Analiza wykorzystywania systemów informatycznych przez polskie szpitale

Information systems are currently applied on a large scale in every sphere of human activity, also in medicine, i.e. in hospital functioning. The purpose of this paper is to discuss the issues related to the use of these systems in the Polish healthcare institutions on the basis of data from the report on healthcare informatization in Poland. As a result we showed that some information systems, mainly HIS, RIS, LIS, PIS and PACS, are used in many Polish hospitals, however the range of their applications is still insufficient. There is an urgent need to implement them in all hospitals in Poland. Each hospital should apply such systems because they bring a number of benefits, such as the increase of management efficiency, reduction of time required for healthcare services and reduction of health care costs.Systemy informatyczne są obecnie stosowane na szeroką skalę praktycznie w każdej sferze działalności człowieka. Dotyczy to także medycyny. Systemy te są obecne również podczas funkcjonowania szpitali. Omówienie zagadnień związanych z wykorzystywaniem tych systemów w polskich placówkach szpitalnych jest przedmiotem prezentowanej pracy. W jej ramach, jako metodę badawczą, zastosowano analizę danych zastanych. W wyniku tej analizy udało się dowieść, że systemy informatyczne, w tym głównie HIS, RIS, LIS, PIS oraz PACS, są stosowane w wielu polskich szpitalach, jednak skala tego jest wciąż niewystarczająca, gdyż dopiero wdrożenie ich we wszystkich szpitalach w Polsce przyniesie oczekiwane rezultaty. Każdy szpital powinien wdrażać takie systemy, gdyż przynoszą one szereg korzyści, takich jak wzrost efektywności zarządzania placówką, zmniejszenie czasu potrzebnego na realizację obsługi pacjentów czy redukcja kosztów ponoszonych w związku z realizacją leczenia

Transbronchial lung cryobiopsy guided by radial "mini-probe" endobronchial ultrasound in interstitial lung diseases - a multicenter prospective study

Introduction: Transbronchial lung cryobiopsy (TBLC) is commonly used in diagnosing interstitial lung diseases (ILDs). Ageneral anesthesia with endotracheal intubation, balloon blockers and fluoroscopy control is the most common modality. Simplifying the procedure without decreasing it’s safety could result in wider use. Prospective, observational study was conducted in three Polish pulmonology centers to evaluate safety and diagnostic yield of TBLC under conscious sedation, without intubation and bronchial blockers and with radial-EBUS guidance instead of fluoroscopy. Material and methods: In patients suspected of ILD, in accordance with high resolution computer tomography (HRCT) selected lung segments were examined with radial-EBUS mini probe without aguide sheath. If the lung infiltrations were visible this locations were preferred. If not, specimens were taken from two different segments of the same lobe. Two to five biopsies with freezing time 5–8 seconds were performed. Moreover ultrasound examination was used to avoid injury of lung vessels. Results: From March 2017 to September 2019 — 114 patients (M: 59, F: 55) of mean (SD) age 54 (14) years were included to the study on the basis of medical history and HRCT. Histopathology was conclusive in 90 (79%) patients and included 16 different diagnoses (sarcoidosis, EAA, COP predominantly). 24 inconclusive biopsies of unclassifiable pulmonary fibrosis were followed up. Complications included five cases (4.4%) of pneumothorax requiring achest tube drainage and aminor and moderate bleeding in few cases. There was no need for use of balloon bronchial blockers. Conclusions: TBLC under conscious sedation guided by radial EBUS mini-probe is novel, reasonable and safe technique for histological diagnosis of ILDs

Transbronchial lung cryobiopsy guided by radial mini-probe endobronchial ultrasound in interstitial lung diseases — a multicenter prospective study

Introduction: Transbronchial lung cryobiopsy (TBLC) is commonly used in diagnosing interstitial lung diseases (ILDs). A general anesthesia with endotracheal intubation, balloon blockers and fluoroscopy control is the most common modality. Simplifying the procedure without decreasing it’s safety could result in wider use.Prospective, observational study was conducted in three Polish pulmonology centers to evaluate safety and diagnostic yield of TBLC under conscious sedation, without intubation and bronchial blockers and with radial-EBUS guidance instead of fluoroscopy. Material and methods: In patients suspected of ILD, in accordance with high resolution computer tomography (HRCT) selected lung segments were examined with radial-EBUS mini probe without a guide sheath. If the lung infiltrations were visible this locations were preferred. If not, specimens were taken from two different segments of the same lobe. Two to five biopsies with freezing time 5–8 seconds were performed. Moreover ultrasound examination was used to avoid injury of lung vessels.Results: From March 2017 to September 2019 — 114 patients (M: 59, F: 55) of mean (SD) age 54 (14) years were included to the study on the basis of medical history and HRCT. Histopathology was conclusive in 90 (79%) patients and included 16 different diagnoses (sarcoidosis, EAA, COP predominantly). 24 inconclusive biopsies of unclassifiable pulmonary fibrosis were followed up. Complications included five cases (4.4%) of pneumothorax requiring a chest tube drainage and a minor and moderate bleeding in few cases. There was no need for use of balloon bronchial blockers.Conclusions: TBLC under conscious sedation guided by radial EBUS mini-probe is novel, reasonable and safe technique for histological diagnosis of ILDs

Sleep apnea and comorbid diseases - a review

Obstructive sleep apnea (OSA) is a common disease spreading around the world. It is unavoidably linked to the increasing rate of obesity, particularly in Western societies. Associated higher prevalence of sleep disordered breathing has also been observed. There are many diseases that can lead to OSA and many that are a result of untreated OSA. From the widely known cardiovascular complications to indirectly related diseases, such as insomnia, Alzeihmer’s disease or psoriasis. Overall, sleep-disordered breathing have been shown to negatively impact quality of life, including general health perception, physical functioning, social functioning, and vitality. That is why it is important to spread awareness about OSA, often asymptomatic, through medical staff and patients in the risk group. In this review we describe the illness, the ways to diagnose it and discuss comorbid diseases

Current practice of care for adolescent and adult patients after Fontan surgery in Poland

Background: The growing number of adults patients after the Fontan operation requires regular surveillance tests in the specialized centers. Aims: Evaluation of current practice of care for Fontan patients in Poland based on a multicenter survey. Methods: Eight centers were included in the study-5 adult congenital heart disease (ACHD) and 3 pediatric centers for adolescents. To aim for a comparison between the centers and facilitate the interpretation of the results, the Fontan Surveillance Score (FSS) was developed. The higher score is consistent with better care, with a maximum of 19 points. Results: The number of 398 Fontan patients (243 adults and 155 adolescents [age 14-18 years]) was included in the study. The median FSS was 13 points with variability between the centers (interquartile range 7-14 points). Centers providing continuous care from the pediatric period until 18 years of age achieved a higher FSS compared to ACHD centers (median: 14 points vs 12 points, p< 0.001). Most of the patients, both in the ACHD (82.3%) and in pediatric centers (89%), were seen annually and had a physical examination, electrocardiogram, and echocardiogram performed at each visit. However, unsatisfactory utilization of tests identifying the early stages of Fontan circulation failure (cardiopulmonary exercise tests, cardiac magnetic resonance, liver biochemistry and imaging, detection of protein-losing enteropathy) was observed. Conclusions: The results of the study showed that there is no unified surveillance approach for Fontan patients in Poland. The practice of care for adults differs from that of adolescents

Asteroid (16) Psyche’s primordial shape: A possible Jacobi ellipsoid

Context. Asteroid (16) Psyche is the largest M-type asteroid in the main belt and the target of the NASA Psyche mission. It is also the only asteroid of this size (D >  200 km) known to be metal rich. Although various hypotheses have been proposed to explain the rather unique physical properties of this asteroid, a perfect understanding of its formation and bulk composition is still missing. Aims. We aim to refine the shape and bulk density of (16) Psyche and to perform a thorough analysis of its shape to better constrain possible formation scenarios and the structure of its interior. Methods. We obtained disk-resolved VLT/SPHERE/ZIMPOL images acquired within our ESO large program (ID 199.C-0074), which complement similar data obtained in 2018. Both data sets offer a complete coverage of Psyche’s surface. These images were used to reconstruct the three-dimensional (3D) shape of Psyche with two independent shape modeling algorithms (MPCD and ADAM). A shape analysis was subsequently performed, including a comparison with equilibrium figures and the identification of mass deficit regions. Results. Our 3D shape along with existing mass estimates imply a density of 4.20  ±  0.60 g cm−3, which is so far the highest for a solar system object following the four telluric planets. Furthermore, the shape of Psyche presents small deviations from an ellipsoid, that is, prominently three large depressions along its equator. The flatness and density of Psyche are compatible with a formation at hydrostatic equilibrium as a Jacobi ellipsoid with a shorter rotation period of ∼3h. Later impacts may have slowed down Psyche’s rotation, which is currently ∼4.2 h, while also creating the imaged depressions. Conclusions. Our results open the possibility that Psyche acquired its primordial shape either after a giant impact while its interior was already frozen or while its interior was still molten owing to the decay of the short-lived radionuclide 26Al.Based on observations collected at the European Organisation for Astronomical Research in the Southern Hemisphere under ESO programme 199.C-0074 (principal investigator: P. Vernazza). P. Vernazza, A. Drouard, M. Ferrais and B. Carry were supported by CNRS/INSU/PNP. J.H. and J.D. were supported by grant 18-09470S of the Czech Science Foundation and by the Charles University Research Programme no. UNCE/SCI/023. E.J. is F.R.S.-FNRS Senior Research Associate. The work of TSR was carried out through grant APOSTD/2019/046 by Generalitat Valenciana (Spain). This work was supported by the MINECO (Spanish Ministry of Economy) through grant RTI2018-095076-B-C21 (MINECO/FEDER, UE)