Percutaneous left atrial appendage closure for thromboembolic prophylaxis in patients with atrial fibrillation. The impact of operator’s experience on the procedure course

Background. Left atrial appendage (LAA) closure represents an alternative strategy to oral anticoagulants in thromboembolic prophylaxis in patients with atrial fibrillation (AF). The LAA closure with the WATCHMAN™ device has been proved to be non-inferior to warfarin therapy. Nevertheless, this strategy is associated with numerous periprocedural complications. This study was conducted to determine whether the experience of the operating team affects the duration of the procedure and its complication rate. Methods. This retrospective single-centre study examined LAA percutaneous closure procedures in 43 consecutive AF patients with contraindications to oral anticoagulation (13 female, 30 male; mean age 70.98 ± 10.69 years). All device implantations were performed by two operators using the WATCHMAN™ device and the result was assessed by two echocardiographers. We compared the first 22 (group A) with the subsequent 21 procedures (group B). Results. For group B, a decrease in the overall procedure time (PT) by 28% (from 83.41 min ± 36.49 to 59.76 min ± 21.70; p = 0.006) was found, with a subsequent reduction in fluoroscopy time (FT) by 33% (from 16.59 min ± 7.25 to 11.2 min ± 7.21; p = 0.019) and the volume of contrast medium (CV) by 40% (from 129.14 mL ± 79.81 to 78.05 mL ± 33.82; p = 0.004). The incidence of periprocedural adverse events and complications was 55% (12 patients) in group A and 33% (7 patients) in group B. Conclusions. The increasing operators’ and echocardiographers’ experience in LAA closure is associated with reduction in procedure time, fluoroscopy time and contrast volume

Memory of the past in the activities of national and ethnic minorities of the Silesian Voivodeship (selected examples)

Organizations of national and ethnic minorities have been subjected to research analysis. They are discussed in many contexts, yet, there is a lack of studies devoted to memory-forming aspects. The aim of the research was to show the activity of minority communities in the Silesian Voivodeship. Their activities aimed at consolidating the memory of generations were presented, showing initiatives of a material and spiritual nature.Organizacje mniejszości narodowych i etnicznych są przedmiotem analiz badawczych. Omawia się je w wielu kontekstach, ale brakuje opracowań poświęconych aspektom pamięciotwórczym. Celem badań było ukazanie aktywności tego typu towarzystw na terenie województwa śląskiego. Zaprezentowano ich działania zmierzające do utrwalenia pamięci o pokoleniach, pokazując inicjatywy o charakterze materialnym i duchowym

Population Genetic Study on the European Flounder (<i>Platichthys flesus</i>) from the Southern Baltic Sea Using SNPs and Microsatellite Markers

The European flounder (Platichthys flesus), which is closely related to the recently discovered Baltic flounder (Platichthys solemdali), is currently the third most commercially fished species in the Baltic Sea. According to the available data from the Polish Fisheries Monitoring Center and fishermen’s observations, the body condition indices of the species in the Baltic Sea have declined in recent years. The aim of the present study was to obtain information on the current patterns of genetic variability and the population structure of the European flounder and to verify whether the Baltic flounder is present in the southern Baltic Sea. Moreover, we aimed to verify whether the observed decline in the body condition indices of the species in the Baltic Sea might be associated with adaptive alterations in its gene pool due to increased fishing pressure. For this purpose, 190 fish were collected from four locations along the central coastline of Poland, i.e., Mechelinki, Władysławowo, the Vistula Lagoon in 2018, and the Słupsk Bank in 2020. The fish were morphologically analyzed and then genetically screened by the application of nineteen microsatellite DNA and two diagnostic SNP markers. The examined European flounder specimens displayed a high level of genetic diversity (PIC = 0.832–0.903, I = 2.579–2.768). A lack of significant genetic differentiation (Fst = 0.004, p > 0.05) was observed in all the examined fish, indicating that the European flounder in the sampled area constitutes a single genetic cluster. A significant deficiency in heterozygotes (Fis = 0.093, p Ne) among the sampled fish groups varied from 712 (Słupsk Bank) to 10,115 (Władysławowo and Mechelinki). However, the recorded values of the Garza–Williamson indicator (M = 0.574–0.600) and the lack of significant (p > 0.05) differences in Heq > He under the SMM model did not support the species’ population size changes in the past. The applied SNP markers did not detect the presence of the Baltic flounder among the fish sampled from the studied area. The analysis of an association between biological traits and patterns of genetic diversity did not detect any signs of directional selection or density-dependent adaptive changes in the gene pool of the examined fish that might be caused by increased fishing pressure

Impact of Hormonal Replacement Therapy on Bone Mineral Density in Premature Ovarian Insufficiency Patients

Premature ovarian insufficiency (POI) is a type of hypergonadotropic hypogonadism caused by impaired ovarian function before the age of 40. Due to the hypoestrogenism, women with POI experience a variety of health complications, including an increased risk of bone mineral density loss and developing osteopenia and osteoporosis, which poses an important problem for public health. Purpose: The aim of this study was to evaluate and compare the values of bone mineral density (BMD), T-score and Z-score within the lumbar spine (L1-L4) using the dual energy X-ray absorptiometry method. The dual-energy X-ray absorptiometry (DXA) scans described in this original prospective article were performed at the time of POI diagnosis and after treatment with sequential hormone replacement therapy (HRT). Materials and methods: This study included 132 patients with a mean age of 31.86 &plusmn; 7.75 years who had been diagnosed with idiopathic POI. The control group consisted of 17 healthy women with regular menstrual cycles, with a mean age of 23.21 &plusmn; 5.86 years. Serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), 17-estradiol (E2), prolactin (PRL), testosterone (T), dehydroepiandrosterone sulfate (DHEA-S), thyroid-stimulating hormone (TSH), free thyroxine (fT4), insulin, and fasting serum glucose were measured. Lumbar spine (L1-L4) BMD was assessed by means of dual-energy X-ray absorptiometry. DXA scans were performed at the time of diagnosis and following treatment with sequential hormone replacement therapy (HRT) comprised of daily oral 2 mg 17-&beta;-estradiol and 10 mg dydrogesterone. The mean time of observation was 3 &plusmn; 2 years. Results: Patients in the POI group presented with characteristic hypergonadotropic hypogonadism. They had a significantly decreased mean lumbar spine BMD when compared to healthy controls (1.088 &plusmn; 0.14 g/cm2) vs. 1.150 &plusmn; 0.30 g/cm2) (p = 0.04) as well as a decreased T-score (0.75 &plusmn; 1.167 vs. &minus;0.144 &plusmn; 0.82) (p = 003). There was a significant increase in BMD (1.088 &plusmn; 0.14 vs. 1.109 &plusmn; 0.14; p &lt; 0.001), T-score (&minus;0.75 &plusmn; 1.17 vs. &minus;0.59 &plusmn; 1.22; p &lt; 0.001), and Z-score (&minus;0.75 &plusmn; 1.12 vs. &minus;0.49 &plusmn; 1.11; p &lt; 0.001) after the implementation of HRT when compared to pre-treatment results. Conclusions: In conclusion, this study has demonstrated that patients with POI often have decreased bone mineral density and that the implementation of HRT has a significant and positive influence on bone mass. The implementation of full-dose HRT and monitoring of bone status is particularly important in these patients