Anticoagulant Rodenticides Poisonings in Humans and Animals – Short Review

Abstract Anticoagulant rodenticides (AR) are among the most commonly used rodent control pesticides. The current second-generation rodenticides in worldwide use are referred to as superwarfarins. These substances have relatively low toxicity to humans but significant toxicity to animals, including pets. AR work at the level of hepatocytes by blocking the synthesis of plasma coagulation factors II, VII, IX, and X as well as proteins C, S, and Z, resulting in severe coagulation disorders predominant in the clinical picture. Deaths associated with AR poisoning are the result of haemorrhages into the gastrointestinal tract, peritoneal cavity, or intracranial cavities. Medico-legal diagnosis of AR poisonings is based on the clinical picture, autopsy, and histopathological and toxicological examinations

Determination of ramipril in human plasma and study of its fragmentation by UPLC-Q-TOF-MS with positive electrospray ionization

This report presents the application of ultra-performance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry with positive electrospray ionization, to determine ramipril in human plasma. First, the proteins in human plasma were precipitated using acetonitrile, then the supernatant was extracted by ethyl acetate at pH 3 and, finally, the extract was analyzed using a UPLC-Q-TOF-MS system. The method was validated and the coefficient of determination (R2) was > 0.999, the lower limit of quantification (LLOQ) was 0.5 ng mL–1. Precision, recovery and stability were determined for three different concentrations of ramipril. RSD for this method ranged from 3.3 to 8.6 %. The intra-day mean recovery was from 65.3 to 97.3 %. In addition, the fragmentation of ramipril was studied. Due to high resolution of the spectrometer, it was possible to measure fragment masses accurately and determine their molecular and chemical formulas with high accuracy

Clinical complexity and impact of the ABC (Atrial fibrillation Better Care) pathway in patients with atrial fibrillation: a report from the ESC-EHRA EURObservational Research Programme in AF General Long-Term Registry

Background: Clinical complexity is increasingly prevalent among patients with atrial fibrillation (AF). The ‘Atrial fibrillation Better Care’ (ABC) pathway approach has been proposed to streamline a more holistic and integrated approach to AF care; however, there are limited data on its usefulness among clinically complex patients. We aim to determine the impact of ABC pathway in a contemporary cohort of clinically complex AF patients. Methods: From the ESC-EHRA EORP-AF General Long-Term Registry, we analysed clinically complex AF patients, defined as the presence of frailty, multimorbidity and/or polypharmacy. A K-medoids cluster analysis was performed to identify different groups of clinical complexity. The impact of an ABC-adherent approach on major outcomes was analysed through Cox-regression analyses and delay of event (DoE) analyses. Results: Among 9966 AF patients included, 8289 (83.1%) were clinically complex. Adherence to the ABC pathway in the clinically complex group reduced the risk of all-cause death (adjusted HR [aHR]: 0.72, 95%CI 0.58–0.91), major adverse cardiovascular events (MACEs; aHR: 0.68, 95%CI 0.52–0.87) and composite outcome (aHR: 0.70, 95%CI: 0.58–0.85). Adherence to the ABC pathway was associated with a significant reduction in the risk of death (aHR: 0.74, 95%CI 0.56–0.98) and composite outcome (aHR: 0.76, 95%CI 0.60–0.96) also in the high-complexity cluster; similar trends were observed for MACEs. In DoE analyses, an ABC-adherent approach resulted in significant gains in event-free survival for all the outcomes investigated in clinically complex patients. Based on absolute risk reduction at 1 year of follow-up, the number needed to treat for ABC pathway adherence was 24 for all-cause death, 31 for MACEs and 20 for the composite outcome. Conclusions: An ABC-adherent approach reduces the risk of major outcomes in clinically complex AF patients. Ensuring adherence to the ABC pathway is essential to improve clinical outcomes among clinically complex AF patients

Impact of clinical phenotypes on management and outcomes in European atrial fibrillation patients: a report from the ESC-EHRA EURObservational Research Programme in AF (EORP-AF) General Long-Term Registry

Background: Epidemiological studies in atrial fibrillation (AF) illustrate that clinical complexity increase the risk of major adverse outcomes. We aimed to describe European AF patients\u2019 clinical phenotypes and analyse the differential clinical course. Methods: We performed a hierarchical cluster analysis based on Ward\u2019s Method and Squared Euclidean Distance using 22 clinical binary variables, identifying the optimal number of clusters. We investigated differences in clinical management, use of healthcare resources and outcomes in a cohort of European AF patients from a Europe-wide observational registry. Results: A total of 9363 were available for this analysis. We identified three clusters: Cluster 1 (n = 3634; 38.8%) characterized by older patients and prevalent non-cardiac comorbidities; Cluster 2 (n = 2774; 29.6%) characterized by younger patients with low prevalence of comorbidities; Cluster 3 (n = 2955;31.6%) characterized by patients\u2019 prevalent cardiovascular risk factors/comorbidities. Over a mean follow-up of 22.5 months, Cluster 3 had the highest rate of cardiovascular events, all-cause death, and the composite outcome (combining the previous two) compared to Cluster 1 and Cluster 2 (all P <.001). An adjusted Cox regression showed that compared to Cluster 2, Cluster 3 (hazard ratio (HR) 2.87, 95% confidence interval (CI) 2.27\u20133.62; HR 3.42, 95%CI 2.72\u20134.31; HR 2.79, 95%CI 2.32\u20133.35), and Cluster 1 (HR 1.88, 95%CI 1.48\u20132.38; HR 2.50, 95%CI 1.98\u20133.15; HR 2.09, 95%CI 1.74\u20132.51) reported a higher risk for the three outcomes respectively. Conclusions: In European AF patients, three main clusters were identified, differentiated by differential presence of comorbidities. Both non-cardiac and cardiac comorbidities clusters were found to be associated with an increased risk of major adverse outcomes

Impact of renal impairment on atrial fibrillation: ESC-EHRA EORP-AF Long-Term General Registry

Background: Atrial fibrillation (AF) and renal impairment share a bidirectional relationship with important pathophysiological interactions. We evaluated the impact of renal impairment in a contemporary cohort of patients with AF. Methods: We utilised the ESC-EHRA EORP-AF Long-Term General Registry. Outcomes were analysed according to renal function by CKD-EPI equation. The primary endpoint was a composite of thromboembolism, major bleeding, acute coronary syndrome and all-cause death. Secondary endpoints were each of these separately including ischaemic stroke, haemorrhagic event, intracranial haemorrhage, cardiovascular death and hospital admission. Results: A total of 9306 patients were included. The distribution of patients with no, mild, moderate and severe renal impairment at baseline were 16.9%, 49.3%, 30% and 3.8%, respectively. AF patients with impaired renal function were older, more likely to be females, had worse cardiac imaging parameters and multiple comorbidities. Among patients with an indication for anticoagulation, prescription of these agents was reduced in those with severe renal impairment, p <.001. Over 24 months, impaired renal function was associated with significantly greater incidence of the primary composite outcome and all secondary outcomes. Multivariable Cox regression analysis demonstrated an inverse relationship between eGFR and the primary outcome (HR 1.07 [95% CI, 1.01–1.14] per 10 ml/min/1.73 m2 decrease), that was most notable in patients with eGFR <30 ml/min/1.73 m2 (HR 2.21 [95% CI, 1.23–3.99] compared to eGFR ≥90 ml/min/1.73 m2). Conclusion: A significant proportion of patients with AF suffer from concomitant renal impairment which impacts their overall management. Furthermore, renal impairment is an independent predictor of major adverse events including thromboembolism, major bleeding, acute coronary syndrome and all-cause death in patients with AF

Media wobec wyzwań społeczeństwa wiedzy: ekonomiczne aspekty zarządzania mediami w warunkach gospodarki cyfrowej

Media in the face of challenges of the knowledge society: economic aspects of media management in the digital economyThe article is the attempt of analyzing key aspects of the management of media companies in the knowledge-based economy. The author concluded that the main factors affecting the shape of management processes in the media market are its unique character and trends related to digitization, among others, fragmentation of the audience, the phenomenon of convergence and changes in the network environment. It was stated that processes of the media transformation determine change of leaders' status in organizations. His role within the organization is more and more often determined by heterarchical power relations, requiring an attitude of openness to continuous learning nature of the digital societyThe article is the attempt of analyzing key aspects of the management of media companies in the knowledge-based economy. The author concluded that the main factors affecting the shape of management processes in the media market are its unique character and trends related to digitization, among others, fragmentation of the audience, the phenomenon of convergence and changes in the network environment. It was stated that processes of the media transformation determine change of leaders' status in organizations. His role within the organization is more and more often determined by heterarchical power relations, requiring an attitude of openness to continuous learning nature of the digital societyThe article is the attempt of analyzing key aspects of the management of media companies in the knowledge-based economy. The author concluded that the main factors affecting the shape of management processes in the media market are its unique character and trends related to digitization, among others, fragmentation of the audience, the phenomenon of convergence and changes in the network environment. It was stated that processes of the media transformation determine change of leaders' status in organizations. His role within the organization is more and more often determined by heterarchical power relations, requiring an attitude of openness to continuous learning nature of the digital societ

Media in the face of challenges of the knowledge society : economic aspects of media management in the digital economy

The article is the attempt of analyzing key aspects of the management of media companies in the knowledge-based economy. The author concluded that the main factors affecting the shape of management processes in the media market are its unique character and trends related to digitization, among others, fragmentation of the audience, the phenomenon of convergence and changes in the network environment. It was stated that processes of the media transformation determine change of leaders’ status in organizations. His role within the organization is more and more often determined by heterarchical power relations, requiring an attitude of openness to continuous learning nature of the digital society

Japanese Aesthetics and Late Work of Yasujirō Ozu

Praca magisterska stanowi próbę przedstawienia i analizy problematyki uwikłania późnej twórczości Yasujirō Ozu w tradycję estetyczną Kraju Kwitnącej Wiśni. Rozdział pierwszy obejmuje teoretyczne wprowadzenie do tematyki japońskiego podejścia do piękna. Treść rozdziału drugiego wyznacza zagadnienie odniesień do estetyki Kraju Wschodzącego Słońca na gruncie świata przedstawionego w filmach reżysera. W rozdziale trzecim przedmiotem analizy pod kątem wspomnianych odwołań jest realizowany przez Ozu model opowiadania. Ostatnia część pracy traktuje natomiast o zagadnieniu wyznaczników japońskiego podejścia do piękna w kontekście stylu filmowego twórcy. W świetle zarysowanych problemów stwierdzono, że analizowane dzieła są bogatym źródłem odniesień do rodzimej estetyki. Ich obecność stanowi istotną płaszczyznę tworzenia znaczeń, wzbogaca ponadto rozważania o kształcie relacji między tradycją i nowoczesnością w otaczającej reżysera rzeczywistości.The master's thesis is the attempt of presenting and analyzing the problems of entanglement of Yasujirō Ozu's late work in the aesthetic tradition of Japan. The first chapter provides a theoretical introduction to the Japanese approach to beauty. The content of the second chapter is determined by the question of references to the aesthetics of the Land of the Rising Sun on the basis of the world presented in the director's films. The third chapter in accordance with these references makes analyses of the model of storytelling implemented by Ozu. Whereas the last part of the work deals with the issue of the determinants of the Japanese approach to beauty in the context of the film style of the maker. It was stated that the analyzed works are a rich source of references to indigenous aesthetics. Their presence is an essential platform to create meanings and enriches the discussion of the shape of the relationship between tradition and modernity in the reality surrounding the director