Discourse on National Identity in Moldovan Politics after 2009

Throughout the 20 years of independence, different concepts of a Moldovan nation have competed in public, scientific, and political discourse. A turning point came in 2009, when the ruling Communist Party of Moldova was replaced by a pro-European coalition of self-styled liberal-democratic parties who brought about a significant pluralisation of Moldovan public life. The goal of this article is to analyse the discourse on national identity in Moldovan politics since 2009

The relationship between pre-pregnancy BMI, gestational weight gain and neonatal birth weight: a retrospective cohort study

Objectives: Maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) have a meaningful impact on pregnancy and perinatal outcomes. The first aim of the study was to analyze the association between pre-pregnancy BMI and the prevalence of small for gestational age (SGA) and large for gestational age (LGA) outcomes. The second aim was to assess the relation- ship between pre-pregnancy BMI combined with gestational weight gain (GWG) and the prevalence of SGA and LGA measurements. Material and methods: The retrospective cohort study was conducted at Jagiellonian University Hospital in Cracow, Po- land from 2016 to 2017. During this time there were 2,123 deliveries. Patients with chronic diseases, multiple pregnancies, fetal defects and incomplete data were excluded. Finally, 474 cases were enrolled. Patients were divided into BMI groups (underweight, normal, overweight and obese) and into GWG groups (inadequate, adequate, excessive). Relationships between maternal BMI, GWG and newborn weight were examined. Results: There was no statistically significant association between maternal pre-pregnancy BMI and prevalence of SGA measurements. However, underweight women with inadequate GWG showed a higher risk to bear SGA babies (OR 5.2, 95% CI 1.57-17.18). Obese women with adequate GWG had higher risk of bearing LGA newborns (OR 5.48, 95% CI 1.15–26.13). High BMI correlated with excessive GWG (overweight: OR 3.0, 95% CI 1.84–3.87; obese OR 2.45, 95% CI 1.1–5.48). Conclusions: There is a considerable risk of giving birth to a SGA newborn for underweight women with inadequate GWG. There is a statistically significant association between maternal obesity and LGA outcomes. Our study shows that redefining the risks of abnormal neonatal weight considering both pre-pregnancy BMI and gestational weight gain can be useful in providing effective prevention during pregnancy.

‘Opioidergic postconditioning’ of heart muscle during ischemia/reperfusion injury

  Background: Ischemic preconditioning and postconditioning are the novel strategies of attaining cardioprotection against ischemia/reperfusion (I/R) injury. Previous studies suggested the role of opioid pathway, however the class of opioid receptors responsible for this effect in humans remains unknown. The aim of the study was to assess the influence of opioids on simulated I/R injury outcomes in the hu­man myocardium. Methods: Trabeculae of the human right atrium were electrically driven in organ bath and subjected to simulated I/R injury. Morphine (10–4M, 10–5M, 10–6M) or d-opioid receptor agonist DADLE (10–8M, 10–7M, 10–6M) was used at the time of re-oxygenation. Additional trabecula was subjected to hypoxia protocol only (Control). Contractive force of the myocardium was assessed as the maximal force of a contraction (Amax), the rate of rise of the force of a contraction (Slope L) and relaxation as the rate of decay of the force of a contraction (Slope T). Results: Application of morphine 10–4M resulted in increase of Amax, Slope L and Slope T during re-oxygenation period as compared to Control (77.99 ± 1.5% vs. 68.8 ± 2.2%, p < 0.05; 45.72 ± 2.9% vs. 34.12 ± 5.1%, p < 0.05; 40.95 ± 2.5% vs. 32.37 ± 4.3%, p < 0.05). Parameters were not significantly different in the lower morphine concentrations. Application of DADLE 10–6M resulted in decrease of Amax and Slope L as compared to Control (68.13 ± 5.5% vs. 76.62 ± 6.6%, p < 0.05; 28.29 ± 2.2 vs. 34.80 ± 3.9%, p < 0.05). Conclusions: At re-oxygenation, morphine improves systolic and diastolic function of the human myo­cardium in the dose-dependent manner. Delta-opioid receptor stimulation attenuates systolic function of human heart muscle which remains in contrast to previous reports with animal models of I/R injury. (Cardiol J 2017; 24, 4: 419–425

Efficacy and Safety of Biosimilar FYB201 Compared with Ranibizumab in Neovascular Age-Related Macular Degeneration.

Abstract Purpose This trial was conducted to investigate the clinical equivalence of the proposed biosimilar FYB201 and reference ranibizumab in patients with treatment-naive, subfoveal choroidal neovascularization caused by neovascular age-related macular degeneration (nAMD). Design This was a prospective, multicenter, evaluation-masked, parallel-group, 48-week, phase III randomized study. Participants A total of 477 patients were randomly assigned to receive FYB201 (n = 238) or reference ranibizumab (n = 239). Methods Patients received FYB201 or ranibizumab 0.5 mg by intravitreal injection in the study eye every four weeks. Main Outcome Measures The primary end point was change from baseline in best corrected visual acuity (BCVA) by Early Treatment Diabetic Retinopathy Study (ETDRS) letters at 8 weeks prior to the third monthly intravitreal injection. Biosimilarity of FYB201 to its originator was assessed via a two-sided equivalence test, with an equivalence margin in BCVA of 3 ETDRS letters. Results BCVA improved in both groups, with a mean improvement of +5.1 (FYB201) and +5.6 (reference ranibizumab) ETDRS letters at week 8. The analysis of covariance (ANCOVA) least squares mean difference for the change from baseline between FYB201 and reference ranibizumab was –0.4 ETDRS letters with a 90% confidence interval (CI) of –1.6 to 0.9. Primary end point was met as the 90% CI was within the predefined equivalence margin. Adverse events were comparable between treatment groups. Conclusions FYB201 is biosimilar to reference ranibizumab in terms of clinical efficacy and ocular and systemic safety in the treatment of patients with nAMD

Levels of actigraphy-derived physical activity among Polish nurses: factors associated with the prevalence of selected metabolic disorders

Numerous studies demonstrate a relationship between physical activity and the development of non-communicable diseases. Nurses play a crucial role in the healthcare system, and their demanding work can have an impact on their health. The objective of this cross-sectional study was to assess physical activity in relation to factors predisposing to the occurrence of specific metabolic disorders among Polish nurses. The measurements included physical activity level using ActiGraph GT3X, body weight composition using Tanita MC-980, body mass index, waist circumference, blood pressure using Welch Allyn 4200B, lipid profile, and fasting blood glucose using CardioChek PA. The results indicate that nearly one-third (31.75%) of the total sample of studied nurses do not meet the criteria for the minimum amount of physical activity of at least moderate intensity. Furthermore, over half of the surveyed nurses (55.5%) were classified as overweight or obese based on BMI, and almost half (42.86%) had abdominal obesity. The regression model, employing linear regression, revealed that factors predisposing to selected metabolic disorders were age, engaging in multiple jobs, and the number of steps per day. There is a pressing need to implement comprehensive and supportive initiatives to improve the overall health condition of nurses in Poland through increased physical activity. Activating and supporting this professional group is an investment that benefits not only the nurses themselves but also the healthcare system and the entire nation

Rola terapii przezcewnikowych w leczeniu ostrej zatorowości płucnej — opinia Polskiej Inicjatywy PERT, Sekcji Krążenia Płucnego, Asocjacji Interwencji Sercowo-Naczyniowych i Asocjacji Intensywnej Terapii Kardiologicznej Polskiego Towarzystwa Kardiologicznego

Dzięki postępom w zakresie technologii kardiologii interwencyjnej leczenie przezcewnikowe stało się w ostatnich latach realną opcją terapeutyczną w leczeniu pacjentów z ostrą zatorowością płucną z wysokim ryzykiem wczesnej śmiertelności. Obecnie stosowane techniki przezcewnikowe umożliwiają miejscową fibrynolizę lub embolektomię przy minimalnym ryzyku powikłań. Stąd mogą być rozważane u pacjentów z grupy wysokiego ryzyka jako alternatywa dla chirurgicznej embolektomii płucnej, gdy systemowa tromboliza jest przeciwwskazana lub nieskuteczna. Rozważane są również u pacjentów z grupy średniego–wysokiego ryzyka, u których pomimo leczenia przeciwzakrzepowego nie uzyskano poprawy lub nastąpiło pogorszenie stanu klinicznego. Celem artykułu było przedstawienie roli technik przezcewnikowych w leczeniu chorych z ostrą zatorowością płucną zgodnie z aktualną wiedzą i opinią ekspertów. Leczenie interwencyjne opisano w szerszym kontekście organizacji opieki nad pacjentem. Przedstawiono organizację i zadania zespołu szybkiego reagowania w zatorowości płucnej, rolę obrazowania przedzabiegowego, zasady antykoagulacji okołozabiegowej, kryteria kwalifikacji pacjentów, wyboru odpowiedniego czasu interwencji oraz rolę intensywnej terapii. Szczegółowo omówiono dostępne terapie przezcewnikowe, w tym wystandaryzowane protokoły, definicje sukcesu i niepowodzenia procedury. Niniejszy dokument został opracowany we współpracy z ekspertami z różnych polskich towarzystw naukowych, co podkreśla rolę pracy zespołowej w opiece nad chorym z ostrą zatorowością płucną

Role of catheter-directed therapies in the treatment of acute pulmonary embolism. Expert opinion of the Polish PERT Initiative, Working Group on Pulmonary Circulation, Association of Cardiovascular Interventions, and Association of Intensive Cardiac Care

Thanks to advances in interventional cardiology technologies the catheter-directed treatment has become recently a viable therapeutic option in the treatment of patients with acute pulmonary embolism at high risk of early mortality. Current transcatheter techniques allow local fibrinolysis or embolectomy with minimal risk of complications. Therefore they can be considered in high risk patients as an alternative to surgical pulmonary embolectomy when systemic thrombolysis is contraindicated or ineffective. They are also considered in patients with intermediate — high risk with a lack of improvement or clinical deterioration despite anticoagulation. The purpose of this article is to present the role of transcatheter techniques in the treatment of patients with acute pulmonary embolism. We describe current knowledge and experts’ opinion in this field. Interventional treatment is described in the broader context of patient care organization and therapeutic modalities. We present the organization and responsibilities of pulmonary embolism response teams, the role of pre-procedural imaging, peri-procedural anticoagulation, patients selection, timing of intervention and intensive care support. Currently available catheter directed therapies are discussed in detail including standardized protocols, definitions of procedure success and failure. This expert opinion has been developed in collaboration with experts from various Polish scientific societies signifying the role of teamwork in the care for patients with acute pulmonary embolism