of the work were carried out using several windshields, with a single standard windscreen at 1.5 m and 4 m height, with an additional microphone shield (tent), and on the board with a double windscreen at a ground level according to IEC 61400-11. Experimental verification of a windshield’s effectiveness and impact under real conditions was carried out using a low-frequency noise source, which was the main fan station at the salt mine shaft. This source generates noise with similar spectral characteristics to wind turbines and can operate in windless conditions. This allowed noise measurements to be made without interference from the wind. Signals were recorded in windless and windy conditions at different wind speeds using tested windshields. An effectiveness analysis of the proposed measurement methods was also carried out on the wind farm. Performed research indicates that the best of the tested variants, when measuring wind turbine noise in the low-frequency range, is to place the microphone on the board with a double windscreen according to IEC 61400-11. At wind speeds of less than 5 m/s at 1.5 m above the ground, the shield effectively eliminates disturbances in the band above 4 Hz. Still, as the wind speed increases above 6 m/s, the level of disturbance increases, and its bandwidth in the lowest frequencies expands

Expression Profile of Selected Genes Involved in Storage Lipid Synthesis in a Model Oleaginous Yeast Species Yarrowia lipolytica

Yarrowia lipolytica yeast is a model species of the group of oleaginous microorganisms capable of intracellular lipids accumulation in an amount exceeding 20% of the dry mass. Single cell oil biosynthesis can follow one of two biochemical pathways—de novo accumulation of cellular lipids in medium containing non-lipid carbon sources (including saccharides, glycerol) and ex novo microbial oil synthesis which involves fatty acids uptake from the environment. The mRNA expression of selected genes of de novo and ex novo lipid synthesis pathways was analyzed and correlated with the phenotypically observed features. It was proved that the accumulation yield of storage lipids via ex novo pathway was to some extent dependent on the limitation of the nitrogen source in the medium. It was also proposed that the synthesis of intracellular lipids in lipid-rich medium proceeded mainly via ex novo pathway, although the activity of genes encoding the enzymes of the de novo pathway were not completely inhibited at the stage of transcription by fatty acids present in the medium (e.g., ATP-citrate lyase). Molecular markers of two biosynthesis routes has been outlined and a hypothetical connection point between de novo and ex novo route were indicated

Experimental Verification of Windshields in the Measurement of Low Frequency Noise from Wind Turbines

Measuring noise from wind turbines is a problematic metrological task due to the significant interference caused by the wind, especially in the low-frequency range. In the audible band, especially A-weighted, the impact of interference from wind is considerably less than in the low-frequency and infrasound bands. In the audible band, especially the A-weighted curve, the impact of interference from wind is significantly less than in the low-frequency and infrasound bands. For this reason, methods are still being sought to reduce interference from wind in the lowest frequency bands effectively. Experimental tests within the scope of the work were carried out using several windshields, with a single standard windscreen at 1.5 m and 4 m height, with an additional microphone shield (tent), and on the board with a double windscreen at a ground level according to IEC 61400-11. Experimental verification of a windshield’s effectiveness and impact under real conditions was carried out using a low-frequency noise source, which was the main fan station at the salt mine shaft. This source generates noise with similar spectral characteristics to wind turbines and can operate in windless conditions. This allowed noise measurements to be made without interference from the wind. Signals were recorded in windless and windy conditions at different wind speeds using tested windshields. An effectiveness analysis of the proposed measurement methods was also carried out on the wind farm. Performed research indicates that the best of the tested variants, when measuring wind turbine noise in the low-frequency range, is to place the microphone on the board with a double windscreen according to IEC 61400-11. At wind speeds of less than 5 m/s at 1.5 m above the ground, the shield effectively eliminates disturbances in the band above 4 Hz. Still, as the wind speed increases above 6 m/s, the level of disturbance increases, and its bandwidth in the lowest frequencies expands