Risk of Short-Term Mortality after Intracerebral Haemorrhage due to Weekend Hospital Admission in Poland.

BACKGROUND: The mortality rate for spontaneous intracerebral haemorrhage (ICH) has remained high and stable for many years. The unfavourable prognostic factors include age, bleeding volume, location of the haematoma, high blood pressure, and disturbed consciousness on admission. Other risk factors associated with medical care also deserve attention. The study aimed to analyse the relationship between day of admission, concerning other prognostic factors, and short-term mortality in ICH, in a Polish specialist stroke unit. METHODS: Medical records of 156 patients (74 males, 82 females, mean age 68.7 years) diagnosed with spontaneous ICH and admitted to a specialist stroke center were retrospectively analysed. Demographics, location, volume of bleeding, blood pressure values, and the Glasgow Coma Scale (GCS), as well as the day of admission, were determined. The relationships were analysed between these factors and 30-day mortality in the patients with ICH. RESULTS: A total of 83 patients were admitted to the hospital during weekdays (Monday 8 am to Friday 3 pm) and 73 during weekends or holidays. Of these, 65 patients died within 30 days. Patients admitted at weekends initially presented with lower GCS scores. Admission on Saturday was associated with an increased risk of death (OR 3.38, 95% CI 1.2-9.48, p < 0.05), but after correction for clinical state measured with the GCS and ICH score, the association was no longer significant. CONCLUSIONS: The time and mode of admission were not associated with increased risk of short-term mortality in ICH patients. Prehospital care issues should be additionally considered as prognostic factors of the outcome.

Transient Global Amnesia - Risk Factors and Putative Background.

OBJECTIVES: Transient global amnesia (TGA) is a temporary short-term reversible memory loss. Etiology of TGA remains unclear with various hypotheses. We analyzed clinical characteristics, neuroimaging, and electrophysiological findings as well as comorbidities and seasonal variation in TGA patients with regard to possible background of the syndrome. MATERIALS AND METHODS: A total of 56 patients (42 women and 14 men) with TGA hospitalized from 2008 to 2016 in the Department of Neurology, Wroclaw Medical University. RESULTS: A total of 52 patients (92.9%) underwent their first-ever episode of TGA. The potential triggers or events before episode could be recognized in 22 patients (39.3%). 35.7% patients had TGA in summer and 26.8% in winter months. In 92.9% patients chronic diseases were found, included: Hypertension (60.7%), dyslipidemia (48.2%), autoimmune thyroiditis (17.9%), and ischemic heart disease (14.3%). One patient (1,8%) suffered from migraine. Doppler ultrasonography of carotid arteries revealed abnormalities in 29 patients (51.8%). Electroencephalography abnormalities were observed in 10 (17.6%) of patients. CONCLUSION: Our findings suggest a putative cerebrovascular background of transient global amnesia. No evidence has been provided for the association between TGA and epilepsy or migraine. Among comorbidities, autoimmune thyroiditis deserves further investigation with regard to its potential links with TGA.

Brdt Bromodomains Inhibitors and Other Modern Means of Male Contraception.

Compared to efficient and secure female contraception, a vasectomy and condoms are the only options for men. The choice of male contraceptive methods is limited, so contraception mainly rests on the shoulders of women. Several concepts are considered: testosterone administration--inhibiting pituitary secretion of lutropin (LH) and follicle stimulating hormone (FSH), progestogen--affecting the secretion of gonadotropin and gonadoliberin (GnRH) antagonists. New potential targets for non-hormonal male contraception were discovered: glyceraldehyde-3-phosphate-dehydrogenase (GAPDHS)--specific to male germ cells and voltage-gated cation channel (CatSper). Both are responsible for sperm motility. Drugs such as thioridazine used in schizophrenia treatment and phenoxybenzamine (antihypertensive activity) exhibit a contraceptive effect. Similar action exhibits an analogue of lonidamine--adjudin and an antagonist of retinoic acid receptors (BMS-189453). Researchers are working on a contraceptive vaccine, whose active ingredient is epididymal protease inhibitor (Eppin). Another promising method acts by blocking Bromodomain testis-specific proteins (Brdt) involved in the process of spermatogenesis. JQ1-the Brdt inhibitor causes reversible infertility without affecting the endocrine signaling pathways. A recent discovery of Juno as the binding partner for Izumo1 identifies these proteins as the cell-surface receptor pair, essential for gamete recognition and this interaction can be inhibited by an anti-Juno monoclonal antibody. Our review shows that the situation of men can change and investigators are close to the optimal solution. In the near future men will be able to choose the best contraceptive suited to their needs.