Sick sinus syndrome — is pacemaker always the best option?

W niniejszej pracy zaprezentowano dwa przypadki pacjentek z objawową dysfunkcją węzła zatokowego. W pierwszym przypadku przeprowadzenie skutecznego zabiegu ablacji nawrotnego częstoskurczu z łącza przedsionkowo-komorowego pozwoliło uniknąć implantacji stymulatora serca z powodu bradykardii i zahamowań zatokowych. W drugim przypadku podanie w skojarzeniu propafenonu i metoprololu w celu przywrócenia rytmu zatokowego u chorej z migotaniem przedsionków spowodowało zaawansowaną niewydolność węzła zatokowego z koniecznością zastosowania czasowej stymulacji serca. W pracy podjęto temat nie zawsze łatwej kwalifikacji chorych do stałej stymulacji serca w chorobie węzła zatokowego ze szczególnym uwzględnieniem zespołu tachykardia–bradykardia. Na wskazania do implantacji rozrusznika serca w tym zespole wpływają nie tylko objawy kliniczne zależne od bradykardii, ale także przebieg i sposób leczenia współistniejącej arytmii nadkomorowej.We present two cases of patients with symptomatic dysfunction of sinus node. In the first example catheter ablation of AVNRT was performed which allowed to avoid pacemaker implantation due to sinus bradycardia and sinus pauses. In the second case combined usage of propafenon and metoprolol was introduced to restore sinus rhythm in patient with persistent AF. It caused severe sinus in sufficiency and temporary cardiac pacing. The article puts up for discussion not always easy qualification for permanent pacemaker implantation in sick sinus syndrome, especially among those patients with tachycardia-bradycardia syndrome. Indications for pacemaker implantation depend not only on clinical criteria but also on natural history and treatment of co-existing supraventrical arrhythmias

Skąpoobjawowa manifestacja ostrego zespołu wieńcowego u 51-letniego mężczyzny bez wywiadu kardiologicznego — indywidualizacja postępowania na podstawie analizy czynników ryzyka choroby wieńcowej

Ischaemic heart disease (IHD), including coronary artery disease, tends to manifest in younger population of cardiologic patients. This process is accelerated by presence of classic coronary artery heart disease risk factors as smoking or dyslipidaemia, as well as contemporary ones as chronic stress. In younger population IHD is often oligosymptomatic which makes it difficult to diagnose correctly.Choroba niedokrwienna serca (IHD), w tym choroba wieńcowa, wykazuje tendencję do ujawniania się w coraz młodszych populacjach chorych. Wpływają na to zarówno szeroko obecnie występujące klasyczne czynniki ryzyka, takie jak palenie tytoniu czy zaburzenia lipidowe, jak i współczesne czynniki, takie jak przewlekły stres. Jednocześnie IHD często przebiega skąpoobjawowo u młodych chorych, co utrudnia jej prawidłowe rozpoznanie

Rola dodatkowej diagnostyki w ustalaniu wskazań do stałej stymulacji serca — opis przypadku

We present a description of a 48-year-old patient after Bentall de Bono procedure due to an ascen-ding aortic aneurysm and a complex aortic valve disorder accepted to the Cardiology Clinic in order to establish indications for constant heart stimula­tion. Based on the presented case, the authors pay attention to the necessity of a thorough analysis of the additional tests carried out in making decisions regarding the patient’s qualification for implantation of the cardiac stimulation system permanently.Przedstawiono opis 48-letniej chorej, po operacji metodą Bentall de Bono z powodu tętniaka aorty wstępującej i złożonej wady dwupłatkowej zastawki aortalnej, przyjętej do kliniki kardiologii w celu ustalenia wskazań do stałej stymulacji serca. Na podstawie prezentowanego przypadku autorzy zwracają uwagę na konieczność wnikliwej analizy przeprowadzonych badań dodatkowych przy podej­mowaniu decyzji dotyczących kwalifikacji pacjenta do implantacji na stałe układu stymulującego serce

Proarrhythmic effect of propafenone — a case report

Propafenon jest lekiem antyarytmicznym, szczególnie zalecanym w terapii nadkomorowych zaburzeń rytmu serca. W przypadku długotrwałego leczenia może przejawiać działanie proarytmiczne. Opisano przypadek chorego z napadowym migotaniem przedsionków, u którego po zastosowaniu propafenonu w doustnej dawce 600 mg wystąpił napad częstoskurczu komorowego. Jak wskazuje zaprezentowany przypadek w przypadku zastosowania dawek terapeutycznych na proarytmiczne działanie tego leku są również narażeni chorzy z nieuszkodzonym mięśniem sercowym.Propafenone is used in the therapy of supraventricular arrhythmias. Its long-term use may be associated with the development of malignant ventricular arrhythmias. We present a case of a patient with paroxysmal atrial fibrillation, who was administered an oral dose of 600 mg of propafenone, which resulted in an episode of ventricular tachycardia. This article indicates that patients without severe heart failure subjected to therapeutic doses of propafenone are also exposed to the possibility of its adverse effects

Land-Sea Interactions in Realisation of Ecosystem Approach in the Marine Spatial Planning in the Baltic Sea Region – Polish Perspective

Maritime spatial planning has become on of the fundamental instruments of managing human activity at the sea. It is mostly due to the rising competition for marine space, which is a consequence of rising number and variety of uses of the sea. Among the principles of marine spatial planning ecosystem approach as well as the taking into account the interaction between land and sea seem to play the most important role. First one is more general and axiological in it’s nature, while the second functions more as technical guide for planners. Together they can be called guiding principles of marine spatial planning. Ecosystem approach is a concept closely related to ecosystem services. It’s main aim is to sustain the productivity of ecosystems in the field of ecosystem services, what is often connotated with the health of the marine ecosystem. Multiple correlations between land and sea can be easily seen in the managerial goals of the marine ecosystem. Trophic relations seems to be reflected in legal regulations, but the question remains if the marine spatial planning regime really reflects the interactions between land and the sea

Pasta as a Source of Minerals in the Diets of Poles; Effect of Culinary Processing of Pasta on the Content of Minerals

Pasta is a product that requires culinary processing which can affect the content of minerals in the finished product. The study aimed to examine how cooking pasta (1) in salted water (1 teaspoon—16 g of salt per 1 litre of water) or unsalted water and (2) rinsing cooked pasta with running water affects the content of minerals. Thirty-five samples of six types of pasta were analysed. The content of minerals was determined using the ICP-OES method. Retention of minerals in the cooked pasta was calculated. Taking the culinary treatment into account, the intake of minerals with pasta was assessed for children, adolescents, and adults, and the values were compared with the recommendations for the population of Poland. The analysed culinary factors had a statistically significant influence on the content of minerals. Adding salt to water when cooking pasta significantly increased the content of Na in the product, which in turn was negatively correlated with the content of other minerals. When pasta was cooked in unsalted water, it contained less Na and more other minerals than pasta cooked in salted water. Rinsing of pasta reduced the content of all minerals. Pasta is an important source of Mg, Cu, and Mn in the diet of Poles. These ingredients are particularly important to ensure correct development and functioning of the human body. The best method of culinary treatment of pasta is cooking in unsalted water without rinsing

Fresh Chokeberry (<i>Aronia melanocarpa)</i> Fruits as Valuable Additive in Extruded Snack Pellets: Selected Nutritional and Physiochemical Properties

In this paper, the nutritional value and (selected) physiochemical properties of extruded snack pellets enriched with fresh chokeberry (Aronia melanocarpa) fruits were analyzed from the perspective of being a new product for the functional food sector. The purpose of this study was to determine the effect of the addition of fresh chokeberry and variation in content and screw speed on extruded snack pellet basic compositions, fatty acid profiles, antioxidant activity, as well as water absorption and solubility indexes, fat absorption and color profiles. The obtained results revealed a significant increase in antioxidant activity for all samples (above 90% of free radical scavenging) in comparison to potato-based control samples (just over 20% of free radical scavenging). The total phenolic content assay revealed the most valuable results for samples enriched with 30% chokeberry, while Ultra Performance Liquid Chromatography (UPLC) analysis allowed the determination of the most important phenolic acids. Of interest, chokeberry addition decreased the fat absorption index (FAI) after expansion by frying. Moreover, the highest values of crude protein and crude ash were observed in snack pellets supplemented by the application of 30% chokeberry. In such samples, the crude protein content was at the level of 4.75–4.87 g 100 g−1 and crude ash content at 4.88–5.07 g 100 g−1. Moreover, saturated fatty acids (SFA) content was lower in snack pellets with chokeberry addition, and increasing the amount of chokeberry additive from 10% to 30% in extruded snack pellet recipes resulted in more than double an increase in polyunsaturated fatty acids (PUFA) proportion in the total fatty acids

Nutritional Characteristics of New Generation Extruded Snack Pellets with Edible Cricket Flour Processed at Various Extrusion Conditions

As new sources of proteins, edible insects may be excellent additives in a new generation of environmentally friendly food products that are nutritionally valuable, safe, sustainable, and are needed in today’s world. The aim of this study was to determine the effect of the application of cricket flour on extruded wheat-corn-based snack pellets’ basic composition, fatty acids profile, nutritional value, antioxidant activity and selected physicochemical properties. Results showed that the application of cricket flour had a significant impact on the composition and properties of snack pellets based on wheat-corn blends. In newly developed products, the enhanced level of protein and almost triple increase in crude fiber was found as an insect flour supplementation reached 30% level in the recipe. The level of cricket flour and the applied processing conditions (various moisture contents and screw speeds) significantly affect the water absorption and water solubility index and texture and color profile. Results revealed that cricket flour application significantly increased the total polyphenols content in the assessed samples in comparison to plain wheat-corn bases. Antioxidant activity was also noted to be elevated with increasing cricket flour content. These new types of snack pellets with cricket flour addition may be interesting products with high nutritional value and pro-health properties