Endocardial lead extraction in the Polish registry : clinical practice versus current Heart Rhythm Society consensus

Introduction: Over the last 10 years, there has been an increasing number of patients with pacemaker (PM) and cardioverter-defibrillator (ICD). This study is a retrospective analysis of indications for endocardial pacemaker and ICD lead extractions between 2003 and 2009 based on the experience of three Polish Referral Lead Extraction Centers. Material and methods: Since 2003, the authors have consecutively retrospectively collected all cases and entered the information in the database. All patients which had indication for lead extraction according to Heart Rhythm Society Guidelines were included to final analyze. Between 2003 and 2005, the data were analyzed together. Since 2006, data have been collected and analyzed annually. Results: In each year, a significant increase in lead extraction was observed. The main indications for LE were infections in 52.4% of patients. Nonfunctioning lead extraction constituted the second group of indications for LE in 29.7% of patients. During the registry period, the percentage of class I indications decreased from 80% in 2006 to only 47% in 2009. On the other hand, increasingly more leads were removed because of class 2, especially class 2b. In 2009, 40% of leads were extracted due to class 2b. Conclusions: Polish Registry of Endocardial Lead Extraction 2003-2009, shows an increasing frequency of lead extraction. The main indication for LE is infection: systemic and pocket. An increase in class 2, especially 2b, LE indication in every center during the study period was found

Chaotic three-dimensional distribution of Ba, Rb, and Sr in feldspar megacrysts grown in an open magmatic system

As has been demonstrated in recent years, the heterogeneities of coeval magmas can be more successfully revealed by zoned megacrysts rather than by analysis of the whole rocks hosting them. Here, the geochemical heterogeneities of feldspar megacrysts from the Karkonosze granite, Poland, are investigated by LA-ICP-MS. The crystals are the product of migration and growth in regions of poorly mixed magmas. 3D-modeling of the Ba, Sr, and Rb distributions emphasizes the importance of micro-domain growth morphologies. Two models of element behavior—a relative concentration model and a composition gradient model—provide a potentially effective tool for tracking the mixing process on a microscale. Measured concentrations of elements of different mobilities do not agree with what might be expected from the mixing of two end-member magmas. If mixing was the only process occurring, linear correlations between the concentrations of any two elements should be observed; this, however, is not the case. For combinations of any two of the three elements, modeling reveals differing non-linear correlations between concentrations. The megacryst heterogeneities provide an insight into how mixing magmas are chaotically advected to growing crystals and the degree of inter-magma element exchange between the magmas

The role of adhesive molecules in endometrial cancer: part I

The carcinogenesis is a result of both functional and structural disorders in the tissue. It initiates as a mutation in a gene encoding protein that is essential for cellular function. The subsequent cascade of events leads to accumulation of mutations and loss of cellular function. The cell loses its tissue-specific morphology, disconnects from other cells and extracellular matrix and migrates – the invasion begins. It is now clear that adhesive molecules are a key player in this cascade. These proteins of the cell membrane surface are responsible for attachment of the cells to each other and to the extracellular matrix. These interactions are crucial for both structural and functional tissue organization. Lack of this homeostasis destroys the tissue architecture, impairs its function and results in invasion. Abnormal expression of adhesive molecules was reported in all examined cancers, including endometrial cancer.Endometrial cancer is the most common gynaecological cancer in developed countries. Although in many cases it is diagnosed and treated in early stages, and thus with good results, some patients cannot be cured. A complete knowledge of the pathogenesis of the disease will be helpful in identifying patients with negative prognostic factors, increased risk of recurrence and, perhaps, finding other therapeutic options. In the paper we are trying to sum up the up-to-date knowledge of the role of adhesive molecules in pathogenesis of endometrial cancer

Emotional intelligence and medical specialty preference – findings from the empirical study

Aim of the study: Literature emphasizes a positive impact of emotional intelligence on interpersonal and communication skills, the doctor‑patient relationship, and the level of empathy. On the other hand, few research studies dealing with the correlation between emotional intelligence and medical specialty choice or preference are available. Our research was aimed at checking if there are differences in the ability to perceive and identify emotions according to facial expression (one of the dimensions of emotional intelligence) between students preferring different medical specialties. Method: The research involved 251 six‑year students of the Medical Faculty, Medical University of Łódź. The examined group consisted of 174 women (69.33%) and 77 men (30.67%). The subjects’ average age was 24.7 years. The surgical specialty was preferred by 44 women (28.21%) and 43 men (58.11%), non‑surgical by 112 women (71.79%) and 31 men (41.89%). The subjects were asked to fill in a questionnaire with demographic data (gender, age, preferred specialty) and the Emotional Intelligence Scale – Faces (SIE‑T) by Matczak, Piekarska and Studniarek. Results: Men significantly more frequently chose surgical specialty (58.11%), as compared to women (28.21%); chi2=19.08, p0.05. Similarly, no differences were found betweenthe students preferring surgical and non‑surgical procedures; Mann‑WhitneyU= ‑0.93, p>0.05. Results: Male and female students of the Medical Faculty do not differ in the level of emotional intelligence. Emotional intelligence does not differentiate the students preferring surgical and non‑surgical specialties.Cel pracy: W literaturze podkreśla się pozytywny wpływ inteligencji emocjonalnej na zdolności interpersonalne i komunikacyjne, na relację lekarza z pacjentem oraz poziom empatii. Jednocześnie dostępnych jest niewiele prac badawczych poświęconych zależności pomiędzy inteligencją emocjonalną a wybieraną lub preferowaną specjalizacją lekarską. Celem naszej pracy było sprawdzenie, czy istnieją różnice w zdolności spostrzegania i identyfikowania emocji na podstawie wyrazu twarzy (jeden z wymiarów inteligencji emocjonalnej) pomiędzy studentami preferującymi różne specjalizacje medyczne. Metoda: Badanie przeprowadzono z udziałem 251 studentów VI roku Wydziału Lekarskiego Uniwersytetu Medycznego w Łodzi. Badana grupa składała się ze 174 kobiet (69,33%) i 77 mężczyzn (30,67%). Średni wiek osób badanych wynosił 24,7 roku. Specjalizację zabiegową preferowały 44 kobiety (28,21%) i 43 mężczyzn (58,11%), niezabiegową – 112 kobiet (71,79%) i 31 mężczyzn (41,89%). Badanych poproszono o wypełnienie kwestionariusza z danymi demograficznymi (płeć, wiek, preferowana specjalizacja) oraz Skali Inteligencji Emocjonalnej – Twarze (SIE‑T) Matczak, Piekarskiej i Studniarek. Wyniki: Mężczyźni istotnie częściej wybierali specjalizację zabiegową (58,11%) niż kobiety (28,21%); chi2=19,08, p0,05. Nie odnotowano także różnic pomiędzy studentami preferującymi specjalizacje zabiegowe i niezabiegowe; UManna‑Whitneya= ‑0,93, p>0,05. Wnioski: Studenci i studentki Wydziału Lekarskiego nie różnią się poziomem inteligencji emocjonalnej. Inteligencja emocjonalna nie różnicuje studentów preferujących specjalizacje zabiegowe i niezabiegowe

The role of adhesive molecules in endometrial cancer: part I Rola moleku³ adhezyjnych w raku endometrium. Czêoeae I

Abstract The carcinogenesis is a result of both functional and structural disorders in the tissue. It initiates as a mutation in a gene encoding protein that is essential for cellular function. The subsequent cascade of events leads to accumulation of mutations and loss of cellular function. The cell loses its tissue-specific morphology, disconnects from other cells and extracellular matrix and migrates -the invasion begins. It is now clear that adhesive molecules are a key player in this cascade. These proteins of the cell membrane surface are responsible for attachment of the cells to each other and to the extracellular matrix. These interactions are crucial for both structural and functional tissue organization. Lack of this homeostasis destroys the tissue architecture, impairs its function and results in invasion. Abnormal expression of adhesive molecules was reported in all examined cancers, including endometrial cancer. Endometrial cancer is the most common gynaecological cancer in developed countries. Although in many cases it is diagnosed and treated in early stages, and thus with good results, some patients cannot be cured. A complete knowledge of the pathogenesis of the disease will be helpful in identifying patients with negative prognostic factors, increased risk of recurrence and, perhaps, finding other therapeutic options. In the paper we are trying to sum up the up-to-date knowledge of the role of adhesive molecules in pathogenesis of endometrial cancer. Key words: adhesion, adhesive molecules, carcinogenesis, invasion, metastasis. Streszczenie Nowotworzenie to wynik zaburzenia struktury i funkcji tkanki na wielu poziomach. Proces zaczyna się od mutacji w kluczowym dla komórki genie, kodującym istotne dla procesów komórkowych białka. Następuje kaskada wydarzeń prowadząca do kumulacji mutacji i zaburzająca funkcję komórki. Traci ona charakterystyczną dla tkanki morfologię, ścisły kontakt z otoczeniem i zaczyna migrować -rozpoczyna się inwazja. Jak się okazuje, istotną rolę w tej kaskadzie odgrywają molekuły adhezyjne -powierzchniowe białka błon komórkowych, odpowiadające za połączenia komórek między sobą oraz komórek z przestrzenią międzykomórkową. Pełnią one kluczową funkcję w strukturalnej i funkcjonalnej organizacji tkanek. Naruszenie wyznaczonego przez nie porządku prowadzi do zaburzenia struktury i funkcji tkanki oraz rozwoju fenotypu inwazyjnego. Wykazano nieprawidłową ekspresję wielu molekuł adhezyjnych we wszystkich badanych nowotworach, w tym w raku endometrium. Jest on obecnie najczęstszym nowotworem złośliwym narządów płciowych kobiet w krajach rozwiniętych, w tym w Polsce. Choć w większości przypadków jest rozpoznawany we wczesnym stadium, kiedy rokowanie jest dobre, części pacjentek nie udaje się wyleczyć. Poznanie biologii tego nowotworu może ułatwić identyfikację pacjentek z rakiem endometrium o gorszym rokowaniu oraz, być może, znaleźć nowe opcje terapeutyczne. Poniższa praca jest próbą przedstawienia obecnego stanu wiedzy na temat roli adhezyn w patogenezie tej choroby. Słowa kluczowe: adhezja, molekuły adhezyjne, karcynogeneza, inwazja, przerzut

Suicide Risk Factors among Polish Adults Aged 65 or Older in 2000–2018 Compared with Selected Countries Worldwide

The aim of this study was to determine the tendencies of change in suicide frequency among Polish adults aged 65 or older, recognize the importance of available socio-demographic data (age, sex, marital status, and education attainment level) and provide an in-depth psychological understanding of the obtained results. We analysed the influence of education and marital status on suicide risk in the Polish adult population aged 65 or older, which has not been previously presented in publications related to the Central Statistical Office or any other research. Our results indicated that male adults aged 65 or older that were single or divorced and with a lower education had a higher risk of death by suicide. In female adults aged 65 or older, those with higher education and who were divorced or married had a higher risk of fatal suicide behaviour meanwhile, single women and widows had a lower risk. The dominant method of suicide among Polish older adults was suicide by hanging, regardless of sex; female older adults were more likely to die by suicide by poisoning or jumping from a height, and male older adults were more likely to die by shooting with a firearm. Although data from recent years highlights a downward trend for suicide rates in Polish older adults, the problem cannot be considered solved

Monitoring of the Achilles tendon healing process: can artificial intelligence be helpful?

The aim of this study was to verify improved, ensemble-based strategy for inferencing with use of our solution for quantitative assessment of tendons and ligaments healing process and to show possible applications of the method. Methods: We chose the problem of the Achilles tendon rupture as an example representing a group of common sport traumas. We derived our dataset from 90 individuals and divided it into two subsets: healthy individuals and patients with complete Achilles tendon ruptures. We computed approx. 160 000 2D axial cross-sections from 3D MRI studies and preprocessed them to create a suitable input for artificial intelligence methods. Finally, we compared different training methods for chosen approaches for quantitative assessment of tendon tissue healing with the use of statistical analysis. Results: We showed improvement in inferencing with use of the ensemble technique that results from achieving comparable accuracy of 99% for our previously published method trained on 500 000 samples and for the new ensemble technique trained on 160 000 samples. We also showed real-life applications of our approach that address several clinical problems: (1) automatic classification of healthy and injured tendons, (2) assessment of the healing process, (3) a pathologic tissue localization. Conclusions: The presented method enables acquiring comparable accuracy with less training samples. The applications of the method presented in the paper as case studies can facilitate evaluation of the healing process and comparing with previous examination of the same patient as well as with other patients. This approach might be probably transferred to other musculoskeletal tissues and joints

Accurate Noninvasive Assessment of Myocardial Iron Load in Advanced Heart Failure Patients

Background. Heart failure patients presenting with iron deficiency can benefit from systemic iron supplementation; however, there is the potential for iron overload to occur, which can seriously damage the heart. Therefore, myocardial iron (M-Iron) content should be precisely balanced, especially in already failing hearts. Unfortunately, the assessment of M-Iron via repeated heart biopsies or magnetic resonance imaging is unrealistic, and alternative serum markers must be found. This study is aimed at assessing M-Iron in patients with advanced heart failure (HF) and its association with a range of serum markers of iron metabolism. Methods. Left ventricle (LV) myocardial biopsies and serum samples were collected from 33 consecutive HF patients (25 males) with LV dysfunction (LV ejection fraction 22 (11) %; NT-proBNP 5464 (3308) pg/ml) during heart transplantation. Myocardial ferritin (M-FR) and soluble transferrin receptor (M-sTfR1) were assessed by ELISA, and M-Iron was determined by Instrumental Neutron Activation Analysis in LV biopsies. Nonfailing hearts (n=11) were used as control/reference tissue. Concentrations of serum iron-related proteins (FR and sTfR1) were assessed. Results. LV M-Iron load was reduced in all HF patients and negatively associated with M-FR (r=−0.37, p=0.05). Of the serum markers, sTfR1/logFR correlated with (r=−0.42; p=0.04) and predicted (in a step-wise analysis, R2=0.18; p=0.04) LV M-Iron. LV M-Iron load (μg/g) can be calculated using the following formula: 210.24–22.869×sTfR1/logFR. Conclusions. The sTfR1/logFR ratio can be used to predict LV M-Iron levels. Therefore, serum FR and sTfR1 levels could be used to indirectly assess LV M-Iron, thereby increasing the safety of iron repletion therapy in HF patients