Search

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2), spreads rapidly and has been announced a pandemic by the World Health Organization (WHO). COVID-19 especially affects cardiovascular system, mostly by leading to the dysfunction of endothelium and its consequences. On the other hand, patients with a history of chronic disease are believed to have a more severe course of COVID-19. Furthermore, apart from an undoubted influence on morbidity and mortality, COVID-19 results in changes in many aspects of human life. It is worth noting that pandemic will also affect people who did not suffer from disease. Nevertheless, due to constantly elevated stress level, COVID-19 may have influence on mental health. Paradoxically, in dealing with stress and COVID-related problems, faith and religiosity can play a leading role. In this review, attention was paid not only to possible cardiac complications of infection but also to the impact of the pandemic on psychological and spiritual effects of the pandemic.

Lower urinary tract symptoms (LUTS) are etiologically heterogeneous group of clinical symptoms, which are related to disorders of the lower urinary tract (bladder, prostate and urethra). LUTS are common break down into two symptoms groups: voiding (obstructive) symptoms or storage (irritative) symptoms. Patients may have mainly voiding symptoms, storage symptoms or a combination of both. The occurrence of LUTS is not limited to specific disease despite the frequent association of these symptoms with the bladder outlet obstruction. Furthermore, they can be an indicator of structural and functional abnormalities of the urinary tract, as well as the indicator of many other non-urological diseases ( e.g. chronic kidney disease, cardiovascular disease, disorders of the central nervous system and endocrine system). In many cases, LUTS are consequence of systemic changes that are caused by cardiovascular risk factors such as diabetes, hyperlipidemia or hypertension. This paper discusses the relationship between the occurrence of LUTS and the cardiovascular disease and the potential clinical implications regarding the management of the patients.

Serotonin plays an important role in regulating the cardiovascular system. Drugs widely used in the treatment of depression, migraine, Parkinson’s disease or obesity affect the serotonergic system. The use of these compounds causes both acute and chronic effects, depending on the type of activated 5-HT receptor and its location. An acute cardiac response to 5-HT, known as Bezold-Jarisch reflex, leads to bradycardia and hypotension. The chronic contribution of serotonin may be associated with fibrosis and cardiac valve degeneration. This article analyses the impact of 5-HT receptors activation on the cardiovascular system and describes side effects of this activation and new therapies targeting this system.

The aging process does not occur in the same way for all patients. The pace of this process, both physical and mental, is very different. The quality of life of an elderly patient depends on many factors, including lifestyle, genetic predisposition and appropriate medical care. The quality of health care depends, among other things, on how quickly and, whether or not, the doctor sees correctly signs of premature or „abnormal” aging. To facilitate this, a set of symptoms was identified, the occurrence of which should alert the doctor due to the relationship with increased mortality. In the English-language literature, this group is called frailty syndrome. In the Polish literature, the most widely used description of this phenomenon is probably zespol kruchości . The aim of this paper was to present the importance of this syndrome in clinical practice.

Cardiovascular risk assessment in clinical practice isessential. It affects treatment methods of cardiovascular diseases in patients. Recommended tools such as POL-SCORE do not take into account the clinical picture of all the patients. The clinical case shows that the use of nonclassical elements of risk factors in clinical practice changes the scheme of action undertaken so far.

Introduction. Arterial hypertension (AH) is a well-known cardiovascular risk factor. Currently, in Poland, approximately 32% of adults suffer from AH, and only 26% of them are treated successfully. The study aims to determine the incidence of atherosclerosis risk factors and their influence on the effectiveness of hypotensive treatment in the population of patients with AH and coexisting coronary artery disease (CAD) or coronary equivalent. Material and methods. The study included 204 adults. The inclusion criteria were: diagnosis of AH with coexisting a diagnosis of CAD (138 people) or coronary equivalent defined as high (≥ 5%) atherosclerosis-related risk of death in 10-year prognosis, estimated using the EURO SCORE scale (66 people). During observation, pharmacological and nonpharmacological treatments were modified according to the current AH treating standards. After 6 months of observation, the effectiveness of AH control was assessed. Results. Multivariate logistic regression analysis revealed that main factors affecting poor blood pressure control after six months of observation were: obesity, age > 65 years, LDL cholesterol level > 130 mg/dL. Moreover, systolic blood pressure (SBP) < 140 mmHg was more frequent in patients with diabetes mellitus. After six months of therapy, good control of SBP was found in 42.7% of patients and normal values of diastolic blood pressure (DBP) — in 65.2 % of patients. Conclusion. Independent risk factors for poor control of blood pressure were: high level of LDL-cholesterol, age > 65 years and female sex. Paradoxically, diabetes was not a risk factor for poor control of hypertension. The introduction of combined hypotensive and lipid-lowering drugs should contribute to a better control of hypertension in Poland.

Background Vitamin D is a compound of great importance in controlling the biological functions of the body in a variety of ways. Significance of vitamin D in the pathogenesis and treatment of various diseases has been described repeatedly. One of the most discussed issues in the literature is the importance of vitamin D deficiency in the pathogenesis of hypertension. This relationship is particularly important in patients burdened with elevated cardiovascular risk, which undoubtedly represent patients with diagnosed disease of the cardiovascular system. The aim of the study was to determine the association between the occurrence of vitamin D deficiency and the prevalence of hypertension in premenopausal women at very high cardiovascular risk. Materials and methods The study included 49 women who had previously been diagnosed with cardiovascular disease. In all patients enrolled in the study serum concentrations of vitamin D were measured and the patients were classified to have vitamin D deficiency or normal vitamin D level, based on the existing criteria. The patients were also tested for the occurrence of hypertension. Medical records of all patients were reviewed for early diagnosis of hypertension, and blood pressure measurements were performed on admission to the hospital before the surgery by a qualified physician, in a manner consistent with current guidelines Results The study population was aged 47.7 ± 13.4 years. The mean body mass index was 25.2 kg/m 2 . Vitamin D deficiency was diagnosed in 25 (51%) patients, and hypertension was diagnosed in 30 women (61.2%). In patients with vitamin D deficiency hypertension occurred in 18 (72%) women, while in the group without vitamin D deficiency hypertension was diagnosed in 50% of cases (12 women). The observed difference between the groups was statistically significant (p = 0.049). There was no difference in the incidence of other cardiovascular risk factors between the groups, including the prevalence of dyslipidaemia or nicotine addiction. Conclusion Association of hypertension with the vitamin D deficiency has been repeatedly underlined in many scientific studies. In the present group of patients at very high cardiovascular risk, we confirmed the relationship of vitamin D deficiency with the occurrence of hypertension. Exact confirmation of this issue requires further, largescale research, but this study may suggest the importance of vitamin D supplementation in these patients.

Background Total hip replacement is a common orthopaedic procedure associated with an elevated cardiovascular risk. There are several methods for total hip replacement, including whether or not to use cement for the prosthesis fixation. The aim of the study was to compare clinical characteristics, including blood pressure, in patients undergoing total hip replacement with and without the use of cement. Material and methods The study included patients with elective total hip replacement surgery, who were divided into those in whom the procedure was performed with or without the use of medical cement. The criteria for using cement were assessed during operation by the operator, according to the current protocol. All patients were interviewed, screened, and had their medical records checked for the prior diagnosis of cardiovascular risk factors. Blood pressure values were measured before and after the procedure according to the current guidelines. Results The study population consisted of 65 patients in whom the total hip replacement was performed (mean age 61.5 ± 15.0 years; 50.8% male). 60% of patients had the hip replacement without cement and 40.0% had a procedure with the use of cement. Patients in whom the cement was used were significantly older (75.0 ± 8.5 vs. 53.0 ± 11.5 years; p < 0.0001) and more often diagnosed with arterial hypertension (61.5 vs. 33.3%; p = 0.04), than those in whom it was not used. Systolic blood pressure values were significantly higher before and after the procedure (138.8 ± 18.2 vs. 130.8 ± 21.5 mm Hg, p = 0.04; 122.6 ± 13.3 vs. 113.8 ± 14.1 mm Hg, p = 0.03; respectively) in the group which required cement. Conclusions Patients with hip replacement using cement have higher systolic values before, and after the surgery than in patients in whom cement wasn’t used. Therefore careful management and risk assessment is especially important in patients receiving the total hip replacement with the use of cement.

Background: Assessment of blood pressure values and early diagnosis of hypertension are especially important in high-risk group, including patients in preoperative and postoperative period. The aim of the current study was the assessment of blood pressure values and prevalence of hypertension in patients undergoing elective hip replacement surgery — an orthopedic procedure associated with one of the highest cardiovascular complication rate. Material and methods: Two hundred and eighty-four consecutive patients admitted for elective hip replacement surgery were screened for arterial hypertension. All patients had their medical records reviewed for prior diagnosis and had their blood pressure measured on admission by a qualified physician prior to the procedure, according to the current guidelines. Results: The mean age of the study population was 62.2 ± 13.9 years and 42.7% of the patients were male. The body mass index (BMI) in the study population was 27.0 ± 4.2 kg/m 2 . Fifty-eight point two percent of patients were diagnosed with arterial hypertension previously. Mean blood pressure values on admission for systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 134.5 ± 20.4 and 78.6 ± 13.1 mm Hg, respectively. In 43.2% of patients, the on admission blood pressure values exceeded the threshold of ≥ 140 and/or 90 mm Hg. Arterial hypertension was diagnosed de novo in 33 (15.0%) patients. Patients with the disease were older (67.5 ± 12.3 vs. 54.4 ± 13.9 years; p < 0.0001), and had higher BMI (27.6 ± 4.3 vs. 26.2 ± 3.8 kg/m 2 ; p = 0.05) than patients without the diagnosed disease. Diabetes mellitus was more often found in hypertensive patients (13.3% vs. 3.3%; p = 0.02), they also more often had history of myocardial infarction (p = 0.02), stable coronary artery disease (p = 0.001) and heart failure (p = 0.006) compared to patients without the diagnosis. Conclusions: The majority of patients scheduled for elective hip replacement surgery is diagnosed with arterial hypertension. The disease is also diagnosed de novo in 15% of these patients. Screening for arterial hypertension is important in this group of patients and can potentially reduce the complication rates of the hip replacement surgery.

Background B-type natriuretic peptide (BNP) is a biomarker commonly used in diagnosing and assessing prognosis in heart failure patients. Its concentration can be elevated in various conditions associated with excessive heart wall stretch including atrial fibrillation and obstructive sleep apnoea (OSA). The aim of the study was to assess if BNP levels in atrial fibrillation patients are associated with the value of apnoea-hypopnea index (AHI). Material and methods Study population were consecutive patients with atrial fibrillation, who underwent overnight sleep study, and had blood taken for BNP concentration assessment. Subsequently, patients were divided into group according to AHI: Group I ( 15/h). Results Analysis covered 158 patients (males, 64.6%; mean age, 58.3 ± 9.2 years). 83 (52.5%) patients had AHI 15 (104.0 ± 150.8 pg/mL; p for trend = 0.03). Conclusions Majority of patients with atrial fibrillation have AHI < 5/h and these generally have lower BMI, and neck circumference. Patients who have AHI exceeding ≥ 5/h BNP levels tend to be elevated, and its values rise along with AHI.

Background Arterial hypertension is one of the major cofounders in the development of atrial fibrillation (AF) and hypertension is commonly found in AF patients. The aim of the study was to establish the prevalence of arterial hypertension in patients undergoing ablation, who are relatively young and healthy group of AF patients. Material and methods 266 consecutive patients admitted for AF ablation were screened for arterial hypertension. All patients had their blood pressure measured on admission by, prior to the ablation procedure by a qualified physician, according to the current guidelines. Also, medical records of patients were reviewed for the previous diagnosis of hypertension or taking hypotensive agents. Results The study group was predominantly male (65.0%; mean age 57.6 ± 10.1 years). Mean body mass index was 29.7 ± 5.0 kg/m 2 . Paroxysmal AF was present in 69.5% of patients. In 72.9% of patients hypertension was diagnosed previously. On admission, mean systolic and diastolic blood pressure values were 131.7 ± 16.7 and 80.7 ± 11.1 mm Hg. 123 (46.2%) patients had systolic and/or diastolic blood pressure values respectively > 140 and/or > 90 mm Hg. Patients with previously diagnosed hypertension were older (58.7 ± 8.7 vs 54.6 ± 12.7 years; p = 0.003), had higher BMI (30.3 ± 5.0 vs 28.1 ± 4.8 kg/m 2 ; p = 0.002), and more often history of diabetes (10.8% vs 1.4%; p = 0.03) compared to non-hypertensive group. There were no differences in terms of history of dyslipidaemia, stroke, myocardial infarction or family history of cardiovascular disease. Conclusions In patients with AF undergoing ablation procedure, prevalence of diagnosed arterial hypertension is very high, much higher than in the general population. Nevertheless, majority of patients meet the criteria for adequate blood pressure control.

Aim of the study: The main purpose of the study was to examine opinions on perinatal care expressed by women hospitalized after childbirth in Poland and Germany. Different socio-demographic variables were also analyzed in order to evaluate the quality of perinatal care in two different countries. Materials and methods: The study group comprised of postpartum patients from two facilities: the Clinical Ward of Gynecology and Obstetrics of Frideric Chopin Province Specialist Hospital in Rzeszow, Poland, and the Obstetrics-Gynecology Hospital in Gross-Gerau, Germany. The group of randomly selected women, who were initially invited to participate in the study, included 259 Polish and 230 German females. In order to measure the level of satisfaction with perinatal care, the authors used “The Newcastle Satisfaction with Nursing Scale” (originally constructed at the Center for Health Services Research, University of Newcastle upon Tyne, UK, and adopted in Poland by Poznan University of Medical Sciences) and their own questionnaire. Finally, 200 patients, one hundred from Poland and one hundred from Germany, were enclosed. Statistical analysis was performed using the Statistics 8.0 software and a p valued below 0.05 was regarded significant. Results: Generally, perinatal care was assessed as being satisfactory by both Polish (91%) and German (97%) respondents. The study population varied in terms of age, education, place of residence or marital status. Only one socio-demographic variable (education) had a significant impact on the perception of the obtained perinatal care. However, a limited number of patients (25% in Poland and 47% in Germany) participated in the prental and parenting classes. Conclusions: 1. Perinatal care was positively assessed by Polish and German patients of both hospitals. 2. The greatest importance in selecting the location for childbirth was attributed by both Polish and German subjects to such factors as: opinion of their friends, highly qualified personnel, modern medical equipment and instruments on premises. Additionally, Polish respondents found it important that the doctor who had provided care for a given woman during pregnancy was employed at that particular hospital. In turn, German respondents also paid particular attention to the distance between their place of residence and hospital. 3. All study participants, regardless of their nationality, admitted that the hospitals offered to their close relatives the possibility to visit and accompany the patients during childbirth.