Implantable cardioverter-defibrillators in prevention of sudden cardiac death in patients with chronic kidney disease

Schorzenia układu sercowo-naczyniowego stanowią najczęstszą przyczynę zgonów pacjentów z przewlekłą chorobą nerek (CKD), szczególnie w bardziej zaawansowanych stadiach. Ryzyko nagłej śmierci sercowej u osób z CKD wynosi 55 na 1000 pacjentów na rok i jest wielokrotnie wyższe niż w populacji ogólnej. Zarówno w europejskich, jak i w amerykańskich standardach postępowania populacja pacjentów kwalifikujących się do leczenia za pomocą wszczepialnego kardiowertera-defibrylatora (ICD) jest bardzo szeroka. W żadnym z dokumentów eksperci nie zróżnicowali wskazań i przeciwwskazań do tego typu urządzeń wszczepialnych zależnie od stopnia wydolności nerek. Niestety, z większości dużych badań randomizowanych dotyczących ICD pacjenci z zaburzeniami czynności nerek byli wyłączani lub w ogóle niebrano pod uwagę parametrów czynności nerek. Wyniki większości badań wskazują, że stosowanie ICD u pacjentów z CKD wiąże się z poprawą przeżycia. Korzyść ta nie jest jednak tak znacząca, jak w grupie chorych z prawidłową czynnością nerek.Cardiovascular diseases are the leading cause of death in patients with chronic kidney disease (CKD), especially in more advanced stages of CKD. The risk of sudden cardiac death in patients with CKD is 55/1000 patients/year and is many times higher than in the general population. Both European and American recommendation sweep a wide population of patients eligible for treatment with ICD. In none of these documents experts do not differentiate indications and contraindications for this type of implantable device, depending on renal function. Unfortunately, patients with renal impairment were excluded from most of the large randomized trials on ICD therapy or renal function was not taken into account. Most studies indicate that the use of ICD patients with CKD is associated with improved survival. However, the benefit is not as significant as in patients with normal renal function

Determining the Trajectory of the Crane Block Using the Finite Element Method

The paper discusses determining crane block trajectories using the finite element method (FEM). The mathematical formulation for air resistance of hooks’ block is presented with kinematic analysis of the block. The three crane blocks are considered: without wind deflector, with a spherical deflector and a cylindrical fairing. The hook block was assumed as a physical pendulum. The FEM analysis is provided with the hook block movement consideration. Movement trajectories of hook blocks for different wind speeds is depicted and the results are. At the end of the paper, the conclusions are provided with the directions of future research

Osborn wave in ECG in elderly patient with so-called urban hypothermia

Kiciński Paweł, Szymańska Monika, Niedziałek Jarosław, Lis Beata, Prystupa Andrzej. Osborn wave in ECG in elderly patient with so-called urban hypothermia. Journal of Education, Health and Sport. 2016;6(8):206-209. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.60084http://ojs.ukw.edu.pl/index.php/johs/article/view/3748   The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 755 (23.12.2015).755 Journal of Education, Health and Sport eISSN 2391-8306 7© The Author (s) 2016;This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, PolandOpen Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium,provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License(http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited.This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercialuse, distribution and reproduction in any medium, provided the work is properly cited.The authors declare that there is no conflict of interests regarding the publication of this paper.Received: 15.07.2016. Revised 25.07.2016. Accepted: 12.08.2016.  Osborn wave in ECG in elderly patient with so-called urban hypothermia Paweł Kiciński1, Monika Szymańska2, Jarosław Niedziałek2, Beata Lis3, Andrzej Prystupa3 1Department of Family Medicine, Medical University of Lublin, Poland2Individual Medical Practice, Lublin, Poland3Department of Internal Diseases, Medical University of Lublin, Poland  AbstractThe Osborn wave is a characteristic twisting at the termination of the QRS complex visible at the J point. Its presence is most commonly associated with hypothermia, electrolyte imbalance, primary cardiac disorders or CNS pathologies. A case of a 78-year–old male with Osborne wave caused by deep hypothermia is presented. Key words: electrocardiography, hypothermia, Osborn wave

Factors influencing troponin T concentration in patients with obstructive sleep apnea syndrome

Introduction. Obstructive sleep apnea syndrome (OSAS) is strongly associated with adverse cardiovascular outcomes, however the relation between OSAS severity and troponin T (TnT) remain unclear.Material and methods. Diagnosis and assessment of OSAS severity was based on non-supervised, overnight screening polysomnography (PSG) performed without an adaptation night. The study group consisted of 72 patients diagnosed with OSAS (including 31 with mild, 10 with moderate and 31 patients with severe OSAS), whereas the control group contained 16 individuals. PSG was performed with equipment fulfilling the criteria of type III diagnostic devices according to the American Academy of Sleep Medicine.Results. Revealed significant differences in troponin T levels between patients with severe OSAS and controls (p = 0.02) as well as in patients with severe and with mild OSAS (p = 0.04). The factors substantially affecting TnT concentrations were found to be apnea–hypopnea index (AHI), apnea index (AI), hypopnea index (HI) and minimum nocturnal saturation.Conclusions. The relationship between sleep apnea syndrome and the level of serum TnT confirms that OSAS predisposes to myocardial damage in a manner dependent on the severity of sleep apnea. The increase in troponin level is mainly associated with AHI and minimum nocturnal saturation. This suggests that early treatment of OSAS patients may protect against myocardial injury.Introduction. Obstructive sleep apnea syndrome (OSAS) is strongly associated with adverse cardiovascular outcomes, however the relation between OSAS severity and troponin T (TnT) remain unclear.Material and methods. Diagnosis and assessment of OSAS severity was based on non-supervised, overnight screening polysomnography (PSG) performed without an adaptation night. The study group consisted of 72 patients diagnosed with OSAS (including 31 with mild, 10 with moderate and 31 patients with severe OSAS), whereas the control group contained 16 individuals. PSG was performed with equipment fulfilling the criteria of type III diagnostic devices according to the American Academy of Sleep Medicine.Results. Revealed significant differences in troponin T levels between patients with severe OSAS and controls (p = 0.02) as well as in patients with severe and with mild OSAS (p = 0.04). The factors substantially affecting TnT concentrations were found to be apnea–hypopnea index (AHI), apnea index (AI), hypopnea index (HI) and minimum nocturnal saturation.Conclusions. The relationship between sleep apnea syndrome and the level of serum TnT confirms that OSAS predisposes to myocardial damage in a manner dependent on the severity of sleep apnea. The increase in troponin level is mainly associated with AHI and minimum nocturnal saturation. This suggests that early treatment of OSAS patients may protect against myocardial injury

Obturacyjny bezdech senny — zasady diagnostyki i leczenia

Istotą obturacyjnego bezdechu sennego (OBS) są powtarzające się w czasie snu epizodyniedrożności górnych dróg oddechowych. Częstość występowania OBS wzra -sta wraz ze zwiększającym się rozpowszechnieniem otyłości, która stanowi jedenz najistotniejszych czynników r yzyka zaburzeń oddychania w czasie snu. W krajachwysoko uprzemysłowionych OBS występuje u 9–26% dorosłej populacji. P odstawąrozpoznania OBS jest całonocne badanie polisomnograficzne będące obiektywnymnarzędziem oceniającym rodzaj i nasilenie zaburzeń oddychania w czasie snu. Celemleczenia obturacyjnego bezdechu sennego jest utr zymanie drożności górnych drógoddechowych. U pacjentów z bezdechem o ciężkim nasileniu metodą z wyboru jestterapia przy użyciu dodatniego ciśnienia w drogach oddechowych. Nieleczony OBSwiąże się nie tylko z pogorszeniem jakości życia, wynikającym przede wszystkim zewzmożonej senności dziennej, ale także ze zwiększonym ryzykiem rozwoju schorzeńsercowo-naczyniowych, zaburzeń metabolicznych i wypadków komunikacyjnych

Implantable cardioverter-defibrillators in prevention of sudden cardiac death in patients with chronic kidney disease

Streszczenie Schorzenia sercowo-naczyniowe stanowią najczęstszą przyczynę zgonów pacjentów z przewlekłą chorobą nerek (CKD, chronic kidney disease), szczególnie w bardziej zaawansowanych stadiach. Ryzyko nagłej śmierci sercowej (SCD, sudden cardiac death) u osób z CKD wynosi 55/1000 pacjentów/rok i jest wielokrotnie wyższe niż w populacji ogólnej. Zarówno europejskie jak i amerykańskie standardy postępowania zakreślają bardzo szeroką populację pacjentów kwalifikujących się do leczenia przy pomocy ICD. W żadnym z dokumentów eksperci nie różnicują wskazań i przeciwwskazań do tego typu urządzeń wszczepialnych w zależności od stopnia wydolności nerek. Niestety z większości dużych badań randomizowanych dotyczących ICD pacjenci z upośledzeniem czynności nerek byli wyłączani bądź też parametry czynności nerek w ogóle nie były brane pod uwagę. Wyniki większości badań wskazują, że stosowanie ICD u pacjentów z CKD wiąże się z poprawą przeżycia. Jednakże korzyść ta nie jest tak znacząca jak w grupie chorych z prawidłową czynnością nerek.Abstract Cardiovascular diseases are the leading cause of death in patients with chronic kidney diseas (CKD), especially in more advanced stages of CKD. The risk of sudden cardiac death (SCD) in patients with CKD is 55/1000 patients/year and is many times higher than in the general population. Both European and American recommendation sweep a wide population of patients eligible for treatment with ICD. In none of these documents experts do not differentiate indications and contraindications for this type of implantable device, depending on renal function. Unfortunately, patients with renal impairment were excluded from most of the large randomized trials on ICD therapy or renal function was not taken into account. Most studies indicate that the use of ICD patients with CKD is associated with improved survival. However, the benfit is not as significant as in patients with normal renal function

Complex relationships between endocrinopathies and obstructive sleep apnea syndrome

Sleep-related disordered breathing (SRDB) is a term covering a heterogeneous group of conditions with a similar clinical picture yet different pathogenesis. Nocturnal episodes of obstructive apnoea, leading to repeated periods of desaturation and re-oxygenation, activate chemoreceptors and increase the activity of the sympathetic as well as renin-angiotensin-aldosterone system. Moreover, the generation of free radicals and proinflammatory cytokines increases. All the above mentioned disturbances interfere with the function of endocrine glands. On the other hand, many endocrine disorders are associated with an increased risk of obstructive sleep apnoea syndrome (OSAS). In this paper, we discuss relationships between selected endocrinopathies and OSAS

MCDM Approach to the Excise Goods Daily Delivery Scheduling Problem. Case Study: Alcohol Products Delivery Scheduling under Intra-community Trade Regulations

AbstractThis paper presents a multiple criteria decision making approach for solving the excise goods daily delivery scheduling problem. The presented procedure enables to determine the schedule of deliveries from many suppliers to one consignee. The algorithm combines heuristic approach and the Light Beam Search method. The minimal dispersion of unloadings in the consignee's warehouse as well as minimal dispersions of loadings in suppliers’ warehouses are the criteria used for selecting the most satisfactory delivery schedule. The paper presents also an example of application of the proposed algorithm in the real problem concerning alcohol products delivery scheduling under Intra-Community Trade regulations

Location of airports - selected quantitative methods

Background: The role of air transport in  the economic development of a country and its regions cannot be overestimated. The decision concerning an airport's location must be in line with the expectations of all the stakeholders involved. This article deals with the issues related to the choice of  sites where airports should be located. Methods: Two main quantitative approaches related to the issue of airport location are presented in this article, i.e. the question of optimizing such a choice and the issue of selecting the location from a predefined set. The former involves mathematical programming and formulating the problem as an optimization task, the latter, however, involves ranking the possible variations. Due to various methodological backgrounds, the authors present the advantages and disadvantages of both approaches and point to the one which currently has its own practical application. Results: Based on real-life examples, the authors present a multi-stage procedure, which renders it possible to solve the problem of airport location. Conclusions: Based on the overview of literature of the subject, the authors point to three types of approach to the issue of airport location which could enable further development of currently applied methods

Serum Concentration of Fluoride in Patients with Alcoholic Liver Cirrhosis from the Lublin Region in Eastern Poland

In view of previous reports, it is important to determine the relationship between liver function and the level of fluoride in the serum. The aim of this study was to investigate serum concentrations of fluoride in 72 patients with alcoholic liver cirrhosis, living in the region of Lublin (Eastern Poland) divided based on the severity of disease according to the Child-Turcotte-Pugh criteria. Higher plasma fluoride concentrations were associated with changes in liver related parameters. In all groups of analyzed patients with different stages of alcoholic liver cirrhosis, elevated levels of plasma fluoride and increased activities of both alanine aminotransferase (ALT) and total bilirubin concentration were shown