16 research outputs found
Micro-timing of backchannels in human-robot interaction
Inden B, Malisz Z, Wagner P, Wachsmuth I. Micro-timing of backchannels in human-robot interaction. Presented at the Timing in Human-Robot Interaction: Workshop in Conjunction with the 9th ACM/IEEE International Conference on Human-Robot Interaction (HRI2014), Bielefeld, Germany
Pineal cyst-related sleep disorders – a narrative review
The pineal gland is an endocrine gland, which is responsible for the human circadian rhythm, through the regulation of its hormone – melatonin. The most common pathology of a pineal gland is pineal cyst – its population incidence is estimated as 1-23%, depending on the publication. The most common symptoms of a pineal cyst include headache (87%), visual field defects (54%), nausea/vomiting (34%), and dizziness/vertigo (31%). Among the majority of patients with the asymptomatic pineal cyst, the wait-and-see strategy is proper.
According to the newest meta-analyze, the prevalence of sleep disturbances among patients with pineal cyst estimates to be 17%. The results of direct melatonin level measurements in pineal cysts remain unclear. The study focused on sleep disturbances in pediatric patients with pineal cysts and showed a significantly higher score on Sleep Disturbance Scale for Children (SDSC) in the domains of disorders of excessive sleepiness and disorders of initiating and maintaining sleep than the control groups. The impact of lesion on sleep quality correlated with its size.
The pineal cyst may be considered a rare, and potentially reversible, cause of sleep disorders. Nevertheless, according to the present reports (often opposite to each other), this thesis and the mechanism of its occurrence need to be further researched
Psoriasiform lesions as a side effect of SGLT-2 therapy
SGLT-2 inhibitors (flozins) are one of the new classes of anti-diabetic drugs, used from 2012. They are highly recommended in case of intolerance or contraindication of metformin, but in Poland they are used usually as third-line drug after metformin and sulfonylurea. They growing popularity is caused by their significance in cardiovascular risk reduction and preventive role in according to diabetes complications like chronic kidney disease, or diabetes-induced dementia. The aid of this article is to summarize the knowledge on the risk of psoriasis development in diabetic patients cured with flozins.
In according to the newest studies, flozins may be considered as a pro-psoriatic factor, increasing the risk of this skin disease, especially in patients with diabetic kidney disease. But on the other hand, SGLT-2 inhibitors have significantly decreasing effect on cardiovascular risk, which is increased in psoriatic patients
From focal epilepsy to Dravet syndrome – Heterogeneity of the phenotype due to SCN1A mutations of the p.Arg1596 amino acid residue in the Nav1.1 subunit
Objective
The aim of this study was to analyze the intra-/interfamilial phenotypic heterogeneity due to variants at the highly evolutionary conservative p.Arg1596 residue in the Nav1.1 subunit.
Materials/participants
Among patients referred for analysis of the SCN1A gene one recurrent, heritable mutation was found in families enrolled into the study. Probands from those families even clinically diagnosed with atypical Dravet syndrome (DS), generalized epilepsy with febrile seizures plus (GEFS+), and focal epilepsy, had heterozygous p.Arg1596 His/Cys missense substitutions, c.4787G>T and c.4786C>T in the SCN1A gene.
Method
Full clinical evaluation, including cognitive development, neurological examination, EEGs, MRI was performed in probands and affected family members in developmental age. The whole SCN1A gene sequencing was performed for all probands. The exon 25, where the identified missense substitutions are localized, was directly analyzed for the other family members.
Results
Mutation of the SCN1A p.1596Arg was identified in three families, in one case substitution p.Arg1596Cys and in two cases p.Arg1596His. Both mutations were previously described as pathogenic and causative for DS, GEFS+ and focal epilepsy. Spectrum of phenotypes among presented families with p.Arg1596 mutations shows heterogeneity ranged from asymptomatic cases, through FS and FS+ to GEFS+/Panayiotopoulos syndrome and epilepsies with and without febrile seizures, and epileptic encephalopathy such as DS. Phenotypes differ among patients displaying both focal and generalized epilepsies. Some patients demonstrated additionally Asperger syndrome and ataxia.
Conclusion
Clinical picture heterogeneity of the patients carrying mutation of the same residue indicates the involvement of the other factors influencing the SCN1A gene mutations’ penetrance
Multidisciplinary approach for a severe head burn caused by high-voltage electrical shock - a case report
In modern reconstructive medicine, personalized bone substitutes provide therapeutic hope for patients with non-standard bone defects. The study aims to present a description of a case of using a personalized bone substitute material, taking into account the vascular connections formed after a previous skin transplant.
The 29-year-old patient was admitted to the plastic surgery department urgently after being electrocuted with high voltage. Due to extensive scalp burns, a skin graft was performed in the area of previously removed skin along with a charred skull bone vault.
After a few months, the patient was qualified for cranioplasty with the use of personalized bone substitutes. The necessity to make cuts around the vascular connections present in the transplanted tissue was the main difficulty in the for the operator.
The operation was successful and the recovery was uneventful. The patient was discharged home in good general and local condition.
The presented case illustrates the need to take into account creating vascular connections with the use of personalized bone substitutes in patients after skin transplants
Severe course of radiation-induced meningioma — a new insight in screening for patients after radiotherapy?
Meningiomas, being mostly benign tumours, are derived from the arachnoid cap cells. Their etiopathogenesis is based on various factors, including past radiation. The presented case of a 25-year-old patient, who developed a radiation-induced superior sagittal sinus meningioma based on his past head radiation distributed during acute lymphocytic leukaemia. The tumour’s clinical image presented at first as headache, nausea, and dizziness, computer tomography and subsequently MRI were performed. The imaging examination revealed a very extensive, contrast-enhanced tumour mass located centrally on both sides and within the superior sagittal sinus. With the most likely diagnosis of parasagittal meningioma, the patient was qualified for tumour excision. The surgery was performed successfully resulting in maximal safe subtotal resection. After the surgery, the patient developed complications including hydrocephalus, which resulted in 5-months long hospitalization. The presented case illustrated the need for increased clinical attention in patients threatened by radiation (including radiotherapy), focused on possible head lesions
Evaluation of plasma adiponectine concentration in relation to selected cardiovascular risk factors in patients with essential hypertension
Wstęp W dostępnym piśmiennictwie istnieje niewielka
liczba doniesień, w których oceniano stężenie
adiponektyny w osoczu u chorych z łagodnym nadciśnieniem
pierwotnym, bez współistniejących powikłań
narządowych, zaburzeń metabolicznych oraz
chorób układu sercowo-naczyniowego. Celem pracy
była ocena stężenia adiponektyny w osoczu u chorych
z nowo wykrytym niepowikłanym nadciśnieniem
tętniczym pierwotnym w odniesieniu do wybranych
czynników ryzyka sercowo-naczyniowego.
Materiał i metody Do badania włączono 54 chorych
w wieku 20-50 lat (śr. wieku 38 ± 8,5 roku),
z nowo wykrytym, dotychczas nieleczonym hipotensyjnie
nadciśnieniem tętniczym. Z badania wykluczono
chorych z otyłością, zespołem metabolicznym,
powikłaniami narządowymi nadciśnienia tętniczego
oraz współistniejącymi chorobami, między innymi
układu sercowo-naczyniowego. Grupę kontrolną stanowiły
53 zdrowe osoby w wieku 20–50 lat (śr. wieku
38 ± 9,5 roku), dobrane pod względem płci, wieku,
wskaźnika masy ciała i zawartości tkanki tłuszczowej
z prawidłowym ciśnieniem tętniczym. U wszystkich
chorych włączonych do badania wykonywano
kliniczne pomiary ciśnienia tętniczego, ABPM,
badania biochemiczne (w tym oznaczenie stężenia adiponektyny), badanie echokardiograficzne oraz badanie
Doppler duplex tętnic nerkowych.
Wyniki Porównywane grupy nie różniły się istotnie
pod względem wieku, płci, ocenianych parametrów
biochemicznych oraz pod względem wskaźnika
masy ciała, procentowej zawartości tkanki tłuszczowej
oraz obwodu talii. Nie stwierdzono statystycznie
znamiennych różnic w stężeniu adiponektyny w osoczu
między chorymi z nadciśnieniem pierwotnym
a grupą kontrolną (6,70 ± 3,79 µg/ml vs. 5,70 ±
2,95 µg/ml, NS). Stężenie adiponektyny w osoczu
było istotnie wyższe u kobiet niż u mężczyzn, zarówno
u chorych z nadciśnieniem tętniczym, jak
i w grupie kontrolnej. W grupie chorych z nadciśnieniem
pierwotnym oraz u osób z prawidłowym
ciśnieniem tętniczym nie wykazano korelacji pomiędzy
stężeniem adiponektyny w osoczu a wartościami
ciśnienia skurczowego oraz rozkurczowego, ocenianymi
w ABPM w ciągu całej doby, w czasie dnia
oraz w godzinach nocnych. W całej grupie badanej,
u chorych z nadciśnieniem pierwotnym oraz w grupie
kontrolnej wykazano istnienie odwrotnej zależności
między stężeniem adiponektyny w osoczu
a obwodem talii (odpowiednio: r = -0,52, p < 0,0001,
r = -0,61, p < 0,001 i r = -0,46, p < 0,0001). Wykazano
również zależność między stężeniem adiponektyny
w osoczu a stężeniem cholesterolu frakcji HDL
i triglicerydów. Obserwowano ujemną korelację między
stężeniem adiponektyny w osoczu a masą lewej komory.
Nie stwierdzono korelacji między stężeniem adiponektyny
w osoczu a wskaźnikiem masy lewej komory serca.
Wnioski Uzyskane wyniki nie wskazują na istnienie
prostej zależności między stężeniem adiponektyny
w osoczu a wysokością ciśnienia skurczowego i rozkurczowego.
Uzyskane wyniki mogą wskazywać na
związek między stężeniem adiponektyny i rozwojem
zaburzeń metabolicznych u chorych z nadciśnieniem
tętniczym bez uchwytnych klinicznie zmian
narządowych oraz bez zespołu metabolicznego
i chorób współistniejących.Background Clinical trials have shown that adiponectin
levels were significantly decreased in patients with severe
hypertension, insulin resistance and other cardiovascular
disorders eg coronary artery disease. The objective of our
study was to evaluate the role of adiponectin in mild and
moderate hypertension, and to estimate its relationship
with metabolic risk factors in hypertensive patients.
Material and methods The study included 2 groups.
Group 1 consisted of 54 untreated persons aged 38 ± 8.5,
with mild to moderate essential hypertension; group 2
- 53 healthy subjects aged 38 ± 9.5 with normal blood
pressure. Patients with obesity, severe hypertension, organ
damage due to hypertension and with other cardiovascular
disorders were not included. In both groups antropometric
(BMI, body mass index, waist circumference) and biochemical
parametres including plasma adiponectin concentration
were evaluated. ABPM, echocardiography and renal
arteries ultrasound examination were also performed.
Results There was no significant difference in concentration
of adiponectin in plasma beetwen hypertensive patients
(6.7 ± 3.79 µg/ml) and control group (5.7 ± 2.95 µg/ml).
Both hypertensive and normotensive women were characterized
by higher plasma adiponectin concentration as
compared with respectively hypertensive and normotensive
men. In both groups positive correlation between
adiponectine and concentration of HDL-cholesterol
(p < 0.0001; r = 0.56) was found. In both groups negative
correlations between adiponectine plasma concentration
and BMI, waist circumference, creatinine and triglicerides
concentrations were also found.
Conclusions In our study there was no significant difference
between plasma adiponectin concentration. These
data may suggest relationship between plasma adiponectin
concentration and the development of metabolic abnormalities
in patients with mild to moderate hypertension without organ damage or concomitant cardiovascular
diseases and metabolic syndrome
The Incidence, Localization and Clinical Relevance of Arterial Fenestrations and Their Association to Brain Aneurysms: A Case–Control Study Based on the STROBE Guidelines
Background: Fenestrations are rare, but well-known, vascular variations of the cerebral arteries. They are mostly incidental, asymptomatic angiographic findings and might precipitate vascular lesions such as AVM, aneurysmal dilatation, or even ischemic symptoms. However, association between arterial fenestration and brain aneurysms has not been clearly established. Objective: To evaluate whether incidence of arterial fenestrations are associated with brain aneurysm development and investigate the prevalence and most-common localizations of arterial fenestrations of the human brain. Design: Case–control study. Setting: All patients examined by CT angiography in University Hospital No. 4 in Lublin from 2009 to 2019. Patients: Each patient showing at least one cerebral aneurysm was included in the case group and each patient without cerebral aneurysm on CT angiography was included in the control group. Measurements: CT angiography examinations were conducted using the standard protocol used in the 1st Department of Radiology, Medical University of Lublin, Poland. The database and statistical research were conducted by use of the Statistica software (ver. 13.3, Tibco Software Inc., Palo Alto, CA, USA). Results: A total of 6545 CTA examinations were included in the study. Most of the aneurysms were located on the MCA: 629 (38.59%), ICA: 466 (28.59%) and AComA: 192 (11.78%). Cerebral arterial fenestration showed a non-statistically significant elevated risk for brain aneurysms in the entire study population (OR: 1.157; 95% CI: 0.826–1.621; p = 0.39). Among 6545 cranial CTA examinations, cerebral vessel fenestration was found in 49 of them, which constituted 0.75%. The most common vascular fenestrations were those located in the ACA (30.61%), BA (30.61%) and AComA (22.45%), while other fenestrations occurred infrequently. There were no significant differences in the age of patients in the individuals with vascular fenestration (p > 0.05). VA fenestration was slightly more common in men (16.67%) than in women (5.41%). However, these differences were not statistically significant (p = 0.216). Limitations: Our study has several limitations, including selection bias regarding examined population. Second, we assume that the total number of fenestrations detected in our study was underestimated due to the limitations of the CT method in comparison to other radiologic modalities. Conclusions: Cerebral arterial fenestrations are rare vascular malformations. The ACA is the most common localization of fenestrations, followed by BA and AComA. Fenestrations of cerebral arteries insignificantly increase the risk of cerebral aneurysm formation. Further prospective studies are necessary to make this association more precise
Metallic Implants Used in Lumbar Interbody Fusion
Over the last decade, pedicle fixation systems have evolved and modifications in spinal fusion techniques have been developed to increase fusion rates and improve clinical outcomes after lumbar interbody fusion (LIF). Regarding materials used for screw and rod manufacturing, metals, especially titanium alloys, are the most popular resources. In the case of pedicle screws, that biomaterial can be also doped with hydroxyapatite, CaP, ECM, or tantalum. Other materials used for rod fabrication include cobalt–chromium alloys and nitinol (nickel–titanium alloy). In terms of mechanical properties, the ideal implant used in LIF should have high tensile and fatigue strength, Young’s modulus similar to that of the bone, and should be 100% resistant to corrosion to avoid mechanical failures. On the other hand, a comprehensive understanding of cellular and molecular pathways is essential to identify preferable characteristics of implanted biomaterial to obtain fusion and avoid implant loosening. Implanted material elicits a biological response driven by immune cells at the site of insertion. These reactions are subdivided into innate (primary cellular response with no previous exposure) and adaptive (a specific type of reaction induced after earlier exposure to the antigen) and are responsible for wound healing, fusion, and also adverse reactions, i.e., hypersensitivity. The main purposes of this literature review are to summarize the physical and mechanical properties of metal alloys used for spinal instrumentation in LIF which include fatigue strength, Young’s modulus, and corrosion resistance. Moreover, we also focused on describing biological response after their implantation into the human body. Our review paper is mainly focused on titanium, cobalt–chromium, nickel–titanium (nitinol), and stainless steel alloys
Biological and Clinical Aspects of Metastatic Spinal Tumors
Spine metastases are a common life-threatening complication of advanced-stage malignancies and often result in poor prognosis. Symptomatic spine metastases develop in the course of about 10% of malignant neoplasms. Therefore, it is essential for contemporary medicine to understand metastatic processes in order to find appropriate, targeted therapeutic options. Thanks to continuous research, there appears more and more detailed knowledge about cancer and metastasis, but these transformations are extremely complicated, e.g., due to the complexity of reactions, the variety of places where they occur, or the participation of both tumor cells and host cells in these transitions. The right target points in tumor metastasis mechanisms are still being researched; that will help us in the proper diagnosis as well as in finding the right treatment. In this literature review, we described the current knowledge about the molecular pathways and biomarkers engaged in metastatic processes involving the spine. We also presented a current bone-targeted treatment for spine metastases and the emerging therapies targeting the discussed molecular mechanisms