Reversal of antithrombotic treatment in intracranial hemorrhage – A review of current strategies and guidelines

In the last few years, there has been a rapid increase in patients being treated with various anticoagulation and antiplatelet agents. In clinical neurology, these drugs are administered for primary and secondary stroke prevention or to avoid the consequences of immobilization of severe stroke patients. Additionally, thrombolytic intravenous therapy and, recently, intra-arterial therapy for stroke have been increasingly employed all over the world. These therapies are associated with an increased risk of hemorrhage, including the most dangerous, intracranial hemorrhage. The knowledge of the standards for the treatment of hemorrhagic complications in the central nervous system is crucial for doctors in neurology and stroke units as well as in emergency rooms. Therefore, we conducted a review of various guidelines and recommendations, including manufacturers’ opinions contained in the summaries of product characteristics (Polish and British or European versions), in Guidelines of the Polish Neurological Society and in international and American guidelines i.e., European Stroke Organization (ESO) and American Heart Association/American Stroke Association (AHA/ASA). In addition, we compared these guidelines with expert opinions published in recent manuscripts and manuals on intensive care in neurology

The Museum of Józef Szajna and Synthesis of the Arts: Documentation Relating to the Context of Multi-media Works of Art – the Protection of His Ideas

The preservation of the identity of a complex work of modern art is a difficult challenge for the curator and conservator. The aim of this text is to demonstrate the preservation of a complex work of modern art, through the documentation of its context. The case study concerns the environment Replika created by Józef Szajna in 1971. The preparation of the documentation of the object is preceded by research intended to investigate and define the full significance of this sort of Gesamkunstwerk. The work of Szajna is an example of Total Art. The concept of his environment involves the combination of the material artwork and its message (including the use of readymades), the creation of a theatrical space with the use of lighting and a special atmosphere. The entire combination of the work is necessary in case of its re-exhibition. Conservation through documentation is a solution to the problem of maintaining the authenticity of a work of art which displays features of a Gesamtkunstwerk. In the past museums or galleries were collections of material objects, while today they are collections of works of art distant from the traditional “fine arts” disciplines: hybrid, comprehensive works of art, including those partially or entirely ephemeral. This problem is followed by the issue of the presentation of works of art in a way which includes the ideological and social context and the Artist’s creative individuality. A lot has been achieved throughout the last decade as far as the issue of documentation of works of art integrating various media is concerned. The issue, however, is still a challenge for a conservator-curator. The documentation procedures are facilitated thanks to the creation of various initiatives’ networks and further development of models, standards and tools as well as by the organisation of training sessions. The documentation forms that include various strategies for the protection of interdisciplinary and ephemeral works of art (reconstruction, re-enactment, emulation and reinterpretation) gradually enter the repertoire of methods used to protect world cultural heritage. The language of Szajna’s art gives full expression to this artist’s total creative personality. The moment when a work of art that integrates various media is displayed again is a key test for the effectiveness of its protection strategies. This problem is followed by the issue of the presentation of an artwork in a way which includes the ideological and social context and the artist’s creative individuality. The documentation programs developed by scientists, conservators and artists show the ways to display works of a complex nature, connected with a given space and which aim to engage the viewer. The reception and interaction of the viewer must lead first to the emotional and then the intellectual levels. Its role in fulfilling the meaning of the work leads the viewer through free interpretation. In phenomenological interpretations, the reaction of the viewer is a component element of the work. Therefore is it important that the complex and multi-componential works are each time re-installed in accordance with the original intention of the author which is expressed in the documentation. In my work as conservator and curator I wish to show the necessity of treating the work and the means of preserving its integrity in an homogeneous manner

The Prognostic Value of Cancer Stem Cell Markers (CSCs) Expression—ALDH1A1, CD133, CD44—For Survival and Long-Term Follow-Up of Ovarian Cancer Patients

Recurrent disease and treatment-associated chemoresistance are the two main factors accounting for poor clinical outcomes of ovarian cancer (OC) patients. Both can be associated with cancer stem cells (CSCs), which contribute to cancer formation, progression, chemoresistance, and recurrence. Hence, this study investigated whether the expression of known CSC-associated markers ALDH1A, CD44, and CD133 may predict OC patient prognosis. We analyzed their expression in primary epithelial ovarian cancer (EOC) patients using immunohistochemistry and related them to clinicopathological data, including overall survival (OS) and progression-free survival (PFS). Expression of ALDH1A1 was detected in 32%, CD133 in 28%, and CD44 in 33% of cases. While Kaplan–Meier analysis revealed no association of the expression of CD133 and CD44 with PFS and OS, ALDH1A1-positive patients were characterized with both significantly shorter OS (p = 0.00022) and PFS (p = 0.027). Multivariate analysis demonstrated that the expression of ALDH1A1, FIGO stage III–IV, and residual disease after suboptimal debulking or neoadjuvant chemotherapy correlated with shorter OS. The results of this study identify ALDH1A1 as a potential independent prognostic factor of shorter OS and PFS in EOC patients. Therefore, targeting ALDH1A1-positive cancer cells may be a promising therapeutic strategy to influence the disease course and treatment response

Baseline characteristics of stroke patients.

<p>Baseline characteristics of stroke patients.</p

Kaplan-Meier curves of mortality in groups with higher and lower TTR (transthyretin) level (above and under the mean value– 46.9 mg/dl) (P = 0.02).

<p>Kaplan-Meier curves of mortality in groups with higher and lower TTR (transthyretin) level (above and under the mean value– 46.9 mg/dl) (P = 0.02).</p

Univariate and multivariate logistic regression analysis for unfavorable outcome.

<p>Univariate and multivariate logistic regression analysis for unfavorable outcome.</p

Predictive value of serum transthyretin for outcome in acute ischemic stroke - Fig 1

<p><b>(A). Serum transthyretin levels in stroke patients with favorable (mRS score <3) and unfavorable (mRS score</b> ≥ <b>3–6) outcomes. (B). Serum transthyretin levels in survivor and non-survival stroke patients.</b> All data are medians and interquartile ranges (IQR) with minimum and maximum values.</p

Temporal changes in regulatory T cell subsets defined by the transcription factor Helios in stroke and their potential role in stroke-associated infection: a prospective case–control study

Abstract Background Regulatory T cells (Tregs) are involved in the systemic immune response after ischemic stroke. However, their role remains unclear, and the effect appears to be both neuroprotective and detrimental. Treg suppressor function may result in immunodepression and promote stroke-associated infection (SAI). Thus we assume that the bidirectional effects of Tregs may be in part attributed to the intracellular transcription factor Helios. Tregs with Helios expression (H+ Tregs) constitute 70–90% of all Treg cells and more frequently than Helios-negative Tregs (H− Tregs) express molecules recognized as markers of Tregs with suppressor abilities. Methods and results We prospectively assessed the circulating Treg population with flow cytometry in 52 subjects on days 1, 3, 10 and 90 after ischemic stroke and we compared the results with those obtained in concurrent age-, sex- and vascular risk factor-matched controls. At all studied time points the percentage of H+ Tregs decreased in stroke subjects—D1: 69.1% p < 0.0001; D3: 62.5% (49.6–76.6), p < 0.0001; D10: 60.9% (56.5–72.9), p < 0.0001; D90: 79.2% (50.2–91.7), p = 0.014 vs. controls: 92.7% (81.9–97.0) and the percentage of H− Tregs increased accordingly. In patients with SAI the percentage of pro-suppressor H+ Tregs on post-stroke day 3 was higher than in those without infection (p = 0.03). After adjustment for confounders, the percentage of H+ Tregs on day 3 independently correlated with SAI [OR 1.29; CI 95%: 1.08–1.27); p = 0.02]. Although the percentage of H+ Tregs on day 3 correlated positively with NIHSS score on day 90 (rS = 0.62; p < 0.01) and the infarct volume at day 90 (rS = 0.58; p < 0.05), in regression analysis it was not an independent risk factor. Conclusions On the first day after stroke the proportion of H+ vs. H− Tregs changes in favor of pro-inflammatory H− Tregs, and this shift continues toward normalization when assessed on day 90. A higher percentage of pro-suppressive H+ Tregs on day 3 independently correlates with SAI and is associated positively with NIHSS score, but it does not independently affect the outcome and stroke area in the convalescent phase of stroke

Effect of Radiant Catalytic Ionization and Ozonation on <i>Salmonella</i> spp. on Eggshells

Three Salmonella enterica strains were used in the study (serovars: S. enteritidis, S. typhimurim and S. virchow). This study evaluated the efficacy of radiant catalytic ionization (RCI) and ozonation against Salmonella spp. on eggshell (expressed as log CFU/egg). The egg surface was contaminated three different bacterial suspension (103 CFU/mL, 105 CFU/mL and 108 CFU/mL) with or without poultry manure. Experiments were conducted at 4 °C and 20 °C in three different time period: 30 min, 60 min and 120 min. Treatment with RCI reduced Salmonella numbers from 0.26 log CFU/egg in bacterial suspension 108 CFU/mL, 4 °C and 20 °C, with manure for 30 min to level decrease in bacteria number below the detection limit (BDL) in bacterial suspension 105 CFU/mL, 20 °C, with or without manure for 120 min. The populations of Salmonella spp. on eggs treated by ozonizer ranged from 0.20 log CFU/egg in bacteria suspension 108 CFU/mL, 20 °C, with manure for 30 min to 2.73 log CFU/egg in bacterial suspension 105 CFU/mL, 20 °C, with manure for 120 min. In all treatment conditions contamination with poultry manure decrease effectiveness the RCI and ozonation. In summary, RCI technology shows similar effectiveness to the ozonation, but it is safer for poultry plant workers and consumers