OPTIMIZATION OF DECOMPRESSIVE CRANIECTOMY BASED ON FINITE ELEMENT SIMULATIONS

Decompressive Craniectomy (DC) is a neurosurgical procedure which is often applied to decrease the intracranial pressure (ICP), even if its optimal execution in terms of the size and location of the skull opening is not known. The current research focuses on DC from a biomechanical perspective. A finite element (FE) modelling strategy is applied where patient-specific head models are developed. These numerical models are used to perform virtual experiments where DC is simulated several times with skull openings having different size and location. During the simulations ICP, stress and strain distributions in the brain tissue are monitored in the function of the skull opening details. In the knowledge of these objective functions suggestions could be made regarding the applied optimization procedure which can lead to the identification of optimal DC scenarios in the future

Szükség van szívódrainre elektív csípőprotézis műtétek során?

Absztrakt Bevezetés: Az utóbbi időben több tanulmány látott napvilágot, amelyek megkérdőjelezték a szívódrén használatának szükségességét elektív csípőprotézis-beültetés során. Célkitűzés: Prospektív tanulmányban azt vizsgálták, hogy a perioperatív vérveszteséget és a vérzéssel kapcsolatos szövődményeket a szívódrén használata hogyan befolyásolja. Módszer: 86, csípőprotézis-beültetésre érkező beteget két csoportra osztottak. A „dréncsoportban” (54 beteg) a műtétet követően szívódrént helyeztek be, míg a „drén nélküli (kontroll)csoportban” (32 beteg) nem használtak szívódrént. Perioperatív vérveszteséget számoltak és feljegyezték a tranexámsav használatát, a trombózisprofilaxis módját, a transzfúzióigényt, az esetlegesen kialakuló posztoperatív vérzéseket, szeptikus komplikációkat, illetve minden egyéb posztoperatív szövődményt. Eredmények: A perioperatív vérvesztést a tranexámsav használata igen, míg a drénhasználat nem befolyásolta szignifikánsan (p = 0,94). A drén nélküli csoportban ugyanakkor tendenciózusan kisebb volt a transzfúzióigény (p = 0,08). A műtétek kapcsán kialakult szövődmények nem mutattak összefüggést a drénválasztással. Következtetés: Az irodalomban közölt eredményekkel összhangban, az elektív csípőprotézis-beültetés során a szívódrén rutinszerű alkalmazása nem feltétlenül szükséges. Orv. Hetil., 2016, 157(29), 1171–1176

Conditions Favoring Proliferation of Glycogen Accumulating Organisms for Excess Biological Carbon Removal in Treating Nutrient Deficient Wastewater

Impact of marginal availability and severe deficiency of nitrogen on the growth of glycogen accumulating organisms (GAOs) and performance of anaerobic/aerobic activated sludge systems treating nutrient deficient wastewater was investigated at marginal availability and severe deficiency of phosphorus. Two continuous-flow lab-scale systems were operated simultaneously fed by model winery wastewater, one with marginal availability and the other one at severe deficiency of nitrogen. In the second experimental stage, marginal availability of P was converted into severe deficiency by interrupting external dosing.Common practice of dosing N- and P-sources to marginal availability caused enhanced proliferation of filamentous bacteria leading to poor biomass settling and instable operation. At marginal N-availability accumulation of GAOs started when conditions became deficient for phosphorus. In severe lack of nitrogen GAOs overgrew filaments, and outcompeted phosphorous accumulating organisms (PAOs) initially present in the seed. Stable and good performance could be maintained even after withdrawal of phosphorous dosing

Long term efficacy of radioiodine treatment in hyperthyroidism.

Radioiodine is the mainstay of the treatment of thyroid hyperfunction. However, it is difficult to apply the appropriate amount of radioidone to achieve optimal efficacy with the least possible adverse effects. Results of the investigation on the efficacy of a relatively new protocol for radioiodine treatment of hyperthyroidism are reported.A retrospective evaluation of data from 326 patients with a mean average follow-up of 5.7 (1.0-11.7) years was performed. 64% of these patients suffered from Graves' disease and 36% had uni- or multinodular toxic goitre.In Graves' disease, the recurrence rate was 5% 1 year after the treatment, and that remained the same after 5 years. In toxic goitre, these rates were 6 and 7%, respectively. After 5 years 70% of the patients with autonomous adenomas were euthyroid, while 78% of the Graves patients developed hypothyroidism and 17% showed euthyroid state. A relationship between the lack of normalisation of thyroid-stimulating hormone levels after radioiodine treatment and the increased recurrence of late hyperthyroidism has also been established in patients with Graves's disease.Compared to the available data published in the literature, the success rate of the treatment is fairly high confirming the effectiveness of our protocol

The role of serum total and free 25-hydroxyvitamin D and PTH values in defining vitamin D status at the end of winter: a representative survey

We sought the lowest serum total 25-hydroxyvitamin D (t-25OHD) values in geographic areas with four seasons and investigated whether the calculation of serum free 25-hydroxyvitamin D (f-25OHD) could provide additional information on vitamin D status. This is a representative, cross-sectional study restricted to a sampling period at the end of winter, using a non-probability, stratified sample of the adult community-dwelling Hungarian population (n = 882). We measured t-25OHD, vitamin D binding protein (DBP), parathyroid hormone (PTH), and albumin levels. f-25OHD concentrations were calculated. We assessed environmental factors that could affect vitamin D levels and diseases possibly related to vitamin D deficiency. Mean t-25OHD values of the total population were 41.3 ± 20.6 nmol/L. t-25OHD levels were below 75, 50, and 30 nmol/L in 97, 77, and 34 % of participants not receiving vitamin D supplementation, respectively. t-25OHD values weakly positively correlated with DBP (r = 0.174; p = 0.000), strongly with f-25OHD (r = 0.70; p = 0.000). The association between t-25OHD and f-25OHD and between t-25OHD and PTH were non-linear (psquared term = 0.0004 and 0.004, respectively). t-25OHD levels were not affected by gender, age, place of residence; however, they were related to body mass index, sunbed sessions, and tropical travel. In contrast, f-25OHD levels were different in males and females but were not related to obesity. t- and f-25OHD were lower among people with cardiovascular diseases (p = 0.012). Nearly the entire Hungarian population is vitamin D insufficient at the end of winter. The use of t-25OHD could show a spurious association with obesity; however, it does not reflect the obvious sex difference. © 2015 The Japanese Society for Bone and Mineral Research and Springer Japa

Stimulus-triggered enhancement of chilling tolerance in zebrafish embryos.

BACKGROUND:Cryopreservation of zebrafish embryos is still an unsolved problem despite market demand and massive efforts to preserve genetic variation among numerous existing lines. Chilled storage of embryos might be a step towards developing successful cryopreservation, but no methods to date have worked. METHODS:In the present study, we applied a novel strategy to improve the chilling tolerance of zebrafish embryos by introducing a preconditioning hydrostatic pressure treatment to the embryos. In our experiments, 26-somites and Prim-5 stage zebrafish embryos were chilled at 0°C for 24 hours after preconditioning. Embryo survival rate, ability to reach maturation and fertilizing capacity were tested. RESULTS:Our results indicate that applied preconditioning technology made it possible for the chilled embryos to develop normally until maturity, and to produce healthy offspring as normal, thus passing on their genetic material successfully. Treated embryos had a significantly higher survival and better developmental rate, moreover the treated group had a higher ratio of normal morphology during continued development. While all controls from chilled embryos died by 30 day-post-fertilization, the treated group reached maturity (~90-120 days) and were able to reproduce, resulting in offspring in expected quantity and quality. CONCLUSIONS:Based on our results, we conclude that the preconditioning technology represents a significant improvement in zebrafish embryo chilling tolerance, thus enabling a long-time survival. Furthermore, as embryonic development is arrested during chilled storage this technology also provides a solution to synchronize or delay the development

Outbreaks of a Methicillin-Resistant Staphylococcus aureus Clone ST398-t011 in a Hungarian Equine Clinic: Emergence of Rifampicin and Chloramphenicol Resistance After Treatment with These Antibiotics.

Between July 2011 and May 2016, a total of 40 Staphylococcus aureus strains originating from 36 horses were confirmed as methicillin resistant (methicillin-resistant Staphylococcus aureus [MRSA]) in a university equine clinic. An additional 10 MRSA strains from 36 samples of clinic workers were obtained in October 2017. The first equine isolate represented the sequence type ST398, spa-type t011, and SCCmec IV. This isolate was resistant to a wide spectrum of antimicrobial agents. MRSA strains with the same genotype and with very similar resistance profiles were isolated on 21 more occasions from September 2013 to September 2014. A second outbreak occurred from May 2015 until May 2016. The first isolate in this second outbreak shared the same genotype, but was additionally resistant to chloramphenicol. The second isolate from August 2015 also showed resistance to rifampicin. The clone was isolated 18 times. Most of the human isolates shared the same genotype as the isolates from horses and their resistance patterns showed only slight differences. We can conclude that the MRSA-related cases at the Department and Clinic of Equine Medicine were all nosocomial infections caused by the same clonal lineage belonging to the clonal complex 398. The clonal complex 398 of equine origin is reported for the first time in Hungary. In addition, our observation of the emergence of new resistance to antimicrobial agents within the clonal lineage after treatment with antibiotics is of concern. Strict hygiene regulations have been introduced to lower the incidence of MRSA isolation and the related clinical disease

Co-occurrence of thyroid and breast cancer is associated with an increased oncogenic SNP burden

Abstract Background Epidemiological evidence suggests that synchronous or metachronous presentation of breast and thyroid cancers exceeds that predicted by chance alone. The following potential explanations have been hypothesized: common environmental or hormonal factors, oncogenic effect of the treatment for the first cancer, closer follow-up of cancer survivors, shared underlying genetic risk factors. While some cases were found to be related to monogenic disorders with autosomal inheritance, the genetic background of most cases of co-occurring breast and thyroid cancer is thought to be polygenic. Methods In this retrospective case-control study we compared the genetic profile of patients with a history of breast cancer (n = 15) to patients with co-occurring breast and thyroid cancer (n = 19) using next generation sequencing of 112 hereditary cancer risk genes. Identified variants were categorized based on their known association with breast cancer and oncogenesis in general. Results No difference between patients with breast and double cancers was observed in clinical and pathological characteristics or the number of neutral SNPs. The unweighted and weighted number of SNPs with an established or potential association with breast cancer was significantly lower in the group with breast cancer only (mean difference − 0.58, BCa 95% CI [− 1.09, − 0.06], p = 0.029, and mean difference − 0.36, BCa 95% CI [− 0.70, − 0.02], p = 0.039, respectively). The difference was also significant when we compared the number of SNPs with potential or known association with any malignancy (mean difference − 1.19, BCa 95% CI [− 2.27, − 0.11], p = 0.032 for unweighted, and mean difference − 0.73, BCa 95% CI [− 1.32, − 0.14], p = 0.017 for weighted scores). Conclusion Our findings are compatible with the hypothesis of genetic predisposition in the co-occurrence of breast and thyroid cancer. Further exploration of the underlying genetic mechanisms may help in the identification of patients with an elevated risk for a second cancer at the diagnosis of the first cancer