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Categorization systems for tick-borne encephalitis virus (TBEV) infection lack consistency in classifying disease severity. To evaluate the need for a standard, consensus-based categorisation system for TBEV infection across subtypes, we gathered an expert panel of clinicians and scientists with diverse expertise in TBEV infection. Consensus was sought using the Delphi technique, which consisted of 2 web-based survey questionnaires and a final, virtual, consensus-building exercise. Ten panellists representing 8 European countries participated in the Delphi exercise, with specialities in neurology, infectious disease, paediatrics, immunology, virology, and epidemiology. Panellists reached unanimous consensus on the need for a standardised, international categorisation system to capture both clinical presentation and severity of TBEV infection. Ideally, such a system should be feasible for use at bedside, be clear and easy to understand, and capture both the acute and follow-up phases of TBEV infection. Areas requiring further discussion were (1) the timepoints at which assessments should be made and (2) whether there should be a separate system for children. This Delphi panel study found that a critical gap persists in the absence of a feasible and practical classification system for TBEV infection. Specifically, the findings of our Delphi exercise highlight the need for the development of a user-friendly classification system that captures the acute and follow-up (i.e., outcome) phases of TBEV infection and optimally reflects both clinical presentation and severity. Development of a clinical categorisation system will enhance patient care and foster comparability among studies, thereby supporting treatment development, refining vaccine strategies, and fortifying public health surveillance.

Introducción: La cirugía laparoscópica en pediatría ha incrementado su adopción debido a sus beneficios, como menor trauma quirúrgico y recuperación más rápida, pero también presenta desafíos únicos, incluyendo la anatomía específica de los pacientes pediátricos y la necesidad de entrenamiento del equipo quirúrgico. Este estudio tuvo como objetivo desarrollar una guía práctica para estandarizar procedimientos en la fase inicial de intervenciones laparoscópicas en pacientes pediátricos, mejorando así la seguridad del paciente y la eficiencia del equipo quirúrgico. Métodos: Se realizó un estudio prospectivo, multicéntrico y de diseño cualitativo, basado en encuestas a cirujanos pediátricos con experiencia en laparoscopia. Se creó un listado de verificación, el cual fue validado por un panel de expertos. Resultados: Hubo consenso unánime entre los expertos sobre la importancia de revisar la historia clínica y realizar evaluaciones preoperatorias detalladas. Se identificaron ítems para una lista de verificación que incluyó: la identidad del paciente, preparación del entorno quirúrgico y verificación de equipos y materiales. La guía final se elaboró a partir de la retroalimentación recibida y se diseñó para ser fácilmente aplicable en entornos de quirófano tanto electivos como de emergencia. Conclusiones: La implementación de una guía práctica y un listado de verificación para la fase inicial de cirugía laparoscópica en pediatría puede reducir eventos adversos, optimizando el tiempo quirúrgico, la comunicación y el trabajo en equipo en el quirófano.

ObjectiveTo analyze the incidence of spinal cord ischemia (SCI) after complex endovascular aortic repair (EVAR) after the introduction of a dedicated SCI preventive protocol.MethodsRetrospective review of all consecutive patients undergoing complex EVAR with branched (BEVAR) and/or fenestrated grafts (FEVAR) during a 6-year period starting January 1st, 2015. The preventive protocol consisted of staging extensive aortic repairs, maintaining a mean arterial pressure (MAP) >80 mm Hg, Hb level >110 g/L, early lower limb reperfusion and neurological control per hour during the post-operative stay in the intensive care unit (36–72 h). Prophylactic cerebrospinal fluid drainage (CSFD) was used selectively. Pre- intra-, and 30-day postoperative clinical data and imaging were collected. Primary end point was the development of perioperative SCI. Secondary outcome included technical and clinical success.ResultsComplex EVAR was performed in 205 patients (167 males, 72 (67–75) years, 182 (88.8%) elective) with juxtarenal aneurysms (JRA, 155 patients) or thoracoabdominal aortic aneurysms (TAAA). SCI occurred after JRA repair in two patients (1.3%, both ruptures) and after TAAA repair in three (6.0%, one rupture) (p = 0.06), all within 9 h postoperatively. There was symptom regression in three cases (one partial, two complete), resulting in a persistent SCI level of 0.6% and 4.0% for JRA and TAAA, respectively. Only one patient with persistent SCI could be discharged from the hospital alive. Patients developing SCI were more commonly female (n = 3, p = .016), presented with rupture (n = 3, p

Background: Parkinson’s disease (PD) is a neurodegenerative disorder characterised by a high prevalence of sporadic cases. Various molecular mechanisms are involved in its pathogenesis. This pilot study aimed to identify potential risk and protective human leukocyte antigen (HLA) alleles in PD, discover candidate alleles for further research, and evaluate potential blood biomarkers. Methods: A total of 43 PD patients and 79 unrelated sex-matched controls were enrolled in this study. We analysed the polymorphism of HLA-DRB1, HLA-DQA1, and HLA-DQB1 alleles and the blood levels of biomarkers such as S100 calcium-binding protein A9 (S1000A9), kynurenic acid (KYNA), neurofilament light chain (NfL), and glutamate decarboxylase (GAD1). Results: We found that the frequencies of the HLA-DRB1*04, -DQA1*02:01, and -DQA1*03:01 alleles were significantly higher in the PD patients than in the controls, suggesting that these alleles are potential risk factors. Furthermore, the HLA-DQA1*02:01 allele was detected more frequently in the PD group when the disease onset was at 60 years or older. On the contrary, the HLA-DRB1*01 and HLA-DQA1*05:01 alleles were less common in the PD patients, indicating a possible protective effect. Regarding biomarkers, the blood levels of S100 calcium-binding protein A9 were significantly higher, and the kynurenic acid levels were significantly lower in the PD group. The NfL levels were also higher in the PD group but did not reach statistical significance, possibly due to the sensitivity limitations of the ELISA method used. The GAD1 levels showed no significant differences between the two groups. Conclusions: Our findings indicate that the HLA-DRB1*01 and -DRB1*04 alleles and the HLA-DQA1*02:01, -DQA1*03:01, and -DQA1*05:01 alleles are associated with PD. Moreover, S100 calcium-binding protein A9 and kynurenic acid can be considered potential blood biomarkers for PD. These findings contribute to the growing body of knowledge on PD and offer new directions for further research in Latvian cohorts.

This study reports the case of a previously healthy man in his late 20s who began experiencing symptoms 3 months before admission to our hospital, including arm and leg weakness and distal hypesthesia. Initially, the patient responded to corticosteroid therapy. However, as his symptoms progressed, he underwent plasmapheresis and received intravenous immunoglobulin therapy, neither of which led to any discernible improvement. With rapid symptom progression during subsequent hospital visits, further investigation led to the detection of neurofascin 155 antibodies. Based on existing evidence of its efficacy, rituximab treatment was initiated. To date, the patient has received three doses of rituximab, which has been partially ineffective. Thus, treatment is ongoing and includes a combination of rituximab and subcutaneous immunoglobulin.

Introducción: Entre los quistes cervicales congénitos, los quistes branquiales ocupan el segundo lugar en frecuencia después de los quistes tiroglosos, con un 30 % de incidencia. Aunque su frecuencia es baja, constituyen la alteración congénita más común de la región cervical. Su presencia está asociada a errores del desarrollo embrionario, aunque su etiología no es conocida. Objetivo: Presentar un caso de quiste branquial de gran tamaño y crecimiento rápido, cuya cercanía a estructuras neurovasculares del cuello implicaba riesgo quirúrgico. Presentación de caso: Se trata de un paciente masculino de 57 años de edad. Refirió que cuatro años antes percibió aumento de volumen en región lateral del cuello. Hace un año aumentó su crecimiento de manera rápida, por lo que alcanzó un tamaño considerable y acudió en agosto de 2022 a la consulta del servicio de Cirugía Maxilofacial del Hospital Clínico Quirúrgico de la ciudad de Holguín. El examen físico y la realización de pruebas diagnósticas resultaron compatibles con quiste branquial. Se decidió intervenir quirúrgicamente y se retiró el quiste sin complicaciones. Conclusiones: El quiste branquial representa una malformación congénita que se manifiesta en los adultos jóvenes, requiere de diagnóstico y tratamiento adecuado. A pesar de ser una entidad benigna de fácil tratamiento, si su tamaño es grande se dificulta su tratamiento quirúrgico por su relación con estructuras vitales localizadas en el cuello. El paciente que se presenta en este trabajo se encuentra recuperado e incorporado a sus actividades de la vida cotidiana. Palabras clave: quiste, quiste branquial, hendidura branquial

Objective: Large language models and artificial intelligence (AI) based chatbots have brought new insights in healthcare, but they also raise major concerns. Their applications in vascular surgery have scarcely been investigated to date. This international survey aimed to evaluate the perceptions and feedback from vascular surgeons on the use of AI chatbots in vascular surgery. Methods: This international open e-survey comprised 50 items that covered participant characteristics, their perceptions on the use of AI chatbots in vascular surgery, and their user experience. The study was designed in accordance with the Checklist for reporting Results of Internet E-Surveys and was critically reviewed and approved by international members of the European Vascular Research Collaborative (EVRC) prior to distribution. Participation was open to self reported health professionals specialised (or specialising) in vascular surgery, including residents or fellows. Results: Of the 342 individuals who visited the survey page, 318 (93%) agreed to participate; 262 (82.4%) finished the survey and were included in the analysis. Most were consultants or attending physicians (64.1%), most declared not having any training or education related to AI in healthcare (221; 84.4%), and 198 (75.6%) rated their knowledge about the abilities of AI chatbots between average to very poor. Interestingly, 95 participants (36.3%) found that AI chatbots were very useful or somewhat useful in clinical practice at this stage and 229 (87.4%) agreed that they should be systematically validated prior to being used. Eighty participants (30.5%) had specifically tested it for questions related to clinical practice and 59 (73.8%) of them experienced issues or limitations. Conclusion: This international survey provides an overview of perceptions of AI chatbots by vascular surgeons and highlights the need to improve knowledge and training of health professionals to better evaluate, define, and implement their use in vascular surgery.

Background and Objectives: COVID-19 disease, caused by the SARS-CoV-2 virus, has presented significant challenges to global health, with acute and chronic implications for various aspects of well-being, including sleep and quality of life. This study aimed to investigate the impact of SARS-CoV-2 infection on sleep quality, daytime sleepiness, and quality of life in hospitalised and home-treated patients after three and six months. Materials and Methods: A longitudinal cohort study was conducted, enrolling hospitalised patients from a single clinical university hospital and home-treated participants through a survey spread through social networks. Individuals who had tested positive for the SARS-CoV-2 virus in the past three months and had a symptomatic course of the disease were included in the study. Participants with previously diagnosed sleep disorders were excluded from the study. Participants were evaluated using internationally validated self-evaluation scales, including the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Patient Health Questionnaire-9 (PHQ-9) and Fatigue Severity Scale (FSS). Data were collected three and six months after laboratory-confirmed SARS-CoV-2 infection, with informed consent obtained from all participants. Statistical analysis was performed using the Wilcoxon signed rank test, Fisher–Freeman–Halton exact, Pearson Chi tests and Spearman correlation. Results were considered statistically significant with p value < 0.05. Results: In total, 66 participants with a mean age of 44.05 ± 21.61 years were enrolled in the study. Most patients (n = 36) were treated at home and 30 at hospital. Six months after SARS-CoV-2 infection, home-treated patients reported a higher prevalence of poor sleep quality (52.8%, n = 19, p = 0.015, PSQI) and hospitalised patients showed a lower prevalence of depressive symptoms (p < 0.001, PHQ-9) as 90% (n = 27) had minimal or no symptoms compared to 30.6% (n = 11) in a home-treated group. Conclusions: These findings mark the importance of the COVID-19 patients’ management settings as people treated at home had worse sleep quality and more depressive symptoms six months after infection indicating worse life quality.

Examinar las alteraciones en la oferta hídrica asociadas a la variabilidad climática, es de gran importancia para ajustar adaptaciones frente a los cambios actuales y futuros, para esto se requiere comprender cambios históricos espacio-temporales en el patrón regional de lluvias. Es por ello que, se analizaron las tendencias y la variabilidad de la precipitación (1980-2015) en escalas de la lluvia anual y mensual; mediante la aplicación de las pruebas no-paramétricas de Mann-Kendall y Cusum en 20 estaciones pluviométricas, pertenecientes de las cuencas de los ríos Esmeraldas, Mira y Cañar ubicada al extremo nor-oeste del territorio ecuatoriano. En los resultados, la precipitación anual tuvo tendencias significativas en el test EMK en la estación (M0001) y saltos en la media anual para las estaciones (M0301 y M0345) aplicando el test de cusum, la precipitación mensual no presento significancia para ninguno de los 2 test aplicados, con respecto a la variabilidad se encontró que la mayoría de las estaciones presentan una mayor precipitación a mayor altitud esto se debe a el efecto Foëhn siendo este uno de los factores más importantes que determinan las características climáticas las cuencas, concentrándose las mayores precipitaciones en las regiones de mayor altitud.

BackgroundAs many as 60% of individuals use a wheelchair long term after a spinal cord injury (SCI). This mode of locomotion leads to chronic decline in lower-extremity weight-bearing activities and contributes to the development of severe sublesional osteoporosis and high rates of fragility fracture. Overground exoskeleton-assisted walking programs provide a novel opportunity to increase lower-extremity weight bearing, with the potential to improve bone health. ObjectiveThe aim of the study is to measure the potential effects of an exoskeleton-assisted walking program on lower-extremity bone strength and bone remodeling biomarkers in individuals with chronic (≥18 months) SCI who use a wheelchair. MethodsIn total, 10 participants completed a 16-week exoskeleton-assisted walking program (34 individualized 1-hour sessions, progressing from 1 to 3 per week). Bone mineral density and bone strength markers (dual-energy x-ray absorptiometry: total body, left arm, leg, total hip, and femoral neck and peripheral quantitative computed tomography: 25% of left femur and 66% of left tibia) as well as bone remodeling biomarkers (formation=osteocalcin and resorption=C-telopeptide) were measured before and after intervention and compared using nonparametric tests. Changes were considered significant and meaningful if the following criteria were met: P5%. ResultsSignificant and meaningful increases were observed at the femur (femoral neck bone mineral content, bone strength index, and stress-strain index) and tibia (cortical cross-sectional area and polar moment of inertia) after the intervention (all P

A 68-year-old man developed aneurysmal degeneration of the aortic arch and proximal descending aorta after an open ascending graft for a type A aortic dissection. A three-branched endovascular aortic arch repair was performed with patency of all branches despite some degree of initial misalignment of the branches in relation to the target vessels. At 6 months postoperatively, an asymptomatic partial crushing of the left common carotid bridging grafts was observed on computed tomography angiography. This was treated by reinforcing the branch with a balloon-expandable endograft. The postoperative course was uneventful but a computed tomography angiography after 1 month showed recurrent asymptomatic compression. A left carotid-subclavian bypass was eventually performed. We have reported a new failure mode of an inner branch arch repair of residual type A chronic dissection.

Background and Objectives: Magnetic resonance imaging is vital for diagnosing cognitive decline. Brodmann areas (BA), distinct regions of the cerebral cortex categorized by cytoarchitectural variances, provide insights into cognitive function. This study aims to compare cortical thickness measurements across brain areas identified by BA mapping. We assessed these measurements among patients with and without cognitive impairment, and across groups categorized by cognitive performance levels using the Montreal Cognitive Assessment (MoCA) test. Materials and Methods: In this cross-sectional study, we included 64 patients who were divided in two ways: in two groups with (CI) or without (NCI) impaired cognitive function and in three groups with normal (NC), moderate (MPG) and low (LPG) cognitive performance according to MoCA scores. Scans with a 3T MRI scanner were carried out, and cortical thickness data was acquired using Freesurfer 7.2.0 software. Results: By analyzing differences between the NCI and CI groups cortical thickness of BA3a in left hemisphere (U = 241.000, p = 0.016), BA4a in right hemisphere (U = 269.000, p = 0.048) and BA28 in left hemisphere (U = 584.000, p = 0.005) showed significant differences. In the LPG, MPG and NC cortical thickness in BA3a in left hemisphere (H (2) = 6.268, p = 0.044), in V2 in right hemisphere (H (2) = 6.339, p = 0.042), in BA28 in left hemisphere (H (2) = 23.195, p < 0.001) and in BA28 in right hemisphere (H (2) = 10.015, p = 0.007) showed significant differences. Conclusions: Our study found that cortical thickness in specific Brodmann Areas—BA3a and BA28 in the left hemisphere, and BA4a in the right—differ significantly between NCI and CI groups. Significant differences were also observed in BA3a (left), V2 (right), and BA28 (both hemispheres) across LPG, MPG, NC groups. Despite a small sample size, these findings suggest cortical thickness measurements can serve as effective biomarkers for cognitive impairment diagnosis, warranting further validation with a larger cohort.

We report the case of a 63-year-old man who presented with a 2-week complaint of lower extremity pain, swelling, and low-grade fever after an episode of septic arthritis in the ipsilateral knee. The investigation showed a rapidly expanding popliteal artery aneurysm (PAA). The rare clinical entity of an infective PAA was suspected and was confirmed by the cultures obtained at the right femoropopliteal bypass with an autologous vein graft and subtotal resection of the aneurysm sac. Streptococcus equi was identified as the primary pathogen, which, to the best of our knowledge, has not been previously described for an infective PAA.

A 61-year-old male patient presented with rest pain and ulceration in his left leg 1 week after a hybrid procedure with bilateral external iliac stenting, common femoral artery thromboendarterectomy, and left-sided femoral popliteal bypass with an in situ saphenous vein. The bypass had been stented intraoperatively but had again become occluded directly after surgery. In the present report, we demonstrate the usefulness of direct percutaneous access to the mid-superficial femoral artery that had been intraoperatively recanalized via brachial artery access during the same procedure. This innovative combination of approaches allows for proximal and distal lower limb revascularization with stenting when avoidance of femoral artery access is considered appropriate.

Purpose: To examine the perspectives of wheelchair users with spinal cord injury (WUSCI) regarding their participation in a 16-week walking program using a wearable robotic exoskeleton (WRE); and explore concerns and expectations regarding potential use of this device and intervention in the context of a home or community-based adapted physical activity program. Method: Semi-structured interviews were conducted using a narrative research, 3 weeks post-intervention. Thematic analysis resulted in 6 themes and 21 subthemes. Results: Seven men and 4 women aged between 32 and 72 years were interviewed; 8 of them had a complete SCI. After the walking program, WUSCI reported positive psychological aspects (having fun and motivation) and experiencing improvements in physical aspects (strength, endurance, balance and flexibility, blood circulation and intestinal transit). The structural aspects of the WRE device were acceptable in a lab with research personnel (appearance, size, weight, and comfort). Participants had concerns about safety on uneven surfaces, and possibility of falling. They expressed the desire to use the WRE for more life habits than just walking. Conclusion: This is the first study in which WUSCI report that the WRE should be implemented in initial rehabilitation. Lack of availability for community use after rehabilitation remains a concern. IMPLICATIONS FOR REHABILITATION: Participation in a walking training program using a wearable robotic exoskeleton, 1-3 times weekly over several weeks, may be well tolerated and provide physical and psychological benefits for wheelchair users with spinal cord injuries. Using a robotic exoskeleton during initial rehabilitation may be well received and help with regaining strength, endurance, balance, and flexibility as well as promoting blood circulation and intestinal transit. The use of the wearable robotic exoskeleton always needs supervision of a clinician for walking and can't be used independently by wheelchair users; there is no possibility for hands free for household tasks (e.g., washing floors, accessing cupboards or reaching shelves, using stairs), and for recreation (e.g., exercising, taking walks, cultural activities, concerts). [ABSTRACT FROM AUTHOR]

This study aimed to assess the levels of delayed onset muscle soreness (DOMS) markers in individuals adhering to vegan and omnivore diets after engaging in acute resistance exercise. A total of 54 untrained young, healthy, normal-body-weight women (age: 26.8±4.1 years; body mass index: 22.5±2.7 kg/m2) participated in the study. Participants were categorized into two groups: vegans (n=27) and omnivores (n=27) based on their dietary preferences, with all subjects having adhered to their respective diets for a minimum of 2 years. DOMS was induced by a single eccentric resistance exercise session, comprising four exercises (leg press, chest press, leg curls, and arm curls), each consisting of four sets of 10 repetitions. Various measurements, including dietary factors, state of wellness, body composition, muscle circumferences, muscle pressure point thresholds (PPTs), and muscle strength, were recorded both before and 48 hours after the exercise session. The results showed that wellness and muscle circumferences remained unchanged or displayed similar changes between the vegan and omnivore groups following acute resistance exercise. However, notable differences were observed in PPTs in favor of vegans, specifically for the right biceps (95% CI: 1.4 to 10.2; p=0.01), the left vastus medialis (95% CI: 0.5 to 6.4; p=0.02), and the right vastus lateralis (95% CI: 3.2 to 12.1; p=0.001). Furthermore, significant differences in right grip strength were found in favor of vegans after the exercise session (95% CI: 3.1 to 26.2; p=0.01). In conclusion, our findings suggest that vegans may experience more favorable changes in DOMS levels following acute resistance exercise in comparison to omnivores. This discrepancy in DOMS markers may indicate enhanced muscle recovery in vegans. [ABSTRACT FROM AUTHOR]

Background: Parkinson's disease (PD) is a neurodegenerative disorder characterised by a high prevalence of sporadic cases. Various molecular mechanisms are involved in its pathogenesis. This pilot study aimed to identify potential risk and protective human leukocyte antigen (HLA) alleles in PD, discover candidate alleles for further research, and evaluate potential blood biomarkers. Methods: A total of 43 PD patients and 79 unrelated sex-matched controls were enrolled in this study. We analysed the polymorphism of HLA-DRB1, HLA-DQA1, and HLA-DQB1 alleles and the blood levels of biomarkers such as S100 calcium-binding protein A9 (S1000A9), kynurenic acid (KYNA), neurofilament light chain (NfL), and glutamate decarboxylase (GAD1). Results: We found that the frequencies of the HLA-DRB1*04, -DQA1*02:01, and -DQA1*03:01 alleles were significantly higher in the PD patients than in the controls, suggesting that these alleles are potential risk factors. Furthermore, the HLA-DQA1*02:01 allele was detected more frequently in the PD group when the disease onset was at 60 years or older. On the contrary, the HLA-DRB1*01 and HLA-DQA1*05:01 alleles were less common in the PD patients, indicating a possible protective effect. Regarding biomarkers, the blood levels of S100 calcium-binding protein A9 were significantly higher, and the kynurenic acid levels were significantly lower in the PD group. The NfL levels were also higher in the PD group but did not reach statistical significance, possibly due to the sensitivity limitations of the ELISA method used. The GAD1 levels showed no significant differences between the two groups. Conclusions: Our findings indicate that the HLA-DRB1*01 and -DRB1*04 alleles and the HLA-DQA1*02:01, -DQA1*03:01, and -DQA1*05:01 alleles are associated with PD. Moreover, S100 calcium-binding protein A9 and kynurenic acid can be considered potential blood biomarkers for PD. These findings contribute to the growing body of knowledge on PD and offer new directions for further research in Latvian cohorts. [ABSTRACT FROM AUTHOR]

Background and Objectives: The aim of this study was to investigate the incidence of cerebrovascular pathology in patients with chronic kidney disease and its effect on functional outcomes. Materials and Methods: In a retrospective cross-sectional study (2018–2021), the medical records of patients with acute hemorrhagic and ischemic stroke with concomitant chronic kidney disease who received treatment in Riga East University Hospital Stroke Unit were analyzed. Data were analyzed using IBM SPSS 26.0. The Kruskal–Wallis, Mann–Whitney U test, and Spearman’s rank correlation coefficient methods were used. Results: The final sample consisted of 305 acute cerebrovascular pathology patients (56.4% females). Overall, 57.3% of stroke patients had second-stage chronic kidney disease with average serum creatinine levels of 104.3 mmol/L (±32.8). The functional outcome of the stroke depended on the stage of chronic kidney disease. There was a statistically significant non-linear correlation between glomerular filtration rate and NIHSS (National Institute of Health Stroke Scale) score on admission (Rho −0.194, p = 0.016), glomerular filtration rate and NIHSS score on discharge (Rho −0.186, p = 0.020), and glomerular filtration rate and modified Rankin score on admission (Rho −0.237, p = 0.003) and discharge (Rho −0.224, p = 0.05). The mean NIHSS score of ischemic stroke patients was 8.3 ± 5.9 on admission and 6.5 ± 5.8 on discharge. In the hemorrhagic stroke patient group, the mean NIHSS score was 9.5 ± 7.3 on admission and 7.1 ± 6.9 on discharge. On average, 34.0% of ischemic stroke patients had an mRS score of 5 on admission, while in the hemorrhagic stroke patient group, this figure was 41%. There was no statistical difference in the glomerular filtration rate between the thrombolyzed versus non-thrombolyzed patient groups (Mann–Whitney U test = 1457, p = 0.794). Conclusions: Chronic kidney disease is an important predictor of the severity and functional outcome of a stroke; furthermore, the early management and prevention of complications should be a top priority in the prophylaxis of this cerebrovascular pathology.

Objectives. The world is rapidly ageing and, with the increasing age, there is a potential increase in the number of patients with Alzheimer’s disease or dementia. This calls for a reliable screening tool that easily and rapidly could identify the symptoms of pathological cognitive decline. As currently such tools are limited in Latvia, the objective of this study was to examine the psychometric properties of the newly translated Montreal Cognitive Assessment test. Materials and Methods. Sixty-five Latvian native speakers aged 55-90 (M = 72.11, SD = 10.26) participated in the study and were divided into three groups – with diagnosis of dementia (n = 21), mild cognitive impairment (n = 18) and control group (n = 26). All participants were assessed using the Montreal Cognitive Assessment test [1], and a test-retest was conducted after 2 weeks (n = 37). Results. Almost all mean values and inter-item correlation coefficients were acceptable (.2-.8), apart from indices in the Naming task and Verbal fluency task. The items showed very high reliability (α = .95) and the test-retest reliability showed consistent results (r = .98). Conclusions. Overall, the results from the pilot study show acceptable psychometric properties; however, the pilot study should be continued and criterion validity should be tested.

Diffusion tensor imaging (DTI) is an MRI analysis method that could help assess cognitive impairment (CI) in the ageing population more accurately. In this research, we evaluated fractional anisotropy (FA) of whole brain (WB) and corpus callosum (CC) in patients with normal cognition (NC), mild cognitive impairment (MCI), and moderate/severe cognitive impairment (SCI). In total, 41 participants were included in a cross-sectional study and divided into groups based on Montreal Cognitive Assessment (MoCA) scores (NC group, nine participants, MCI group, sixteen participants, and SCI group, sixteen participants). All participants underwent an MRI examination that included a DTI sequence. FA values between the groups were assessed by analysing FA value and age normative percentile. We did not find statistically significant differences between the groups when analysing CC FA values. Both approaches showed statistically significant differences in WB FA values between the MCI-SCI and MCI-NC groups, where the MCI group participants showed the highest mean FA and highest mean FA normative percentile results in WB.

Uterine angiolipoleiomyomas are rare, benign mixed mesenchymal lesions. A manifestation in the gynecological region is quite uncommon, with few cases described in the literature so far. We present an interesting case of a 59-year-old woman diagnosed with uterine angiolipoleiomyoma, and the results of the conducted systematic review of the literature. The patient presented with a pelvic mass masquerading as a leiomyoma on the ultrasound and postmenopausal vaginal bleeding. At laparotomy, a large uterus was noticed and the histopathology set the diagnosis of angiolipoleiomyoma. Immunohistochemistry revealed negativity for Melan-A and HMB-45 melanoma-specific antibodies and positivity for Van Gieson and orcein histochemical stains. We systematically reviewed the literature. The eligible articles were those written in English, excluding animal studies and studies reporting angiolipoleiomyomas in other regions beside the uterus. The present case is one of the 10 cases of uterine angiolipoleiomyoma reported in the literature. In 8 out of 11 (72.7%) cases, uterine angiolipoleiomyomas arose from the corpus of the uterus, while in 2 (18.1%) cases they were located at the cervix, and in one case (9%) angiolipoleiomyoma was located in the broad ligament. Concerning symptoms, four of the patients (36.4%) presented with abdominal and pelvic pain, two (18.1%) with postmenopausal vaginal bleeding, one with menometrorrhagia (9%), and one with uterine prolapse and cystocele (9%). Immunohistochemical staining of uterine angiolipoleiomyomas was positive for SMA in 4 patients (36.4%), positive for desmin in 3 cases (27.3%), positive for anti-S-100 protein antibody in 2 patients (18.1%), while in one case (9%) immunopositivity was observed for CD31. Only our case (9%) was also tested for CD34, Van Gieson and orcein, the first of these being negative and the other two positive (at the blood vessels in a specialized pattern). Three of the patients (27.3%) were also tested for HMB-45 and all three were immunonegative. In order to establish the diagnosis of uterine angiolipoleiomyomas, ultrasonography and additional MRI may help the preoperative prediction of a benign mass. Immunohistochemistry will show strong positivity of alpha-smooth muscle actin and desmin. Complete abdominal hysterectomy is the preferable treatment.