The changes of reflex ventilatory response to hypercapnia in obstructive sleep apnea patients

Odruchową odpowiedź oddechową na postępującą hiperkapnię hiperoksyczną badano w 3 grupach osób z obturacyjnym bezdechem sennym (OBS). Wśród pacjentów z prawidłowym stężeniem dwutlenku węgla nie obserwowano różnic w wielkości oddechowej reakcji na hiperkapnię. Pacjenci z lekko podwyższonym stężeniem dwutlenku węgla w powietrzu końcowo-wydechowym wykazywali cechy przesunięcia w prawo prostych regresji charakteryzujących zależność wentylacji minutowej od stężenia dwutlenku węgla. U chorych z OBS i współistniejącą niewydolnością oddechową stwierdzono niemalże całkowity brak reakcji oddechowej na hipoksję. Oznacza to, że u tych pacjentów dochodzi do całkowitego załamania się możliwości obrony przed hiperkapnią, a tym samym do wyeliminowania odruchowych mechanizmów przerywających bezdech.The reflex ventilatory response to progressive hyperoxic hypercapnia was studied in three groups of obstructive sleep apnea patients. In patients with normal end-tidal PACO2 no differences were found as compared with the control group. Patients with inreased end-tidal PACO2 showed an impaired ventilatory response to hypercapnia, occuring on a background elevation of the arterial carbon dioxid: 1. the right shift with the normal slope of the regression curve of relationship between end-tidal PACO2 and minute ventilation and 2. the right shift with decrease of slope of the regression curve of relationship between end-tidal PACO2 and minute ventilation. Patients, who develop hypercapnic respiratory failure awake, showed an impaired hypercapnic defence reaction

Temperature Effects Explain Continental Scale Distribution of Cyanobacterial Toxins

Insight into how environmental change determines the production and distribution of cyanobacterial toxins is necessary for risk assessment. Management guidelines currently focus on hepatotoxins (microcystins). Increasing attention is given to other classes, such as neurotoxins (e.g., anatoxin-a) and cytotoxins (e.g., cylindrospermopsin) due to their potency. Most studies examine the relationship between individual toxin variants and environmental factors, such as nutrients, temperature and light. In summer 2015, we collected samples across Europe to investigate the effect of nutrient and temperature gradients on the variability of toxin production at a continental scale. Direct and indirect effects of temperature were the main drivers of the spatial distribution in the toxins produced by the cyanobacterial community, the toxin concentrations and toxin quota. Generalized linear models showed that a Toxin Diversity Index (TDI) increased with latitude, while it decreased with water stability. Increases in TDI were explained through a significant increase in toxin variants such as MC-YR, anatoxin and cylindrospermopsin, accompanied by a decreasing presence of MC-LR. While global warming continues, the direct and indirect effects of increased lake temperatures will drive changes in the distribution of cyanobacterial toxins in Europe, potentially promoting selection of a few highly toxic species or strains.Peer reviewe

Quality Cost Account as a Framework of Continuous Improvement at Operational and Strategic Level

The aim of the article is to present an exemplary system for recording and analyzing quality costs and to demonstrate that it is helpful in planning and assessing the effectiveness of continuous improvement processes at the operational and strategic level. Various approaches to defining quality costs are described, followed by indicators for assessing effectiveness and tools to collect data on the values of individual groups of quality costs and compare them with financial indicators. The practical part presents a case study on the quality cost accounting system in a medical company and the possibility of using quality cost accounting to plan and evaluate continuous improvement processes and make managerial decisions

Przyczyny dyskwalifikacji z operacji laserowej korekcji wzroku

The aim of the article is to establish the reasons for disqualification from laser vision correction surgery and to compile data on the most common reasons for not qualifying for the procedure. The specific patients in which the procedure can be performed should be carefully considered. For people who are not qualified for surgery, there are many alternative methods of correcting vision defects.Celem pracy jest ustalenie przyczyn dyskwalifikacji z operacji laserowej korekcji wzroku oraz zestawienie danych dotyczących najczęstszych powodów niezakwalifikowania do zabiegu. Należy dokładnie rozważyć, u jakich pacjentów można go wykonać. Dla osób niezakwalifikowanych do zabiegu istnieje wiele alternatywnych metod korekcji wad wzroku

New Route to Glycosylated Porphyrins via Aromatic Nucleophilic Substitution (SNAr)—Synthesis and Cellular Uptake Studies

Glycoporphyrins are group of compounds of high value for the purpose of photodynamic therapy and other biomedical applications. Despite great progress in the field, new diversity-oriented syntheses of carbohydrate-porphyrin hybrids are increasingly desired. Herein, we present efficient, mild, and metal-free conditions for synthesis of glycoporphyrins. The versatile nature of the SNAr procedure is presented in 16 examples. Preliminary biological studies have been conducted on the cytotoxicity and cellular uptake of the final molecules

Influence of the Type and Amount of Plasticizer on the Sensory Properties of Microspheres Sensitive to Lipophilic Ions

Working parameters of chemical sensors, such as selectivity and sensitivity, can be adjusted by optimizing components of chemosensitive layers, including type and amount of plasticizer in the case of PVC membranes in optodes. Plasticizers are also used in the process of creating micro/nanospheres that are incorporated with chemical indicators to form micro/nano-scale optodes. This study investigated the influence of the type of plasticizer (polar o-NPOE and non-polar DOS) on the optical response of microspheres that are sensitive to lipophilic ions. Moreover, the amount of plasticizer was also adjusted in order to obtain satisfactory sensitivity in the widest linear range. The chemosensory response of the developed microspheres was studied with the use of spectrophotometry and spectrofluorimetry, while size of the optodes was estimated by confocal microscopy

Analysis of selected factors affecting patients' realization of dietary recommendations in the first two years after bariatric surgery.

Wstęp: Chirurgia bariatryczna skutkuje znaczną redukcją masy ciała w pierwszym roku po operacji jednak badania wykazują ponowny wzrost u części pacjentów w kolejnych latach. Poszukiwane są czynniki, które wpływają na powstawanie tego zjawiska. Cel: Weryfikacja czy czas od operacji oraz współpraca z dietetykiem i psychologiem wpływają na przestrzeganie przez pacjentów zaleceń odpowiedniej diety. Materiał i metody: Zakwalifikowano 187 pacjentów (kobiety n=156, 83,4%) będących do 2 lat po operacji rękawowej resekcji żołądka. Uczestnicy wypełnili ankietę internetową zawierającą punktowane pytania dotyczące prawidłowej diety po operacji oraz współpracy z dietetykiem i psychologiem. Wyniki: W grupie pacjentów 22 dni-12 miesięcy po operacji mediana wyników była wyższa (mediana Me=22), niż w grupie 13-24 miesiące po (Me=20, p=0,002). Wyższe wyniki uzyskiwały grupy korzystające z porad dietetyka (Me=23 vs Me=21 , p<0,001) i psychologa (Me=23 vs Me=21 , p<0,001). Wnioski: Z czasem od operacji pacjenci coraz mniej przestrzegają zaleceń odpowiedniej diety. Pacjenci konsultujący się ze specjalistami ściślej stosują zalecenia.Background: Bariatric surgery results in a significant reduction in body weight in the first year after surgery, but studies show weight gain in some patients in subsequent years. Factors that contribute to this phenomenon are being sought. Aim: To verify if time since surgery and cooperation with dietitian and psychologist affect patients’ adherence to the proper diet recommendations. Material and methods: A total of 187 participants (female n=156, 83,4%) up to 2 years after sleeve gastrectomy were enrolled. Partinipants completed an online questionnaire containing scored questions regarding proper diet and cooperation with specialists. Results: The group of patients 22 days-12 months after surgery had higher median scores (median Me=22) than the group 13-24 months after (Me=20, p=0.002). The groups cooperating with dietician (Me=23 vs Me=21 , p<0.001) and a psychologist (Me=23 vs Me=21, p<0.001) had higher scores. Conclusions: Over time from surgery, patients are less adherent to recommendations for an adequate diet. Patients who consult with specialists follow recommendations more accurately