Usunięcie lewej elektrody komorowej z dostępu udowego

A 55-year-old man with signs of infectious endocarditis was admitted to the clinic in order to remove the CRT-D system. Due to difficult anatomical conditions and technical limitations, the decision was made to perform two-stage procedure and removal of the left ventricular lead by access from the femoral vein.Mężczyzna, 55-letni, z objawami infekcyjnego zapalenia wsierdzia został przyjęty do kliniki w celu usunięcia układu CRT-D. Z uwagi na trudne warunki anatomiczne i ograniczenia techniczne, zdecydowaniu o przeprowadzeniu zabiegu dwuetapowo i usunięciu lewej elektrody komorowej przez dostęp z żyły udowej

Repozycjonowanie lewej elektrody komorowej z fiksacją stentem bioresorbowalnym

83-year-old man was referred to a clinic due to exacerbation of chronic heart failure. CRT-D interrogation revealed lack of efficient left ventricular pacing. Patient was qualified to the left ventricular lead reposition. Due to anatomical conditions and technical limitations it was decided to stabilize the lead with the bioresorbable vascular scaffold.Mężczyzna, 83-letni, został skierowany do kliniki z powodu zaostrzenia przewlekłej niewydolności serca. Interrogacja CRT-D wykazała brak skutecznej stymulacji lewej komory, a pacjent został zakwalifikowany do repozycjonowania lewej elektrody. Ze względu na trudne warunki anatomiczne i techniczne ograniczenia, podjęto decyzję o wykonaniu stabilizacji przy użyciu rusztowania bioresorbowalnego

Dlaczego załamek P powinien być dokładnie mierzony?

The electrophysiological activity of the heart is recorded and presented in form of ECG. In 1998 the concept of the P wave dispersion as the risk factor for AF recurrence was introduced. The aim of our review is to prove the P wave dispersion is an artifact of low accuracy in P wave measurement, basing on the overview of the publications and the own research in this field. By comparing and contrasting various publications on this topic, we observed that it was the imprecise measurement method that resulted in different durations of all P wave parameters in contrast with the precise measurements. It was indicated that the value of the imprecise P wave dispersion correlated highly with the maximal P wave duration measured in the similar way. In contrast with the imprecise measurement method the minimal and the maximal durations of the P waves, measured accurately, were almost identical. The studies and the methodological considerations indicate that the P wave dispersion is a derivative of the imprecise measurement of the ECG recording, inconsistent with the physics rules describing the flow of electric current. The results confirm our observation that the precise measurement of the P wave makes the phenomenon of dispersion no longer exists. Unfortunately, only a few researchers dare to question the phenomenon of the P wave dispersion. The discussion should continue, because the P-wave parameters are the data of great importance, as they reflect the dimensions of the atria, electrical conductivity and the condition of the muscle.The electrophysiological activity of the heart is recorded and presented in form of ECG. In 1998 the concept of the P wave dispersion as the risk factor for AF recurrence was introduced. The aim of our review is to prove the P wave dispersion is an artifact of low accuracy in P wave measurement, basing on the overview of the publications and the own research in this field. By comparing and contrasting various publications on this topic, we observed that it was the imprecise measurement method that resulted in different durations of all P wave parameters in contrast with the precise measurements. It was indicated that the value of the imprecise P wave dispersion correlated highly with the maximal P wave duration measured in the similar way. In contrast with the imprecise measurement method the minimal and the maximal durations of the P waves, measured accurately, were almost identical. The studies and the methodological considerations indicate that the P wave dispersion is a derivative of the imprecise measurement of the ECG recording, inconsistent with the physics rules describing the flow of electric current. The results confirm our observation that the precise measurement of the P wave makes the phenomenon of dispersion no longer exists. Unfortunately, only a few researchers dare to question the phenomenon of the P wave dispersion. The discussion should continue, because the P-wave parameters are the data of great importance, as they reflect the dimensions of the atria, electrical conductivity and the condition of the muscle

Unrooting management education and entrepreneurial self from neoliberal demands : an action research approach

This study applies an action research to investigate the possibility of unsettling management education and the entrepreneurial self from neoliberal logic. The reflection takes as its case an action research diploma seminar in a Polish management school based on collaboration among students, employers from public and nongovernmental sectors, and academic teachers in the preparation of master's theses. The main goal of this article is to illustrate the struggles involved in resisting neoliberal demands, including the ethical reorientation of the entrepreneurial self, in the management classroom. We conclude with a discussion of the emancipatory value of our project and its limitations

In pursuit of COVID-19 surgical risk stratification to manage a limited workforce and supplies in minimally invasive surgery

The protective barriers used so far in surgery do not provide adequate protection against SARS-CoV-2 virus, and reinforced protective equipment is needed. The rapid increase in the number of patients and the worldwide panic associated with the increasingly low availability of protective equipment has resulted in a shortage of protective equipment In many hospitals. Appropriatepersonal protective equipment must be provided so that the surgical team proceeding to surgery is not excluded from the further struggle for patients’ health, especially in MIS. Reckless and excessive use of maximum protective equipment may result in a severe shortage of these products when the number of infected person

Mechanical thrombectomy in acute stroke – Five years of experience in Poland

Objectives Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. Methods and results We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. Results Most of the CSCs (74%) were founded at University Hospitals and most (65.2%) work round the clock. In 78.3% of them, the working teams are composed of neurologists and neuro-radiologists. All CSCs perform CT and angio-CT before MT. In total 586 patients were subjected to MT and data from 531 of them were analyzed. Mean time laps from stroke onset to groin puncture was 250±99min. 90.3% of the studied patients had MT within 6h from stroke onset; 59.3% of them were treated with IV rt-PA prior to MT; 15.1% had IA rt-PA during MT and 4.7% – emergent stenting of a large vessel. M1 of MCA was occluded in 47.8% of cases. The Solitaire device was used in 53% of cases. Successful recanalization (TICI2b–TICI3) was achieved in 64.6% of cases and 53.4% of patients did not experience hemorrhagic transformation. Clinical improvement on discharge was noticed in 53.7% of cases, futile recanalization – in 30.7%, mRS of 0–2 – in 31.4% and mRS of 6 in 22% of cases. Conclusion Our results can help harmonize standards for MT in Poland according to international guidelines

Guidelines for DNA recombination and repair studies: Cellular assays of DNA repair pathways

Understanding the plasticity of genomes has been greatly aided by assays for recombination, repair and mutagenesis. These assays have been developed in microbial systems that provide the advantages of genetic and molecular reporters that can readily be manipulated. Cellular assays comprise genetic, molecular, and cytological reporters. The assays are powerful tools but each comes with its particular advantages and limitations. Here the most commonly used assays are reviewed, discussed, and presented as the guidelines for future studies