The presence of Tau protein in blood as a potential prognostic factor in stroke patients.

Tau protein is found in the blood of 40 - 50% of patients in the acute phase of a stroke, as a result of the degradation of neurons and damage to the blood-brain barrier. The aim of the study was to assess the incidence of tau protein in the blood of stroke patients, as well as to evaluate the potential impact of tau protein presence in the blood of patients on their neurological state during the first 24 hours, and their functional condition three months after the stroke. Eighty-seven patients aged 39 - 99 (42 females and 45 males) diagnosed with stroke were enrolled in the prospective study (August 2014 - April 2015). The following parameters were analyzed in enrolled participants: the age at which first ischemic stroke occurred, neurological state during the first 24 hours (National Institutes of Health Stroke Scale - NIHSS), blood tau protein and brain derived neurotrophic factor (BDNF) concentrations on day 2 of stroke, the functional condition on day 90 after stroke onset (mRankin). A multifactorial analysis was carried out to establish independent factors for the presence of serum tau protein and to identify independent factors for poor prognosis. Eighty-seven patients of the mean age of 71.7 ± 11.8 years (median 74; min. 39 max. 99 years) took part in the study. The tau protein was found in the serum of 42 (48.27%) patients in the concentrations between 29.56 and 19 023.50 ng/ml. The female sex was the only independent factor for the presence of tau protein in blood (RR 4.49 (1.68 - 11.97), P = 0.003). The mean BDNF concentration in the evaluated group was: 9.96 ± 5.21; median 10.39. Three independent factors for poor functional condition of patients on day 90 after the stroke were identified: the presence of tau protein in blood (RR 3.90 (1.45 - 10.49), P = 0.007), BDNF concentration below the mean value for the study (RR 14.49 (4.60 - 45.45); P = 0.000) and NIHSS score > 4 during the first 24 hours of stroke (RR 1.14; 95% CI: 1.00 - 1.31; P = 0.027). The presence of the tau protein, low BDNF concentrations, and moderate/serious neurological state during the first 24 hours of stroke can be considered as negative prognosis for the patient's functional condition. The coincidence of high BDNF concentrations and absence of tau in blood during the acute phase of an ischemic stroke is a predictor of patient's good state in 3 months after stroke.

Changes in physiological tremor resulting from sleep deprivation under conditions of increasing fatigue during prolonged military training.

The aim of the study was to define the changes of the characteristics of physiological postural tremor under conditions of increasing fatigue and lack of sleep during prolonged military training (survival). The subjects of the study were 15 students of the Polish Air Force Academy in Deblin. The average age was 19.9±1.3 years. During the 36-hour-long continuous military training (survival) the subjects were deprived of sleep. Four tremor measurements were carried out for each of the subjects: Day 1 - morning, after rest (measurement 0); Day 2 - morning, after overnight physical exercise (measurement 1); afternoon, after continuous sleep deprivation (measurement 2); Day 3 - morning, after a full night sleep (measurement 3). The accelerometric method using an acceleration measuring kit was applied to analyse tremor. A significant difference between mean values of the index evaluating tremor power in low frequencies L2-4 in measurement 0 and measurement 3 was observed (p<0.01). No significant differences were found in mean values of index L10-20. Mean frequencies F2-4 differed significantly from each other (F2,42=4.53; p<0.01). Their values were 2.94±0.11, 2.99±0.9, 2.93±0.07 and 2.91±0.07 for successive measurements. A gradual, significant decrease of F8-14 was observed (F2,42=5.143; p<0.01). Prolonged sleep deprivation combined with performing tasks demanding constant physical effort causes long-lasting (over 24 hours) changes of the amplitude of low-frequency tremor changes. This phenomenon may significantly influence psychomotor performance, deteriorating the ability to perform tasks requiring movement precision.

[Evaluation of agreement between clinical and pathomorphologic diagnosis of pulmonary embolism]. / Ocena zgodnosci rozpoznania klinicznego i patomorfologicznego zatoru tetnicy plucnej.

The rate of both: false-positive and false-negative diagnoses of pulmonary embolism (PE) is high. To determine the accuracy of the ante-mortem diagnosis of PE we reviewed 78 autopsies and compared the clinical and pathological diagnoses in that group. In 64 cases PE was diagnosed clinically: in 43 it was confirmed by autopsy (67%). In 21 cases (33%) the clinical diagnoses were false-positive. There were 57 pathological diagnoses altogether: in 14 cases (25%) the clinical diagnoses were false-negative. Among falsely diagnosed patients, the diagnoses of myocardial infarction, pneumonia and malignancy were most frequent. We tried to find some distinctive features separating the cases in the subgroups. Among them venous diseases were more frequent in PE than in falsely diagnosed patients.

[Plasma antithrombin III activity in patients with pulmonary thromboembolism]. / Aktywnosc antytrombiny III w osoczu u chorych z choroba zakrzepowo-zatorowa.

A decreased plasma antithrombin III activity has been noted in 12 out of 20 patients. In 2 patients it was most probably congenital defect, whereas in the remaining 10 patients--acquired. The observed disorders in the activity of antithrombin III with particular reference to anticoagulant therapy have been discussed.

[Difficulties in diagnosing tuberculous pericarditis]. / Trudnosci diagnostyczno-róznicowe w rozpoznawaniu gruzliczego zapalenia osierdzia.

Malignancy was diagnosed cytologically in a 62 year old female with exudative pericarditis. Despite extensive diagnostical procedures the primary source of the neoplasm could not be defined. After 18 months the patient died. Autopsy disclosed tuberculous pericarditis. The authors discussed the differential diagnosis between malignant and tuberculous pericarditis and the reasons for this diagnostical error.