Correction: Bonior, J., et al. Capsaicin-Sensitive Sensory Nerves Are Necessary for the Protective Effect of Ghrelin in Cerulein-Induced Acute Pancreatitis in Rats. Int. J. Mol. Sci. 2017, 18, 1402.

We would like to submit the correction to our published paper [...].

Frailty is associated with an increased mortality among patients ≥ 80 years old treated in Polish ICUs

BACKGROUND: The increasing population of very old intensive care patients (VIPs) is a major challenge currently faced by clinicians and policymakers. Reliable indicators of VIPs' prognosis and purposefulness of their admission to the intensive care unit (ICU) are urgently needed. METHODS: This is a report from the Polish sample of the VIP1 multicentre cohort study (NCT03134807). Patients ≥ 80 years of age admitted to the ICU were included in the study. Information on the type and reason for admission, demographics, utilisation of ICU procedures, ICU length of stay, organ dysfunction and the decision to apply end-of-life care was collected. The primary objective was to investigate the impact of frailty syndrome on ICU and 30-day survival of VIPs. Frailty was assessed with the Clinical Frailty Scale (≥ 5 points on a scale of 1-9). RESULTS: We enrolled 272 participants with a median age of 84 (81-87) years. Frailty was diagnosed in 170 (62.5%) patients. The ICU and 30-day survival rates were equal to 54.6% and 47.3% respectively. Three variables were found to significantly increase the odds of death in the ICU in a multiple logistic regression model: SOFA score (OR = 1.16; 95%CI 1.16-1.24), acute mode of admission (OR = 5.1; 95%CI 1.67-15.57) and frailty (OR = 2.25; 95%CI 1.26-4.01). CONCLUSION: Measuring frailty in critically ill older adults can facilitate making more informed clinical decisions and help avoid futile interventions.

Capsaicin-Sensitive Sensory Nerves Are Necessary for the Protective Effect of Ghrelin in Cerulein-Induced Acute Pancreatitis in Rats.

Ghrelin was shown to exhibit protective and therapeutic effect in the gut. Aim of the study was to investigate the role of sensory nerves (SN) in the protective effect of ghrelin in acute pancreatitis (AP). Studies were performed on male Wistar rats or isolated pancreatic acinar cells. After capsaicin deactivation of sensory nerves (CDSN) or treatment with saline, rats were pretreated intraperitoneally with ghrelin or saline. In those rats, AP was induced by cerulein or pancreases were used for isolation of pancreatic acinar cells. Pancreatic acinar cells were incubated in cerulein-free or cerulein containing solution. In rats with intact SN, pretreatment with ghrelin led to a reversal of the cerulein-induced increase in pancreatic weight, plasma activity of lipase and plasma concentration of tumor necrosis factor-α (TNF-α). These effects were associated with an increase in plasma interleukin-4 concentration and reduction in histological signs of pancreatic damage. CDSN tended to increase the severity of AP and abolished the protective effect of ghrelin. Exposure of pancreatic acinar cells to cerulein led to increase in cellular expression of mRNA for TNF-α and cellular synthesis of this cytokine. Pretreatment with ghrelin reduced this alteration, but this effect was only observed in acinar cells obtained from rats with intact SN. Moreover, CDSN inhibited the cerulein- and ghrelin-induced increase in gene expression and synthesis of heat shock protein 70 (HSP70) in those cells. Ghrelin exhibits the protective effect in cerulein-induced AP on the organ and pancreatic acinar cell level. Sensory nerves ablation abolishes this effect.

Molecular Ghrelin System in the Pancreatic Acinar Cells: The Role of the Polypeptide, Caerulein and Sensory Nerves.

Ghrelin (GHRL) is an endogenous ligand for the growth hormone secretagogue receptor (GHS-R). Experimental studies showed that GHRL protects the stomach and pancreas against acute damage, but the effect of GHRL on pancreatic acinar cells was still undetermined. AIM: To investigate the effect of GHRL and caerulein on the functional ghrelin system in pancreatic acinar cells taking into account the role of sensory nerves (SN). METHODS: Experiments were carried out on isolated pancreatic acinar cells and AR42J cells. Before acinar cells isolation, GHRL was administered intraperitoneally at a dose of 50 µg/kg to rats with intact SN or with capsaicin deactivation of SN (CDSN). After isolation, pancreatic acinar cells were incubated in caerulein-free or caerulein containing solution. AR42J cells were incubated under basal conditions and stimulated with caerulein, GHRL or a combination of the above. RESULTS: Incubation of isolated acinar cells with caerulein inhibited GHS-R and GHRL expression at the level of mRNA and protein in those cells. Either in rats with intact SN or with CDSN, administration of GHRL before isolation of acinar cells increased expression of GHRL and GHS-R in those cells and reversed the caerulein-induced reduction in expression of those parameters. Similar upregulation of GHS-R and GHRL was observed after administration of GHRL in AR42J cells. CONCLUSIONS: GHRL stimulates its own expression and expression of its receptor in isolated pancreatic acinar cells and AR42J cells on the positive feedback pathway. This mechanism seems to participate in the pancreatoprotective effect of GHRL in the course of acute pancreatitis.

Antidepressant-like effects of ketamine, norketamine and dehydronorketamine in forced swim test: Role of activity at NMDA receptor.

Ketamine produces rapid and long-lasting antidepressant effects in patients. The involvement of ketamine metabolites in these actions has been proposed. The effects of ketamine and its metabolites norketamine and dehydronorketamine on ligand binding to 80 receptors, ion channels and transporters was investigated at a single concentration of 10 µM. The affinities of all three compounds were then assessed at NMDA receptors using [3H]MK-801 binding. The dose-response relationships of all 3 compounds in the forced swim test were also investigated in mice 30 min after IP administration. The effects of ketamine and norketamine (both 50 mg/kg) were then examined at 30 min, 3 days and 7 days post administration. Among the 80 potential targets examined, only NMDA receptors were affected with a magnitude of >50% by ketamine and norketamine at the concentration of 10 µM. The Ki values of ketamine, norketamine and dehydronorketamine at NMDA receptors were 0.119±0.01, 0.97±0.1 and 3.21±0.3 µM, respectively. Ketamine and norketamine reduced immobility with minimum effective doses (MEDs) of 10 and 50 mg/kg, respectively; dehydronorketamine did not affect immobility at doses of up to 50 mg/kg. Neither ketamine nor norketamine reduced immobility in the forced swim test 3 and 7 days following administration. Further, oral administration of ketamine (5-50 mg/kg) did not affect immobility. We demonstrate that ketamine and norketamine but not dehydronorketamine given acutely at subanesthetic doses reduced immobility in the forced swim test. These antidepressant-like effects appear attributable to NMDA receptor inhibition.

[Regional analgesia for trauma patients]. / Znieczulenie przewodowe jako element postepowania z ofiarami urazów.

BACKGROUND: We retrospectively assessed the effects and usefulness of regional techniques, performed at the time of admission to the emergency department, in patients with lower limb trauma. METHODS: A fascia iliaca compartment block using "three in one" method, and the sciatic nerve block from the lateral approach in the popliteal fossa were used.The effectiveness of blocks were assessed according to the Numerical Rating Scale. RESULTS: A fascia iliaca compartment block was performed in 12 cases, and sciatic nerve block in 13 cases. Various doses and drugs combination were used depending on parients needs.The "three in one" technique was satisfactory in 11 cases and popliteal technique in 10. No anaesthesia-related side effects or complications were observed. CONCLUSIONS: Regional techniques may be useful in the emergency department, for patients with lower limb trauma but they require expertise and skills.

[The role of serum amyloid A in the early diagnosis of acute coronary syndrome]. / Rola bialka amyloidowego A we wczesnej diagnostyce ostrego zespolu wiencowego.

The aim of this study was to evaluate diagnostic usefulness of serum amyloid A (SAA) in diagnosis of acute myocardial infarction (AMI) in group of patients with stenocardia. The study was carried out in group of 62 patients admitted to Emergency Unit of 5-th Military Hospital in Krakow. The study group consisted of 24 (38.7%) patients with unstable angina pectoris and 38 (61.3%) with acute myocardial infarction. It was found that SAA concentration significantly increases in patients with AMI: 136.0 +/- 220.6 mg/L versus 7.38 +/- 8.8 mg/L in unstable angina pectoris (p < or = 0.009). Studies of mutual relations between SAA levels and cardiac markers have shown a remarkably positive correlation between SAA and troponin I (r = 0.39; p < or = 0.01) and negative correlation between SAA concentrations and platelet count decrease (r = -0.55; p < or = 0.01).

[Real profits of CKMBmass determination in early differentiation of acute coronary syndrome in patients admitted to the emergency unit]. / Praktyczne wykorzystanie oznaczania CKMBmass we wczesnym róznicowaniu postaci ostrego zespolu wiencowego u chorych zglaszajacych sie do Izby Przyjec Oddzialu Ratunkowego.

The aim of this study was to evaluate actual diagnostic profits of CKMBmass concentration in diagnosis of acute myocardial infarction (AMI) in the group of patients admitted to the Emergency Unit with stenocardia and comparison to CKMB activity test. The study carried out in a group of 53 patients admitted to the Emergency Unit of 5-th Military Hospital in Krakow. The study group consisted of 28 (52.8%) of patients with acute myocardial infarction and 25 (47.2%) with unstable angina pectoris. It was found that diagnostic sensitivity of both parameters (CKMBmass 70.8% and CKMB 67.8%) are equivalent for early diagnosis of acute coronary syndrome in the Emergency Unit.

[The role of serum troponin I and high sensitivity C-reactive protein concentrations in early diagnosis of acute coronary syndrome in patients admitted to Emergency Unit]. / Rola troponiny I oraz ultraczulego bialka C-reaktywnego we wczesnej ocenie ryzyka u chorych z ostrym zespolem wiencowym zglaszajacych sie do izby Przyjec Oddzialu Ratunkowego.

The aim of this study was to show clinical benefit of simultaneous determinations of troponin I (cTnI) and high sensitivity C-reactive protein (hsCRP) at early diagnosis in the group of patients with stenocardia admitted to the Emergency Unit of 5-th Military Hospital in Krakow. The study group consisted of 38 (51.3%) patients with acute myocardial infarction (AMI) and 36 (48.6%) with unstable angina pectoris. ROC function analysis for cTnI (cutoff value 0.69 ng/mL) and hsCRP (3.33 mg/L) indicated significant amelioration of diagnostic sensitivity into 84.9% at early diagnostics of AMI in group of patients with acute coronary syndrome (ACS). Moreover, studies of mutual relationship between elevated levels of hsCRP and cTnI concentrations have shown a remarkably positive correlation (r = 0.90; p < or = 0.01) in the group of patients with AMI.