Risk Factors for Subdural Bleeding in Elderly Population

In the elderly, a larger proportion of the intracranial bleeds is related to non-traumatic causes or is caused by slight trauma – such that in a younger patient would not be expected to cause a bleed. In clinical practice, there is a prevailing impression that these bleeds, especially subdural hematomas of chronic and sub-chronic duration with or without acutization (evidence of »fresh« bleeding) are in many cases related directly to the use of anticoagulant therapy. A retrospective survey of medical documentation was performed for patients treated at the Neurosurgery Clinic of KBC Rijeka during the period of 2011 and 2012. Statistical analysis showed a signifi cantly greater incidence of spontaneous SDH (subdural hematoma) in patients taking oral anticoagulation therapy (Fisher exact test, p<0.01). In the article 3 typical cases of such patients are also presented. This survey confi rmed the existence of a relationship between oral anticoagulant therapy and SDH, in particular the subgroup of »spontaneous« SDH. A larger study is planned

Epidural Steroid Injection

Epiduralne injekcije odavno se upotrebljavaju u anesteziji operativnih zahvata trupa, abdomena i donjih ekstremiteta. U posljednje vrijeme sve je učestalija uporaba epiduralnih injekcija u terapiji bolnog sindroma leđa s ciljem ubrizgavanja steroida u epiduralni prostor, radi smanjivanja upale korijena živca i okolnih struktura koje se smatraju osnovnim uzrokom radikularnog bola. U epiduralni prostor može se ući interlaminarnim ili transforaminalnim pristupom.Epidural injections have long been used in anesthesia for surgery on the trunk, abdomen and lower extremities. In recent years is it frequent use of epidural injections in the treatment of back pain syndrome, with the aim of injecting steroids into the epidural space to suppress inflammation in the nerve and surrounding soft tissues which is believed to be the basis for radicular pain. The epidural space can be entered with interlaminar or transforaminal approach

Epidural Steroid Injection

Epiduralne injekcije odavno se upotrebljavaju u anesteziji operativnih zahvata trupa, abdomena i donjih ekstremiteta. U posljednje vrijeme sve je učestalija uporaba epiduralnih injekcija u terapiji bolnog sindroma leđa s ciljem ubrizgavanja steroida u epiduralni prostor, radi smanjivanja upale korijena živca i okolnih struktura koje se smatraju osnovnim uzrokom radikularnog bola. U epiduralni prostor može se ući interlaminarnim ili transforaminalnim pristupom.Epidural injections have long been used in anesthesia for surgery on the trunk, abdomen and lower extremities. In recent years is it frequent use of epidural injections in the treatment of back pain syndrome, with the aim of injecting steroids into the epidural space to suppress inflammation in the nerve and surrounding soft tissues which is believed to be the basis for radicular pain. The epidural space can be entered with interlaminar or transforaminal approach

Low back pain

Bol donjeg segmenta leđa značajan je javnozdravstveni problem. Radi se o čestom kliničkom stanju od kojeg često obolijeva radno aktivno stanovništvo. Kronična ili akutna lumbalgija neupitno spada u vodeće dijagnoze zbog kojih radno aktivno stanovništvo izostaje s posla. Simptomi bola u donjem dijelu leđa zahvaćaju i stariju populaciju. Iznimno kompleksna anatomska struktura slabinskog segmenta kralježnice sklona je ozljedama te prenaprezanju, koje su vodeći uzrok bola. S biomehaničkog pogleda radi se o dijelu kralježnice koji je zadužen za kretnje velikih amplituda (fleksija i ekstenzija, naginjanje u stranu te aksijalna rotacija) te je istovremeno podvrgnut velikim silama (prijenos aksijalne težine, nošenje i podizanje predmeta). Sve to može dovesti do ozljeda. Bol može biti uzrokovan promjenama i narušavanjem integriteta svih anatomskih struktura slabinskog segmenta (kralježak, zigoapofizijalni zglob, sakroilijakalni zglob, mišićje i ligamentarni aparat). Najčešće se ipak radi o bolesti intervertebralnog diska (hernija) s posljedičnom kompresijom na neuralne strukture. Tada govorimo o radikulopatiji (lumboishijalgiji). Osim navedenih ozljeda uvijek se mora razmišljati i o mogućem isključenju ostale patologije koja kao simptom ima bol u leđima (ekspanzivni procesi, infekcije, trauma, bolesti bubrega). Liječenje lumbalgije i/ili radikulopatije uglavnom je konzervativno i kod najvećeg broja bolesnika konzervativni tretman dovodi do potpunog izlječenja. Kod nastupa kroniciteta tegoba uz proširenje neuroradiološke obrade, u obzir dolazi i operacijsko liječenje.Low back pain is an important public health problem. It is a relatively frequent clinical condition among active population. Chronic or acute low back pain is among the most frequent diagnosis that make people miss their work. Back pain is found also among the elderly. The exceptionally complex anatomical structure of the lumbar segment makes it prone to injuries and overstrain, as the main causes of pain symptoms. From the biomechanical point of view it is the spinal segment which is responsible for large amplitude motions (flexion and extension, lateral banding and axial rotation), which means that this segment is subject to great force i.e. strain (axial weight and lifting). All these factors may lead to injuries. Pain can be caused by changes and loss of integrity of all anatomical structures of the lumbar segment (vertebra, fasset joint, sacro-iliacal joint, muscles or ligaments). More often, the main spine problem is intervertebral disc disease (disc herniation), with compression effect on spinal nerve roots and medula. In these case, the leading symptom is sciatica (radiculopathy). Along with the above mentioned spinal conditions, there is also need to consider other possible problems associated with back pain (tumors, infections, trauma, kidney diseases). The treatment of back pain/radiculopathy is almost always conservative and in the majority of patients it leads to complete recovery. If back pain starts to be chronic, this requires neuroradiologic analysis, with surgical treatment being also an option

Low back pain

Bol donjeg segmenta leđa značajan je javnozdravstveni problem. Radi se o čestom kliničkom stanju od kojeg često obolijeva radno aktivno stanovništvo. Kronična ili akutna lumbalgija neupitno spada u vodeće dijagnoze zbog kojih radno aktivno stanovništvo izostaje s posla. Simptomi bola u donjem dijelu leđa zahvaćaju i stariju populaciju. Iznimno kompleksna anatomska struktura slabinskog segmenta kralježnice sklona je ozljedama te prenaprezanju, koje su vodeći uzrok bola. S biomehaničkog pogleda radi se o dijelu kralježnice koji je zadužen za kretnje velikih amplituda (fleksija i ekstenzija, naginjanje u stranu te aksijalna rotacija) te je istovremeno podvrgnut velikim silama (prijenos aksijalne težine, nošenje i podizanje predmeta). Sve to može dovesti do ozljeda. Bol može biti uzrokovan promjenama i narušavanjem integriteta svih anatomskih struktura slabinskog segmenta (kralježak, zigoapofizijalni zglob, sakroilijakalni zglob, mišićje i ligamentarni aparat). Najčešće se ipak radi o bolesti intervertebralnog diska (hernija) s posljedičnom kompresijom na neuralne strukture. Tada govorimo o radikulopatiji (lumboishijalgiji). Osim navedenih ozljeda uvijek se mora razmišljati i o mogućem isključenju ostale patologije koja kao simptom ima bol u leđima (ekspanzivni procesi, infekcije, trauma, bolesti bubrega). Liječenje lumbalgije i/ili radikulopatije uglavnom je konzervativno i kod najvećeg broja bolesnika konzervativni tretman dovodi do potpunog izlječenja. Kod nastupa kroniciteta tegoba uz proširenje neuroradiološke obrade, u obzir dolazi i operacijsko liječenje.Low back pain is an important public health problem. It is a relatively frequent clinical condition among active population. Chronic or acute low back pain is among the most frequent diagnosis that make people miss their work. Back pain is found also among the elderly. The exceptionally complex anatomical structure of the lumbar segment makes it prone to injuries and overstrain, as the main causes of pain symptoms. From the biomechanical point of view it is the spinal segment which is responsible for large amplitude motions (flexion and extension, lateral banding and axial rotation), which means that this segment is subject to great force i.e. strain (axial weight and lifting). All these factors may lead to injuries. Pain can be caused by changes and loss of integrity of all anatomical structures of the lumbar segment (vertebra, fasset joint, sacro-iliacal joint, muscles or ligaments). More often, the main spine problem is intervertebral disc disease (disc herniation), with compression effect on spinal nerve roots and medula. In these case, the leading symptom is sciatica (radiculopathy). Along with the above mentioned spinal conditions, there is also need to consider other possible problems associated with back pain (tumors, infections, trauma, kidney diseases). The treatment of back pain/radiculopathy is almost always conservative and in the majority of patients it leads to complete recovery. If back pain starts to be chronic, this requires neuroradiologic analysis, with surgical treatment being also an option

Low back pain

Bol donjeg segmenta leđa značajan je javnozdravstveni problem. Radi se o čestom kliničkom stanju od kojeg često obolijeva radno aktivno stanovništvo. Kronična ili akutna lumbalgija neupitno spada u vodeće dijagnoze zbog kojih radno aktivno stanovništvo izostaje s posla. Simptomi bola u donjem dijelu leđa zahvaćaju i stariju populaciju. Iznimno kompleksna anatomska struktura slabinskog segmenta kralježnice sklona je ozljedama te prenaprezanju, koje su vodeći uzrok bola. S biomehaničkog pogleda radi se o dijelu kralježnice koji je zadužen za kretnje velikih amplituda (fleksija i ekstenzija, naginjanje u stranu te aksijalna rotacija) te je istovremeno podvrgnut velikim silama (prijenos aksijalne težine, nošenje i podizanje predmeta). Sve to može dovesti do ozljeda. Bol može biti uzrokovan promjenama i narušavanjem integriteta svih anatomskih struktura slabinskog segmenta (kralježak, zigoapofizijalni zglob, sakroilijakalni zglob, mišićje i ligamentarni aparat). Najčešće se ipak radi o bolesti intervertebralnog diska (hernija) s posljedičnom kompresijom na neuralne strukture. Tada govorimo o radikulopatiji (lumboishijalgiji). Osim navedenih ozljeda uvijek se mora razmišljati i o mogućem isključenju ostale patologije koja kao simptom ima bol u leđima (ekspanzivni procesi, infekcije, trauma, bolesti bubrega). Liječenje lumbalgije i/ili radikulopatije uglavnom je konzervativno i kod najvećeg broja bolesnika konzervativni tretman dovodi do potpunog izlječenja. Kod nastupa kroniciteta tegoba uz proširenje neuroradiološke obrade, u obzir dolazi i operacijsko liječenje.Low back pain is an important public health problem. It is a relatively frequent clinical condition among active population. Chronic or acute low back pain is among the most frequent diagnosis that make people miss their work. Back pain is found also among the elderly. The exceptionally complex anatomical structure of the lumbar segment makes it prone to injuries and overstrain, as the main causes of pain symptoms. From the biomechanical point of view it is the spinal segment which is responsible for large amplitude motions (flexion and extension, lateral banding and axial rotation), which means that this segment is subject to great force i.e. strain (axial weight and lifting). All these factors may lead to injuries. Pain can be caused by changes and loss of integrity of all anatomical structures of the lumbar segment (vertebra, fasset joint, sacro-iliacal joint, muscles or ligaments). More often, the main spine problem is intervertebral disc disease (disc herniation), with compression effect on spinal nerve roots and medula. In these case, the leading symptom is sciatica (radiculopathy). Along with the above mentioned spinal conditions, there is also need to consider other possible problems associated with back pain (tumors, infections, trauma, kidney diseases). The treatment of back pain/radiculopathy is almost always conservative and in the majority of patients it leads to complete recovery. If back pain starts to be chronic, this requires neuroradiologic analysis, with surgical treatment being also an option

Extensive soot compaction by cloud processing from laboratory and field observations

Soot particles form during combustion of carbonaceous materials and impact climate and air quality. When freshly emitted, they are typically fractal-like aggregates. After atmospheric aging, they can act as cloud condensation nuclei, and water condensation or evaporation restructure them to more compact aggregates, affecting their optical, aerodynamic, and surface properties. Here we survey the morphology of ambient soot particles from various locations and different environmental and aging conditions. We used electron microscopy and show extensive soot compaction after cloud processing. We further performed laboratory experiments to simulate atmospheric cloud processing under controlled conditions. We find that soot particles sampled after evaporating the cloud droplets, are significantly more compact than freshly emitted and interstitial soot, confirming that cloud processing, not just exposure to high humidity, compacts soot. Our findings have implications for how the radiative, surface, and aerodynamic properties, and the fate of soot particles are represented in numerical models

Extensive Soot Compaction by Cloud Processing from Laboratory and Field Observations

Soot particles form during combustion of carbonaceous materials and impact climate and air quality. When freshly emitted, they are typically fractal-like aggregates. After atmospheric aging, they can act as cloud condensation nuclei, and water condensation or evaporation restructure them to more compact aggregates, affecting their optical, aerodynamic, and surface properties. Here we survey the morphology of ambient soot particles from various locations and different environmental and aging conditions. We used electron microscopy and show extensive soot compaction after cloud processing. We further performed laboratory experiments to simulate atmospheric cloud processing under controlled conditions. We find that soot particles sampled after evaporating the cloud droplets, are significantly more compact than freshly emitted and interstitial soot, confirming that cloud processing, not just exposure to high humidity, compacts soot. Our findings have implications for how the radiative, surface, and aerodynamic properties, and the fate of soot particles are represented in numerical models.Peer reviewe

Hyaluronan Benzyl Ester as a Scaffold for Tissue Engineering

Tissue engineering is a multidisciplinary field focused on in vitro reconstruction of mammalian tissues. In order to allow a similar three-dimensional organization of in vitro cultured cells, biocompatible scaffolds are needed. This need has provided immense momentum for research on “smart scaffolds” for use in cell culture. One of the most promising materials for tissue engineering and regenerative medicine is a hyaluronan derivative: a benzyl ester of hyaluronan (HYAFF®). HYAFF® can be processed to obtain several types of devices such as tubes, membranes, non-woven fabrics, gauzes, and sponges. All these scaffolds are highly biocompatible. In the human body they do not elicit any adverse reactions and are resorbed by the host tissues. Human hepatocytes, dermal fibroblasts and keratinocytes, chondrocytes, Schwann cells, bone marrow derived mesenchymal stem cells and adipose tissue derived mesenchymal stem cells have been successfully cultured in these meshes. The same scaffolds, in tube meshes, has been applied for vascular tissue engineering that has emerged as a promising technology for the design of an ideal, responsive, living conduit with properties similar to that of native tissue

Genome-wide association meta-analysis identifies 48 risk variants and highlights the role of the stria vascularis in hearing loss

Hearing loss is one of the top contributors to years lived with disability and is a risk factor for dementia. Molecular evidence on the cellular origins of hearing loss in humans is growing. Here, we performed a genome-wide association meta-analysis of clinically diagnosed and self-reported hearing impairment on 723,266 individuals and identified 48 significant loci, 10 of which are novel. A large proportion of associations comprised missense variants, half of which lie within known familial hearing loss loci. We used single-cell RNA-sequencing data from mouse cochlea and brain and mapped common-variant genomic results to spindle, root, and basal cells from the stria vascularis, a structure in the cochlea necessary for normal hearing. Our findings indicate the importance of the stria vascularis in the mechanism of hearing impairment, providing future paths for developing targets for therapeutic intervention in hearing loss