Telemedicine in acute stroke

Abstract Background   Telemedicine is increasingly being used in acute stroke care. Some of the first studies and network projects are already applying remote audiovisual communication for patient evaluation. Formerly the telephone was the method of choice to contact experts for case discussion. We compared remote video-examination and telephone consultation in acute stroke care. Methods   Two district hospitals were linked to stroke centers in Northern Bavaria. Patients with symptoms suggestive of an acute stroke were included. Remote video examination (RVE) was provided by live audiovisual communication and access to brain images; telephone consultation (TC) was done via standard telephone using a structured interview. There was a weekly rotation of the two methods. Demographic data and other data concerning process and quality of care as well as outcome 10 days after stroke were recorded and compared between the two groups. Results   Within the study period 151 consultations were made in acute stroke patients (mean age 66.8 years). 77 patients were seen by RVE and 74 by TC. Total examination times were 49.8 min for RVE and 27.2 min for TC (p < 0.01). Patients were more frequently transferred to the stroke center after TC consultation (9.1 % vs. 14.9 %, p < 0.05) and had a higher mortality 10 days after stroke (6.8 % vs. 1.3 %, p < 0.05). Diagnosis made by TC had to be corrected more frequently (17.6 % vs. 7.1 %; p < 0.05). Conclusions   Creating a network improves stroke care by establishing cooperation between hospitals. Telephone consultation could be a simple method of telemedicine to support cooperation as it is easy and widely available. However, outcome parameters like mortality indicate that remote video examination is superior to TC. Therefore, full-scale audiovisual communication is recommended for remote consultation in acute stroke care.     

Interleukin-10 gene polymorphism in Parkinson's disease patients

BACKGROUND: The etiology of sporadic Parkinson's disease (PD) is not well established. Recent studies revealed that inflammatory processes might also play an important role in the pathogenesis of PD. We hypothesized that genetically determined differences in the immune response, especially in anti-inflammatory cytokines production, might influence the risk of sporadic PD development and/or onset. To prove this hypothesis, two DNA polymorphisms at IL-10 promoter (-1082 and -519) were examined in sporadic PD patients. METHODS: The study enrolled 341 patients with diagnosed idiopathic PD. All cases of secondary parkinsonism were excluded from the study. For the purpose of this study the patients were also divided into two subgroups: group 1: patients with onset of Parkinson's disease, i.e., <50 years of age (early onset) included 60 patients, as well as group 2: patients with onset of Parkinson's disease >50 years of age (late onset) comprising 281 subjects. Control samples were from 315 randomly selected healthy individuals from the same geographical region who were free from signs of parkinsonism as evaluated by consultant neurologists. PCR-RFLP methods were used for genotyping. RESULTS: No statistically significant differences between PD patients and controls were found in the frequency of a single locus (-1082, -519) of IL-10 promoter. Likewise, haplotype analysis did not demonstrate any significant differences between evaluated groups. The frequency of the evaluated IL-10 genotypes was also similar in EOPD and LOPD patients. CONCLUSIONS: Results from our study revealed that the IL-10 (-1082G>A, -592C>A) polymorphism is not a risk factor of sporadic Parkinson's disease in a Polish population.     

siRNA knockdown of mitochondrial thymidine kinase 2 (TK2) sensitizes human tumor cells to gemcitabine

Nucleoside metabolism enzymes are determinants of chemotherapeutic drug activity. The nucleoside salvage enzyme deoxycytidine kinase (dCK) activates gemcitabine (2′, 2′-difluoro-2′-deoxycytidine) and is negatively regulated by deoxycytidine triphosphate (dCTP). Reduction of dCTP in tumor cells could, therefore, enhance gemcitabine activity. Mitochondrial thymidine kinase 2 (TK2) phosphorylates deoxycytidine to generate dCTP. We hypothesized that: (1) TK2 modulates human tumor cell sensitivity to gemcitabine, and (2) antisense knockdown of TK2 would decrease dCTP and increase dCK activity and gemcitabine activation. siRNA downregulation of TK2 sensitized MCF7 and HeLa cells (high and moderate TK2) but not A549 cells (low TK2) to gemcitabine. Combined treatment with TK2 siRNA and gemcitabine increased dCK. We also hypothesized that TK2 siRNA-induced drug sensitization results in mitochondrial damage that enhances gemcitabine effectiveness. TK2 siRNA and gemcitabine decreased mitochondrial redox status, DNA content, and activity. This is the first demonstration of a direct role for TK2 in gemcitabine resistance, or any independent role in cancer drug resistance, and further distinguishes TK2 function from that of other dTMP-producing enzymes [cytosolic TK1 and thymidylate synthase (TS)]. siRNA knockdown of TK1 and/or TS did not sensitize cancer cells to gemcitabine indicating that, among the 3 enzymes, only TK2 is a candidate therapeutic target for combination with gemcitabine.     

The size does not matter - the presence of microvascular obstruction but not its extent corresponds to larger infarct size in reperfused STEMI

Background

Microvascular obstruction (MVO) is a cardiac magnetic resonance (CMR) marker of no-reflow in ST-segment elevation myocardial infarction (STEMI). It remains unresolved whether the infarct size corresponds only to the presence of MVO or also to its extent.

Methods

The study included 53 patients with first STEMI (median age 61.5 years, 77% male) treated with percutaneous coronary intervention (PCI) who underwent CMR after median 5 days from PCI. Small MVO was defined as patchy, non-confluent spots of dark areas of absent contrast surrounded by late gadolinium enhancement (LGE). Large MVO was defined as confluent areas of MVO comprising a large amount of the infarct zone.

Results

Microvascular obstruction was observed in 32 patients (60%) including 18 patients with small MVO (36%) and 14 patients with large MVO (24%). Patients with MVO were more likely to have TIMI 0/1 grade flow on initial angiogram, higher levels of necrotic markers, larger infarct size, larger left ventricular end-diastolic and end-systolic volume and lower ejection fraction in comparison to patients without MVO. These differences were not observed between patients with large and small MVO.

Conclusions

The presence of MVO but not its extent corresponds to larger infarct size in STEMI.     

Toxicity of Ammonia Nitrogen to Ciliated Protozoa <Emphasis Type="Italic">Stentor coeruleus</Emphasis> and <Emphasis Type="Italic">Coleps hirtus</Emphasis> Isolated from Activated Sludge of Wastewater Treatment Plants

We assessed the toxicity of ammonia ions to Stentor coeruleus and Coleps hirtus (Protozoa) isolated from activated sludge taken from two municipal wastewater treatment plants in southern Poland. Stentor coeruleus is a rarely occurring species in activated sludge, unlike the widespread Coleps hirtus. The mean LC50 values (concentration causing 50 % mortality) calculated for the 24 h tests differed hugely between the tested species: 43.03 mg NH⁴⁺ dm⁻³ for Stentor coeruleus and 441.12 mg NH⁴⁺ dm⁻³ for Coleps hirtus. The ammonia ion concentration apparently is an important factor in the occurrence of these protozoan species in activated sludge.     

Leaching and VOC Emission Tests of Polymer Composites Produced from Post-Consumer Waste in Terms of Application in the Construction Sector

One of the existing priorities of the European Union is to search for rational waste management and to keep such waste in the economic cycle, while meeting the highest safety requirements. The paper presents the results of environmental tests of composites based on the polyethylene (rPE) and polypropylene (rPP) matrix and reinforced with cellulose fibres (newsprint, NP). Raw materials were obtained by recycling post-consumer waste such as beverage bottles and newsprint. The composites were tested for their potential use as materials in cladding panels and acoustic barriers. Given that normative documents for these products do not define specific environmental requirements, the composites were tested for the release of dangerous substances, such as anions of inorganic compounds, heavy metals, volatile organic compounds (VOCs), and their impact on the environment. A detailed in-depth analysis of the mechanisms of release of substances (diffusion, dissolution, surface leaching and depletion) from the rPP/NP composite into surface water, groundwater and soil was carried out. In turn, emission of VOCs from the rPE (low-density:high-density (LD:HD)—50:50) and rPE (LD:HD—30:70) composites into indoor air was also carried out. Raw materials in the form of granulates and loose cellulose fibres, used to produce the composites, were also tested for their environmental impact.     

Sonographic findings in a neonate with cobb syndrome

Cobb syndrome (cutaneomeningospinal angiomatosis) is a rare phacomatosis characterized by vascular abnormality of the spinal cord associated with a vascular naevus at the same metamere. We report the case of a newborn with Cobb syndrome, diagnosed by sonography of the spine and later confirmed by MRI. In neonates and young infants with dermatomal cutaneous vascular abnormalities, sonography of the spine should be used as the first imaging modality. © 2012 Wiley Periodicals, Inc. J Clin Ultrasound, 2013     

Sympathetic denervation impairs epidermal healing in cutaneous wounds

The involvement of peripheral nerves in dermal wound healing, particularly in the inflammatory response has not been extensively studied. Therefore, this study was performed to examine the role of peripheral nerves in the healing of rat skin linear incisions. We report that chemical sympathectomy with 6-hydroxydopamine significantly impaired wound healing as measured on days 7, 11, and 14 postsurgery (by day 14, 48% of the sympathectomized rats were healed in contrast with 84% of the controls; p = 0.0104). In contrast, neonatal capsaicin treatment, which predominantly destroys sensory afferents, had no effect on wound healing ( p > 0.05 on all days). These results support the hypothesis that sympathetic efferents are important for wound healing. Unlike previous research, which showed that peripheral nerves influence ischemic skin flaps, we are the first to demonstrate a role for peripheral nerves in the healing of skin incisions. Because inflammation is an important step in cutaneous wound healing, we propose that a reduction of neurogenic inflammation caused by sympathectomy may explain the impaired wound healing that we observed in our study.     

Homology modeling of the serotonin 5-HT1A receptor using automated docking of bioactive compounds with defined geometry

This paper describes a rhodopsin-based model of 5-HT(1A) serotonin receptor. The flexibility of the receptor was considered by using large number of models for ligand dockings. Rearrangements of the heptahelical bundle were introduced, which resulted in the improvement of correlation between computational results and experimental data. The model was validated by automated docking of conformationally restricted arylpiperazines. Specific interactions, responsible for the recognition of arylpiperazine derivatives, were identified. An ionic bond was formed between the protonated amine of ligands and Asp3.32. The aromatic moiety and its substituents specifically interacted with Phe6.52 and Ser5.42, respectively, while the carbonyl groups of imide part of ligands formed hydrogen bonds with Asn7.39 and Tyr7.43. The model reproduced the binding affinity of the test group of ligands (correlation r = 0.8 between pK(i) and docking score). It also gave the enrichment in virtual screening-like experiment (100 compounds), in which 34 high-affinity compounds were found among 50 top-scored ligands.