Polymerase chain reaction based detection of bacterial 16S rRNA gene in the cerebrospinal fluid in the diagnosis of bacterial central nervous system infection in the course of external cerebrospinal fluid drainage. Comparison with standard diagnostics currently used in clinical practice

Background and purpose External drainage of cerebrospinal fluid (CSF) is a commonly used neurosurgical procedure. Complications of the procedure comprise central nervous system (CNS) bacterial infections, the frequency of which is estimated at around 6–10%. Detection of these infections is ineffective in many cases. The aim of the study was to evaluate the usefulness of a polymerase chain reaction (PCR)-based detection of bacterial 16S rRNA gene (16S rDNA) in the CSF. Material and methods The study group consisted of 50 patients. Clinical signs of CNS infection were monitored and routine laboratory and microbiological tests were performed. The results of standard methods were compared with the bacterial 16S rDNA detection. Results Using cultures, CNS infection was diagnosed in 8 patients, colonization of the drainage catheter in 6 patients, and sample contamination in 7 patients. In the group of the remaining 29 patients, no positive CSF culture was obtained and 13 of these patients also had all negative results for 16S rDNA detection. For the remaining 16 patients of this group, CNS infection, colonization of the catheter and sample contamination were diagnosed via PCR alone. Routine biochemical CSF tests and blood inflammatory parameters had a supporting value. Conclusions Routine hospital tests do not provide rapid and efficient detection of the external drainage related bacterial CNS infection. It is justified to use several diagnostic methods simultaneously. The16S rDNA determination in CSF can increase the probability of detection of possible pathogens

Nutrition in chronic kidney disease

Częstość występowania przewlekłej choroby nerek (CKD) narasta wraz ze starzeniem się społeczeństw na całym świecie. Przewlekła choroba nerek zwiększa obciążenie budżetów ochrony zdrowia nie tylko z powodu kosztów leczenia nerkozastępczego, ale również kosztów inwazyjnych procedur kardiologicznych. Dlatego duże znaczenie ma wczesne rozpoznawanie tej choroby i wdrożenie działań nefro- i kardioprotekcyjnych. Spośród działań niefarmakologicznych istotną rolę odgrywa dostosowanie diety do potrzeb chorego organizmu. Odpowiednio dobrana dieta pozwala utrzymać dobry stan odżywienia organizmu, spowalnia progresję CKD i zapobiega zaburzeniom metabolicznym sprzyjającym uszkodzeniu układu krążenia. W niniejszej pracy dokonano przeglądu aktualnych zaleceń żywieniowych u osób z CKD w zależności od stadium zaawansowania choroby.The prevalence of chronic kidney disease (CKD) is increasing worldwide along with aging of populations. Chronic kidney disease rises the burden of health providers budgets both by rising the cost of renal replacement therapy, and of cardiologic invasive procedures. Thus early detection of CKD and implementation of nephroprotection and cardioprotection therapy is crucial. Among nonpharmacological interventions nutritional management, appropriate for the sick organism, plays the important role. Proper diet sustains good nutritional status, slows renal damage and prevents metabolic disturbances that increase the cardiovascular system injury. This review describes recommended dietary nutrient intake for CKD patients in various stages of the disease

Udrożnienia przewlekłych okluzji tętnic wieńcowych : rola wielorzędowej tomografii komputerowej : opis przypadku

Nieinwazyjne metody obrazowania serca pozwalają ocenić żywotność miokardium (ocena wskazań do zabiegu) oraz ułatwić wybór strategii zabiegu i sprzętu stosowanego podczas przezskórnej interwencji wieńcowej (ang. percutaneous coronary interventions, PCI). Przedstawiamy opis zabiegu u pacjenta poddanego PCI przewlekłej okluzji tętnicy wieńcowej po diagnostyce metodami nieinwazyjnymi, w tym po wykonaniu wielorzędowej tomografii komputerowej (multi-slice computed tomography, MSCT).Non-invasive diagnostics of the heart allow one to assess myocardium viability (indication for procedure) and facilitate the choice of strategy and tools used during percutaneous coronary intervention (PCI). We present a case of PCI of chronic total occlusion (CTO) after non-invasive diagnostics, including multi-slice computed tomography (MSCT)

Cardiopulmonary resuscitation in pregnancy – European Resuscitation Council guidelines

Abstract Cardio-pulmonary resuscitation is a life-saving technique that should be familiar to all people, even those without medical education. There are two basic life-saving levels: BLS (Basic Life Support) and ALS (Advanced Life Support). ALS a medical procedure that is restricted to medical practitioners. Cessation of circulation may happen to anyone. Cardiac arrest in case of pregnant women is a very specific state. The cause of life- threatening states during pregnancy can be connected with new infections, exacerbation of chronic diseases, as well as changes connected with the pregnancy itself. In those situations, due to physiological and anatomical changes which occur during pregnancy, some modifications in the procedure of resuscitation are necessary

Changes in morphological and cytological properties of blood during physical exercise in water at 4o^{o}C and 25o^{o}C

Praca recenzowana / peer-reviewed paperObjective: The aim of this study was to determine the effect of a single swimming exercise till exhaustion, in water on the morphological and cytological blood parameters in laboratory rats. Methods: The experiment involved 60 male rats from the Wistar strain, aged 8 weeks and 36 weeks. The animals were separated into 6 groups: 3 groups (I, II, III) of 8-week old animals, and 3 groups (IV, V, VI) of 36-week old animals. The rats in the study groups i.e. II, III, V, and VI were made to swim till exhaustion in water at 4ºC and at 25°C. After the experiment blood samples were collected from each rat and hematological and cytological determinations were completed for each sample. Results: Compared with the control group, in the rats from group II (8-week old, swimming in water at 4ºC) a significant increase was noted in the RBC count, Hb, Ht, and MCHC, and MCH indices, whereas in the rats from group V (36-week old, swimming in water at 4ºC) increases were noted in the MCHC and MCH indices (again when compared with the control group). In the rats from group III (8-week old, swimming in water at 25ºC), compared with the control group, significant increases were noted in the Hb and Ht parameters, as well as in the MCHC, and MCH indices, whereas in the group VI rats (36-week old swimming at 25ºC) – the increase was noted in the MCHC index. No alterations were found in the reticulocyte count, and in poikilocytes during exercise in water at low temperatures in either the 8-week or 36-week old rats. Conclusions: The increases in the majority of blood parameters, testifies to the dehydration of the body during physical exercise which in turn affects the microcirculation function. The lack of alterations in the reticulocyte count in the peripheral blood may, in turn, testify to the ineffectiveness of low temperature during exercise upon the function of the bone marrow

Normative Values for Heart Rate Variability Parameters in School-Aged Children: Simple Approach Considering Differences in Average Heart Rate

Background: Heart rate variability (HRV) analysis is a clinical tool frequently used to characterize cardiac autonomic status. The aim of this study was to establish normative values for short-term HRV parameters by considering their main determinants in school-aged children.Methods: Five-minute electrocardiograms were taken from 312 non-athlete children (153 boys) at age of 6 to 13 years for computation of conventional time- and frequency-domain HRV parameters. Heart rate (HR), respiratory rate, age, body mass index, and sex were considered as their potential determinants. Multiple regression analysis revealed that HR was the principal predictor of all standard HRV indices. To develop their universal normative limits, standard HRV parameters were corrected for prevailing HR.Results: The HRV correction for HR yielded the parameters which became independent on both sex and HR, and only poorly dependent on age (with small effect size). Normal ranges were calculated for both time- and frequency-domain indices (the latter computed with either fast Fourier transform and autoregressive method). To facilitate recalculation of standard HRV parameters into corrected ones, a calculator was created and attached as a Supplementary Material that can be downloaded and used for both research and clinical purposes.Conclusion: This study provides HRV normative values for school-aged children which have been developed independently of their major determinants. The calculator accessible in the Supplementary Material can considerably simplify determination if HRV parameters accommodate within normal limits

Przezcewnikowa implantacja zastawki aortalnej w leczeniu dysfunkcyjnych bioprotez chirurgicznych i przezcewnikowych. Opinia ekspertów Asocjacji Interwencji Sercowo-Naczyniowych Polskiego Towarzystwa Kardiologicznego

Ponad 15-letnie doświadczenie i wyniki dużych badań obserwacyjnych, na podstawie których tworzone są wytyczne, wskazują na bezpieczeństwo i skuteczność zabiegów przezcewnikowej implantacji „zastawki w zastawkę” (ViV-TAVI, valve-in-valve transcatheter aortic valve implantation), zmniejszając tym samym potrzebę reoperacji u pacjentów wysokiego ryzyka. Oczekuje się, że liczba zabiegów ViV-TAVI w Polsce, szacowana na około 2% wszystkich przezcewnikowej implantacji zastawki aortalnej w 2020 roku, będzie rosła. Niniejszy dokument ma na celu przegląd aspektów proceduralnych ViV-TAVI, w tym odpowiednich metod planowania przedzabiegowego, sposobów optymalizacji wyników hemodynamicznych i ograniczania ryzyka okluzji tętnic wieńcowych. Dokument zawiera również wstępny przegląd wskazań i wytycznych dotyczących ponownego zabiegu TAVI (re-do TAVI) u pacjentów ze zdegenerowanymi zastawkami przezcewnikowymi