Interdependence of Rheological and Biochemical Parameters of Blood in a Group of Patients with Clinically Silent Multifocal Vascular Cerebral Lesions.

BACKGROUND: Hemorheology is a field of science which often becomes interesting to researchers studying impairments related to blood flow disturbances. Clinically silent vascular cerebral lesions (CSVCLs) are considered a problem of great importance in neurology. OBJECTIVE: This work aimed to analyze the interdependencies of the rheological and biochemical parameters of the blood. METHODS: The group of patients included persons with clinically silent multifocal vascular cerebral lesions diagnosed using neuroimaging. The control group had no symptoms in the central nervous system (CNS). We analyzed hemorheological profiles in 69 patients with CSVCLs diagnosed via magnetic resonance imaging (MR) or 64-row computer tomography measurements. Rheological data were acquired using a rotary-oscillating rheometer, the Contraves LS-40, an instrument dedicated to blood viscosity measurements. For each sample, the hematocrit value was measured using the standard method. Analysis of erythrocytes' aggregability and deformability was performed using the rheological model of Quemada. Biochemical tests of blood were also performed. RESULTS: The results of rheological and biochemical studies were compared with those obtained in the control group. Special attention was paid to the correlation analysis of rheological and biochemical parameters. CONCLUSIONS: Such correlations were found, e.g., between the red cells' deformability and the fibrinogen level. The results improve our understanding of blood flow hemodynamics by analyzing the shear-dependent behavior of the aggregation and deformability of red blood cells.

Ulcerated skin evaluation by electrical impedance measurements.

In the presented study, the transdermal results from the areas surrounding the ulcerated skin areas were compared with those obtained from healthy skin tissue. The analysis of electrical parameters, such as the slope of the Nyquist plot, min. IM, min. RE, min. f, Imagine part index, Phase index, Real part index, and Magnitude index were conducted. Electrical parameters have been measured in the group without lower leg ulceration and in the group with lower leg ulcers. On the basis of the statistical analysis, it was determined that these parameters may be effective in the evaluation of the skin. In fact, the skin surrounding the ulceration was characterised by different values of electrical parameters as compared with healthy skin tissue. A statistically significant difference was found in the electrical parameters obtained for the healthy leg skin and the skin surrounding the ulceration. This study was to investigate the applicability of electrical parameters in the evaluation of the skin in lower leg ulcers. The electrical parameters can be used as an effective tool in assessing the condition of the skin, both healthy and surrounding the ulcerations. The most useful parameters in assessing skin condition using electrical parameters include min. IM, min. RE, min. f, Imagine part index, Phase index, and Magnitude index.

Can Assessment of Rheological Properties of Whole Blood and Plasma Be Useful in the Diagnosis of Tinnitus? A Pilot Study.

Tinnitus is a sensation of ringing in the ears in the absence of any physical source in the environment. Between 9-35% of adults experience some form of tinnitus. Common causes of tinnitus include noise, head injury, ototoxic substances, as well as disorders of blood and blood vessels. Vascular causes include: head-neck tumours, turbulent blood flow, problems with blood supply and inner ear cell damage. The aspect of rheology in terms of tinnitus has not been described yet. In the present study, which comprised 12 patients aged 30 to 74 years presenting with tinnitus, rheological properties of whole blood and plasma were assessed. All the subjects underwent audiological and neurological evaluation. The Quemada model was used to describe the variability of red blood cell shape, as well as their tendency to form aggregates. On the basis of the experimental study, statistically different results of haemorheological measurements were observed in the evaluated group in comparison to a reference group.

Body Balance Analysis in the Visually Impaired Individuals Aged 18-24 Years.

BACKGROUND: Proper body balance is maintained by both sensory, i.e., vision, hearing, vestibular, and proprioception, and motor nervous systems. Visual control facilitates balance both in a static position, as well as during movement. Visual dysfunctions can adversely affect balance and stability control. METHODS: The study comprised a group of 30 individuals visually impaired from birth aged 18-24 years. The control group consisted of 50 persons in the same age range as the study group. The trial was performed as four separate tests: two on a stable surface platform, and two on an unstable surface platform. RESULTS: No statistically significant differences were found in the posturography test on the stable platform between the study groups. When tested on an unstable ground surface, the visually impaired subjects obtained showed worse performance than the sighted persons. Statistically significant differences were observed in the majority of the analyzed results. CONCLUSIONS: Visually impaired individuals present a poorer ability to maintain balance under dynamic conditions. Tests conducted on the unstable surface platform seem to be more relevant and applicable in the diagnosis of the subjects with visual impairment, as they differentiate the subjects to a greater extent.

Venous leg ulcers treated with fish collagen gel in a 12-week randomized single-centre study.

Introduction: Venous ulcers are difficult to heal chronic wounds. Most challenging are the non-healing and recurrent ulcers, because of which we are seeking for therapies that stimulate and support their healing. Aim: To assess the efficacy of fish collagen and its impact on the process of healing of venous leg ulcers. Material and methods: This 12-week randomized single-centre study included a total of 97 adults with venous leg ulcer, randomized into two groups: the study group (n = 48) and the control group (n = 49). All patients received specialist medical care including skin and limb care, wound development according to the TIME scheme (tissue debridement, infection and inflammation control, moisture balance, edge) and short-stretch bandage compression (compression class II). In addition, the study group received tropocollagen gel applied to the skin around the wound. Every 2 weeks we evaluated the wound surface and temperature distribution on the shin (average temperature, median, minimum and maximum) - symmetrically on the sick and healthy limb. Results: We observed a greater number of complete ulcer healing in the study group (week 12: 29.2% vs. 22.4%; week 24: 52.1% vs. 36.7%). Faster healing time in the study group was observed in both big and small ulcers. The thermographic analysis showed statistically significant reduction in periwound inflammation among patients from the study group (p < 0.05). Statistically significant reduction in mean as well as maximum values of limb temperature occurred only in the study group (Tx: R = 0.37, p < 0.001; Tmax: R = 0.40, p < 0.001). Conclusions: Thermographic analysis showed better wound healing effects in the group using tropocollagen. Significant impact of collagen on the healing process was observed only after 8 weeks of application.

The effects of acoustic and optokinetic stimulus on the postural stability.

Objectives: This article addresses the question of whether the simultaneous auditory and optokinetic stimulation affects the postural stability differently than only the stimulation with a single auditory or optokinetic stimulus. Methods: The study involved 30 volunteers. The postural stability was evaluated by means of the posturography platform, which allows for both stable and dynamic posturography tests as well as for applying optokinetic stimulus. Three series of measurements were performed in each patient: measurements on an only with the optokinetic stimulus, measurements using only the acoustic stimulus, and finally measurements with both stimuli applied simultaneously. Results: The results indicate that there are statistically significant differences in the findings obtained with the simultaneous auditory and visual stimulation and the observed results with only one of the stimuli on the dynamic platform. Hence, on the basis of the results obtained, it is possible to conclude that the acoustic stimulus has the potential to help maintain a stable posture. However, this process is not sufficiently compensated with the optokinetic stimulation alone. Conclusion: The sense of sight may be essential for the maintenance of a stable posture. The presence of a sound stimulus improves the postural stability, although this improvement does not compensate for the disturbance caused by the optokinetic stimulus. Hence, functioning of auditory and visual system can influence patients posture. Level of Evidence: 4.

The impact of regular diving on the condition of the middle ear.

OBJECTIVES: It is generally held that exposure to both high-pressure and long-lasting contact with water makes diving a potentially hazardous sports activity as far as the ears are concerned. There is a number of research investigating the condition of the middle ear in a short period following diving; however, the knowledge regarding the long-term effects of regularly repeated diving remains limited. MATERIAL AND METHODS: The aim of this study is to evaluate the function of the middle ear after a diving season in a group of 31 adults diving regularly (1-17 years) by means of the following methods: 1) interview, 2) otoscopy, 3) pure tone audiometry, 4) classic tympanometry, and 5) wideband tympanometry. RESULTS: Periodic problems with pressure equalization in the middle ear were observed in 12 individuals (38.7%). In all the analyzed cases, the authors found a normal condition of the external auditory canal and the tympanic membrane in otoscopy, normal hearing in pure tone audiometry, curve type A, and normal gradient in both classic and wideband tympanometry. CONCLUSIONS: Safe diving (according to safety precautions) does not have any long-term negative effects on the condition of the middle ear. However, these observations should be verified in a larger group of divers. Int J Occup Med Environ Health. 2021;34(6):779-88.

Instrumental diagnosis of facial skin-A necessity or a pretreatment recommendation in esthetic medicine.

BACKGROUND: This paper presents the possibilities of pretreatment instrumental diagnosis for assessing the condition of various facial skin areas. AIM: Tests which aimed at determining the firmness and elasticity of facial skin were conducted. METHODS: Analysis of skin parameters in selected facial areas in adults over a wide age range was performed using the Cutometer Dual MPA 580 probe. Parameters R0, R2, R5, R7, R8, and R9 were analyzed. RESULTS: The following results were obtained: R0 (0.20-0.33) mm; R2 (0.66-0.82) a.u.; R5 (0.60-0.92) a.u.; R7 (0.37-0.52) a.u.; R8 (0.10-0.27) mm; and R9 (0.03-0.05) mm. The R0 parameter showed no statistically significant correlation between skin firmness and age. On the basis of the other parameters, it can be concluded that skin elasticity and an ability to return to its original shape around the eyes, on the cheeks and around the lips, are greater in younger patients than in older groups. There were no statistically significant differences within each age group between the right and left sides of the face. CONCLUSION: Skin firmness described by the R0 parameter is constant in the studied groups and independent of age. Skin elasticity, and an ability to return to its original shape around the eyes, on the cheeks and around the lips, is greater in younger patients. The aging process simultaneously affects the entire facial skin.

Ototoxicity after platinum-based chemotherapy in the treatment of melanotic neuroectodermal tumour of infancy.

Melanotic neuroectodermal tumor of infancy (MNTI) is a rare infantile tumor that originates from mesenchymal-neuroectodermal cells, the treatment of which uses platinum derivatives that can affect hearing loss. The present study evaluated the long-term effects of ototoxicity following chemotherapy with cisplatin, vincristine, cyclophosphamide, teniposide and adriamycin in a 10-year-old patient after surgical removal of a MNTI tumor at the age of 8 months. Audiometric tests (high-frequency tonal audiometry, speech audiometry, speech acoustics, tympanometry and absorbance measurements) were performed during a 10-year follow-up after receiving chemotherapy. Hearing disorders in the high-frequency range (6,000 to 16,000 Hz range) were demonstrated for both ears, indicating that these may be the long-term effects of chemotherapy with use of platinum compounds during the treatment of infants.

Cleidocranial Dysplasia-dental Disorder Treatment and Audiology Diagnosis.

A review of numerous case reports was made, in order to demonstrate the possibilities for treatment of dental disorders in patients with Cleidocranial dysplasia (CCD). In this paper, our own report, including a diagnosis of the effect on the auditory system, is presented. In addition to the triad of CCD symptoms that include hypoplastic or aplastic clavicles, impacted and supernumerary teeth, delayed closure of fontanelles and cranial sutures, impairment of the hearing system resulting in conductive hearing loss also occurs. Our own report is based on the case of a 12-year-old CCD patient, in whom Cone Beam Computed Tomography (CBCT) revealed the presence of 12 supernumerary teeth. Furthermore, a clinical examination pointed to the presence of retained deciduous teeth and a delayed eruption of permanent teeth. Orthodontic-surgical procedures were implemented, in accordance with the literature. During the course of the orthodontic treatment, a decrease in auditory sensitivity was observed, for which reason hearing tests were also performed. Conductive hearing loss was detected. As such, it is important to remember that in such cases, auditory check-ups need to be performed between the many surgical and orthodontic interventions, which usually last a few years.

The influence of the acoustic stimulus on postural stability.

PURPOSE: The purpose of this study was to assess if 65 dB and 4000 Hz stimuli affect postural stability of young normally hearing people. METHODS: Posturography examinations belong to clinical tests which evaluate the motor skills. Posturography can be divided into static posturography and dynamic posturography. In both static and dynamic posturography patient stays on the platform with opened and closed eyes, but in the case of dynamic one, platform is unstable. In this study the Multitest Equilibre platform produced by FRAMIRAL was used. Patients took part in tests with opened and closed eyes, on stable and unstable platform. Additionally, patients were exposed to 65 dB and 4000 Hz acoustic stimuli. The sound pressure level, and frequency was belonging to the best audibly frequency range. RESULTS: Parameters such as velocity and surface were examined. The difference between velocity measured with acoustic stimuli and without acoustic stimuli was observed. On the other hand there was no difference in surface results. CONCLUSIONS: The statistically significant difference between velocity of patients center of gravity movements, measured on unstable platform, in the presence of 4000 Hz, 65 dB acoustic stimulus and without additional disturbances was observed.

The sun--our friend or foe?

INTRODUCTION AND OBJECTIVE: Sunlight is the major source of the energy on Earth. Visible light, ultraviolet and infrared radiation are necessary to sustain life on our planet. However, besides the range of positive effects, such as photosynthesis in plants, warmth, vision, and synthesis of vitamin D, sunlight may also be responsible for negative biologic effects - sunburn, induction of photodermatoses or carcinogenesis. Ultraviolet is regarded as the major environmental, physical hazard to the human skin. ABBREVIATED DESCRIPTION OF THE STATE OF KNOWLEDGE: The acute clinical effect of ultraviolet involves melanogenesis, i.e. tanning, which protects from sunburn if exposure is overdosed. A single exposure, as well as acute suberythemal irradiation, suppresses sensitization of the contact hypersensitivity. The chronic biological effects are photoageing and skin cancer, especially squamous cell carcinoma (SCC). Vitamin D synthesis is regarded as a benefit of natural acute and chronic exposure to ultraviolet. Ultraviolet also plays an important role in aetiology of the group of disorders characterized by photosensitivity. On the other hand ultraviolet is a known inducer of immunosuppression in the skin; therefore, phototherapy is a therapeutic option for patients with activation of dermal immunity. SUMMARY: Without sunlight, the existence of life on Earth is not possible. On the other hand, UVR radiation is regarded as representing one of the most important environmental hazards for human skin. For a better understanding of the mechanisms related to the influence of UVR on human skin, and the most dangerous chronic effects of carcinogenesis, it is necessary to undertake some protective activities. Moreover, UVR may become our ally in the treatment of selected skin disorders.