Mechanical thrombectomy for acute ischaemic stroke during therapeutic anticoagulation: long-term outcomes

Aim of study. Mechanical thrombectomy (MT) is one of the aetiological treatment options recommended for anticoagulated patients with acute ischaemic stroke (AIS). We analysed its long-term outcomes using the modified Rankin Score (mRS) or mortality on day 90.Clinical rationale for the study. Data describing the anticoagulant efficacy and safety of MT in patients with AIS is limited.Materials and methods. This study included 291 patients with AIS (49% women, mean [SD] age 66 [15] years) who underwent MT in the Comprehensive Stroke Centre in Krakow, Poland. Data describing demographics, stroke risk factors, NIHSS on admission, postprocedural thrombolysis in cerebral infarction score, 24-hour postprocedural haemorrhagic transformation (ECASS-2) as seen on computed tomography, and time between stroke onset and groin puncture was collected. The outcome measure was the mRS on day 90 after stroke onset (a favourable outcome was defined as an mRS not exceeding 2 points; an unfavourable outcome was death).Results. Thirty-seven patients (13%) were on therapeutic anticoagulation during MT. Univariate analysis showed that anticoagulated patients were older and more likely to have been diagnosed with hypertension, ischaemic heart disease, or atrial fibrillation. The patient groups did not differ in terms of clot location, postprocedural thrombolysis in cerebral infarction score, haemorrhagic transformation on computed tomography, or mRS on day 90. Multivariate logistic regression analysis showed that younger age, male sex, no history of diabetes mellitus, lower NIHSS score on admission, shorter time between stroke onset and groin puncture, and better recanalisation were associated with favourable outcomes at day 90, and that therapeutic anticoagulation was not (OR, 1.00; 95%CI, 0.46-2.15; p = 0.99). Anticoagulation did not affect mortality at day 90 (OR, 1.28; 95%CI, 0.56-2.92; p = 0.55).Conclusion and clinical implications. In anticoagulated patients with AIS, MT does not affect long-term outcomes

Comparison of Hepatic and Nephric Total Mercury Concentrations Between Feral and Ranch American Mink (Neovison vison) from Northwestern Poland

For many years the American mink (Neovison vison) has been used in North America (where it originates from) as a sensitive indirect bioindicator in assessing the degree of mercury (Hg) contamination in terrestrial ecosystems. The aim of this paper was the determination of total concentrations of Hg in the liver and kidneys of feral and ranch mink from the Warta Mouth National Park (WMNP) and from farms located in northwestern Poland, for comparison with similar data on American mink from North America. In road-killed feral mink from the WMNP, the mean concentrations were 11.8 and 14.1 mg/kg dry weight in the liver and kidney, respectively. Mean Hg concentrations in feral mink were from 240 to 90 times higher in these two respective tissues than in ranch mink. The feral mink from northwestern Poland had concentrations of hepatic and nephric Hg similar to the highest concentrations that have been recorded over the past several decades in wild American mink from certain areas of Canada and the USA

Państwo, gospodarka, społeczeństwo w integrującej się Europie TOM 1

Ze wstępu: "III Międzynarodowa Konferencja Naukowa, jaką w pierwszych dniach czerwca 2003 roku zorganizowała Krakowska Szkoła Wyższa, poświęcona była uczczeniu wyjątkowego jubileuszu 500-lecia urodzin jej patrona - Andrzeja Frycza Modrzewskiego. Jednak to nie myśl polityczna tego wielkiego Polaka i reformatora stała się wiodącym tematem konferencji. W centrum zainteresowań znalazły się zagadnienia 0 wiele bardziej aktualne, dotyczące bowiem integracji europejskiej. Problematyka tym bardziej żywotna, gdyż dotykająca bieżącego życia politycznego - zwłaszcza w kontekście referendum akcesyjnego, które odbyło się w równy tydzień po konferencji. Tak więc jej uczestnicy mieli doskonałą okazję do podjęcia interesujących rozważań związanych z perspektywą rozwoju państwa, gospodarki i społeczeństwa w warunkach integracji europejskiej."(...

Research needs in allergy: an EAACI position paper, in collaboration with EFA

Abstract In less than half a century, allergy, originally perceived as a rare disease, has become a major public health threat, today affecting the lives of more than 60 million people in Europe, and probably close to one billion worldwide, thereby heavily impacting the budgets of public health systems. More disturbingly, its prevalence and impact are on the rise, a development that has been associated with environmental and lifestyle changes accompanying the continuous process of urbanization and globalization. Therefore, there is an urgent need to prioritize and concert research efforts in the field of allergy, in order to achieve sustainable results on prevention, diagnosis and treatment of this most prevalent chronic disease of the 21 st century. The European Academy of Allergy and Clinical Immunology (EAACI) is the leading professional organization in the field of allergy, promoting excellence in clinical care, education, training and basic and translational research, all with the ultimate goal of improving the health of allergic patients. The European Federation of Allergy and Airways Diseases Patients' Associations (EFA) is a non-profit network of allergy, asthma and Chronic Obstructive Pulmonary Disorder (COPD) patients' organizations. In support of their missions, the present EAACI Position Paper, in collaboration with EFA, highlights the most important research needs in the field of allergy to serve as key recommendations for future research funding at the national and European levels. Although allergies may involve almost every organ of the body and an array of diverse external factors act as triggers, there are several common themes that need to be prioritized in research efforts. As in many other chronic diseases, effective prevention, curative treatment and accurate, rapid diagnosis represent major unmet needs. Detailed phenotyping/endotyping stands out as widely required in order to arrange or re-categorize clinical syndromes into more coherent, uniform and treatment-responsive groups. Research efforts to unveil the basic pathophysiologic pathways and mechanisms, thus leading to the comprehension and resolution of the pathophysiologic complexity of allergies will allow for the design of novel patient-oriented diagnostic and treatment protocols. Several allergic diseases require well-controlled epidemiological description and surveillance, using disease registries, pharmacoeconomic evaluation, as well as large biobanks. Additionally, there is a need for extensive studies to bring promising new biotechnological innovations, such as biological agents, vaccines of modified allergen molecules and engineered components for allergy diagnosis, closer to clinical practice. Finally, particular attention should be paid to the difficult-to-manage, precarious and costly severe disease forms and/or exacerbations. Nonetheless, currently arising treatments, mainly in the fields of immunotherapy and biologicals, hold great promise for targeted and causal management of allergic conditions. Active involvement of all stakeholders, including Patient Organizations and policy makers are necessary to achieve the aims emphasized herein

Placement of allergen specific immunotherapy in ocular allergy

Morbidity of ocular allergic diseases has been growing all over the world alongside with other allergic diseases, especially the allergic rhinitis. Unfortunately epidemiologic data and studies about immunotherapy in ocular allergy have so far been scarce in comparison to extensive research of various aspects of allergic rhinitis. The author presents three studies of allergen-specific immunotherapy in ocular allergy and certain of numerous studies on allergic conjunctivitis (AC) and allergic rhinoconjunctivitis (ARC) that included separate evaluation of ocular symptoms. This article emphasizes the need for further research on the proper placement of ocular allergies in allergology and establishing indications for allergen-specific immunotherapy of allergic conjunctivitisZachorowalność na alergiczne choroby oczu rośnie na świecie wraz ze wzrostem innych chorób alergicznych, szczególnie z alergicznym nieżytem nosa. Niestety badania nad epidemiologią i immunoterapią w alergii oczu są nadal nieliczne w porównaniu z badaniami dotyczą- cymi wszystkich aspektów alergicznego nieżytu nosa. Autor przedstawia 3 prace ze swoistej immunoterapii alergenowej dotyczące alergii oczu i omawia niektóre, z licznych badań, dotyczących immunoterapii nieżytu alergicznego nosa i spojówek, które oceniały osobno poprawę objawów ocznych. Artykuł próbuje wykazać zasadność dalszych badań nad właściwym miejscem w alergologii wiedzy o alergii oczu, a w szczególności ustalenia wskazań do swoistej immunoterapii w alergicznych zapaleniach spojówek

Contact blepharoconjunctivits - the description of two case studies

The rate of occurrence of CBC (Contact Blepharo-Conjuncitivis) has been increasing in recent years due to growing exposure of the population to allergens and chemical substances (pharmaceuticals, cosmetics, preservatives). Typical symptoms of CBC are as follows: itching and stinging of eyelids, erythema with possible lichenification of skin in the eye sockets area, conjunctival edema and hyperemia. Thorough analysis of patient’s medical history is crucial for identification a cause of CBC, but whenever this is insufficient one needs to seek for IgE dependent allergies (allergic airborne eczema) or allergies to various chemical substances, which as haptens are responsible for type IV response according to Gell and Coombs (path tests). This article presents two cases of CBC.Kontaktowe zapalenie spojówek i skóry powiek zdarza się coraz czę- ściej z powodu zwiększonej możliwości kontaktu skóry oczodołu z przeróżnymi substancjami: alergenami i związkami chemicznymi (leki, kosmetyki, konserwanty). Obraz kliniczny to swędzenie lub pieczenie skóry powiek, rumień aż po cechy lichenizacji skóry oczodołu, obrzęk i przekrwienie spojówek. Podstawą diagnostyki jest dokładny wywiad, a jeśli nie daje rozpoznania - diagnostyka alergologiczna z poszukiwaniem zależnej od IgE alergii (przyczyna wyprysku powietrznopochodnego) lub uczulenia na różnorodne grupy związków chemicznych, które jako hapteny odpowiadają za reakcję typu IV wg Gella i Coombsa (testy płatkowe). W artykule przedstawiono 2 przypadki CBC

Efficiency and Eco-Costs of Air Purifiers in Terms of Improving Microbiological Indoor Air Quality in Dwellings—A Case Study

Air pollution, a by-product of economic growth, generates an enormous environmental cost in Poland. The issue of healthy living spaces and indoor air quality (IAQ) is a global concern because people spend approximately 90% of their time indoors. An increasingly popular method to improve IAQ is to use air purifiers (APs). Indoor air is often polluted by bioaerosols (e.g., viruses, bacteria, fungi), which are a major concern for public health. This work presents research on culturable bacterial aerosol (CBA) samples collected from dwellings with or without active APs during the 2019 summer season. The CBA samples were collected using a six-stage Andersen cascade impactor (ACI). The CBA concentrations were expressed as Colony Forming Units (CFU) per cubic metre of air. The average concentration of CBA in dwellings when the AP was active was 450–570 CFU/m3, whereas the average concentration when the AP was not active was 920–1000 CFU/m3. IAQ, when the APs were active, was on average almost 50% better than in cases where there were no procedures to decrease the concentration of air pollutants. Moreover, the obtained results of the particle size distribution (PSD) of CBA indicate that the use of APs reduced the proportion of the respirable fraction (the particles < 3.3 µm) by about 16%. Life cycle assessment (LCA) was used to assess the ecological cost of air purification. Our conceptual approach addresses the impact of indoor air pollution on human health and estimates the ecological cost of APs and air pollution prevention policies

Effectiveness and Eco-Costs of Air Cleaners in Terms of Improving Fungal Air Pollution in Dwellings Located in Southern Poland—A Preliminary Study

Epidemiological evidence shows that air pollution is responsible for several million premature deaths per year. By virtue of being responsible for these deaths, economic evidence shows that air pollution also imposes a so-called economic cost to society of several trillion dollars per year. The diseases caused by biological air pollutants are of primary global concern for both social and economic reasons, and given that people may spend more than 90% of their time in enclosed spaces, the investigation into methods to remove indoor air pollutants is of paramount importance. One of the methods to improve indoor air quality (IAQ) is to use air cleaners (ACLs) with high-efficiency particulate air filters (HEPA) that remove biological indoor air pollutants from indoor environments. This work presents the results of a study of fungal aerosol samples collected during the summer season from inside two dwellings (DG1 and DG2) before and after starting the use of ACLs. The fungal aerosol samples collected from each of the six stages of the sampler were incubated on agar plates at 26 °C, and the colony forming units (CFU) were manually counted and statistically corrected. The concentration of living airborne fungi was expressed as the CFU in the volume of air (CFU·m−3). The average concentration of fungal aerosol decreased the most when the ACLs were active for 24 min. The reduction was from 474 CFU·m−3 to 306 CFU·m−3, and from 582 CFU·m−3 to 338 CFU·m−3 in DG1 and DG2, respectively. The use of ACLs was assessed by the life cycle assessment (LCA) methodology. This study highlights the benefits of controlling biological air pollutants in order to keep occupants of buildings happy and healthy

Cyclohaler’s acceptance by asthma and COPD patients

Wstęp: Akceptacja programu leczenia i gotowość zażywania przez chorego zalecanej dawki leków są podstawowymi warunkami powodzenia procesu terapeutycznego. Celem pracy było zbadanie stopnia akceptacji (jego cech fizycznych, użytkowych i związanych z techniką inhalacji) przez chorych jednego z inhalatorów proszkowych - cyclohalera. Materiał i metody: Badanie polegało na wypełnieniu przez użytkowników samozwrotnej, anonimowej ankiety. Pacjentów rekrutowano spośród chorych na astmę i/lub POChP leczonych ambulatoryjnie w poradniach astmologicznych we Wrocławiu i Lublinie. Do udziału zakwalifikowano 230 osób z astmą i/lub POChP (przewlekła obturacyjna choroba płuc), a ankietę wypełniło 220 pacjentów. Wyniki: Spośród cech fizycznych wielkość i ciężar inhalatora uzyskały akceptację największej liczby ankietowanych (96,4 i 94,5% ocen pozytywnych), zyskując wyższą akceptację niż kolor (odpowiednio p = 0,003 i p = 0,02). Zbliżony stopień ocen pozytywnych zyskały cechy użytkowe, szczególnie "ochrona urządzenia przed zanieczyszczeniem" i "wygodny ustnik" urządzenia (odpowiednio 97,3 i 98,2% odpowiedzi pozytywnych). Te dwie cechy oceniła pozytywnie większa liczba ankietowanych niż "dyskrecję i łatwość noszenia inhalatora" (odpowiednio p = 0,015 i p = 0,028). Odsetek ankietowanych oceniających pozytywnie poszczególne właściwości związane z techniką inhalacji leku wynosił 94-96% dla następujących cech: czytelność instrukcji obsługi, możliwość kontroli liczby przyjętych dawek i pewność przyjęcia dawki leku. Wnioski: Badany inhalator uzyskał wysoki stopień akceptacji, głównie dzięki cechom decydującym o łatwej technice inhalacji leku i możliwości wizualnej oceny jej przebiegu.Introduction: The patients’ acceptance of the treatment scheme and their readiness to stick to the prescribed dosing is considered to be the most important condition on which successful treatment of asthma and COPD depends. With regard to this assumption, a study was designed whose aim was to find out how patients assess a particular powder inhaler, cyclohaler and to what degree they approve of its physical and technical features. Material and methods: The study consisted in completing an anonymous questionnaire. The study group was recruited from asthmatic and COPD patients treated in outpatient units in Wroclaw and Lublin, Poland. 230 persons passed the recruitment stage, 220 completed the study. Results: 96.4 and 94.5% of the patients ranked small size and low weight of the inhaler, respectively, as its most positive features, ranking the features higher than the device’s colour (respectively p = 0.003 and p = 0.02). Other features, like dust protection and comfortable mouthpiece won almost equally high evaluation (respectively 97.3 and 98.2%). Most patients assessed these features as more important than discretion and easy handling and transportation (respectively p = 0.015 and p = 0.028). A high percentage of the study group praised the inhaler’s technological efficacy. 94-96% at the least gave positive opinions about such features as: clear instruction, certainty of a dose’s intake, the possibility of checking the amount of inhaled doses. Conclusion: The inhaler that was the object of the study enjoyed a high degree of acceptance mostly due to its features facilitating easy and efficient inhalation