Association Between Left Atrial Appendage Morphology and Function and the Risk of Ischaemic Stroke in Patients with Atrial Fibrillation

AF is the most common cardiac arrhythmia and has been identified as an independent risk factor for stroke. The European Society of Cardiology guidelines recommend a thromboembolic event risk assessment based on the CHA2DS2-VASc score. However, stroke also occurs in some patients with a low CHA2DS2-VASc score. Therefore, it is necessary to find new factors to improve thromboembolic risk stratification in AF patients. Over 90% of embolic strokes are caused by thrombi originating from the left atrial appendage (LAA). Thus, certain anatomical or functional parameters of the LAA could potentially be used to predict cardioembolic stroke. Studies have suggested that some of these factors, such as LAA morphology, number of LAA lobes, LAA dimensions, LAA volume, distance from the LAA ostium to the first bend of LAA, LAA orifice diameter, extent of LAA trabeculations, LAA takeoff, LAA flow velocity and LAA strain rate, are independently associated with a higher risk of stroke in a population of patients with AF and improve the performance of the CHA2DS2-VASc score. However, the results are conflicting and, so far, no new parameter has been added to the CHA2DS2-VASc score

Reducing flower competition for assimilates by half results in higher yield of Fagopyrum esculentum

Despite abundant flowering throughout the season, common buckwheat develops a very low number of kernels probably due to competition for assimilates. We hypothesized that plants with a shorter flowering period may give a higher seed yield. To verify the hypothesis, we studied nutrient stress in vitro and in planta and analyzed different embryological and yield parameters, including hormone profile in the flowers. In vitro cultivated flowers on media with strongly reduced nutrient content demonstrated a drastic increase in degenerated embryo sacs. In in planta experiments, where 50% or 75% of flowers or all lateral ramifications were removed, the reduction of the flower competition by half turned out to be the most promising treatment for improving yield. This treatment increased the frequency of properly developed embryo sacs, the average number of mature seeds per plant, and their mass. Strong seed compensation under 50% inflorescence removal could result from increased production of salicylic and jasmonic acid that both favor more effective pollinator attraction. Plants in single-shoot cultivation finished their vegetation earlier, and they demonstrated greater single seed mass per plant than in control. This result suggests that plants of common buckwheat with shorter blooming period could deliver higher seed yield

Wound packing trainee construction

Haemorrhage is one of the main causes of death in injuries in both civilian and military conditions. Controlling bleeding is the most important task facing the rescuer when helping a casualty. There are many ways to control bleeding, but these methods are often misused. Most of the methods described have their roots in battlefield medicine developed on the basis of experience from armed conflicts. Currently, there is a clear trend towards adapting tactical medicine solutions for civil rescues because they are effective and simple. Increased awareness among civilian rescuers and regular training will hopefully lead to more effective help for injured people. The authors' work focused on the construction of an effective trainer to mimic a hip wound and a practical examination of how training affects the time to stop bleeding using the wound packing technique

Contemporary treatment options for male hypogonadism

Introduction Male hypogonadism is a disease in which testicular function is impaired. Its symptoms are due to testosterone deficiency and most of them show low specificity. These include reduced libido, erectile dysfunction and mood disorders, among others. The biochemical indicator of hypogonadism is a testosterone concentration below 350 ng/ml (12nmol/L), according to the European Association of Urology (EAU). The increased incidence of hypogonadism is associated with aging and the presence of comorbidities such as type II diabetes and obesity. Men with testosterone deficiency have an increased risk of cardiovascular disease and premature death. Goals Summary of current reports on the diagnosis and treatment of hypogonadism. An overview of the advantages and disadvantages of the different types of formulations used in testosterone replacement therapy. MethodsReview of literature available in PubMed and Google Scholar databases. Conclusions The medical interview, physical examination and ancillary tests help to classify hypogonadism appropriately. Measuring the concentration of gonadotropins, helps diversify primary from secondary hypogonadism. Testosterone replacement therapy (TRT) uses formulations that have varying release profiles, route of administration and drug formulation. The choice of testosterone product should involve age, lifestyle, and individual preferences of the patient

Obesity as a risk factor of in-hospital outcomes in patients with endometrial cancer treated with laparoscopic surgical mode

Objectives: Obesity has been suggested to have a negative influence on procedural outcomes of endometrial cancer laparoscopic treatment. Obesity and other possible risk factors of laparoscopic endometrial cancer treatment has not been precisely described in the literature. The aim of the study is to determine the factors that have the greatest influence on the course of laparoscopic surgery for endometrial cancer, with particular emphasis on the influence of obesity. Material and methods: The study included 75 females who were treated for endometrial cancer by laparoscopic surgery. Preoperative body-mass index (BMI), waist circumference(WC), waist to hip ratio(WHR), and selected anatomical indices were measured. The duration of surgery and hospitalization stay, loss of hemoglobin, and procedural-related complications served as parameters of in-hospital outcomes. Results: Multiple linear regression analysis indicate the body mass as most sensitive parameter of obesity which influence in-hospital outcomes in patients treated with laparoscopic procedure. Procedural-related complications occurred in the group of patients with significantly greater WC and BMI. Multiple linear regression indicates also histological grading (G1–G3), external conjugate, intertrochanteric distance as significant risk factors. The multiple linear regression analysis confirmed also that implementation of sentinel lymph node procedure is related with decreased hemoglobin loss in patients with cancer of endometrium compare to lymphadenectomy without sentinel node biopsy(Est.: 0.488; 95% CI: 0.083–0.892, p = 0.018). Conclusions: The most sensitive risk factor of in-hospital outcomes in laparoscopic treatment of endometrial cancer is body mass. The implementation of the sentinel node procedure is associated with reduced surgery time and reduced hemoglobin loss

Chronic migraine prevention from the perspective of a family doctor: a literature review

Chronic migraine is a disease that significantly reduces the quality of life of patients. It affects millions of people around the world, and is common particularly among young women. Family physicians often encounter the problem of migraine headaches in their daily practice. The diagnostic problem results from absence of tests or imaging studies that can clearly indicate the cause of the headache. In order to establish a diagnosis and exclude secondary sources of pain, doctors focus on a detailed medical history and analysis of symptoms presented over time. Preventive treatment of migraine requires appropriate drug selection after weighing the benefits and risks for each patient. This review paper presents and briefly discusses selected pharmacological and non-pharmacological methods used in migraine prevention. They were selected by searching the PubMed Internet database. The presented non-pharmacological methods include the use of nutraceutics, acupuncture and behavioral therapy. The discussed pharmacological methods include treatment with beta-blockers, topimarate, flunarizine or one of the latest methods - the use of monoclonal antibodies against CGRP. In addition, the use of botulinum toxin type A in the treatment of chronic migraine has also been demonstrated. It should be remembered that the type of therapy chosen should be individualized: according to the patient's preferences, treatment effectiveness, possible side effects or accompanying diseases. Proper management of chronic migraine prophylaxis can significantly improve the quality of life of patients and reduce the frequency of headache attacks

Uterine fibroids - a literature review

Uterine fibroids are the most common benign neoplastic lesions occurring in women. They are formed as a result of proliferation of smooth muscle tissue cells. Their appearance and proliferation are influenced by both genetic and environmental factors. 70% of them remain asymptomatic, so they are often detected only during a routine gynecological examination or pelvic imaging studies. Uterine myomas can generate pelvic and lower abdominal discomfort and pain, abnormal, prolonged, heavy bleeding, anemia, dyspareunia, frequent urination, bloating, constipation, abdominal cramps, low back pain and obstetric complications. Available therapeutic strategies include conservative, pharmacological and surgical treatment. The choice of a particular method is considered on an individual basis and depends on the presence of clinical symptoms, the size, location of the myomas, or the age and procreative plans of the patient

Obesity as a risk factor of in-hospital outcomes in patients with endometrial cancer treated with laparoscopic surgical mode

Objectives: Obesity has been suggested to have a negative influence on procedural outcomes of endometrial cancer laparoscopic treatment. Obesity and other possible risk factors of laparoscopic endometrial cancer treatment has not been precisely described in the literature. The aim of the study is to determine the factors that have the greatest influence on the course of laparoscopic surgery for endometrial cancer, with particular emphasis on the influence of obesity. Material and methods: The study included 75 females who were treated for endometrial cancer by laparoscopic surgery. Preoperative body-mass index (BMI), waist circumference(WC), waist to hip ratio(WHR), and selected anatomical indices were measured. The duration of surgery and hospitalization stay, loss of hemoglobin, and procedural-related complications served as parameters of in-hospital outcomes. Results: Multiple linear regression analysis indicate the body mass as most sensitive parameter of obesity which influence in-hospital outcomes in patients treated with laparoscopic procedure. Procedural-related complications occurred in the group of patients with significantly greater WC and BMI. Multiple linear regression indicates also histological grading (G1–G3), external conjugate, intertrochanteric distance as significant risk factors. The multiple linear regression analysis confirmed also that implementation of sentinel lymph node procedure is related with decreased hemoglobin loss in patients with cancer of endometrium compare to lymphadenectomy without sentinel node biopsy(Est.: 0.488; 95% CI: 0.083–0.892, p = 0.018). Conclusions: The most sensitive risk factor of in-hospital outcomes in laparoscopic treatment of endometrial cancer is body mass. The implementation of the sentinel node procedure is associated with reduced surgery time and reduced hemoglobin loss

The Nature of Interactions and UV-Induced Response within α-Zirconium Phosphate Intercalation Compounds with Azobenzenes

Azobenzenes immobilization on a solid support enables the usage of their trans-cis isomerization ability for preparation of functional materials. The behavior of azobenzenes in the interlayer space of α-zirconium phosphate (ZrP) upon the UV−Vis irradiation was investigated. Two experimental approaches were performed: (1) co-intercalation of benzylalkylammonium surfactants and azobenzene in the interlayers of ZrP (ZBCnA), and (2) intercalation of p-aminoazobenzene (ZpA). The materials were characterized with XRD, FTIR, UV−Vis, CHN analysis, and the molecular modeling. The molecules in ZBCnA samples were sparsely packed and held by weak hydrophobic interactions. Conversely, the molecules in ZpA sample were strongly H-bonded to the ZrP, well-ordered, and densely packed. These structural features determined the samples’ photoresponsive behavior. Low density of molecules in the ZBCnA samples, allowed the effective, fast, and reversible isomerization of azobenzene. Whereas the ZpA sample did not react to the UV irradiation because of the steric hindrance of tightly packed molecules

K-Ar dating of deformation of metasedimentary rocks from the Yargait Formation of the Zavkhan terrane (Khasagt Mountains, Mongolia) : preliminary results

The SW margin of the Zavkhan terrane is significant for research on Paleozoic amalgamation of the Central Asian Orogenic Belt (CAOB). The study area is located in the western part of the Khasagt Mountains, western Mongolia. We present a new preliminary K-Ar dating of metasedimentary rocks from the Yargait Formation which were deformed during collision of the Zavkhan terrane with the Lake Zone terrane. Our results include two dating that are similar to earlier data by other authors (Stípskáetal., 2010; Bold et al., 2016b). The first dating equal to 544.1 ±13.7 Ma can be interpreted as the age ofmetamorphism and the subduction of the SW margin ofthe Zavkhan terrane under the Lake Zone terrane during the late Ediacaran-early Cambrian. The second dating of 441.1 ±11.7 Ma indicates the Late Ordovician - Silurian regional extension event