Регионарная анестезия при каротидной эндартерэктомии у пациентов в остром периоде ишемического инсульта (пилотное исследование)

Objective. The aim of this study is to assess the safety of the use of regional anesthesia for performing carotid endarterectomy (CEA) in patients in the acute phase of ischemic stroke.Material and methods. The study included 66 patients in the acute phase of ischemic stroke (atherothrom botic subtype according to the TOAST classification) who underwent carotid endarterectomy. The inclusion criteria for the study were as follows: acute phase of atherothrombotic ischemic stroke (first 28 days), ipsilateral symptomatic “ 50% stenosis of the internal carotid artery, 1–4 points neurological deficit according to the mod ified Rankin Scale (mRS), 1–13 points neurological deficit according to the National Institutes of Health Stroke Scale (NIHSS), size of the cerebral ischemic lesion ™ 4 cm. This singlecenter prospective cohort study compared two anesthetic approaches, regional anesthesia (RA, 46 patients) and general anesthesia (GA, 20 patients). The RA techniques included ultrasoundguided superficial and deep cervical plexus blocks on the side of the surgery.Results. The study found no significant differences in the baseline patient characteristics, surgery techniques and clinical outcomes between the groups. There were no neurological or cardiovascular toxic reactions to the local anesthetics. Conversions from RA to GA were not performed. In the RA group, recurrent ipsilateral ischemic strokes, myocardial infarctions, wound hemorrhagic complications and lethal outcomes did not occur.Conclusion. This pilot study has demonstrated the safety of RA for performing CEA in patients in the acute phase of ischemic stroke. RA provides adequate neuromonitoring and timely intraoperative recognition of «new» ischemic complications. To compare the efficacy of RA and GA for performing CEA in patients with acute ischemic stroke, large randomized controlled trials are needed.Цель исследования. Оценка безопасности регионарной анестезии при выполнении каротидной эндартерэктомии (КЭЭ) у пациентов в остром периоде ишемического инсульта.Материалы и методы. В одноцентровое проспективное когортное исследование включили 66 паци ентов в остром периоде ишемического инсульта, соответствующего атеротромботическому подтипу по классификации TOAST, которым была выполнена КЭЭ. Критериями включения являлись: ишемический инсульт атеротромботического подтипа (первые 28 дней), ипсилатеральный ишемическому инсульту стеноз ВСА 50% и более, неврологический дефицит 1–4 балла по модифицированной шкале Rankin, нев рологический дефицит 1–13 баллов по шкале инсульта NIHSS, размер ишемического очага в головном мозге не более 4 см. Сравнили два анестезиологических подхода — регионарную анестезию (РА) и общую анестезию (ОА). У 46 пациентов применяли РА, у 20 больных — ОА. РА выполняли под ультразвуковой навигацией в объеме блокады поверхностного и глубокого шейных сплетений на стороне операции.Результаты. Статистически значимых различий в исходных характеристиках пациентов, особен ностях хирургических операций и клинических исходах между группами не выявили. Токсических реакций на местный анестетик в виде неврологических или сердечнососудистых реакций не отме тили. Конверсии с РА на ОА не выполняли. На госпитальном этапе повторного ишемического ипси латерального инсульта, инфаркта миокарда, раневых геморрагических осложнений, а также леталь ных исходов в группе РА не произошло.Заключение. В пилотном исследовании продемонстрировали безопасность РА при выполнении КЭЭ у пациентов в остром периоде ишемического инсульта. РА позволяет осуществлять адекватный нейромониторинг и своевременную интраоперационную диагностику «новых» ишемических ослож нений. Для сравнения эффективности РА и ОА при КЭЭ у пациентов в остром периоде ишемического инсульта необходимо проведение крупных рандомизированных исследований

Nanotechnology in peripheral nerve repair and reconstruction

The recent progress in biomaterials science and development of tubular conduits (TCs) still fails in solving the current challenges in the treatment of peripheral nerve injuries (PNIs), in particular when disease-related and long-gap defects need to be addressed. Nanotechnology-based therapies that seemed unreachable in the past are now being considered for the repair and reconstruction of PNIs, having the power to deliver bioactive molecules in a controlled manner, to tune cellular behavior, and ultimately guide tissue regeneration in an effective manner. It also offers opportunities in the imaging field, with a degree of precision never achieved before, which is useful for diagnosis, surgery and in the patientâ s follow-up. Nanotechnology approaches applied in PNI regeneration and theranostics, emphasizing the ones that are moving from the lab bench to the clinics, are herein overviewed.The authors acknowledge the Portuguese Foundation for Science and Technology (FCT) for the financial support provided to Joaquim M. Oliveira (IF/01285/2015) and Joana Silva-Correia (IF/00115/2015) under the program “Investigador FCT”.info:eu-repo/semantics/publishedVersio

Mycorrhi zalfungi of the fir-grove near the brook

36 species of mycorrhizal fungi from 14 genera and 8 families were found in the fir-grove near the brook. Families Russulaceae, Cortinariaceae and Tricholomataceae include the largest number of species. The predominance of these families emphasizes the boreal character of the researched area

Monitoring of agarics of lichen-reedgrass pine forest

Agarics have been monitored with a stationary method since 1975 until the present in the lichen-reedgrass pine forest (the Perm Territory, the southern taiga subzone). 1st period of monitoring — 1975–1977; 2nd — 1994–1996; 3rd — 2010–2012. 194 species of agarics were found during all the periods. Plants composition has been changing greatly (Jaccard index: JI–II =33; JII–III =28; JI–III =37). Yet mushrooms composition has been rather stable (JI–II =96; JII–III =70; JI–III =73). Most species are in families Cortinariaceae, Tricholomataceae and Russulaceae. Mycorhiza mushrooms prevail (60.3 %). In the Perm region in the southern taiga subzone monitored agaricoid Basidiomycetes stationary method since 1975. Presents some data for pine lichen-reed species composition of fungi, ecological and trophic groups and the dominant species of fungi

Optical studies of nanodiamond-tissue interaction:skin penetration and localization

Abstract In this work, several optical-spectroscopic methods have been used to visualize and investigate the penetration of diamond nanoparticles (NPs) of various sizes (3–150 nm), surface structures and fluorescence properties into the animal skin in vitro. Murine skin samples have been treated with nanodiamond (ND) water suspensions and studied using optical coherence tomography (OCT), confocal and two-photon fluorescence microscopy and fluorescence lifetime imaging (FLIM). An analysis of the optical properties of the used nanodiamonds (NDs) enables the selection of optimal optical methods or their combination for the study of nanodiamond–skin interaction. Among studied NDs, particles of 100 nm in nominal size were shown to be appropriate for multimodal imaging using all three methods. All the applied NDs were able to cross the skin barrier and penetrate the different layers of the epidermis to finally arrive in the hair follicle niches. The results suggest that NDs have the potential for multifunctional applications utilizing multimodal imaging

Informative feature selection method for Raman micro-spectroscopy data

The paper presents an algorithm based on low order statistics for the informative feature extraction for Raman spectroscopy data. The proposed method was tested on mouse preimplantation embryos Raman spectra. Both supervised and unsupervised machine learning methods were applied to selected the most informative features to test the separability of the processed data