Alcohol — heart out of harmony

Patomechanizmy migotania przedsionków (AF) zwykle są złożone. W młodości, u osób bezorganicznej choroby serca, najczęściej występuje tak zwane ogniskowe, odosobnione napadowemigotanie przedsionków. Migotanie jest jednym z powikłań chorób poligenowych,wczesnym — reumatycznej wady zastawki mitralnej, późnym — wady aortalnej. W wiekudojrzałym i starszym towarzyszy nadciśnieniu, chorobie niedokrwiennej, cukrzycy. Nierzadkopojawia się w u osób z chorobami monogenowymi, w tym w zespole Wolffa, Parkinsonai White’a, różnych postaciach kardiomiopatii. Groźnymi czynnika mi usposabiającymi domigotania są między innymi: otyłość, zespół obturacyjnego bezdechu sennego. Udziałw rozwoju migotania pr zedsionków mogą mieć substancje działające kardiotoksycznie,miedzy innymi: niekorzystnie modyfikując przewodzenie elektryczne w sercu i wpływającna powstawanie czynników wyzwalających. Jedną z nich jest alkohol etylowy, zarówno kiedywypity jest w dużej dawce, jak i kiedy nadużywany jest w sposób przewlekły.Przedstawiamy zarys wiedzy uwzględniający działanie alkoholu na występowanie migotaniaprzedsionków oraz towarzyszących chorobie trudności terapeutycznych.Complex mechanisms that cause atrial fibrillation (AF) are not complete understood. Thisarrhythmia is strongly epidemiologically connected with mono- and poligenic cardiovasculardiseases. There is a possibility that some substances which are cardiotoxic and modifyautonomic nervous system, electrical activity and conduction in heart may induce AF. Suchsubstance, commonly used, although chronic and in huge doses is ethanol. In this articleauthors would like to present recent knowledge and to recapitulate the relationship betweenAF and alcohol, and its diagnostic and treatment problems

Occupational risks for SARS-CoV-2 infection : the Polish experience

The disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), termed COVID-19, is asymptomatic or mild in most cases. These patients do not need treatment in hospital and can be isolated at home. To date, most studies have been conducted among inpatients with severe COVID-19. In this study, the authors surveyed patients with mild COVID-19 who remained in home isolation, and analyzed the sources and occupational risk factors for SARS-CoV-2 infections. Material and Methods: This cross-sectional study was carried out on April 17-18, 2020, among patients infected with SARS-CoV-2 who remained in home isolation in Poland. Data were acquired through a structured interview that included questions about the isolation course, symptoms, comorbidities, infection source, household characteristics, occupation, and workplace. Data were presented with descriptive statistics. Results: Of the 4878 patients in home isolation, the authors were able to contact 3313. Of them, 1191 patients declined their invitation, and 2122 agreed to take part. The median age of the patients included in the study was 50 years; 59% were female. Most patients (92%) had not been abroad before the infection. More than half (55%) knew how they became infected; of them, 75% became infected at work. Of all patients, 70% were occupationally active. Nearly half of the occupationally active patients (48%) worked in healthcare, 3% worked in public administration or defense, 3% worked in transportation, and 2% worked in education. Sixty-five percent of the occupationally active patients worked in companies with >100 employees. Conclusions: Most of the patients with COVID-19 in home isolation in Poland were occupationally active, wherein the majority of people who were aware of the source of SARS-CoV-2 infection worked in healthcare. As most of the infected patients worked in companies with >100 employees, which is not a Polish employment pattern, the authors expect that smaller companies may have a lower risk of SARS-CoV-2 infections

Burden of multimorbidity in a Polish cohort of ambulatory and hospitalized heart failure patients from two large European registry programs: prognostic implications

n/

A subjective sense of the quality of life in adolescents from the Świętokrzyskie Voivodship

ObjectivesThe measurement of the health-related quality of life (HRQOL) is one of the most important methods for self-assessment of health, which makes it possible to identify irregularities in the physical, mental and social functioning. The aim of the research was to determine HRQOL using the Health Related Quality of Life Questionnaire for Children and Young People (the KIDSCREEN-52 questionnaire) – the instrument recommended by the World Health Organization – which makes it possible to distinguish groups of adolescents with a diversified subjective sense of the quality of life.Material and MethodsThe study involved a group of 871 adolescents, 411 boys and 460 girls, aged 13–16 years, residing in the Świętokrzyskie Voivodship. The method of a diagnostic survey was used in the research. The KIDSCREEN-52 questionnaire, which is an instrument for examining the HRQOL of adolescents, was employed in the study. The k-means clustering method was applied, which made it possible to establish 3 groups of adolescents with a different subjective sense of the quality of life.ResultsThree groups of adolescents with a diversified subjective sense of the quality of life (high, average, low) were identified using the KIDSCREEN-52 questionnaire. The subjective quality of life in the majority of the respondents was high, in particular in those living in rural areas. The surveyed boys with a high subjective quality of life showed a significantly higher self-esteem, acceptance and peer support than the surveyed girls.ConclusionsThe KIDSCREEN-52 questionnaire is an accurate and sensitive tool for assessing HRQOL. It allows identifying 3 groups of adolescents with a diversified subjective sense of the quality of life. It can form the basis for further diagnosis of the bio-psycho-social functioning of adolescents

New hope for patients and challenges for the multidisciplinary arrhythmia team: a hybrid convergent approach for atrial fibrillation treatment

Background: Available data suggest the important role of ablation of the left atrial posterior wall and epicardial myocardial layers in rhythm control therapy in patients with persistent drug‑refractory atrial fibrillation (AF). However, endocardial ablation is not always effective in transmural substrate modification. The alternative treatment option is minimally invasive hybrid approach (HABL) combining the strengths of surgical and catheter ablation. Aims: This study aimed to assess the periprocedural safety as well as acute and long‑term outcomes of HABL for AF. Methods: This is a retrospective single‑center study of patients who underwent HABL using the minimally invasive transabdominal approach between July 2009 and January 2020. Demographic in‑hospital data and 12‑month follow‑up results were obtained. The number of hospitalizations, cardioversions, re‑ablations, and severe adverse events in a 3‑year period before and after HABL were compared using data from the national healthcare provider. Results: In total, 158 patients (mean [SD] age, 51.02 [10.67] years) who underwent HABL were included; 61.4% had persistent AF. There was a 4.4% incidence of periprocedural complications without any fatalities. In 66% of patients, additional endocardial substrate modification was needed, in 52.6% on the posterior wall. In the 12‑month follow‑up, most patients (78.3%) remained free of arrhythmias. There was a significant reduction in the number of hospitalizations (for AF, 1.65 vs 0.54; or any other cause, 2.56 vs 1.31 per patient), cardioversions, and re‑ablations after HABL (all P < 0.05). Conclusions: The hybrid multidisciplinary approach for treatment of AF is a safe and very effective treatment method in long‑term follow‑up, which reduces healthcare burden. It could be considered as an alternative therapeutic option especially in patients with persistent AF

The potential benefits of the influenza vaccination on COVID-19 mortality rate - a retrospective analysis of patients in Poland

In this study, we used publicly available data from the Centrum e-Zdrowia (CeZ) Polish Databank proposing a possible correlation between influenza vaccination and mortality due to COVID-19. We limited our search to the patients with positive COVID-19 laboratory tests from 1 January 2020 to 31 March 2021 and who filled a prescription for any influenza vaccine during the 2019–2020 influenza season. In total, we included 116,277 patients and used a generalized linear model to analyze the data. We found out that patients aged 60+ who received an influenza vaccination have a lower probability of death caused by COVID-19 in comparison to unvaccinated, and the magnitude of this difference grows with age. For people below 60 years old, we did not observe an influence of the vaccination. Our results suggest a potential protective effect of the influenza vaccine on COVID-19 mortality of the elderly. Administration of the influenza vaccine before the influenza season would reduce the burden of increased influenza incidence, the risk of influenza and COVID-19 coinfection and render the essential medical resources accessible to cope with another wave of COVID-19. To our knowledge, this is the first study showing a correlation between influenza vaccination and the COVID-19 mortality rate in Poland