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Aims The hybrid comprehensive telerehabilitation (HCTR) consisting of telecare (with psychological telesupport), telerehabilitation, and remote monitoring of cardiovascular implantable electronic devices might be an option to improve both physical capacity and depressive symptoms. The aim of the study was to investigate the influence of HCTR on depressive symptoms and physical capacity in heart failure (HF) patients in comparison with usual care (UC). Methods and results The present analysis formed part of a multicentre, randomized trial that enrolled 850 HF patients (New York Heart Association I–III, left ventricular ejection fraction ≤ 40%). Patients were randomized 1:1 to HCTR or UC. Patients underwent an HCTR programme (1 week in hospital and 8 weeks at home; exercise training 5 times weekly) or UC with observation. The Beck Depression Inventory II (BDI-II) score (cut point for depression ≥ 14) was used to assess depression and the physical capacity was measured by peak oxygen consumption (peak VO2; mL/kg/min). Measurements were made before and after 9-week intervention/observation (HCTR/UC group). Both groups were comparable in terms of demographic and clinical characteristics. In HCTR group, at entry, 23% of the sample obtained BDI-II scores ≥14 vs. 27.5% in UC group. There were no significant differences between groups regarding ΔBDI-II score (P = 0.992) after 9-week HCTR/UC. There was a significant improvement in physical capacity only in the HCTR group in both patients with (P = 0.033) and without (P < 0.001) depression. Conclusions In HF patients, HCTR provided similar reduction of depressive symptoms as UC. HCTR resulted in a significant improvement in physical capacity in patients with and without depression.

Background: Sleep is a complex, reversible process that is responsible for the modulation of various physiological mechanisms. COVID-19-related sleep disorders are affecting different populations with a heterogenous prevalence, yet high rates among infected patients are frequently reported. The aim of the study is to assess the prevalence of insomnia in the early post-COVID-19 recovery period and explore the differences in the results acquired by the Athens Insomnia Scale (AIS) by gender and selected infection severity parameters. Methods: The data presented in the paper come from a prospective, observational study on COVID-19 complications (SILCOV-19) consisting of 200 COVID-19 patients. The AIS was used for the quantitative measurement of insomnia symptoms based on ICD-10 criteria. Results: 32% (n = 64) of all patients in the study group obtained results indicating sleep disturbances (>5 points on the scale), while 21.5% (n = 43) obtained results indicating insomnia (>10 points on the scale). The analysis of the results obtained by all patients in the AIS showed a significant correlation with the duration of symptoms (Spearman’s rank-order: R = 0.18; p < 0.05), but not with the number of days spent in the hospital or age. Women achieved a higher score in overall AIS, as well as in questions assessing total sleep time, well-being the next day, physical and mental fitness the next day, and sleepiness during the day (p < 0.05). Conclusions: the prevalence of insomnia in the early post-COVID-19 recovery period is high.

Cel pracyCelem pracy było oszacowanie efektywności psychoedukacji w ograniczaniu przyrostu masy ciała chorych z rozpoznaniem schizofrenii, u których włączono atypowe leki przeciwpsychotyczne w monoterapii.MetodaStworzony na zlecenie firmy Moneo Pharma Group program edukacyjny „Dbamy o Zdrowie i Linię” zastosowano u chorych na schizofrenię. Założenia programu obejmowały przekazywanie informacji dotyczących stylu życia i odżywiania.WynikiRoczną obserwację ukończyło 7541 pacjentów. Średni przyrost BMI (wskaźnik masy ciała) w ciągu roku wyniósł 0,56, różnica pomiędzy mężczyznami (0,52) i kobietami (0,60) była istotna statystycznie ( p < 0,001 ). Średni, roczny przyrost masy ciała wyniósł 1,63 kg, podczas gdy średnie, roczne zwiększenie obwodu brzucha wyniosło 1,25cm. Nie było statystycznie znaczących różnic pomiędzy płciami. Subiektywna ocena stosowania się do zaleceń wzrastała systematycznie z każdą wizytą, zarówno dla mężczyzn jak i kobiet. Pacjenci, którzy najlepiej stosowali się do zaleceń rzadziej doświadczali wzrostu masy ciała (pWnioskiProgram edukacyjny poskutkował zmniejszeniem przyrostu masy ciała otyłych pacjentów leczonych atypowymi lekami przeciwpsychotycznymi. Osoby z BMI 30 częściej niż inne uzyskały redukcję masy ciała w czasie trwania programu edukacyjnego. Jakość współpracy w czasie pierwszej i drugiej wizyty ma wartość predykcyjną dla oceny zmian masy ciała w czasie trwania programu edukacyjnego. Ta metoda edukacji jest łatwa do zastosowania w praktyce klinicznej.

Introduction Lung transplantation (LTx) is the only effective method of treatment to improve the health and quality of life (QoL) of patients with end-stage lung diseases. After LTx, medical examination accompanied by quality of life assessment should be performed on routine follow-up visits. The aim of the study was to assess the QoL of patients after LTx. Material and methods The study group consisted of 60 patients (29 women and 31 men); 20 patients received single lung transplantation (SLT), and 40 received double lung transplantation (DLT). To determine the patient’s QoL, the General Health Questionnaire (GHQ), the World Health Organization Quality of Life Test–BREF (WHOQOL-BREF), and the Saint George Respiratory Questionnaire (SGRQ) were used. Spirometry and the 6-minute walk test were analyzed to examine efficiency of transplanted organs. Results In SGRQ there are differences between patients with cystic fibrosis and interstitial lung disease in symptom domain (20.28% vs 39.26%, P = .025) and total score (19.38% vs 32.47%, P = .028). As reported in the GHQ, men had worse overall results than women in sten scale (5.22 points vs 4.69 points). Patients after SLT achieved similar scores in every questionnaire. Conclusion Studies assessing QoL should be an important addition to lung function tests and an integral part of control during postoperative follow-up visits. This study is one of the important contributions to understanding of how essential QoL is after LTx. The authors of this study realize that their work does not cover the whole issue, and further studies in this area are warranted.

IntroductionHybrid comprehensive telerehabilitation (HCTR) consisting of telecare (with psychological telesupport), telerehabilitation and remote monitoring of implantable devices might be an innovative option improving heart failure (HF) patients’ quality of life (QoL) and emotional health. The aim of the study was to investigate the influence of HCTR on various facets of QoL in HF patients in comparison with usual care (UC) alone.Material and methodsThe present analysis formed part of a multicenter, randomized trial that enrolled 850 HF patients (NYHA I–III, LVEF ≤ 40%). Patients were randomized 1 : 1 to HCTR plus UC or UC only. Patients underwent either an HCTR program or UC with observation. The psychological intervention in the HCTR group included supportive psychological counseling via mobile phone. The Medical Outcome Survey Short Form 36 Questionnaire was used to assess QoL. Measurements were made before and after a 9-week intervention (HCTR group)/observation (UC group).ResultsAfter the intervention, the HCTR group showed significant improvement in overall QoL, physical domain (PD) of QoL, and 4 areas of QoL (physical functioning (PhF), role functioning related to physical state (RF), general health (GH), vitality (VI)). A significant positive change in QoL in the UC group was observed only in VI and social functioning. There were also significant differences in QoL after 9-week intervention/observation between the two groups. The results showed greater improvement in HCTR for overall QoL (p = 0.009), PD of QoL (p = 0.0003) and three specific areas of QoL: PhF (p = 0.001), RF (p = 0.003), bodily pain (BP) (p = 0.015).ConclusionsIn comparison to UC, HCTR resulted in improvement in overall QoL, PD of QoL and 3 specific areas of QoL: PhF, RF and BP.

Background: The revascularization of carotid arteries minimizes the risk of future cerebral stroke and usually improves cognitive functions. The aim of this study was to assess changes in cognitive function and verify the hypothesis assuming an improvement of selected cognitive functions—psychomotor speed, visuospatial episodic memory, executive function and verbal fluency—in patients after carotid artery stenting during a 12-month follow-up. Methods: 47 persons subject to CAS, including 13 symptomatic persons, were examined before and 12 months after a procedure with a psychological test battery (digit symbol test—DS, Rey–Osterrieth complex figure test—ROCF, Wisconsin Card Sorting Test—WCST, letter verbal fluency—LVF). Sociodemographic data and clinical parameters were acquired from an author questionnaire. Results: The one-year follow-up, after the performed CAS procedure, demonstrated a significant improvement of psychomotor speed, visuospatial episodic memory, and executive function. No changes in the area of verbal fluency or decline in any of cognitive functions under analysis were observed. Conclusions: Carotid artery stenting improves cognitive functioning, both in the area of basic and more complex cognitive functions in persons with carotid atherosclerosis.

Due to the extent of the pandemic, high prevalence and severity of complications in the early post‑recovery period are expected.This study aimed to compare the scope of early post-COVID‑19 complications in patients who had the disease and were or were not hospitalized.This was a prospective, observational, registry‑based cohort study conducted at a tertiary cardiovascular hospital in Silesia, Poland. Interdisciplinary diagnostics, including cardiovascular, pneumatological, respiratory, neurological, and psychiatric tests, was performed during the study visit. All patients completed the study. Two‑hundred unselected, adult, white men and women with the symptoms of acute COVID‑19 were included, of which 86 patients had the disease but did not require hospitalization.The median (interquartile range) time from symptom onset to the study visit was 107 (87-117) and 105 (79-127) days in nonhospitalized and hospitalized patients, respectively. Lung lesions on high‑resolution computed tomography were found in 10 (8.8%) and 33 (39.3%) of nonhospitalized and hospitalized patients, respectively (P0.01); no lesions were visualized on chest X‑ray images. Elevated platelet distribution width was found in more than 70% of the patients in both groups. More than half of the patients had insomnia, regardless of the hospitalization status.The abnormal platelet parameters, functional and radiological findings in the lungs, and insomnia were the most frequent short‑term COVID‑19 complications in hospitalized and nonhospitalized patients. Considering the number of patients who have had COVID‑19 worldwide, a high burden of the post-COVID‑19 complications might be expected.

For the first time the application of unmodified boron doped diamond electrode for dopamine (DA) and paracetamol (PA) determination in biological samples and pharmaceutical preparations with the use of differential pulse voltammetry was demonstrated in the present work. The wide linear range of calibration graphs: from 1 × 10−7 to 2 × 10−4 mol L−1 for DA and PA, and very low detection limits were achieved, equaling 1.87 × 10−8 mol L−1 for DA and 1.35 × 10−8 mol L−1 for PA. The proposed sensor was successfully applied for determination of dopamine in urine samples, paracetamol in syrups for children, and for simultaneous determination of paracetamol and dopamine in blood and serum samples.

Background: The sense of coherence is lower in patients with somatic diseases and psychiatric disorders. Purpose: The purpose of this study was to evaluate the intensity of depression and anxiety symptoms and their relationship with the sense of coherence and to try to determine the relationship between the strength of sense of coherence and symptoms of depression and anxiety with the presence of symptoms of carotid atherosclerosis in a group of patients undergoing carotid artery stenting. Methods: 35 patients, including 13 with symptomatic atherosclerosis in the carotid arteries, completed self-report tests: Hospital Scale of Depression and Anxiety (HADS) and the SOC-29 Life Orientation Questionnaire (SOC-29), 22 of whom also rated their subjective feelings of anxiety and depression on a scale included in the author’s questionnaire. Results: Both symptomatic and asymptomatic patients did not differ significantly in the severity of depression, but they differed in anxiety levels as assessed by the HADS scale. There were no differences in the overall strength of sense of coherence and its individual components. Nearly 12% of those undergoing carotid artery stenting have pronounced anxiety symptoms, and just over 14% have pronounced depression symptoms. A higher overall sense of coherence and its components are associated with lower severity of depression symptoms. Lower severity of anxiety correlates negatively with a higher sense of understanding, meaningfulness, and holistic Sense of Coherence (SOC). Manageability appeared higher in men. Conclusions: SOC is an important health-promoting factor that is preferably related to mental health parameters of patients with carotid atherosclerosis.

Background: Patients with stable coronary artery disease (CAD) have a worse quality of life (QoL) in comparison to patients without stable CAD. Standardized questionnaires are used in evaluation of QoL. Hybrid coronary revascularization (HCR) is a recently-introduced, minimally invasive option for patients requiring revascularization for coronary lesions. The aim of this study was to assess healthrelated quality of life (HRQoL) in patients with multivessel CAD (MVCAD), according to the mode of revascularization: coronary artery bypass grafting (CABG) or HCR, using the generic SF-36 v.2 questionnaire. Methods: From November 2009 to July 2012, 200 patients from POLMIDES study with diagnosed MVCAD and were referred for conventional CABG were randomized to HCR (n = 98) or CABG (n =102) groups in 1:1 ratio. HRQoL were measured at two time points: hospital admission and 12-month follow up. The primary endpoint was the difference in HRQoL after the procedure. Results: Both groups showed the same improvement of HRQoL: in HCR group: 13.5 (3.82–22.34) vs. CABG group: 10.48 (2.46–31.07); p = 0.76. Conclusions: HRQoL in patients after both modes of revascularization significantly improved after 12 months in all domains.

Confusion on a somatic basis is a dangerous problem mainly related with aging of the population. Data says that consciousness disorders concern 10-15% of patients in general wards, and up to 50% of patients admitted to geriatric wards. The persistence of the symptoms of confusion results in increase of agitation, disorganization, fear, which increases the risk of self-injuries of patients, it causes the need for parenteral feeding and hydratation, as well as maintaining water balance, and also disturbs cooperation, worsening the course and prognosis of the primary disease. It is believed that consciousness disorders are one of the most difficult diagnostic problems and the most difficult therapy problem among psychotic disorders. So far in Poland there have been no screening evaluation tools to assess the occurrence of confusion on the somatic basis. The purpose of this paper is to introduce the Polish translation of the widely used scale to assess consciousness disorders, intended also for middle personnel of health care - Confusion Assessment Method (CAM). Numerous studies over 16 years established the position of CAM as an exceptionally effective standardized diagnostic test, specifying the sensitivity of 94-100%, specificity from 90-95%, positive predictive value of 91-94%, negative predictive value of 90-100%. The questionnaire and instructions of its interpretation have been translated by doctors with active help from the original creators of CAM. Further studies are required in order to validate and determine the effectiveness of the newly formed diagnostic tool.Majaczenie na podłożu somatycznym jest powszechnym i niebezpiecznym problemem związanym głównie ze starzeniem się populacji. Podaje się, że zaburzenia świadomości dotyczą 10-15% pacjentów na oddziałach ogólnych oraz do 50% pacjentów przyjmowanych w trybie ostrym na oddziały geriatryczne. Utrzymywanie się objawów majaczenia skutkuje narastaniem pobudzenia ruchowego, dezorganizacji, lęku, co zwiększa ryzyko urazów i samookaleczeń pacjentów, powoduje konieczność karmienia i pojenia pozajelitowego oraz prowadzenia bilansu wodnego, a także zaburza współpracę, co pogarsza przebieg i rokowanie choroby podstawowej. Uważa się, że zaburzenia świadomości są jednym z najtrudniejszych problemów diagnostycznych i najtrudniejszym problemem terapeutycznym wśród zaburzeń psychotycznych. Do tej pory w Polsce nie istniały żadne narzędzia do przesiewowej oceny występowania majaczenia na tle somatycznym. Celem niniejszej pracy jest wprowadzenie polskiego tłumaczenia szeroko stosowanej na świecie skali do oceny zaburzeń świadomości, przeznaczonej także dla personelu średniego służby zdrowia –

The holistic concept of health, popularization of knowledge, as well as social and economic factors have contributed to the growing interest in research concerning quality of life in cardiovascular diseases. The value of direct measurements of the patient's well-being and the extent of their functioning in everyday life (i.e., health-related quality of life; HRQoL) has gained appreciation. Questionnaires are the most popular method of measuring quality of life. On the basis of the literature, we can conclude that the Short-Form Health Survey (SF-36) questionnaire is one of the most widely used tools measuring the quality of life of patients undergoing cardiological treatment and cardiac surgery.Z uwagi na holistyczną koncepcję zdrowia, rozpowszechnienie, a także skutki społeczne i ekonomiczne wzrosło zainteresowanie badaniami nad jakością życia w chorobach układu sercowo-naczyniowego. Doceniona została wartość bezpośredniego pomiaru samopoczucia chorych i zakresu ich funkcjonowania w codziennym życiu, czyli jakości życia zależnej od stanu zdrowia (

The paper presents four cases of mental disorders in cardiac patients. The first patient, treated for decompensated heart failure, continued to report coronary-like symptoms despite significant improvement of heart contractility. The second one underwent artificial pacemaker implantation due to bradycardia and heart block. The patient still suffered from distinct weakness with lowered mood. In the third case, a patient with long-term ischemic heart disease underwent successful invasive treatment for myocardial infarction, but after a few months his symptoms relapsed in the form of what he himself interpreted as angina pectoris. The last described patient was referred by her GP because of breathing difficulties and fatigue. In all the described cases, depression was diagnosed, and successful psychiatric treatment was implemented. Discussion: In all the described cases, the symptoms persisted and worsened the patients’ comfort despite achieving objective improvement. This alarmed the attending physicians and could have resulted in unnecessary treatment modifications. Paying attention to the psychopathological aspects of the heart diseases enabled the physicians to diagnose the present mental disorders, employ efficacious treatment, and sig

CelCelem pracy była ocena poczucia koherencji w grupie kobiet poddanych diagnostyce inwazyjnej choroby wieńcowej i próba powiązania siły poczucia koherencji z krytycznymi przewężeniami tętnic wieńcowych.MetodaDo oceny poczucia koherencji użyto Kwestionariusz Orientacji Życiowej SOC-29 Antonovsky’ego oraz specjalnie skonstruowany kwestionariusz zawierający dane socjodemograficzne. Badania prowadzono przed i po 6-9 miesiącach od badania koronarograficznego. Wynik badania angiograficznego decydował o zakwalifikowaniu pacjentek do jednej z grup. Pierwszą grupę utworzyło 48 kobiet bez istotnych zwężeń w naczyniach wieńcowych, którym najczęściej diagnozowano kardiologiczny zespół X. Druga grupa obejmowała 42 osoby z potwierdzonymi, istotnymi zmianami miażdżycowymi.WynikiW grupie pacjentek z nieistotnym zwężeniem tętnic zanotowano znamiennie statystycznie niższe wartości poczucia zrozumienia w pierwszym i drugim badaniu, a także znamiennie statystycznie niższe wartości w poczuciu zaradności w badaniu kontrolnym, w porównaniu z grupą pacjentek z istotnymi zmianami miażdżycowymi. Wyjściowa siła ogólnego poczucia koherencji była porównywalna w obu grupach i nie zmieniła się istotnie po 6-9 miesiącach od koronarografii. Brak wsparcia społecznego, tendencje do przeżywania stanów depresyjnych i lękowych oraz gorsze wykształcenie związane było z niższym poczuciem koherencji w obu grupach.Wnioski1.Wyjściowa siła ogólnego poczucia koherencji nie różnicowała podgrup i nie zmieniła się istotnie po 6-9 miesiącach od koronarografii. 2.Pacjentki bez istotnych zwężeń tętnic wieńcowych mają niższe poczucie zrozumiałości przed i po koronarografii i niższe poczucie zaradności po koronarografii, w porównaniu z grupą pacjentek z istotnymi zmianami miażdżycowymi. 3.Brak wsparcia społecznego, częstsze korzystanie z porad lekarskich, tendencje do przeżywania stanów depresyjnych i lękowych oraz gorsze wykształcenie związane było z niższym poczuciem koherencji w obu badanych grupach.