Endovascular treatment of complex intracranial aneurysms.

PURPOSE: Complex intracranial aneurysms (CIA) are heterogenous group of intracranial vascular malformations. Due to its giant size, difficult location, broad neck, branches arising from the aneurysm, wall structure, calcification, presence of intraluminal thrombus or previous treatments it requires more careful approach. The aim of this study was to evaluate endovascular treatment results of CIA in our Department. MATERIAL AND METHODS: In order to differentiate CIA from all the aneurysms, treated endovascularly in years 2008-2014, authors proposed their own qualification criteria. Additionally, subgroup of patients with CIA with simultaneous subarachnoid haemorrhage (SAH) was divided. Clinical outcomes of patients were assessed with Glasgow Outcome Scale (GOS), while radiological outcomes were assessed with Montreal Scale. Aneurysm localization, incidence of aborted procedures, intraoperative complications were also evaluated. RESULTS: Internal carotid artery was the most common localization in both CIA and non-complex (nCIA) groups. Incidence of aborted procedures was significantly higher in CIA group than in nCIA (25% vs. 7%; p < 0.01). CIA group had worse Montreal scores then nCIA group (1.90 vs. 1.49; p < 0.01). Clinical outcome in GOS scale in patients with SAH and CIA was significantly worse than in SAH and nCIA (2.86 vs. 4.06; p = 0.04). CONCLUSIONS: To conclude, proposed criteria of CIA should be taken into consideration during diagnosis and qualification to invasive treatment. Classifying aneurysm as CIA is related to greater possibility of aborting endovascular procedure due to technical difficulties.

Assessment of symptom severity in psychotic disorder patients based on heart rate variability and accelerometer mobility data.

BACKGROUND: Advancement in mental health care requires easily accessible, efficient diagnostic and treatment assessment tools. Viable biomarkers could enable objectification and automation of the diagnostic and treatment process, currently dependent on a psychiatric interview. Available wearable technology and computational methods make it possible to incorporate heart rate variability (HRV), an indicator of autonomic nervous system (ANS) activity, into potential diagnostic and treatment assessment frameworks as a biomarker of disease severity in mental disorders, including schizophrenia and bipolar disorder (BD). METHOD: We used a commercially available electrocardiography (ECG) chest strap with a built-in accelerometer, i.e. Polar H10, to record R-R intervals and physical activity of 30 hospitalized schizophrenia or BD patients and 30 control participants through ca. 1.5-2 h time periods. We validated a novel approach to data acquisition based on a flexible, patient-friendly and cost-effective setting. We analyzed the relationship between HRV and the Positive and Negative Syndrome Scale (PANSS) test scores, as well as the HRV and mobility coefficient. We also proposed a method of rest period selection based on R-R intervals and mobility data. The source code for reproducing all experiments is available on GitHub, while the dataset is published on Zenodo. RESULTS: Mean HRV values were lower in the patient compared to the control group and negatively correlated with the results of the PANSS general subcategory. For the control group, we also discovered the inversely proportional dependency between the mobility coefficient, based on accelerometer data, and HRV. This relationship was less pronounced for the treatment group. CONCLUSIONS: HRV value itself, as well as the relationship between HRV and mobility, may be promising biomarkers in disease diagnostics. These findings can be used to develop a flexible monitoring system for symptom severity assessment.

Analysis of Factors Influencing Polish Students' Opinions on Euthanasia.

Due to the continuous development of palliative care and methods of pain relief in the last moments of patients' lives, we are faced with the question of how long we should take measures to delay inevitable death for, without providing prolonged therapy against the patient's will. For terminally ill and people experiencing unimaginable suffering, euthanasia is considered as one of the possible options for a dignified farewell. The aim of the study was to determine the views on euthanasia in a group of students from Polish universities. Questionnaire responses were analyzed for 9686 students (79.9% of women and 20.1% of men) aged 18−35 years. Respondents were asked to complete their own questionnaire on demographic data and attitudes toward euthanasia in the case of severe terminal illness or paralysis preventing independent living. Euthanasia was significantly more acceptable among women (85% vs. 75%, p < 0.0001; 69% vs. 62%, p < 0.0001) and non-believers [98% vs. 97% (denominations other than Christian), 84% (other forms of Christianity), 69% (Roman Catholic); p < 0.0001] in every case considered. Religious affiliation was the factor that most influenced attitudes toward euthanasia. Among the other elements influencing attitudes toward euthanasia, residence and field of study were distinguished. Considering the large sample size and specific conclusions, the article should be an important argument in the discussion on euthanasia.