Rola badania jakości życia u pacjentów z komorowymi zaburzeniami rytmu bez organicznej choroby serca poddawanych zabiegom ablacji przeznaczyniowej

Wstęp: Komorowe zaburzenia rytmu u pacjentów bez organicznej choroby serca (NHVA) u części chorych wiążą się z istotnymi objawami klinicznymi. U takich pacjentów korzystne wydaje się wykonanie ablacji przeznaczyniowej (RFA) w celu identyfikacji i zniszczenia przyczyn arytmii. Badanie jakości życia (QoL) za pomocą kwestionariusza jest próbą obiektywizowania wskazań do zabiegu ablacji. Materiał i metody: Przebadano 15 pacjentów (w tym 12 kobiet) w wieku 23–62 lat (śr. 42 lata) poddanych zabiegom RFA z powodu NHVA. Zależną od stanu zdrowia QoL oceniano za pomocą polskiej adaptacji kwestionariusza SF 36 przed RFA oraz w okresie 3–12 miesięcy po zabiegu. Wyniki porównywano ze średnią uzyskaną w zdrowej populacji. Oceniano wynik całkowity testu oraz podskale aktywności fizycznej, ograniczenia aktywności zależnej od zdrowia fizycznego, funkcjonowania społecznego, bólu, poczucia zdrowia psychicznego, ograniczenia aktywności, zależnych od problemów emocjonalnych, żywotności, ogólnego poczucia zdrowia. Wyniki: Nie obserwowano powikłań RFA. Uzyskano ustąpienie lub istotną redukcję arytmii. Po RFA objawy związane z arytmią nie występowały lub uległy złagodzeniu. W grupie badanej przed zabiegiem wyniki były znacząco gorsze niż w grupie kontrolnej. Po RFA obserwowano poprawę samooceny QoL w grupie badanej do wartości porównywalnych z zarejestrowanymi w grupie kontrolnej. Wnioski: U pacjentów bez organicznej choroby serca z komorowymi zaburzeniami rytmu serca, ze znacznie ograniczoną QoL, zabieg RFA istotnie poprawia jakość życia. Można rozważać wprowadzenie badania QoL jako dodatkowego testu w celu ustalenia wskazań do RFA w tej grupie chorych. (Folia Cardiol. 2004; 11: 521–527

Results of the treatment of patients with solid tumours and liver metastases: 8 years experience of one institution

Wstęp. Leczenie chirurgiczne przerzutów nowotworów litych do wątroby powinno odbywać się w ramach zespołu wielodyscyplinarnego.Cel pracy. Celem pracy jest ocena wyników leczenia skojarzonego chorych na różne nowotwory lite z przerzutami do wątroby przez zespół wielodyscyplinarny jednego ośrodka onkologicznego w ciągu ostatnich 8 lat.Materiał i metody. Retrospektywną analizą objęto 166 chorych (84 kobiety i 82 mężczyzn) w wieku od 19 do 78 lat (średnia 58 ± 11,2), leczonych z powodu przerzutów do wątroby pierwotnych nowotworów litych o różnej lokalizacji, z wyjątkiem guzów neuroendokrynnych. Każdorazowo rozważano okołooperacyjne leczenie systemowe zgodnie z aktualnymi zaleceniami Polskiej Unii Onkologii.Wyniki. W czasie obserwacji (mediana 35 miesięcy) zmarło 46% chorych. Resekcje wątroby wykonano u 107 (65%)chorych, w tym u 19 chorych połączono je z (RF-)termoablacją zmian przerzutowych, którą wykonano jako samodzielny zabieg u dalszych 59 (36%) chorych. Śmiertelność pooperacyjna wyniosła 1,2%. Powikłania II° wg klasyfikacji Clavien-Dindo wystąpiły u 33 (19,8%) chorych, natomiast III° i IV° — u 8 (4,8%) chorych. Przeżycia 1-roczne, 3-letniei 5-letnie wyniosły odpowiednio 78%, 41% i 37%. Pięcioletnie przeżycia całkowite u chorych na raka jelita grubego po resekcjach przerzutów metachronicznych wyniosły 48%.Wnioski. Skojarzone leczenie chorych na nieendokrynne nowotwory lite z przerzutami do wątroby przez zespół wielodyscyplinarny jest bezpieczne i skuteczne. W starannie dobranej grupie chorych można osiągnąć blisko 50% całkowitych przeżyć 5-letnich. Resekcja wątroby jest optymalną metodą leczenia chirurgicznego przerzutów do wątroby.Introduction. Surgical treatment of liver metastases from solid tumours should be provided by multidisciplinary teams.Aim. The aim of the present study is to analyse results of the combined treatment of patients with different solid tumours and liver metastases by single institution multidisciplinary team for last 8 years.Material and methods. This is a retrospective analysis of 166 patients (84 females and 82 males), aged from 19 to 78 years (mean 58 ± 11.2), treated due to liver metastases from solid tumours in various primary localizations: except neuroendocrine tumours. In every patient, perioperative systemic therapy was evaluated in agreement with current recommendations of the Polish Union of Oncology.Results. In the follow-up time available (median 35 months) 46% of patients died. Liver resections were performed in 107 (65%) patients, including 19 patients in whom resections were supplemented with (RF-)thermoablations of their liver metastases. This was the sole surgical treatment in the 59 (36%) patients. Perioperative mortality was 1.2%. Grade II complications according to the Clavien-Dindo classification were found in 33 (19.8%) patients, whereas grade III and IV complications were treated in 8 (4.8%) patients. One-, 3-, and 5-year survival rates were respectively 78%, 41%, and 37%. Five-year overall survival in patients with colorectal carcinoma after liver resection of metachronous metastases was 48%. We conclude that combined treatment of patients with liver metastases from non-endocrine solid tumours by the multidisciplinary team is safe and effective. A nearly 50% 5-year survival is achievable in a carefully selected group of patients. We also conclude that hepatic resection is an optimal method of surgical treatment of liver metastases

Interdyscyplinarne aspekty nauk o zdrowiu

Praca recenzowana / Peer-reviewed pape

Globally, songs and instrumental melodies are slower, higher, and use more stable pitches than speech: a registered report

Both music and language are found in all known human societies, yet no studies have compared similarities and differences between song, speech, and instrumental music on a global scale. In this Registered Report, we analyzed two global datasets: (i) 300 annotated audio recordings representing matched sets of traditional songs, recited lyrics, conversational speech, and instrumental melodies from our 75 coauthors speaking 55 languages; and (ii) 418 previously published adult-directed song and speech recordings from 209 individuals speaking 16 languages. Of our six preregistered predictions, five were strongly supported: Relative to speech, songs use (i) higher pitch, (ii) slower temporal rate, and (iii) more stable pitches, while both songs and speech used similar (iv) pitch interval size and (v) timbral brightness. Exploratory analyses suggest that features vary along a “musi-linguistic” continuum when including instrumental melodies and recited lyrics. Our study provides strong empirical evidence of cross-cultural regularities in music and speech

The use of ultrasound in the assessment of the glenoid labrum of the glenohumeral joint. Part I: Ultrasound anatomy and examination technique

The glenohumeral joint is a spherical articulation with a remarkable range of motion in several planes and decreased stability. The maintenance of joint stability is influenced by the functioning of specific muscle groups in the shoulder region, a complex system of ligaments reinforcing the joint capsule, and the labrum which augments the glenoid fossa. Lesions of the aforementioned structures require accurate diagnosis prior to a decision for operative treatment. Ultrasound is one of the imaging methods that has been widely used in the assessment of various shoulder pathologies. In the author opinion, this imaging modality may also be applied for the evaluation of labral tears. Being attached along the glenoid rim, the labrum forms a collar deepening the glenoid fossa thus increasing area of its contact with the head of the humerus. To better describe the location of lesions, the glenoid labrum is usually divided into certain zones. Most of them may be visualized sonographically. The US examination of the posterior labrum can be performed during evaluation of the infraspinatus and teres minor muscles. The anterior labrum along with capsulolabral complex is seen at the glenoid edge under the subscapularis tendon. Sonographic examination of the inferior labrum is best performed using axillar approach. The superior labrum is only partially available for US examination. A crucial part of the sonographic assessment of the labrum is the dynamic examination during rotation of the upper extremity. The paper presents normal sonographic anatomy of the glenoid labrum and technique of the examination

What Does the Lyrebird Hear? Trouble With Birdsong in the Anthropocene

Human-made noise pollutes the Earth further every day. It is important to investigate how that process affects the whole biosphere. I present a symbolic case of the Australian lyrebird, which is a songbird that mimics the sounds of its surroundings. Today its songs sound like chainsaw and other heavy machinery. All animal species are polluted by human noise to some extent. There are many studies about sonic perception in animals, but it seems that this knowledge is still hardly popularised. The phenomenon of sharing sounds between humans and other animals may also be better understood by new approaches to studies on cultural evolution

The use of ultrasound in the assessment of the glenoid labrum of the glenohumeral joint. Part II: Examples of labral pathologies

Labral pathologies of the glenohumeral joint are most commonly caused by trauma. The majority of lesions affect the anterior part of labrum, resulting from much higher frequency of anterior shoulder dislocations over posterior ones. Another subgroup of labral lesions, not directly related to joint instability, are SLAP tears. Other findings include degenerative changes of labrum and paralabral cysts. Diagnostic imaging is crucial for making a decision regarding operative treatment. Apart from a standard X-ray examination, the imaging mainly relies on magnetic resonance or computed tomography arthrography. Based on their own experience, the authors propose the use of ultrasound in the assessment of labral tears of the glenohumeral joint. Different signs indicating labral pathology may be discovered and assessed during ultrasound examination. They include permanent displacement of the labrum onto the glenoid, labral instability during dynamic examination, lack of the labrum in the anatomical position, hypoechoic zone at the base of the labrum >2 mm in width, residual or swollen labrum as well as paralabral cyst(s). The most frequent appearance of labral pathology is displacement of the anteroinferior labrum onto the external aspect of the glenoid typically seen after anterior shoulder dislocation. The another most important US feature is labral instability while dynamically examined. The swelling or reduced size of the labrum usually indicates degeneration. This article presents sonographic images of selected labral pathologies

Flame Retardancy Properties and Physicochemical Characteristics of Polyurea-Based Coatings Containing Flame Retardants Based on Aluminum Hydroxide, Resorcinol Bis(Diphenyl Phosphate), and Tris Chloropropyl Phosphate

Polyurea is a synthetic material made by the reaction of isocyanate and polymer blend-containing amines. Due to its outstanding mechanical properties and fast curing, polyurea-based coatings have found dozens of applications, including waterproofing and anti-corrosion coatings. Further development of this material can create a flame-retardant product, a good alternative for common products available on the market, such as intumescent coatings. To improve the flame retardancy of polyurea, several flame retardants were investigated. The influence of aluminum hydroxide, resorcinol bis(diphenyl phosphate) (RDP), and tris chloropropyl phosphate (TCPP) on flame retardancy and morphology was studied. The following methods were used: infrared spectroscopy, scanning electron microscopy, thermogravimetric analysis, limiting oxygen index, and tensile strength. The examinations mentioned above showed the improvement of flame-retardancy of polyurea for two products: chlorinated organophosphate and organophosphate. Nevertheless, using the chlorinated organophosphate additive caused a rapid deterioration of mechanical properties

Coating Composites Based on Polyurea Elastomers with Increased Fire Resistance and Their Use as Roofing Systems

This paper presents the results of tests on elastomer coatings based on polyurea–polyurethane formulation with increased fire parameters. Coatings modified with flame retardants: bis(phenylphosphate) resorcinol (RDP), trischloropropyl phosphate (TCPP), and aluminum hydroxide (ATH) were tested. Fourier transform infrared spectroscopy (FTIR) and thermogravimetric analysis (TGA/DTG) were used to investigate the structure and thermal stability. The effectiveness of resorcinol bis(phenylphosphate) (RDP), tris chloropropyl phosphate (TCPP), and aluminum hydroxide (ATH) on heat release rate (HRR), smoke release rate (RSR), and oxygen consumption was evaluated using cone calorimetry. The cone calorimetry results were correlated with the mechanical properties of the coatings. The cone calorimetry analysis showed suitable organophosphorus flame retardant (FR) performance, significantly decreasing HRR and oxygen consumption. Additionally, 15% TCPP caused a reduction of HRR by over 50%, obtaining 211.4 kW/m2 and pHRR by over 55%, reaching 538.3 kW/m2. However, organophosphorus flame retardants caused a significant deterioration of mechanical properties simultaneously. Introducing a mixture of two FRs (RDP/TCPP) resulted in obtaining a coating with improved fire resistance and maintained good mechanical strength. The polyurea–polyurethane coating, modified with a mixture of two RDP/TCPP retardants (10:5), was simulated for the burning of roof systems. The result of the simulation was assessed positively. Thus, finally, it was confirmed that the proposed polyurea–polyurethane coating achieved the assumed flame retardant level