Dwa przypadki wtórnej nadczynności przytarczyc u pacjentek z przewlekłą chorobą nerek leczonych wieloletnią dializoterapią o dramatycznym przebiegu. Czy wszystko zrobiliśmy dla tych chorych?

Typowe powikłania kostne u pacjentów z przewlekłą niewydolnością nerek wiążą się między innymi z podwyższonym metabolizmem kostnym, spowodowanym wtórną nadczynnością przytarczyc. W pracy przedstawiono dwa przypadki zaawansowanej wtórnej nadczynności przytarczyc u pacjentek dializowanych ze schyłkową chorobą nerek. W obu przypadkach zaobserwowano wysoki obrót kostny i dramatyczny przebieg w okresie długoterminowej obserwacji mimo wielokierunkowego leczenia (sewelamer, kalcymimetyki, paratyroidektomia). Na podstawie przypadków przedstawiono hipotetyczną koncepcję przyszłościowych prób leczenia takich pacjentów paricalcitolem połączonym z J131 (powcześniejszym zablokowaniu jodochwytności tarczycy preparatami jodu) w celu nieoperacyjnej inwolucji przytarczyc. Idea ta jest warta rozważenia, chociaż wymaga sprawdzenia możliwości wykonania stosownej syntezy i ewentualnych dalszych wielokierunkowych prób doświadczalnych oraz klinicznych.Typical bone complications in patients with impaired kidney are associated to the increased bone metabolism, caused by secondary hyperparathyroidism. In this report two cases of the advanced hyperparathyroidism in dialysed patients with end-stage kidney disease are presented. In both cases high bone turnover and dramatic course over the period of long-term follow-up was observed; in both patients multidirectional treatment was commenced including calimimetics, however, the outcome of the therapy was proved unsuccessful. Novel approach for the treatment of patients with end-stage kidney disease is necessary and may include both calicmimetics and/or vitamin D receptor activators. At the same time we present hypothetical conception of treatment with paricalcitol connected with J131 which can caused non-operative involution of parathyroid gland. We should consider this idea, although it would require an appropriate course of synthesis and research

An introduction to prediction with the use of artificial neural networks and statistical methods

Podejście statystyczne umożliwia prowadzenie prognoz zdarzeń lub procesów. Wyróżnia się modele regresyjne liniowe i nieliniowe, modele szeregów czasowych oraz modele neuronowe. Predykcja określa przewidywanie przyszłych cech statystycznych zdarzeń losowych, które można zmierzyć. Wyznacza prognozy dla maksymalizacji. Korzyści, jakie wynikają z prognozowania, to: porównywanie, grupowanie, analizowanie zmienności, określania trendów oraz wyznaczania prognoz uzyskanych wyników, z wykorzystaniem optymalnego wektora zmiennych niezależnych predyktorów do wyciągania sukcesywnych wniosków.The statistical approach allows the introduction of predictions of events or processes. Among these are linear and nonlinear regression models, time series models and neural models. Prediction is defined by the anticipation of future statistical characteristics of random events which can be measured, and designates forecasts for maximizing. The benefits which stem from prediction are comparison, grouping, analysis of variation, determinion of trends and setting forecasts of the results obtained with the use of an optimal vector of independent variables predictors for drawing successive conclusions

A Comparison of a Step Load Unilateral and Bilateral Resistance Training Program on the Strength and Power of the Lower Limbs in Soccer Players

The purpose of the investigation was to determine the influence of a four-week unilateral (UNI) and bilateral (BIL) resistance training program on peak torque and peak power of the lower limbs in soccer players. Background: We evaluated the effects of a 3:1 step load training program using UNI and BIL forms of exercises on the level of peak torque and peak power of the knee joint extensors and flexors. Methods: The study included 16 division I soccer players having the highest number of matches played in the first round of the season. The motor tests included isokinetic evaluation of peak torque and peak power of the extensors and flexors of the knee joint. Results: The results showed that both types of training sessions were equally effective. Only in terms of power during knee flexion, unilateral training contributed to improvement, whereas bilateral training did not. Conclusions: The use of periodization using a step load progression based on an extended eccentric phase of the movement during the preseason period in combination with UNI training may increase peak torque and peak power of knee flexors and extensors in soccer players

Analysis of the 30-m running speed test results in soccer players in third soccer leagues

The basic goal of this study was to analysis of the results of the 30-m running speed test in soccer players in third soccer leagues. The study examined the group of randomly selected seventy athletes from two soccer teams from the Ekstraklasa league, two teams from the first league and two teams from the second leagues were randomized into the study group. All the measurements were performed in indoor arenas. The temperature in the arenas ranged from 22 to 24 C. Measurements were recorded in the morning (between 10:00 am and 12:00 am). The Running Speed Test was used in the study to diagnose speed potential in the athletes. The running speed was measured by means of a set of photocells located at 0m, 5m, 20m, 30m. The results obtained demonstrated that the elite-level matches are more dynamic since the players show higher values of speed parameters. Apart from starting speed, the results obtained for the distance of 5 m provide information for coaches concerning their work on special strength. The speed is indicated by the results obtained for 20 and 30 m distances, whereas flying measurements between 5/20m and 20/30m reflect inherited speed aptitudes

Should Emergency Medical Service Stuff Use Respirators with Filtered Valve during the COVID-19 Pandemic?

Performing medical procedures with the use of personal protective equipment may reduce the efficiency of medical procedures performed [...

Analysis of the 30-m running speed test results in soccer players in third soccer leagues

The basic goal of this study was to analysis of the results of the 30-m running speed test in soccer players in third soccer leagues. The study examined the group of randomly selected seventy athletes from two soccer teams from the Ekstraklasa league, two teams from the first league and two teams from the second leagues were randomized into the study group. All the measurements were performed in indoor arenas. The temperature in the arenas ranged from 22 to 24 C. Measurements were recorded in the morning (between 10:00 am and 12:00 am). The Running Speed Test was used in the study to diagnose speed potential in the athletes. The running speed was measured by means of a set of photocells located at 0m, 5m, 20m, 30m. The results obtained demonstrated that the elite-level matches are more dynamic since the players show higher values of speed parameters. Apart from starting speed, the results obtained for the distance of 5 m provide information for coaches concerning their work on special strength. The speed is indicated by the results obtained for 20 and 30 m distances, whereas flying measurements between 5/20m and 20/30m reflect inherited speed aptitudes

Should emergency medical service stuff use respirators with filtered valve in COVID-19 pandemic?

Performing medical procedures with the use of personal protective equipment may reduce the efficiency of medical procedures performed, for example, as with the current use of respiratory protection devices, including N95 or surgical masks. Healthcare workers (HCWs) using N95 respirators or medical masks may experience discomfort associated with wearing a mask when performing medical procedures, in particular those associated with increased physical activity, causing increased respiratory effort

Combined Aerobic and Resistance Training Performed under Conditions of Normobaric Hypoxia and Normoxia Has the Same Impact on Metabolic Control in Men with Type 1 Diabetes

(1) Background: The aim was to assess whether combined aerobic and resistance training performed under hypoxic and normoxic conditions had an impact on diabetes control, VO2max (maximum oxygen consumption), and echocardiological and anthropometric parameters in men with long-term type 1 diabetes. (2) Methods: Sixteen male participants (mean age: 37 years, mean HbA1c (glycated hemoglobin): 7.0%) were randomly assigned to two groups: training in normoxic conditions or training in conditions of altitude hypoxia. All subjects participated in 60 min combined aerobic and resistance training sessions twice a week for 6 weeks. At baseline and in the 6th week, echocardiography, incremental exercise test, and anthropometric and diabetes control parameters were assessed. (3) Results: After 6 weeks, there was no significant change in HbA1c value in any group. We noted a more stable glycemia profile during training in the hypoxia group (p > 0.05). Patients in the hypoxia group required less carbohydrates during training than in the normoxia group. A comparable increase in VO2max was observed in both groups (p > 0.05). There were no significant differences in cardiological and anthropometric parameters. (4) Conclusions: Combined aerobic and resistance training improved VO2max after 6 weeks regardless of the conditions of the experiments. This exercise is safe in terms of glycemic control in patients with well-controlled diabetes

Intraosseous versus intravenous access while wearing personal protective equipment: a meta-analysis in the era of COVID-19

Background: Obtaining vascular access is one of the key procedures performed in patients in emergency settings. Aims: The study was conducted as a meta‑analysis and a systematic review and aimed to address the following question: which intravascular access method should be used in patients with COVID‑19 when wearing full personal protective equipment (PPE)? Methods: We performed a systematic search of PubMed, EMBASE, and CENTRAL databases for randomized controlled trials that compared intravascular access methods used by operators wearing full level C PPE. We evaluated procedure duration and the success rate of intraosseous and peripheral intravenous accesses. Results: Eight randomized controlled trials were included in quantitative synthesis. The use of PPE during intravascular access procedures had an impact on procedure duration in the case of intraosseous access (mean difference [MD], 11.69; 95% CI, 6.47–16.92; P < 0.001), as well as reduced the success rate of intraosseous access by 0.8% and intravenous access by 10.1%. Under PPE conditions, intraosseous access, compared with peripheral intravenous access, offered a shorter procedure time (MD, –41.43; 95% CI, –62.36 to –24.47; P < 0.001). Conclusion: This comprehensive meta‑analysis suggested that the use of PPE significantly extends the duration of intravascular procedures. However, under PPE conditions, operators were able to obtain intraosseous access in a shorter time and with a higher success rate than in the case of intravenous access

Hospital Audit as a Useful Tool in the Process of Introducing Falsified Medicines Directive (FMD) into Hospital Pharmacy Settings—A Pilot Study

Background: Recently, the European Union has introduced the Falsified Medicines Directive (FMD). Additionally, in early 2016, a Delegated Act (DA) related to the FMD was published. The main objective of this study was to evaluate the usefulness of external audits in the context of implementing new regulations provided by the FMD in the secondary care environment. Methods: The external, in-person workflow audits were performed by an authentication company in three Polish hospital pharmacies. Each audit consisted of a combination of supervision (non-participant observation), secondary data analysis, and expert interviews with the use of an independently designed authorial Diagnostic Questionnaire. The questionnaire included information about hospital drug distribution procedures, data concerning drug usage, IT systems, medication order systems, the processes of medication dispensing, and the preparation and administration of hazardous drugs. Data analysis included a thorough examination of hospital documentation in regard to drug management. All data were subjected to qualitative analysis, with the aim of generating meaningful information through inductive inference. Results: Only one dispensing location in the Polish hospitals studied has the potential to be a primary authentication area. In the audited hospitals, an Automated Drug Dispensing System and unit dose were not identified during the study. Hospital wards contained an enclosed place within the department dedicated to drug storage under the direct supervision of senior nursing staff. An electronic order system was not available. In the largest center, unused medications are re-dispensed to different hospital departments, or may be sold to various institutions. Additionally, in one hospital pharmacy, pharmacists prepared parenteral nutrition and chemotherapeutic drugs for patients admitted to the hospital. Conclusions: External audits might prove beneficial in the course of introducing new regulations into everyday settings. However, such action should be provided before the final implementation of authentication services. To sum up, FMD can impact several hospital departments