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Electrocardiographic (ECG) examination has long been used to assess cardiovascular function in clinical practice. Age-related ECG changes are observed as the cardiovascular system matures from the neonatal period to adolescence.This study aimed to evaluate the effects of sex and age on ECG parameters in healthy schoolchildren.The study included 336 healthy participants aged 5-12 years from Masovian voivodeship. Children were divided into age groups of 5-8 and 9-12 years.Values for heart rate (HR), time intervals and amplitudes of P and QRS waves, and QRS axis for pediatric ECGs were estimated.Significant differences between boys and girls aged 5-8 years old were discovered for such parameters as PR interval, R-wave, and S-wave, R/S ratio. Age-related decline in HR, Q-wave in V5, and V6, R-wave in V1-V4, and increase in QRS duration were noted. Girls presented higher HR and shorter QRS than boys. HR, QRS axis, P wave amplitude in the II lead, and amplitude of R and S in the precordial leads were different in our population than previously reported.Pediatric ECG tracings were estimated for the first time for school-aged Polish healthy children. Sex-related differences in selected ECG parameters in the younger age group were noticed. Several parameters differed from those previously reported in other ethnic populations. These findings are clinically significant and suggest that diagnostic criteria for pediatric ECG should be revised to establish if they are justifiable for the entire population.

COVID-19 has a deteriorating impact on health which is especially important for endurance athletes (EAs) who need to maintain continuity of training. The illness affects sleep and psychology, which influence sport performance. The aims of this study were: (1) to assess the consequences of mild COVID-19 on sleep and psychology and (2) to assess the consequences of mild COVID-19 on cardiopulmonary exercise test (CPET) results. A total of 49 EAs (males = 43, 87.76%; females = 6, 12.24%; age = 39.9 ± 7.8 years; height = 178.4 ± 6.8 cm; weight = 76.3 ± 10.4 kg; BMI = 24.0 ± 2.6 kg·m−2) underwent a maximal cycling or running CPET pre- and post-COVID-19 and completed an original survey. Exercise performance deteriorated after COVID-19 (maximal oxygen uptake, VO2max = 47.81 ± 7.81 vs. 44.97 ± 7.00 mL·kg·min−1 pre- and post-infection, respectively; p < 0.001). Waking up at night affected the heart rate (HR) at the respiratory compensation point (RCP) (p = 0.028). Sleep time influenced pulmonary ventilation (p = 0.013), breathing frequency (p = 0.010), and blood lactate concentration (Lac) (p = 0.013) at the RCP. The maximal power/speed (p = 0.046) and HR (p = 0.070) were linked to the quality of sleep. Stress management and relaxation techniques were linked with VO2max (p = 0.046), maximal power/speed (p = 0.033), and maximal Lac (p = 0.045). Cardiorespiratory fitness deteriorated after mild COVID-19 and was correlated with sleep and psychological indices. Medical professionals should encourage EAs to maintain proper mental health and sleep after COVID-19 infection to facilitate recovery.

Wstęp: Osłabienie siły mięśniowej jest jednym z kluczowych objawów ograniczających motorykę u pacjentów z mózgowym porażeniem dziecięcym (MPD). Przeprowadzony przegląd piśmiennictwa skupia się na efektach treningu siłowego (TS) kończyn górnych u dzieci z MPD. Materiał i Metody: Przegląd piśmiennictwa przeprowadzono zgodnie z wytycznymi PRISMA Statement. W celu weryfikacji skuteczności TS przeszukano wybrane medyczne bazy danych używając słów kluczowych: mózgowe porażenie dziecięce, trening siłowy, kończyna górna. Badania podzielono na dwie kategorie, te w których występuje sam trening siłowy oraz te, w których trening siłowy jest połączony z inną interwencją terapeutyczną. Wyniki: Znaleziono 19 publikacji, z których do końcowej analizy włączono 9 prac: 4 badania randomizowane, 1 badanie inne niż randomizowane i 4 analizy przypadku. Wyniki przedstawiono w formie tabelarycznej zgodnie z Międzynarodową Klasyfikacją Funkcjonowania, Niepełnosprawności i Zdrowia na poziomach: struktury i funkcji, aktywności oraz partycypacji. W analizowanych badaniach wykorzystywano: TS jako samodzielną interwencję, TS wraz z elektrostymulacją oraz TS w połączeniu z iniekcjami toksyny botulinowej. Wnioski: Na podstawie przeanalizowanych badań nie można określić precyzyjnych wytycznych TS kończyn górnych w grupie dzieci z MPD z powodu zbyt dużej różnorodności badań w zakresie typu treningu, jego intensywności i czasu trwania. Istnieje konieczność ustalenia charakterystyki pacjentów z MPD i protokołu treningowego, które pozwolą na osiągnięcie maksymalnych korzyści płynących z tego rodzaju treningu na płaszczyźnie aktywności i partycypacji w życiu codziennym.

The diagnosis of cerebral palsy is usually made between the 12 and 24 months of age which often delays the implementation of early therapeutic intervention. General movements assessment is one of the tools for the early diagnosis of cerebral palsy. The aim of this study was to present the current knowledge on the use of the general movements assessment in predicting cerebral palsy. The literature review was made in accordance with the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. The PubMed medical database was searched, 24 publications were identified and included in the detailed analysis. The highest sensitivity was demonstrated for the general movements assessment performed during the fidgety period and in preterm infants. General movements assessment and/or Hammersmith Infant Neurological Examination (HINE) are recommended as a routine screening of newborns with documented risk factors for cerebral for the earliest possible diagnosis. Raising the awareness of medical personnel should be of key importance for the implementation of the recommended procedure.

Advances in pre- and postnatal care have resulted in increased survival rates of infants in risk groups. Consequently, a growing number of children need interdisciplinary care and early intervention in the first stages of life. Early detection of developmental abnormalities may allow for a more effective therapy. Observation of motor and behavioural skills is one of the crucial elements in the assessment of child’s development. Prechtl’s assessment of general movements is used in the first six months of a child’s life. It enables the identification and prediction of neurodevelopmental disorders. The aim of the study was to present Prechtl’s method and summarise knowledge about this approach based on a literature review of PubMed medical database. The key issues related to the assessment procedure, including reliability, consistency and compliance of the method, as well as its use for predicting neurodevelopmental disorders were discussed. Additionally, combined use of the tool with neuroimaging methods for assessing neuromotor development, and knowledge of the use of novel technologies for automatization of the general movements assessment were summarised. Due to its non-invasiveness, availability, and ease of implementation, the method has a wide use in clinical practice. Prechtl’s method allows for a careful observation of the child’s motor skills and may allow both clinicians and parents for early identification of neurodevelopmental disorders.

Introduction: Both constraint-induced movement therapy and botulinum toxin injection are well-researched and described therapeutic interventions in the group of patients with cerebral palsy. One of the main symptoms of damage to the central nervous system is excessive muscle tension, which may limit, among many other things, the manipulative and grasping skills of the upper limb. The most appropriate approach in patients with hemiplegia seems to be one that is aimed at enabling and then facilitating the use of the less functional limb. The aim of this study is to evaluate the efficacy of constraint-induced movement therapy combined with botulinum toxin injection in paediatric patients with cerebral palsy. Methods: In order to determine the efficacy of botulinum toxin injection combined with constraint-induced movement therapy, the PubMed medical database was searched using the following keywords: “botulinum toxin” and “constraint-induced movement therapy.” The inclusion criteria were the following: only papers in English and relating to paediatric patients. The literature review was based on the PRISMA Statement guidelines. Results: As a result of the database search, a total of 32 articles were found, of which four met the inclusion criteria. The protocols of all studies varied both in terms of the daily dose of training and the duration of therapy. Discussion: The combination of constraint-induced movement therapy with botulinum toxin injection allows for more frequent and effective use of the directly affected hand in children with cerebral palsy. A longer-lasting constraint-induced movement therapy with a lower intensity brings better results than a shorter-lasting therapy with a higher intensity. A significant improvement was observed for the grip assessment (functional assessment and Quality of Upper Extremity Skills Test – QUEST scale) and in the Goal Attainment Scaling – GAS results.

Introduction: Children with cerebral palsy present with diverse mobility abnormalities which are classified at the levels of structure and function and activity according to the International Classification of Functioning, Disability and Health. The authors of most studies on independent mobility in children with cerebral palsy have focused on gait abnormalities. The aim of this literature review was to analyse the running ability in children with cerebral palsy. Methods: A scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. A search of the PubMed database was performed using the terms “cerebral palsy” and “running.” Results: Children with cerebral palsy run at a lower speed compared to their healthy peers. They have a shorter stride length. The power generated by various muscle groups is different from that observed in typically developing children. This results in different kinematics and hence lower quality of running. Implementation of training focused on running as part of the rehabilitation process in children with cerebral palsy may bring positive results. Discussion: The ability of running is important not only to move quickly but also to participate in the activities of daily living performed by typically developing children. Because of that, it is advisable to incorporate elements of running training into the rehabilitation process in children with cerebral palsy, whenever possible.

Wearable devices enable RR interval (RRi) measurements during various conditions. We aimed to assess the validity of the Polar H10 for RRi acquisition during pre-rest stabilization, rest, sympathetic nervous system activity stimulation and recovery conditions for heart rate variability (HRV) analysis in ski mountaineers. RRi were simultaneously obtained via electrocardiogram and the Polar H10 with V800 wrist-watch among eleven elite athletes in the supine position. Short-term (5-min) and ultra-short-term (1-min) heart rate (HR) and HRV parameters were analyzed. Mean absolute percentage difference between parameters from different devices ranged from 0% to 5.4%. Intraclass correlation and concordance correlations ranged between 0.76 and 1.00. Limits of agreement (LoA) for short-term measures did not exceed the defined maximum acceptable difference (SWC) through all conditions for mean RRi, HR, time-domain and nonlinear indices, and for frequency-domain (fast-Fourier-related) during the rest condition. LoA exceeded the SWC for mean, minimal and maximal HR, time-domain and nonlinear parameters from select 1-minute samples in all conditions. The Polar H10 provides RRi that could be used for short-and ultra-short-term HRV analysis from stable resting conditions in elite ski mountaineers. Ultra-short-term parameters from exercise should be analyzed with caution especially from later minutes of activity.

The prevalence of coronary artery disease (CAD) increases every year; however, the impact of microelements on its underlying cause—atherosclerosis—is still unclear. Copper plays numerous regulatory roles in cardiovascular health and was suggested to influence the classic risk factors for CAD. The copper-to-zinc-ratio (Cu/Zn-ratio) reflects systemic oxidative stress–one of the factors in the complex pathogenesis of atherosclerosis. Hair incorporates metal ions during its growth; thus, it reflects the metal exposure that occurred over the last 4–8 weeks. The aim of the presented study was to verify the association between Cu and Cu/Zn-ratio content and the occurrence of acute coronary syndrome (ACS) in the hair of 133 patients who underwent coronary angiography due to suspected ACS. Additionally, association between Cu and Cu/Zn-ratio and selected risk factors for CAD was analyzed. Neither Cu nor Cu/Zn-ratio levels were associated with the occurrence of ACS, regardless of its type (UA/NSTEMI/STEMI). We did not find a significant association between Cu content in hair and risk factors for CAD. The Cu/Zn-ratio in hair was significantly correlated only with body mass index. The relationship of Cu content and Cu/Zn-ratio in hair with CAD, its risk factors and ACS appears to be complex and requires further well-designed research.

Coronary artery disease (CAD), the leading cause of death worldwide, has an underlying cause in atherosclerosis. The activity of this inflammatory process can be measured with neutrophil-to-lymphocyte ratio (NLR). The anti-inflammatory and anti-atherogenic properties of vitamin D affect many mechanisms involved in CAD. In this study, we investigated the association between NLR, vitamin D concentration, and severity of CAD in a group of patients with a history of myocardial infarction (MI). NLR was higher in patients with acute coronary syndrome (ACS) in comparison to those with stable CAD (median: 2.8, range: 0.96–24.3 vs. median: 2.3, range: 0.03–31.6; p < 0.05). No associations between NLR and severity of CAD (p = 0.14) in the cohort and in the subgroups with stable CAD (p = 0.40) and ACS (p = 0.34) were observed. We found no correlation between vitamin D level and NLR neither in the whole study group (p = 0.29) nor in subgroups of patients with stable CAD (p = 0.84) and ACS (p = 0.30). NLR could be used as prognostic biomarker of consecutive MI in patients with CAD and a history of MI.

Wstęp. Mózgowe porażenie dziecięce (MPD) jest zaburzeniem neurologicznym spowodowanym niepostępującym uszkodzeniem ośrodkowego układu nerwowego (OUN) w okresie okołoporodowym lub niemowlęcym. Uszkodzenie OUN nie ma charakteru progresywnego, natomiast powoduje postępujące zmiany zarówno w kontroli nerwowej mięśni, jak i w ich strukturze. Częstym powikłaniem tej niepogłębiającej się patologii OUN są przykurcze mięśniowe. Jedną z teorii wyjaśniającą powstawanie przykurczy jest ograniczona liczba komórek satelitarnych. Są to komórki macierzyste mięśni, odpowiadające za ich wzrost, rozwój i regenerację po urazie. Udowodniono, że u pacjentów z MPD w mięśniu przykurczonym jest o 60-70% mniej komórek satelitarnych niż w mięśniu osób zdrowych. Celem niniejszej pracy jest przedstawienie na podstawie systematycznego przeglądu piśmiennictwa zagadnienia dotyczącego komórek satelitarnych w grupie pacjentów z MPD. Materiał i metody. Przegląd piśmiennictwa został przeprowadzony zgodnie z rekomendacjami PRISMA Statement. Przeszukano medyczną bazę danych MEDLINE/PubMed z wykorzystaniem słów kluczowych: "komórki satelitarne" (ang. satellite cells) w połączeniu z "mózgowe porażenie dziecięce" (ang. cerebral palsy). Wyniki. W latach 2013-2021 zidentyfikowano 10 publikacji spełniających kryteria wyszukiwania, z tego 3 zakwalifikowano do szczegółowej analizy. Zanotowano znacznie mniejszą liczbę komórek satelitarnych w mięśniach, zmniejszoną liczbę włókien mięśniowych w obszarze dla każdej komórki satelitarnej, mniejszą łączną liczbę włókien mięśniowych, obniżenie szybkości tworzenia miotubuli u pacjentów z MPD w porównaniu do mięśni osób zdrowych. Wnioski. Planując proces leczenia i rehabilitacji, zespoły terapeutyczne powinny brać pod uwagę zredukowaną zawartość komórek satelitarnych w mięśniach pacjentów z MPD.

Wstęp: W literaturze anglojęzycznej opisane zostało wiele narzędzi pozwalających na ocenę stanu neuromotorycznego noworodków i niemowląt. Celem niniejszej pracy jest przedstawienie w polskiej literaturze medycznej skali Hammersmith Infant Neurological Examination (HINE) oraz przeprowadzenie systematycznego przeglądu piśmiennictwa dotyczącego stosowania jej u niemowląt w predykcji mózgowego porażenia dziecięcego (MPD). Metoda: Przeszukano medyczną bazę danych MEDLINE PubMed używając następujących zwrotów kluczowych: cerebral palsy w połączeniu z Hammersmith Infant Neurological Examination, znajdujących się w tytule i/lub streszczeniu publikacji. Dodatkowym kryterium włączenia był język angielski publikacji. Wyniki: Zidentyfikowano łącznie 22 publikacje. Pierwsza analiza pozwoliła wykluczyć 7 badań niespełniających kryteriów włączenia do szczegółowej analizy. Bazując na wynikach analizowanych badań można stwierdzić, że wynik HINE poniżej 66 punktów uzyskany w 3, 6, 9 i/lub 12 miesiącu życia wskazuje na ryzyko wystąpienia MPD w późniejszym etapie życia dziecka. Wnioski: Skala HINE jest użytecznym narzędziem wykorzystywanym już w pierwszych miesiącach życia dziecka do oceny ryzyka wystąpienia zaburzeń neurorozwojowych, w tym MPD. Umożliwia wczesne wykrycie zespołu zaburzeń, co jest szczególnie istotne w zaplanowaniu dalszego odpowiedniego leczenia. Zaleca się połączenie badania neurologicznego HINE z badaniem metodą Prechtla oraz badaniami neuroobrazowymi w celu zwiększenia mocy predykcyjnej. Jednakże, ze względu na wysoką czułość obu narzędzi, w codziennej praktyce klinicyści mogą zdecydować się na użycie tylko jednego z nich (HINE lub ocena wg Prechtla). Mimo ogólnodostępnej i nieskomplikowanej formy badania, HINE nie znajduje jednak szerokiego zastosowania u klinicystów, co, bez wątpienia, powinno ulec zmianie.

Wstęp: Muzykoterapia wykorzystuje muzykę i/lub jej elementy w celu poprawy stanu klinicznego pacjentów z różnymi schorzeniami. Wyniki wielu badań wykazują korzystny wpływ muzykoterapii na stan pacjentów neurologicznych, m.in. pacjentów z chorobą Parkinsona, demencją starczą, zaburzeniami snu czy padaczką. Eksperymenty wykazały, że najlepszy wpływ na aktywność mózgu ma muzyka Mozarta. Wpływ muzyki tego kompozytora na różne dolegliwości został nazwany „Efektem Mozarta”. Celem pracy jest ocena wpływu muzyki Mozarta na stan kliniczny pacjentów pediatrycznych z padaczką na podstawie przeglądu piśmiennictwa. Materiał i metody: Przegląd piśmiennictwa przeprowadzono zgodnie z rekomendacjami PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Dokonano przeglądu medycznej bazy danych Pubmed, używając słów/zwrotów kluczowych: dziecko, padaczka, „efekt Mozarta”, muzykoterapia. Wyniki: Od roku 2010 do 2018 zidentyfikowano 97 publikacji spełniających wstępne kryteria włączenia, z których wybrano 7 do szczegółowej analizy. Wnioski: We wszystkich badaniach wykazano zmniejszenie liczby napadów padaczkowych u badanych pacjentów. Autorzy włączonych badań zasugerowali mechanizmy działania muzyki Mozarta obejmujące m.in. zwiększenie poziomu dopaminy w śródmózgowiu oraz wzrost aktywności układu przywspółczulnego. Muzyka Mozarta może stanowić dodatkową, wspomagającą formę terapii u pacjentów pediatrycznych z padaczką.

Hypertonia Assessment Tool (HAT) stanowi użyteczne narzędzie do oceny i klasyfikacji wygórowanego napięcia mięśniowego, i może być stosowane podczas badania pacjentów pediatrycznych z zaburzeniami neurologicznymi. Prawidłowa ocena rodzaju hipertonii (dystonia, spastyczność, sztywność) jest kluczowa w doborze odpowiedniego leczenia i ustalania programu rehabilitacji. Celem pracy było omówienie praktycznego wykorzystania narzędzia HAT u pacjentów pediatrycznych oraz dokonanie przeglądu piśmiennictwa badań wykorzystujących to narzędzie do oceny napięcia mięśniowego. Przegląd piśmiennictwa przeprowadzono zgodnie z rekomendacjami PRISMA przeszukując medyczną bazę danych Pubmed. Uwzględniono jedynie publikacje anglojęzyczne. Zidentyfikowano 5 publikacji spełniających powyższe kryteria, oraz jeden komentarz. Autorzy włączonych badań sugerują, że HAT jest przydatne do wykrywania sztywności i spastyczności, natomiast przy dystonii zaleca się dokładniejszą analizę i modyfikację użycia tego narzędzia. HAT charakteryzuje się dobrą wiarygodnością i trafnością w identyfikacji spastyczności i braku sztywności, a także umiarkowaną dokładności rozpoznawczą w przypadku dystonii. Przedstawiony artykuł przedstawia tłumaczenie własne kwestionariusza wykorzystywanego podczas badania hipertonii oraz opis konstrukcji i zalet narzędzia. Zaleca się wykorzystywanie narzędzia HAT do oceny rodzaju podwyższonego napięcia mięśniowego u pacjentów pediatrycznych z zaburzeniami neurologicznymi.

Coronary artery disease continues to be the leading cause of death in developed countries. Elevated mean platelet volume (MPV) is associated with an increased incidence of myocardial infarction (MI) and MI-related mortality. Vitamin D concentrations affect the level and function of platelets, which are the crucial mediator of atherothrombosis and plaque rupture. The main aim of this study was to examine the relationship of serum 25-hydroxyvitamin D (25(OH)D) levels with the platelet activity in patients with a history of an acute coronary syndrome (ACS). This prospective study recruited 268 patients with a history of MI who underwent coronary angiography due to the suspicion of another ACS. Serum 25(OH)D concentration was determined by electrochemiluminescence. Platelet activity was assessed using the MPV and platelet-large cell ratio (P-LCR) parameters. There was no significant difference in MPV and P-LCR values between patients diagnosed with subsequent MI and patients with chronic coronary syndrome (CCS). A significantly lower level of 25(OH)D was demonstrated in patients who had another MI compared to those with CCS (p < 0.05). No significant correlation of 25(OH)D concentrations with platelet activity parameters values was found. The subgroup of patients with consecutive MI was characterized by significantly lower serum vitamin D levels, but this was not related to the analyzed parameters of platelet activity.

Cardiovascular diseases (CVDs) are the leading cause of death worldwide. Although zinc (Zn) was reported to have antioxidant, anti-inflammatory and protective properties in CVDs, its association with coronary artery disease (CAD) is still unclear. As methods commonly used to assess Zn levels in blood and urine do not show the full picture of the microelement supply, in this study, the nutritional status of Zn in patients with angiographically confirmed CAD was assessed using inductively coupled plasma optical emission spectrometry. We found no association between Zn and the severity of CAD evaluated with the Coronary Artery Surgery Study Score (p = 0.67). There were no statistically significant differences in Zn levels between patients with acute coronary syndrome and those with stable CAD (p = 0.937). A statically significant negative correlation was observed between Zn content and serum triglyceride concentration (p < 0.05). Patients with type 2 diabetes mellitus were found to have a significantly lower hair Zn content compared to non-diabetic individuals (p < 0.01). The role of Zn in the pathogenesis of CAD and its complications need further well-designed research as the moderation and supplementation of Zn dietary intake could be a simple intervention to reduce the CVDs risk.

Atherosclerosis, the underlying cause of coronary artery disease (CAD), has a significant inflammatory component. White blood cell count is an affordable and accessible way to assess the systemic immune response, as it comprises many subgroups with distinct and complex functions. Considering their multidirectional effect on atherosclerosis, new biomarkers integrating various leukocyte subgroups, the Systemic Inflammatory Index (SII) and the Systemic Inflammatory Response Index (SIRI), were recently devised to describe the balance between inflammation and immune reaction. This research aimed to evaluate the relationship of the intensity of inflammation measured by these biomarkers with the severity of CAD assessed with coronary angiography and with the diagnosis of acute coronary syndrome (ACS) or stable CAD in 699 patients. SIRI, but not SII, was associated with the diagnosis, having the highest values for patients with ACS (STEMI), significantly higher than in patients with stable CAD (p < 0.01). The highest SII and SIRI values were observed in patients with three-vessel CAD. SII and SIRI require further in-depth and well-designed research to evaluate their potential in a clinical setting.

Coronary artery disease (CAD) in women occurs later than in men. Underlying atherosclerosis, a chronic process of lipoprotein deposition in arterial walls with a prominent inflammatory component, is influenced by several risk factors. In women, commonly used inflammatory markers are generally found to be related to the occurrence of acute coronary syndrome (ACS), as well as the development of other diseases that influence CAD. New inflammatory markers derived from total blood count—systemic inflammatory response index (SII), systemic inflammatory reaction index (SIRI), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), and neutrophil-lymphocyte ratio (NLR)—were analyzed in the group of 244 elderly, postmenopausal women with the diagnosis of ACS or stable CAD. SII, SIRI, MLR, and NLR were significantly higher in women with ACS compared to those with stable CAD (p < 0.05 for all)—the highest values were observed in women with NSTEMI. MLR from new inflammatory markers, HDL, and history of MI turned out to be significant factors associated with ACS. These results suggest that MLR as representative of blood count-derived inflammatory markers may be considered as additional CVD risk factors in women with suspected ACS.

Individuals with Down syndrome (DS) present similar heart rate variability (HRV) parameters at rest but different responses to selected movement maneuvers in comparison to individuals without DS, which indicates reduced vagal regulation. The present study undertakes a scoping review of research on HRV in individuals with DS, with special attention paid to the compliance of the studies with standards and methodological paper guidelines for HRV assessment and interpretation. A review was performed using PubMed, Web of Science and CINAHL databases to search for English language publications from 1996 to 2020 with the MESH terms “heart rate variability” and “down syndrome”, with the additional inclusion criteria of including only human participants and empirical investigations. From 74 studies, 15 were included in the review. None of the reviewed studies met the recommendations laid out by the standards and guidelines for providing the acquisition of RR intervals and necessary details on HRV analysis. Since authors publishing papers on this research topic do not adhere to the prescribed standards and guidelines when constructing the methodology, results of the research papers on the topic are not directly comparable. Authors need to design the study methodology more robustly by following the aforementioned standards, guidelines and recommendations.

The incidence of ischemic heart disease (IHD) increases every year. This cardiovascular disease has an inflammatory factor in its etiology due to different immune cells that influence atherogenesis. New inflammatory biomarkers—the Systemic Inflammatory Index (SII) and the Systemic Inflammatory Response (SIRI)—attempt to describe the pro- and anti-inflammatory balance and quantify the complex impact of the immune system on atherosclerosis, while vitamin D has a multidirectional impact on the human body, including the cardiovascular and immune systems. Hence, the objective of this research was to analyze the association between SII and SIRI and serum vitamin D concentrations in patients with IHD. A significant correlation was observed between SIRI and 25(OH)D in the whole group and between both biomarkers (SII and SIRI) and 25(OH)D in the group of patients with ACS but not in the group of patients with stable IHD. The role of vitamin D in IHD complications and its association with new inflammatory biomarkers requires further well-designed, large-scale research.

Epidemiological data on serum vitamin D levels in the population of Polish patients with angiographically confirmed coronary artery disease are limited.The aim of the study was to prospectively assess the concentrations of vitamin D in a group of patients from the Cardiological Department in Bielanski Hospital in Warsaw referred for coronary angiography due to suspected coronary artery disease.The study included a total of 1,043 qualified patients (374 women and 669 men, age: 66,9±11,0 years) who underwent coronary angiography between the years of 2013 and 2017. Plasma 25(OH)D concentrations were assessed by electrochemiluminescence.The median 25(OH)D concentration in the study group was 15.2 ng/ml (range: 4.0 - 55.0 ng/ml). Optimal 25(OH)D concentrations (ie., equal to or greater than 30 ng/ml) were found in 64 patients (6%). Severe deficiencies (less than 10 ng/ml) were found in 229 patients (22%). Moderate deficiencies (concentration equal to or greater than 10 ng/ml and less than 20 ng/ml) and mild deficiencies (concentration equal to or greater than 20 ng/ml and less than 30 ng/ml) were observed in 525 (50%) and 225 patients (22%), respectively.Vitamin D deficiency was found in 94% of residents of central Poland with angiographically confirmed coronary artery disease. 22% of patients had a severe vitamin D deficiency. Due to the documented effects of vitamin D on the cardiovascular system and the fact that cardiovascular disease (including coronary artery disease) is still the most common cause of death in developed countries, prophylactic and therapeutic strategies should be considered to combat 25(OH)D deficiency in this group of Polish patients.

Introduction Ischaemic heart disease is the main cause of death in developed countries. There are many modifiable risk factors associated with coronary heart disease (CAD). A growing number of studies point to vitamin D deficiency as a risk factor for heart attacks and the conditions associated with cardiovascular disease. This study aimed to analyse the relationship between the level of 25-hydroxyvitamin D (25(OH)D) and the severity of coronary artery atherosclerosis and to study 25(OH)D levels in non-diabetic patients hospitalised due to acute coronary syndrome and those diagnosed with stable CAD. Material and methods Coronary angiography was performed prospectively in 410 successive cardiac patients. The severity of coronary artery atherosclerosis was assessed according to the Coronary Artery Surgery Study Score (CASSS). The plasma 25(OH)D level was assessed with the electrochemiluminescence method. Results The 25(OH)D level proved to be one of the significant determinants of the CASSS (p < 0.05). In subjects without significant lesions in the coronary arteries the 25(OH)D level was significantly higher compared to patients with one- to three-vessel coronary atherosclerosis (p < 0.05). A significantly higher 25(OH)D level was noted in patients diagnosed with stable CAD compared to patients hospitalised due to acute coronary syndrome (p < 0.01). Conclusions Patients with one- to three-vessel atherosclerosis have a significantly lower 25(OH)D level compared to patients without significant lesions in the coronary arteries. A lower 25(OH)D level was observed in patients hospitalised due to acute coronary syndrome compared to patients diagnosed with stable CAD.

Monitoring of markers reflecting cardiac autonomic activity before and during stressful situations may be useful for identifying the physiological state of an athlete and may have medical or performance implications. The study aimed to determine group and individual changes in short-term (5 min) and ultra-short-term (1 min) heart rate (HR), respiratory rate (RespRate), and time-domain heart rate variability (HRV) parameters during sympathetic nervous system activity (SNSa) stimulation among professional endurance athletes. Electrocardiographic recordings were performed in stable measurement conditions (Baseline) and during SNSa stimulation via isometric handgrip in 12 elite modern pentathlonists. Significant increases in short-term HR and decreases in time-domain HRV parameters with no changes in RespRate were observed during SNSa stimulation. Significant differences were observed between Baseline (all minutes) and the last (i.e., 5th) minute of SNSa stimulation for ultra-short-term parameters. Analysis of intra-individual changes revealed some heterogeneity in responses. The study provides baseline responses of HR, RespRate, and time-domain HRV parameters to SNSa stimulation among elite pentathlonists, which may be useful for identifying abnormal responses among fatigued or injured (e.g., concussed) athletes. More attention to individual analysis seems to be necessary when assessing physiological responses to sympathetic stimuli in professional endurance athletes.

Research on reliability of heart rate variability (HRV) parameters in athletes has received increasing attention. The aims of this study were to examine the inter-day reliability of short-term (5 min) and ultra-short-term (1 min) heart rate (HR), respiratory rate (RespRate) and HRV parameters, agreement between short-term and ultra-short-term parameters, and association between differences in HR, RespRate and HRV parameters in elite modern pentathletes. Electrocardiographic recordings were performed in stable measurement conditions with a week interval between tests. Relative reliability was evaluated by intra-class correlation coefficients, absolute reliability was evaluated by within-subject coefficient of variation, and agreement was evaluated using Bland–Altman (BA) plot with limits of agreement and defined a priori maximum acceptable difference. Short-term HR, RespRate, log transformed (ln) root mean square of successive normal-to-normal interval differences (lnRMSSD), ln high frequency (lnHF) and SD2/SD1 HRV indices and ultra-short-term HR, RespRate and lnRMSSD presented acceptable, satisfactory inter-day reliability. Although there were no significant differences between short-term and ultra-short-term HR, RespRate and lnRMSSD, no parameter showed acceptable differences with BA plots. Differences in time-domain and non-linear HRV parameters were more correlated with differences in HR than with differences in RespRate. Inverse results were observed for frequency-domain parameters. Short-term HR, RespRate, lnRMSSD, lnHF, and SD2/SD1 and ultra-short-term HR, RespRate and lnRMSSD could be used as reliable parameters in endurance athletes. However, practitioners should interpret changes in HRV parameters with regard to concomitant differences in HR and RespRate and caution should be taken before considering 5 min and 1 min parameters as interchangeable.

Cardiac autonomic dysfunction has been reported in patients with cerebral palsy (CP). The aim of this study was to assess the existing literature on heart rate variability (HRV) in pediatric patients with CP and a special attention was paid to the compliance of the studies with the current HRV assessment and interpretation guidelines. A systematic review was performed in PubMed, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases searched for English language publications from 1996 to 2019 using Medical Subject Headings (MeSH) terms “heart rate variability” and “cerebral palsy” in conjunction with additional inclusion criteria: studies limited to humans in the age range of 0–18 years and empirical investigations. Out of 47 studies, 12 were included in the review. Pediatric patients with CP presented a significantly higher resting heart rate and reduced HRV, different autonomic responses to movement stimuli compared to children with normal development, but also reduced HRV parameters in the children dependent on adult assistance for mobility compared to those generally independent. None of the included studies contained the necessary details concerning RR intervals acquisition and HRV measurements as recommended by the guidelines. Authors of HRV studies should follow the methodological guidelines and recommendations on HRV measurement, because such an approach may allow a direct comparison of their results.

Background Hand grip strength (HGS) test is commonly used as an indicator of overall muscle strength in medical and sport practices. Recently, several studies have proposed that the measurement of the maximal HGS depends on dynamometer’s handle position. The aim of the present study was to identify the optimal handle position to obtain maximal HGS using the hand grip dynamometer (HGD) for school-aged children. Methods HGS was assessed with the Jamar digital HGD. Each participant performed three maximum contractions of each hand on three handle positions progressing from first to third position. Results A total of 135 healthy children aged 5–9 years participated in the study. Participants obtained significantly higher results using position 2 than using positions 1 or 3. The maximal mean (± SD) HGS achieved was 9.9 (± 3.1) kg with position 1, 10.4 (± 3.1) kg with position 2, and 9.0 (± 3.2) kg with position 3. Handle position 2 was the most comfortable position for 73% of participants. Conclusions Our results provide useful methodological information indicating that the second handle position of the Jamar digital HGD is optimal to measure maximal HGS in non-athletic healthy pediatric participants aged 5–9 years.

Introduction: Number of population suffering from hypertension is increasing. So that, monitoring of this phenomenon should concentrate attention of medical industry, and receive high priority. One of the recommended procedure in hypertension treatment, and control is home blood pressure monitoring, which can be tested using smartphone application. Aim of the research : To evaluate the feasibility of a new blood pressure (BP) measurement tool – a smartphone application. Material and methods : The study included 50 subjects with the diagnosis of hypertension. Blood pressure measurement was tested in the following conditions: using a sphygmomanometer and using a smartphone by a specialist, and using a smartphone by the patient him/herself. The total number of results that differed from the measurement performed by the specialist by more than 5 mm Hg, and by 10% or more, was counted. Results: Mean results of systolic and diastolic BP did not differ significantly between measurements done by a specialist using a sphygmomanometer and those done using a smartphone application. There were 82% of results of systolic and 92% of diastolic BP that differed from Korotkoff sound technique in a range greater than 5 mm Hg and 36% in systolic and 86% in diastolic BP by 10% or more. Conclusions: The tested application should not yet be used for BP monitoring.

Introduction Spasticity is considered to be one of the most important factors hampering functional abilities among patients with a cerebral palsy (CP). Aim The aim of the study was to present results of the selective dorsal rhizotomy (SDR) procedure combined with the physiotherapy process in a 3 year follow-up study, presented from a functional and structural perspective. Case study After the diagnosis of CP in the form of spastic diplegia, the 2-years-old patient (GMFCS 4) was directed for a comprehensive rehabilitation. After clinical examination and family consultation, spasticity was found to be important factor limiting patient functional abilities. Results and discussion The patient was directed to SDR operation. The patient was evaluated four times: before the SDR, and then 1, 2 and 3 years after the SDR surgery. The spasticity was assessed using the modified Tardieu scale. A functional assessment was done using the gross motor function measure (GMFM) scale, 6-min walk test and functional assessment questionnaire (FAQ-10). A muscle tension remained decreased throughout the 3 years of the follow up period. The achieved reduction in muscle tone was accompanied by a change in a range of motion, an improvement in GMFM total score result, an increased distance in 6-min walk test and in the FAQ-10 questionnaire. Conclusions SDR procedure combined with comprehensive rehabilitation programs leads to short- and long-term reduction in the spasticity of a 5-year-old boy with a spastic diplegia. Decreased level of spasticity was accompanied by an increased gross motor functioning and mobility.