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Abstract Background Cognitive impairment is a common complication of the acute phase of stroke, which can be transient and resolve while still in the hospital. This study evaluated the prevalence and risk factors for transient cognitive impairment and their impact on long-term prognosis in a population of acute-phase stroke patients. Methods Consecutive patients admitted to a stroke unit with acute stroke or transient ischemic attack were screened twice for cognitive impairment using the parallel version of Montreal Cognitive Assessment: the first time between the first and third day and the second time between the fourth and seventh day of hospitalization. If the second test score increased by two or more points, transient cognitive impairment was diagnosed. Patients were scheduled for follow-up visits three and 12 months after stroke. Outcome assessment included place of discharge, current functional status, dementia, or death. Results Four hundred forty-seven patients were included in the study, 234 (52.35%) were diagnosed with transient cognitive impairment. Delirium was the only independent risk factor for transient cognitive impairment (OR 2.417, 95%CI 1.096–5.333, p = 0.029). In the analysis of effects on three- and twelve-month prognosis, patients with transient cognitive impairment had a lower risk of hospital or institution stay 3 months after stroke compared with patients with permanent cognitive impairment (OR 0.396, 95%CI 0.217–0.723, p = 0.003). There was no significant effect on mortality, disability or risk of dementia. Conclusions Transient cognitive impairment, which often occurs in the acute phase of stroke, does not increase the risk of long-term complications.

BackgroundAppropriate fluid management is essential in the treatment of critically ill trauma patients. Both insufficient and excessive fluid volume can be associated with worse outcomes. Intensive fluid resuscitation is a crucial element of early resuscitation in trauma; however, excessive fluid infusion may lead to fluid accumulation and consequent complications such as pulmonary edema, cardiac failure, impaired bowel function, and delayed wound healing. The aim of this study was to examine the volumes of fluids infused in critically ill trauma patients during the first hours and days of treatment and their relationship to survival and outcomes.MethodsWe retrospectively screened records of all consecutive patients admitted to the intensive care unit (ICU) from the beginning of 2019 to the end of 2020. All adults who were admitted to ICU after trauma and were hospitalized for a minimum of 2 days were included in the study. We used multivariate regression analysis models to assess a relationship between volume of infused fluid or fluid balance, age, ISS or APACHE II score, and mortality. We also compared volumes of fluids in survivors and non-survivors including additional analyses in subgroups depending on disease severity (ISS score, APACHE II score), blood loss, and age.ResultsA total of 52 patients met the inclusion criteria for the study. The volume of infused fluids and fluid balance were positively correlated with mortality, complication rate, time on mechanical ventilation, length of stay in the ICU, INR, and APTT. Fluid volumes were significantly higher in non-survivors than in survivors at the end of the second day of ICU stay (2.77 vs. 2.14 ml/kg/h) and non-survivors had a highly positive fluid balance (6.21 compared with 2.48 L in survivors).ConclusionIn critically ill trauma patients, worse outcomes were associated with higher volumes of infusion fluids and a more positive fluid balance. Although fluid resuscitation is lifesaving, especially in the first hours after trauma, fluid infusion should be limited to a necessary minimum to avoid fluid overload and its negative consequences.

Borehole engineering encompasses the part of mining that involves the process of drilling boreholes and their utilization (e.g., for research, exploration, exploitation, and injection purposes). According to legal regulations, mining pits must be closed after their use, and this applies to pits in the form of boreholes as well. The Laboratory of Geoenergetics at AGH University of Krakow is involved in adapting old, exploited and already closed boreholes for energetic purposes. This includes geothermal applications, as well as energy storage in rock formations and boreholes. Geoenergetics is a relatively new concept that combines geothermal energy with energy storage in rock formations (including boreholes). One type of analysed borehole is a freezing borehole. They are used, for example, in drilling mining shafts that are in the vicinity of aquifers and are drilled using the rotary drilling method with a reverse circulation of drilling mud, or in peat bogs. For borehole heat exchangers based on freezing boreholes for long-term mathematical modelling, several heating scenarios were considered with several thermal loads. The maximum average power obtained after one year of usage of four boreholes with variable temperatures was 11 kW. With the usage of 10 boreholes the power reached over 27 kW. The heat-carrying temperature was assumed to be 22 °C during early summer (June and July) and 2 °C during the rest of the year. When considering stable exploitation during a 10-year period with four boreholes with the same temperatures, a heating power of over 12 kW was obtained, as well as a power of over 28 kW when considering using 10 boreholes. The maximum amount of heat obtained during the 10-year period using 10 boreholes was over 8.8 thousand GJ. Once they have fulfilled their function, these boreholes lose their technological significance. In the paper, the concept is outlined, and the results of the analysis are described using the numerical program BoHEx.