Safety and efficacy of intra-arterial fibrinolytics as adjunct to mechanical thrombectomy: A systematic review and meta-analysis of observational data

Background: Achieving the best possible reperfusion is a key determinant of clinical outcome after mechanical thrombectomy (MT). However, data on the safety and efficacy of intra-arterial (IA) fibrinolytics as an adjunct to MT with the intention to improve reperfusion are sparse. Methods: We performed a PROSPERO-registered (CRD42020149124) systematic review and meta-analysis accessing MEDLINE, PubMed, and Embase from January 1, 2000 to January 1, 2020. A random-effect estimate (Mantel-Haenszel) was computed and summary OR with 95% CI were used as a measure of added IA fibrinolytics versus control on the risk of symptomatic intracranial hemorrhage (sICH) and secondary endpoints (modified Rankin Scale ≤2, mortality at 90 days). Results: The search identified six observational cohort studies and three observational datasets of MT randomized-controlled trial data reporting on IA fibrinolytics with MT as compared with MT alone, including 2797 patients (405 with additional IA fibrinolytics (100 urokinase (uPA), 305 tissue plasminogen activator (tPA)) and 2392 patients without IA fibrinolytics). Of 405 MT patients treated with additional IA fibrinolytics, 209 (51.6%) received prior intravenous tPA. We did not observe an increased risk of sICH after administration of IA fibrinolytics as adjunct to MT (OR 1.06, 95% CI 0.64 to 1.76), nor excess mortality (0.81, 95% CI 0.60 to 1.08). Although the mode of reporting was heterogeneous, some studies observed improved reperfusion after IA fibrinolytics. Conclusion: The quality of evidence regarding peri-interventional administration of IA fibrinolytics in MT is low and limited to observational data. In highly selected patients, no increase in sICH was observed, but there is large uncertainty

Nefelometr fotoelektryczny do badań białek i innych makromolekularnych składników żywności

Wysunięto propozycję nowej konstrukcji nefelometru fotoelektrycznego do badań biofizycznych. Modulacja strumienia świetlnego padającego na ośrodek rozpraszający zapewnia wysoką czułość wykrywania. Pomiary wykazują, że nefelometr pozwala na rejestrację bardzo małych wyników dostrzegalnych na tle zaburzeń i szumów. Urządzenie można stosować do badania wielkocząsteczkowych składników artykułów żywnościowych

Effect of soy whey on fermentation properties of wheat and rye flours

Celem pracy było określenie wpływu dodatku serwatki sojowej na właściwości fermentacyjne mąki pszennej typu 750 i żytniej typu 720. Serwatkę sojową stosowano jako zamiennik wody w ilości 50 i 100 % w stosunku do ilości wody używanej w próbie kontrolnej, prowadzonej bez serwatki. Zaobserwowano korzystny wpływ dodatku serwatki na właściwości fermentacyjne mąki. Pozytywne efekty uzyskano zwłaszcza w przypadku mieszaniny serwatki sojowej i wody w stosunku 1 : 1. Stwierdzono wówczas wzrost ogólnej ilości ditlenku węgla wydzielonego podczas fermentacji ciasta pszennego o 9 %, a żytniego – o 10 % oraz wzrost ilości gazu zatrzymanego przez badane ciasta odpowiednio: o 4 i 9 %. Całkowite zastąpienie wody serwatką sojową pozwoliło istotnie zmniejszyć czas fermentacji ciasta pszennego do rozrostu optymalnego o 38 %, natomiast ciasta żytniego – o 11 %. Nie zaobserwowano wyraźnych zmian pod względem jakości badanych kleików pszennych i żytnich po wprowadzeniu serwatki sojowej. Odnotowano tylko nieznaczny wzrost początkowej temperatury kleikowania w przypadku wszystkich zawiesin sporządzonych z jej udziałem. Dodatek do mąki 50-procentowego roztworu serwatki spowodował zwiększenie aktywności amylolitycznej danej próby, co znalazło wyraz w postaci obniżenia liczby opadania mąki pszennej średnio o 3 %, a mąki żytniej – o 13 %. Przeprowadzone badania wskazują, że serwatka sojowa może być stosowana jako naturalny regulator zdolności gazotwórczej mąki, zwłaszcza żytniej.The objective of the research study was to determine the effect of soy whey on fermentation properties of wheat flour of type 750 and rye flour of type 720. Soy whey was added as a substitute of water and its amount was 50 % and 100 % by weight of water used in the control sample prepared without soy whey. I was found that the soy whey added had a favourable effect on the fermentation properties of flour. In particular, positive results were obtained for the 1: 1 mixture of soy whey and water. In the latter case, it was found that the total quantity of carbon dioxide released during fermentation of wheat flour dough increased by 9 % and that of rye flour dough by 10 %, and the quantity of gas trapped in the doughs analysed increased by 4 and 9 %, respectively. In the case of replacing 100 % of water with soy whey, it was possible to significantly reduce the fermentation time of wheat flour to the optimum growth of 38 % and that of the rye flour dough to 11 %. No apparent changes were found in the quality of the wheat and rye gruels with the soy whey added. Only a slight increase in the initial gelatinization temperature was reported for all the suspensions made with the soy whey added. A 50 % solution of whey added to the flour caused the amylolytic activity in the sample to increase, and the result thereof was a reduction in the falling number of wheat flour by 3 % on average, and that of rye flour by ca. 13 %. The research study performed suggests that the soy whey can be used as a natural regulator of the gas-generating ability of flours, especially of rye flour

Correlation of Collateral Scores Derived from Whole-Brain Time-Resolved Flat Panel Detector Imaging in Acute Ischemic Stroke.

BACKGROUND AND PURPOSE Flat panel detector CT imaging allows simultaneous acquisition of multiphase flat panel CTA and flat panel CTP imaging directly in the angio suite. We compared collateral assessment derived from multiphase flat panel CTA and flat panel CTP with collateral assessment derived from DSA as the gold-standard. MATERIALS AND METHODS We performed a retrospective analysis of patients with occlusion of the first or second segment of the MCA who underwent pre-interventional flat panel detector CT. The hypoperfusion intensity ratio as a correlate of collateral status was calculated from flat panel CTP (time-to-maximum > 10 seconds volume/time-to-maximum > 6 seconds volume). Intraclass correlation coefficients were calculated for interrater reliability for the Calgary/Menon score for multiphase flat panel CTA and for the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) score for DSA collateral scores. Correlations of the hypoperfusion intensity ratio, multiphase flat panel CTA score, and the ASITN/SIR score were calculated using the Spearman correlation. RESULTS From November 2019 to February 2020, thirty patients were included. Moderate interrater reliability was achieved for the ASITN/SIR DSA score (0.68; 95% CI, 0.50-0.82) as well as for the Calgary/Menon multiphase flat panel CTA score (0.53; 95% CI, 0.29-0.72). We found a strong correlation between the ASITN/SIR DSA and Calgary/Menon multiphase flat panel CTA score (ρ = 0.54, P = .002) and between the hypoperfusion intensity ratio and the Calgary/Menon multiphase flat panel CTA score (ρ = -0.57, P < .001). The correlation was moderate between the hypoperfusion intensity ratio and the ASITN/SIR DSA score (ρ = -0.49, P = .006). The infarct core volume correlated strongly with the Calgary/Menon multiphase flat panel CTA score (ρ = -0.66, P < .001) and the hypoperfusion intensity ratio (ρ = 0.76, P < .001) and correlated moderately with the ASITN/SIR DSA score (ρ = -0.46, P = .01). CONCLUSIONS The Calgary/Menon multiphase flat panel CTA score and the hypoperfusion intensity ratio correlated with each other and with the ASITN/SIR DSA score as the gold-standard. In our cohort, the collateral scoring derived from flat panel detector CT was clinically reliable

Balloon-assisted coil embolization and large stent delivery for cerebral aneurysms with a new generation of dual lumen balloons (Copernic 2L).

Dual coaxial lumen balloon microcatheters through which small stents can be delivered have recently been described. We report a series of a new type of dual lumen balloon catheter with a parallel lumen design enabling enhanced inflation and deflation properties through which larger stents may be deployed, including flow diverters (FD). All aneurysms that were treated with a Copernic 2L (COP2L) dual lumen balloon catheter at our institution between February 2014 and December 2016 were assessed. Patient demographics, aneurysm characteristics, clinical and angiographic follow-up, as well as adverse events were analyzed. A total of 18 aneurysms in 16 patients (14 women) were treated with the COP2L. Mean maximal aneurysm diameter was 6.4 mm, mean neck size was 3.3 mm (min 1; max 6.3), and mean aneurysm height/width was 1.1 (min 0.5; max 2.1). The COP2L was used for balloon-remodeled coiling exclusively in 2 aneurysms; coiling and FD stenting in 8; coiling and braided stent delivery in 3; coiling, braided and FD stenting in 1; and FD stenting without coiling in 4 (stenting alone). The rate of Roy-Raymond 1 (complete occlusion) changed from 22% in the immediate postoperative period to 100% at 3 months (mean imaging follow-up 8.2 months). There were three technical complications (3/16, 18.7%), including a perforation and two thromboembolic asymptomatic events that were rapidly controlled with the COP2L. There was no immediate or delayed morbidity or mortality (modified Rankin Scale score 0-1 in 100% of patients). The COP2L is a new type of dual lumen balloon catheter that may be useful for balloon and/or stent-assisted coiling of cerebral aneurysms. The same device can be used to deliver stents up to 4.5 mm and to optimize stent/wall apposition or serve as a life-saving tool in case of thromboembolic or hemorrhagic events. Long-term efficacy and safety need to be further assessed with larger case-controlled cohorts