Prognostic value of daytime heart rate, blood pressure, their products and quotients in chronic heart failure

Background: Chronic heart failure (CHF) is an important epidemiological and therapeuthic issue  with poor prognosis. The aim of the study was to estimate the prognostic value of daytime heart rate (HR), blood pressure (BP), their products and quotients in patients with CHF. Methods: The study included 80 stable patients with CHF and reduced left ventricular ejection frac- tion (LVEF ≤ 35%). Physical examination, laboratory blood tests, electrocardiogram, chest X-ray, echocardiography, 6-minute walk test, telemetry monitoring and BP measurements were performed in all participants. We estimated mean daytime: BP, HR, their products and quotients. The follow-up period was 6 months. Major adverse cardiac events (MACE) included: death, cardiovascular death, hospitalization due to CHF exacerbation.  Results: The analysis involved all recruited patients with CHF (91% men) aged 59 ± 12 years, in New York Heart Association class 2.15 ± 0.57 and reduced LVEF (mean LVEF: 23 ± 6%). The 3-month and 6-month mortality rates were 4% and 6%, respectively. There was a significant correlation between diastolic blood pressure (DBP), all-cause mortality (p = 0.048) and CHF decompensation (p = 0.0004) after 3-month observation period. No relationship was found between HR or systolic blood pressure (SBP) and MACE. Both higher SBP × HR and DBP × HR products were related to lower risk of heart failure exacerbations during 6-month follow-up. None of the analyzed products or ratios had an impact on mortality in this study group.  Conclusions: Diastolic blood pressure, SBP × HR and DBP × HR products may be useful in sub- sequent heart failure exacerbation risk stratification. Moreover, DBP value may predict short-term mortality in patients with CHF.

Echocardiographic evaluation of right ventricular systolic function: The traditional and innovative approach

Estimation of right ventricular (RV) performance still remains technically challenging due to its anatomical and functional distinctiveness. The current guidelines for the echocardiographic quantification of RV function recommend using multiple indices to describe the RV in a thorough and comprehensive manner, such as RV index of myocardial performance, tricuspid annular plane systolic excursion, fractional area change, Doppler tissue imaging-derived tricuspid lateral annular systolic velocity (S’-wave), three-dimensional RV ejection fraction (3D RVEF), RV longitudinal strain (RVLS)/strain rate by speckle- tracking echocardiography (STE). Among these, the last one mentioned here is an innovative and a particularly promising tool that yields more precise information about complex regional and global RV mechanics. STE was initially designed to evaluate left ventricular function, but recently it has been introduced to assess RV performance, which is difficult due to its unique structure and physiology. Many studies have shown that both free wall and 6-segment RVLS present a stronger correlation with the RVEF assessed by cardiac magnetic resonance than conventional parameters and seem to be more sensitive in detecting myocardial dysfunction at an earlier, subclinical stage

Paternal investment and low birth weight : the mediating role of parity

According to life-history theory, paternal investment affects the well-being of offspring. We hypothesized that environmental stress caused by a lack of paternal investment may diminish maternal resource allocation during pregnancy, especially for women who already have dependent children. Our study was conducted on a representative group of more than 80,500 singleton, live-born, full-term infants born in Krakow, Poland in the period 1995-2009. Birth data were obtained from the birth registry. We found that missing data about fathers (a proxy measure of low paternal investment) was associated with higher probability of multiparous mothers giving birth to low-birth-weight infants (1.48; 95% CI 1.05-2.08), but this was not the case with primiparous mothers (1.19; 95% CI 0.89-1.59). The statistically significant synergistic effect between parity and paternal investment was found (Synergy Factor = 2.12; 95% CI 1.47-3.05, p<0.001). These findings suggest that in situations of low paternal investment, multiparous mothers face trade-offs between investing in existing versus unborn children, therefore investment in the latter is lower. Such a strategy may benefit maternal fitness due to investment in older children, who have higher reproductive value

Inventories of Helena Dąbczańska's collection of books in the Library of the Academy of Fine Arts in Kraków

W artykule przedstawiono inwentarze księgozbioru Heleny Dąbczańskiej, znanej kolekcjonerki lwowskiej, która ostatnie lata życia spędziła w Krakowie. Księgozbiór ten jest obecnie w posiadaniu Biblioteki Akademii Sztuk Pięknych im. Jana Matejki w Krakowie.The author describes inventories of Helena Dąbczańska’s collection of books. Dąbczańska was a well-known collector from Lwów who spent the last years of her life in Kraków. At present her collection is owned by the the Library of the Academy of Fine Arts in Kraków

Jonah complex : image of Russia in Polish literature at the turn of XIX and XX century

Rozprawa dotyczy językowych sposobów przedstawiania Rosji jako tematu literatury przełomu XIX i XX wieku. Ujmując zagadnienie od strony skomplikowanych uwarunkowań komunikacji literackiej, ze szczególnym uwzględnieniem ingerencji cenzury, autor wskazuje na zmieniające się elementy poetyki prozatorskiej w literackiej refleksji na temat imperium rosyjskiego w momencie zbliżającej się wolności Polski oraz pierwszych ruchów rewolucyjnych. Szerokim tłem wypowiedzi są stereotypy utrwalone w literaturze popularnej reprezentowanej przez M. Rodziewiczównę, zaś kontrapunktem dla wizji Żeromskiego jest twórczość Brzozowskiego. Wskazując na zakorzenienie w świecie "wysadzonych z siodła" autor odsłania ich związki z tradycyjnymi problemami literatury wieku XIX, od których łatwiej było uciec w dyskursywnych formach wypowiedzi niż w prozie artystycznej. Trwając w świecie szlacheckich ostatków wymienieni pisarze nie byli w stanie sformułować nowej definicji własnej tożsamość, choć z niedostatków istniejących formuł zdawali sobie sprawę i próbowali stworzyć projekt człowieka na miarę suwerennej ojczyzny. Rozważania zamykają uwagi poświęcone Wacławowi Berentowi, jako przedstawicielowi nurtu modernistycznego, który wobec problemów społecznych i narodowych początku wieku XX zdefiniował problem polskości.The thesis discusses imagery concerning Russia in Polish literature at the turn of XIX and XX century. The problem is regarded on the base of two writers: Stefan Żeromski and Stanisław Brzozowski whose antagonism seems to stem from a common background, that is their family decline as a result of 1863 uprising. A rebel and a loving continuator are contrasted against common clichés preserved in popular literature as well as a modernist writer Wacław Berent. Author of the thesis shows how literary imagery changes over the years that were foreshadowed with the first social revolution acts as well as raising hopes for an independent country. It is also important to notice the complexity of the literary language caused by severe political censorship, which makes it possible to perceive their novels as an expression of colonial state of things being rejected