Polish paralympic sports in the opinion of athletes and coaches in retrospective studies

The study aimed to identify the limitations observed in Polish Paralympic sport depending on the environment in which athletes train on a daily basis. The study included 581 persons divided into two basic groups. The first group consists of athletes (n = 324) and coaches (n = 88) appointed to the national team by associations and unions providing sports training exclusively for athletes with disabilities. The second group consisted of athletes with disabilities (n = 146) and their coaches (n = 23), who work in national sports associations working for both able-bodied and disabled people. The study used the diagnostic survey method with a questionnaire developed by Sobiecka. The difficulties indicated by the respondents referred to various aspects related to the activity in professional sport. Particularly emphasised difficulties were related to organizational and financial limitations as well as the management and coaching staff. At the same time, it was demonstrated that the environment was a differentiating factor between the studied groups of athletes and coaches

Medical aspect of the preparation for the 2016 Summer Paralympics in the opinion of athletes and their coaches

Systematyczne badania naukowe przeprowadzane w polskim środowisku paraolimpijskim wykazały, iż poważnym a zarazem negatywnym zjawiskiem, wpływającym na warunki uprawiania sportu przez osoby z niepełnosprawnością, jest brak profilaktyki oraz dostępu do szeroko rozumianej opieki medycznej. Celem badań była ocena warunków w zakresie opieki medycznej, w jakich przygotowywali się zawodnicy i zawodniczki do udziału w XV Letnich Igrzyskach Paraolimpijskich w Rio de Janeiro 2016, z uwzględnieniem środowiska sportowego (polskich związków sportowych i ogólnopolskich organizacji sportowych działających wyłącznie dla osób z niepełnosprawnością), w którym na co dzień trenowali. Badaniami objęto łącznie 80 sportowców z uszkodzeniem narządu ruchu oraz z dysfunkcją wzroku (28 zawodniczek i 52 zawodników), a także 25 szkoleniowców (3 kobiety i 22 mężczyzn), zakwalifikowanych do kadry paraolimpijskiej. Wśród badanych wyodrębniono cztery grupy: pierwsza liczyła 22 paraolimpijczyków wywodzących się z sześciu polskich związków sportowych, druga - 58 sportowców zrzeszonych w ogólnopolskich organizacjach prowadzących szkolenie sportowe tylko dla zawodniczek i zawodników z określonymi dysfunkcjami, trzecia - 9 szkoleniowców reprezentacji paraolimpijskiej powołanych przez władze polskich związków, a czwarta - 16 trenerów, przedstawicieli ogólnopolskich organizacji sportowych pracujących jedynie z osobami z niepełnosprawnością. W badaniach posłużono się metodą sondażu diagnostycznego, wykorzystując kwestionariusz ankiety Jadwigi Kłodeckiej-Różalskiej, który za zgodą autorki zmodyfikowano na potrzeby sportu niepełnosprawnych. Składał się on z dwóch części: pierwsza obejmowała 2 pytania otwarte i 23 zamknięte, a druga - "metryczka" - zawierała informacje o cechach społeczno-demograficznych oraz sportowych badanych osób. Następnie z kwestionariusza wyodrębniono opinie dotyczące wyłącznie aspektu przygotowania medycznego, które skategoryzowano. Do analizy danych wykorzystano metody statystyki opisowej oraz metody wnioskowania statystycznego. Ponadto w każdej grupie badanych (sportowców i szkoleniowców) uwzględniono środowisko sportowe. Otrzymane wyniki pozwoliły na stwierdzenie, iż podczas przygotowań paraolimpijskich nie zapewniono opieki medycznej wszystkim osobom powołanym do kadry narodowej. Poza tym wypowiedzi zawodniczek i zawodników polskiej reprezentacji, a także ich szkoleniowców, w sprawie odbywania regularnych badań w zakresie medycyny sportowej w okresie przygotowań paraolimpijskich Rio de Janeiro 2016, były zróżnicowane w poszczególnych środowiskach sportowych. Badania ujawniły również - obok pozytywnych - opinie niezadowalające sportowców, bądź ich szkoleniowców, w zakresie efektów realizowania opieki lekarskiej oraz współpracy z dietetykiem i fizjologiem. Natomiast zbliżone oceny pozytywne (o zróżnicowanym poziomie), wyrażone zarówno przez sportowców jak i szkoleniowców z obydwu środowisk sportowych, dotyczyły tylko dostępu do opieki lekarskiej oraz współpracy z psychologiem.Systematic scientific research conducted in the Polish Paralympic environment revealed a serious and negative phenomenon of the lack of prevention and access to medical care in the broad sense of the term that has an effect on conditions of practising sports by people with disabilities. The aim of the study was to assess the conditions of medical care during preparation of athletes for participation in the 15th Summer Paralympic Games in Rio de Janeiro in 2016, taking into account the athletic environment (Polish sports associations and national sports organizations operating exclusively for people with disabilities) in which they practised on a daily basis. The study covered a total of 80 athletes with musculoskeletal disorders and vision impairments (28 female and 52 male athletes) and 25 coaches (3 women and 22 men), qualified for the Paralympic team. The participants were divided into four groups: the first group consisted of 22 Paralympians from six Polish sports associations, the second group consisted of 58 athletes associated in national organizations providing sports training only for female and male athletes with specific dysfunctions, the third group was 9 coaches of the Paralympic national team appointed by the Polish authorities, and the fourth group was 16 coaches, representatives of national sports organizations working only for people with disabilities. A diagnostic survey method was employed in the study, based on the questionnaire prepared by Jadwiga Kłodecka-Różalska, which, with the author’s consent, was adjusted to the needs of disabled sports. It consisted of two parts: the first one consisted of 2 open and 23 closed questions, whereas the second one contained respondent data about sociodemographic and athletic characteristics of the athletes. Next, the opinions concerning only the aspect of medical preparation were separated from the questionnaire and categorized. The data were analysed by means of descriptive statistics and statistical reasoning methods. Furthermore, athletic environment was taken into account in each study group (athletes and coaches). The results led to the conclusion that during Paralympic preparations, adequate medical care was not provided to all athletes appointed to the national team. Furthermore, the statements of the athletes from the Polish national team and their coaches concerning the regular sports medical examinations during the period of preparations for the Paralympic Games in Rio de Janeiro in 2016 were differentiated in individual athletic environments. Besides positive statements, the survey also found unsatisfactory opinions of athletes or their coaches regarding the effects of medical care and working with dieticians and physiologists. Similar positive assessments (at different levels), expressed by both athletes and coaches from both athletic environments, concerned only the access to medical care and working with a psychologist

Standards of conditions during preparations for the Summer Paralympic Games between 2004 and 2012 assessed by Polish athletes

The quality of training conditions affects sporting success, injuries and health. The aim of the work was to present the conditions during the preparations of Polish athletes for the Summer Paralympic Games 2004–2012. The study encompassed 271 paralympians: Athens (91), Beijing (89) and London (91), competing in 13 disciplines. The research was based on a two-part questionnaire by Kłodecka-Różalska adjusted for disabled sports, and was conducted one month before each PG. Part 1 contained 20 closed-ended questions regarding conditions during preparations, while Part 2 concerned socio-demographic and sports-related data. Three levels of conditions: good, satisfactory and poor, were identified. The analysis showed that while the relationships between the athletes were good in all the preparatory periods, the co-operation with the paralympic coaches worsened. The standards of accommodation, food and sports facilities lowered. Personal orthopaedic supply was satisfactory in London; personal sporting equipment was good at all PG. The quality of medical care was the highest in London. The co-operation with physicians, physiotherapists and massage therapists was satisfactory. Consultations with the dietician were sporadic and assessed as poor. Psychological consultations were rare but satisfactory in Beijing and London. Contacts with the mass media were poor at all PG. Although combining private life, work, and education with sport was satisfactory, it was increasingly difficult to manage, particularly before London. The conditions during preparations for the PG 2004–2012 varied. Improvement was noticed only in the quality of medical care and personal orthopaedic supply

Fenofibrate reduces the asthma-related fibroblast-to-myofibroblast transition by TGF-Β/Smad2/3 signaling attenuation and connexin 43-dependent phenotype destabilization

The activation of human bronchial fibroblasts by transforming growth factor-β1 (TGF-β1) leads to the formation of highly contractile myofibroblasts in the process of the fibroblast–myofibroblast transition (FMT). This process is crucial for subepithelial fibrosis and bronchial wall remodeling in asthma. However, this process evades current therapeutic asthma treatment strategies. Since our previous studies showed the attenuation of the TGF-β1-induced FMT in response to lipid-lowering agents (e.g., statins), we were interested to see whether a corresponding effect could be obtained upon administration of hypolipidemic agents. In this study, we investigated the effect of fenofibrate on FMT efficiency in populations of bronchial fibroblasts derived from asthmatic patients. Fenofibrate exerted a dose-dependent inhibitory effect on the FMT, even though it did not efficiently affect the expression of α-smooth muscle actin (α-SMA; marker of myofibroblasts); however, it considerably reduced its incorporation into stress fibers through connexin 43 regulation. This effect was accompanied by disturbances in the actin cytoskeleton architecture, impairments in the maturation of focal adhesions, and the fenofibrate-induced deactivation of TGF-β1/Smad2/3 signaling. These data suggest that fenofibrate interferes with myofibroblastic differentiation during asthma-related subepithelial fibrosis. The data indicate the potential application of fenofibrate in the therapy and prevention of bronchial remodeling during the asthmatic process

Mechanical thrombectomy in acute stroke – Five years of experience in Poland

Objectives Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. Methods and results We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. Results Most of the CSCs (74%) were founded at University Hospitals and most (65.2%) work round the clock. In 78.3% of them, the working teams are composed of neurologists and neuro-radiologists. All CSCs perform CT and angio-CT before MT. In total 586 patients were subjected to MT and data from 531 of them were analyzed. Mean time laps from stroke onset to groin puncture was 250±99min. 90.3% of the studied patients had MT within 6h from stroke onset; 59.3% of them were treated with IV rt-PA prior to MT; 15.1% had IA rt-PA during MT and 4.7% – emergent stenting of a large vessel. M1 of MCA was occluded in 47.8% of cases. The Solitaire device was used in 53% of cases. Successful recanalization (TICI2b–TICI3) was achieved in 64.6% of cases and 53.4% of patients did not experience hemorrhagic transformation. Clinical improvement on discharge was noticed in 53.7% of cases, futile recanalization – in 30.7%, mRS of 0–2 – in 31.4% and mRS of 6 in 22% of cases. Conclusion Our results can help harmonize standards for MT in Poland according to international guidelines

Pentoxifylline and its active metabolite lisofylline attenuate transforming growth factor \beta1-induced asthmatic bronchial fibroblast-to-myofibroblast transition

Bronchial asthma is characterized by persistent airway inflammation and airway wall remodeling. Among many different cells and growth factors triggering changes in bronchi structure, transforming growth factor β1-induced fibroblast to myofibroblast transition is believed to be very important. The aim of this study was to evaluate whether theophylline (used in asthma therapy) and two other methylxanthines (pentoxifylline and its active metabolite lisofylline), may affect transforming growth factor β1-induced fibroblast to myofibroblast transition in bronchial fibroblasts derived from asthmatic patients. We show here for the first time that selected methylxanthines effectively reduce transforming growth factor β1-induced myofibroblast formation in asthmatic bronchial fibroblast populations. PTX was found to be the most effective methylxanthine. The number of differentiated myofibroblasts after PTX, LSF and THEO administration was reduced at least twofold. Studies on the use of methylxanthines opens a new perspective in the development of novel strategies in asthma therapy through their two-pronged, anti-inflammatory and anti-fibrotic action. In the future they can be considered as promising anti-fibrotic drugs