Typical variant of takotsubo cardiomyopathy in oncological patients : two case reports and review of the literature

Takotsubo cardiomyopathy (TCM) represents an acute systolic left ventricular dysfunction typically triggered by severe psychological or physical stress. Oncological patients due to emotional distress of the diagnosis, proinflammatory and prothrombotic nature of cancer and also physical stress often following complex anticancer therapies are at high-risk of TCM. Moreover, there are also few reports of TCM associated with oncological treatment, mostly chemotherapy. Recent data from large registries indicate a surprisingly high incidence of malignancy in TCM, significant differences in clinical characteristics and unfavorable short- and long-term clinical outcomes in this specific group of patients. Therefore, we present two case reports of TCM that occurred during active anticancer therapy. Both women were admitted with suspicion of acute coronary syndrome. The first patient underwent mastectomy two years before due to hormone receptor-positive breast cancer and on admission she was during adjuvant hormonotherapy with tamoxifen. The admission of the second patient was preceded by fifteen fractions of adjuvant external beam radiotherapy due to intermediate-risk endometrial cancer after radical hysterectomy. Based on coronary angiography type I of acute coronary syndrome was excluded. Both patients negated stressful situations in the period immediately before the symptoms onset. Within hospital course baseline apical ballooning observed in both cases fully recovered and enabled subsequent completion of oncological treatment in accordance with adopted treatment protocols without recurrence of TCM. To our knowledge, presented cases are the first reports showing direct relationship between TCM and adjuvant hormonotherapy with tamoxifen or pelvic radiotherapy

Remote system for reading traffic signs and information

This paper presents an experimental system for remote communication between road users and traffic signs. Implemented solution consists of two modules: a transmitter (traffic sign), including novel system for remote waking-up by the passing vehicle with use of the quasi-passive (biased) diode detector circuit, and a receiver (vehicle), which is responsible for  wake-up signaling and interpreting received messages. Both modules use Wi‑Fi protocol operating in 2.4 GHz ISM band for sending data, and OOK signaling in 868 MHZ ISM band for sending wake-up signals. The paper provides theoretical analysis, description of design challenges and chosen solutions, and finally, laboratory measurements as well as the results of tests conducted in the systems’ target environment with a moving vehicle, confirming correct operation of the system

Isolated systolic hypertension — evaluation of the scale of the problem among medical students — pilot study

Introduction. Interest in isolated systolic hypertension (ISH) in young people has increased in recent years. The applanation tonometry technique provides new diagnostic opportunities in this group of patients. The aim of the study was to evaluate the incidence of ISH among young adults and factors contributing to its occurrence. Material and methods. One hundred and two medical students aged 21 to 26 years were examined. The study was based on three peripheral blood pressure measurements and central blood pressure measurement. Information on health status and physical activity was collected using the author-developed questionnaire. Results. Based on the mean of peripheral blood pressure measurements, hypertension (HT) was detected in 23 students (22.55%): 18 had ISH, 4 — combined systolic/diastolic HT and 1 — isolated diastolic HT. Pulse wave analysis showed that all individuals with ISH had central blood pressure within the normal range — higher than those without HT, but lower than in the combined systolic/diastolic HT group (p < 0.001). Subjects with ISH were characterized by higher pulse pressure amplitude and lower augmentation index (AIx) compared to those with normal blood pressure. Subjects with ISH were taller, had a higher body mass index (BMI) and were more likely to have a positive family history of HT compared to normotensives. They also reported more frequent coffee consumption; and 22% of them used creatine supplements (vs. 0% in non-HT group). Conclusions. Measurement of central arterial blood pressure by applanation tonometry should be an integral part of the assessment of young patients with ISH. The study confirmed that ISH patients are characterized by higher growth, weight and physical activity. Further studies are needed to assess the clinical significance of ISH

Preoperative thrombocytosis in surgically treated patients with non-small cell lung cancer

Lung cancer is the most common cause of cancer‑related death. Accurate and easy‑to‑use prognostic factors are necessary. Increased platelet count might be a potential prognostic factor. We aimed to investigate the relationship between thrombocytosis and stage of lung cancer and to assess the frequency and clinical importance of thrombocytosis in this patient group. We retrospectively analyzed hospital records of consecutive patients with non-small cell lung cancer (NSCLC) who underwent curative‑intent pulmonary resections. Of 323 patients, 285 patients with NSCLC were selected (mean [SD] age, 66.55 [8.52] years; men, 63.86%). Squamous cell carcinoma was diagnosed in 130 patients (45.61%); adenocarcinoma, in 128 (44.91%); large cell carcinoma, in 16 (5.61%); and adenosquamous carcinoma, in 11 (3.86%). The prevalence of preoperative thrombocytosis in the whole sample was 10.18% (n = 29). Anemia was more common in patients with thrombocytosis compared with those without thrombocytosis (65.52% vs 30.08%; P <0.001). Thrombocytosis was found in 22.41% of patients with stage III+IV cancer and in 3.82% of those with stage I (P <0.001). Moreover, in patients with no metastases (N0, M0 according to the 7th edition of the TNM classification), thrombocytosis was more frequent in the group with stage II than in that with stage I cancer (3.85% vs 20.00%; P = 0.002). Thrombocytosis was also more frequent in patients with N2 than with N1 disease (9.76% vs 23.81%; P = 0.09). Thrombocytosis is often observed in patients with NSCLC and is significantly associated with the higher stage of disease

Delayed thrombin generation is associated with minor bleedings in venous thromboembolism patients on rivaroxaban : usefulness of calibrated automated thrombography

leeding is the most feared and difficult to predict adverse event of anticoagulation. We sought to investigate whether calibrated automated thrombography (CAT) parameters are associated with minor bleeding (MB) in anticoagulated patients following venous thromboembolism (VTE). Enrolled were 132 patients on rivaroxaban, 145 on vitamin K antagonists (VKA) and 31 controls who stopped anticoagulation. Prior to the next dose of the anticoagulant, we measured CAT parameters, along with rivaroxaban concentration and INR. During a median follow-up of 10 months, we recorded minor and major bleedings. On rivaroxaban, 27 (20.5%) patients with MB had longer time to start thrombin generation, lower peak thrombin generation and lower endogenous thrombin potential compared with subjects without MB (all p < 0.001). All CAT parameters, except for peak thrombin generation (p = 0.049), were similar in VKA patients with (n = 25, 17.2%) vs. without MBs. By logistic regression, time to start thrombin generation (p = 0.007) and unprovoked VTE (p = 0.041) independently predicted MBs on rivaroxaban. Major bleedings were more frequent in patients with MBs (17.3% vs. 1.8%, p < 0.001). Abnormal CAT parameters characterize VTE patients prone to MBs on rivaroxaban, but not on VKA. Time to start thrombin generation measured about 24 h since the last rivaroxaban dose might help predict MBs

Topsoil texture maps based on calibration of soil electrical conductivity with soil datasets varying in size

The purpose of the study was to verify the possibility of creation of reliable soil texture class (STC) maps of a topsoil based on a linear calibration of shallow (0-30cm) soil electrical conductivity (ECsh) with small datasets of soil samples with laboratory determined STC . ECsh values were calibrated against four datasets of soil samples. The smallest datasets (5-6 soil samples per field) were selected: 1) in an arbitrary way; or 2) based on the quartiles of ECsh values. A dataset of an intermediate size (11-17 points) and a full dataset of all ST data available (33-38 points) were also tested. For one field, the calibration with ECsh quartiles produced STC maps with greater agreement with field's status than the complete dataset of laboratory results. Although, the root mean square errors and mean absolute errors were greater for quartiles than for the other datasets. The ECsh values depended on the content of fine soil (&lt;2 mm) fractions to a depth of 90 cm, so ECsh measurements are efficient in mapping the topsoil texture of fields with relatively uniform texture in subsoil. The datasets, which produced lower values of errors did not always permit to prepare more accurate STC maps.