Stent-assisted embolization of wide-neck anterior communicating artery aneurysms: Review of consecutive 34 cases

Objective We report our experience with stent-assisted coiling of anterior communicating artery aneurysms with special consideration of angiographic and clinical outcomes, retreatment rate and periprocedural complications. Materials and methods The analysis included 34 consecutive ruptured and unruptured wide-neck aneurysms. The aneurysm size ranged from 2 to 18mm (mean 5.47). Clinical examinations with the use of modified Rankin Score and angiographic outcomes were evaluated initially post-embolization and at a minimum follow-up of 6 months. Results Initial post-treatment complete and near-complete aneurysm occlusion was achieved in 32 (94%) and 2 (6%) cases, respectively. Imaging follow-up, performed in 28 (82%) patients, showed no change in the degree of occlusion in 25 (89%) cases and coil compaction in 3 (11%) patients. Of these, one (3.6%) patient underwent a second coil embolization. The periprocedural severe complication rate was 2.9% (1/35) and was associated with prolonged attempt of retrieval of migrated coil resulting in anterior cerebral artery infarct with serious clinical consequences. In another 3 patients periprocedural adverse events without delayed clinical consequences were noticed. The clinical follow-up evaluation achieved in 33 (97%) patients showed no change in 30 (91%) cases, one patient (3%) with clinical improvement and two (6%) cases of neurological deterioration. Conclusions The use of stent is feasible and effective for coil embolization of wide-necked anterior communicating artery aneurysms. Although periprocedural complications resulting in severe morbidity are rare, they should be noted, since in terms of thromboembolic events some of them presumably have a potential to be avoidable

Low back pain in pregnant wome

Pain of lumbosacral segment of the vertebral column and the pelvis concerns about 45% of all pregnant women. The change of the body posture during pregnancy is the result of gravity centre relocation, which affects the musculosceletal system. Development of the joint, ligament and myofascial dysfunctions, as well as the pain in the lumbosacral segment and the pelvis, are the most common reasons of spine pain. The aim of this review is to present the current state of knowledge about lumbar spine pain in pregnant women with special focus on the pain connected with muscular, joint and ligament disorders. Pregnancy is a serious burden for the female osteo-skeletal system. Lumbar pain with different location and intensification is the negative consequence of the position changes during pregnancy. Pharmacotherapy could be useful only in cases of intensive low back pain, with possible application of small spectrum of drugs that are safe during pregnancy. Physical therapy, including manual therapy, exercises, massage and techniques of local anesthesia are alternative methods in case of low back pain in pregnant women

A Worldwide Test of the Predictive Validity of Ideal Partner Preference-Matching

©American Psychological Association, [2024]. This paper is not the copy of record and may not exactly replicate the authoritative document published in the APA journal. The final article is available, upon publication, at: [ARTICLE DOI]”Ideal partner preferences (i.e., ratings of the desirability of attributes like attractiveness or intelligence) are the source of numerous foundational findings in the interdisciplinary literature on human mating. Recently, research on the predictive validity of ideal partner preference-matching (i.e., do people positively evaluate partners who match versus mismatch their ideals?) has become mired in several problems. First, articles exhibit discrepant analytic and reporting practices. Second, different findings emerge across laboratories worldwide, perhaps because they sample different relationship contexts and/or populations. This registered report—partnered with the Psychological Science Accelerator—uses a highly powered design (N=10,358) across 43 countries and 22 languages to estimate preference-matching effect sizes. The most rigorous tests revealed significant preference-matching effects in the whole sample and for partnered and single participants separately. The “corrected pattern metric” that collapses across 35 traits revealed a zero-order effect of β=.19 and an effect of β=.11 when included alongside a normative preference-matching metric. Specific traits in the “level metric” (interaction) tests revealed very small (average β=.04) effects. Effect sizes were similar for partnered participants who reported ideals before entering a relationship, and there was no consistent evidence that individual differences moderated any effects. Comparisons between stated and revealed preferences shed light on gender differences and similarities: For attractiveness, men’s and (especially) women’s stated preferences underestimated revealed preferences (i.e., they thought attractiveness was less important than it actually was). For earning potential, men’s stated preferences underestimated—and women’s stated preferences overestimated—revealed preferences. Implications for the literature on human mating are discussed.Unfunde

Nordic Walking – nowa forma ćwiczeń w rehabilitacji

Nordic Walking (NW) has become a popular form of physical activity. NW is a form of outdoor physical activity based on marching with use of poles adapted from cross–country skiing. The main goal of using the poles is to involve muscles, which are not used during normal walking. This enables performing high intensity exercises with a relatively low level of perceived exertion. The history, methodology and technique of Nordic Walking were presented in this paper. Moreover, possible role of Nordic Walking in physical rehabilitation, in particular in early cardiac rehabilitation, was discussed. This paper is based on the available data from the literature and on our own experience concerning the application of Nordic Walking in rehabilitation of patients early after a myocardial infarction. This study was performed in patients admitted to the Centre of Cardiac Rehabilitation in Kiekrz. NW is added as an additional training to standard rehabilitation program comprising ergometer endurance training and callisthenics. The literature review focused mainly on the usefulness of Nordic Walking in rehabilitation of various groups of patients, such as the elderly, patients with pain, and patients with neurological or cardiovascular disorders. The available evidence suggests that Nordic Walking is a natural and safe, yet intensive, form of physical activity that can be widely used in physical rehabilitation.W niniejszej pracy przedstawiono dostępną wiedzę o historii, metodyce i technice, coraz bardziej popularnej formy ćwiczeń ruchowych, znanych jako Nordic Walking (NW). NW jest formą aktywności ruchowej w terenie, której głównym elementem jest marsz., przy wykorzystaniu kijków zaadaptowanych z narciarstwa biegowego. Głównym celem używania kijków jest zaangażowanie mięśni nieużywanych podczas zwykłego marszu, przy zachowaniu wysokiej intensywności ćwiczeń i niskiego, subiektywnie odczuwanego poziomu zmęczenia. Zwrócono uwagę na możliwość zastosowania tej formy aktywności w rehabilitacji ruchowej – w tym wczesnej rehabilitacji kardiologicznej. W pracy wykorzystano informacje zawarte w dostępnej literaturze, a także doświadczenie własne z badań prowadzonych w tej dziedzinie, u pacjentów we wczesnym okresie po zawale mięśnia sercowego. Badania te są wykonywane u pacjentów Ośrodka Rehabilitacji Kardiologicznej w Kiekrzu. NW jest włączany, jako dodatkowy trening, w standardowy program rehabilitacji obejmujący ćwiczenia ogólnousprawniające i trening wytrzymałościowy na cykloergometrze. W przeglądzie piśmiennictwa skupiono się głównie na zastosowaniu Nordic Walking w rehabilitacji. Badania dotyczyły osób starszych, a także pacjentów z zespołami bólowymi, chorobami układu nerwowego i układu krążenia. Wyniki wskazują, że Nordic Walking to naturalna, bezpieczna a jednocześnie intensywna forma ruchu. Może być stosowana w różnych obszarach rehabilitacji

Deep Tissue Massage and Nonsteroidal Anti-Inflammatory Drugs for Low Back Pain: A Prospective Randomized Trial

Objective. To investigate whether chronic low back pain therapy with deep tissue massage (DTM) gives similar results to combined therapy consisting of DTM and non-steroid anti-inflammatory drugs (NSAID). Design. Prospective controlled randomized single blinded trial. Settings. Ambulatory care of rehabilitation. Participants. 59 patients, age 51.8 ± 9.0 years, with chronic low back pain. Interventions. 2 weeks of DTM in the treatment group (TG) versus 2 weeks of DTM combined with NSAID in the control group (CG). Main Outcome Measures. Visual analogue scale, Oswestry disability index (ODI), and Roland-Morris questionnaire (RM). Results. In both the TG and the CG, a significant pain reduction and function improvement were observed. VAS decreased from 58.3 ± 18.2 to 42.2 ± 21.1 (TG) and from 51.8 ± 18.8 to 30.6 ± 21.9 (CG). RM value decreased from 9.8 ± 5.1 to 6.4 ± 4.4 (TG), and from 9.3 ± 5.5 to 6.1 ± 4.6 (CG). ODI value decreased from 29.2 ± 17.3 to 21.4 ± 15.1 (TG) and from 21.4 ± 9.4 to 16.6 ± 9.4 (CG). All pre-post-treatment differences were significant; however, there was no significant difference between the TG and the CG. Conclusion. DTM had a positive effect on reducing pain in patients with chronic low back pain. Concurrent use of DTM and NSAID contributed to low back pain reduction in a similar degree that the DTM did

Test Fullerton jako miernik sprawności fizycznej osób starszych

General fitness establishes the quality of life, but it often decreases with age. Therefore, it becomes vital to find out a method of evaluationof individual fitness level and to design a targeted exercise programme. Assessment tools used hitherto, i.e. the Katz index, the Lawton scale, the Barthel index or the Eurofit tests for adults conducted using cycloergometer, have not met the expectations of researchers and practitioners. Physical fitness parameters such as strentgth, flexibility, coordination and endurance cannot be determined using these tools. They do not specify fitness parameters like strength and muscular endurance, mobility, dexterity, speed, body balance, motor coordination, reaction time, flexibility. All these parameters can be measured by the Fullerton Functional Fitness Test, invented by Roberta E. Rikli and C. Jessie Jones in the Lifespan Wellness Clinic at California State University in Fullerton. It uses 6 items to assess these parameters. Because of limitations resulting from age and coexisting diseases, it is required that some easy and safe motor patterns are used that should be based on everyday-day activities. It is safe for the adults, requires minimal equipment and can measure small unit changes. It is suitable even for patients with cardiovascular disease. If performed both before and after an individualized training, it enables identification of a problem, providing a targeted intervention programme and evaluation of its effects.Wiek niesie ze sobą często ograniczenia sprawności fizycznej, a ponieważ jest to podstawowy czynnik warunkujący jakość życia, coraz więcej uwagi poświęca się temu zagadnieniu. W związku z tym pojawia się problem metod oceny sprawności, które jednocześnie umożliwią programowanie treningów usprawniających oraz ocenę ich efektów. Stosowane do tej pory narzędzia pomiarowe takie jak między innymi skale Katza, Lawtona, Barthela, testy Eurofit dla dorosłych, nie spełniają oczekiwań badaczy i praktyków. Za ich pomocą nie można określić parametrów sprawności fizycznej, takich jak siła, elastyczność, koordynacja czy wytrzymałość. Badania w tym kierunku doprowadziły do opracowania w Stanach Zjednoczonych Testu Fullerton. Za pomocą 6 prób pozwala on ocenić wspomniane wyżej parametry. Jest to test bezpieczny, niewymagający specjalistycznego sprzętu, a co istotne, może być stosowany u osób starszych, w tym także poddawanych rehabilitacji. Test daje możliwość oceny nie tylko parametrów związanych z wydolnością sercowo-naczyniową organizmu, ale również ocenę sprawności ogólnej. Jego zastosowanie pozwala na zaplanowanie procesu usprawniania oraz ocenę jego przebiegu i efekt

Relationship between morphometric and mechanical properties of superficial lumbosacral soft tissue layers in healthy young adults

Introduction: It is commonly considered that myotonometry is a non-invasive method capable of quantifying linear elastic and viscoelastic properties of the myofascial tissue through the application of a weak mechanical impulse to the surface of the skin. However, before the impulse can reach the myofascial tissue, it must cross more superficial tissues such as the skin and subcutaneous tissue (ST). All these superficial tissues have different distributions and organizations of structural components. Therefore, the study aimed to examine the potential relationships between the mechanical and morphometric properties of various superficial soft tissues surrounding the lumbar multifidus muscle (LM).Methods: Myotonometric measurements of dynamic stiffness, logarithmic decrement, and creep, and ultrasonographic measurements of thickness and echogenicity of cutaneous, subcutaneous, perimuscular tissue, and LM were obtained from 50 healthy individuals in the resting prone position and during contralateral arm lift.Results: The most important findings were that in both the relaxed and contracted LM state, the dynamic stiffness strongly negatively (r = −0.69; p < 0.001 in relaxation, r = −0.83; p < 0.001 in contraction) and creep strongly positively (r = 0.79; p < 0.001 in relaxation, r = 0.85; p < 0.001 in contraction) correlated with the thicknesses of the ST. Similar but weaker correlations were noticed between both these measures and the perimuscular tissue thickness. Elasticity was uncorrelated to the thicknesses of the tissues. With LM contraction (change from the relaxed to contracted state), the relative increase in dynamic stiffness was correlated with the relative decrease in dermis (r = −0.51; p < 0.001) and ST (r = −0.47; p = 0.001) thickness, and with the relative increase in LM (r = 0.36; p = 0.010) thickness. Moreover, the relative decrease (thinning) in the ST thickness was correlated with the relative increase in logarithmic decrement (i.e., decrease in soft tissue elasticity, r = −0.37, p = 0.011). The mechanical properties of the soft tissues were not related to their echogenicity.Discussion: In conclusion, the thicker the subcutaneous and perimuscular layers, the lesser the stiffness and the greater the time-dependent deformation to the external force of the tissues surrounding the LM during its relaxation and isometric contraction. Moreover, the greater the thinning of the ST and the thickening of the LM during its contraction, the higher the increase in lumbosacral tissue stiffness and the decrease in elasticity. Therefore, one should consider the thickness of the ST before planning or analyzing the outcomes of myotonometric or other external biomechanical measurements to avoid drawing the wrong conclusions about the mechanical properties of the myofascial tissue

Irreversible electroporation in the treatment of locally advanced pancreas and liver metastases of colorectal carcinoma

Aim of the study : Irreversible electroporation is a new, non-thermal ablation technique in the treatment of parenchymal organ tumors which uses short high voltage pulses of electricity in order to induce apoptosis of targeted cells. In this paper the application of this method of treatment in locally advanced pancreatic cancer (LAPC) and liver cancer is analyzed. Material and methods : Between 04.2014 and 09.2014 two patients with LAPC and one with colorectal liver metastasis (CRLM) were qualified for treatment with irreversible electroporation. Both patients remained under constant observation and control. PubMed/Medline, Embase and Google Scholar databases were searched and eight original reports on irreversible electroporation of pancreatic and liver tumors based on the biggest groups of patients were found. Results : Two patients with LAPC and one with CRLM were qualified for ablation with irreversible electroporation. In all three patients a successful irreversible electroporation (IRE) procedure of the whole tumor was conducted. In the minimum seven-month follow-up 100% local control was achieved – without progression. In the literature review the local response to treatment ranged from 41% to 100%. The event-free survival rate in six-month observation was 94%. Conclusions : Ablation with irreversible electroporation is a new non-thermal ablation technique which has been demonstrated, both in the previously published studies and in the cases described in this paper, as a safe and efficient therapeutic method for patients with LAPC and CRLM

Suicidal tendencies under the influence of alcohol – a rational strategy in a psychiatric admission room. Preliminary report

Suicidal declarations made by patients intoxicated with alcohol are a common problem in the psychiatric practice. The following study was conducted in order to check how many patients who declared suicidal tendencies while intoxicated with alcohol, with no history of previous psychiatric treatment, still declare suicidal tendencies after being referred to a sobering‑up station. To this end, a study group consisting of 81 patients, aged 18 to 65 (mean 37.3) years old, 47 men and 34 women, brought to the Provincial Multidisciplinary Hospital No 4 Admission Room by the emergency due to suicidal tendencies, in period 01.06.2010‑31.05.2011, was analysed. The criteria of the group included no previous history of psychiatric treatment, alcohol blood concentration of at least one per mille, no other (i.e. internist) contraindications to referral to the sobering‑up station. Patients diagnosed with psychiatric illnesses other than alcohol dependency syndrome during the initial consultation were excluded from the study. A percentage of patients with persevering suicidal threat aftersobering‑up was calculated. The results show that among 81 patients referred to the sobering‑up station, suicidal tendencies were declared after sobering‑up by 7 (8.64%). Statistical significance was determined by using McNemar test to be p<0.001. None of the patients withdrawing from the suicidal tendencies appeared again in the admission room during the course of the study, also none of the patients died a suicidal death in this period, which was confirmed in police statistics. The study suggests that, considering the limited place in the psychiatric wards and hospitals, referring an intoxicated patient who declares suicidal tendencies to a sobering‑up station is a clinically‑confirmed course of action. The sobering‑up station guarantees strict scrutiny and impossibility of realizing the suicidal threat as well as specialist detoxification. It is imperative for the patient to be reconsulted by a psychiatrist after sobering‑up – the examination ought to include known suicide risk factors (i.e. as in standards of American Psychiatric Association).Deklaracje suicydalne pod wpływem alkoholu są częstym problemem w praktyce psychiatrycznej. Niniejsze badanie przeprowadzono celem sprawdzenia, jaki odsetek pacjentów zgłaszających się na psychiatryczną izbę przyjęć, będących pod wpływem alkoholu i jednocześnie deklarujących myśli suicydalne, dotychczas nieleczonych psychiatrycznie po wytrzeźwieniu w warunkach izby wytrzeźwień (IW) podtrzymuje, podczas rekonsultacji psychiatrycznej, zamiary suicydalne. W tym celu przeanalizowano 81 pacjentów w wieku od 18 do 65 lat, w tym 47 mężczyzn i 34 kobiety, przywiezionych przez zespół pogotowia ratunkowego na Izbę Przyjęć Wojewódzkiego Szpitala Specjalistycznego nr 4 w Bytomiu (IP WSS4) z powodu myśli suicydalnych, w okresie 01.06.2010‑31.05.2011 roku. Kryteria doboru grupy obejmowały brak wcześniejszego leczenia psychiatrycznego, stężenie alkoholu w surowicy na poziomie co najmniej jednego promila, brak innych (np. Internistycznych) przeciwwskazań do pobytu na IW. Z badania wykluczono pacjentów, u których podczas wstępnej konsultacji psychiatrycznej rozpoznano jednostki inne niż upojenie alkoholowe. Wyliczono odsetek pacjentów, u których po wytrzeźwieniu utrzymywało się zagrożenie suicydalne i którzy wymagali hospitalizacji psychiatrycznej. Jak pokazują wyniki, spośród 81 pacjentów odesłanych na IW myśli suicydalne po wytrzeźwieniu podtrzymywało 7 (8,64% wszystkich badanych). Do określenia istotności statystycznej zastosowano test McNemara, uzyskując poziom istotności p<0,001. Żaden z pacjentów wycofujących się z wcześniej zgłaszanych zamiarów suicydalnych nie trafił powtórnie na IP WSS4 podczas trwania badania, nie zginął także śmiercią samobójczą, co zweryfikowano w policyjnych statystykach. Z badania wynika, że wytrzeźwienie pacjenta w warunkach IW przed ewentualnym przyjęciem na oddział, biorąc pod uwagę ograniczoną liczbę miejsc na oddziałach psychiatrycznych, jest postępowaniem uzasadnionym klinicznie – IW gwarantuje zarówno ścisłą obserwację i brak możliwości realizacji zamiarów suicydalnych, jak i specjalistyczną detoksykację. Po wytrzeźwieniu bezwzględnie konieczna jest rekonsultacja psychiatryczna z określeniem ryzyka suicydium – badanie psychiatryczne powinno uwzględniać uznane czynniki ryzyka (np. w wytycznych Amerykańskiego Towarzystwa Psychiatrycznego)