Is whole-body trauma MDCT justified in patients in good clinical condition but with dangerous trauma mechanism?

Background: To assess whether whole body MDCT is justified in patients in good clinical condition yet with dangerous trauma mechanism. Material/Methods: The study included 81 patients who were examined between January and July 2008 with wholebody trauma CT protocol. Inclusion into the study was based on a dangerous trauma mechanism and the possibility of an unbiased calculation of the weighted revised trauma score (RTSw). All examinations were performed with 16 row MDCT scanner located in emergency department. The cut off of the RTSw over 6.0 was used to separate the patients in good clinical condition. The CT examinations and medical records of patients were reviewed to assess the number of significant injuries, the need for emergency surgery and other types of medical treatment, the number of negative CT examinations, the number of patients admitted to hospital, and mortality. Results: 28 life-threatening injuries were found in 21 of 61 patients with RTS over 6.0 (34.4%). Only two of those patients required emergency surgery (laparotomy). CT studies were negative for traumatic injuries in 22 patients from this group (36.0%). Conclusions: Whole-body MDCT may detect injuries in patients in good clinical condition, with some of them demanding medical treatment. Still, further studies are required to balance the advantages of MDCT and potentially harmful effects of radiation dose, especially better triage systems and lowdose protocols are needed

Optical coherence tomography versus intravascular ultrasound for culprit lesion assessment in patients with acute myocardial infarction

Introduction: In patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI) the implanted stent may not fully cover the whole intravascular ultrasound (IVUS)-derived thin-cap fibroatheroma (TCFA) related to the culprit lesion (CL). Aim: Whether this phenomenon is more pronounced when optical coherence tomography (OCT) assessment of the CL is performed is not known. Material and methods: Thus, we aimed to assess CLs in 40 patients with AMI treated with PCI, using VH (virtual histology)-IVUS and OCT before and after intervention. The results were blinded to the operator and PCI was done under angiography guidance. Results: Uncovered lipid-rich plaques were identified in the stent reference segments of 23 (57.5%) patients: in 13 (32.5%) of them in the distal reference segment and in 19 (47.5%) of them in the proximal reference segment. In 9 of them (22.5%) lipid plaques were found in both reference segments. In 36 (90%) patients OCT confirmed lipid plaques identified as VH-derived TCFA by VH-IVUS in the reference segments of the stented segment. However, OCT confirmed that only in 2 (5%) patients were uncovered lipid plaques true TCFA as defined by histology. Comparing IVUS and OCT qualitative characteristics of the stented segments OCT detected more thrombus protrusions and proximal and distal stent edge dissections compared to IVUS (92.5 vs. 55%, p = 0.001; 20% vs. 7.5%, p = 0.03 and 25% vs. 5%, p < 0.001, respectively). Conclusions: Due to its superior resolution, OCT identifies TCFA more precisely. OCT more often shows remaining problems related to stent implantation than IVUS after angiographically guided PCI

Guidelines for Soil Description and Classification Central and Eastern European Students’ Version.

Soil investigation may be carried out on various levels of knowledge, research capacity and proficiency. Scientists commonly apply advanced methodology for soil resources inventory, including the professional terminology for landscape and soil description, data acquisition and processing, soil classification and mapping, soil and land evaluation. By default, an internationally accepted system should be recommended. An implementation of such methodology is also recommended in more advanced courses of soil science studies on bachelor and master study levels. However, the long-term teaching experience reveals difficulties connected mainly with complicated terminology and excessive number of characteristics obligatory to know, and justifies some simplification of the language, rules and structure at the introductory stage of teaching. This was the base and rationale for the preparation of simplified Guidelines for Soil Description and Classification: Central and Eastern European Students’ Version. This book is divided into three parts. The first one – Site and soil description - follows the layout and content of professional edition of Guidelines for Soil Description, 4th ed., published by FAO (2006), simplified for educational purposes. The order of description has been modified to correspond to the layout of an original Soil description sheet. The second part - Soil classification - is a simplified WRB classification (based on a 2014/2015 edition) limited to reference soil groups known from Central Europe. The third part is an Illustrated explanatory guide that includes: i) examples of typical soil profiles for all Central European Reference Soil Groups; ii) morphological features important for soil description and identification in the field; iii) soil- landscape relationships. The photos have been enriched with graphical tips helpful at the recognizing of important soil features. The textbook was developed in the framework of EU Erasmus+ FACES project (Freely Accessible Central European Soil) aiming to facilitate the knowledge and implementation of an international rules of soil characterization adopted by the FAO. It will be used to unify the presentation of soil data collected in the partner countries. The interpretation of soil data fully based on the international soil classification WRB (World Reference Base for Soil Resources 2015) as WRB was endorsed by the International Union of Soil Sciences (IUSS) and accepted by the European Commission as an official system for the European Union. Therefore, this guideline might be a starting point for preparation of basic teaching materials to spread the knowledge on an internationally recommended rules and terminology for soil description and classification. However, this guideline is designed as teaching tool for students in Central and Eastern European countries and therefore it may not be applicable worldwide. Moreover, it is suited for the “first step” training, and it is not substituting any professional original classification. Authors of this guidebook assume that the users are familiar with the basic knowledge in soil science. Therefore, the guidelines do not contain explanations related to basic soil forming factors, soil forming processes and basic physico-chemical features

Administration of Cyclosporine A in Pregnant Rats - the Effect on Blood Pressure and on the Glomerular Number in Their Offspring

Background/Aims: Cyclosporine A (CsA) is a commonly used immunosuppressive agent. In some patients treatment with CsA has to be continued during pregnancy. The aim of the study was to assess in an experimental model whether the exposure to CsA during fetal life influences the number and volume of glomeruli, kidney function and blood pressure in the offspring. Methods: Eight pregnant female Sprague-Dawley rats were allocated to 2 treatment regimens: with CsA or solvent. Blood pressure was measured in the offspring at 7 and 11 weeks of age and albuminuria was determined at 11 weeks of age. In the kidney the number and mean volume of glomeruli was assessed using stereological methods. Results: In the offspring of pregnant rats treated with CsA the number of glomeruli was significantly lower and the mean volume of glomeruli was higher when compared to the offspring of pregnant rats receiving solvent. Systolic and diastolic blood pressures as well as albuminuria were significantly higher in the offspring of mothers treated with CsA during gestation compared to the offspring from the control group. Conclusions: Exposure of rats to CsA during fetal life impairs kidney development, thus potentially predisposing to chronic kidney disease and hypertension in the adult life