Mechanical thrombectomy in acute stroke – Five years of experience in Poland

Objectives Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. Methods and results We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. Results Most of the CSCs (74%) were founded at University Hospitals and most (65.2%) work round the clock. In 78.3% of them, the working teams are composed of neurologists and neuro-radiologists. All CSCs perform CT and angio-CT before MT. In total 586 patients were subjected to MT and data from 531 of them were analyzed. Mean time laps from stroke onset to groin puncture was 250±99min. 90.3% of the studied patients had MT within 6h from stroke onset; 59.3% of them were treated with IV rt-PA prior to MT; 15.1% had IA rt-PA during MT and 4.7% – emergent stenting of a large vessel. M1 of MCA was occluded in 47.8% of cases. The Solitaire device was used in 53% of cases. Successful recanalization (TICI2b–TICI3) was achieved in 64.6% of cases and 53.4% of patients did not experience hemorrhagic transformation. Clinical improvement on discharge was noticed in 53.7% of cases, futile recanalization – in 30.7%, mRS of 0–2 – in 31.4% and mRS of 6 in 22% of cases. Conclusion Our results can help harmonize standards for MT in Poland according to international guidelines

Interactive web-based map and story map. A comparative analysis of touristic map of Tomaszów Mazowiecki city

Artykuł przedstawia wyniki analizy porównawczej map turystycznych Tomaszowa Mazowieckiego wykonanych w technologii ArcGIS on-line firmy ESRI, a mianowicie aplikacji interaktywnej mapy oraz mapy narracyjnej (story map). Analiza map pod kątem docelowej grupy użytkowników, zakresu udostępnianych informacji i stopnia interaktywności uzasadnia następujące stwierdzenia: mapa interaktywna jest prezentacją bardziej zaawansowaną i wymaga większych umiejętności kartograficznych zarówno od jej twórcy jak i użytkownika, natomiast mapa narracyjna jest łatwa w przygotowaniu i najczęściej pełni rolę przewodnika turystycznego po danym regionie lub obiekcie.The paper presents comparative analysis of two touristic maps created in the ESRI technology, namely interactive web-base map and story map of the Tomaszow Mazowiecki city. Based on set-up criteria: target user group, difficulty of application development, amount of displayed information, level of interactivity, the study shows that the interactive map gives the user more information, allows for higher interaction and is targeted at a wider audience, while, narrative map, while the narrative map is easier to prepare and usually acts as a tourist guide

Kamchatka Berry (<i>Lonicera caerulea</i> L.) Pomace Bioferment as an Innovative Cosmetic Raw Material

Kamchatka berries (Lonicera caerulea L.) are known for their high content of phenolic compounds or vitamins, which is reflected in their antibacterial, detoxifying and anti-inflammatory properties. They are used in the production of jams, juices, wines and as natural dye. A bioferment was prepared from the pomace of the Kamchatka berry varieties Aurora and Indigo Gem and the strains Saccharomyces cerevisiae and Lacticaseibacillus paracasei, which was used to prepare a cosmetic preparation with a concentration of 5% in accordance with the guidelines of the COSMOS certification body. We conducted physico-chemical and organoleptic analyses and bioactive profile characterisation (UHPLC-DAD and UHPLC-ESI-MS/MS). The results showed that the presence of caffeic acid (4.47 ± 0.07 mg/100 g) was detected after fermentation of Kamchatka berry pomace. In addition, vitamin C content increased by 141% after fermentation. The results of stability tests showed that in the process of physico-chemical analysis of the cosmetic preparation with bioferment of Kamchatka berry pomace, the pH should oscillate in the range of 4.38–4.76 ± 0.01. Stability tests showed that the cosmetic should be protected from high temperatures and UV radiation and proved that the product is stable under changing conditions, resulting in lower transport and storage costs

Trabajo de campo etnográfico : prácticas y Saberes

En la cátedra de Metodología y Técnicas de la Investigación de Campo se articulan los saberes de los estudiantes con el aprendizaje del oficio del trabajo de campo antropológico a partir de sus propios intereses de indagación. Esta obra se focaliza en la observación de fuentes escritas y en su empleo en medios audiovisuales, así como el uso de la entrevista antropológica en el testimonio de situaciones traumáticas. Se recupera el aprendizaje de la escritura etnográfica en modalidades particulares: informes finales de los estudiantes, la redacción de documentos analíticos en tesis de grado y para la divulgación científica.Libros de Cátedr

Mechanical thrombectomy in acute stroke : five years of experience in Poland

Objectives: Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. Methods and results: We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. Results: Most of the CSCs (74%) were founded at University Hospitals and most (65.2%) work round the clock. In 78.3% of them, the working teams are composed of neurologists and neuro-radiologists. All CSCs perform CT and angio-CT before MT. In total 586 patients were subjected to MT and data from 531 of them were analyzed. Mean time laps from stroke onset to groin puncture was 250 99 min. 90.3% of the studied patients had MT within 6 h from stroke onset; 59.3% of them were treated with IV rt-PA prior to MT; 15.1% had IA rt-PA during MT and 4.7% - emergent stenting of a large vessel. M1 of MCA was occluded in 47.8% of cases. The Solitaire device was used in 53% of cases. Successful recanalization (TICI2b–TICI3) was achieved in 64.6% of cases and 53.4% of patients did not experience hemorrhagic transformation. Clinical improvement on discharge was noticed in 53.7% of cases, futile recanalization - in 30.7%, mRS of 0–2 - in 31.4% and mRS of 6 in 22% of cases. Conclusion: Our results can help harmonize standards for MT in Poland according to international guideline

Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI) : a phase 3, placebo-controlled, randomised trial

Background: Patients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. These patients are generally treated with aspirin. In this trial, we aimed to investigate if these patients would benefit from treatment with aspirin plus ticagrelor. Methods: The Effect of Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study (THEMIS) was a phase 3 randomised, double-blinded, placebo-controlled trial, done in 1315 sites in 42 countries. Patients were eligible if 50 years or older, with type 2 diabetes, receiving anti-hyperglycaemic drugs for at least 6 months, with stable coronary artery disease, and one of three other mutually non-exclusive criteria: a history of previous PCI or of coronary artery bypass grafting, or documentation of angiographic stenosis of 50% or more in at least one coronary artery. Eligible patients were randomly assigned (1:1) to either ticagrelor or placebo, by use of an interactive voice-response or web-response system. The THEMIS-PCI trial comprised a prespecified subgroup of patients with previous PCI. The primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, or stroke (measured in the intention-to-treat population). Findings: Between Feb 17, 2014, and May 24, 2016, 11 154 patients (58% of the overall THEMIS trial) with a history of previous PCI were enrolled in the THEMIS-PCI trial. Median follow-up was 3·3 years (IQR 2·8–3·8). In the previous PCI group, fewer patients receiving ticagrelor had a primary efficacy outcome event than in the placebo group (404 [7·3%] of 5558 vs 480 [8·6%] of 5596; HR 0·85 [95% CI 0·74–0·97], p=0·013). The same effect was not observed in patients without PCI (p=0·76, p interaction=0·16). The proportion of patients with cardiovascular death was similar in both treatment groups (174 [3·1%] with ticagrelor vs 183 (3·3%) with placebo; HR 0·96 [95% CI 0·78–1·18], p=0·68), as well as all-cause death (282 [5·1%] vs 323 [5·8%]; 0·88 [0·75–1·03], p=0·11). TIMI major bleeding occurred in 111 (2·0%) of 5536 patients receiving ticagrelor and 62 (1·1%) of 5564 patients receiving placebo (HR 2·03 [95% CI 1·48–2·76], p<0·0001), and fatal bleeding in 6 (0·1%) of 5536 patients with ticagrelor and 6 (0·1%) of 5564 with placebo (1·13 [0·36–3·50], p=0·83). Intracranial haemorrhage occurred in 33 (0·6%) and 31 (0·6%) patients (1·21 [0·74–1·97], p=0·45). Ticagrelor improved net clinical benefit: 519/5558 (9·3%) versus 617/5596 (11·0%), HR=0·85, 95% CI 0·75–0·95, p=0·005, in contrast to patients without PCI where it did not, p interaction=0·012. Benefit was present irrespective of time from most recent PCI. Interpretation: In patients with diabetes, stable coronary artery disease, and previous PCI, ticagrelor added to aspirin reduced cardiovascular death, myocardial infarction, and stroke, although with increased major bleeding. In that large, easily identified population, ticagrelor provided a favourable net clinical benefit (more than in patients without history of PCI). This effect shows that long-term therapy with ticagrelor in addition to aspirin should be considered in patients with diabetes and a history of PCI who have tolerated antiplatelet therapy, have high ischaemic risk, and low bleeding risk