Polyurethane-Based Porous Carbons Suitable for Medical Application.

The main aim of the study was to synthesize and analyze spectral data to determine the structure and stereometry of the carbon-based porous material internal structure. Samples of a porous biomaterial were synthesized through anionic polymerization following our own patent and then carbonized. The samples were investigated using MALDI ToF MS, FTIR ATR spectroscopy, optic microscopy, SEM, confocal laser scanning microscopy and CMT imaging. The analysis revealed the chemical and stereological structure of the obtained porous biomaterial. Then, the parameters characterizing the pore geometry and the porosity of the samples were calculated. The developed material can be used to collect adsorption of breathing phase samples to determine the parity composition of exhaled air.

Impact of sound levels and patient-related factors on sleep of patients in the intensive care unit: a cross-sectional cohort study.

Sleep disruption is common in patients in the intensive care unit (ICU). The aim of the study was to measure sound levels during sleep-protected time in the ICU, determine sources of sound, assess the impact of sound levels and patient-related factors on duration and quality of patients' sleep. The study was performed between 2018 and 2019. A commercially available smartphone application was used to measure ambient sound levels. Sleep duration was measured using the Patient's Sleep Behaviour Observational Tool. Sleep quality was assessed using the Richards-Campbell Sleep Questionnaire (RCSQ). The study population comprised 18 (58%) men and 13 (42%) women. There were numerous sources of sound. The median duration of sleep was 5 (IQR 3.5-5.7) hours. The median score on the RCSQ was 49 (IQR 28-71) out of 100 points. Sound levels were negatively correlated with sleep duration. The cut-off peak sound level, above which sleep duration was shorter than mean sleep duration in the cohort, was 57.9 dB. Simple smartphone applications can be useful to estimate sound levels in the ICU. There are numerous sources of sound in the ICU. Individual units should identify and eliminate their own sources of sound. Sources of sound producing peak sound levels above 57.9 dB may lead to shorter sleep and should be eliminated from the ICU environment. The sound levels had no effect on sleep quality.

Impact of Light Intensity on Sleep of Patients in the Intensive Care Unit: A Prospective Observational Study.

AIMS AND OBJECTIVES: Sleep deprivation in the intensive care unit (ICU) has been linked to numerous complications. Light levels might impact the sleep of patients in the ICU. The aim of the study was to measure light levels during sleep-protected time in the ICU and to assess the impact of light intensity on sleep quantity/quality. MATERIALS AND METHODS: This prospective, observational study was conducted in a 10-bed, mixed surgical/medical ICU. For measuring light levels, a commercially available smartphone application was used. The measurements were performed between 23:30 and 06:15 hours at 15-minute intervals. To assess sleep quantity, we used Patient's Sleep Observation Behavioral Tool and to assess sleep quality, we used Richards-Campbell Sleep Scale. RESULTS: The median number of time points at which patients were asleep was 20 (interquartile range, IQR 14-23) out of 25 (5 hours). The median self-reported quality of sleep (overall score) was 49 (IQR 28-71). The median values for individual questions are: question 1 (sleep depth)-54.0 (IQR 37-78), question 2 (sleep latency)-40.5 (IQR 6-90), question 3 (awakenings)-52.5 (IQR 28-76), question 4 (returning to sleep)-25.5 (IQR 11-78), and question 5 (sleep quality)-67.5 (IQR 5-76). No correlation was found between self-reported sleep quality and time spent asleep (p = 0.36). There was no correlation between average light levels during sleep-protected time and sleep quantity (p = 0.42)/sleep quality (p = 0.13). There was a correlation between average (13 ± 5 lux) light levels before sleep-protected time and sleep quality (p = 0.008). CONCLUSION: Mean light levels of 11 ± 9 lux during sleep-protected time have no negative impact on quantity and quality of sleep in intensive care unit patients. Light levels up to 18 lux directly before falling asleep improve patients' self-reported quality of sleep in the ICU. CLINICAL SIGNIFICANCE: Finding safe levels of light intensity during sleep-protected time in ICU. HOW TO CITE THIS ARTICLE: Czempik PF, Jarosinska A, Machlowska K, Pluta M. Impact of Light Intensity on Sleep of Patients in the Intensive Care Unit: A Prospective Observational Study. Indian J Crit Care Med 2020;24(1):33-37.

Comparison of spirometric results obtained from the sitting and standing position in children participating in an epidemiological study.

INTRODUCTION: It is recommended that spirometric testing in children be completed while sitting. Our experience indicates that children prefer standing during spirometry. AIM: We sought to compare spirometric results obtained from the sitting (SIP) and standing (STP) positions. MATERIAL AND METHODS: Two testing sessions were performed in random order (SIP vs. STP: 30-45 min apart) in 118 children (7-13 years), attending one, randomly selected, primary school (response rate: 92%). RESULTS: Acceptable quality was found in 77.9% of STP and 77.1% of SIP maneuvers. Higher values of spirometric variables on STP, compared to SIP, were obtained for forced vital capacity (FVC) (2.12 ±0.41 l vs. 2.11 ±0.39 l) and forced expiratory volume in 1 s (FEV1) (1.78 ±0.36 l vs. 1.77 ±0.35 l) but the differences were not statistically significant. Relative between-position differences (RBPD) ≤ 5% were found with the following frequencies: FVC: 56.4%, FEV1: 69.2%, PEF: 21.7%, and FEF25-75: 24.3%. Similar patterns were found for FEF25, FEF50, and FEF75. Relative between-position differences were related to age in the case of FEV1 (p = 0.005), FEF25 (p = 0.02), and FEF25-75 (p = 0.01) where older children had smaller RBPD. Forced vital capacity RBPD was lower (p = 0.01) in subjects with current wheeze; PEF RBPD were lower (p = 0.02) in children with asthma. CONCLUSIONS: In epidemiological studies, the position of spirometric testing does not affect the results of lung function assessment.

E-smoking among students of medicine - frequency, pattern and motivations.

INTRODUCTION: E-smoking has become a public health problem. The objectives of this study were to assess the prevalence of e-cigarette and tobacco cigarette use; to compare the patterns of smoking; to assess the attitudes and motivations for e-cigarette use. MATERIAL AND METHODS: All 1,700 students from Faculty of Medicine (Medical University of Silesia) were invited to questionnaire based cross-sectional study about the frequency and attitudes towards the use of traditional and electronic cigarettes. RESULTS: The data were obtained from 1,318 medical students (response 77.5%) aged 22.1 ± 2.2 years. Traditional tobacco smoked 18.1%, e-cigarettes 1.3% and 2.2% were dual smokers. The overall frequency of e-smokers was 4.9% among men and 2.8% among women (p = 0.05). Compared to tobacco users in e-smokers duration of smoking was shorter (p < 0.001), the intensity of smoking was larger (p = 0.01), the number of e-cigarettes smoked daily was higher (p < 0.001). Dual smokers more frequently used tobacco cigarettes than e-cigarettes (p = 0.01) but smoked more e-cigarettes daily (p = 0.003). The choice of e-liquid depended on the flavour (50.0%), nicotine concentration (21.7%) and price (7.6%). No-nicotine e-cigarettes were used by 6.5% smokers. Dual smokers more frequently chose e-liquids with high nicotine concentration (p = 0.01). Motivations leading to e-smoking were: quitting tobacco (58.7%), less harmful impact on health (43.5%) and the price (34.8%). E-smoking as safe for health was perceived by 6.0% of respondents (35.5% in e-smokers vs. 4.9% in non e-smokers; p < 0.001). CONCLUSION: Among students of medicine, e-smoking is apparently less popular than smoking tobacco cigarettes. Respondents considered e-cigarettes to be harmful and addictive.

[Assessment of the response of peripheral blood mononuclear leukocytes on Helicobacter pylori infection in children]. / Ocena odpowiedzi swoistej limfocytów z krwi obwodowej na zakazenie Helicobacter pylori u dzieci.

In the study the proliferative response of peripheral blood mononuclear leukocytes (PBML) from children with chronic dyspepsia (chr. d) to H.p. antigens was investigated. From 38 children aged 7-18, with chr. d., blood was collected just before upper GI endoscopy. Twenty one patients were found to be H.p. (+). PBML were used for the cultures and were stimulated with heat-killed H.p. G27 bacteria, heated and unheated glycine extract (GE) of H.p. G27 or with H.p. LPS containing Lewis X and Lewis Y determinants, in the presence or absence IL-2. The cell proliferation was estimated on the basis of [3H] - thymidine incorporation. In the cultures, the phenotype of responding cells was determined by an EIA with monoclonal antibody to human CD3, CD4 and CD8. PBML from patients H.p. (-), responded to killed H.p. bacteria and to heated GE more frequently and more intensively than PBML from the H.p.(+). IL-2 enhanced PBML response to these antigens. Unheated GE did not induce PBML proliferation even in the cultures with IL-2. LPS alone induced proliferation of PBML from 3 patients (2 H.p. - and 1 H.p.+). However, in the presence of IL-2, LPS induced proliferation of PBML from 15 patients. In the cultures of PBML stimulated with whole bacteria or heated EG, T cells dominated. In the cultures of PBML from H.p. (+) we found a higher percentage of CD8 cells in comparison with the cultures of PBML from H.p. (-). Data demonstrate a significant variation in the response of PBML from dyspeptic children to H.p. antigens.

Helicobacter pylori lipopolysaccharide in the IL-2 milieu activates lymphocytes from dyspeptic children.

In this study, we assessed the proliferative response of peripheral blood mononuclear leukocytes (PBML) from 33 children/young adolescents with chronic dyspepsia, to H. pylori LPS in the presence and absence of IL-2 as a T cell growth factor. A rapid urease test (RUT) and a presence of Helicobacter-like organisms (HLO) in the biopsy specimens allowed us to distinguish RUT/HLO-positive (17/33) and -negative (16/33) patients. H. pylori LPS alone induced a proliferation of PBML from 4 out of 33 dyspeptic patients. IL-2 increased the prevalence of the response to LPS to 59% and 74% of RUT/HLO-positive and -negative patients, respectively. PBML from RUT/HLO-positive patients responded significantly less intensively to H. pylori LPS in the presence of IL-2, to IL-2 alone and to H. pylori LPS+IL-2. However, there was no difference in PHA-driven proliferation of PBML from the patients of those two groups. A negative correlation between the responsiveness to H. pylori LPS of PBML and occurrence of type B inflammation in gastric mucosa was demonstrated. The results suggest a contribution of H. pylori LPS to an outcome of H. pylori infection. It is speculated that H. pylori LPS by an activation of immunocompetent cells may reduce gastric inflammation, decrease bacterial load and prolong H. pylori infection.