Białystok, Poland
Białystok, Poland

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Andrzej R.,Medical University of Lublin | Piotr R.,Medical University of Lublin | Tomasz S.,Medical University of Lublin | Andrzej B.,Medical University of Lublin | And 3 more authors.
Annals of Noninvasive Electrocardiology | Year: 2010

Background: We studied the acute effect of pacing at the right ventricular outflow tract (RVOT), right ventricular apex (RVA) and simultaneous RVA and RVOT-dual-site right ventricular pacing (DuRV) in random order on systolic function using impedance cardiography. Methods: Seventy-three patients (46 males), aged 52-89 years (mean 71.4 years) subjected to routine dual chamber pacemaker implantation with symptomatic chronic II or atrioventricular block, were included to the study. Results: DuRV pacing resulted in significantly higher cardiac index (CI) in comparison to RVOT and RVA and CI at RVOT was higher than at RVA pacing (2.46 vs 2.35 vs 2.28; P < 0.001). In patients with ejection fraction >50% significantly higher CI was observed during DuRV pacing when compared to RVOT and RVA pacing and there was no difference of CI between RVOT and RVA pacing (2.53 vs 2.41 vs 2.37; P < 0.001). In patients with ejection fraction <50%, DuRV and RVOT pacing resulted in significantly higher CI in comparison to RVA pacing while no difference in CI was observed between RVOT and DuRV pacing (2.28 vs 2.21 vs 2.09; P < 0.001). Conclusion: Dual-site right ventricular pacing in comparison to RVA pacing improved cardiac systolic function. RVOT appeared to be more advantageous than RVA pacing in patients with impaired, but not in those with preserved left ventricular function. No clear hemodynamic benefit of DuRV in comparison to RVOT pacing in patients with impaired systolic function was observed. © 2010, Wiley Periodicals, Inc.

Czarzasty W.,Administration Hospital | Kruszewski W.,Center of Oncology of Poland | Zielinski J.,Medical University of Gdańsk | Nianik M.,Administration Hospital
Polski Przeglad Chirurgiczny/ Polish Journal of Surgery | Year: 2011

Articles presenting treatment outcomes of stapled hemorrhoidopexy are rarely based on detailed analyses of the quality of life.The aim of the study was the assessment of changes within one year of treatment in the quality of life of patients who underwent stapled hemorrhoidopexy using QLQ-C30 form (version 3).Material and methods. 120 patients with grade III and IV internal hemorrhoidal disease treated with stapled hemorrhoidopexy were enrolled in the study. They answered questions from QLQ-C30 form and were subjected to examination a day before surgery and 1 day, 7 days, 4 weeks, 6 and 12 months after surgery. Assessment included operation site inspection, pain intensity measurement in VAS scale and parameters incorporated in QLQ-C30 form evaluation.Results. The overall quality of life decreased immediately after surgery (a day after 50% vs. 60% before surgery), but rapidly improved in one week and in one month periods (60% and 80% consecutively) reaching a plateau one month after surgery. Early complications occurred in 6 patients (5%). Recurrence of the disease was not observed. Bleeding from anastomosis site and severe pain in anal area immediately post surgery as a result of improper purse-string suture placement were the main complications.Conclusions. In patients with grade III or IV hemorrhoidal disease, stapled hemorrhoidopexy ensures a rapid improvement in the quality of life after surgery to the level experienced prior to the operation. 7-day convalescence period is sufficient. After one month, the overall quality of life improves significantly and reaches a plateau.

Luczynski W.,Medical University of Bialystok | Wawrusiewicz-Kurylonek N.,Medical University of Bialystok | Bossowski A.,Medical University of Bialystok | Ilendo E.,Medical University of Bialystok | And 3 more authors.
Kardiologia Polska | Year: 2011

Background: Much research has been done in the recent years to establish an association between obesity, metabolic syndrome and the immune system. Numerous data suggest that the decreased number and/or function of regulatory T cells (Treg cells) can lead to chronic minimal inflammation present in patients with obesity and trigger formation of atheroscleroticplaque. Aim: To generate Treg cells from the peripheral blood in children meeting the diagnostic criteria of metabolic syndrome. Methods: A total of 25 children with metabolic syndrome and 25 controls were enrolled in the study. Peripheral blood was collected, CD4 +/CD25- cells were separated and cultured for 4 weeks in the presence of a Treg expander (CD3/CD28) and interleukin-2. The expression of the transcription factor FoxP3 as a Treg marker was assessed before and after culture using reverse transcriptase polymerase chain reaction (RT-PCR) and flow cytometry. Results: Before the culture we observed a slightly lower percentage of Treg cells in children with metabolic syndrome vs controls. After the culture we noted a significant increase in mRNA expression and in the percentage of FoxP3-positive cells. We observed no differences in the results between the children with metabolic syndrome and the controls. Conclusions: Our study shows that it is possible to generate Treg cells from peripheral blood of children with metabolic syndrome. In future, these findings could be used to develop a model of immunotherapeutic intervention for patients at risk of cardiovascular disease. Copyright © Polskie Towarzystwo Kardiologiczne.

Pachowicz M.,Medical University of Lublin | Drozd J.,Administration Hospital | Belz M.,Medical University of Lublin | Maciejewski R.,Medical University of Lublin | Chrapko B.,Medical University of Lublin
Folia Morphologica (Poland) | Year: 2014

Coronary artery fistulae (CAF) are anomalies related to coronary artery abnormal termination. This is a very rare congenital malformation accounting for about 0.2-0.4% of congenital cardiac anomalies, but in some patients it can be haemodynamically important. Single-photon emission computed tomography or positron emission tomography myocardial perfusion imaging (MPI) using radioactive agents is widely used in clinical practice for cardiac ischaemia detection as a very sensitive and non-invasive tool. We are going to present 2 patients with bilateral CAFs to the pulmonary trunk without signs of the rest or stress ischaemia in MPI. Copyright © 2014 Via Medica

Cecil S.S.,Administration Hospital
Rehabilitation Nursing | Year: 2011

The following is a clinical narrative that describes one nurse's attempt to motivate a patient who had recently sustained an injury that caused quadriplegia and the practice implications that arose from "silo" thinking between disciplines.

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