Autoimmune / inflammatory syndrome induced by adjuvants (ASIA) – variety of symptoms

Introduction The autoimmune / inflammatory syndrome induced by adjuvants (ASIA) has been described by Shoenfeld and Agon-Levin (in 2011). It is an autoimmune / auto-inflammatory disease caused by adjuvants. Adjuvants are substances able to induce autoimmunity via various mechanisms such as a change in the host immune system, polyclonal activation of B cells, effects on cellular immunity, immunoregulatory cells, antibodies induced by viruses or acceleration of molecular mimicry. The aim The purpose of the work was to congregate information about ASIA useful in medical practice. State of knowledge The ASIA syndrome can be diagnosed when two main or one main and two smaller criteria are fulfil. The main criteria: External stimulus exposure Muscle pains, muscle inflammation or muscle weakness Arthralgia and / or arthritis Chronic fatigue, sleep without rest or sleep disorder Neurological symptoms Impaired cognitive function, memory loss Fever, dry mouth Removal of the inducing factor induces an improvement Result of organ biopsy Smaller criteria: Other clinical signs (irritable bowel syndrome) Presence of HLA antigens (ie HLA DRB1, HLA DQB1) Development of autoimmune disease (multiple sclerosis, systemic sclerosis). Asia syndrome may occur after implantation of silicone breast implants and cause various complications of other pain, fever and skin changes. Conclusion Autoimmune / auto-inflammatory disorders can be caused by silicone implants and vaccine adjuvants: they include the presence of autoantibodies, muscle and joint pain, lupus-like symptoms and hardened-like symptoms

Percutaneous removal of endocardial implantable cardioverter-defibrillator lead displaced to the right pulmonary artery

We describe a case of percutaneous removal of endocardial implantable cardioverter-defibrillator lead displaced to the right pulmonary artery. The procedure was performed from two accesses; from the lower one (femoral) and then, due to technical problems, from the upper one (subclavian). In the last stage the flattened Dotter’s basket was introduced to the heart inside the Byrd dilator and then fastened to the described lead as the external ‘splint’. This solution is an alternative to the recommended use of the internal metal leader with anchoring function in case of significant malformation of the internal lumen of the lead. The procedure we describe is an example of the sort of individual, original solution indispensable for the efficient and safe removal of untypically displaced leads

Perforacje jam serca przez elektrody rozruszników i kardiowerterów-defibrylatorów. Doświadczenia własne w diagnostyce, leczeniu i metodach prewencji

Cardiac chamber perforation is an uncommon, but potentially dangerous, complication of implantation of a pacemaker (PM) or a cardioverter-defibrillator (ICD). Different clinical presentations are related to the time between implantation and perforation, localisation of the perforation and concomitant lesions in neighbouring organs. Diagnosis is based on concomitant analysis of the clinical picture, ECG tracings, PM or ICD function check-up with a programmer, and review of echocardiographic, X-ray and computed tomography pictures. We analysed seven cases of perforation. Perforating leads were removed in all cases and a new pacing system was implanted in five cases. Choice of operative technique (unscrewing and direct traction from device pocket, Cook system or surgical procedure with pericardial drainage) depended on the time elapsing between implantation and perforation, the presence of lesions of other organs, and the amount of fluid in the pericardial sac. Avoiding unsafe localisation of a pacing electrode in the apex and free wall of the right ventricle and in the free anterolateral wall of the right atrium, and avoiding leaving an extra length of pacing lead under tension and overscrewing of the lead helix seem to be the best ways of prevention

Percutaneous removal of endocardial implantable cardioverter-defibrillator lead displaced to the right pulmonary artery

We describe a case of percutaneous removal of endocardial implantable cardioverter-defibrillator lead displaced to the right pulmonary artery. The procedure was performed from two accesses; from the lower one (femoral) and then, due to technical problems, from the upper one (subclavian). In the last stage the flattened Dotter’s basket was introduced to the heart inside the Byrd dilator and then fastened to the described lead as the external ‘splint’. This solution is an alternative to the recommended use of the internal metal leader with anchoring function in case of significant malformation of the internal lumen of the lead. The procedure we describe is an example of the sort of individual, original solution indispensable for the efficient and safe removal of untypically displaced leads. (Cardiol J 2010; 17, 3: 293-298

Trend or disease? - gluten-free diet

Introduction and purpose of work: Over the past few years, the topic of gluten-free diets has become very popular. In the past, it was understood only in the context of a specific medical indication, implemented in the event of a disease, e.g. celiac disease, as part of the patient's treatment. Today, the concept has changed a bit. The abatement of the concept of a gluten-free diet is attributed to social media, which, in a way, suggests recipients to use it on a daily basis, clearly emphasizing the harmful effects of gluten on the human body. better mood".The aim of the study is to analyze the awareness of the society on the use of a gluten-free diet.Material and method: The results of the study were obtained on the basis of an online survey.Results: 213 respondents took part in the survey, 36.2% of the respondents were women and 63.8% men, 88.7% of the surveyed respondents correctly answered the question what gluten is, but 65.7% are associated with the presence of gluten in products food industry with the development of this industry, 42.3% of respondents believe that consumption of gluten should be avoided. Only 8.9% of people on a gluten-free diet heard from a doctor for the first time, over 36% from the media. As many as 78.4% of respondents are not aware of about the need to balance this diet, but still uses it.Conclusions: The study shows that the society is not fully educated on the use of a gluten-free diet. It can be concluded that the approval of the society is not based on the merits, but rather an expression of a trend. The dissemination of this concept is due to the media

Pacemaker implantation in a patient with cor triatriatum sinister : preoperative evaluation

A case of 72 year old-male with cor triatriatum sinister, permanent atrial fibrillation and symptomatic bradycardia is presented. Patient was scheduled for pacemaker implantation. A preoperative evaluation with transesophageal echocardiography revealed a nonrestrictive membrane in left atrium, normal right superior vena cava and absence of persistent left superior vena cava and other cardiac anomalies. A right ventricular pacemaker lead was implanted through left subclavian approach. Preoperative evaluation shortened a radiation exposure and procedure time

AAI stimulation and nodal rhythm

We describe the case of a 77 year-old white woman treated by AAI pacing. Nodal rhythm with ventriculo-atrial conduction and retrograde P wave were observed in ECG Holter monitoring. The retrograde P wave was sensed by the pacemaker, which responded correctl

Badanie echokardiograficzne u pacjentów z wrodzoną wadą serca (L-TGA, ccTGA) leczonych terapią resynchronizującą z powodu niewydolności systemowej anatomicznie prawej komory

A congestive heart failure is common in population of adult patients with congenital heart disease, especially among patients with systemic right ventricle. According to literature 4-9% of patients with systemic right ventricle can be treated with resynchronisation therapy (CRT). Authors present results of echocardiographic examination in two patients with ccTGA treated by CRT because of failure of systemic right ventricle. Kardiol Pol 2010; 68, 11: 1287-129

Echocardiographic examination in patients with corrected transposition of great arteries (L-TGA, ccTGA) with failure of systemic (anatomically) right ventricle treated with resynchronisation therapy

A congestive heart failure is common in population of adult patients with congenital heart disease, especially among patients with systemic right ventricle. According to literature 4–9% of patients with systemic right ventricle can be treated with resynchronisation therapy (CRT). Authors present results of echocardiographic examination in two patients with ccTGA treated by CRT because of failure of systemic right ventricle