Termowizja jako metoda diagnostyczna stosowana w kardiologii

Thermography is a diagnostic method which is totally non-invasive, painless and safe for both a patient and a diagnostician. It enables to define the physiological condition of the examined tissues or organs basing on the emission of the infrared radiation. Thermography examination has its application in almost every branch of medicine. For a few years in cardiology, there has been an intensive research on introducing the new methods of identifying the high risk atherosclerotic plaques which is largely based on evaluating the degree of escalation of the inflammation process within the atherosclerotic changes. Thanks to applying thermography within the vessels, it is possible to measure the temperature of the wall of the vessel in order to detect the high risk atherosclerotic plaques and evaluate the potential risk of occurrence of the acute coronary syndrome. Kardiol Pol 2010; 68, 9: 1052-105

Preparation of patients with low pressure lifting patients

Sawicka Katarzyna M., Prasał Marek, Krzyżanowska Ewa, Łuczyk Robert Jan, Trąbka Monika, Daniluk Jadwiga. Preparation of patients with low pressure lifting patients. Journal of Education, Health and Sport. 2017;7(8):135-149. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.844063 http://ojs.ukw.edu.pl/index.php/johs/article/view/4705 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26.01.2017). 1223 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Authors 2017; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 20.07.2017. Revised: 02.08.2017. Accepted: 15.08.2017. PRZYGOTOWANIE PACJENTÓW Z NADCIŚNIENIEM TĘTNICZYM DO SAMOKONTROLI Preparation of patients with low pressure lifting patients Katarzyna M. Sawicka1, Marek Prasał3, Ewa Krzyżanowska1, Robert Jan Łuczyk1, Monika Trąbka2, Jadwiga Daniluk1 1Katedra Interny z Zakładem Pielęgniarstwa Internistycznego, Wydział Nauk o Zdrowiu, Uniwersytet Medyczny w Lublinie 2Absolwentka Wydziału Nauk o Zdrowiu Uniwersytetu Medycznego w Lublinie 3Klinika Kardiologii, Samodzielny Publiczny Szpital Kliniczny Nr 4 w Lublinie STRESZCZENIE Wstęp. Nadciśnienie tętnicze stanowi jedną z najczęściej występujących chorób układu krążenia. Leczenie nadciśnienia tętniczego oprócz standardowej farmakoterapii obejmuje także leczenie niefarmakologiczne. Zachowania zdrowotne w istotny sposób wpływają na poprawę samopoczucia pacjentów z chorobą nadciśnieniową, pozwalają ją kontrolować oraz zapobiegać jej powikłaniom, dlatego tak istotna jest edukacja zdrowotna pomagająca pacjentowi przygotować się do prowadzenia samokontroli. Cel pracy. Określenie stopnia przygotowania pacjentów z nadciśnieniem tętniczym do samokontroli. Materiał i metoda. Badanie przeprowadzono wśród 110 pacjentów, leczonych z powodu nadciśnienia tętniczego, za pomocą kwestionariusza ankiety autorskiej składającego się z metryczki i 23 pytań. Wyniki. Na podstawie przeprowadzonego badania stwierdzono, że większość pacjentów chorujących na nadciśnienie tętnicze posiada przeciętną wiedzę na temat zasad samokontroli choroby, a czynniki socjodemograficzne nie mają wpływu na stopień przygotowania pacjentów do samokontroli nadciśnienia tętniczego. Jedynie wykształcenie badanych oraz czas trwania choroby istotnie wpływa na przygotowanie pacjentów do samokontroli choroby. Słowa kluczowe: nadciśnienie tętnicze, samokontrola SUMMARY Admission. Hypertension is one of the most common cardiovascular diseases. Treatment of hypertension in addition to standard pharmacotherapy also includes non-pharmacological treatment. Health behaviors have a significant impact on the wellbeing of patients with hypertension, control and prevent complications, so health education is essential to help patients prepare for self-control. Aim of the job. Determining the degree of preparation of patients with hypertension for self-control. Material and method. The study was conducted among 110 patients treated for hypertension using a questionnaire consisting of a questionnaire consisting of a questionnaire and 23 questions. Results. Based on the study, it was found that the majority of patients with hypertension had a mediocre knowledge of the principles of self-monitoring and that sociodemographic factors had no effect on the degree of self-monitoring of hypertension. Only the education of the subjects and the duration of the disease significantly affect the preparation of patients for self-control of the disease. Key words: hypertension, self-contro

Metabolic syndrome is associated with similar long-term prognosis in non-obese and obese patients. An analysis of 45 615 patients from the nationwide LIPIDOGRAM 2004-2015 cohort studies

Aims We aimed to evaluate the association between metabolic syndrome (MetS) and long-term all-cause mortality. Methods The LIPIDOGRAM studies were carried out in the primary care in Poland in 2004, 2006 and 2015. MetS was diagnosed based on the National Cholesterol Education Program, Adult Treatment Panel III (NCEP/ATP III) and Joint Interim Statement (JIS) criteria. The cohort was divided into four groups: non-obese patients without MetS, obese patients without MetS, non-obese patients with MetS and obese patients with MetS. Differences in all-cause mortality was analyzed using Kaplan-Meier and Cox regression analyses. Results 45,615 participants were enrolled (mean age 56.3, standard deviation: 11.8 years; 61.7% female). MetS was diagnosed in 14,202 (31%) by NCEP/ATP III criteria, and 17,216 (37.7%) by JIS criteria. Follow-up was available for 44,620 (97.8%, median duration 15.3 years) patients. MetS was associated with increased mortality risk among the obese (hazard ratio, HR: 1.88 [95% CI, 1.79-1.99] and HR: 1.93 [95% CI 1.82-2.04], according to NCEP/ATP III and JIS criteria, respectively) and non-obese individuals (HR: 2.11 [95% CI 1.85-2.40] and 1.7 [95% CI, 1.56-1.85] according to NCEP/ATP III and JIS criteria respectively). Obese patients without MetS had a higher mortality risk than non-obese patients without MetS (HR: 1.16 [95% CI 1.10-1.23] and HR: 1.22 [95%CI 1.15-1.30], respectively in subgroups with NCEP/ATP III and JIS criteria applied). Conclusions MetS is associated with increased all-cause mortality risk in non-obese and obese patients. In patients without MetS obesity remains significantly associated with mortality. The concept of metabolically healthy obesity should be revised

Clinical utility and prognostic implications of the novel 4S-AF scheme to characterize and evaluate patients with atrial fibrillation: a report from ESC-EHRA EORP-AF Long-Term General Registry

Aims: The 4S-AF classification scheme comprises of four domains: stroke risk (St), symptoms (Sy), severity of atrial fibrillation (AF) burden (Sb), and substrate (Su). We sought to examine the implementation of the 4S-AF scheme in the EORP-AF General Long-Term Registry and compare outcomes in AF patients according to the 4S-AF-led decision-making process. Methods and results: Atrial fibrillation patients from 250 centres across 27 European countries were included. A 4S-AF score was calculated as the sum of each domain with a maximum score of 9. Of 6321 patients, 8.4% had low (St), 47.5% EHRA I (Sy), 40.5% newly diagnosed or paroxysmal AF (Sb), and 5.1% no cardiovascular risk factors or left atrial enlargement (Su). Median follow-up was 24 months. Using multivariable Cox regression analysis, independent predictors of all-cause mortality were (St) [adjusted hazard ratio (aHR) 8.21, 95% confidence interval (CI): 2.60-25.9], (Sb) (aHR 1.21, 95% CI: 1.08-1.35), and (Su) (aHR 1.27, 95% CI: 1.14-1.41). For CV mortality and any thromboembolic event, only (Su) (aHR 1.73, 95% CI: 1.45-2.06) and (Sy) (aHR 1.29, 95% CI: 1.00-1.66) were statistically significant, respectively. None of the domains were independently linked to ischaemic stroke or major bleeding. Higher 4S-AF score was related to a significant increase in all-cause mortality, CV mortality, any thromboembolic event, and ischaemic stroke but not major bleeding. Treatment of all 4S-AF domains was associated with an independent decrease in all-cause mortality (aHR 0.71, 95% CI: 0.55-0.92). For each 4S-AF domain left untreated, the risk of all-cause mortality increased substantially (aHR 1.35, 95% CI: 1.16-1.56). Conclusion: Implementation of the novel 4S-AF scheme is feasible, and treatment decisions based on this scheme improve mortality rates in AF

Clinical utility and prognostic implications of the novel 4S-AF scheme to characterize and evaluate patients with atrial fibrillation: a report from ESC-EHRA EORP-AF Long-Term General Registry

International audienceAbstract Aims The 4S-AF classification scheme comprises of four domains: stroke risk (St), symptoms (Sy), severity of atrial fibrillation (AF) burden (Sb), and substrate (Su). We sought to examine the implementation of the 4S-AF scheme in the EORP-AF General Long-Term Registry and compare outcomes in AF patients according to the 4S-AF-led decision-making process. Methods and results Atrial fibrillation patients from 250 centres across 27 European countries were included. A 4S-AF score was calculated as the sum of each domain with a maximum score of 9. Of 6321 patients, 8.4% had low (St), 47.5% EHRA I (Sy), 40.5% newly diagnosed or paroxysmal AF (Sb), and 5.1% no cardiovascular risk factors or left atrial enlargement (Su). Median follow-up was 24 months. Using multivariable Cox regression analysis, independent predictors of all-cause mortality were (St) [adjusted hazard ratio (aHR) 8.21, 95% confidence interval (CI): 2.60–25.9], (Sb) (aHR 1.21, 95% CI: 1.08–1.35), and (Su) (aHR 1.27, 95% CI: 1.14–1.41). For CV mortality and any thromboembolic event, only (Su) (aHR 1.73, 95% CI: 1.45–2.06) and (Sy) (aHR 1.29, 95% CI: 1.00–1.66) were statistically significant, respectively. None of the domains were independently linked to ischaemic stroke or major bleeding. Higher 4S-AF score was related to a significant increase in all-cause mortality, CV mortality, any thromboembolic event, and ischaemic stroke but not major bleeding. Treatment of all 4S-AF domains was associated with an independent decrease in all-cause mortality (aHR 0.71, 95% CI: 0.55–0.92). For each 4S-AF domain left untreated, the risk of all-cause mortality increased substantially (aHR 1.35, 95% CI: 1.16–1.56). Conclusion Implementation of the novel 4S-AF scheme is feasible, and treatment decisions based on this scheme improve mortality rates in AF

The SAMe-TT2R2 score and quality of anticoagulation in atrial fibrillation: a simple aid to decision-making on who is suitable (or not) for vitamin K antagonists

International audienc

Contemporary stroke prevention strategies in 11 096 European patients with atrial fibrillation: a report from the EURObservational Research Programme on Atrial Fibrillation (EORP-AF) Long-Term General Registry

International audienc

Epidemiology and impact of frailty in patients with atrial fibrillation in Europe

Background: Frailty is a medical syndrome characterised by reduced physiological reserve and increased vulnerability to stressors. Data regarding the relationship between frailty and atrial fibrillation (AF) are still inconsistent. Objectives: We aim to perform a comprehensive evaluation of frailty in a large European cohort of AF patients. Methods: A 40-item frailty index (FI) was built according to the accumulation of deficits model in the AF patients enrolled in the ESC-EHRA EORP-AF General Long-Term Registry. Association of baseline characteristics, clinical management, quality of life, healthcare resources use and risk of outcomes with frailty was examined. Results: Among 10,177 patients [mean age (standard deviation) 69.0 (11.4) years, 4,103 (40.3%) females], 6,066 (59.6%) were pre-frail and 2,172 (21.3%) were frail, whereas only 1,939 (19.1%) were considered robust. Baseline thromboembolic and bleeding risks were independently associated with increasing FI. Frail patients with AF were less likely to be treated with oral anticoagulants (OACs) (odds ratio 0.70, 95% confidence interval 0.55–0.89), especially with non-vitamin K antagonist OACs and managed with a rhythm control strategy, compared with robust patients. Increasing frailty was associated with a higher risk for all outcomes examined, with a non-linear exponential relationship. The use of OAC was associated with a lower risk of outcomes, except in patients with very/extremely high frailty. Conclusions: In this large cohort of AF patients, there was a high burden of frailty, influencing clinical management and risk of adverse outcomes. The clinical benefit of OAC is maintained in patients with high frailty, but not in very high/extremely frail ones

Association between antithrombotic treatment and outcomes at 1-year follow-up in patients with atrial fibrillation: the EORP-AF General Long-Term Registry

International audienceAims In recent years, stroke prevention in patients with atrial fibrillation (AF) has radically changed, with increasing use of non-vitamin K antagonist oral anticoagulants (NOACs). Contemporary European data on AF thromboprophylaxis are needed. Methods and results We report 1-year follow-up data from the EURObservational Research Programme in Atrial Fibrillation (EORP-AF) General Long-Term Registry. Outcomes were assessed according to antithrombotic therapy. At 1-year follow-up, 9663 (88.0%) patients had available data for analysis: 586 (6.1%) were not treated with any antithrombotic; 681 (7.0%) with antiplatelets only; 4066 (42.1%) with vitamin K antagonist (VKA) only; 3167 (32.8%) with NOACs only; and 1163 (12.0%) with antiplatelet and oral anticoagulant. At 1-year follow-up, there was a low rate of stroke (0.7%) and any thromboembolic event (TE) (1.2%), while haemorrhagic events occurred in 222 patients (2.3%). Cardiovascular (CV) death and all-cause death occurred in 3.9% and 5.2% of patients, respectively. Cumulative survival for all the three main outcomes considered was highest amongst patients treated only with NOACs (P < 0.0001). Multivariable-adjusted Cox regression analysis found that VKA or NOACs use was independently associated with a lower risk for any TE/acute coronary syndrome/CV death, while all treatments were independently associated with a lower risk for CV death and all-cause death. Conclusion The 1-year follow-up of EORP-AF General Long-Term Registry reported a low occurrence of thromboembolic and haemorrhagic events, although mortality was high. Both VKA and NOACs were associated with a lower risk of all main adverse outcomes. All treatments were associated with a lower risk for CV death and all-cause death