Conclusions

The project was finances by the Polish National Science Centre (Agreement No. UMO-2013/11B/HS5/04121)

Performance of subsurface vertical flow constructed wetlands receiving municipal wastewater

The efficiency of pollution removal from municipal sewage in two vertical flow constructed wetlands consisting of gravel filters with a surface area of 4 × 5 m, depth 60 cm, planted with reed (Phragmites) was assessed over a period of about two years. The flow of wastewater was 50 mm per day. Wastewater underwent only primary treatment before application to reed bed B, but reed bed A was supplied with wastewater after mechanical and biological treatment. Measurements were taken of sewage supply and discharge, precipitation and wastewater temperatures. The main indicator of efficiency was the elimination of suspended solids, BOD5, nitrogen and phosphorus from the wastewater during treatment. The elimination of the pollution load was 2-25g O2 per square meter per day for the BOD5 and 0-3.5 g per square meter per day for so-called "total nitrogen". Rates of pollution removal were between 2 and 4 times as high in bed B (after primary treatment) as in bed A (after biological treatment), but the loading rate of bed B was also substantially higher. The rate of BOD5 removal and the coefficient k for BOD5 were greatly dependent on temperature for reed bed B (primary treatment); less so for bed A (biological treatment). The difference between summer and winter temperatures indicates that the surface area of constructed wetland B with wastewater after mechanical treatment should be about 3 times greater during winter, to obtain the summer rate of BOD5 pollution removal in the climatic conditions of Northern Poland (54oN)

Early recanalisation of middle cerebral artery in thrombolytic therapy of cardiogenic stroke - a case study

Udary niedokrwienne stanowią 85–90% udarów mózgu, większość z nich to rezultat niedrożności tętnic mózgowych lub szyjnych. Wysoka śmiertelność oraz znaczny odsetek chorych obarczonych trwałym inwalidztwem wskazują na konieczność poszukiwania skuteczniejszych form terapii. Tromboliza mózgowa pozwala na istotne zmniejszenie deficytu neurologicznego. W pracy przedstawiono przypadek 54-letniego mężczyzny, u którego zastosowano leczenie trombolityczne w przebiegu kardiogennego ogniska niedokrwiennego mózgu w dorzeczu tętnicy mózgu środkowej. Poprawa stanu neurologicznego (regresja objawów ogniskowych) nastąpiła już w pierwszej godzinie leczenia i.v. rekombinowanym tkankowym aktywatorem plazminogenu (rt-PA). Rekanalizację tętnicy mózgu środkowej potwierdzono badaniem przezczaszkowej ultrasonografii dopplerowskiej.Acute ischaemic stroke constitutes 85–90% of all stroke subtypes. Majority of brain ischaemia results from cerebral or carotid arteries occlusion. High mortality and invalidity due to stroke are still unsatisfactory. Thrombolytic therapy enables recovery improvement and significant reduction of neurological deficits. In this report we present a case of 54-year-old male with ischaemic stroke of cardiogenic origin in territory of middle cerebral artery. Significant neurological recovery was observed during the first hour of i.v. rt-PA infusion. Recanalisation of middle cerebral artrery was confirmed with Transcranial Doppler examination

Vaccination against influenza among medical students of selected Medical Universities in Poland in the 2014/2015 influenza season

Vaccinations against influenza are one of the most beneficial elements of prevention. Adoption of measures to popularize vaccination among reluctant to be vaccinated against influenza Polish population, especially in the environment of future doctors should be one of the priorities in the universities. The article analyzes the level of basic knowledge, opinions and declared behaviors related to influenza and its prevention among medical students of selected Medical University in Poland. The study included 1,031 individuals during the 2014/2015 epidemic. It represented a diverse population of sex, age, place of residence. For the purpose of the research an original questionnaire was used. The results were subjected to statistical analysis, which reveals that only 76 individuals got inoculated against influenza, which accounted for only 7.37% of the study population of students studying in various academic centers in Poland. Analysis of own research shows that regularly over the last five influenza seasons only 70 individuals (6.79%) have got inoculated, while the vast majority – 72.45% of the population did not get inoculated at all, and 20.75% occasionally declared inoculation against the influenza. Despite seasonal influenza epidemics, undertaken educational and preventive tests among vulnerable group rather a pessimistic picture emerges of the Polish population

Zastosowanie bronchoskopii w diagnostyce zakażeń układu oddechowego

Bronchoskopia została wprowadzona do praktyki klinicznej przed ponad 100 laty. Dzięki postępowi technicznemu dzisiejsze zabiegi bronchoskopowe nie ograniczają się tylko do światła tchawicy i pierwszych generacji oskrzeli, ale pozwalają także na uzyskanie obrazów i pobranie materiałów diagnostycznych z obwodowych dróg oddechowych oraz struktur położonych poza światłem oskrzeli. Dostępne dziś techniki bronchoskopowe, takie jak płukanie oskrzelowo-pęcherzykowe, chroniona szczoteczka mikrobiologiczna, transbronchialna biopsja płuca i węzłów chłonnych, pozwalają na wykorzystanie bronchoskopii jako metody diagnostycznej w różnych postaciach zakażeń dolnych dróg oddechowych. Należą do nich m.in. wewnątrzszpitalne zapalenia płuc, w których pozyskanie wysokiej jakości materiału diagnostycznego z dolnych dróg oddechowych pozwala na odpowiednie ukierunkowanie leczenia. Inną, ważną grupę chorych, u których bronchoskopia jest rutynowo wykorzystywana w diagnostyce zakażeń dolnych dróg oddechowych stanowią pacjenci z zaburzeniami odporności. Ze względu na postęp medycyny liczebność tej grupy systematycznie się zwiększa, co w konsekwencji skutkuje większą liczbą oportunistycznych zakażeń dolnych dróg oddechowych. Bronchoskopia odgrywa kluczową rolę w diagnostyce tych zakażeń. Przykład stanowią biorcy przeszczepu płuca, u których bronchoskopia pozwala na monitorowanie procesu odrzucania i różnicowania tego procesu z zakażeniami. Bronchoskopia odgrywa również ważną rolę w diagnostyce zakażeń prątkami gruźliczymi i niegruźliczymi. W tej grupie chorych ma ona szczególne znaczenie u pacjentów niepotrafiących wykrztusić plwociny do badań mikrobiologicznych

The role of bronchoscopy in the diagnosis of lower respiratory tract infections

Bronchoscopy was introduced into clinical practice over 100 years ago. Due to technological advances, diagnostic capabilities of current bronchoscopy are not limited to the trachea and proximal bronchi but also include the peripheral airways as well as various anatomical structures located outside the bronchi. A wide range of available techniques that include bronchoalveolar lavage, protected microbiological brush, transbronchial biopsy of the lungs and mediastinal lymph nodes makes bronchoscopy useful in diagnosing various lower respiratory tract infections. For example, the collection of high quality biological samples for microbiological examination plays a crucial role when treating patients with nosocomial pneumonia. Bronchoscopy may provide the samples directly from the site of infection. In immunocompromised hosts bronchoscopy is routinely used as the diagnostic tool in lower respiratory tract infections. Due to implementation of novel therapies, the number of immunocompromised patients is steadily increasing, hence there are growing needs for effective diagnosis of opportunistic pulmonary infections. In the specific group of lung transplant recipients, bronchoscopy play a crucial role in monitoring the rejection process and also in differentiating between the rejection and pulmonary infections. Bronchoscopy is also useful in diagnosing tuberculosis or nontuberculous pulmonary infections. This particularly refers to patients who are unable to produce sputum for microbiological examination

Nucleus accumbens as a stereotactic target for the treatment of addictions in humans: a literature review

Deep brain stimulation (DBS) has achieved substantial success as a treatment for movement disorders such as Parkinson’s Disease (PD), essential tremor (ET), and dystonia. More recently, a limited number of basic and clinical studies have indicated that DBS of the nucleus accumbens (NAc) and other neighbouring structures of the reward circuit may be an effective intervention for patients with treatment-refractory addiction. We performed a structured literature review of human studies of DBS for addiction outlining the clinical efficacy and adverse events. We found 14 human studies targeting mostly the NAc with neighbouring structures such as anterior limb of the internal capsule (ALIC). Five studies including 12 patients reported the outcomes for alcohol dependence. Nine studies including 18 patients reported the outcomes for addictions to various psychoactive substances. The most common indication was addiction to heroin, found in 13 patients, followed by methamphetamine, 3 patients, cocaine, one patient, and polysubstance drug abuse in one patient. The limited clinical data available indicates that DBS may be a promising therapeutic modality for the treatment of intractable addiction. In general, the safety profile of DBS in patients with addiction is good. Based on the data published in the literature, the NAc is the most often targeted, and is probably the most effective, structure of the reward circuit in the treatment of addiction in humans. Given the ever-expanding understanding of the psychosurgery of addiction, DBS could in the future be a treatment option for patients suffering from intractable addictive disorders