45 research outputs found

    Postępowanie w ostrej hipotonii

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    Activated carbon modification towards efficient catalyst for high value-added products synthesis from alpha-pinene

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    DT0-activated carbons modified with HCl and HNO3 acids, which were used for the first time in the catalytic process of alpha-pinene isomerization, are presented in this study. The carbon materials DT0, DT0_HCl, DT0_HNO3, and DT0_HCl_HNO3 were examined with the following methods: XRF, SEM, EDX, XPS, FT-IR, XRD, and N2 adsorption at -196 °C. It was shown that DT0_HCl_HNO3-activated carbon was the most active material in the alpha-pinene isomerization process. Detailed studies of alpha-pinene isomerization were carried out over this carbon by changing the reaction parameters such as time (5–180 min) and temperature (60–175 °C). The 100% conversion of alpha-pinene was achieved at the temperature of 160 °C and catalyst content of 5 wt% after 3 h over the DT0_HCl_HNO3 catalyst. Camphene and limonene were the main products of the alpha-pinene isomerization reaction.Peer ReviewedPostprint (published version

    Metabolic control of type 2 diabetes in cardiac patients — with respect to the changing Diabetes Poland guidelines

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    Wstęp. Cukrzyca istotnie zwiększa ryzyko wystąpienia zdarzeń sercowo-naczyniowych. Celem pracy była ocena wyrównania cukrzycy u pacjentów z cukrzycą typu 2, obciążonych kardiologicznie. Materiał i metody. Analizą objęto 293 pacjentów z cukrzycą typu 2, obciążonych dodatkowymi czynnikami ryzyka sercowo-naczyniowego, wyselekcjonowanych spośród uczestników prospektywnego badania AVO­CADO (2008–2011). Przeprowadzono ocenę wyrównania cukrzycy zgodnie z wytycznymi Polskiego Towarzystwa Diabetologicznego z 2008, 2011 i 2014 roku. Wyniki. Średnia wieku w badanej grupie wynosiła 67,4 roku, a mediana czasu trwania cukrzycy — 8 lat. Wyłącznie doustnymi lekami przeciwcukrzycowymi leczonych było 66,6% pacjentów, wyłącznie insuliną — 13,7%, a leczenie skojarzone otrzymywało 19,8% chorych. Nadciśnienie tętnicze występowało u 91,5%, choroba wieńcowa u 54,6%, przebyty zawał serca u 30,7%, a przebyty udar mózgu lub przejściowy epizod niedokrwienny ośrodkowego układu nerwowego u 9,9% chorych. Mediana odsetka hemoglobiny glikowanej (HbA1c) wynosiła 6,6%. Odsetek HbA1c mniejszy lub równy 7,0% stwierdzono u 74,4% pacjentów. Kryterium wyrównania gospodarki węglowodanowej zgodnie z wytycznymi PTD z 2008 roku spełniało 46,1% pacjentów, a z lat 2011 i 2014 — 57,3% chorych. Docelowe wartości stężenia cholesterolu całkowitego, LDL, HDL i triglicerydów osiągnięto odpowiednio u: 62,1%, 43,4%, 53,9% i 67,9% chorych. Kryterium wyrównania ciśnienia tętniczego zgodnie w wytycznymi PTD z 2008, 2011 i 2014 roku spełniało odpowiednio 13,7%, 39,6% i 34,5% pacjentów. Jedynie 2,1% (PTD 2008), 6,5% (PTD 2011) i 4,8% (PTD 2014) chorych spełniało jednocześnie wszystkie kryteria wyrównania cukrzycy. Prawidłowy wskaźnik masy ciała stwierdzono u 10,3% pacjentów. Wnioski. W porównaniu z innymi polskimi badaniami i rejestrami w analizowanej grupie pacjentów z cukrzycą typu 2 ze współistniejącymi chorobami układu krążenia stwierdzono stosunkowo dobre wyrównanie cukrzycy. Najrzadziej osiąganym kryterium wyrównania metabolicznego była redukcja stężenia cholesterolu LDL. Niezależnie od zastosowanych wytycznych, jedynie niewielki odsetek chorych spełniał jednocześnie wszystkie kryteria wyrównania cukrzycy.Introduction. Diabetes mellitus significantly increases the risk of cardiovascular events. The aim of the study was to assess diabetes control in type 2 diabetic patients with coexisting cardiovascular disease.   Material and methods. A total of 293 type 2 diabetic patients with coexisting additional cardiovascular risk factors, recruited from the prospective AVOCADO study (2008–2011), were included in the analysis. Evaluation of diabetes control was conducted in accordance with the 2008, 2011 and 2014 Diabetes Poland guidelines.   Results. Mean patient age was 67.4 years, and median duration of diabetes was 8 years. Two-thirds of patients were treated solely with oral antidiabetic drugs, 13.7% of patients were on insulin monotherapy and 19.8% of patients received a combination of oral antidiabetic drugs and insulin. Hypertension was present in 91.5%, coronary artery disease in 54.6%, previous myocardial infarction in 30.7% and previous stroke or transient ischemic attack in 9.9% of patients. Median glycated hemoglobin (HbA1c) was 6.6%. A proportion of HbA1c of ≤ 7% was achieved in 74.4% of patients. Glycemic compensation according to 2008 Polish Diabetes guidelines was achieved in 46.1% of patients, and according to 2011 and 2014 guidelines — in 57.3% of patients. Therapeutic goals in terms of total cholesterol concentration were achieved in 62.1%, LDL cholesterol concentration in 43.4%, HDL cholesterol concentration in 53.9%, triglyceride concentration in 67.9% of patients. Therapeutic goals in terms of blood pressure values were achieved in 13.7%, 39.6% and 34.5% of patients according to Polish Diabetes 2008, 2011 and 2014 guidelines, respectively. Only 2.1%, 6.5% and 4.8% of patients fulfilled all the compensation criteria according to Polish Diabetes 2008, 2011 and 2014 guidelines, respectively. Only 10.3% of patients had a normal body mass index. Conclusions. In comparison to other polish studies and registries, the study group of type 2 diabetic patients with coexisting cardiovascular diseases was characterized by a relatively good diabetes control. Out of all the metabolic therapeutic goals, reduction in LDL cholesterol concentration was the most difficult to achieve. Only a small proportion of patients fulfilled all the compensation criteria, irrespective of the guidelines used for diabetes control assessment

    Carbonaceous catalysts from orange pulp for limonene oxidation

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    The possibility of orange pulp utilization for nanoporous carbons production was investigated. Moreover, processing the obtained materials as limonene oxidation catalysts was studied as well. Limonene was separated from orange pulp obtained from fragmented orange peels—the waste from industrial fruits processing—by means of simple distillation. After the sepa-ration of limonene from the biomass, the dried orange pulp was converted to three types of nanoporous carbon catalysts: without activating agent, with NaOH, and with KOH. The catalysts were characterized by XRD, SEM, EDX, AFM, and sorption of N2 methods. The activities of the obtained catalysts were tested in the oxidation of limonene to perillyl alcohol (the main product), carveol, carvone, and 1,2-epoxylimonene and its diol. In the oxidation processes, hydrogen peroxide was used as the oxidizing agent. This work has shown for the first time that nanoporous carbons obtained from orange pulp waste, after separation of limonene, are active catalysts for limonene oxidation to industrially important value-added productsPeer ReviewedPostprint (published version

    Management of patients with COVID-19 in radiology departments, and indications regarding imaging studies : recommendations of the Polish Medical Society of Radiology

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    The pandemic involving COVID-19 caused by the SARS-CoV-2 coronavirus, due to its severe symptoms and high transmission rate, has gone on to pose a control challenge for healthcare systems all around the world. We present the second version of the Recommendations of the Polish Medical Society of Radiology, presuming that our knowledge on COVID-19 will advance further rapidly, to the extent that further supplementation and modification will prove necessary. These Recommendations involve rules of conduct, procedures, and safety measures that should be introduced in radiology departments, as well as indications for imaging studies

    A core curriculum for the continuing professional development of nurses: Developed by the Education Committee on behalf of the Council on Cardiovascular Nursing and Allied Professions of the ESC

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    Background: The European Society of Cardiology and the Council on Cardiovascular Nursing and Allied Professions share a vision; to decrease the burden of cardiovascular disease in Europe. Nurses represent the largest sector of the health professional workforce and have a significant contribution to make, which has not yet been fully realised. Recent evidence highlights an association between the level of nurse education and inpatient mortality making this an important topic, particularly as the provision of nurse education in Europe is variable. Aim: To develop a core curriculum to inform the education of nurses following initial qualification for work in cardiovascular settings. Method: A syllabus was developed using published literature, policy documents and existing curricula with expert input from service users, specialist nurses, cardiologists, educationalists and academics. The syllabus formed the framework for the development of the core curriculum. Results: Eight key themes characterise the core curriculum which are presented together with an account of the development process. While the curriculum is not intended to cover all aspects of the highly complex role of the cardiovascular nurse, the themes do exemplify the science and art of nursing and are transferable across different levels of clinical practice and settings. The curriculum functions both as a ‘map’, which identifies key themes to include in nurse education, and as a ‘tool’ to inform educational provision that bridges’ the gap between initial nurse education and advanced specialist practice. Content can be adapted for use to fit the national context and reflects the specific needs, health priorities, legislative and regulatory standards that govern safe nursing practice across different countries. Conclusion: The core curriculum can be used as a learning framework to guide nurse education, in particular the continuing professional education of post-qualifying nurses working in cardiovascular settings. This represents a significant step towards streamlining cardiovascular nurse education in Europ

    Difficulties in the diagnostics of renal tumor in a child with tuberous sclerosis : case report

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    Background: Angiomyolipoma (AML) is the most common renal tumor in tuberous sclerosis (TS) patients. However, these patients also face an increased risk of malignant kidney neoplasms. Case report: A 7-year-old boy with a diagnosis of TS was sent for abdominal CT due to a single isoechoic tumor in the lower pole of left kidney, which was revealed in US. CT exam confirmed the presence of a hiperdense tumor which exceeded margins of the left kidney. The tumor was homogenously enhanced after contrast administration. The absence of regions of negative attenuation in CT and the isoechogenisity in US suggested rather malignant lesion than AML. Partial nephrectomy was performed. Subsequent pathologic examination classified the tumor as a low-fat AML. Conclusions: Radiological diagnosis of low-fat AML is difficult and requires a careful differentiation from other lesions

    Costs of the use of carbetocin in the prevention of uterine atony following delivery of the infant by Caesarean section — retrospective multicenter study

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    Objectives: The aim of this study was to compare the costs of using carbetocin in the prevention of uterine atony following delivery of the infant by Cesarean section (C-section) under epidural or spinal anesthesia with standard methods of prevention (SMP). Material and methods: This retrospective multicenter study was based on data from three medical centers. A questionnaire was developed to gather patient records on consumption and costs of resources related to C-section, prevention of uterine atony and postpartum hemorrhage (PPH) treatment. Six subpopulations were considered, depending on patient characteristics. The analysis covered two perspectives: that of the hospital and of the public payer. Results: The subpopulations were homogenous, which was a premise for pooling the data. The use of carbetocin in the prevention of uterine atony following Cesarean section generates savings for hospital in comparison with SMP (oxytocin) in 5 of 6 subpopulations. The biggest savings were observed amongst patients who experienced severe PPH and reached 2.6–6.2 thousand PLN per patient. Costs of services related to C-section borne by the hospitals were higher than the refund received from a public payer. The greatest underestimation reached 12.1 thousand PLN per patient. Nevertheless, loss generated by this underfunding was lower in carbetocin versus oxytocin group. Conclusions: The use of carbetocin instead of SMP gives hospitals an opportunity to make savings as well as to reduce losses resulting from the underfunding of the services provided by the National Health Fund

    Recommendations of the Polish Medical Society of Radiology and the Polish Society of Neurology for the routinely used magnetic resonance imaging protocol in patients with multiple sclerosis

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    Magnetic resonance imaging (MRI) is a widely used method for the diagnosis of multiple sclerosis (MS) that is essential for the detection and follow-up of the disease. The Polish Medical Society of Radiology (PLTR) and the Polish Society of Neurology (PTN) present the second version of the recommendations for examinations routinely conducted in magnetic resonance imaging departments in patients with MS, which include new data and practical comments for electroradiology technicians and radiologists. The recommended protocol aims to improve the MRI procedure and, most importantly, to standardise the method of conducting scans in all MRI departments. This is crucial for the initial diagnostics that are necessary to establish a diagnosis as well as monitor patients with MS, which directly translates into significant clinical decisions. MS is a chronic idiopathic inflammatory demyelinating disease of the central nervous system (CNS), the aetiology of which is still unknown. The nature of the disease lies in the CNS destruction process disseminated in time and space. MRI detects focal lesions in the white and grey matter with high sensitivity (with significantly less specificity in the latter). It is also the best tool to assess brain atrophy in patients with MS in terms of grey matter volume and white matter volume as well as local atrophy (by measuring the volume of thalamus, corpus callosum, subcortical nuclei, hippocampus) as parameters that correlate with disability progression and cognitive dysfunctions. Progress in magnetic resonance techniques, as well as the abilities of postprocessing the obtained data, has become the basis for the dynamic development of computer programs that allow for a more repeatable assessment of brain atrophy in both cross-sectional and longitudinal studies. MRI is unquestionably the best diagnostic tool used to follow up the course of the disease and to treat patients with MS. However, to diagnose and follow up the patients with MS on the basis of MRI in accordance with the latest standards, an MRI study must meet certain quality criteria, which are the subject of this paper
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