Prospective assessment of aneurysmal rupture risk scores in patients with subarachnoid hemorrhage: a multicentric cohort.

PURPOSE: The natural evolution of unruptured intracranial aneurysms (UIA) is indeed difficult to predict at the individual level. OBJECTIVE: In a large prospective multicentric European cohort, we aimed to evaluate whether the PHASES, UCAS, and ELPASS scores in patients with aneurysmal subarachnoid hemorrhage would have predicted a high risk of aneurysmal rupture or growth. METHODS: Academic centers treating patients with intracranial aneurysms were invited to prospectively collect de-identified data from all patients admitted at their institution for a subarachnoid hemorrhage-related to intracranial aneurysmal rupture between January 1 and March 31, 2021 through a trainee-led research collaborative network. Each responding center was provided with an electronic case record form (CRF) which collected all the elements of the PHASES, ELAPSS, and UCAS scores. RESULTS: A total of 319 patients with aneurysmal subarachnoid hemorrhage were included at 17 centers during a 3-month period. One hundred eighty-three aneurysms (57%) were less than 7 mm. The majority of aneurysms were located on the anterior communicating artery (n = 131, 41%). One hundred eighty-four patients (57%), 103 patients (32%), and 58 (18%) were classified as having a low risk of rupture or growth, according to the PHASES, UCAS, and ELAPSS scores, respectively. CONCLUSION: In a prospective study of European patients with aneurysmal subarachnoid hemorrhage, we showed that 3 common risk-assessment tools designed for patients with unruptured intracranial aneurysms would have not identified most patients to be at high or intermediate risk for rupture, questioning their use for decision-making in the setting of unruptured aneurysms.

The effect of feed supplementation with a copper-glycine chelate and copper sulphate on selected humoral and cell-mediated immune parameters, plasma superoxide dismutase activity, ceruloplasmin and cytokine concentration in broiler chickens.

The varied bioavailability and different effects of organic forms of copper on the immune system of poultry have prompted the search for new feed additives based on copper compounds containing modified chelate complexes. The aim of the study was to determine the effect of inorganic and organic forms of copper on selected parameters of the cellular and humoral immune response in broiler chickens by determining the percentages of CD3+ CD4+ , CD3+ CD8+ and CD25+ lymphocytes, cells with MHC Class II expression, and BU-1+ cells, as well as the concentrations of SOD, IL-2, IL-10 and TNF-α in the peripheral blood. The experiments were conducted using 500 one-day-old Ross 308 roosters divided into five groups. Cu was added in inorganic form (CuSO4 ), in inorganic form with the addition of phytase (CuSO4 + F), in organic form in combination with glycine (Cu-Gly) and in organic form in combination with glycine and a phytase supplement (Cu-Gly+F). The results of the study indicate an increase in the percentage of CD3+ CD4+ and CD3+ CD8+ T lymphocytes, CD25+ T cells, and cells expressing MHC class II molecules, and in the concentration of ceruloplasmin, activity of superoxide dismutase and the concentration of IL-2 in the groups that received copper, particularly copper-glycine chelates. Based on the study, we can conclude that supplementation of poultry feed with copper chelates activates mainly the Th1 cellular immune response and the response of peripheral blood T lymphocytes. Furthermore, it promotes secretion of cytokines, which are involved in potentiation and regulation of the immune response in birds.

Microencapsulated sodium butyrate reduces the frequency of abdominal pain in patients with irritable bowel syndrome.

AIM: Abdominal pain, defaecation disorder and change of bowel habit are the commonest symptoms of irritable bowel syndrome (IBS). The effect of microencapsulated sodium butyrate (MSB) was assessed on the severity of symptoms in patients with IBS. METHOD: Sixty-six patients treated with one of the standard pharmacological therapies for at least 3 months were included in the study. They were randomized to receive MSB as a supplemental treatment to standard therapy or to receiving a placebo. Previous pharmacological therapy was continued throughout the study in both arms. Clinical evaluation was performed at baseline, 4 and 12 weeks. Each assessment was documented by a validated visual analogue score questionnaire measuring the severity of selected clinical symptoms, a closed-end questionnaire measuring the frequency of selected clinical symptoms and a single closed-end question measuring the subjective improvement of symptoms. RESULTS: After 4 weeks there was a significant decrease of pain during defaecation in the MSB group which extended to improvement of urgency and bowel habit at 12 weeks. Reduction of abdominal pain, flatulence and disordered defaecation was not statistically significant. CONCLUSIONS: MSB as a supplemental therapy can reduce the frequency of selected clinical symptoms in patients with IBS, without significant influence on reducing symptom severity.

Distribution of UL144, US28 and UL55 genotypes in Polish newborns with congenital cytomegalovirus infections.

Human cytomegalovirus (HCMV) is the most common congenital infection. HCMV strains display genetic variability in different regions. Distribution of HCMV genotypes in the population of congenitally infected newborns from Central Poland and viral load in newborns' blood is described and discussed. HCMV isolates were analysed by sequencing at three sites on the genome: the UL144 tumour necrosis factor-alpha (TNFα)-like receptor gene, the US28 beta-chemokine receptor gene and the UL55 envelope glycoprotein B (gB) gene. The newborns' blood was examined for HCMV DNA with a nested (UL144, UL55) or heminested (US28) polymerase chain reaction, and the genotypes were determined by sequence analysis. HCMV DNA was detectable in 25 out of 55 examined newborns born by HCMV-infected mothers (45.5%). The blood viral load in mother-infant pairs was determined. Most of the newborns had identical virus genotype, gB2 (96%), UL144 B1 (88%) and US28 A2 (84%). These genotypes were detected in all newborns with asymptomatic congenital infection. The occurrence of UL144 B1 or US28 A2 genotypes in the babies examined was significant in comparison to other genotypes (p=0.0002 and p=0.040 respectively). There was no association between specific gB subtypes in all patients groups (p=0.463). There was no correlation between HCMV genotypes and the outcome.

The mechanical properties and bactericidal degradation effectiveness of tannic acid-based thin films for wound care.

The surface area is the most important aspect when considering the interactions between a material and the surrounding environment. Chitosan (CTS) and tannic acid (TA) were previously successfully tested by us to obtain thin films to serve as wound dressings or food packaging materials. However, surface properties as well as the antimicrobial activity of the material were not considered. They are important if the material is likely to find application in biomedical or food packaging application. Thereby, this study is a further investigation of chitosan/tannic acid films surface properties. The results showed that higher content of tannic acid increases the surface free energy and roughness, which is beneficial when considering the application of the materials as wound dressings. However, higher content of chitosan provides better antibacterial properties. Hence, the most optimal complex of chitosan and tannic acid for proposed application is the ratio 80/20.

Design, characterization and in vitro evaluation of thin films enriched by tannic acid complexed by Fe(III) ions.

Materials based on carbohydrate polymers may be used for biomedical application. However, materials based on natural polymers have weak physicochemical properties. Thereby, there is a challenge to improve their properties without initiation of toxicity. The alternative method compared to toxic chemical agents' addition is the use of metal complexation method. In this study, chitosan/tannic acid mixtures modified by Fe(III) complexation are proposed and tested for potential applications as wound dressings. Thereby, surface properties, blood compatibility as well as platelet adhesion was tested. In addition, the periodontal ligament stromal cells compatibility studies were carried out. The results showed that the iron(III) addition to chitosan/tannic acid mixture improves properties due to a decrease in the surface free energy and exhibited a reduction in the hemolysis rate (below 5%). Moreover, cells cultured on the surface of films with Fe(III) showed higher metabolic activity. The current findings allow for the medical application of the proposed materials as wound dressings.

Physicochemical properties of scaffolds based on mixtures of chitosan, collagen and glycosaminoglycans with nano-hydroxyapatite addition.

Scaffolds based on chitosan (CTS), collagen (Coll), and glycosaminoglycans (GAGs) mixtures with nano-hydroxyapatite (HAp) were obtained with the use of the freeze-drying method. They were characterized by different analyses, e.g. SEM images and mechanical testing. Moreover, swelling behavior and biocompatibility tests were carried out. The results showed that the scaffolds based on the blends of chitosan, collagen, and glycosaminoglycans with hydroxyapatite are stable in aqueous environment. SEM images allowed the observation of a porous scaffolds structure with the pores size ~250 µm. The main purpose of the research was to detect the influence of hydroxyapatite addition on the glycosaminoglycans-enriched scaffolds properties. The physicochemical properties as swelling and mechanical parameters were tested. The scaffolds structure was observed by SEM. Moreover, the preliminary assessment of scaffolds suitability for cell growth, human osteosarcoma cell line SaOS-2 was used. The obtained results indicate that the addition of hydroxyapatite improves the mechanical parameters and cells biological response of the studied materials.

The application of chitosan/collagen/hyaluronic acid sponge cross-linked by dialdehyde starch addition as a matrix for calcium phosphate in situ precipitation.

Scaffolds based on chitosan, collagen and hyaluronic acid, cross-linked by dialdehyde starch were obtained through the freeze-drying method. The porous structures were used as matrixes for calcium phosphate in situ precipitation. Composites were characterized by different analyses, e.g. infrared spectroscopy, SEM images, porosity, density, and mechanical tests. Moreover, an examination involving the energy dispersive X-ray spectroscopic method was carried out for the calcium and phosphorus ratio determination. In addition, the adhesion and proliferation of human osteosarcoma SaOS-2 cells were examined on the obtained scaffolds. The results showed that the properties of the scaffolds based on chitosan, collagen, and hyaluronic acid can be modified by dialdehyde starch addition. The mechanical parameters (i.e. compressive modulus and maximum compressive force), porosity, and density of the material were improved. Calcium phosphate was deposited in the scaffolds at the Ca/P ratio ∼2. SEM images showed the homogeneous structure, with interconnected pores. The cross-linker addition and an inorganic compound precipitation improved the biocompatibility of the scaffolds. The obtained materials can provide the support required in tissue engineering and regenerative medicine.

Influence of glycosaminoglycans on the properties of thin films based on chitosan/collagen blends.

Thin films based on chitosan, collagen, and glycosaminoglycans isolated from fish skin were obtained by solvent evaporation. The films were characterized by different analyses, e.g. surface free energy determination, swelling tests, roughness, mechanical and thermal measurements. Moreover, the degradation studies were carried out by the film treatment with collagenase. The results showed that the properties of the films based on chitosan and collagen can be modified by the glycosaminoglycans addition. It was noticed that the addition of glycosaminoglycans enhances the surface hydrophilicity and reduces surface free energy. Surfaces of films modified by glycosaminoglycans (GAGs) show more roughness which inhibits the risk of biofilm formation. The highest films swelling was obtained after 2 h immersion in phosphate-buffered saline (PBS). After their immersion in PBS, the films were more elastic, which was assumed on the basis of the elongation at break values higher than in the case of films on a dry surface. The proposed films can create biocompatible coatings for biomedical applications.

New composite materials prepared by calcium phosphate precipitation in chitosan/collagen/hyaluronic acid sponge cross-linked by EDC/NHS.

Nowadays, fabrication of composite materials based on biopolymers is a rising field due to potential for bone repair and tissue engineering application. Blending of different biopolymers and incorporation of inorganic particles in the blend can lead to new materials with improved physicochemical properties and biocompatibility. In this work 3D porous structures called scaffolds based on chitosan, collagen and hyaluronic acid were obtained through the lyophilization process. Scaffolds were cross-linked by EDC/NHS. Infrared spectra for the materials were made, the percentage of swelling, scaffolds porosity and density, mechanical parameters, thermal stability were studied. Moreover, the scaffolds were used as matrixes for the calcium phosphate in situ precipitation. SEM images were taken and EDX analysis was carried out for calcium and phosphorous content determination in the scaffold. In addition, the adhesion and proliferation of human osteosarcoma SaOS-2 cells was examined on obtained scaffolds. The results showed that the properties of 3D composites cross-linked by EDC/NHS were altered after the addition of 1, 2 and 5% hyaluronic acid. Mechanical parameters, thermal stability and porosity of scaffolds were improved. Moreover, calcium and phosphorous were found in each kind of scaffold. SEM images showed that the precipitation was homogeneously carried in the whole volume of samples. Attachment of SaOS-2 cells to all modified materials was better compared to unmodified control and proliferation of these cells was markedly increased on scaffolds with precipitated calcium phosphate. Obtained materials can provide the support useful in tissue engineering and regenerative medicine.

In vivo study on scaffolds based on chitosan, collagen, and hyaluronic acid with hydroxyapatite.

Scaffolds based on chitosan, collagen, and hyaluronic acid supplemented with nano-hydroxyapatite were obtained with the use of the freeze-drying method. Composites swelling behavior was assessed by the liquid uptake test. The adhesion and proliferation of human osteosarcoma SaOS-2 cells on the scaffolds were examined in 4-day culture. The biocompatibility of the chosen scaffolds was further studied by in vivo implantation into subcutaneous tissue of rabbits. The results showed low stability of the scaffolds based on chitosan, collagen, and hyaluronic acid supplemented with hydroxyapatite. The addition of hydroxyapatite delayed the degradation process of the obtained scaffolds. The X-ray images of the tissues surrounding the scaffolds showed that both, the control scaffold without hydroxyapatite (HAp) and those with addition of 50% wt. HAp underwent degradation after 6 months. However, the scaffolds supplemented with 80% wt. HAp premained in the implanted place. The results showed satisfactory tissue response on the implanted scaffolds.

Ischemic cholangiopathy after liver transplantation from controlled non-heart-beating donors-a single-center experience.

BACKGROUND: Previous reports have shown that livers from controlled non-heart-beating-donors (NHBD) are associated with higher rates of primary failure and ischemic cholangiopathy of orthotopic liver transplantation (OLT) as a complication of the prolonged warm ischemia. METHODS: This retrospective review of activities from 1999 to 2006 examined donor characteristics of age, liver function tests, warm ischemic time before (1WITa) and after cardiac arrest (1WITb), cold ischemic time (CIT) and transplant results. RESULTS: Eleven NHBD retrieved livers were transplanted from "ideal" donors except for one elderly donor (73 years). Of the 11 recipients, 3 developed biliary cholangiopathy (27%). There were no episodes of primary graft nonfunction, but one recipient displayed primary graft dysfunction. Two recipients died: one due to biliary complications with sepsis (long CIT >10 hours, fatty liver), and the other due to aspiration pneumonia and hypoxic brain damage with normal liver function. One recipient required retransplantation owing to ischemic cholangiopathy (1WITb 45 min) at 6 months after OLT with a good result. The other eight recipients are alive (observation period 72 to 14 months) including six with normal liver function, one with biopsy-proven biliary ischemia and one with recurrent primary sclerosing cholangitis without biliary ischemic changes on biopsy. Among 164 heart-beating donors recipients transplanted in the same period, biliary complications occurred in 27 patients (16%), of whom 12 were leaks and 15 anastomotic strictures. CONCLUSION: NHBD were a good source for livers with reasonable early results. To avoid late complications especially ischemic cholangiopathy, caution is urged with the use of these organs as well as strict donor and ischemic time criteria.

Effect of feed supplementation with zinc glycine chelate and zinc sulfate on cytokine and immunoglobulin gene expression profiles in chicken intestinal tissue.

The aim of the study was to evaluate the effect of inorganic and organic forms of Zn on the expression of cytokines (IL-2, TNF-α, IFN-γ, IL-12, IL-17, IL-4, IL-10, and TGF-ß) and immunoglobulins (IgA and IgG) in the tissues of the small intestine (jejunum and ileum) of broiler chickens. In the experiment, 90 broiler chickens were divided into 4 experimental groups and a control group, with 18 birds each. The birds received Zn supplements in inorganic form with and without phytase (ZnSO4 and ZnSO4 + F), and in organic form with glycine, with and without phytase (Zn-Gly and Zn-Gly + F). The total rearing period was 42 days. Quantitative real-time (RT)-PCR was used to measure the expression of the cytokines and immunoglobulins. The differences between the results obtained for the control and experimental groups, between the groups receiving ZnSO4 and Zn-Gly, and between groups ZnSO4-F and Zn-Gly-F were analyzed statistically. High relative expression of IL-2 was observed for the chickens in the groups receiving ZnSO4-F, Zn-Gly, and Zn-Gly-F on d 42 in comparison to the control group. High relative expression of TNF-α, IL-12, and IL-17 was noted in the group that received ZnSO4 + F. High expression of IgG, IgA, IL-4, TGF-ß, and IL-10 was noted in the groups of chickens that received feed supplemented with Zn-Gly and Zn-Gly + F chelates on d 42 of the study in comparison to the control group. In conclusion, supplementation with Zn-Gly chelates can ensure Th1 and Th2 balance during the immune response in the gut-associated lymphoid tissue (GALT), and, by increasing IgA and IgG expression, also can stimulate potentiation of the immune response involved in passive protection of the body from infection. In contrast, the use of inorganic forms of Zn, in the form of sulfates, can induce local inflammatory processes in the intestines, which, in the case of long-term supplementation, lead to the development of infections.

Characterization of gelatin and chitosan scaffolds cross-linked by addition of dialdehyde starch.

In this study the influence of the addition of dialdehyde starch on the properties of scaffolds based on gelatin and chitosan obtained by the freeze-drying method was investigated. In addition, the adhesion and proliferation of human osteosarcoma SaOS-2 cells on the obtained scaffolds was examined. Chitosan and gelatin were mixed in different weight ratios (75/25, 50/50, 25/75) with 1, 2 and 5 wt% addition of dialdehyde starch. The obtained scaffolds were subjected to mechanical testing, infrared spectroscopy, swelling measurements, low-pressure porosimetry and zeta potential measurement. Internal material structures were observed by scanning electron microscopy. The results showed that the cross-linking process occurred after the addition of dialdehyde starch and resulted in increased mechanical strength, swelling properties, zeta potential and porosity of studied materials. The attachment of SaOS-2 cells to all modified materials was better compared to an unmodified control and the proliferation of these cells was markedly increased on modified scaffolds.

The influence of UV-irradiation on chitosan modified by the tannic acid addition.

The influence of UV-irradiation with the wavelength 254 nm on the properties of chitosan modified by the tannic acid addition was studied. Tannic acid was added to chitosan solution in different weight ratios and after solvent evaporation thin films were formed. The properties of the films such as thermal stability, Young modulus, ultimate tensile strength, moisture content, swelling behavior before and after UV-irradiation were measured and compared. Moreover, the surface properties were studied by contact angle measurements and by the use of atomic force microscopy. The results showed that UV-irradiation caused both, the degradation of the specimen and its cross-linking. The surface of the films made of chitosan modified by the addition of tannic acid was altered by UV-irradiation.

Neurolinguistic analysis of verbal utterances in patients with focal lesions of frontal lobes.

Verbal utterances of 105 patients have been analyzed. Six groups of subjects were examined including patients with left dorsolateral frontal lesions, left orbitofrontal lesions, right frontal lobe lesions, posterior aphasics, posterior brain-damaged patients without aphasia, and a matched control group. Results indicate that the left frontal lobe is involved in organization of linguistic information. Its dorsolateral part seems to be concerned with forming the sequential pattern of an utterance, and the orbital part with the directed development of a narrative. It is conceivable that the right frontal lobe is important for the global, nonlinguistic organization of information to be uttered.

Electrochemical therapy in palliative treatment of malignant dysphagia: a pilot study.

BACKGROUND/AIMS: Electrochemical therapy (ECT), a method based on the application of a low-level direct current, was employed in this study to relieve severe dysphagia. In addition, we aimed to assess the efficacy, safety and requirements for follow-up re-interventions. METHODOLOGY: Sixteen patients with inoperable and circumferential malignant stenosis of the esophagus were palliated by ECT at presentation and then repeatedly whenever tumor growth and dysphagia recurred. The electrode was inserted and placed at the level of stenosis under fluoroscopic guidance, and an electric quantity of 300-560 coulombs (5-6.5 V; 60-90 mA) was given. When total luminal occlusion was found, prior balloon dilatation enabled insertion of the electrode. Patients with squamous cell carcinoma also received external beam radiotherapy of 20-30 Gy in 10 daily fractions. Dysphagia was graded on a scale of O to 4 (O = normal; 4 = complete dysphagia), and follow-up esophagograms were obtained for response evaluation. RESULTS: The severity of dysphagia decreased by 1-4 (median: 2) grades with an improvement in 6 patients with totally obstructing lesions. Dysphagia recurred in all but 1 patient after a median interval of 10 weeks, but was easily treated with repeat ECT sessions. However, 2 patients became unresponsive to ECT after 7 and 3 months of therapy, respectively. There were no ECT-related complications. CONCLUSIONS: In conclusion, this pilot study suggests that electrochemical therapy may provide safe and effective palliation of narrowing and circumferential esophageal carcinoma. It requires repeat interventions and dilatation expertise is necessary for insertion of the electrode through the totally obstructing lesion.

[A contribution to diagnosing receptive-expressive dysphasia]. / Przyczynek do rozpoznawania dysfazji receptywno-ekspresywnej.

Diagnosis of disturbances of speech and the language of the receptive-expressive type of dysphasia was described in 8-year-old child. These disturbances were found to be the problems in learning. Complex clinical evaluation of such cases was stressed as very important.