Kicz w języku plastycznym sztuki religijnej – kryzys czy świadome działanie?

Autor przedstawia rozważania na temat obecności kiczu i przyczyn jego rozwoju w sztuce religijnej. Kicz wkrada się bowiem do niej od stuleci i z różnym nasileniem osłabia, deprecjonuje, niszczy. A może patologia kiczowatości została zaakceptowana i już nie stanowi moralnych dylematów?Udostępnienie publikacji Wydawnictwa Uniwersytetu Łódzkiego finansowane w ramach projektu „Doskonałość naukowa kluczem do doskonałości kształcenia”. Projekt realizowany jest ze środków Europejskiego Funduszu Społecznego w ramach Programu Operacyjnego Wiedza Edukacja Rozwój; nr umowy: POWER.03.05.00-00-Z092/17-00

ANALYSIS OF VIBROACOUSTIC SIGNALS RECORDED IN THE PASSENGER LIFT CABIN

The analysis of private tests is presented in the article. The applicable tests refer to accelerations, the level of the sound pressure as well as to the sound power emitted by the passenger lift cabin at different technical conditions of the lift. For a group of lifting devices the accelerations were tested at three axes with the use of an accelerometer. The accelerometer was placed in the central part of the cabin with simultaneous measurement of the acoustic parameters with the sound analyzer equipped with the sound volume double microphone probe. The attempt was made to determine the impact of the frame - cabin system construction as well as the lift technical condition on the recorded parameters. It can allow to establish the limit values of the lift structure parameters under which a rapid drop of comfort takes place while travelling in the lift as well as to indicate those construction elements the modification of which would affect the improvement of the operation noiselessness

Lead extraction: The road to successful cardiac resynchronization therapy

Background: Still increasing life expectancy in patients with implanted devices and large number of leads more and more often induce the need to cure the treatment complications or to change especially to cardiac resynchronization therapy (CRT). In order to prevent further complications, the possibility of damaged or redundant leads extraction should be taken into consideration. The aim of the paper was to assess the effectiveness and safety of transvenous lead extraction (TLE) with co-implantation of resynchronization systems. Methods and results: Between 2008 and March 2013, the system removal with TLE was conducted in 246 patients. In 38 patients (11 women, 28.9%), aged 43–79 (mean 65 years), it was combined with co-implantation of CRT-pacemaker or defibrillator (CRT-P/D). Indica­tions for TLE covered: lead failure in 21 (55.3%) patients, redundant leads in 6 (15.8%), and the occluded venous system in 7 (18.4%). The up-grade of the pacemaker or defibrillator system to CRT-D was performed in 19 cases, CRT-P/D revision in next 19. Together 32 defibrillation leads and 42 pacing leads (27 left ventricular leads, and 1 epicardial lead) were implanted. The intended clinical target — an effective resynchronization therapy — was obtained in all patients. There was no case of death or severe complications. In 2 cases of venous occlusion, the implantation on the contralateral side was required. Conclusions: TLE enables effective resynchronization therapy also in the case of the presence of too many leads, occlusion of the venous system or lead failure. Significant technical problems can occur especially in patients with venous system occlusion

The effectiveness of transvenous leads extractions implanted more than 10 years before

Background: The increasing number of patients with cardiac implantable electronic devices (CIEDs) causes a rise in the absolute percentage of individuals qualifying for a transvenous lead extraction (TLE) due to infectious, vascular or lead failure related indications. As the survival time prolongs, TLE procedures more and more often concern the electrodes of long- -term functioning. Authors provide a retrospective analysis of the effectiveness and safety of TLE performed on leads implanted at least 10 years before the extraction. Methods: Between 2008 and 2012 we performed TLE of 364 electrodes in 217 patients. Out of these, 66 (18.1%) leads in 43 (19.8%) patients had been implanted for at least 10 years. The mean dwelling time for electrodes was 161 months (120 to 330). In 62% of cases CIED-related infection was an indication for TLE. The following extracting techniques were used: manual direct traction, device traction, mechanical telescopic sheaths, autorotational cutting sheaths and femoral approach. Results: Fifty-eight pacemakers and 8 defibrillating leads were extracted. Sixty-three (95%) completely, in the remaining 3 cases the clinical success was achieved with the small portion of the lead left into the vascular space. No major procedure complications were observed; minor complications were found in 3 (6%) patients. Conclusions: TLE with the use of various endovascular techniques is an effective and safe method for treating infectious, vascular and mechanical complications of long-lasting CIEDs therapy.

Occurrence and extraction of implantable cardioverter-defibrillator leads with conductor externalization

   Background: The increasing number of patients with implantable cardioverter-defibrillators (ICD) contributes to the rising number of patients qualifying for a transvenous lead extraction (TLE) due to infection, vascular or lead failure related indications. The purpose of this study was to perform a retrospective analysis of the occurrence of conductor externalization in TLE patients and to assess the success rate in the extraction of these leads. Methods: TLE procedure was performed between 2012 and 2014 of 428 electrodes in 259 patients. Out of these, 143 (33.4%) leads in 138 (52.9%) patients were ICD leads. The indications for the TLE in ICD patients were: infection in 37 patients, lead failure in 84 patients, and others in 17 patients. Conductor externalization was observed in 8 ICD leads (5.6%) in 8 (5.8%) patients. The mean dwell­ing time for externalized leads was 87.9 (55 to 132) months compared to 60.1 (3 to 246) months of the remaining 135 ICD leads (p = 0.0329). All externalized leads were successfully and completely extracted using device traction, mechanical telescopic sheaths and/or autorotational cutting sheaths. No complica­tions of lead extraction procedures were observed in 8 patients with externalization. Results: Patients with lead externalization were often in a better New York Heart Association func­tional class (I or II) compared to those in the rest of the study group (p = 0.0212). Conclusions: Conductor externalization is a rare finding in patients undergoing TLE. This occurs with different manufacturers and lead types. In this complication transvenous lead extraction with the mechanical extraction tools can be safely performed.

Vismodegib in the treatment of basal cell carcinoma — Polish clinical experience in the frame of therapeutic program

Introduction. Vismodegib is a small-molecule inhibitor of the sonic hedgehog pathway, registered for the treat- ment of patients with metastatic or locally advanced basal cell carcinoma, who were disqualified from surgical excision or radiotherapy. The full treatment refund from the National Health Fund has been available in Poland since 1st January 2018. The aim of the study was to analyse the frequency of occurrence of adverse events based on CTCAE and the treatment results based on the RECIST 1.1 criteria, in a group of patients treated for six or 12 months with vismodegib.  Material and methods. The patient database was gathered from three sites and consisted of 42 patients, who represented 53.8% of the patients treated with vismodegib in Poland. The duration of the treatment ranged between three weeks and 68 months. The median of the treatment period was 8.25 months (0.75–68); the median of the observation of patients treated for less than 12 months was eight months (6–11), and for those treated for more than 12 months it was 14 months (12–68).  Results. The summary of the treatment results after six and 12 months was performed on 29/42 and 17/42 patients accordingly. Complete response was achieved in 3/29 (10.3%) and 3/16 (17.6%) patients after six and 12 months of treatment, respectively, partial response in 13/29 (44.8%) and 5/16 (29.4%) patients, respectively, and stable disease in 13/29 (44.8%) and 8/16 (50.0%) patients, respectively. Progression of the disease was experienced by 7/42 (16.6%) patients within the period of 3–28 months of treatment. One patient with brain metastases died due to the progression of the disease. Adverse events were reported in 31/42 (73.8%) patients, more than one adverse event in a single patient was reported in 22/42 (52.3%) patients. No serious adverse events were observed.

Wismodegib w leczeniu zaawansowanego raka podstawnokomórkowego skóry — polskie doświadczenia kliniczne w ramach programu lekowego

Wstęp. Wismodegib to małocząsteczkowy inhibitor szlaku sygnałowego Hedgehog zarejestrowany do leczenia pacjentów, u których stwierdzono raka podstawnokomórkowego w fazie choroby przerzutowej lub miejscowo zaawansowanego raka podstawnokomórkowego niespełniającego kryteriów leczenia chirurgicznego lub radiote- rapeutycznego. Od 1 stycznia 2017 roku dostępne jest na terenie Polski leczenie w ramach programu lekowego refundowanego przez NFZ.  Celem pracy była analiza grupy chorych zakwalifikowanych do terapii wismodegibem, uwzględniająca ocenę częstości występowania działań niepożądanych wraz z określeniem ich stopnia nasilenia według CTCAE oraz wyniki leczenia po 6 i 12 miesiącach zgodnie z kryteriami RECIST 1.1. Materiał i metody. Dane dotyczące chorych pochodziły z trzech ośrodków, które w sumie prowadziły 42/78 (53,8%) pacjentów leczonych w Polsce od początku trwania programu lekowego. Czas leczenia chorych był bardzo zróżnicowany i zawierał się pomiędzy 3 tygodniami a 68 miesiącami. Mediana czasu leczenia wyniosła 8,25 miesiąca (0,75–68), mediana czasu obserwacji pacjentów leczonych krócej lub dłużej niż 12 miesięcy — wyniosła odpowiednio 8 miesięcy (6–11) i 14 miesięcy (12–68).  Wyniki. Podsumowanie danych po 6 i 12 miesiącach leczenia było możliwe odpowiednio u 29/42 i 17/42 chorych. Całkowitą odpowiedź uzyskano u 3/29 (10,3%) oraz u 3/16 (17,6%) pacjentów po odpowiednio 6 i 12 miesiącach leczenia, częściową odpowiedź odnotowano odpowiednio u 13/29 (44,8%) i 5/16 (29,4%) pacjentów, stabilizację choroby uzyskano odpowiednio u 13/29 (44,8%) i 8/16 (50,0%). Progresję choroby stwierdzono u 7 z 42 chorych (16,6%) w okresie 3–28 miesięcy od rozpoczęcia leczenia. Odnotowano 1 przypadek zgonu z powodu progresji choroby u pacjenta z obecnymi przerzutami do mózgu w momencie kwalifikacji do udziału w programie. Działania niepożądane wystąpiły u 31/42 (73,8%), a liczne działania niepożądane u tego samego pacjenta wystąpiły u 22/42 (52,3%) chorych. Nie odnotowano żadnego przypadku poważnych działań niepożądanych