Long-term survival following surgical ablation for atrial fibrillation concomitant to isolated and combined coronary artery bypass surgery-analysis from the polish national registry of cardiac surgery procedures (KROK)

The current investigation aimed to evaluate long-term survival in patients undergoing isolated and combined coronary artery bypass grafting (CABG) with concomitant surgical ablation for atrial fibrillation (AF). Procedural data from KROK (Polish National Registry of Cardiac Surgery Procedures) were retrospectively collected. Eleven thousand three hundred sixteen patients with baseline AF (72.4% men, mean age 69.6 ± 7.9) undergoing isolated and combined CABG surgery between 2006–2019 in 37 reference centers across Poland and included in the registry were analyzed. The median follow-up was four years (3.7 IQR 1.3–6.8). Over a 12-year study period, there was a significant survival benefit (Hazard Ratio (HR) 0.83; (95% Confidence Interval (CI): 0.73–0.95); p = 0.005) with concomitant ablation as compared to no concomitant ablation. After rigorous propensity matching (LOGIT model, 432 pairs), concomitant surgical ablation was associated with over 25% improved survival in the overall analysis: HR 0.74; (95% CIs: 0.56–0.98); p = 0.036. The benefit of concomitant ablation was maintained in the subgroups, yet the most benefit was appraised in low-risk patients (EuroSCORE < 2, p = 0.003) with the three-vessel disease (p < 0.001) and without other comorbidities. Ablation was further associated with significantly improved survival in patients undergoing CABG with mitral valve surgery (HR 0.62; (95% CIs: 0.52–0.74); p < 0.001) and in patients in whom complete revascularization was not achieved: HR 0.43; (95% CIs: 0.24–0.79); p = 0.006. View Full-Text

Transformation of a large multi-speciality hospital into a dedicated COVID-19 centre during the coronavirus pandemic

Introduction. The article describes the process of converting a large multi-specialized hospital into one dedicated to COVID-19 patients, and present established standards of work organization in all the wards and training system of the medical and supporting staff. The several weeks pandemic of the COVID-19 disease has forced the healthcare systems of numerous countries to adjust their resources to the care of the growing number of COVID-19 patients. Managers were presented with the challenge of protecting the healthcare workers from transmission of the disease within medical institutions, and issues concerning the physical and psychological depletion of personnel. Materials and method. Based on analyses of the structure and work processes in Central Clinical Hospital (CCH) reconstructive strategic plan was developed. It included: division of existing wards into observation and isolation wards; installing locks; weekly plan for supplying personal protection equipment (PPE); designating new access to the hospital and communication routes; training of medical and supporting staff. The plan was implemented from the first days of conversion of the hospital. Results. The wards of the CCH were converted for observation and isolation, and each one was fitted with sanitary locks. There was a big improvement in the supply of PPE for the medical staff. Separation of the ‘dirty’ and ‘clean’ parts of the CCH were attained, and widespread intensive training not only protected personnel against infections, but also diminished unrest which was discernable at the beginning of conversion. Conclusions. The transformation efforts will ultimately be appraised at the end of the epidemic, but the data looks encouraging. Two weeks after conversion, the testing of hospital Staff was started and by the end of April, 459 tests were had been conducted, of which only 11 were positive

Predictors of COVID-19 severity among pregnant patients

Coronavirus disease 2019 (COVID-19) was declared a pandemic and has spread around the globe, unsparingly affecting vulnerable populations. Effective prevention measures for pregnant women, who are particularly affected, include early identification of those patients at risk of developing in-hospital complications, and the continuous improvement of maternal-fetal treatment strategies to ensure the efficient use of health resources. The objective of our retrospective study was to determine which patient biomarkers on hospital admission correlate with disease severity as measured by disease course classification, the need for oxygen supplementation and higher demand for oxygen, the need for mechanical ventilation, intensive care unit admission, and length of hospital stay. Analysis of 52 PCR SARS-CoV-2 positive pregnant women revealed that the median date of hospital admission was the 30th gestational week, with dyspnoea, cough, and fever as the leading symptoms. The presence of diabetes and hypertension predisposed pregnant women to the severe course of illness. Lung involvement shown by CT scans on admission correlated with the greater clinical severity. The main laboratory predictors of disease progression were lymphocytopenia, hypocalcemia, low total cholesterol, low total protein levels, and high serum levels of C-reactive protein, ferritin, interleukin-6, glucose, lactate dehydrogenase, procalcitonin, and troponin I. Further research with a larger cohort of pregnant women is needed to determine the utility of these results for everyday practice

Dziedzictwo kulturowe. Edukacja. Historia. Dziedzictwo regionalne. Muzyka, literatura, sztuka i media

The following publication showcases research on national heritage by early career researchers from Poland. Articles included are related to the broad domain of pedagogy, spanning over social sciences or arts and humanities. Contributions represent both historical and contemporary insights from a range of disciplines: education, history, area studies, art and media studies. Various examples of national heritage are discussed from both Polish and general perspective. The aim of the book was to contribute to the process of inclusion of new researchers into interdisciplinary and intergenerational dialogue

Interdiffusion revisited

We define the volume density and basing on the Euler’s and Lagrange theorems derive the volume continuity equation. These fundamental formulae define the volume fixed frame of reference in the multicomponent, solid and liquid solutions. The volume velocity is a unique frame of reference for all processes namely, the mass diffusion, charge transport, heat flow, etc. No basic changes are obligatory in the foundations of linear irreversible thermodynamics except recognizing the need to add volume density to the usual list of extensive physical properties undergoing transport in every continuum. The volume fixed frame of reference allows the use of the Navier-Lamé equation of mechanics of solids. Proposed modifications of Navier-Lamé and energy conservation equations are self-consistent with the literature for solid-phase continua dating back to the classical experiments of Kirkendall and their interpretation by Darken. We do show that when Darken constraints are used the general formulae reduce to the Darken expression

Interdiffusion revisited

We define the volume density and basing on the Euler’s and Lagrange theorems derive the volume continuity equation. These fundamental formulae define the volume fixed frame of reference in the multicomponent, solid and liquid solutions. The volume velocity is a unique frame of reference for all processes namely, the mass diffusion, charge transport, heat flow, etc. No basic changes are obligatory in the foundations of linear irreversible thermodynamics except recognizing the need to add volume density to the usual list of extensive physical properties undergoing transport in every continuum. The volume fixed frame of reference allows the use of the Navier-Lamé equation of mechanics of solids. Proposed modifications of Navier-Lamé and energy conservation equations are self-consistent with the literature for solid-phase continua dating back to the classical experiments of Kirkendall and their interpretation by Darken. We do show that when Darken constraints are used the general formulae reduce to the Darken expression