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Abstract Background Cardiac arrest constitutes a critical medical emergency necessitating swift intervention to reinstate normal heart rhythm and prevent harm to vital organs. The pivotal role of bystander cardiopulmonary resuscitation (CPR) in influencing survival rates is well recognized. With older adults being the most common group to witness such events, it’s curcial to understand their attitudes and knowledge about performing CPR. Additionally, understanding if health status has an influence can help in tailoring education for specific seniors needs. Methods A cross-sectional survey was sent to University of the Third Age (UTA) students. The survey comprised sections focusing on demographic data, CPR knowledge, automated external defibrillator (AED) knowledge, first aid training, and readiness to perform CPR and use AEDs. Participants’ health conditions were also assessed through multiple-choice options. Results We received 456 responses. Significant awareness of emergency numbers and cardiac arrest recognition was revealed. However, knowledge gaps persisted, particularly in compression rates. Most participants comprehended AED usage, yet training primarily relied on theoretical approaches. Health conditions notably affected CPR readiness, with associations between specific chronic diseases and willingness to perform CPR. Conclusions Addressing knowledge gaps and tailoring education for elderly needs are crucial for improving survival rates. Future research should explore barriers to bystander CPR during out-of-hospital cardiac arrests to further enhance survival prospects.

After the first phase of the COVID-19 pandemic in Europe, a new highly pathogenic variant of echovirus 11 (E11) was detected. The aim of this study was to analyze the genetic diversity of Polish E11 environmental and clinical strains circulating between 2017 and 2023 as well as compare them with E11 strains isolated from severe neonatal sepsis cases reported in Europe between 2022 and 2023. Additionally, the study explores the effectiveness of environmental monitoring in tracking the spread of new variants. For this purpose, the complete sequences of the VP1 capsid protein gene were determined for 266 E11 strains isolated in Poland from 2017 to 2023, and phylogenetic analysis was performed. In the years 2017–2023, a significant increase in the detection of E11 strains was observed in both environmental and clinical samples in Poland. The Polish E11 strains represented three different genotypes, C3, D5 and E, and were characterized by a high diversity. In Poland, the intensive circulation of the new variant E11, responsible for severe neonatal infections with a high mortality in Europe, was detected in the years 2022–2023. This investigation demonstrates the important role of environmental surveillance in the tracking of enteroviruses circulation, especially in settings with limited clinical surveillance.

In Poland there are still nearly 20 million individuals with hypercholesterolaemia, most of them are unaware of their condition; that is also why only ca. 5% of patients with familial hypercholesterolaemia have been diagnosed; that is why other rare cholesterol metabolism disorders are so rarely diagnosed in Poland. Let us hope that these guidelines, being an effect of work of experts representing 6 main scientific societies, as well as the network of PoLA lipid centers being a part of the EAS lipid centers, certification of lipidologists by PoLA, or the growing number of centers for rare diseases, with a network planned by the Ministry of Health, improvements in coordinated care for patients after myocardial infarction (KOS-Zawał), reimbursement of innovative agents, as well as introduction in Poland of an effective primary prevention program, will make improvement in relation to these unmet needs in diagnostics and treatment of lipid disorders possible.

Introduction Increased serum cholesterol levels constitute one of the main risk factors for cardiovascular diseases. Statins are a major method for reducing the levels which also lower the risk of cardiovascular events. However, these valuable drugs cannot be used in all patients who need them due to contraindications and intolerance. In such cases, help can be sought from nutraceutics that reduce the serum cholesterol concentration. Since there are numerous products of this type available at drugstores, registered as supplements, there seems to be a need to demonstrate their effectiveness in preventing cardiovascular diseases induced by atherosclerosis. In literature, increasingly more attention is drawn to red yeast rice, Armolipid, berberine and bergamot. Brief description This article presents knowledge about these nutraceutics based on clinical studies and expert statements relating to their use. The results of clinical studies and metaanalyses have shown that nutraceutics with cholesterol lowering properties, red yeast rice and Armolipid are the most favourable for reducing cardiovascular events. However, the evidence of benefits of berberine and bergamot is not so conclusive. Results Conclusions Red yeast rice products and Armolipid may be used as an alternative treatment in statin intolerant patients, especially in combination with ezetimibe. These nutraceutics can be also considered, as an adjunct to diet therapy in primary prevention of cardiovascular diseases in patients with mild and moderate hypercholesterolaemia. The opinion of experts on berberine and bergamot is ambiguous.

(1) Alcohol consumption contributes to the development of numerous diseases and is a big organizational burden on emergency departments (EDs). (2) We examined data on alcohol-related ED admissions in Poznan, Poland between 1 April 2019 and 31 March 2022. A total of 2290 patients’ records were collected and analysed. The main goal was to determine the impact that these visits had on the functioning of the ED and the hospital. (3) The alcohol-related admission rate was significantly higher in males (78.95% vs. 21.05%), and the median blood alcohol concentration (BAC) level was 2.60 (1.78–3.38) ‰. Most of the visits took place at weekends and in the evening. Patients with higher BAC tended to stay longer in the ED, but had a lower chance of being admitted. A majority of patients required radiology and laboratory testing, 20.44% needed psychiatric examination, and 19.69% suffered trauma, mainly to the head. (4) Injuries and mental problems were the most common medical emergencies. This study presents trends in alcohol-related ED attendances, examines reasons for visits, and makes an attempt to assess overall burden on EDs.

Introduction Polyunsaturated n-3 fatty acid preparations containing eicosapentaenoic acid (EPA) and docosahexanaenoic acid (DHA), or EPA only, have long been recommended in the management of hypertriglyceridaemia, especially when severe (triglyceride levels ≥500 mg/dL), at the dose of 2–4 g/d, mostly for the prevention of acute pancreatitis. Material and Methods The presented article reviews clinical trials and their metaanalyses which evaluated the effect of n-3 fatty acids on cardiovascular disease risk, and regulatory agencies’ and cardiac societies’ positions regarding their use. Results The findings indicate that only EPA is effective. Particular clinical benefit (25% reduction of cardiovascular events) was observed in the recently published REDUCE-IT trial which evaluated EPA (icosapent ethyl) at the dose of 4 g/d for 4.9 years (median), compared to placebo, in hypertriglycerydaemic patients at high or very high cardiovascular risk. This positive effect has been reflected in the expert opinions which recommend eicosapent ethyl (4 g/d) in patients similar to those participating in the REDUCE-IT trial. Additional data in favour of the above position have been provided by the EVAPORATE trial results which showed reduced progression of coronary atherosclerosis with EPA at the dose of 4 g/d. Conclusions The clinical studies and metaanalyses strongly point out that only EPA (icosapent ethyl), especially at dose of 4 g/d, is effective in reducing cardiovascular events in very high and high risk patients with hypertriglyceridemia. The use of EPA + DHA preparations in doses up to 1 g/d does not prevent recurrent cardiovascular events.

Background. Arterial hypertension is caused by environmental factors and genetic predisposition. Objective. The aim of this study was to assess the association between the angiotensin converting enzyme (ACE) gene variants and environmental factors, biochemical and anthropometric parameters and the incidence of hypertension. Material and methods. A total of 73 patients, aged 24 to 68, with Body Mass Index (BMI) above 25 kg/m2 took part in this study. Nutrient intake was assessed with a diet based on consumption records. The ACE gene insertion/deletion (I/D) polymorphism was determined by the polymerase chain reaction (PCR) method. Results. Normal pressure predominated in persons with genotype II (59.1%), whereas hypertension in persons with genotype ID (55.2%). The frequency of the D allele was 5% higher in the hypertensive group (53% vs. 48%), but this difference was not statistically significant. The percentage of patients who consumed alcohol and smoked cigarettes in the D allele group was higher than in the I allele group. People with the D allele had lower vitamin D intake and higher copper intake than carriers of the allele I. The highest vitamin D intake was found in people with genotype II, and the differences were significant compared to patients with ID genotype. People with the D allele consumed more carbohydrates and less protein than those with the I allele, but these differences were not statistically significant. Conclusions. Hypertensive subjects were more frequent DD and ID genotypes, whereas normotensive subjects - the II genotype. People with the D allele had lower vitamin D and protein intake, while the carbohydrate and copper intake was higher than those with the I allele. The group with the D allele had a higher percentage of smokers and alcohol drinkers. Our studies have shown a relationship between environmental and genetic factors and hypertension, but more research is needed.

Introduction Emergency medical services personnel is an occupational group exposed to the occurrence of musculoskeletal disorders in relation to the work performed, including back pain syndrome (BPS). The most frequent causes of BPS are unfavourable environmental factors, repeated patient handling during the day, and forced body positions at work. Objectives The aim of the study was to assess the occurrence of BPS in relation to the work performed and its impact on functional disability in paramedics. Material and methods The study included 70 emergency medical services personnel aged 24–56 years working in shift mode in Greater Poland. The survey included questions about socio-demographic data, characteristics of the work of paramedics, intensity of back pain according to the Visual Analogue Scale (VAS) scale and level of disability on the Oswestry Questionnaire Results Every paramedic declared the occurrence of BPS. The majority (61%) felt pain in the spine a few times a month, most often (65%) in the lumbosacral segment. BPS in more than half (56%) of the respondents caused moderate pain on the VAS scale. The level of disability in 70% of respondents was minimal. Intensity of back pain had the greatest impact on functional limitations in the daily life of the subjects (p

Background: Due to the increase in life expectancy, both the general population and the population of patients of emergency departments (ED) are getting older. An understanding of differences, workload and resource requirements may be helpful in improving patient care. The main goal of this study was to evaluate the reasons for geriatric admissions in the ED, identify typical medical problems and assess the number of resources in order to provide more effective management. Methods: We examined 35,720 elderly patients’ ED visits over the course of 3 years. The data collected included age, sex, timing and length of stay (LOS), use of various resources, endpoint (admission, discharge or death) and ICD-10 diagnoses. Results: The median age was 73 years [66–81], with more females (54.86%). There were 57.66% elderly (G1), 36.44% senile (G2) and 5.89% long-liver (G3) patients. There were more females in the older groups. The total admission rate was 37.89% (34.19% for G1, 42.21% for G2 and 47.33% for G3). The average length of the patient’s stay was 150 min [81–245] (G3 180 min [108–277], G2 (162 min [92–261]) and G1 139 min [71–230]). Heart failure, atrial fibrillation and hip fracture were the most common diagnoses. Nonspecific diagnoses were common in all groups. Conclusion: The vast majority of geriatric patients required considerable resources. With increasing ages, the number of women, LOS and number of admissions increased.

Background. Successful defibrillation is commonly followed by a transient nonperfusing state. To provide perfusion in this stagnant phase, chest compressions are recommended irrespective of arrhythmia termination. Implantable cardioverters-defibrillators (ICD) used immediately after delivery of the shock are capable of pacing the heart, and this feature is commonly activated in these devices. Potential utility of external, transcutaneous postshock pacing in patients with SCA in shockable rhythms has not been determined. This study aimed at presenting an impact of a short-term external postshock pacing (ePSP) on a quality of chest compressions (CC) without compromising them. Methods. The study was designed as a high-fidelity simulation study. Twenty triple-paramedic teams were invited. Participants were asked to take part in a 10-minute adult cardiac arrest scenario with ventricular fibrillation. In the first simulation, paramedics had to resume compressions after each shock (control group). In the second, simultaneous with compressions, one of the rescuers started transcutaneous pacing (TCP) with a current output of 200 mA and a pacer rate of 80 ppm. TCP was finished after 30 seconds (experimental group). The primary outcomes were chest compression fraction (CCF), mean depth and rate of compressions, percent of fully recoiled compressions, and percent of compressions of correct depth and their rate. Results. In both experimental and control group, CCF, mean depth, and rate were similar (84.65 ± 3.67 vs. 85.45 ± 4.95, p=0.54; 55.75 ± 3.40 vs. 55.25 ± 2.73, p=0.63; 122.70 ± 4.92 vs. 120.80 ± 6.00, p=0.25, respectively). In turn, percent of CC performed in correct depth, rate, and recoil was unsatisfactory in both groups (51.00 ± 17.40 vs. 52.60 ± 18.72, p=0.76; 122.70 ± 4.92 vs. 120.80 ± 6.00, p=0.25, respectively). Small differences were not statistically significant. Moreover, appropriate hand-positioning was observed more frequently in the control group, and this was the only significant difference (95.60 ± 5.32 vs. 99.30 ± 1.59, p=0.006). Conclusion. This difference was statistically significant (p

Background. Early defibrillation and high-quality chest compressions are crucial in treatment of sudden cardiac arrest (SCA) subjects. The aim of this study was to assess an impact of defibrillation methods on cardiopulmonary resuscitation (CPR) quality. Methods. A randomized simulation cross-study was designed, in which 100 two-person paramedical teams participated. Two 10-minute scenarios of SCA in the mechanism of ventricular fibrillation were analysed. In the first one, teams had at their disposal defibrillator with hard paddles (group C), whereas in the second one, adhesive electrodes were used (group MFE). The CPR quality was evaluated on the basis of the chest compression parameters (rate, depth, recoil, compression fraction (CCF), and no-flow time), airways patency achievement, and successful emergency drug administration. Results. Substituting standard hard paddles with adhesive electrodes led to an increase in CCF (77% vs 73%; p

Protection of antique book collections is a complicated and multistage process that demands deliberated maintenance among users, caretakers and owners as well as the appropriate conservation procedures. Undoubtedly, the common goal of everyone who is involved in this process is to keep the collection it in the best possible condition. Unfortunately, storage conditions of books and their state of preservation require in many cases the immediate intervention.Systematization of demanded actions and establishment of conservation priorities are difficult and very hard to objectivize tasks. In this article we would like to present a method (heritage studies-based evaluation analysis) that may help in solving above mentioned problems. This method is shown in the example of the Żarnowiec Convents old print collection. It has enabled determination of the scope of work and designated objects to be firstly taken care of under the conservation programme.

Background: The outbreak of the Coronavirus Disease 2019 (COVID-19) pandemic has caused many significant social and economic changes. The consecutive waves of the epidemic in various countries have had dissimilar courses depending on the methods used to combat it. The aim of this study was to determine the dynamics of the third wave of COVID-19 from the perspective of emergency departments (ED). Methods: This was a retrospective review of medical records from ED. The authors have identified the most frequent symptoms. Prognostic factors have been chosen—prognostic scales, length of stay (LOS)—and a number of resources required have been calculated. Results: As the time passed, there were fewer patients and they presented mild symptoms. A statistically significant difference was observed in the median of blood oxygenation measurement (p = 0.00009), CRP level (p = 0.0016), and admission rate. Patients admitted to the hospital required more resources at ED. LOS was shorter in patients discharged home (p < 0.0001). Conclusions: The blood oxygen saturation (SPO2) and CPR levels can be helpful in decision-making regarding medical treatment. The fast-track for patients in good clinical condition may shorten the duration of stay in ED, and reduce the number of required resources.

Introduction : There are currently no reports available from a Polish clinical practice on heterozygous familial hypercholesterolemia (HeFH) management. The aim of this study was to test the efficacy of HeFH hypolipidemic treatment in a Polish outpatient metabolic clinic according to treatment targets outlined in the European Atherosclerosis Society (EAS) and European Society of Cardiology (ESC) guidelines. Material and methods : This retrospective, observational study was performed on HeFH patients who attended their routine follow-up visits in the metabolic outpatient clinic in the period between April and September 2016. According to EAS/ESC guidelines, the goal and intensity of therapy were assigned individually for every patient based on cardiovascular (CV) risk (high or very high). The treatment target was achievement of low-density lipoprotein cholesterol (LDL-C) levels < 1.8 mmol/l for very high CV risk patients and < 2.6 mmol/l for high CV risk patients. A ≥ 50% decrease in LDL-C over the observation period was an additional outcome measure. Results : In the overall group of 222 HeFH patients (mean age: 55.2 16.2 years, 72% women), LDL-C levels decreased on average by 52.6%. More than half of the patients were treated with the maximum tolerated dose of statins. A total of 25.2% of patients attained target levels of LDL-C and 55.9% attained a ≥ 50% reduction in its concentration. Despite therapy, significantly elevated post-follow-up levels of LDL-C (> 4.1 mmol/l) remained in 14% of all patients. Conclusions : Hypolipidemic therapy according to EAS/ESC guidelines was suboptimal for a significant number of HeFH patients. Additional clinical management should be considered.

The notion ‘trade format’ means a particular way of carrying out retailing or wholesaling, in the stationary or non-stationary form. The aim of the article is to identify the changes that took place in formats of stationary retail trade in fast moving consumer goods (FMCG) in Poland in 2008–2015. An analysis comprised hypermarkets, supermarkets, department stores and malls, discount stores, convenience stores, and specialized stores with food articles as well as points of sale of cosmetics and toilet preparations. The object of the analysis included: assets, assortment and service offer, prices, communication with customers. The article was prepared on the basis of CSO (GUS) data, including those specially ordered by the Institute for Market, Consumption and Business Cycles Research (IBRKK), as well as various materials from secondary sources, including papers, articles, and interviews with trade representatives published in the business press. The author also made use of information acquired directly from entrepreneurs during meetings with trade representatives as well as quantitative and qualitative methods of contents analysis. The article is of the analytical and descriptive nature.

Introduction. In case of sudden cardiac arrest (SCA) quick recognition and provision of immediate high quality cardiopulmonary resuscitation (CPR) increases chance of survival. It has been proven that Poles’ knowledge about the basic life support is insufficient. Alumni of medical universities are expected to have practical skills and extensive knowledge to provide appropriate help to SCA victim. Material and methods. This was a descriptive, cross-sectional study. We invited all Polish-language students of Poznan University of Medical Sciences (PUMS). 434 people took part in the survey. The research tool was online questionnaire containing 20 questions. Results. Most of correct answers was given by students of Medical Faculty I, then Faculty of Health Sciences, Medical Faculty II and Faculty of Pharmacy (median of correct answers as follows: 9.48, 8.86, 7.90, 6.93). The biggest problem our students had with questions about: time of interruptions in chest compressions, depth of compressions and duration of a single breath (respectively: 27.63%, 36.53%, 38.64% of correct answers). 42.56% of students would initiate CPR if they saw agonal breaths. 34.50% percent believed that they are properly prepared for CPR while 60.05% said that the number of first aid course hours is insufficient. We found statistically significant relationship between number of critical mistakes and faculty of study (p = 0.00003, contingency factor = 0.2282). Conclusions. The knowledge of PUMS students about CPR is inadequate. It is suggested to evaluate the number of hours dedicated to CPR classes. We should pay attention to identifying agonal breaths and all the criteria of CPR quality.

• Overcrowded EDs impact staff mental health and care quality. • Avoidable ED visits contribute to healthcare cost hikes. • Patient-driven ED visits necessitate improved primary care access. • Study highlights motives behind low-acuity ED visits in Poland. Emergency departments (EDs) worldwide are dealing with overcrowding, system fragmentation, and coordination problems, which impact patient wait times, staff job satisfaction, and patient outcomes. Inappropriate ED visits, particularly those for low acuity conditions, exacerbate these challenges. However, the motivations behind these visits are poorly understood, with limited data from the patient perspective. This study investigated patient-reported motives behind ED visits triaged as low acuity in Poznan, Poland, to propose health care system flow enhancements. A cross-sectional survey and retrospective chart review were conducted in the ED of the Hipolit Cegielski Medical Center in Poznań, Poland, over three months in 2022–23. Patients who were triaged to have low acuity conditions were invited to participate in the survey. The data collected through the questionnaire included patient and ED visit characteristics. Additional information on the visits was extracted from the patient charts. This study involved 293 patients who underwent low-acuity triage. Among them, 58 % were deemed to have conditions that could have been treated in primary care. Most of the patients (74 %) visited the ED of their own volition due to concerns about their health. Other reasons for ED attendance were challenges accessing primary care or a specialist clinic (11 %), system navigation problems (5 %), or a lack of trust in their primary care provider (2 %). This study showed that of the patients surveyed, the majority had conditions that could have been treated outside of the ED setting. We recommend prioritizing education, particularly among younger adults, to increase awareness about nonurgent care options while improving health care policies. [ABSTRACT FROM AUTHOR]

There is a strong evidence that more marked lowering of low-density lipoprotein cholesterol (LDL-C) leads to progressively lower risk of cardiovascular disease (CVD) events. The evidence on validity of this hypothesis comes from epidemiological, genetic and clinical studies. The hypothesis "the lower the better" has been recently strongly supported by the results of secondary prevention trials with PCSK9 inhibitors. The combination of PCSK9 inhibitors and statins has resulted in achieving extremely low LDL-C levels with additional reduction of CVD events in secondary prevention. However, despite large clinical benefits, the safety of aggressive LDL-C lowering should be always taken into consideration, and there is still an ongoing discussion on whether very low LDL-C might result in some non-CVD adverse events. However, based on the available knowledge, so far the serious adverse events associated with achieving of very low LDL-C levels or intensive drug therapy have not been noted. These positive clinical effects were reflected in current ESC/EAS Guidelines (2019) for dyslipidaemia management. The experts strongly recommended the LDL-C lowering to levels that have been achieved in trials of PCSK9 inhibitors. In this state of the art review, we aimed to finally justify the critical need for LDL-C reduction to very low levels in secondary prevention patients in order to be as low as possible, as early as possible, and preferably lifelong. [ABSTRACT FROM AUTHOR]

Introduction: Increased serum cholesterol levels constitute one of the main risk factors for cardiovascular diseases. Statins are a major method for reducing the levels which also lower the risk of cardiovascular events. However, these valuable drugs cannot be used in all patients who need them due to contraindications and intolerance. In such cases, help can be sought from nutraceutics that reduce the serum cholesterol concentration. Since there are numerous products of this type available at drugstores, registered as supplements, there seems to be a need to demonstrate their effectiveness in preventing cardiovascular diseases induced by atherosclerosis. In literature, increasingly more attention is drawn to red yeast rice, Armolipid, berberine and bergamot. Brief description: This article presents knowledge about these nutraceutics based on clinical studies and expert statements relating to their use. The results of clinical studies and metaanalyses have shown that nutraceutics with cholesterol lowering properties, red yeast rice and Armolipid are the most favourable for reducing cardiovascular events. However, the evidence of benefits of berberine and bergamot is not so conclusive. Conclusions: Red yeast rice products and Armolipid may be used as an alternative treatment in statin intolerant patients, especially in combination with ezetimibe. These nutraceutics can be also considered, as an adjunct to diet therapy in primary prevention of cardiovascular diseases in patients with mild and moderate hypercholesterolaemia. The opinion of experts on berberine and bergamot is ambiguous. [ABSTRACT FROM AUTHOR]

Introduction. Polyunsaturated n-3 fatty acid preparations containing eicosapentaenoic acid (EPA) and docosahexanaenoic acid (DHA), or EPA only, have long been recommended in the management of hypertriglyceridaemia, especially when severe (triglyceride levels ≥500 mg/dL), at the dose of 2–4 g/d, mostly for the prevention of acute pancreatitis. Materials and method. The presented article reviews clinical trials and their metaanalyses which evaluated the effect of n-3 fatty acids on cardiovascular disease risk, and regulatory agencies’ and cardiac societies’ positions regarding their use. Results. The findings indicate that only EPA is effective. Particular clinical benefit (25% reduction of cardiovascular events) was observed in the recently published REDUCE-IT trial which evaluated EPA (icosapent ethyl) at the dose of 4 g/d for 4.9 years (median), compared to placebo, in hypertriglycerydaemic patients at high or very high cardiovascular risk. This positive effect has been reflected in the expert opinions which recommend eicosapent ethyl (4 g/d) in patients similar to those participating in the REDUCE-IT trial. Additional data in favour of the above position have been provided by the EVAPORATE trial results which showed reduced progression of coronary atherosclerosis with EPA at the dose of 4 g/d. Conclusion. The clinical studies and metaanalyses strongly point out that only EPA (icosapent ethyl), especially at dose of 4 g/d, is effective in reducing cardiovascular events in very high and high risk patients with hypertriglyceridemia. The use of EPA + DHA preparations in doses up to 1 g/d does not prevent recurrent cardiovascular events. [ABSTRACT FROM AUTHOR]

Elevated circulating concentrations of lipoprotein(a) [Lp(a)] is strongly associated with increased risk of atherosclerotic cardiovascular disease (CVD) and degenerative aortic stenosis. This relationship was first observed in prospective observational studies, and the causal relationship was confirmed in genetic studies. Everybody should have their Lp(a) concentration measured once in their lifetime. CVD risk is elevated when Lp(a) concentrations are high i.e. > 50 mg/dL (≥100 mmol/L). Extremely high Lp(a) levels >180 mg/dL (≥430 mmol/L) are associated with CVD risk similar to that conferred by familial hypercholesterolemia. Elevated Lp(a) level was previously treated with niacin, which exerts a potent Lp(a)-lowering effect. However, niacin is currently not recommended because, despite the improvement in lipid profile, no improvements on clinical outcomes have been observed. Furthermore, niacin use has been associated with severe adverse effects. Post hoc analyses of clinical trials with proprotein convertase subtilisin/kexin type-9 (PCSK9) inhibitors have shown that these drugs exert clinical benefits by lowering Lp(a), independent of their potent reduction of low-density lipoprotein cholesterol (LDL-C). It is not yet known whether PCSK9 inhibitors will be of clinical use in patients with elevated Lp(a). Apheresis is a very effective approach to Lp(a) reduction, which reduces CVD risk but is invasive and time-consuming and is thus reserved for patients with very high Lp(a) levels and progressive CVD. Studies are ongoing on the practical application of genetic approaches to therapy, including antisense oligonucleotides against apolipoprotein(a) and small interfering RNA (siRNA) technology, to reduce the synthesis of Lp(a). [ABSTRACT FROM AUTHOR]

Abstract: Heterozygous familial hypercholesterolemia (HFH) affects on average 1 in 500 individuals in European countries, and it is estimated that HeFH in Poland may affect more than 80,000 people. Cardiovascular mortality in individuals with FH between 20 and 39 years of age is 100 times higher than in the general population. HFH is a relatively common lipid disorder, but usually still remaining undiagnosed and untreated. A very high risk of cardiovascular diseases and a shortened lifespan in patients with this condition require early diagnosis and intensive treatment. The aim of the position paper was to present the importance and scale of this problem in Poland, which has not been raised enough so far, as well as the recommendations of diagnosis, treatment and prevention methods. [Copyright &y& Elsevier]

After the first phase of the COVID-19 pandemic in Europe, a new highly pathogenic variant of echovirus 11 (E11) was detected. The aim of this study was to analyze the genetic diversity of Polish E11 environmental and clinical strains circulating between 2017 and 2023 as well as compare them with E11 strains isolated from severe neonatal sepsis cases reported in Europe between 2022 and 2023. Additionally, the study explores the effectiveness of environmental monitoring in tracking the spread of new variants. For this purpose, the complete sequences of the VP1 capsid protein gene were determined for 266 E11 strains isolated in Poland from 2017 to 2023, and phylogenetic analysis was performed. In the years 2017-2023, a significant increase in the detection of E11 strains was observed in both environmental and clinical samples in Poland. The Polish E11 strains represented three different genotypes, C3, D5 and E, and were characterized by a high diversity. In Poland, the intensive circulation of the new variant E11, responsible for severe neonatal infections with a high mortality in Europe, was detected in the years 2022-2023. This investigation demonstrates the important role of environmental surveillance in the tracking of enteroviruses circulation, especially in settings with limited clinical surveillance.