Predictors of outcomes of patients ≥ 80 years old admitted to intensive care units in Poland - a post-hoc analysis of the VIP2 prospective observational study.

INTRODUCTION: Elderly patients pose a significant challenge to intensive care unit (ICU) clinicians. In this study we attempted to characterise the population of patients over 80 years old admitted to ICUs in Poland and identify associations between clinical features and short-term outcomes. MATERIAL AND METHODS: The study is a post-hoc analysis of the Polish cohort of the VIP2 European prospective observational study enrolling patients > 80 years old admitted to ICUs over a 6-month period. Data including clinical features, clinical frailty scale (CFS), geriatric scales, interventions within the ICU, and outcomes (30-day and ICU mortality and length of stay) were gathered. Univariate analyses comparing frail (CFS > 4) to non-frail patients and survivors to non-survivors were performed. Multivariable models with CFS, activities of daily living score (ADL), and the cognitive decline questionnaire IQCODE as predictors and ICU or 30-day mortality as outcomes were formed. RESULTS: A total of 371 patients from 27 ICUs were enrolled. Frail patients had significantly higher ICU (58% vs. 44.45%, P = 0.03) and 30-day (65.61% vs. 54.14%, P = 0.01) mortality compared to non-frail counterparts. The survivors had significantly lower SOFA score, CFS, ADL, and IQCODE than non-survivors. In multivariable analysis CFS (OR 1.15, 95% CI: 1.00-1.34) and SOFA score (OR 1.29, 95% CI: 1.19-1.41) were identified as significant predictors for ICU mortality; however, CFS was not a predictor for 30-day mortality ( P = 0.07). No statistical significance was found for ADL, IQCODE, polypharmacy, or comorbidities. CONCLUSIONS: We found a positive correlation between CFS and ICU mortality, which might point to the value of assessing the score for every patient admitted to the ICU. The older Polish ICU patients were characterised by higher mortality compared to the other European countries.

Acute mercuric chloride poisoning at a potentially lethal dose ended with survival: symptoms, concentration in cerebrospinal fluid, treatment.

This study aims to present a case of acute mercuric chloride poisoning at a potentially lethal dose treated with the antidote - 2,3-dimercapto- 1-propanesulfonic acid (DMPS) and continuous renal replacement therapy (CRRT) combined with CytoSorb. A 21-year-old woman was admitted to a hospital with abdominal pain, vomiting, and suspected gastrointestinal bleeding after taking 5000 mg of mercuric chloride for suicidal purposes. Due to the patient deteriorating general condition and multiple organ damage, on the third day she was transported to the Clinic of Anaesthesiology and Intensive Care (CAaIC), Lódz, Poland. Laboratory tests confirmed features of acute kidney injury and high mercury levels in the blood (1051 µg/l) and urine (22 960 µg/l) - DMPS therapy and CRRT combined with CytoSorb were instituted. Due to nervous system complaints (headache, dizziness), a lumbosacral puncture was performed - the mercury concentration in the cerebrospinal fluid (CSF) was 5.45 µg/l. During a colonoscopy, significant diagnostic abnormalities revealed features of colonic mucosal necrosis. The treatment resulted in a decrease in subjective complaints, decreased mercury levels in biological material, and improved parenchymal organ function. On the 15th day of therapy, the patient was transferred to the primary care center for further treatment. The case confirms the possibility of improvement of patient condition following ingestion of a potentially lethal dose (5 g) as a result of the initiation of appropriate therapy even on the third day. The presence of mercury in CSF confirms that inorganic mercury compounds (mercuric chloride) can pass through the blood-brain barrier after oral ingestion. Int J Occup Med Environ Health. 2023;36(5):685-92.

Decreasing the hazardous effect of waste quartz powder and the toxicity of epoxy resin by its synergistic application in industrial coatings.

Quartz powder sourced from industrial wastes is very hazardous. It is because it contains large amounts of fine particles. Thus, it has the potential to cause cancer and nervous system impact on humans and animals. Furthermore, its disposal leads to water pollution and plant pollination (negative for the environment). It will not be dangerous if incorporated into a hardened epoxy resin coating. In turn, epoxy resin is very harmful to the environment, in particular to aquatic organisms; therefore, it is necessary to reduce its mass in coatings by using additives. The article describes the systematic investigation of the adhesion of an epoxy resin coating and an economic and toxicity analysis showing the cost and toxicity reduction of the epoxy resin coating by replacing a part of the epoxy resin mass with waste quartz powder. The key novelty of the following article is to highlight a new way to decrease the hazardous effect of waste quartz powder, thanks to its utilization in epoxy resin coatings. Furthermore, the novelty is to decrease the toxicity of epoxy resin by reducing its mass necessary to make the industrial coating.

The Effect of Steel and Polypropylene Fibers on the Properties of Horizontally Formed Concrete.

The article presents a comparative analysis of the impact of the addition of steel and polypropylene fibers on the properties of the concrete mixes and hardened concrete used in the concrete floor industry. The behavior of concrete intended for floors is different from conventional structural concrete because it is formed horizontally; until now, the effect of steel and polypropylene fibers on the properties of concrete formed horizontally has not yet been fully understood. Therefore, the aim of this article is to examine this issue and compare the behavior of concrete modified with steel and polypropylene fibers in concrete that is formed horizontally. The following properties of fresh concrete mixes were analyzed: consistency, the content of air-voids, and bulk density. Consequently, the following properties of hardened concrete were analyzed: compressive strength, bending tensile strength, and brittleness. It was confirmed that steel and polypropylene fibers have a different type of effect on the properties of fresh concrete mixes and hardened concrete. Finally, a combined economic and mechanical analysis was performed.

The Effect of the Addition of Polypropylene Fibers to Primer on the Pull-Off Strength of Epoxy Resin Coatings.

This article describes the effect of adding polypropylene fibers to primer on the pull-off strength of epoxy resin coatings. Investigated primers were laid on substrates made of cement mortar and cement slurry. The primer was made of epoxy resin modified with the addition of 0.5%, 1%, 1.5% and 2% of polypropylene fibers. One reference sample was made without the addition of fibers. Then, an epoxy resin coating was applied to each substrate. Four pull-off strength tests were performed for each material configuration. For this purpose, an automatic device for measuring the pull-off strength of the coatings was used. The results were compared with the results obtained for the reference sample. The optimum content of polypropylene fibers was found to be in the range of 0.5-1.0 wt. % of the mass of the resin. One percent of fibers was optimum for the epoxy resin laid on the cement slurry, while 0.5 wt. % of fibers was optimum for the mortar substrate. The addition of a higher amount of polypropylene fibers resulted in a lower pull-off strength of coatings than for the reference sample.

Dynamin inhibitors impair endocytosis and mitogenic signaling of PDGF.

Platelet-derived growth factor (PDGF) isoforms regulate cell proliferation, migration and differentiation both in embryonic development and adult tissue remodeling. At the cellular level, growth-factor signaling is often modulated by endocytosis. Despite important functions of PDGF, its endocytosis remains poorly studied, mainly for lack of tools to track internalized ligand by microscopy. Here, we developed such a tool and quantitatively analyzed internalization and endosomal trafficking of PDGF-BB in human fibroblasts. We further show that PDGF can be internalized in the presence of dynamin inhibitors, arguing that both dynamin-dependent and dynamin-independent pathways can mediate PDGF uptake. Although these routes operate with somewhat different kinetics, they both ultimately lead to lysosomal degradation of PDGF. Although acute inhibition of dynamin activity only moderately affects PDGF endocytosis, it specifically decreases downstream signaling of PDGF via signal transducer and activator of transcription 3 (STAT3). This correlates with reduced expression of MYC and impaired cell entry into S-phase, indicating that dynamin activity is required for PDGF-induced mitogenesis. Our data support a general view that the components governing endocytic trafficking may selectively regulate certain signaling effectors activated by a growth factor.

Recruitment of APPL1 to ubiquitin-rich aggresomes in response to proteasomal impairment.

Inhibitors of proteasomes have been shown to affect endocytosis of multiple membrane receptors, in particular at the step of cargo sorting for lysosomal degradation. Here we demonstrate that the inhibition of proteasomes causes specific redistribution of an endosomal adaptor APPL1, which undergoes initial solubilization from APPL endosomes followed by clustering in the perinuclear region. MG132 treatment decreases APPL1 labeling of endosomes while the staining of the canonical early endosomes with EEA1 remains unaffected. Upon prolonged treatment with proteasome inhibitors, endogenous APPL1 localizes to the site of aggresome formation, with perinuclear APPL1 clusters encapsulated within a vimentin cage and co-localizing with aggregates positive for ubiquitin. The clustering of APPL1 is concomitant with increased ubiquitination and decreased solubility of this protein. We determined that the ubiquitin ligase Nedd4 enhances polyubiquitination of APPL1, and the ubiquitin molecules attached to APPL1 are linked through lysine-63. Taken together, these results add APPL1 to only a handful of endogenous cellular proteins known to be recruited to aggresomes induced by proteasomal stress. Moreover, our studies suggest that the proteasome inhibitors that are already in clinical use affect the localization, ubiquitination and solubility of APPL1.