Penile fracture with associated urethral trauma — case report

Złamanie prącia jest rzadko spotykanym urazem narządów płciowych, który wymaga pilnego leczenia operacyjnego. W pracy przedstawiono analizę przypadku złamania prącia z towarzyszącym urazem cewki moczowej u 51-letniego mężczyzny. Leczenie operacyjne polegało na zszyciu pękniętej osłonki szwem ciągłym oraz zespoleniu cewki moczowej szwami pojedynczymi. Leczenie operacyjne złamania prącia daje dobre efekty czynnościowe.Penile fracture is rare genital injury that requires urgent surgical treatment. The authors described case report of penile fracture with an associated urethral trauma in 51-year old man. Surgical treatment consisted of suturing the cracked tunica albuginea using continuous suture and combining the urethra using single sutures. Surgical treatment of penile fracture gives good functional results

Stanowisko ekspertów Polskiego Towarzystwa Kardiologicznego dotyczące stosowania andeksanetu alfa w warunkach polskich — interdyscyplinarny protokół

Andeksanet alfa (AA) jest rekombinowanym, nieaktywnym analogiem ludzkiego czynnika Xa (FXa), skutecznie odwracającym działanie jego inhibitorów — dostępnych w Polsce rywaroksabanu i apiksabanu. Lek otrzymał rejestrację po opublikowaniu wyników badania ANNEXA-4 (Andexanet Alfa, a Novel Antidote to the Anticoagulation Effects of FXA Inhibitors 4), w którym udowodniono jego skuteczność w przywracaniu hemostazy w zagrażających życiu krwawieniach w grupie pacjentów stosujących te leki przeciwkrzepliwe. Dlatego AA jest obecnie zalecany u pacjentów stosujących terapię apiksabanem lub rywaroksabanem z masywnymi i niemożliwymi do opanowania krwotokami, w tym udarami krwotocznymi i krwawieniami z przewodu pokarmowego. Najodpowiedniejsze do oszacowania stężenia rywaroksabanu i apiksabanu w osoczu, poza jego bezpośrednią oceną, są chromogenne testy anty-Xa specyficzne dla leku. Brak aktywności anty-Xa stwierdzony przy użyciu tych oznaczeń wyklucza istotne klinicznie stężenie inhibitora FXa w osoczu. Dawka AA nie powinna być natomiast modyfikowana na podstawie wyników badań hemostazy. Zależy ona wyłącznie od czasu, jaki upłynął od przyjęcia ostatniej dawki inhibitora FXa, oraz od dawki i rodzaju stosowanego przewlekle leku. Andeksanet alfa podawany jest w postaci bolusa dożylnego a następnie włączony zostaje wlew dożylny leku. Maksymalne odwrócenie aktywności anty-Xa następuje w ciągu 2 minut od zakończenia podawania bolusa, a kontynuowanie ciągłej infuzji dożylnej umożliwia utrzymanie efektu aż do 2 godzin po jego zakończeniu. Ponieważ aktywność leku przeciwkrzepliwego może się pojawić ponownie po zakończeniu wlewu, obecnie nie jest jasne, w jakim momencie po podaniu AA można (ponownie) podać inhibitory FXa lub heparynę

Recommendations of Polish Cardiac Society expert regarding the use of andexanet alpha in the Polish context. An interdisciplinary protocol

Andexanet alfa (AA) is a recombinant, inactive analog of human factor Xa (FXa), effectively reversing the effects of its inhibitors — rivaroxaban and apixaban, which are available in Poland. The drug was granted registration after the publication of the ANNEXA-4 trial (Andexanet Alfa, a Novel Antidote to the Anticoagulation Effects of FXA Inhibitors 4), in which its efficacy in restoring hemostasis in life-threatening hemorrhages in a group of patients using the aforementioned anticoagulants was proven. Hence, AA is now recommended for patients receiving apixaban or rivaroxaban therapy with massive and uncontrollable hemorrhages, including hemorrhagic strokes (HS) and gastrointestinal bleeding. Drug-specific chromogenic anti-Xa assays are generally best suited for estimating rivaroxaban and apixaban plasma levels, aside from direct assessment of their concentrations. The absence of anti-Xa activity, determined using these assays, allows to outrule the presence of clinically relevant plasma concentrations of the FXa inhibitor. On the other hand, the dose of AA should not be modified based on the results of hemostasis tests, as it depends solely on the time elapsed since the last dose of FXa inhibitor, and on the dose and type of long-term medication used. AA is administered as an intravenous (i.v.) bolus, followed by an i.v.infusion of the drug. The maximum reversal of anti-Xa activity occurs within two minutes of the end of the bolus treatment, with the continuation of the continuous i.v. infusion allowing the effect to be maintained for up to two hours afterwards. Because anticoagulant activity can reappear after the infusion is completed, it is currently unclear at what point after AA administration FXa inhibitors or heparin should be readministered

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

RFID implementations in the wood supply chains: state of the art and the way to the future

The focus of this review paper is to present the state of the art regarding RFID implementations in wood supply chains, covering the tree marking stage till the transportation to the final processor. The easier than ever collection of data using sensors and the emerging ability to exchange information in the context of the Internet of Things (IoT) form a very promising new environment for the optimization of wood supply chains. Driven by currently enhanced, ability to store different layers of information per merchantable unit (tree assortments at final or semi-final form or containers of woody biomass), RFID applications can provide valuable solutions and revolutionize wood supply chains by warranting traceability, combating illegal logging, minimizing waste and offering detailed information of the wood products properties, among other benefits that are presented in the text. The benefits can be identified at the ecological, social and economic levels, addressing the sustainability concerns of modern societies. To make use of this huge potential, a continuous flow and fusion of information at all supply chain stages must be taken for granted, as well as the close cooperation among stakeholders

Blockchain Technology in Life Cycle Assessment—New Research Trends

Environmental protection is currently one of the key priority areas of the European Union (EU). The search for precise tools to assess the impact of the economy, industry, or the production of individual products or services is crucial for an effective and efficient policy in environmental protection. Blockchain technology, originally related to the financial sector and cryptocurrencies, is an innovative solution that is increasingly being implemented by other areas of the economy and industry sectors. The authors reviewed the literature and based on it presented the possibilities and effects of using blockchain technology in Life Cycle Assessment (LCA), which is in line with the current development trends of this method. The analysis of the research conducted in this area also allowed to present not only the advantages of blockchain in LCA, but also the limitations of this technology and the potential directions of further research

Positive Management. Managing the Key Areas of Positive Organisational Potential for Company Success, 366 s.

The book presents the outcomes of the empirical research on strategic management of the key areas of Positive Organisational Potential. The following key areas are studied: corporate governance, leadership, middle managers, trust, interpersonal relationships, talent management, the language of internal communication, organisational citizenship behaviours and corporate social responsibility. The book is focused on four research objectives. First of all, it verifies the assumption that the aforementioned key areas are the constituent components of Positive Organisational Potential. Secondly, it explores antecedents and approaches to develop the key areas of Positive Organisational Potential. Thirdly, it identifies the mechanisms explaining how the key areas of Positive Organisational Potential influence the development of an organisation. Finally, the authors develop a reference model for managing the key areas of Positive Organisational Potential. The concept of Positive Organisational Potential combines the ideas of Positive Organisational Scholarship and Resource Based View. Positive Organisational Potential is a configuration of tangible and intangible resources which determine the emergence of the positive culture and the positive climate, consequently stimulating positive emotions crucial for the pro-developmental employee behaviours. The pro-developmental behaviours are considered to be an undisputed source of organisational development. The development of companies is manifested by the increase in productivity, innovativeness, competitiveness, the quality of business processes and products, the satisfaction of stakeholders, the reputation of a company, its profitability and the growth of value. In order to generate Positive Organisational Potential the configuration of organisational resources should be shaped in a conscious, consistent and organised way within the strategic management process. Organisational resources are a very complex construct. Numerous interactions between their components are observed. They include cause-effect relations where some resources are recognised as the determinants and stimuli of the others. Therefore managers should focus their attention on developing constituent resources which determine the state, level and configuration of other resources. Such resources can be recognised as the key areas of Positive Organisational Potential. The effective development of these key areas is a prerequisite for the development of the whole system of Positive Organisational Potential

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 99 min. 90.3% of the studied patients had MT within 6 h 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 guideline