Opinia członków ZRM dotycząca funkcjonowania systemu teletransmisji EKG

Wstęp. Do istotnych elementów pracy personelu ZRM należy zarówno sporządzanie elektronicznej dokumentacji medycznej (składającej się na elektroniczny rekord pacjenta), jak i udostępnianie zawartych w niej danych, co możliwe jest dzięki wdrożeniu rozwiązań telemedycznych, takich jak system teletransmisji EKG. Ponieważ opinia pracowników może warunkować wykorzystywanie wdrożonych systemów, duże znaczenie mają poglądy personelu nt. przydatności opracowanych rozwiązań oraz wynikających z nich korzyści. Cel pracy. Celem pracy było ustalenie opinii członków ZRM (P oraz S) dotyczącej funkcjonowania systemu teletransmisji EKG. Materiał i metoda. Na potrzeby badania (przeprowadzonego metodą sondażu diagnostycznego) przygotowano kwestionariusz ankiety składający się z 18 pytań. W badaniu udział wzięło 115 członków ZRM pracujących w KPR (w tym 82 ratowników medycznych, 21 pielęgniarek oraz 12 lekarzy). Wyniki. Wykonywanie teletransmisji EKG zadeklarowało 93,91% (n=108) respondentów. Ze stwierdzeniem, że bezpośredni transport pacjenta do OKI znacznie skraca czas rozpoczęcia inwazyjnego leczenia w porównaniu do przewiezienia chorego do najbliższego SOR zdecydowanie lub raczej zgadza się 99,13% ankietowanych. 87,83% (n=101) respondentów jest zdecydowanie lub raczej zadowolonych z możliwości wykonywania teletransmisji EKG. Wdrożony system oceniony został jako zdecydowanie lub raczej przydatny przez 93,91% członków ZRM. Wśród respondentów 91,30% osób jest zdecydowanie lub raczej pozytywnie nastawionych wobec wdrażania oraz rozwijania w systemie PRM rozwiązań telemedycznych. Wnioski. Ratownicy medyczni i pielęgniarki znamiennie statystycznie częściej deklarują wykonywanie teletransmisji ECG podczas pracy zawodowej w porównaniu do lekarzy. Ratownicy medyczni i pielęgniarki istotnie statystycznie częściej postrzegają system teletransmisji ECG jako przydatny w opiece nad pacjentem z podejrzeniem Ostrego Zespołu Wieńcowego w porównaniu do lekarzy. Ratownicy medyczni istotnie statystycznie częściej uważają, że wdrożenie systemu teletransmisji ECG wpływa na poprawę jakości pracy ZRM w porównaniu do lekarzy. Ratownicy medyczni znamiennie statystycznie częściej są zadowoleni z możliwości wykonywania teletransmisji ECG w porównaniu do lekarz.Introduction. Filling in the electronic medical documentation (which the electronic patient record is comprising of) and sharing data (which are included in documents) are important elements of Medical Rescue Team (MRT) staff’s work. That’s possible due to implementation telemedicine solutions like ECG teletransmission. The personnel’s opinions can affect the use of systems. That is the reason, the staff’s opinion on usefulness and benefits of systems is very important. The purpose of the study. The aim of the study is to establish the MRT (Basic: BMRT and Specialist: SMRT) staff’s opinion on the subject of functioning of ECG teletransmission system in Emergency Medical Service (EMS) in Cracow. Material and method. The survey questionnaire (which contains 18 questions) was prepared for the needs of the study (carried out by a method of diagnostic survey). 115 MRT employees of EMS in Cracow (82 paramedics, 21 nurses and 12 doctors) took part in the research. Results. 93,91% respondents declared making an ECG teletransmission. 99,13% participants definitely or rather agree with the statement that direct patient transport to the interventional cardiology unit significantly shortens the time of invasive treatment. 87,83% MRT members are definitely or rather satisfied with the possibility of using ECG teletransmission system. 93,91% MRT employees evaluate the implemented system as definitely or ra-ther useful. 91,30% respondents are definitely or rather positive about the implementing and developing the telemedicine in EMS in Poland. Conclusions. Medical rescuers and nurses significantly more often declare Electrocardiograpfy teletransmissions during their professional work than doctors. Medical rescuers and nurses significantly more often perceive the ECG teletransmission system as useful in the care of a patient with suspected Acute Coronary Syndrome compared to doctors. Medical rescuers are statistically signifi-cantly more likely to believe that the implementation of the ECG teletransmission system improves the quality of work of the Medical Rescue Team as compared to physicians. Medical rescuers are statistically significantly more often satisfied with the possibility of ECG teletransmission in comparison to physicians

Prevention of HIV infection

W artykule przedstawiono podstawowe zagadnienia służące zapobieganiu rozprzestrzenianiu się wirusa HIV, profilaktykę i programy o charakterze prewencyjnym. Szczegółowiej omówiono czynniki społeczne powodujące podatność na HIV, oraz profilaktykę poekspozycyjną.This article presents basic facts that are helpful in the avoidance of HIV infection and preventive programmes. Social factors triggering susceptibility to HIV as well as post-exposure prophylaxis were discussed in greater detail

The self-care of diabetics : the role of a nurse

Chorzy na cukrzycę powinni stać się samowystarczalni w zakresie kontroli stężenia glukozy we krwi oraz wstrzyknięć insuliny do tkanki podskórnej. Posiadanie tych umiejętności nie uzależnia ich od innych osób. Stawiają się w komfortowej sytuacji, jaką jest zdolność do samoopieki. Wychodząc naprzeciw tej tezie autorzy omawiają korzystanie ze strzykawki do wstrzyknięć insuliny, charakteryzują obsługę automatycznych wstrzykiwaczy ( PEN-ów). Przedstawiają także nowoczesne rozwiązania techniczne stosowane w leczeniu chorych na cukrzycę insulinozależną.Diabetics should become self-sufficient as far as controlling their glucose level and injecting insulin to the subcutaneous tissue are concerned. Having these skill makes them independent from the help of others. It puts them in a convenient position of being capable of self-care. With the intention of exploring this matter, the authors discuss using the syringe to inject insulin and characterize the use of automatic injectors (pens). They also present modern technological solutions used for treating the insulin-dependent diabetics

Metabolic associated fatty liver disease and cardiovascular risk: The expert opinion of the Working Group on Cardiovascular Pharmacotherapy of the Polish Cardiac Society

The diagnosis of metabolic associated fatty liver disease (MAFLD) is significant for patients’ prognosis, as the disease accelerates the development of cardiovascular complications and, on the other hand, cardiometabolic conditions are risk factors for the development of fatty liver diseases. This expert opinion presents principles of MAFLD diagnosis and standards of management to reduce cardiovascular risks in patients with MAFLD

Molecular EPISTOP, a comprehensive multi-omic analysis of blood from Tuberous Sclerosis Complex infants age birth to two years

We present a comprehensive multi-omic analysis of the EPISTOP prospective clinical trial of early intervention with vigabatrin for pre-symptomatic epilepsy treatment in Tuberous Sclerosis Complex (TSC), in which 93 infants with TSC were followed from birth to age 2 years, seeking biomarkers of epilepsy development. Vigabatrin had profound effects on many metabolites, increasing serum deoxycytidine monophosphate (dCMP) levels 52-fold. Most serum proteins and metabolites, and blood RNA species showed significant change with age. Thirty-nine proteins, metabolites, and genes showed significant differences between age-matched control and TSC infants. Six also showed a progressive difference in expression between control, TSC without epilepsy, and TSC with epilepsy groups. A multivariate approach using enrollment samples identified multiple 3-variable predictors of epilepsy, with the best having a positive predictive value of 0.987. This rich dataset will enable further discovery and analysis of developmental effects, and associations with seizure development in TSC.</p

Pharmacotherapy of heart failure A.D. 2023. Expert opinion of Working Group on Cardiovascular Pharmacotherapy, Polish Cardiac Society

Heart failure (HF) remains one of the most common causes of hospitalization and mortality among Polish patients. The position of the Section of Cardiovascular Pharmacotherapy presents the currently applicable options for pharmacological treatment of HF based on the latest European and American guidelines from 2021–2022 in relation to Polish healthcare conditions. Treatment of HF varies depending on its clinical presentation (acute/chronic) or left ventricular ejection fraction. Initial treatment of symptomatic patients with features of volume overload is based on diuretics, especially loop drugs. Treatment aimed at reducing mortality and hospitalization should include drugs blocking the renin-angiotensin-aldosterone system, preferably angiotensin receptor antagonist/neprilysin inhibitor, i.e. sacubitril/valsartan, selected beta-blockers (no class effect — options include bisoprolol, metoprolol succinate, or vasodilatory beta-blockers — carvedilol and nebivolol), mineralocorticoid receptor antagonist, and sodium-glucose cotransporter type 2 inhibitor (flozin), constituting the 4 pillars of pharmacotherapy. Their effectiveness has been confirmed in numerous prospective randomized trials. The current HF treatment strategy is based on the fastest possible implementation of all four mentioned classes of drugs due to their independent additive action. It is also important to individualize therapy according to comorbidities, blood pressure, resting heart rate, or the presence of arrhythmias. This article emphasizes the cardio- and nephroprotective role of flozins in HF therapy, regardless of ejection fraction value. We propose practical guidelines for the use of medicines, profile of adverse reactions, drug interactions, as well as pharmacoeconomic aspects. The principles of treatment with ivabradine, digoxin, vericiguat, iron supplementation, or antiplatelet and anticoagulant therapy are also discussed, along with recent novel drugs including omecamtiv mecarbil, tolvaptan, or coenzyme Q10 as well as progress in the prevention and treatment of hyperkalemia. Based on the latest recommendations, treatment regimens for different types of HF are discussed

Genome biology of the paleotetraploid perennial biomass crop Miscanthus

Miscanthus is a perennial wild grass that is of global importance for paper production, roofing, horticultural plantings, and an emerging highly productive temperate biomass crop. We report a chromosome-scale assembly of the paleotetraploid M. sinensis genome, providing a resource for Miscanthus that links its chromosomes to the related diploid Sorghum and complex polyploid sugarcanes. The asymmetric distribution of transposons across the two homoeologous subgenomes proves Miscanthus paleo-allotetraploidy and identifies several balanced reciprocal homoeologous exchanges. Analysis of M. sinensis and M. sacchariflorus populations demonstrates extensive interspecific admixture and hybridization, and documents the origin of the highly productive triploid bioenergy crop M. x giganteus. Transcriptional profiling of leaves, stem, and rhizomes over growing seasons provides insight into rhizome development and nutrient recycling, processes critical for sustainable biomass accumulation in a perennial temperate grass. The Miscanthus genome expands the power of comparative genomics to understand traits of importance to Andropogoneae grasses