The First Patient in Poland Treated for SMA with Nusinersen During Pregnancy.

The accessibility of effective SMA (spinal muscular atrophy) treatment is resulting in a growing number of affected women reaching fertility age and deciding to conceive. Pregnancy in women with SMA is associated with a high risk of rapid progression of symptoms, including increased weakness, growing paresis, or even onset of respiratory failure requiring ventilation support. Muscle weakness frequently leads to disability, which in a high percentage is irreversible.

Comparison of Two Techniques to Assess Muscle Mass Loss During ICU Stay: Muscle Ultrasound vs Bioelectrical Impedance Analysis.

Background And Aims: Muscle wasting is a prevalent issue among long-term critically ill patients and is associated with adverse clinical outcomes. Evaluating muscle mass in the ICU presents challenges due to the lack of a consistent methodology and the significant impact of fluid balance range in ICU patients. This prospective study aimed to compare the utility of bioelectrical impedance analysis (BIA) and ultrasound (US) for monitoring muscle wasting in critically ill patients over an initial seven-day period of critical illness.

Detection of Subarachnoid Hemorrhage Using CNN with Dynamic Factor and Wandering Strategy-Based Feature Selection.

: Subarachnoid Hemorrhage (SAH) is a serious neurological emergency case with a higher mortality rate. An automatic SAH detection is needed to expedite and improve identification, aiding timely and efficient treatment pathways. The existence of noisy and dissimilar anatomical structures in NCCT images, limited availability of labeled SAH data, and ineffective training causes the issues of irrelevant features, overfitting, and vanishing gradient issues that make SAH detection a challenging task.

Machine learning prediction of unexpected readmission or death after discharge from intensive care: A retrospective cohort study.

Background: Intensive care units (ICUs) harbor the sickest patients with the utmost needs of medical care. Discharge from ICU needs to consider the reason for admission and stability after ICU care. Organ dysfunction or instability after ICU discharge constitute potentially life-threatening situations for patients.

Preferences for albumin use in adult intensive care unit patients with shock: An international survey.

Introduction: Use of albumin is suggested for some patients with shock, but preferences for its use may vary among intensive care unit (ICU) physicians.

Methods: We conducted an international online survey of ICU physicians with 20 questions about their use of albumin and their opinion towards a randomised trial among adults with shock comparing the use versus no use of albumin.

Results: A total of 1248 respondents participated, with a mean response rate of 37%, ranging from 18% to 75% across 21 countries.

Analysis of metabolic alterations as 30 days intensive care mortality predictors for patients undergoing continuous renal replacement therapy.

Background: Acute kidney injury patients on continuous renal replacement therapy are subjected to alterations in metabolism, which in turn are associated with worse clinical outcome and mortality. The aim of this study is to determine which metabolism indicators can be used as independent predictors of 30 days intensive care unit (ICU) mortality.

Methods: This was a prospective observational study on critical care patients on renal replacement therapy.

Impact of Prescription Opioid Detoxification on Quality of Life and Pain Levels.

Purpose: The aim of this study was to examine the impact of detoxification from prescription opioids on the quality of life (QoL) and pain levels among patients reliant on these medications for chronic pain management.

Objective: Long-term use of opioids for pain management may lead to a range of adverse effects, including tolerance, dependence, significant societal costs, and a decline in overall quality of life (QoL). Despite these challenges, there is a limited amount of research focusing on the effects of detoxification and its impact on the QoL for patients with chronic pain tolerant to prescription opioids.

Accidental Intravenous Administration of Simethicone in a 4-Year-Old Patient: A Case Report.

Simethicone is an antiflatulent medication exclusively administered orally, thus its systemic effects remain unknown. We present a case of an inadvertent intravenous administration of simethicone to a 4-year-old patient, precipitating respiratory difficulty, cyanosis, and altered mental status. The patient's condition improved rapidly with appropriate interventions, leading to discharge in a fully recovered state.

Hypoxaemic respiratory failure and awake prone ventilation (HYPER-AP) - Protocol for randomized, controlled clinical trial.

Background: Awake prone positioning is studied extensively during Covid-19 pandemic, but there is very limited evidence on its utility in acute hypoxic respiratory failure caused by bacterial infections or other causes. The aim of our research is to evaluate the impact of awake prone positioning on outcomes in non-intubated adult patients with acute non-Covid19 hypoxemic respiratory failure.

Methods: This is a multi-center randomized controlled trial (RCT) with a parallel-group design and a 1:1 allocation ratio.

Prospective validation of a model-informed precision dosing tool for vancomycin treatment in neonates.

We recruited 48 neonates (50 vancomycin treatment episodes) in a prospective study to validate a model-informed precision dosing (MIPD) software. The initial vancomycin dose was based on a population pharmacokinetic model and adjusted every 36-48 h. Compared with a historical control group of 53 neonates (65 episodes), the achievement of a target trough concentration of 10-15 mg/L improved from 37% in the study to 62% in the MIPD group ( = 0.

Objective structured clinical examination to teach competency in planetary health care and management - a prospective observational study.

Background: Health professionals are increasingly called upon and willing to engage in planetary health care and management. However, so far, this topic is rarely covered in medical curricula. As the need for professional communication is particularly high in this subject area, this study aimed to evaluate whether the objective structured clinical examination (OSCE) could be used as an accompanying teaching tool.

Deciphering the enigmatic symptoms of Pancoast tumors: Navigating the complex landscape of pain management-A case report.

Pancoast tumors, also known as superior sulcus tumors, encompass a diverse spectrum of neoplasms that infiltrate the apex of the chest wall, yielding distinctive clinical presentations. One of the earliest signs of tumor growth is pain radiating to the upper limb, stemming from peripheral nerve involvement, which can mimic joint pain or spinal radicular irritation. In this case report, we present the clinical history of a 64-year-old female smoker who had previously been recommended for orthopedic elbow surgery due to epicondylitis.

Functional and Morphological Differences of Muscle Mitochondria in Chronic Fatigue Syndrome and Post-COVID Syndrome.

Patients suffering from chronic fatigue syndrome (CFS) or post-COVID syndrome (PCS) exhibit a reduced physiological performance capability. Impaired mitochondrial function and morphology may play a pivotal role. Thus, we aimed to measure the muscle mitochondrial oxidative phosphorylation (OXPHOS) capacity and assess mitochondrial morphology in CFS and PCS patients in comparison to healthy controls (HCs).

Impact of the WHO "best buys" for alcohol policy on consumption and health in the Baltic countries and Poland 2000-2020.

Alcohol use is a major risk factor for burden of disease. This narrative review aims to document the effects of major alcohol control policies, in particular taxation increases and availability restrictions in the three Baltic countries (Estonia, Latvia, and Lithuania) between 2000 and 2020. These measures have been successful in curbing alcohol sales, in general without increasing consumption of alcoholic beverages from unrecorded sources; although for more recent changes this may have been partly due to the COVID-19 pandemic.

Effects of Different Crystalloid Fluids on Renal Tissue in an Experimental Model of Hemorrhagic Shock.

Objective: The type of fluid that should be used in uncontrollable hemorrhages remains an area of research. This study was designed to compare the effects of resuscitation with Ringer's lactate (RL) solution versus a normal saline (NS) solution on hemodynamics, renal tissue histopathology, coagulation, and apoptosis in a rat model of hemorrhagic shock.

Methods: The study employed groups designated as the control, hemorrhage, NS, and RL groups.

Occurrence of butyrylcholinesterase polymorphisms in patients undergoing surgery in Slovakia.

Background: Post-operative residual curarization is a persisting problem, characterized by muscle fatigue, exhaustion or paresis, caused by the use of neuromuscular blocking agents with prolonged postoperative effect. Genetically, determined changes in cholinesterase activity can be a major reason for persistent muscle blockade after administration of muscle relaxants.

Methods: Regarding the subsistence of polymorphisms in the plasma cholinesterase gene causing change in enzyme activity and metabolism of applied drugs, we investigated the frequency of two polymorphisms known to reduce its activity significantly in patients undergoing surgery.

Replacing protein via enteral nutrition in a stepwise approach in critically ill patients: the REPLENISH randomized clinical trial protocol.

Background: Protein intake is recommended in critically ill patients to mitigate the negative effects of critical illness-induced catabolism and muscle wasting. However, the optimal dose of enteral protein remains unknown. We hypothesize that supplemental enteral protein (1.

Endoscopic discectomy of the herniated intervertebral disc and changes in quality-of-life EQ-5D-5L analysis.

Herniated lumbar discs are a common cause of low back pain, which can negatively impact the quality of life of working-age individuals. This study aimed to evaluate changes in the quality of life in patients with sciatica who underwent endoscopic discectomy, a minimally invasive surgical procedure. The study (ClinicalTrials.

Effect of early directed implementation of family-integrated care measures on colonisation with in preterm neonates in NICU.

Background: Hospital-acquired strains (HASs) and multiresistant strains in neonatal intensive care unit often harbour virulence and resistance mechanisms, carrying the risk of invasive infections. We describe colonisation with in neonates receiving early directed versus routine family-integrated care (FIC) within the first month of life.

Methods: A prospective cohort study included neonates with a gestational age below 34 weeks.