Selected hormone levels and lipid abnormalities in patients with acne vulgaris

Introduction

Acne vulgaris is one of the most common dermatological diseases. Hormonal imbalance affects the skin condition and results in the formation of acne vulgaris lesions.

Aim

To evaluate serum levels of testosterone, prolactin, luteinizing hormone (LH), follicle-stimulating hormone (FSH), triglycerides (TG), and high-density lipoprotein (HDL) in patients with acne vulgaris and compare them to healthy population.

Material and methods

Forty-one patients with acne vulgaris and 47 age- and body mass index (BMI)-matched controls were enrolled in the study.

Results

The mean ± SD testosterone serum level in the study group was 0.45 ±1.03 ng/ml in females and 4.24 ±0.68 in males and in the control group 0.73 ±2.03 ng/ml and 5.3 ±1.3 ng/ml in females and males, respectively. The prolactin serum level was 16.73 ±8.02 ng/ml in the study group and in the control group 13.74 ±8.71 ng/ml (p = 0.011). The FSH serum level was 12.17 ±16.93 mIU/ml and 6.2 ±7.3 mIU/ml in the study and control groups, respectively (p = 0.0001), whereas LH serum levels were 18.44 ±19.71 mIU/ml and 11.26 ±8 mIU/ml, respectively (p = 0.2659). The HDL serum level was 65.63 ±15.67 mg/dl in the study group and 61.53 ±15.89 mg/dl in the control group (p = 0.219), and TG levels were 175.29 ±82.15 mg/dl and 87.32 ±30.64 mg/dl, respectively (p < 0.00001).

Conclusions

Our study demonstrates, that hormonal and lipid imbalance could be linked to acne vulgaris formation. Evaluation of hormonal and lipid abnormalities could help in treatment decisions and could affect the occurrence of complications and the course of acne.

A comprehensive review and meta-analysis of suPAR as a predictor of acute kidney injury

INTRODUCTION AND OBJECTIVE

The global impact of acute kidney injury (AKI) has not been thoroughly investigated. With the development of new techniques, soluble urokinase plasminogen activator receptor (suPAR) has become increasingly important in the diagnosis of AKI. Therefore, a systematic review and meta-analysis was carried out to evaluate the predictive value of suPAR for AKI.

MATERIAL AND METHODS

The review and meta-analysis investigated the relationship between suPAR levels and acute kidney injury. Pubmed, Scopus, Cochrane Controlled Register of Trials, and Embase were searched for relevant studies from inception to 10 January 2023. Stata (Ver. 16 StataCorp, College Station, TX, USA) was used for all statistical analyses. A random effects model using the Mantel-Haenszel approach was employed, and odds ratios (OR) and standard mean differences (SMD) with 95% confidence intervals (CI) were calculated for binary and continuous outcomes, respectively.

RESULTS

Nine studies reported suPAR levels among patients with and without AKI. Pooled analysis showed that suPAR levels in patients with and without AKI varied and amounted to 5.23 ± 4.07 vs. 3.23 ±0.67 ng/mL (SMD = 3.19; 95%CI: 2.73 to 3.65; p<0.001). The results from the sensitivity analysis did not alter the direction.

CONCLUSIONS

This results show that increasing suPAR levels are associated with the occurrence of AKI. SuPAR might act as a novel biomarker for CI-AKI in clinical practice.

The Lack of Synergy between Carvedilol and the Preventive Effect of Dexrazoxane in the Model of Chronic Anthracycline-Induced Cardiomyopathy

The anticancer efficacy of doxorubicin (DOX) is dose-limited because of cardiomyopathy, the most significant adverse effect. Initially, cardiotoxicity develops clinically silently, but it eventually appears as dilated cardiomyopathy with a very poor prognosis. Dexrazoxane (DEX) is the only FDA-approved drug to prevent the development of anthracycline cardiomyopathy, but its efficacy is insufficient. Carvedilol (CVD) is another product being tested in clinical trials for the same indication. This study's objective was to evaluate anthracycline cardiotoxicity in rats treated with CVD in combination with DEX. The studies were conducted using male Wistar rats receiving DOX (1.6 mg/kg b.w. i.p., cumulative dose: 16 mg/kg b.w.), DOX and DEX (25 mg/kg b.w. i.p.), DOX and CVD (1 mg/kg b.w. i.p.), or a combination (DOX + DEX + CVD) for 10 weeks. Afterward, in the 11th and 21st weeks of the study, echocardiography (ECHO) was performed, and the tissues were collected. The addition of CVD to DEX as a cardioprotective factor against DOX had no favorable advantages in terms of functional (ECHO), morphological (microscopic evaluation), and biochemical alterations (cardiac troponin I and brain natriuretic peptide levels), as well as systemic toxicity (mortality and presence of ascites). Moreover, alterations caused by DOX were abolished at the tissue level by DEX; however, when CVD was added, the persistence of DOX-induced unfavorable alterations was observed. The addition of CVD normalized the aberrant expression of the vast majority of indicated genes in the DOX + DEX group. Overall, the results indicate that there is no justification to use a simultaneous treatment of DEX and CVD in DOX-induced cardiotoxicity.

Dexmedetomidine Increases MMP-12 and MBP Concentrations after Coronary Artery Bypass Graft Surgery with Extracorporeal Circulation Anaesthesia without Impacting Cognitive Function: A Randomised Control Trial

Postoperative neurological deficits remain a concern for patients undergoing cardiac surgeries. Even minor injuries can lead to neurocognitive decline (i.e., postoperative cognitive dysfunction). Dexmedetomidine may be beneficial given its reported neuroprotective effect. We aimed to investigate the effects of dexmedetomidine on brain injury during cardiac surgery anaesthesia. This prospective observational study analysed data for 46 patients who underwent coronary artery bypass graft surgery with extracorporeal circulation between August 2018 and March 2019. The patients were divided into two groups: control (CON) with typical anaesthesia and dexmedetomidine (DEX) with dexmedetomidine infusion. Concentrations of the biomarkers matrix metalloproteinase-12 (MMP-12) and myelin basic protein (MBP) were measured preoperatively and at 24 and 72 h postoperatively. Cognitive evaluations were performed preoperatively, at discharge, and 3 months after discharge using Addenbrooke's Cognitive Examination version III (ACE-III). The primary endpoint was the ACE-III score at discharge. Increased MMP-12 and MBP concentrations were observed in the DEX group 24 and 72 h postoperatively. No significant differences in ACE-III scores were observed between the groups at discharge; however, the values were increased when compared with initial values after 3 months (p = 0.000). The current results indicate that the administration of dexmedetomidine as an adjuvant to anaesthesia can increase MMP-12 and MBP levels without effects on neurocognitive outcomes at discharge and 3 months postoperatively.

Self-compassion mediates the relationship between self-esteem and social anxiety symptoms in socially anxious individuals

Introduction

Fear of evaluation and a negative view of the self are the key characteristics of social anxiety, which is one the most prevalent anxiety problem. Self-esteem refers to views of oneself, including individual’s personal feelings towards self, whereas self-compassion refers to caring attitude toward oneself. Both constructs are two distinct positive views of the self, and were found to be related to each other, well-being and good mental health. To date, however, little is known, how they interplay in people with predominantly negative view of themselves, that is in socially anxious individuals.

Objectives

The current research aims at evaluating how social anxiety interacts with self-esteem and self-compassion and to assess whether self-compassion, mediates the relationship between social anxiety and self-esteem.

Methods

In this research, 388 adult participants with elevated social anxiety level (LSAS score M = 81.47, SD = 21.20) were recruited via open calls posted on the Internet and completed measures of social anxiety, self-compassion, and self-esteem.

Results

In accordance with the view that individuals with social anxiety tend to have negative mental representation of the self, we found that both self-esteem and self-compassion correlated negatively with social anxiety, and positively with one another. More importantly, self-compassion partially mediates the relationship between self-esteem and social anxiety.

Conclusions

These findings suggest that self-compassion may play an important role in buffering against social anxiety and suggest that enhancing self-compassion might be beneficial for reducing symptoms of social anxiety

Disclosure

No significant relationships.

Topological transitions in an oscillatory driven liquid crystal cell

Matter under different equilibrium conditions of pressure and temperature exhibits different states such as solid, liquid, gas, and plasma. Exotic states of matter, such as Bose-Einstein condensates, superfluidity, chiral magnets, superconductivity, and liquid crystalline blue phases are observed in thermodynamic equilibrium. Rather than being a result of an aggregation of matter, their emergence is due to a change of a topological state of the system. These topological states can persist out of thermodynamics equilibrium. Here we investigate topological states of matter in a system with injection and dissipation of energy by means of oscillatory forcing. In an experiment involving a liquid crystal cell under the influence of a low-frequency oscillatory electric field, we observe a transition from a non-vortex state to a state in which vortices persist, topological transition. Depending on the period and the type of the forcing, the vortices self-organise, forming square lattices, glassy states, and disordered vortex structures. The bifurcation diagram is characterised experimentally. A continuous topological transition is observed for the sawtooth and square forcings. The scenario changes dramatically for sinusoidal forcing where the topological transition is discontinuous, which is accompanied by serial transitions between square and glassy vortex lattices. Based on a stochastic amplitude equation, we recognise the origin of the transition as the balance between stochastic creation and deterministic annihilation of vortices. Numerical simulations show topological transitions and the emergence of square vortex lattice. Our results show that the matter maintained out of equilibrium by means of the temporal modulation of parameters can exhibit exotic states.

On the origin of the optical vortex lattices in a nematic liquid crystal light valve

Optical vortices and lattices of these are attracting the attention of the scientific community because of their applications in various fields of optical processing, communications, enhanced imaging systems, and bio-inspired devices. Programmable optical vortices lattices with arbitrary distributions have been achieved using illuminated liquid crystals with photosensitive walls. Using an amplitude equation that describes these optical valves close to the Freédericksz transition allows us to characterize analytically the vortices and the lattices they form. The numerical simulations of the amplitude equation, analytical solutions, and experimental observations show good agreement.

MMP-9 and MMP-2 regulation in patients undergoing non-oncological and non-vascular elective surgery independent of the use of propofol or sevoflurane

BACKGROUND

There is debate regarding whether inhaled sevoflurane or intravenous propofol used during anesthesia achieves the best outcome. Propofol has been shown to affect expression of matrix metalloproteinases (MMPs). MMPs are enzymes that play a role in extracellular matrix remodeling, with activity balance disturbances during surgery. The goal of this study was to compare MMP-2/9 concentrations, activity, and tissue inhibitors of metalloproteinases (TIMPs) 1/2 concentrations in blood of who had undergone 2 types of anesthesia: based on volatile sevoflurane and intravenous propofol during non-oncological, non-vascular surgery.

METHODS

39 patients were enrolled into analysis, 20 anesthetized with total intravenous anesthesia with propofol (P), 19 with volatile induction/maintenance of anesthesia with sevoflurane (S). Plasma samples collected before and 24 h after surgery were analyzed for MMP-2/9, and TIMP-1/2 concentrations using ELISAs. Additionally, MMP-2/9 activities were assessed by gelatin zymography.

RESULTS

Study revealed increased MMP-9 concentration (ELISA) (P:p = 0.011; S:p = 0.001) and activity (zymography) (P:p = 0.004; S:p = 0.008) in both groups 24 h after surgery. We noticed decreased (both groups) MMP-2 concentration (P:p = 0.044; S:p = 0.027) with MMP-2 activity increase (P:p = 0.002; S:p = 0.006) 24 h after surgery. We observed decreased TIMP-1 plasma concentrations (P:p = 0.002; S:p = 0.000) 24 h after procedures, while TIMP-2 plasma levels remain unchanged (P:p = 0.097; S:p = 0.172). There were no differences between concentration and activity of MMPs and TIMPs in regard to anesthetic used. Meperidine administration correlated with lower MMP-9 activity (R=-0.430; p = 0.006).

CONCLUSIONS

Concluding, neither sevoflurane nor propofol used as anesthetics modulate MMP-2 and MMP-9 concentrations and activities during non-oncological, non-vascular elective surgery. Meperidine seems to decrease MMP-9 activity.

Stress coping styles among anaesthesiology and intensive care unit personnel - links to the work environment and personal characteristics: a multicentre survey study

BACKGROUND

High levels of stress among anaesthesiology and intensive care unit workers are commonly reported. Personnel in these units are prone to stress because of specific characteristics of their work. Their development of skills to cope with stress may affect their psychophysical condition and, consequently, patient safety.

OBJECTIVES

The aim of this study was to define the coping styles of anaesthesiology and intensive care unit personnel and to evaluate the connections between the work environment as well as personal characteristics and the dominant coping styles.

METHODS

Anaesthesiology and intensive care unit personnel from 15 selected Polish hospitals were surveyed using the Coping Inventory for Stressful Situations, which examines task-oriented coping, emotion-oriented coping and avoidance-oriented coping. The Perceived Stress Scale was used to assess stress levels.

RESULTS

The analysis included 425 successfully completed surveys. The examined population was divided into two groups: Group N comprised 311 nurses (73.18%) and group P comprised 114 physicians (26.82%). For 167 participants (39.29%), the dominant coping style was defined. The most common style was the task-oriented coping style; it was dominant in 96 participants (22.58% of the entire examined population). This style was significantly predominant among men. The domination of some coping styles coexisted with marital status, number of children and financial situation. The occurrence of different coping styles did not significantly differ among workers at different-sized hospitals, with different job seniority or with different living locations. Perceived stress was correlated with all coping styles.

CONCLUSIONS

Work-related stress among anaesthesiology and intensive care unit workers is an important problem. Further investigations of stress levels and the causes and effects of stress in this population are necessary.

Lambda-cyhalothrin affects swimming activity and physiological responses of Daphnia magna

λ-cyhalotrin is a pyrethroid pesticide used for protection of crops against various insect pests. Knowledge on behavioural and physiological responses of non-target organisms such as cladocerans is very limited. Daphnia is a sensitive organism commonly used in determination of ecotoxicological risk for various substances introduced to aquatic environment, however the main experimental endpoints used such as mortality or immobilisation may not be sufficient to evaluate subtle alterations in zooplankton. The aim of the present study was to evaluate swimming behaviour and physiological parameters of Daphnia magna exposed to λ-cyhalothrin (Karate Zeon 050 CS) at concentrations of 0.05, 0.5, 5 and 50 μg L^-1 for 2, 24 and 48 h. The results showed that λ-cyhalothrin affected D. magna swimming behaviour inducing a concentration-dependent inhibition of swimming track density, speed and turning ability. Depression of physiological parameters such as heart rate and thoracic limb activity was also noted. The results suggest that in natural conditions swimming behaviour and physiological endpoints of D. magna may be disturbed by environmental concentrations of λ-cyhalothrin leading to ecological consequences.

Effect of corticotropin releasing hormone and corticotropin releasing hormone antagonist on biosynthesis of gonadotropin relasing hormone and gonadotropin relasing hormone receptor in the hypothalamic-pituitary unit of follicular-phase ewes and contribution of kisspeptin

This study aimed to determine the mechanisms governing Gonadotropin releasing hormone (GnRH) biosynthesis and luteinising hormone (LH) secretion in follicular-phase sheep after infusion of corticotropin releasing hormone (CRH) and/or CRH antagonist corticotropin releasing hormone nist (CRH-A) into the third cerebral ventricle. The study included two experimental approaches: first, we investigated the effect of CRH or CRH-A (α-helical CRH 9-41) on GnRH and GnRH receptor (GnRHR) biosynthesis in the preoptic area (POA), anterior (AH) and ventromedial hypothalamus (VMH), stalk/median eminence (SME), and on GnRHR in the anterior pituitary (AP) using an enzyme-linked immunosorbent assay (ELISA); second, we used real-time PCR to analyse the influence of CRH and CRH-A on the levels of kisspeptin (Kiss1) mRNA in POA and VMH including arcuate nucleus (VMH/ARC), and on Kiss1 receptor (Kiss1r) mRNA abundance in POA-hypothalamic structures. These analyses were supplemented by radioimmunoassay (RIA) and ELISA methods for measurement of LH and cortisol levels in the blood, respectively. Our results show that administration of CRH significantly decreased GnRH biosynthesis in the POA/hypothalamus. CRH also decreased GnRHR abundance in the hypothalamus and in the AP, but increased it in the POA. Furthermore, administration of CRH decreased plasma LH concentration and levels of Kiss1 mRNA in the POA and VMH/ARC as well as Kiss1r mRNA in these structures and in the SME. Significant increase in plasma cortisol concentration in the group treated with CRH was also observed. For CRH-A, all analysed effects were opposite to those induced by CRH. The study demonstrates that intracerebroventricular (i.c.v.) infusion of both CRH and CRH-A affects the GnRH/GnRHR biosynthesis and LH secretion in follicular-phase sheep conceivably via either central and peripheral mechanisms including Kiss1 neurons activity and cortisol signals. It has also been suggested that CRH and CRH-A infusion probably had effects directly at the AP.

First Measurement of the g Factor in the Chiral Band: The Case of the ^{128}Cs Isomeric State

The g factor of the 56 ns half-life isomeric state in ^{128}Cs has been measured using the time-differential perturbed angular distribution method. This state is the bandhead of the positive-parity chiral rotational band, which emerges when an unpaired proton, an unpaired neutron hole, and an even-even core are coupled such that their angular momentum vectors are aplanar (chiral configuration). g-factor measurements can give important information on the relative orientation of the three angular momentum vectors. The measured g factor g=+0.59(1) shows that there is an important contribution of the core rotation in the total angular momentum of the isomeric state. Moreover, a quantitative theoretical analysis supports the conclusion that the three angular momentum vectors lie almost in one plane, which suggests that the chiral configuration in ^{128}Cs demonstrated in previous works by characteristic patterns of electromagnetic transitions appears only above some value of the total nuclear spin.

Successful 1:1 proportion ventilation with a unique device for independent lung ventilation using a double-lumen tube without complications in the supine and lateral decubitus positions. A pilot study

INTRODUCTION

Adequate blood oxygenation and ventilation/perfusion matching should be main goal of anaesthetic and intensive care management. At present, one of the methods of improving gas exchange restricted by ventilation/perfusion mismatching is independent ventilation with two ventilators. Recently, however, a unique device has been developed, enabling ventilation of independent lungs in 1:1, 2:1, 3:1, and 5:1 proportions. The main goal of the study was to evaluate the device's utility, precision and impact on pulmonary mechanics. Secondly- to measure the gas distribution in supine and lateral decubitus position.

MATERIALS AND METHODS

69 patients who underwent elective thoracic surgery were eligible for the study. During general anaesthesia, after double lumen tube intubation, the aforementioned control system was placed between the anaesthetic machine and the patient. In the supine and lateral decubitus (left/right) positions, measurements of conventional and independent (1:1 proportion) ventilation were performed separately for each lung, including the following: tidal volume, peak pressure and dynamic compliance.

RESULTS

Our results show that conventional ventilation using Robertshaw tube in the supine position directs 47% of the tidal volume to the left lung and 53% to the right lung. Furthermore, in the left lateral position, 44% is directed to the dependent lung and 56% to the non-dependent lung. In the right lateral position, 49% is directed to the dependent lung and 51% to the non-dependent lung. The control system positively affected non-dependent and dependent lung ventilation by delivering equal tidal volumes into both lungs with no adverse effects, regardless of patient's position.

CONCLUSIONS

We report that gas distribution is uneven during conventional ventilation using Robertshaw tube in the supine and lateral decubitus positions. However, this recently released control system enables precise and safe independent ventilation in the supine and the left and right lateral decubitus positions.

Superdeformed and Triaxial States in ^{42}Ca

Shape parameters of a weakly deformed ground-state band and highly deformed slightly triaxial sideband in ^{42}Ca were determined from E2 matrix elements measured in the first low-energy Coulomb excitation experiment performed with AGATA. The picture of two coexisting structures is well reproduced by new state-of-the-art large-scale shell model and beyond-mean-field calculations. Experimental evidence for superdeformation of the band built on 0_{2}^{+} has been obtained and the role of triaxiality in the A∼40 mass region is discussed. Furthermore, the potential of Coulomb excitation as a tool to study superdeformation has been demonstrated for the first time.

Light-matter interaction induces a shadow vortex

By sending a light beam on a homeotropic nematic liquid-crystal cell subjected to a voltage with a photosensitive wall, a stable matter vortex can be induced at the center of the beam. When the applied voltage is decreased, the vortex disappears from the illuminated region; however, the system shows a stationary molecular texture. Based on a forced Ginzburg-Landau amplitude equation, we show that the vortex with a core of exponentially suppressed amplitude always remains in a shadow region below instability threshold and that the observed texture is induced by its phase distribution. This is a different type of vortex phase singularity solution. Numerical simulations and experimental observations show a quite fair agreement.

The differential effects of green tea on dose-dependent doxorubicin toxicity

Background

Doxorubicin (DOX) is an anticancer drug displaying cardiac and hepatic adverse effects mostly dependent on oxidative stress. Green tea (GT) has been reported to play a protective role in diseases resulting from oxidative stress.

Objective

The objective of this study was to evaluate if GT protects against DOX-induced oxidative stress, heart and liver morphological changes, and metabolic disorders.

Methods

Male Wistar rats received intraperitoneal injection of DOX (1.0 or 2.0 mg/kg b.w.) for 7 weeks or concomitantly GT extract soluble in drinking water.

Results

There were multidirectional effects of GT on blood metabolic parameters changed by DOX. Among all tested biochemical parameters, statistically significant protection of GT against DOX-induced changes was revealed in case of blood fatty acid–binding protein, brain natriuretic peptide, and superoxide dismutase.

Conclusion

DOX caused oxidative stress in both organs. It was inhibited by GT in the heart but remained unchanged in the liver. DOX-induced general toxicity and histopathological changes in the heart and in the liver were mitigated by GT at a higher dose of DOX and augmented in rats treated with a lower dose of the drug.

Physiological, physical and on-ice performance criteria for selection of elite ice hockey teams

The purpose of this study was to examine physiological and physical determinants of ice-hockey performance in order to assess their impact on the result during a selection for ice hockey. A total of 42 ice hockey players took part in the selection camp. At the end of the camp 20 best players were selected by team of expert coaches to the ice hockey team and created group G1, while the second group (G2) consisted of not selected players (non-successful group Evaluation of goodness of fit of the model to the data was based on the Hosmer Lemeshow test. Ice hockey players selected to the team were taller 181.95±4.02 cm, had lower% body fat 13.17±3.17%, a shorter time to peak power 2.47±0.35 s, higher relative peak power 21.34±2.41 W·kg(-1) and higher relative total work 305.18±28.41 J·kg(-1). The results of the aerobic capacity test showed significant differences only in case of two variables. Ice hockey players in the G1 had higher VO2max 4.07±0.31 l·min(-1) values than players in the G2 as well as ice hockey players in G1 showed a higher level of relative VO2max 51.75±2.99 ml·min(-1)·kg(-1) than athletes in G2. Ice hockey players selected to the team (G1) performed better in the 30 m Forwards Sprint 4.28±0.31 s; 6x9 Turns 12.19±0.75 s; 6x9 stops 12.79±0.49 s and Endurance test (6x30 m stops) 32.01±0.80 s than players in G2. The logistic regression model showed that the best predictors of success in the recruitment process of top level ice hockey players were time to peak power, relative peak power, VO2max and 30 m sprint forwards on ice. On the basis of the constructed predictive logistic regression model it will be possible to determine the probability of success of the athletes during following the selection processes to the team.

Intraoperative awareness--comparison of its incidence in women undergoing general anaesthesia for caesarean section and for gynaecological procedures

BACKGROUND

Intraoperative awareness (IA) is diagnosed when patients can recall their surroundings or an event related to the surgery that occurred while they were under general anaesthesia. The female gender and Caesarean section are considered to be contributing factors. The aim of the present study was to analyse the frequency of IA in patients undergoing general anaesthesia either for Caesarean section or gynaecological procedures.

METHODS

ASA I and II women were included into the study. Patients were randomly allocated to 4 groups: A, B and C included patients qualified for elective gynaecological surgery, and group D comprised Caesarean section patients. Premedication was not given. Group A received total intravenous anaesthesia with TCI, and groups B, C and D received balanced anaesthesia. The depth of anaesthesia was monitored with an AEP monitor. Blinded structured interviews were conducted 2 hours after anaesthesia and on postoperative days 7 and 30.

RESULTS

337 patients were enrolled into the study. 45 patients reported diverse sensations connected to the anaesthesia (Group A - 7 patients, B - 9 patients, C - 2 patients, D - 28 patients). There were mainly dream sensations, but IA was present in 3 cases. In all of the cases, IA was recognised during the first interview. One episode of awareness appeared in group B, and the other two appeared in group D. One Caesarean section was complicated by intraoperative haemorrhage. The patient from group B had similar sensations during previous anaesthesia. Two women enrolled in the study reported awareness in the past, which did not occur this time.

CONCLUSION

Awareness during general anaesthesia occurs occasionally. The frequency of occurrence in a group of patients undergoing general anaesthesia for uncomplicated Caesarean section is not higher than for other procedures. The anaesthesia for Caesarean section, as well as for other procedures, may be accompanied by pleasant dreams.

Symmetry breaking of nematic umbilical defects through an amplitude equation

The existence, stability properties, and bifurcation diagram of the nematic umbilical defects is studied. Close to the Fréedericksz transition of nematic liquid crystals with negative anisotropic dielectric constant and homeotropic anchoring, an anisotropic Ginzburg-Landau equation for the amplitude of the tilt of the director away from the vertical axis is derived by taking the three-dimensional (3D) to 2D limit of the Frank-Oseen model. The anisotropic Ginzburg-Landau equation allows us to reveal the mechanism of symmetry breaking of nematic umbilical defects. The positive defect is fully characterized as a function of the anisotropy, while the negative defect is characterized perturbatively. Numerical simulations show quite good agreement with the analytical results.

New generation pulse oximetry in the assessment of peripheral perfusion during general anaesthesia - a comparison between propofol and desflurane

BACKGROUND

A pulse oximeter is a standard device for perioperative monitoring. It is well known that the early detection of tissue hypoxia is of great importance. It has been made easier due to a new generation pulse oximetry device from Masimo. This enables measurements of the peripheral perfusion index (PI) in real time. It has been found that volatile anaesthetics such as sevoflurane and desflurane increase the perfusion index. As we know, no data is available about perfusion index during propofol/remifentanil total intravenous anaesthesia.

METHODS

ASA I and II class women scheduled for elective gynaecological surgery were eligible for the study. Patients were divided into two groups: group P receiving propofol/remifentanil intravenous anaesthesia and group D receiving desflurane/fentanyl general anaesthesia. PI was noted before anaesthesia, after remifentanil/fentanyl injection, after endotracheal intubation, at the beginning of surgery, during the procedure at ten minute intervals, at the end of the procedure, after awakening, after extubation and before discharge to the ward.

RESULTS

Eighty-three patients were enrolled to the study. In both groups, PI increased significantly from the start to the end of surgery. There was a significant correlation between PI and end-tidal desflurane concentration (r = 0.807; P = 0.001). No correlation was found between propofol or remifentanil concentrations and PI.

CONCLUSION

Both intravenous propofol/remifentanil and desflurane/fentanyl general anaesthesia increase peripheral perfusion. An increase in end-tidal desflurane concentration raises peripheral perfusion.

University of Lodz an electron spectrometer--a new conversion-electron spectrometer for "in-beam" measurements

The designed and constructed at the University of Lodz an electron spectrometer is devoted to "in-beam" measurements. The apparatus is characterized by high efficiency up to 9%, good energy resolution (FWHM = 5 keV at 482 keV) and, what is very important good suppression of delta electrons, positrons, and photons emitted by the targets. This achievement was obtained using a combination of magnetic field in two different layouts: perpendicular and parallel to the axis of the spectrometer being orthogonal to the beamline. The conversion-electron spectrometer coupled to the EAGLE array was successfully tested in an "in-beam" measurement.

Carotid surgery affects plasma kynurenic acid concentration: a pilot study

BACKGROUND

An increase in plasma kynurenic acid (KYNA) concentration has been observed following surgery, inflammation, and cerebral pathologies. The aim of the present study was to analyze the changes in plasma KYNA concentration in patients undergoing carotid surgery (CS).

MATERIAL AND METHODS

Adult patients undergoing elective carotid endarterectomy (CEA) or carotid angioplasty with stent placement (CAS) were studied. Plasma KYNA concentrations were analyzed before surgery and at 4 time points after CS. The amount of inflammation was measured as neutrophil-lymphocyte ratio (NLR).

RESULTS

Forty patients (10 female and 30 male) aged 55-86 years of age were evaluated in this study. In patients with unstable carotid plaque, the plasma KYNA concentration was higher than in patients with stable carotid plaque. Moreover, the NLR was significantly higher in patients with unstable carotid plaque undergoing CEA than in patients undergoing CAS. Plasma KYNA concentration increased after surgery in patients undergoing CEA and CAS. There was a strong correlation between plasma KYNA concentration and NLR in patients with postoperative neurological disorders.

CONCLUSIONS

CS increases plasma KYNA concentration, and changes in plasma KYNA concentration can indicate neurologic outcomes in patients undergoing CS.

Decay chains and photofission investigation based on nuclear spectroscopy of highly enriched uranium sample

Nuclear spectroscopy experiments were performed for 100g metallic uranium rod enriched to 93% (235)U, in order to establish and characterize the most prominent γ-rays in the natural decay series and photofission reaction. Single γ-ray spectra and γ-γ coincidences measurements were conducted before irradiation. The uranium sample was subsequently irradiated with 15 MeV bremsstrahlung photons. Relative intensities of γ-lines and several values of half-lives of the fission fragments decays were determined. The obtained information can be utilized in detection of smuggled nuclear materials and characterization of bulky nuclear waste packages.

Emotional sequelae among survivors of critical illness: a long-term retrospective study

CONTEXT

Treatment in an ICU can be stressful and traumatic for patients, and can lead to various physical, psychological and cognitive sequelae.

OBJECTIVES

The aim of the study was to assess the influence of the social, economic and working status of individuals in regard to long-term anxiety and depression among ICU convalescents.

DESIGN

Retrospective, cross-sectional, 5-year survey between 2005 and 2009.

SETTING

The general ICUs of two hospitals in Lublin (Poland): the Teaching Hospital, Medical University of Lublin and the District Hospital.

PATIENTS

All adults surviving an ICU stay of more than 24 h were eligible. In December 2010, 533 questionnaires were sent to discharged ICU survivors, and 195 (36.6%) were returned. One hundred and eighty-six patients were enrolled in the study. Patients with brain injuries were excluded.

MAIN OUTCOME MEASURES

The questionnaire consisted of the Hospital Anxiety and Depression Scale (HADS); questions defining social, economic and working status before and after intensive care stay, health status before intensive care stay, as well as questions about memories and readmissions to intensive care were included.

RESULTS

According to HADS, 34.4% patients had an anxiety disorder and 27.4% were depressed. There was a strong positive correlation between anxiety and depression (r = +0.726, P<0.001). Better material and housing conditions correlated with lower anxiety and depression rates. Acute Physiology and Chronic Health Evaluation II scores on admission positively correlated with both anxiety (r =+0.187; P=0.011) and depression (r = +0.239; P=0.001). A negative correlation between health status before intensive care admission and HADS scores was observed (anxiety rs = -0.193; P=0.008; depression rs = -0.227; P=0.002); better health resulted in less anxiety and depression disorders.

CONCLUSION

Adverse social and economic status is associated with higher rates of anxiety and depression following ICU stay.

Interleukin-17A and interleukin-23 in morphea

INTRODUCTION

Morphea is a disease included in the group of scleroderma type autoimmune diseases. Interleukin (IL)-17A may play a role at every stage of its pathogenesis. The study aimed at evaluation of IL-17A and IL-23 (as the main cytokine which is supposed to stimulate and maintain synthesis of IL-17) in pathogenesis of morphea.

MATERIAL AND METHODS

The studies were performed on 41 blood samples from patients with morphea. Skin was sampled from 29 patients. The evaluation included: (1) expression of IL-17A and IL-23 genes in peripheral blood mononuclear cells (PBMC) using real-time polymerase chain reaction (PCR), (2) plasma concentrations of IL-17A and IL-23 using ELISA, (3) expression of IL-17A and IL-23 genes in skin using real-time PCR.

RESULTS

The results of gene expression are expressed as median number of copies per million copies of GAPDH. Higher expression of IL-17A has been demonstrated in PBMC of morphea vs. control group (2630 and 1906 respectively; p = 0.004), accompanied by absence of significant differences in its plasma concentration (10 pg/ml in both groups) and by lowered expression in affected skin (9119 and 19113 respectively; p = 0.036). The results failed to demonstrate elevated IL-23 plasma concentration in morphea vs. control group (5 pg/ml and 6 pg/ml respectively; p = 0.335) or its increased expression in the skin (292 vs. 427; p = 0.383), although we noted its increased expression in PBMC (4419 vs. 808; p < 0.001).

CONCLUSIONS

BASED ON THE OBSERVED CORRELATIONS WE SUGGEST THAT: (1) IL-17A does not represent a factor which promotes tissue injury in morphea, (2) IL-23 may playa role in pathogenesis of morphea.

Another rare case of a child with de novo terminal 9p deletion and co-existing interstitial 9p duplication: clinical findings and molecular cytogenetic study by array-CGH

Trisomy 9p is the fourth most common chromosome abnormality found in liveborns. We report on a rare case of partial trisomy 9p complicated by partial monosomy 9p. Clinical manifestation included craniofacial abnormalities typical for trisomy 9p syndrome, developmental delay, mental retardation and brain anomaly in the form of Dandy-Walker malformation. The cytogenetic abnormality was investigated with FISH and array-CGH to characterize the breakpoints of the complex rearrangement. The patient's karyotype was 46,XX,der(9)del(9)(p24)dup(9)(p21p24)dn.arr 9p24.3p24.2 (1-2,414,485)×1,9p24.2p21.3(2,414,485-24,101,280)×3. The cytogenetic rearrangement led to a 2.4-Mb deletion of 9p24.2pter and a 21.6-Mb duplication of 9p24.2p21.3. The clinical and cytogenetic findings in our and other similar patients are compared.

Independent lung ventilation for treatment of post-traumatic ARDS

BACKGROUND

Independent lung ventilation (ILV) has been recommended for unilateral pulmonary pathology. We describe a case of a multiple trauma patient treated with ILV for unilateral lung injury.

CASE REPORT

Following a road accident, an 18 year-old male patient was referred to the university hospital with multiple organ failure, a ruptured liver and spleen, a fractured spine at the Th1-2 level, and left lung contusion. Splenectomy and liver repair had been performed in a regional hospital. On admission, a left sided pneumothorax and haemothorax were diagnosed and an emergency thoracotomy was performed, with partial resection of the left lower lobe. Because of the failure of recruitment of the left upper lobe, the patient was intubated with a double lumen tube and ILV was started using a single ventilator and a prototype flow separator, allowing separation of volume and PEEP settings. The left lung was ventilated with larger volumes and a higher PEEP than the right side, resulting in rapid improvement of gas exchange, reduction of air leak, and a return to conventional ventilation within two days. The patient underwent spinal stabilisation, and was extubated a few days later and transferred to a rehabilitation unit.

CONCLUSIONS

ILV with a larger tidal volume and high PEEP may be indicated in unilateral lung injury with a significant air leak from the injured tissue.

Evidence for a smooth onset of deformation in the neutron-rich Kr isotopes

The neutron-rich nuclei 94,96Kr were studied via projectile Coulomb excitation at the REX-ISOLDE facility at CERN. Level energies of the first excited 2(+) states and their absolute E2 transition strengths to the ground state are determined and discussed in the context of the E(2(1)(+)) and B(E2;2(1)(+)→0(1)(+)) systematics of the krypton chain. Contrary to previously published results no sudden onset of deformation is observed. This experimental result is supported by a new proton-neutron interacting boson model calculation based on the constrained Hartree-Fock-Bogoliubov approach using the microscopic Gogny-D1M energy density functional.

Levosimendan - a calcium sensitising agent with potential anti-arrhythmic properties

Levosimendan is a 'Ca(2+)sensitiser', which exerts its inotropic effect by increasing the affinity of troponin C for Ca(2+), directly stabilising the Ca(2+)-induced conformation of troponin C. It leads to a positive inotropic effect without impairing diastolic relaxation and causing cytosolic Ca(2+) ion overload, which might result in cardiac myocyte dysfunction, arrhythmias and cell death. Levosimendan may also have significant anti-inflammatory properties. Data from various studies suggest that levosimendan might have anti-arrhythmic effects, although the outcome of clinical trials on the effect of this agent in (for example) atrial fibrillation (AF) remains controversial. Currently, on the basis of available data, it is especially worth emphasising the potential role of this drug in the termination of AF after cardiac surgery, which significantly influences early- and long-term morbidity and mortality. This review considers the putative anti-arrhythmic properties of levosimendan and discusses the potential clinical application of such a drug.

[Costs of subarachnoid vs. general anaesthesia for caesarean section]

BACKGROUND

Modern medicine is becoming increasingly aware of economic-organizational aspects. In the field of anaesthesiology, the number of agents used markedly increases due to continuous pharmacological progress. A high proportion of them are expensive. The aim of the study was to compare hospital costs of general vs. subarachnoid anaesthesia for Caesarean section.

METHODS

Costs were assessed from the perspective of a service provider. Direct costs were measured using the micro-cost method based on detailed data of the resources used during anaesthetic procedures. Non-medical costs were calculated by the direct allocation method (costs of auxiliary units). Unit costs of hospitalization were determined using the "top-to-bottom" assessment. Costs related to anaesthetic staff work were calculated by the micro-cost method based on duration of anaesthesia. Sensitivity analysis was performed.

RESULTS

Mean direct cost of general anaesthesia for Caesarean section was lower than of subarachnoid anaesthesia. Mean personnel cost of subarachnoid anaesthesia was found to be higher compared to general anaesthesia. Costs of pharmaceuticals for general anaesthesia were lower than for subarachnoid one. Costs of medical materials related to the method used were significantly higher in subarachnoid anaesthesia.

CONCLUSIONS

Subarachnoid anaesthesia takes more time than general one, which results in higher costs of medical staff work. Avoiding inhalation anaesthetics (sevoflurane) makes indirect costs of general anaesthesia lower compared to subarachnoid anaesthesia.

[Pain in children in historical perspective]

Pain in children, especially in infancy, is frequently underestimated. Surprisingly, in ancient times, writers were more aware of the existence of pain in infancy and the need for its relief than in 20th century. They rated pain perception as being higher in infancy than in childhood. The study by McGraw (1941), although badly designed, convinced the vast majority of clinicians that infants do not feel pain and do not require analgesia. This theory, reinforced by the fear of using opioids in young children, dominated medical thinking for more than 30 years. Later studies on pain perception in foetuses, and careful analysis of infants' reactions to blood sampling, helped doctors to understand the necessity of adequate analgesia in young children. In this review, we present the approach to pain in children over centuries, from ancient times to the latest developments in this field.

[Peripheral blood perfusion during desflurane anaesthesia]

BACKGROUND

Peripheral perfusion may be compromised during anaesthesia and surgery, however its direct assessment is difficult, and sometimes may lead to false conclusions. Recently, a new generation of pulse oximeters has been introduced, which allows for the differentiation between pulsatile and non-pulsatile flow. The difference is expressed as the perfusion index (PI).

METHODS

ASA I and II class women, scheduled for elective gynaecologic surgery, received fentanyl/ desflurane anaesthesia were studied. PI was noted before anaesthesia, after fentanyl injection, after endotracheal intubation, at the beginning of surgery, during the procedure at 10 minute intervals, at the end of procedure, after eye opening, after extubation, and before discharge to the ward. The depth of anaesthesia was assessed by spectral entropy and expressed as the A-line Autoregressive Index (AAI); the latter was compared to PI.

RESULTS

Forty-five patients aged 37 +/- 13.8 years were enrolled in the study. PI increased after induction of anaesthesia and remained increased during surgery. There was a significant negative correlation between PI and AAI (r = -0.908; p = 0.00000), and between AAI and end-tidal desflurane concentration ((r = -0.788; p = 0.0008). PI correlated positively with end-tidal desflurane concentration (r = +0.757; p = 0.002).

CONCLUSION

The new generation of pulse oximeters allows not only the more accurate assessment of haemoglobin saturation, but also the detection of pathologic forms of haemoglobin and the assessment of peripheral blood flow. Peripheral perfusion is increased during desflurane anaesthesia, and is also closely related to the depth of anaesthesia.

[Independent lung ventilation during general anaesthesia--preliminary report]

BACKGROUND

Unitaleral lung pathology presents a serious challenge for the anaesthesiologist. Conventional ventilation usually leads to over distension of the non-affected lung and hypoventilation of the affected lung. The optimal ventilatory strategy in such situations, is intubation with a double lumen tube and independent lung ventilation with two respirators. This is expensive and difficult, especially in an operating room. A novel approach to this problem is based on the use of a single ventilator with a volume splitter, which enables the independent ventilation of each lung, with the same frequency but different volumes, I:E ratios and PEEPs.

METHODS

We used the splitter in thirty-four patients, of both sexes, aged 19-78 years, and scheduled for elective thoracic surgery. All patients were intubated with a double lumen tube and ventilated in the supine and lateral positions with and without the splitter. When the lateral position was used, the volume delivered by the ventilator was split equally to each lung.

RESULTS

In the lateral position, without the splitter, the distribution of gas delivered by the ventilator was unequal: the dependent lung receiving 47.4 +/- 6.8% of the total volume, and the non-dependent lung receiving 52.6 +/- 6.8%. When the splitter was used, both lungs were ventilated with equal volumes. All patients were cardiovasculary stable.

CONCLUSION

A novel method of ventilation during anaesthesia is described, opening up new possibilities for thoracic anaesthesia that allows easy and atraumatic independent lung ventilation.