Religia, z którą można zrobić, co się chce.

The aim of an article is to analyse a problem of belief and history in Franz Overbeck’s selected writings. Overbeck (1837–1905), a German theologian-agnostic and historian of Christianity, known also in regard to his close friendship with Friedrich Nietzsche, describes in his works the eschatological and countercultural dimension of an origin Christianity. During the history of the Church eschatology was slowly replaced by a conservative project with its aim to maintain and to stabilize the Western culture and civilization. For this reason Overbeck – defending Christianity as an integral cultural phenomenon and referring to its universalist heritage – criticizes representatives of the “cultural Protestantism” (A. Harnack) and post-Christian and nationalistic alternatives (P. Lagarde, D.F. Strauss). In my paper I argue that from the perspective of eschatological Christianity Overbeck’s remarks against traditionalistic, liberal and leftist political theology remain valid. I present also two separate ways of Overbeck’s reception in 20th-century German thought – a revival of Protestantism as a “state of exception” religion (K. Barth) and a critique of theology and a skeptical-ironic farewell to Christianity (H. Blumenberg).Celem tej recenzji jest analiza problemu wiary i historii w wybranych pismach Franza Overbecka. Overbeck (1837–1905), niemiecki teolog-agnostyk, historyk chrześcijaństwa, przyjaciel Fryderyka Nietzschego, opisuje w swoich pracach eschatologiczny i kontrkulturowy wymiar pierwotnego chrześcijaństwa. Dzieje Kościoła opierają się według niego na powolnym wypieraniu eschatologii oraz zastąpieniu jej konserwatywnym projektem podtrzymywania i stabilizowania zachodniej kultury i cywilizacji. Z tego powodu Overbeck – broniąc integralności chrześcijaństwa jako kulturowego fenomenu oraz jego uniwersalistycznego dziedzictwa – krytykuje zarówno współczesny mu protestantyzm kulturowy (A. Harnack) jak i postchrześcijańskie i nacjonalistyczne alternatywy (D.F. Strauss, P. Lagarde). W artykule wskazuję na aktualność Overbeckowskich zastrzeżeń wobec wszelkiej – tradycjonalistycznej, liberalnej i lewicowej – teologii politycznej z punktu widzenia chrześcijaństwa zorientowanego na eschatologię. Analizuję również dwie ścieżki recepcji myśli Overbecka w dwudziestowiecznych Niemczech: próbę odnowienia protestantyzmu jako religii stanu wyjątkowego (K. Barth) oraz krytykę teologii i sceptyczno-ironiczne pożegnanie z chrześcijaństwem (H. Blumenberg)

Poziom wiedzy medycznej oraz zachowania zdrowotne pacjentów po zabiegu pomostowania aortalno-wieńcowego

Introduction. Coronary artery bypass grafting (CABG) is a method of myocardial revascularization. Patients after CABG require comprehensive care and rehabilitation. The aim of this study was to evaluate the level of medical knowledge and health behaviours of patients with coronary artery disease who underwent CABG. Data from this study will be used to develop educational workshops for this group of patients.Material and methods. The study included 106 patients after CABG hospitalized in a cardiac rehabilitation unit and was based on a highly standardized questionnaire developed by the authors. Statistical analysis included descriptive statistics, chi-square test, and correspondence analysis (p < 0.05 was considered statistically significant).Results. Medical knowledge of respondents was poor (one fourth did not know a single risk factor for coronary artery disease, only 33% knew the components of a cardioprotective diet, and 25%, 67% and 55% did not know normal values of blood pressure, cholesterol level, and glycaemia, respectively) and their health-related behaviours were inappropriate (76% did not make any major change in their lifestyle since the diagnosis, only 40% followed dietary recommendations, 61% forgot to take medications regularly, and only 60% measured blood pressure regularly). Analysis of the study data confirmed that poor medical knowledge and inappropriate health-related behaviours were related to low economic status, poor education, and inhabiting small cities/towns.Conclusions. Due to insufficient level of medical knowledge and inappropriate health-related behaviours of patients after CABG, it is necessary to incorporate health education within cardiac rehabilitation programs for this group of patients, with a particular focus on inequalities in health and disease.Wstęp. Pomostowanie aortalno-wieńcowe (CABG) jest jedną z metod rewaskularyzacji mięśnia sercowego. Chorzy po tym zabiegu wymagają kompleksowej opieki oraz rehabilitacji. Celem pracy było poznanie poziomu wiedzy medycznej oraz zachowań zdrowotnych pacjentów z chorobą niedokrwienną serca po przebytym zabiegu kardiochirurgicznym. Dane z pracy posłużą do opracowania warsztatów edukacyjnych dla tej grupy pacjentów.Materiał i metody. Badaniem objęto 106 pacjentów po zabiegu CABG hospitalizowanych na oddziale rehabilitacji kardiologicznej. Podstawą badania był autorski kwestionariusz obejmujący wywiad o wysokim poziomie standaryzacji. W analizie danych posłużono się statystykami opisowymi, a w celu badania zależności obliczano wartość statystyki χ2oraz zastosowano analizę korespondencji (za poziom istotności uznano < 0,05).Wyniki. Badani pacjenci odznaczają się małą wiedzą medyczną (1/4 nie zna ani jednego czynnika ryzyka choroby niedokrwiennej serca; zaledwie 33% zna zasady diety kardioprotekcyjnej; 25%, 67% i 55% nie zna prawidłowych wartości, odpowiednio, ciśnienia tętniczego, cholesterolemii i glikemii) oraz przejawiają niekorzystne zachowania zdrowotne (76% nie dokonała większych zmian w dotychczas prowadzonym stylu życia od momentu postawienia diagnozy; zaledwie 40% realizuje zalecenia dietetyczne; 61% zapomina o regularnym przyjmowaniu leków; tylko 60% regularnie mierzy ciśnienie tętnicze). Analiza danych potwierdziła, że małej wiedzy medycznej oraz niewłaściwym zachowaniom zdrowotnym sprzyjają gorsza sytuacja ekonomiczna, niskie wykształcenie badanych oraz zamieszkiwanie w małych miejscowościach.Wnioski. Ze względu na niewystarczający poziom wiedzy medycznej oraz niewłaściwie zachowania zdrowotne pacjentów po CABG niezbędne jest poszerzenie programu rehabilitacji kardiologicznej o edukację zdrowotną tej grupy pacjentów ze szczególnym zwróceniem uwagi na kwestię nierówności w zdrowiu i chorobie

Prevention of contrast-induced acute kidney injury in patients undergoing cardiovascular procedures : a systematic review and network meta-analysis

BACKGROUND: Interventional diagnostic and therapeutic procedures requiring intravascular iodinated contrast steadily increase patient exposure to the risks of contrast-induced acute kidney injury (CIAKI), which is associated with death, nonfatal cardiovascular events, and prolonged hospitalization. The aim of this study was to investigate the efficacy of pharmacological and non-pharmacological treatments for CIAKI prevention in patients undergoing cardiovascular invasive procedures with iodinated contrast.METHODS AND FINDINGS: MEDLINE, Google Scholar, EMBASE and Cochrane databases as well as abstracts and presentations from major cardiovascular and nephrology meetings were searched, up to 22 April 2016. Eligible studies were randomized trials comparing strategies to prevent CIAKI (alone or in combination) when added to saline versus each other, saline, placebo, or no treatment in patients undergoing cardiovascular invasive procedures with administration of iodinated contrast. Two reviewers independently extracted trial-level data including number of patients, duration of follow-up, and outcomes. Eighteen strategies aimed at CIAKI prevention were identified. The primary outcome was the occurrence of CIAKI. Secondary outcomes were mortality, myocardial infarction, dialysis and heart failure. The data were pooled using network meta-analysis. Treatment estimates were calculated as odds ratios (ORs) with 95% credible intervals (CrI). 147 RCTs involving 33,463 patients were eligible. Saline plus N-acetylcysteine (OR 0.72, 95%CrI 0.57-0.88), ascorbic acid (0.59, 0.34-0.95), sodium bicarbonate plus N-acetylcysteine (0.59, 0.36-0.89), probucol (0.42, 0.15-0.91), methylxanthines (0.39, 0.20-0.66), statin (0.36, 0.21-0.59), device-guided matched hydration (0.35, 0.12-0.79), prostaglandins (0.26, 0.08-0.62) and trimetazidine (0.26, 0.09-0.59) were associated with lower odds of CIAKI compared to saline. Methylxanthines (0.12, 0.01-0.94) or left ventricular end-diastolic pressure-guided hydration (0.09, 0.01-0.59) were associated with lower mortality compared to saline.CONCLUSIONS: Currently recommended treatment with saline as the only measure to prevent CIAKI during cardiovascular procedures may not represent the optimal strategy. Vasodilators, when added to saline, may significantly reduce the odds of CIAKI following cardiovascular procedures

The position of the individual in the face of modernity in the philosophy of Arnold Gehlen. Exercise in the critique of culture

Praca poświęcona jest analizie i krytyce koncepcji nowoczesności Arnolda Gehlena, niemieckiego filozofa i socjologa (1904-1976). W centrum uwagi stoi sytuacja jednostki wobec przemian „epoki technicznej”. W I rozdziale przedstawione zostały antropologiczne podstawy teorii kultury Gehlena wraz z wiodącym pojęciem „odciążenia” (Entlastung). Rozdział II poświęcony jest analizie głównych wątków jego koncepcji nowoczesności i jej konsekwencji dla jednostki (rozwój techniki i nauki, „erozja instytucji”, „subiektywizacja” , utrata przestrzeni do działania). W III rozdziale rozważone zostają „szanse jednostki” – możliwe formy „dobrego życia” w nowoczesnej cywilizacji. W krytycznym nawiązaniu zarówno do Gehlena, jak i do M. Webera, M. Foucaulta oraz H. Arendt proponuję koncepcje „ascezy wewnątrzświatowej” oraz „osobowości-instytucji” jako podstawy etyki życia codziennego.The thesis is an analysis and critique of the concept of modernity by Arnold Gehlen (1904-1976), a German philosopher and sociologist. The main focus is the position of the individual in the face of the changes of the ‘age of technology’. In Chapter 1 anthropological foundations of Gehlen’s theory of culture are described including the vital concept of ‘relief’ (die Entlastung). Chapter 2 is concerned with an analysis of the main problems of Gehlen’s concept of modernity and its relation to the individual (scientific and technological development, ‘erosion of institutions’, ‘subjectivization’, loss of the space for action). Chapter 3 consists of a discussion of ‘the opportunities of the individual’ i. e. potential forms of ‘a decent life’ in the modern world. In a critical approach to the theories of A. Gehlen, M. Weber, M. Foucault and H. Arendt I suggest concepts of ‘worldly asceticism’ and ‘personality-insititution’ to describe the foundations of the everyday life ethics

Incidence of Influenza Virus Infection among Wroclaw’s Healthcare Workers in Pre-COVID-19 2019–2020 Influenza Season Using Novel Flu SensDx Device

Background: Healthcare workers (HCWs) are more exposed to influenza infection, and the influenza vaccination is recommended each year, to reduce the risk of influenza infection and prevent influenza transmission. This study is a cross-sectional study and the objectives were to determine the rate of influenza virus infection among HCWs in the 2019–2020 influenza season. Methods: Between January and March 2020, a survey was carried out in 2 hospitals and 15 primary health-care settings (PHCS) in Wroclaw (Poland). The novel point-of-care testing Flu SensDx device was used, which detects the M1 protein of the influenza virus using electrochemical impedance spectroscopy from biological material (throat/nasal swabs). Results: A total of 150 samples were collected. The majority of participating HCWs by profession were 83 physicians (55.3%) and half (51.3%) of the participating HCWs worked in PHCS. Influenza vaccination coverage was 61.3% in 2019–2020 and 46.0% in the 2018–2019 season for all participants. Of the participating HCWs, 44.0% were positive tested by the Flu SensDx device. There were no statistically significant differences among the positive tested HCWs, their influenza immunization history, and the presence of symptoms of influenza-like illness (p > 0.05). Conclusion: Although the results of the present study suggest that influenza vaccination does not reduce the frequency of influenza virus detection by Flu SensDx testing in the HCWs participants, larger studies are needed to estimate the incidence of influenza virus infection among HCWs to understand the underlying mechanism and fine-tune policies aimed at reducing nosocomial infections

Influenza Vaccination Coverage, Motivators for, and Barriers to Influenza Vaccination among Healthcare Workers in Wroclaw, Poland

Background: Influenza vaccination, as a key element of control activities intended to prevent nosocomial influenza transmission, is recommended each year for all healthcare workers (HCWs). The objectives were to determine the rate of influenza vaccination and to identify reasons for receiving or declining the influenza vaccine among HCWs in the 2018/19 and 2019/20 influenza seasons. Methods: This study is a cross-sectional observational study carried out between January and March 2020, in 2 hospitals and 15 primary health-care settings (PHCS) in Wroclaw (Poland). Results: A total of 165 questionnaires were completed. The majority of participating HCWs were female—137 (83.0%), and, by profession, the majority were physicians 92 (55.8%). Influenza vaccination coverage was 61.2% in 2019/20, and 47.9% in the 2018/19 season for all participants. Participants who were male, physicians and personnel from PHCS were more frequently vaccinated in both seasons. According to the statistical analysis, physicians were more likely to receive vaccinations than nurses (p < 0.01), as were HCWs who had been vaccinated in the previous season (p < 0.001). Conclusion: The identified barriers were mainly caused by misconceptions (fear of vaccine adverse effects and perception of not being at risk/no need to get vaccinated) and an organizational barriers (lack of time). These findings may prove useful for designing immunization campaigns to tailor strategies to reach specific groups

Seasonal influenza vaccination of healthcare workers: a narrative review

Influenza is an acute respiratory disease caused by the influenza virus which often occurs in outbreaks and epidemics worldwide. The World Health Organization recommends annual vaccination of healthcare workers (HCWs) against influenza, because most of them are involved in the direct care of patients with a high risk of influenza-related complications. Given the significance of the disease burden, a targeted literature review was conducted to assess issues related to influenza vaccination among HCWs. The primary aim of this review was to assess the incidence of influenza among medical personnel and healthcare-associated influenza, and to outline the benefits of influenza vaccination for patients and HCWs themselves. Vaccination of HCWs seems to be an important strategy for reducing the transmission of influenza from healthcare personnel to their patients and, therefore, for reducing patient morbidity and mortality, increasing patient safety, and reducing work absenteeism among HCWs. The benefits of influenza vaccination for their patients and for HCWs themselves are addressed in literature, but the evidence is mixed and often of low-quality

Influenza vaccination in healthcare workers – vaccination coverage, determinants, possible interventions

Szczepienia przeciw grypie są zalecane każdego roku wszystkim pracownikom medycznym jako kluczowy element działań mających na celu m.in. zapobieganie transmisji grypy w placówkach opieki zdrowotnej. Biorąc pod uwagę to zalecenie oraz znaczenie takich szczepień, dokonano przeglądu niesystematycznego literatury, by ocenić kwestie związane z poziomem zaszczepienia, deklarowanymi motywami oraz barierami dotyczącymi szczepień, a także interwencjami, których celem jest zwiększenie wskaźnika szczepień w tej grupie zawodowej. Dane z dostępnych publikacji wskazują, że wskaźnik realizacji szczepień przeciw grypie wśród pracowników medycznych jest ogólnie niski i zróżnicowany w czasie, lokalnie, a także wśród poszczególnych zawodów medycznych. Głównym motywem szczepienia przeciw grypie jest chęć ochrony siebie i rodziny. Wśród licznych barier wymienia się najczęściej błędne przekonania dotyczące bezpieczeństwa i skuteczności szczepień oraz bariery organizacyjne. Wskazuje się, że jest duża potrzeba prowadzenia działań edukacyjnych oraz promocyjnych będących kluczowymi elementami zwiększania poziomu zaszczepienia w strategii dobrowolnych szczepień.Influenza vaccination, as a key element of control activities intended, inter alia, to prevent nosocomial influenza transmission, is recommended each year for all healthcare workers (HCWs). Due to these recommendations and the importance of influenza vaccination among HCWs, a targeted literature review was conducted to assess issues related to vaccination coverage, declared motivators and barriers, as well as interventions to increase vaccination coverage in this professional group. Data obtained from the available publications implies that influenza vaccination rates among WHCs are universally low and vary over time as well as between regions and different types of healthcare professionals (physicians/nurses). One of the main determinants of influenza vaccine uptake is the desire to protect oneself and one’s family. On the other hand, practical considerations and misconceptions about the safety and effectiveness of vaccines are the most frequently mentioned preventative causes. There is an urgent need to implement well-organized educational campaigns as this is key to increasing vaccination rates as part of a non-mandatory vaccination strategy. Med Pr. 2021;72(3):305–1

Patent ductus arteriosus – not only apaediatric issue

The ductus arteriosus is a vascular structure of the foetal circulation that connects the great arteries and determines the blood flow from the pulmonary trunk to the aorta bypassing the pulmonary circulation. After birth, it comes to the functional and structural closure of the ductus arteriosus and the foetal circulation changes into circulation of adult type. Sometimes, however, physiological degradation of the duct after the first few weeks of life does not happen – this situation is called patent ductus arteriosus and accounts for approximately 10% of congenital heart defects. Patent ductus arteriosus may be asymptomatic or manifest itself with disturbances, mainly associated with the respiratory and circulatory systems, as well as disorders of other organs. A common clinical symptom is a characteristic continuous murmur, called machine-like murmur. The occurrence and severity of symptoms depend primarily on the size of the shunt through the duct and also on the age of the patient. The major complications of patent ductus arteriosus are bacterial endocarditis and pulmonary vascular disease. Treatment is based on the definitive closure of the ductus. During the first few weeks after birth, pharmacological closure with cyclooxygenase inhibitors (indomethacin, ibuprofen) is possible. Patent ductus arteriosus can also be managed with the use of non-invasive techniques (catheter procedures) or surgical treatment (a less invasive video-assisted thoracoscopy is also possible). The situation is different when there are complex anatomical heart defects in which the postnatally patent ductus arteriosus plays a different, beneficial role – these are so-called ductus-dependent defects. The management of such patients consists in maintaining the patency of the ductus arteriosus, because it determines the normal blood flow. There are also rare cases of premature (prenatal) closure of the ductus arteriosus, which may lead to the failure of foetal circulation

Potential Applications of Computational Fluid Dynamics for Predicting Hemolysis in Mitral Paravalvular Leaks

Paravalvular leaks (PVLs) may lead to hemolysis. In vitro shear stress forces above 300 Pa cause erythrocyte destruction. PVL channel dimensions may determine magnitude of shear stress forces that affect erythrocytes; however, this has not been tested. It remains unclear how different properties of PVL channels contribute to presence of hemolysis. A model of a left ventricle was created based on data from computer tomography with Slicer software PVLs of various shapes and sizes were introduced. Blood flow was simulated using ANSYS Fluent software. The following variables were examined: wall shear stress, shear stress in fluid, volume of PVL channel with shear stress exceeding 300 Pa, and duration of exposure of erythrocytes to shear stress values above 300 Pa. In all models, shear stress forces exceeded 300 Pa. Shear stress increased with blood flow rates and cross-sectional areas of any PVL. There was no linear relationship between cross-sectional area of a PVL and volume of a PVL channel with shear stress > 300 Pa. Blood flow through mitral PVLs is associated with shear stress above 300 Pa. Cross-sectional area of a PVL does not correlate with volume of a PVL channel with shear stress > 300 Pa and duration of exposure of erythrocytes to shear stress > 300 Pa