La protección comunitaria: el enfoque del CICR

El CICR intenta garantizar que sus actividades en favor de los desplazados internos y aquellos en riesgo de desplazamiento sean un apoyo y no menoscaben los mecanismos ni las estrategias de resolución de problemas de las comunidades y los individuos

Low to middle Pleistocene paleoclimatic record from the Kraków-Częstochowa Upland (Poland) based on isotopic and calcite fabrics analyses

The quality of paleoenvironmental reconstruction based on speleothem records depends on the accuracy of the used proxies and the chronology of the studied record. As far as the dating method is concerned, in most cases, the best solution is the use of the U-series method to obtain a precise chronology. However, for older periods (i.e., over 0.5 Ma), dating has become a serious challenge. Theoretically, older materials could be dated with the U-Pb dating method. However, that method re-quires a relatively high uranium content (minimum of several ppm), whereas typical speleothems from Poland (and all of Central Europe) have uranium concentrations below 0.1 ppm. Because the materials in Polish caves are problematic, we applied oxygen isotope stratigraphy (OIS) as a tool for speleothem dating. By using OIS as an alternative tool to create a chronology of our flowstone, it was found that the studied flowstone crystallized from 975 to 470 ka with three major discontinuities, so obtained isotopic record can be correlated with oxygen isotopic stages from MIS 24 to MIS 12. The observed isotopic variability was also consistent and confirmed with the petrographic observations of the flowstone

Xanthine Oxidoreductase Reference Values in Platelet-Poor Plasma and Platelets in Healthy Volunteers

Introduction. Xanthine oxidoreductase (XOR) is an enzyme belonging to the class of hydroxylases. XOR is stated, inter alia, in the kidneys, liver, and small intestine as well as in leukocytes and platelets and endothelial cells of capillaries. Its main role is to participate in the conversion of hypoxanthine to xanthine and the uric acid. It occurs in two isoforms: dehydrogenase (XD) and oxidase (XO), which is considered one of the sources of reactive oxygen species. Aim of the Study. Determination of reference values of xanthine oxidoreductase activity in PPP and platelets. Materials and Methods. Study group consisted of 70 healthy volunteers. The isoform activities of xanthine oxidoreductase were determined by kinetic spectrophotometry. Results. A statistically significant difference between the activity of the XOR in PPP and platelets (P<0.001). The highest activity of XO was found in both PPP and blood platelets. Significant differences between the activity of the various isoforms in PPP (P=0.0032) and platelets (P<0.001) were also found. Conclusions. The healthy volunteers showed the highest activity XO (prooxidant) and the lowest XD (antioxidant), which indicates a slight oxidative stress and confirmed physiological effects of XOR

"The Weak Heart" as an educational model for patients hospitalized due to decompensation of heart failure with reduced ejection fraction

Introduction. KONS (Kompleksowa opieka nad chorymi z niewydolnością serca) is the name of a Polish programme for the coordinated care for patients with heart failure that has been proposed as a complex heart failure management solution based on European Society of Cardiology (ESC) Heart Failure recommendations. The challenge is that there are currently no available systemic solutions for educating these patients. Our project aimed to evaluate the effectiveness of a pilot model of education and telemonitoring known as ‘The Weak Heart’ for patients hospitalised due to decompensation of heart failure with reduced ejection fraction (HFrEF). Materials and methods. ‘The Weak Heart’ educational model consists of three phases: phase I - training and certification of nurses to perform the role of heart failure nurse specialists; phase II - checking the effectiveness of the model in a clinical setting; and phase III - implementation of patient education standards in cardiac centres. Data collected will be used to evaluate the impact of the programme on patients’ understanding regarding heart failure, their compliance with recommendations, and their pro-health behaviours in terms of self-care and self-control. Conclusion. ‘The Weak Heart’ programme will allow conclusions to be drawn concerning the usefulness and effectiveness of the first targeted heart failure-based patient educational model in Poland. Positive results in this pilot project could become the basis for implementing systemic changes, and introducing the model into everyday clinical practice

„W trosce o słabe serce” — model edukacji chorych hospitalizowanych z powodu dekompensacji niewydolności serca ze zmniejszoną frakcją wyrzutową

Introduction. Kompleksowa opieka nad chorymi z niewydolnością serca (KONS) is the name of a Polish programme for the coordinated care for patients with heart failure that has been proposed as a complex heart failure management solution based on European Society of Cardiology (ESC) Heart Failure recommendations. The challenge is that there are currently no available systemic solutions for educating these patients. Our project aimed to evaluate the effectiveness of a pilot model of education and telemonitoring known as ‘The Weak Heart’ for patients hospitalised due to decompensation of heart failure with reduced ejection fraction (HFrEF). Materials and methods. ‘The Weak Heart’ educational model consists of three phases: phase I — training and certification of nurses to perform the role of heart failure nurse specialists; phase II — checking the effectiveness of the model in a clinical setting; and phase III — implementation of patient education standards in cardiac centres. Data collected will be used to evaluate the impact of the programme on patients’ understanding regarding heart failure, their compliance with recommendations, and their pro-health behaviours in terms of self-care and self-control. Conclusion. ‘The Weak Heart’ programme will allow conclusions to be drawn concerning the usefulness and effectiveness of the first targeted heart failure-based patient educational model in Poland. Positive results in this pilot project could become the basis for implementing systemic changes, and introducing the model into everyday clinical practice.Introduction. Kompleksowa opieka nad chorymi z niewydolnością serca (KONS) is the name of a Polish programme for the coordinated care for patients with heart failure that has been proposed as a complex heart failure management solution based on European Society of Cardiology (ESC) Heart Failure recommendations. The challenge is that there are currently no available systemic solutions for educating these patients. Our project aimed to evaluate the effectiveness of a pilot model of education and telemonitoring known as ‘The Weak Heart’ for patients hospitalised due to decompensation of heart failure with reduced ejection fraction (HFrEF). Materials and methods. ‘The Weak Heart’ educational model consists of three phases: phase I — training and certification of nurses to perform the role of heart failure nurse specialists; phase II — checking the effectiveness of the model in a clinical setting; and phase III — implementation of patient education standards in cardiac centres. Data collected will be used to evaluate the impact of the programme on patients’ understanding regarding heart failure, their compliance with recommendations, and their pro-health behaviours in terms of self-care and self-control. Conclusion. ‘The Weak Heart’ programme will allow conclusions to be drawn concerning the usefulness and effectiveness of the first targeted heart failure-based patient educational model in Poland. Positive results in this pilot project could become the basis for implementing systemic changes, and introducing the model into everyday clinical practice

Presentation of Graves' orbitopathy within European Group On Graves' Orbitopathy (EUGOGO) centres from 2012 to 2019 (PREGO III)

Background: Graves' orbitopathy (GO) is subject to epidemiological and care-related changes. Aim of the survey was to identify trends in presentation of GO to the European Group On Graves' Orbitopathy (EUGOGO) tertiary referral centres and initial management over time. Methods: Prospective observational multicentre study. All new referrals with diagnosis of GO within September-December 2019 were included. Clinical and demographic characteristics, referral timelines and initial therapeutic decisions were recorded. Data were compared with a similar EUGOGO survey performed in 2012. Results: Besides age (mean age: 50.5±13 years vs 47.7±14 years; p 0.007), demographic characteristics of 432 patients studied in 2019 were similar to those in 2012. In 2019, there was a decrease of severe cases (9.8% vs 14.9; p&lt;0.001), but no significant change in proportion of active cases (41.3% vs 36.6%; p 0.217). After first diagnosis of GO, median referral time to an EUGOGO tertiary centre was shorter (2 (0-350) vs 6 (0-552) months; p&lt;0.001) in 2019. At the time of first visit, more patients were already on antithyroid medications (80.2% vs 45.0%; p&lt;0.001) or selenium (22.3% vs 3.0%; p&lt;0.001). In 2019, the initial management plans for GO were similar to 2012, except for lid surgery (2.4% vs 13.9%; p&lt;0.001) and prescription of selenium (28.5% vs 21.0%; p 0.027). Conclusion: GO patients are referred to tertiary EUGOGO centres in a less severe stage of the disease than before. We speculate that this might be linked to a broader awareness of the disease and faster and adequate delivered treatment