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Introduction: Although breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is infrequent, with less than 1000 noted cases worldwide, patients consenting for breast implant surgery should be aware of its risk. We describe the first Polish multicenter case-series data on BIA-ALCL patients and present diagnostic and treatment recommendation for breast surgeons. Material and methods: In cooperation with the Polish Society of Surgical Oncology and Polish Lymphoma Research Group, we collected BIA-ALCL cases in Poland. Results: We retrospectively reviewed clinical data of seven BIA-ALCL patients, diagnosed between July 2013 and November 2019. The median time from implant placement to the first BIA-ALCL symptoms was 65 months (range: 33-96 months). All the patients were exposed to textured implants at presentation. Capsulectomy with implant removal was performed in all the patients with immediate reimplantation in 2 cases. In a median follow-up of 19 months (range 5-81 months), there was no recurrence and all the patients stayed alive. Between 2013 and 2019, the incidence of BIA-ALCL in Polish female population age 30 and above ranged from 0 to 0.021/100 000/year. Conclusions: BIA-ALCL is scarce in the Polish population. In a short-term follow-up, patients' prognosis remains excellent. Due to the withdrawal of roughly textured implants from the market and the exclusion of likely the most potent etiologic factor, it might be expected that the incidence of BIAALCL will become even rarer. [ABSTRACT FROM AUTHOR]

Purpose: To assess glycemic control and safety of children and adolescents with type 1 diabetes participating in a 2-day football tournament. Methods: In total, 189 children with type 1 diabetes from 11 diabetes care centers, in Poland, participated in a football tournament in 3 age categories: 7–9 (21.2%), 10–13 (42.9%), and 14–17 (36%) years. Participants were qualified and organized in 23 football teams, played 4 to 6 matches of 30 minutes, and were supervised by a medical team. Data on insulin dose and glycemia were downloaded from personal pumps, glucose meters, continuous glucose monitoring, and flash glucose monitoring systems. Results: The median level of blood glucose before the matches was 6.78 (4.89–9.39) mmol/L, and after the matches, it was 7.39 (5.5–9.87) mmol/L (P =.001). There were no episodes of severe hypoglycemia or ketoacidosis. The number of episodes of low glucose value (blood glucose ≤3.9 mmol/L) was higher during the tournament versus 30 days before: 1.2 (0–1.5) versus 0.7 (0.3–1.1) event/person/day, P <.001. Lactate levels increased during the matches (2.2 [1.6–4.0] mmol/L to 4.4 [2.6–8.5] mmol/L after the matches, P <.001). Conclusions: Large football tournaments can be organized safely for children with type 1 diabetes. For the majority of children, moderate mixed aerobic–anaerobic effort did not adversely affect glycemic results and metabolic safety. [ABSTRACT FROM AUTHOR]

Misophonia, characterized by hypersensitivity to specific sounds, significantly impacts family dynamics and children's school experiences. This study aims to understand this condition from teachers' and parents' viewpoints, providing insights into coping strategies within educational and family contexts. Research Questions: 1. Are teachers able to recognize symptoms of misophonia in students at school? 2. How do teachers manage the challenges posed by misophonia? Do they view it as a challenge affecting their professional experience? 3. How do parents perceive and respond to their children's symptoms of misophonia at home? 4. What coping strategies do parents employ to manage misophonia in both family and school settings? 5. What support and intervention strategies do teachers and parents prefer for dealing with misophonia? Research Methodology: Participant Selection: The study involves teachers and parents. Teachers working with students of various age groups and parents of school-aged children are included. Sample: Approximately 300 individuals will be surveyed, including parents (both mothers and fathers). Additionally, 20 participants will be selected for in-depth interviews. Surveys: Participants will complete anonymous surveys. In-Depth Interviews: Selected participants will engage in detailed interviews to discuss their experiences and coping strategies. Expected Outcomes: This study aims to provide information on how teachers and parents perceive misophonia and identify effective coping strategies for managing this disorder in school and family settings. This exploratory research addresses a significant gap, as little is known about the experiences of those dealing with misophonia in children and adolescents. Study Objectives: The primary objective is to investigate the perceptions and experiences of misophonia in children and adolescents from the perspectives of teachers and parents. The study will explore its impact on family functioning and children's school performance. Significance of the Study: 1. Children with Misophonia: Highlighting the need for support due to the disorder's relative obscurity and the subsequent impact on students. 2. Parents' Experience: Examining how parents perceive their children's symptoms and their connections with school functioning, including interactions with teachers regarding misophonia. 3. Teachers' Perspective: Assessing teachers' awareness of misophonia, their experiences with affected students, and their observations on how these children function in the school environment. Project Outcomes: 1. Final Report. 2. Conference Presentations. 3. Scientific Publication. 4. Public Dissemination. Dissemination: The study's findings will be shared through participation in student conferences, promotion on social media by student organizations, and dissemination among students at the Faculty of Psychology, University of Warsaw. By the time of the conference, preliminary results on parents' and teachers' perspectives and their coping strategies for dealing with misophonia symptoms in children will be available, with the qualitative interview phase still to be conducted. [ABSTRACT FROM AUTHOR]

This research concerns the possibility of monitoring low deformation rates in tectonically stable regions using GPS/GNSS observations. The study was conducted in an area of Poland located in Central and Eastern Europe, where horizontal stress resulting from plate boundary forces in the N–S or NNE–SSW direction has been observed. This stress can translate into deformation of the Earth's surface. The problem, however, is that it corresponds to strain rate magnitudes of much lower than 10 × 10−9 per year. This is not much higher than the figure determined using current GNSS observation capabilities. In this study, long-term observations from several GNSS networks were used. The result was a very dense but irregular velocity field. By carefully analyzing and filtering the data, it was possible to eliminate the impact of various errors, creating a more consistent velocity field. This article presents a final GNSS strain rate model for Poland and determines the impacts of the analysis methods on its variation. Regardless of the filtering method adopted, dominant compression rates in the N-S direction are evident. Moreover, this result is consistent despite the use of varying velocity. This shows that even in tectonically stable regions, strain rates can be monitored at 10−9 per year (below 3 × 10−9/year). [ABSTRACT FROM AUTHOR]

Misophonia presents significant challenges for those affected. While potential interventions have emerged and are gaining momentum, there is still no evidence-based treatment for this disorder. Cognitive reappraisal (CR), a psychotherapeutic technique that alters the perception of triggering sounds, sources, and context to regulate emotional responses, holds promise in reducing misophonic reactions. However, its effectiveness in misophonia, as well as the expectations and experiences of misophonia sufferers with this method, remain unexplored. This study aims to address these gaps. The proposed intervention employs a process-based treatment approach, examining one technique at a time in the context of individual needs, possibilities, and characteristics. Preliminary data from the ongoing main study, which includes a control group, will be presented at the conference, along with the pilot quantitative and qualitative data and protocol characteristics. Below are selected results from the pilot study. Twenty-three participants completed the pilot study. Misophonia, anxiety, and depression symptoms, among others, were assessed at three time points: twice before the four weekly sessions and after the treatment. The first session was a 90-minute online group session focused on psychoeducation about CR and increasing motivation. This was followed by three weekly individual 30-minute sessions tailored to each participant's needs, such as finding the optimal time for CR implementation, the most accessible situations, and the most acceptable types of reappraisals, as well as reinforcing motivation to use CR. All sessions were audio-recorded and analyzed for protocol adherence. After completing the study, volunteering participants engaged in additional audio-recorded focus groups to discuss the most and least valuable and challenging aspects of the study, the most suitable time points for using CR (before, during, or after the trigger), and potential adverse effects of the treatment. The main study, currently ongoing, includes a separate group of 108 participants, including a control group practicing Schultz's Autogenic Training, allowing for more rigorous pre- and post-treatment assessments. In both the pilot and the main study, apart from assessing misophonia symptoms, we conducted semi-structured interviews for psychiatric and personality disorders, cognitive and audiological tests, and various psychological questionnaires. In the pilot study, there was a significant reduction in misophonia symptoms post-treatment. We observed a significant decrease (p < .001; partial eta-squared = .41) in the impact of misophonia, as measured by the S-Five scale. There were similar effects on the remaining scales. Eighteen participants (78%) experienced at least a 10% reduction in symptoms, while three showed no change, and two experienced a worsening of symptoms. Qualitative analysis indicated that meeting others with the same disorder was perceived as beneficial, as was the awareness that "somebody is researching Misophonia", "misophonia is real" or "being a part of the misophonia community." Indeed, while misophonia symptoms decreased only after the treatment, we observed a significant decrease in anxiety and depression not only after the treatment but also between the first and second assessments (yet before the treatment began). In addition to the pilot study findings, preliminary results from the ongoing randomized controlled trial (RCT) will be presented at the conference. [ABSTRACT FROM AUTHOR]

Aim Type 1 diabetes mellitus (T1DM) is a disease characterized by an absolute deficiency of endogenous insulin secretion. Insulin resistance (IR) may develop among patients with T1DM. Vitamin D deficiency was reported to be a risk factor in the development of IR. The aim of the study was to assess the relationship between serum concentrations of 25-hydroxyvitamin D (25(OH)D) and IR among patients with T1DM. Methods The test group consisted of 110 adult patients [males=65 (59%)] with T1DM. Participants were recruited in Poland between 1st October and 30th April in 2015/2016 and 2016/2017. VD serum level was assessed by ELISA array. IR was assessed by estimated Glucose Disposal Rate (eGDR). Results In the study group 21 (19%) patients were recognized as IR according to eGDR cut-offs (<7.5 mg/kg/min), 52 (47.3%) patients had VD deficiency (25(OH)D<20 ng/ml), 16 (14.5%) patients had 25(OH)D<10 ng/ml. Only 6 (5%) participants reported VD supplementation. Patients with IR, according to eGDR cut-off revealed significantly lower 25(OH)D serum level 15.7 (9.2–28.4) vs. 22.1 (13.0–38.4) ng/ml; p=0.04 as compared to patients without IR. R Spearman analysis found a positive relationship between VD and eGDR (Rs=0.27; p<0.01). Logistic regression analysis revealed significant relationship between the presence of IR and VD serum level/presence of 25(OH)D serum level below 10 ng/ml, both models adjusted to sex, age, BMI, LDL and triglycerides, accordingly (OR=0.95, CI: 0.90–0.99; p=0.04) and (OR=4.19, CI: 1.04–16.93; p=0.04). Conclusion The serum concentration of Vitamin D is negatively associated with insulin resistance in patients with T1DM and may have clinical implications. [ABSTRACT FROM AUTHOR]

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The aim of this paper is to present the results of a comparative analysis of the application of the critical chain project management and traditional scheduling established according to the critical path method for the programme of the construction of several marinas in north-western Poland. Obtained results are of a significant importance as their possible application by building contractors or investors. Besides, they might be useful for further research connected with the effective management of a set of projects. [ABSTRACT FROM AUTHOR]

Left ventricular hypertrophy (LVH) is traditionally considered a physiological compensatory response to LV pressure overload, such as hypertension and aortic stenosis (AS), in an effort to maintain LV systolic function in the face of an increased afterload. According to the Laplace law, LV wall thickening lowers LV wall stress, which in turn would be helpful to preserve LV systolic performance. However, numerous studies have challenged the notion of LVH as a putative beneficial adaptive mechanism. In fact, the magnitude of LVH is associated with higher cardiovascular morbidity and mortality, especially when LVH is disproportionate to LV afterload. We have briefly reviewed: first, the importance of non-valvular factors, beyond AS severity, for total LV afterload and symptomatic status in AS patients; second, associations of excessive LVH with LV dysfunction and adverse outcome in AS; third, prognostic relevance of the presence or absence of pre-operative LVH in patients referred for aortic valve surgery; fourth, time course, determinants and prognostic implications of LVH regression and LV function recovery after surgical valve replacement and transcatheter aortic valve implantation (TAVI) with a focus on TAVI-specific effects; fifth, the potential of medical therapy to modulate LVH before and after surgical or interventional treatment for severe AS, a condition perceived as a relative contraindication to renin-angiotensin system blockade. [ABSTRACT FROM AUTHOR]

Despite decades of development of formal tools for modelling legal knowledge and reasoning, the creation of a fully fledged legal decision support system remains challenging. Among those challenges, such system requires an enormous amount of commonsense knowledge to derive legal expertise. This paper describes the development of a negotiation decision support system (the Parenting Plan Support System or PPSS) to support parents in drafting an agreement (the parenting plan) for the exercise of parental custody of minor children after a divorce is granted. The main objective here is to discuss problems of framing an intuitively appealing and computationally efficient knowledge base that can adequately represent the indeterminate legal concept of the well-being of the child in the context of continental legal culture and of Polish law in particular. In addition to commonsense reasoning, interpretation of such a concept demands both legal expertise and significant professional knowledge from other domains. [ABSTRACT FROM AUTHOR]

The article offers a look at the achievements of Polish interventional cardiology in 2011. There is an upward trend for the number of interventional cardiology procedures during the year. The total number of accredited catheterization laboratories is 88, while the number of physicians performing the procedures registered in the Association of Cardiovascular Interventions of the Polish Cardiac Society is 705. A total of 194 coronary angiography procedures were preformed in 2011.

In our study we examined the possibility of using strain rate data, determined from geodetic satellite measurements for estimations of magnitude of contemporary stress in a relatively stable area of northern Poland, comprised of fragments of the East European Craton, the Teisseyre-Tornquist Tectonic Zone and the Palaeozoic Platform. The strain rates and their principal directions were determined from 63 GNSS stations lacking special stabilization. The method for filtrating the unstable stations allowed us to eliminate half of these stations from the final strain rate calculations that included data averaging in a correlation radius of 150 km. A comparison of the horizontal strain directions determined by geodetic methods with the directions of contemporary stress based on borehole data (four of which were determined in this study) showed a high degree of convergence. Also the trends of strain rate variations showed consistency with integrated lithospheric strength of main tectonic units. The strain rates obtained are consistent with those published for the adjacent areas. Stress magnitudes were estimated by calibrating the timing of elastic strain accumulation by earthquakes in the Sambia Peninsula (Kaliningrad Oblast) and assuming a transient state of elastic strain on the craton. Our results indicate that the crystalline upper crust in the analysed part of the craton is in the strike-slip faulting stress regime prevailing over the normal faulting stress regime. The present state of an elastic strain has been accumulated over the last few million years causing stress being far from the critical state in the Mohr-Coulomb frictional criteria, except of the seismically active Sambia Peninsula. • Application of method of strain rate determination from non-stabilized GNSS permanent stations. • Validation of strain rate results by comparison to stress, lithosphere strength and seismic data. • New concept of stress magnitude evaluation based on geodetic strain rate in elastic crust. • Application of above concept to the analysed portion of the East European Craton. [ABSTRACT FROM AUTHOR]

Zespol fixator, which was created in Poland by Ramatowski and Granowski, has an angular stable connection of screws and plate. These properties of this plate fixator, that is effective and not an expensive system of osteosynthesis of shaft of long bone widely used in Poland, impelled us to adapt it as a transpedicular plate fixator of spine. The aim of our in vitro study was to measure loads acting on spine stabilized by transpedicular plate fixator and to determine if its stability is comparable with uninjured spine. We also hypothesized that the spine stability with examined fixator had similar properties as spine fixators constructed with screws and rods. We tested its biomechanical properties and compared it with a CD device by using specimens of four human spines. Each spine with damage induced in laboratory conditions was stabilised by one of those stabilisers in one (L4–L5) or two (Th12–L2) motion segments and subsequently were subject to load. The spines without and with one of transpedicular stabilization were subject to an unsymmetrical shift of +3/−4 mm for extension–compression and symmetrical shift for bending, in the frontal plane (+0.14/−0.14 rad) and the sagittal plane (+0.11/−0.11 rad), respectively. Loads during extension–compression and bending in the sagittal plane were similar to the uninjured spine for short stabilization by using both stabilizers and amounted to 92.3 and 98.26%, respectively, of the load range sums of healthy spines. For long stabilization these loads amounted to 93.2 and 84.4%, respectively. Only following short and long stabilization for both devices in case of bending in the frontal plane the increase in loads up to 144.2 and 163.3% of the range sums of uninjured spines was achieved. It corroborates the fact that the application of the modified Zespol device for spine stabilisation provides the possibility of restoring its load transfer capacity similar to that in the healthy spine and comparable with the CD device. [ABSTRACT FROM AUTHOR]

An increase in temperature causes higher evaporation of water from water bodies; consequently, the water content in the atmosphere also increases. The precipitable water (PW), as the water content in the atmospheric air column, is therefore an important parameter to consider when studying climate change. The aim of this study was to analyse multi-annual precipitable water data derived from a dense Global Navigational Satellite Systems (GNSS) network. Twelve years of observations from over a hundred ASG-EUPOS stations were used to estimate changes in precipitation water values over Poland. The data were validated by comparison with the available radio-sounding data. The analysis of the GPS-based PW values showed an upward trend in the PW value of 0.078 mm/year. The spatio-temporal distribution of the mean PW values and their fluctuations over the years were studied and visualised in the form of maps. The results are congruent with the fact that Poland lies on the border of influence of both continental and oceanic climates. Our results are also consistent with other climate research concerning this region. [ABSTRACT FROM AUTHOR]

In NCBJ, Poland a new laboratory for BNCT research is being constructed at MARIA reactor. In the first phase it will provide a thermal neutron beam for experiments with cellular samples and small animals. In the next step, a converter will be mounted to provide fast neutron beam. Beam shaping assembly will moderate the beam to epithermal energies allowing for irradiation human phantoms. The laboratory infrastructure as well as radiation shielding of the laboratory are being designed using MCNP6 software. • A Beam Shaping Assembly with neutron converter and neutron filter is under construction. • Monte Carlo simulations were used to design the shielding and evaluate radiation conditions in the laboratory rooms. • Radiological and beam measurements with TLD, NAA and active detectors were performed in the irradiation room. [ABSTRACT FROM AUTHOR]

EPOS as a pan-European project may be a source of inspiration and motivation for the complex and ambitious efforts of building national research infrastructures (RI). Such a case happened in Poland, where new, national RI is aimed to facilitate research and to improve its outputs in the area of Solid Earth sciences. The areas of interest are anthropogenic seismicity, magnetism and magnetotelluric studies, GNSS observations, gravimetry, radiometry, deep seismic soundings and multiscale laboratories of Solid Earth. The project called EPOS PL is run by the Consortium of scientific and industrial partners lead by Institute of Geophysics, PAS. Consortium members are: ACC Cyfronet AGH, Central Mining Institute (GIG), Institute of Geodesy and Cartography, Wrocław University of Environmental and Life Sciences, The Jarosław Dąbrowski Military University of Technology (WAT) and Polska Grupa Górnicza (industrial partner). Multidisciplinary approach to the scientific challenges with use of the smart R&D environment in the form of web platform including dedicated software and visualization tools is one of the priorities of the project. Following this approach, it is possible to conduct the research across the disciplines as well as within specific subject with use of the EPOS-PL RI. The first layer of RI is built by so called Research Infrastructure Centers (RICs). RIC provides a complete dataset concerning given research field (e.g. seismic data, geodetic data, geological data). Each national RIC has its own IT support. This solution ensures effective data storage and basic computing resources. Data from all the RIC will be served for EPOS through dedicated TCS's. The second layer of innovative EPOS-PL infrastructure concerns the integration of infrastructure in the scale of Poland. Measurement polygons for the integrated observation of geodynamic processes are going to be built. The first polygons from the group of MUSE - Multidisciplinary Upper Silesian Episode will be built in mining and post-mining areas of Upper Silesian Coal Basin (Poland). The first step for the creation of MUSE is to build an integrated geodetic observation system, which uses a combination of various point and surface measurement techniques. Additionally, in MUSE areas an integrated geophysical observation and measurement system will be used in order to observe physical processes, which take place inside the rock mass. The system will include local and regional seismological, geodetic, gravimetric and geophysical networks. Collected data and products will be integrated as a Multidisciplinary Upper Silesian Episode and would be available as new episodes on IS-EPOS platform.EPOS-PL is multidisciplinary infrastructural project, but in broader perspective there are significant scientific goals, which built RI is aimed for. Data and data products obtained during EPOS-PL would be part of dedicated TCS's and may be used in specialized research within every specialty represented in the project as well as in multidisciplinary, holistic approach exemplified by MUSE. [ABSTRACT FROM AUTHOR]

Introduction: Acute pulmonary embolism (APE) poses significant diagnostic challenges, with potentially fatal outcomes if not promptly identified and treated. Despite the availability of clinical guidelines, adherence to diagnostic strategies varies globally, impacting patient outcomes., Objectives: Our aim was to investigate current practices for PE diagnosis among Polish physicians and their adherence to the contemporary 2019 European Society of Cardiology (ESC) guidelines., Patients and Methods: This cross‑sectional study, utilizing a web‑based survey developed with the Delphi methodology, included hospital‑based physicians of various specialties from Poland. The survey focused on diagnostic practices, risk stratification, and adherence to the ESC 2019 guidelines for PE., Results: The study showed a limited use of guideline‑recommended clinical prediction rules, with predominant reliance on D‑dimer assessment and computed tomography pulmonary angiography. Risk stratification practices varied, and were often based on individual experience rather than evidence‑based strategies. The vast majority of physicians (80.5%) had never contacted a PE response team, but 88% stated that they would if it were available. Cardiologists were more likely to employ guideline‑recommended methods than other specialists., Conclusions: There is a need for increased adherence to guideline‑recommended diagnostic and risk stratification strategies in APE among physicians in Poland. Enhancing the availability of PE response teams and promoting guideline‑directed practices could improve diagnostic accuracy and patient outcomes.

Background: Acute pulmonary embolism (APE) represents the third most common acute cardiovascular disease in Poland, posing an increasing burden on healthcare systems., Aims: This study aimed to assess the availability of diagnostic methods and unmet needs in APE diagnosis in Polish hospitals., Methods: An online survey prepared using the modified Delphi method was distributed to hospital departments for completion by physicians. In this analysis, we assessed the full set of responses to questions related to the availability of diagnostic tests and the unmet needs in APE diagnostics., Results: We received 204 full sets of responses. Round-the-clock access to echocardiography and ultrasonographic compression tests was declared by 119 (58.3%) and 89 (43.6%) respondents, respectively. A group of 171 (83.82%) respondents reported 24-hour access to computed tomography angiography (angio-CT). However, only 13 (6.4%) declared routine availability to the measurement of the right ventricle to left ventricle ratio in angio-CT reports. Most respondents did not have (88; 43.1%) access to Pulmonary Embolism Response Team consultations or were unaware of this option (41; 20.1%). The risk of death in APE was most commonly attributed to the diagnosis of a "saddle embolism" (n = 152; 74.5%). Relatively rarely (n = 102; 50%) was high importance attributed to multiparametric risk assessment scores., Conclusions: Our study indicates a need for improving the organization and accessibility of APE diagnostics in Polish hospitals and increasing awareness of current standards in APE diagnosis among physicians.

Thanks to advances in interventional cardiology technologies, catheter-directed treatment has become recently a viable therapeutic option in the treatment of patients with acute pulmonary embolism at high risk of early mortality. Current transcatheter techniques allow for local fibrinolysis or embolectomy with minimal risk of complications. Therefore, these procedures can be considered in high-risk patients as an alternative to surgical pulmonary embolectomy when systemic thrombolysis is contraindicated or ineffective. They are also considered in patients with intermediate-high-risk pulmonary embolism who do not improve or deteriorate clinically despite anticoagulation. The purpose of this article is to present the role of transcatheter techniques in the treatment of patients with acute pulmonary embolism. We describe current knowledge and expert opinions in this field. Interventional treatment is described in the broader context of patient care organization and therapeutic modalities. We present the organization and responsibilities of pulmonary embolism response team, role of pre-procedural imaging, periprocedural anticoagulation, patient selection, timing of intervention, and intensive care support. Currently available catheter-directed therapies are discussed in detail including standardized protocols and definitions of procedural success and failure. This expert opinion has been developed in collaboration with experts from various Polish scientific societies, which highlights the role of teamwork in caring for patients with acute pulmonary embolism.

Context: Higher prevalence of polycystic ovary syndrome (PCOS) in women with type 1 diabetes (T1DM) is linked to exogenous insulin, especially when diabetes is diagnosed before puberty., Objective: The study evaluates the impact of prepubertal onset of T1DM and insulin therapy on PCOS diagnosis and phenotypic characteristics in women with T1DM., Design, Setting, and Patients: We studied 83 women with T1DM (age 26 ± 5 years, BMI 24 ± 3 kg/m2) 36 with premenarchal (PM) onset of T1DM [17 with PCOS diagnosed (PCOS+PM) and 19 without PCOS (noPCOS+PM)] and 47 women with postmenarchal onset of T1DM [24 with PCOS (PCOS-noPM) and 23 without PCOS (noPCOS-noPM)]., Outcome Measurements: Clinical examination, assessment of serum sex hormones, glycated hemoglobin (HbA1c) and ultrasonographic evaluation of the ovaries were performed in all women., Results: Applying Rotterdam criteria, 49% of women with T1DM were diagnosed with PCOS. There were no differences in hormonal profile and ovarian parameters between PCOS+PM and PCOS-noPM. Women with T1DM+PM had higher insulin dose/24 h and U/kg bw/24 h than T1DM-noPM (P-values = 0.014 and 0.001, respectively). Both PCOS+PM and noPCOS+PM groups had higher insulin dose U/kg bw/24 h in comparison to PCOS-noPM (P-values = 0.004 and = 0.006, respectively). In multivariable logistic regression analysis, age of menarche [odds ratio (OR): 0.672; 95% confidence interval (CI): 0.465-0.971] and HbA1c (OR: 0.569; 95% CI: 0.383-0.846) were associated with the diagnosis of PCOS., Conclusions: There were no differences in the prevalence of PCOS between T1DM+PM and T1DM-noPM; however, earlier menarche might have an influence on PCOS diagnosis in women with T1DM., (© The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Long-term insulin treatment can slow the growth process and decrease physical fitness level in children. In diabetic children, these two developments should be constantly monitored. The aim of the present study was to examine differences in somatic and physical fitness characteristics between soccer-training boys with type 1 diabetes and healthy boys of the same age (reference values based on Polish population norms for somatic and motor parameters). The participants were 94 boys (8-17 years), diagnosed with diabetes, who participated in soccer training on a regular basis and received routine medical care. The study involved (a) anthropometric and body composition measurements, (b) general motor ability assessments, and (c) comparison of those characteristics with the healthy Polish population. The diabetic boys were found to have lower levels of almost all somatic traits and motor abilities as compared with the healthy boys ( p ≤ 0.05). Handgrip strength was a variable with the smallest difference between the two groups. The observed differences indicate the necessity to design an appropriate control and assessment system based on simple medical and fitness field tests for diabetic children and adolescents. It will allow optimizing advanced training as well as minimize health risks before, during, or after exercise.

Background: A pulmonary embolism response team (PERT) is a multidisciplinary team established to improve clinical care for patients with pulmonary embolism (PE). However, data regarding detailed institutional experience and clinical outcomes from such teams are sparse., Aims: We aim to assess the frequency of activations, patients' characteristics, PE severity, applied treatments, and outcomes of PE patients treated by Polish PERTs., Methods: The survey registry was conducted between June 2018 and July 2020. All consecutive PERT activations of four institutionalized PERTs in Poland were analyzed. Patients' characteristics, therapies applied, and in-hospital outcomes were evaluated., Results: There were 680 unique PERT activations. Most activations originated from Emergency Departments (44.9%), and the remaining originated from internal medicine/cardiology units (31.1%), surgery/orthopedics (9.1 %), oncology (6.3%), intensive care units (6.0%), and others (2.5%). The origin of activation varied significantly among institutions (P <0.01). Most PERT cases were patients with intermediate-high risk PE (42.9%), whereas high-risk PE occurred in 10% of patients. Anticoagulation alone was delivered to 80.3% of patients, and 23.3% of patients received at least one advanced therapy: catheter-directed therapies (11.3%), systemic thrombolysis (5.3%), surgical embolectomy (2.4%), vena cava filter placement (3.7%), and extracorporeal membrane oxygenation (0.6%). In-hospital mortality in the whole study group was 5.1%, with significant differences between institutions (P = 0.01)., Conclusions: The frequency of PE severity, type of delivered catheter-directed treatment, and in-hospital mortality vary between institutions without significant discrepancies in PERT activations. This variation between expert centers highlights the local differences in PERTs' organizational and operational forms.

Atrial septal defect is the most common congenital heart lesion in adults. Although atrial septal defect closure is recommended in those with right heart enlargement or paradoxical embolism, data informing such indications in adults are quite limited. This population has many unique characteristics and needs. In recent years, significant progress has been made with regard to diagnostic modalities that facilitate the diagnostic workup of these patients. However, the decision‑making process, especially in selected adult patients population (advanced age, various concomitant diseases, poor LV function [both systolic and diastolic], pulmonary hypertension, concomitant arrhythmias or multiple defects, or deficient rims) is still not easy. Available data are predominantly focused on imaging endpoints and short‑term morbidity and mortality rather than long‑‑term. The evidence base for outcomes with or without defect closure comes from various studies with different observation periods. Moreover, the clinical experience in diagnosing and treating that subgroup of patients is inhomogeneous between individual physicians (cardiologists, imaging specialists, operators) and between small and large experience centers. In the view of the above, the joint group of experts from the Association of Cardiovascular Interventions and the Grown‑Up Congenital Heart Disease Section of the Polish Cardiac Society developed the following consensus opinion in order to standardize the principles of diagnosis, indications for treatment, methods of performing procedures, and tenets of postoperative care in Poland.

Introduction: Currently, no risk score for predicting significant bleeding complications (SBCs) after cardiac implantable electronic device (CIED) surgery is available., Objectives: We aimed to develop a new scoring system for predicting SBCs aft er CIED surgery., Patients and Methods: The incidence of SBCs was 4.5%. Based on multivariable analyses, the following predictors of SBCs were identified: age ≥75 years (odds ratio [OR], 8.10; 95% CI, 3.54-18.54); cardiac resynchronization therapy or implantable cardioverter-defibrillator surgery (OR, 5.96; 95% CI, 2.48-14.32); upgrade procedure (OR, 10.22; 95% CI, 4.05-25.78); uncontrolled arterial hypertension (OR, 4.82; 95% CI, 1.78-13.06); presence of valvular prosthesis (OR, 7.85; 95% CI, 3.15-19.58); current malignancy (OR, 6.11; 95% CI, 1.81-20.66); renal failure (OR, 4.28; 95% CI, 1.86-9.87); and the use of antiplatelet drugs (clopidogrel [OR, 6.69; 95% CI, 2.48-18.04] or ticagrelor [OR, 22.25; 95% CI, 4.56-108.46]). The score was created using the weighted points proportional to the β regression coefficient of each predictor rounded to the nearest integer, and the acronym PACE DRAP corresponds to the predictor's first letter. The cutoff point for the high risk of SBCs was 6 points with a sensitivity of 88.24% and a specificity of 87.23%. The PACE DRAP showed good predictive ability (area under the curve, 0.95 ; P <0.001)., Conclusions: The PACE DRAP score is useful in identifying patients at high risk for SBCs after CIED surgery.

Background: Pulmonary hypertension (PH) results in severely impaired quality of life (QoL) in people with this condition. The CAMbridge Pulmonary Hypertension Outcome Review (CAMPHOR) is the only questionnaire providing a disease-specific measurement of symptoms, functioning and QoL in PH patients. It has already been adapted for use in several countries. The aim of this study was to adapt and validate CAMPHOR for the Polish-speaking population., Methods: Two panels (bilingual and lay) were conducted to translate CAMPHOR into Polish. This new version was then tested by cognitive debriefing interviews with 15 patients. Finally, a postal validation survey was conducted with 56 patients on two occasions 2 weeks apart to assess its psychometric properties., Results: No problems were experienced in producing a Polish translation of CAMPHOR. Interviewees responded well to the Polish CAMPHOR, finding it relevant, comprehensible and easy to complete. For all three CAMPHOR scales (Symptoms, Activity, QoL), The Cronbach alpha coefficients were above 0.8 at both time points, indicating high internal consistency. Test-retest reliability for the three scales achieved a value above 0.80. Predicted correlations with the Nottingham Health Profile provided evidence of the construct validity of CAMPHOR scales. The Polish CAMPHOR could distinguish between patients who differed according to their perceived general health and perceived disease severity. No significant differences in scores were found between participants grouped by gender or age., Conclusions: The Polish version of CAMPHOR demonstrated good psychometric properties and is recommended for use in clinical practice.

The presence of patent foramen ovale (PFO) was found to be associated with a number of medical conditions, including embolic stroke and recurrent transient neurological defects. The closure of PFO remains controversial; however, in recently published guidelines from the European Association of Percutaneous Cardiovascular Interventions in collaboration with 7 other European societies, which extensively refer to the latest randomized clinical trials, it is explicitly recommended to perform percutaneous PFO closure in the prevention of recurrent thromboembolic events. In connection with the above facts and expected increasing number of PFO closure procedures, the joint expert group of the Association of Cardiovascular Interventions and the Grown‑Up Congenital Heart Disease Section of the Polish Cardiac Society developed the following consensus opinion in order to standardize the principles of diagnosis, indications, methods of performing procedures, and postoperative care in relation to Polish conditions and experiences.

Pulmonary Embolism Response Team (PERT) is a multidisciplinary team established to stratify risk and choose optimal treatment in patients with acute pulmonary embolism (PE). Established for the first time at Massachusetts General Hospital in 2013, PERT is based on a concept combining a Rapid Response Team and a Heart Team. The growing role of PERTs in making individual therapeutic decisions is identified, especially in hemodynamically unstable patients with contraindications to thrombolysis or with co-morbidities, as well as in patients with intermediate-high risk in whom a therapeutic decision may be difficult. The purpose of this document is to define the standards of PERT under Polish conditions, based on the experience of teams already operating in Poland, which formed an agreement called the Polish PERT Initiative. The goals of Polish PERT Initiative are: improving the treatment of patients with PE at local, regional and national levels, gathering, assessing and sharing data on the effectiveness of PE treatment (including various types of catheter-directed therapy), education on optimal treatment of PE, creating expert documents and supporting scientific research, as well as cooperation with other communities and scientific societies.

Introduction Diabetic ketoacidosis is a life-threatening condition that requires prompt management. Objectives We aimed to assess the impact of adherence to potassium replacement protocol according to the guidelines of Diabetes Poland on the duration of diabetic ketoacidosis (DKA) treatment. Patients and methods This retrospective analysis included 242 adults (median age, 27 years; range, 21-38 years). Nonadherence to potassium replacement protocol was assessed, along with the relationship between nonadherence and duration of DKA management. Nonadherence to the protocol was defined as too low or too high doses of potassium compared with the recommended potassium replacement protocol. Results The median duration of DKA treatment was longer in the nonadherent group than in the adherent group: 37 hours (interquartile range [IQR], 27-48) and 30 hours (IQR, 17-43), respectively (P = 0.005). Treatment duration correlated positively with nonadherence to potassium replacement protocol (r = 0.18; P = 0.005) and severity of DKA (r = 0.52; P <0.0001). Stepwise multivariate linear regression analysis indicated nonadherence to the protocol (β = 0.14; P = 0.02) and severity of DKA (β = 0.43; P <0.0001) as predictors of treatment duration, after adjustment for body mass index and age (R2 = 0.28; P <0.0001). Conclusions Nonadherence to potassium replacement protocol leads to prolongation of DKA management. Medical staff should be educated about the benefits of potassium replacement and precision in potassium administration and dosing in patients with DKA.

Background: Coronary artery disease (CAD) and degenerative aortic stenosis often coexist. However, the impact of CAD and its management on the prognosis after transcatheter aortic valve implantation (TAVI) remains uncertain. We sought to evaluate the impact of obstructive CAD, SYNTAX score (Ss), and percutaneous coronary intervention (PCI) prior to TAVI on short-term outcome., Methods: Overall, 896 patients who underwent TAVI after heart team decision was included. Pre-procedural angiograms were analysed to calculate baseline Ss (bSs) and residual Ss (rSs). Baseline, procedural and follow-up data up to 30 days was acquired from the national POL-TAVI registry., Results: Patients with obstructive CAD at baseline (n = 462, 52%) had higher mortality as compared with the remaining (8.7 vs. 5.1%, log-rank P = 0.039). Also, after correction for confounding factors obstructive CAD was identified as independent predictor of mortality (hazard ratio [HR] 1.74, 95% confidence intervals [CIs] 1.03-2.94, P = 0.037). In obstructive CAD, neither bSs (AUC 0.47, CI 0.38-0.56, P = 0.47) nor rSs (AUC 0.47, CI 0.30-0.64, P = 0.72 for those undergoing PCI and AUC 0.48, CI 0.37-0.59, P = 0.75 for the remaining) was predictive of mortality. When revascularization status was considered, patients with PCI prior to TAVI had similar outcome as those without obstructive CAD at baseline (7.7 vs. 5.1%, log-rank P = 0.23) with no negative impact on mortality (HR 1.13, CI 0.62-2.09, P = 0.69)., Conclusions: In conclusion, obstructive CAD at baseline evaluation for TAVI has independent negative impact on short-term prognosis. However, neither baseline nor residual Ss values have prognostic ability in patients undergoing TAVI. Revascularization prior to TAVI seems to improve survival to levels comparable with patients without obstructive CAD at baseline., (© 2017 Wiley Periodicals, Inc.)

Objective: The aim of the study was to investigate whether changes in the level of oxidized LDL (oxLDL) over 2-years contribute to the development of subclinical macroangiopathy and/or microvascular complications in patients with DM1., Design and Methods: Basic clinical and biochemical parameters and oxLDL level were measured in 70 patients at baseline and after 2 years of the study. In addition, an ultrasonographic study was performed to assess the carotid intima media thickness (IMT)., Results: Patients did not differ according to basic clinical and biochemical parameters at the beginning and after 2 years of the study. IMT increased (p=0.000001) whereas oxLDL level decreased (p=0.00001) in DM1 patients during 2 years. Multivariate regression analysis showed that oxLDL independently influences IMT in DM1 patients (β=0.454, R2=0.35). Further, positive correlations between oxLDL value and LDL-C concentration (r=0.585, p<0.05, n=70) and between oxLDL level and apo-B concentration have been established (r=0.610, p<0.05, n=70). Moreover, patients with chronic microvascular complications showed a higher value of IMT in comparison with patients without them (p=0.003)., Conclusion: Our results provide the evidence that oxLDL accelerates atherosclerotic plaque formation and may contribute to the development of microvascular complications in DM1., (Copyright © 2012 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.)

The Aim of the Study: The assessment of post-traumatic events experienced at work by medical rescuer., Material and Methods: The research covered 40 individuals working as medical rescuer (20 males and 20 females) with average 35.6 years old. The rescuer were employed in the Hospital Emergency Department. The individuals were interviewed with the use of a scale, assessing the reactions of a medical rescue worker to the death of a patient being rescued. The frequency and kind of posttraumatic experiences in the job of a medical rescue worker were analyzed., Results: The most numerous group of the interviewed (40%) reported the dissociation caused by the death of a patient being rescued by them. The most frequently mentioned post-traumatic event was a physical assault, threatening the life of the interviewed person., Conclusions: Medical rescuer are exposed to the occurrence of post-traumatic stress disorder (PTSD), which contributes to the reduced feeling of safety at workplace.

Despite a dramatic reduction in restenosis and target vessel revascularisation rates by drug eluting stents (DES), conflicting concerns have been raised over the risk for late DES thrombosis when compared to bare metal stents. Certainly, the heterogeneity of DES results from the introduction of a great variety of new DES types with diverse efficacy and safety parameters. Furthermore, we observe a steady increase in DES availability without parallel and robust data from randomised clinical trials. Thus, the postulated class effect of DES should be regarded as non-obligatory. This article is based on 110 randomised DES trials performed on 72 305 patients. Current status of DES and guidelines for DES implantation in various clinical scenarios were discussed.

Topic of professional burnout has been discussed in Poland since 80'. Professional burnout is a state of emotional and physical exhaustion caused by excessive and prolonged stress. As the stress continues, you begin to lose the interest or motivation of job, additionally burnout reduces your productivity and energy. That's why it's important to recognize the early signs of burnout and head it off. Three phases of professional burnout have been described: emotional exhaustion, depersonalization and reduced personal accomplishment. The risk of professional burnout involves especially people who are suffering from many disturbances, including dermatological diseases and carry out of professions named Human Services.

Background: Although primary coronary angioplasty seems to be the best treatment in acute myocardial infarction (MI), thrombolytic therapy still remains the most common reperfusion strategy particularly in smaller centers. Nowadays, different regional networks are developed to improve the treatment of patients with MI., Aim: To analyse the effects of different therapeutic strategies on 30-day and long-term mortality (median time 18.3 months) after ST-elevation MI (STEMI) in a population of 3 350 000 people from the Wielkopolska Region., Methods: In 2002, 3780 patients with STEMI entered the registry. Complete data were available for 3564 (94.3%) patients. Depending on therapeutic strategies, patients were divided into five groups: the PCI group--direct percutaneous coronary angioplasty (PCI) in small cathlab, 'selected patients', n=381 (10.7%); the PA group--aged <70, treated with tissue plasminogen activator (rt-PA) up to 4 hours from the onset of chest pain, n=479 (13.4%); the IS group - invasive strategy in every patient, 24-hour duty, setting of unselected patients with STEMI, n=989 (27.7%); the SK group--patients receiving standard streptokinase treatment up to 12 hours from the onset of chest pain, n=584 (16.4%); the NR group--no reperfusion therapy, n=1131 (31.7%)., Results: The 30-day mortality rate in the groups above was: 3.15, 4.38, 4.54, 9.25, and 12.5% respectively (p <0.001). Long-term mortality rate was: 4.2, 9.4, 9.4, 14.4, and 18.50% respectively (p <0.001). The rate of urgent PCI in the PA group was 25% and in the SK group--11% (p <0.001)., Conclusions: Treatment with rt-PA in patients under 70 years of age and up to 4 hours from pain onset may be an alternative to an invasive strategy. However, a quarter of those patients require urgent PCI. In long-term observation the mortality benefit can be clearly seen only in patients with early PCI.

Unlabelled: Studies performed in recent years in different countries suggest a considerable prevalence of depressive disorders in primary care patients. The aim of our study was the assessment of depressive disorders among primary care patients in Poland., Material and Methods: Three-hundred thirty-three randomly chosen private and public primary care clinics from the whole country took part in the study. In each centre, 20 or 25 patients aged 18-65 years coming for a regular visit were asked to participate in the study. All patients filled in the Beck Depression Inventory (BDI). Additionally, basic demographic data and information on the presence of chronic somatic diseases were collected. Those patients who scored 12 or more points on BDI (cut-offpoint for depression in Poland) were evaluated by a primary care physician for presence of a depressive disorder upon the ICD-10 criteria and subsequently referred for a psychiatric consultation to the nearest psychiatric outpatient clinic for establishing plausible diagnosis of depression., Results: Out of 7360 patients approached, 7289 (95.5%) agreed to participate. The mean age of the sample was 43.3 +/- 13.2 and 71% were females. Forty one percent of patients (2985) had 12 or more points on the BDI and were referred for a psychiatric evaluation. Only half of them came for a psychiatric consultation. Depressive disorder was recognised in 906 patients. Estimated prevalence of depressive disorders in the whole sample was 23.3%. The patients in whom depressive disorders were confirmed by psychiatric assessment had significantly more often hypertension, ischaemic heart disease, anaemia, stroke and hypothyroidism., Conclusions: The results obtained show that depressive disorders' prevalence in primary care patients in Poland is significant. The patients who had depressive disorders significantly more often than patients without depression suffered from some somatic diseases. In light of the results, both recognition and adequate treatment of depressive disorders in primary care patients should be regarded as equally important as the recognition and treatment of cardiovascular diseases or other common somatic illnesses.

Unlabelled: The benefit of thrombolysis in acute myocardial infarction (AMI) is time dependent, but there is lack of evidence of such a close correlation in patients undergoing primary percutaneous transluminal coronary angioplasty (pPTCA). The aim of this study was to evaluate the importance of delay of treatment for myocardial reperfusion and early and late ventricular function in patients with anterior AMI treated with pPTCA., Methods: 106 consecutive patients (76 men, 30 women, age 63 +/- 11 years) treated with pPTCA for anterior AMI was included in this study. We evaluated angiographic (myocardial blush grade (MBG), TIMI flow, corrected TIMI frame count) and electrocardiographic (resolution of ST segment elevation--nST) markers of myocardial reperfusion. Echocardiography was performed 3 and 180 days after pPTCA. End-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction were calculated. Patients were divided into three groups: group A (41 pts.) reperfused within 3 hours, group B (40 pts.) reperfused between 3-6 hours, group C (25 pts.) reperfused between 6-12 hours from symptoms onset., Results: MBG 0-1 (lack of myocardial reperfusion) was significantly more common in group B and C, compared with group A (p = 0.002). The incidence of nST was higher in group A (p < 0.0001). The EF after 3 days (p = 0.03) and after 6 months (p = 0.04) was better in group A in comparison to group C. There was not significant difference in EDV after 3 days, but after 6 months EDV was significantly higher in group C (p = 0.02)., Conclusions: The delay of treatment over 3 hours is associated with decreasing of myocardial reperfusion efficacy and deterioration of the early and late LV function.

The aims of the Polish survey were to assess efficacy of screening for depression in gynecological practice and to estimate prevalence of depressive disorders in midlife women visiting gynecologists. The study included 2262 female outpatients aged 45-55, who were screened by 120 gynecologists throughout Poland. Patients completed the Beck's Depression Inventory (BDI) and were assessed by gynecologists to verify the presence of symptoms of a current Depressive Episode according to ICD-10 diagnostic criteria. Patients who obtained a score of 12 points or more on the BDI were referred for psychiatric evaluation, including the modified version of Mini International Neuropsychiatric Interview (MINI). The study showed that gynecologists in Poland are able to perform screenings for depression effectively in outpatient settings. Results also suggested that about 19% of women aged 45 to 55 years visiting gynecologists may suffer from depressive disorders.

For the assessing the incidence of mood disturbances among the neurological out-patients 3287 of them were examined by 111 neurologists during their routine practice. Early diagnosis, the type of mood disturbances and the depth of depression were estimated by the use of Beck's Depression Inventory, the questionnaire based on The Mini-International Neuropsychiatric Interview and Hamilton Depression Rating Scale, as well. Around half of the patients (50.47%) were suspected on depression, as an early diagnosis. In suspected and diagnosed depressive patients the symptoms as anxiety, low activity precordial pain, headaches, dry mouth, constipation, sleep and appetite troubles were significantly (p < 0.01) more frequent than in euthymic subjects. Among all studied patients the episode of depression were found as a final diagnose in 17.2%, recurrent depressive disorders--in 17.6% and dysthymia--in 2.8% of subjects. In finally diagnosed depressive patients the chronic neurological problems were significantly (p = 0.013) more frequent, as the cause of the visit, than in the euthymic ones. The low mood was equally frequent among the patients with Parkinson's disease, multiple sclerosis and cerebrovascular disorders, as well.