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Renal dysplasia is a severe congenital abnormality of the kidney parenchyma, which is an important cause of end-stage renal failure in childhood and early adulthood. The diagnosis of renal dysplasia relies on prenatal or postnatal ultrasounds as children show no specific clinical symptoms before chronic kidney disease develops. Prompt diagnosis is important in terms of early introduction of nephroprotection therapy and improved long-term prognosis. Metabolomics was applied to study children with renal dysplasia to provide insight into the changes in biochemical pathways underlying its pathology and in search of early indicators for facilitated diagnosis. The studied cohort consisted of 72 children, 39 with dysplastic kidneys and 33 healthy controls. All subjects underwent comprehensive urine metabolic profiling with the use of gas chromatography and liquid chromatography coupled to mass spectrometry, with two complementary separation modes of the latter. Univariate and multivariate statistical calculations identified a total of nineteen metabolites, differentiating the compared cohorts, independent of their estimated glomerular filtration rate. Seven acylcarnitines, xanthine, and glutamine were downregulated in the urine of renal dysplasia patients. Conversely, renal dysplasia was associated with higher urinary levels of dimethylguanosine, threonic acid or glyceric acid. This is the first metabolomic study of subjects with renal dysplasia. The authors define a characteristic urine metabolic signature in children with dysplastic kidneys, irrespective of renal function, linking the condition with altered fatty acid oxidation, amino acid and purine metabolisms.

In advanced-stage colorectal cancer (CRC), a strategy based on a sequence of systemic therapies brings survival benefits in most patients. Trifluridine and tipiracil hydrochloride (TT) is a chemotherapy drug effective in patients in the third- or later line setting. No highly specific biomarkers have been established for TT therapy so far. However, a systemic immune-inflammation index (SII), which is based on platelet, neutrophil and lymphocyte counts is applied to predict prognosis. In this retrospective, multicenter study, clinical data on 179 metastatic CRC patients treated with TT were collected. To evaluate factors predicting TT therapy response and overall survival, univariate logistic regression analysis was conducted. Subsequently, factors with p < 0.05 in univariate analysis were included in multivariate analysis. In the multivariate analysis of progression-free survival (PFS), three favorable parameters were significant: good to moderate histological differentiation ( p = 0.0038), carcinoembryonic antigen (CEA) < 5 ng/L ( p = 0.0316) and SII ≤ 550 ( p = 0.007). Favorable prognostic factors revealed in the multivariate analysis of overall survival (OS) were: <3 prior lines of treatment ( p = 0.02), good to moderate histological differentiation ( p = 0.0003), CEA < 5 ng/L ( p = 0.0227) and SII ≤ 550 ( p = 0.0001). Our study indicated that pre-treatment SII may be clinically useful for selecting likely responder patients and assessing the prognosis for mCRC patients treated with TT.

In this work, a synthesis and activation path, which enabled the preparation of spherical activated carbon from a lignin precursor, characterized by high adsorption capacity in the removal of phenolic compounds from water, was successfully developed. Two industrial by-products, i.e., Kraft lignin and sodium lignosulfonate, were used to form spherical nanometric lignin grains using pH and solvent shift methods. The obtained materials became precursors to form porous activated carbons via chemical activation (using K 2 CO 3 or ZnCl 2 as activating agents) and carbonization (in the temperature range of 600-900 °C). The thermal stabilization step at 250 °C was necessary to ensure the sphericity of the grains during high-temperature heat treatment. The study investigated the influence of the type of chemical activator used, its quantity, and the method of introduction into the lignin precursor, along with the carbonization temperature, on various characteristics including morphology (examined by scanning electron microscopy), the degree of graphitization (evaluated by powder X-ray diffraction), the porosity (assessed using low-temperature N 2 adsorption), and the surface composition (analyzed with X-ray photoelectron spectroscopy) of the produced carbons. Finally, the carbon materials were tested as adsorbents for removing phenol from an aqueous solution. A conspicuous impact of microporosity and a degree of graphitization on the performance of the investigated adsorbents was found.

The manifestation of a new pathogen, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), constitutes a new problem for modern health care systems. Developing updated standards for all emergency services working at an accident site during the pandemic has been a continuous challenge. The principal method of preventing the transmission of the SARS-CoV-2 virus is the use of personal protective equipment, such as protective suits, masks and goggles, or face shields. The study aims to present the recommended on-site procedures during the coronavirus pandemic based on the description of an accident of an ambulance transporting a patient with confirmed SARS-CoV-2 infection, emphasizing the actions taken by the emergency services sent to the accident site.

Introduction: Currently, invasive cardiology techniques are the preferred method of treatment for patients with ST-elevation myocardial infarction (STEMI). Improving the care of patients with STEMI is possible by minimizing the time that elapses from the onset of pain to the start of treatment. As studies indicate, early pharmacotherapy, especially with antiplatelet and anticoagulant medications, allows for their early effectiveness., Aim: To assess the influence of early administration of antiplatelet (clopidogrel) and anticoagulant medications in the pre-hospital period in patients with ST-elevated myocardial infarction on the frequency of in-hospital deaths and on the left ventricular ejection fraction evaluated at hospital discharge., Material and Methods: In this study, a retrospective analysis of 573 patients hospitalized due to ST-segment elevation myocardial infarction in one of Krakow's hospitals from January 2011 to December 2015 (excluding the whole of 2013) was used as a research method., Results: As many as 97% of patients received pre-hospital pharmacotherapy, but only 46.0% of respondents received unfractionated heparin, and 19.2% received clopidogrel. The in-hospital mortality rate was 6.7%, but among patients prehospitally treated with clopidogrel and unfractionated heparin, the in-hospital mortality rate was 1.1%. Prehospital administration of clopidogrel significantly decreased the possibility of reduced left ventricular ejection fraction (OR = 0.27; 95% CI: 0.09-0.90)., Conclusions: Among pre-hospital procedures, only administration of a second antiplatelet drug (clopidogrel) significantly decreased the risk of reduced left ventricular ejection fraction, and administration of clopidogrel or heparin, or a combination of both, significantly decreased the risk of in-hospital death in patients with STEMI., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2021 Termedia Sp. z o. o.)

Background: Cardiovascular disease accounts for nearly half of all deaths in Poland. The aim of this study was to assess both the duration and the delays of prehospital treatment in ST-segment elevation myocardial infarction (STEMI) patients and how it impacts left ventricle ejection fraction (LVEF) measured at the time of discharge and the frequency of in-hospital patient mortality., Methods: This study retrospectively analyzed medical records from January 2011 to December 2015 (excluding the year 2013) of 573 patients who were transported to a hospital with a diagnosis of STEMI., Results: The mean time of prehospital system delays was 59 min with a maximum time of 152 min and a minimum time of 23 min. The relationship between reduced LVEF (< 55%) and in-hospital patient mortality and the relationship between length of time from first medical contact (FMC) to hospital admission was analysed in 515 respondents. Extending the time of FMC to hospital admission by 1 min increased the chances of lowering LVEF by 2% (95% CI: 1.004-1.041) and increased the chances of death by 2% (95% CI: 1.002-1.04) in STEMI patients., Conclusions: This study emphasised how vital it is to minimise time spent with STEMI patients at the scene of their cardiovascular event by performing an ECG as quickly as possible and by immediately transporting the patient to the hospital with the targeted treatment. This may lead to the implementation of additional training in the field of ECG interpretation, increase the prevalence of teletransmission systems, and improve communication between Emergency Medical Services (EMS) and catheterization laboratories ultimately reducing patient mortality.