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The sediment flux through Himalayan rivers directly impacts water quality and is important for sustaining agriculture as well as maintaining drinking-water and hydropower generation. Despite the recent increase in demand for these resources, little is known about the triggers and sources of extreme sediment flux events, which lower water quality and account for extensive hydropower reservoir filling and turbine abrasion. Here, we present a comprehensive analysis of the spatiotemporal trends in suspended sediment flux based on daily data during the past decade (2001-2009) from four sites along the Sutlej River and from four of its main tributaries. In conjunction with satellite data depicting rainfall and snow cover, air temperature and earthquake records, and field observations, we infer climatic and geologic controls of peak suspended sediment concentration (SSC) events. Our study identifies three key findings: First, peak SSC events (≥99th SSC percentile) coincide frequently (57-80 %) with heavy rainstorms and account for about 30% of the suspended sediment flux in the semi-arid to arid interior of the orogen. Second, we observe an increase of suspended sediment flux from the Tibetan Plateau to the Himalayan Front at mean annual timescales. This sediment-flux gradient suggests that averaged, modern erosion in the western Himalaya is most pronounced at frontal regions, which are characterized by high monsoonal rainfall and thick soil cover. Third, in seven of eight catchments, we find an anticlockwise hysteresis loop of annual sediment flux variations with respect to river discharge, which appears to be related to enhanced glacial sediment evacuation during late summer. Our analysis emphasizes the importance of unconsolidated sediments in the high-elevation sector that can easily be mobilized by hydrometeorological events and higher glacialmeltwater contributions. In future climate change scenarios, including continuous glacial retreat and more frequent monsoonal rainstorms across the Himalaya, we expect an increase in peak SSC events, which will decrease the water quality and impact hydropower generation. [ABSTRACT FROM AUTHOR]

Soil erosion and sediment yield are strongly affected by land use/land cover (LULC). Spatially distributed erosion models are of great interest to assess the expected effect of LULC changes on soil erosion and sediment yield. However, they can only be applied if spatially distributed data is available for their calibration. In this study the soil erosion and sediment delivery model WATEM/SEDEM was applied to a small (2.84 km²) experimental catchment in the Central Spanish Pyrenees. Model calibration was performed based on a dataset of soil redistribution rates derived from point 137Cs inventories, allowing capture differences per land use in the main model parameters. Model calibration showed a good convergence to a global optimum in the parameter space, which was not possible to attain if only external (not spatially distributed) sediment yield data were available. Validation of the model results against seven years of recorded sediment yield at the catchment outlet was satisfactory. Two LULC scenarios were then modeled to reproduce land use at the beginning of the twentieth century and a hypothetic future scenario, and to compare the simulation results to the current LULC situation. The results show a reduction of about one order of magnitude in gross erosion (3180 to 350Mgyr-1) and sediment delivery (11.2 to 1.2Mgyr-1 ha-1) during the last decades as a result of the abandonment of traditional land uses (mostly agriculture) and subsequent vegetation recolonization. The simulation also allowed assessing differences in the sediment sources and sinks within the catchment. [ABSTRACT FROM AUTHOR]

A landslide affecting two small villages located on the Northwestern Italian Apennines has been investigated since the year 2000 through the use of different equipment. A complex monitoring system has been installed in the area. The system includes several inclinometers, piezometers and a raingauge. An Automatic Inclinometric System (AIS) has been also installed that automatically performs measurements, twice a day, along the entire length of a pipe that is 45m deep. This monitoring system has been set up to identify a methodology that allowed to deal with landslides, trying to predict their behaviour beforehand for warning purposes. Previous researches carried out in the same area for a period of about 7 months, in the year 2000, have allowed to identify a correlation between deep slope movements and rainfalls. In particular, it has been possible to determine the time lag needed for a rainfall peak to produce a corresponding peak of the landslide movements; this time lag was of 9 days. This result was possible because the AIS allows to obtain, as mentioned, daily inclinometric measurements that can be correlated with the recorded rainfalls. In the present report we have extended the analysis of the correlation between deep slope movements and rainfalls to a greater period of observation (2 years) to verify over this period the consistency of the time lag mentioned above. The time lag previously found has been confirmed. We have also examined the possibility to extend to the entire landslide body the correlation that has been found locally, analyzing the results of the remaining inclinometric tubes with traditional reading installed on the landslide and comparing them with the results of the AIS. The output of the tubes equipped with piezometric cells has also been analyzed. The relations existing among rainfalls, ground water level oscillations and the related slope movements have been explored. [ABSTRACT FROM AUTHOR]

Protection forests play an important role in mitigating the influence of natural hazards. Despite the growing need for protective functions due to aging forests and increased risk of natural disturbances, active forest management has become increasingly uncommon across the Alps. Active management of protection forests can be facilitated by state subsidies. This requires an objective delineation of forests with a direct protection function and the development of silvicultural techniques that mitigate natural hazards. A study of protection efficiency of beech-dominated forests in the Soteska gorge in NW Slovenia, where a main state road and railway are at risk from debris flows and rockfall, was performed. We assessed the starting points of debris-flow hazard based on a small-scale geological survey of the terrain characteristics and a local debris flow susceptibility map. We applied the TopRunDF model for determination of the run-out zones. Forest structure data were obtained from 26 sample plots. A detailed description and delineation of forest stands was performed. The results showed that these forests play an important role in the protection of infrastructure. Forest protection efficiency can be improved by stand thinning for stability and careful planning of regeneration patches over time and space. In areas where silvicultural measures cannot provide sufficient protection, technical measures are needed. Since these forests have not been managed for several decades, natural disturbances (windthrow) are frequent. Research findings suggest that regular assessment and management of these beech-dominated protection forests are necessary, contrary to the current practice of non-management in protection forests in Slovenia.

Limb amputation often results in a change of profession or withdrawal from the workforce. Occupational rehabilitation plays a key role in assisting individuals with finding, maintaining, and advancing in employment. The aim of this review was to determine the precise number of amputations performed in Poland from January 2014 to June 2022 and to present selected available rehabilitation programs aimed at the social reintegration of individuals after amputations, with a particular focus on vocational rehabilitation. The analysis was conducted in 2 stages. First, the team reviewed data obtained from the central IT system of the National Health Fund and analyzed it. Then, a literature review was conducted using English-language databases: PubMed, Scopus, Science Direct, Medline, and websites searched through Google Scholar and Google. A total of 29 sources (from the years 2006-2024) out of 75 found were analyzed. Articles were searched using the following keywords: "rehabilitation programs," "amputations," "occupational rehabilitation," "disability," "vocational activation," and "rehabilitation effectiveness." A significant number of amputations are performed in Poland. Individuals who undergo such procedures can benefit from occupational rehabilitation programs that facilitate a faster return to professional activity. It is crucial to develop and implement preventive measures aimed at reducing the incidence of amputations in Poland, as well as to introduce new vocational rehabilitation programs that will enable individuals with disabilities to return to professional activity more effectively and efficiently. Med Pr Work Health Saf. 2024;75(5):445-454., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Background: The patency of intracranial stents may not be reliably assessed with either CT angiography or MR angiography due to imaging artifacts. We investigated the potential of ultra-high resolution CT angiography using a photon counting detector (PCD) CT to address this limitation by optimizing scanning and reconstruction parameters., Methods: A phantom with different flow diverters was used to optimize PCD-CT reconstruction parameters, followed by imaging of 14 patients with intracranial stents using PCD-CT. Images were reconstructed using three kernels based on the phantom results (Hv56, Hv64, and Hv72; Hv=head vascular) and one kernel to virtually match the resolution of standard CT angiography (Hv40). Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) measurements were calculated. Subjective image quality and diagnostic confidence (DC) were assessed using a five point visual grading scale (5=best, 1=worst) and a three point grading scale (1=best, 3=worst), respectively, by two independent neuroradiologists., Results: Phantom images demonstrated the highest image quality across dose levels for 0.2 mm reconstructions with Hv56 (4.5), Hv64 (5), and Hv72 (5). In patient images, SNR and CNR decreased significantly with increasing kernel sharpness compared with control parameters. All reconstructions showed significantly higher image quality and DC compared with the control reconstruction with Hv40 kernel (P<0.001), with both image quality and DC being highest with Hv64 (0.2 mm) and Hv72 (0.2 mm) reconstructions., Conclusion: Ultra-high resolution PDC-CT angiography provides excellent visualization of intracranial stents, with optimal reconstructions using the Hv64 and the Hv72 kernels at 0.2 mm., Registration: BASEC 2021-00343., Competing Interests: Competing interests: TF is an employee of Siemens Healthcare. HA has received institutional grants from Bayer, Canon, Guerbet, and Siemens. HA received speaker honoraria from Siemens., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Alcohol addiction is characterized by extensive alcohol consumption that dominates other behaviours previously important to a patient. According to data from The State Agency for Prevention of Alcohol-Related Problems, up to 900,000 people in Poland are addicted to alcohol. On average, approximately 9.7 L of pure alcohol per capita was consumed in 2021. Alcohol addiction may cause severe health problems and is one the key risk factors for various diseases. Stress plays an important role in the process of alcohol addiction and is also a predictor for lower enjoyment in life. On the other hand, sense of coherence may be a stronger protective factor. The aim of our study was to verify the relation between the level of perceived stress among patients with alcohol addiction and satisfaction with life. Because sense of coherence is a disposition that allows for managing stress effectively, the latter should be reflected in the results of multivariate analyses that take both the level of stress and sense of coherence into account. In the present study, sense of coherence and perceived stress were negatively correlated; therefore, strengthening internal resources for managing difficult and stressful situations is recommended.

Introduction: Current literature is inconclusive as to whether transversus abdominis (TrA) training can provide an additional benefit to pelvic floor muscle (PFM) training in female stress urinary incontinence (SUI). We designed a study to investigate the effect of PFM and TrA training on incontinence parameters., Material and Methods: 60 females with SUI were randomised to PFM training alone or PFM plus TrA training. They all attended 12 weekly training sessions by a single physical therapist and completed relevant questionnaires at baseline and study completion., Results: Both interventions reduced the number of incontinence episodes and improved quality of life (QoL) and sexual function. Women on PFM+TrA training reduced the number of used pads per day (p = 0.007), improved the QoL (p = 0.031) and the sexual lubrication score (p = 0.04), and reported better satisfaction rates compared to PFM alone (66.7% versus 43.3%). A subgroup analysis reported that women with pure SUI benefit more from combined PFM+TrA training compared to PFM alone (p = 0.04)., Conclusions: TrA add-on to PFM training was similar to PFM training alone in the reduction of incontinence episodes but was superior in reducing the number of pads needed, which suggests a beneficial effect on the severity of incontinence., Competing Interests: The authors declare no conflicts of interest., (Copyright by Polish Urological Association.)

Alcohol consumption is linked to over 200 diseases and injuries. It is also classified as a risk factor for several types of neoplasms as well as infectious diseases (i.e., HIV and tuberculosis). In 2019, among people aged 25 to 49, alcohol use was the leading risk factor for attributable burden of disease. There are many factors that affect alcohol drinking patterns such as social and economic status, social norms, cultural customs, availability of alcohol, etc. Stress also plays a significant role in the process of developing alcohol addiction. The aim of our study was to examine health patterns and stress levels among patients undergoing alcohol addiction treatment. The study sample consisted of 104 patients who were treated in a hospital ward due to alcohol dependence. Three standardized questionnaire tools were used to measure the sense of coherence and the level of stress among those patients. The main results suggest that the level of perceived stress correlated negatively with all dimensions of sense of coherence and all indicators of health behaviors, however, age was positively correlated with positive mental attitude, proper eating habits, and health behaviors. In conclusion, it is worth noting that developing patterns for positive health behaviors will make it possible to avoid alcohol dependence or reinforce the treatment results if alcohol dependence syndrome occurs.

(1) Background: Acceptance of illness is a process in which a person with an illness accepts its presence and treats it as an integral part of their life. With regard to alcoholism, acceptance of illness is one of the important elements of the healing process. (2) Methods: The study group consisted of 104 residents in an addiction treatment ward. Questionnaires SOC-29, AIS and PSS-10 were used to check levels of coherence, stress and acceptance of illness. The analysis was based on regression analysis. Patient age was analysed as a moderator of correlations between perceived indicators. Moderation analysis was based on the simple moderation model. (3) Results: The level of perceived stress correlated negatively with all areas of the sense of coherence and with acceptance of illness. All areas of the sense of coherence correlated with acceptance of illness positively. (4) Conclusions: The acceptance of illness by the patient is a factor that can be motivating for further treatment, through a positive approach to illness and strengthening the sense of control in experiencing it. The combination of strengthening behavioural, cognitive and motivational resources can be used in the treatment of people experiencing the challenges of addiction to alcohol.

The financial burden of adverse healthcare outcomes in Poland still remains unknown. The objective of the study was to estimate the cost of adverse healthcare outcomes in the Polish healthcare system. Cost calculation was performed on the basis of civil cases completed in Polish courts against doctors and healthcare entities. The research material consisted of 183 civil cases completed by a final judgment in 2011-2013. The case study was conducted in five out of forty-five district courts across the country. Out of 183 reviewed cases, 73 complaints ended up with favorable judgments (39.9%). The average value of the subject matter of the dispute was USD 78,675. The total expected value of lawsuits in the 183 reviewed cases was USD 11,299,020. The total amount awarded in 73 judgments from medical facilities to injured patients was USD 2,653,595, which on average means USD 36,351 per case. The average amount of awarded compensation was USD 33,317 per case. The average compensation amount in the analyzed cases was USD 11,724. The average one-time annuity for a patient was USD 11,788. The estimated costs of negative healthcare outcomes amounted to USD 8,000,000 per year.

Introduction: Alcohol dependence is one of the world's major health challenges. The salutogenic concept of health developed by Antonovsky focuses on the search for resources and factors supporting health. Its basic concept of the sense of coherence (SOC) focuses on strengthening the global orientation of the patient, and creating permanent internal resources that translate into the improvement of pro-health behavior, including the fight against alcoholism., Objective: The objective of this study was to determine the correlation between individual factors and the SOC as well as the influence of the SOC concept on pro-health behavior of people addicted to alcohol., Materials and Methods: The study group consisted of 110 men undergoing treatment in an addiction treatment ward. To check the level of the SOC, two standardized questionnaires, Antonovsky's "SOC-29 Life Orientation Questionnaire" and Juczyński's "Health Behaviour Inventory", were used. The correlation coefficient between the sociodemographic variables was checked using the Pearson's r test., Results: A positive correlation was found with the intensity of pro-health behaviors for three sociodemographic variables. In people aged 43-65 (r = 0.299; p = 0.030), people with primary/vocational education (r = 0.276; p = 0.015), and respondents living in rural areas (r = 0.303; p = 0.028) a greater SOC was associated with pro-health behaviors., Conclusions: Individuals addicted to alcohol are characterized by a low SOC and a low level of pro-health behaviors. Strengthening the internal level of the SOC can constitute an element of addiction therapy when introducing health education to prepare the patient for independent life in sobriety.

Introduction and Objective: Cancer triggers many negative emotions in patients which affect the quality of life and low acceptance of the illness. The level of acceptance of illness is related to the level of pain and the degree of compliance with medical recommendations. The aim of the study is evaluation of the use of the Acceptance of Illness Scale (AIS) among people with cancer., Material and Methods: The study involved 1,187 patients (666 women aged 21-96 (M=58.17; SD=12.88) and 521 men aged 22-96 (M=67.12; SD=13.75) diagnosed with malignant cancer under outpatient care of the Maria Sklodowska-Curie Institute - Oncology Center in Warsaw. An acceptance of illness questionnaire developed by B. J. Felton, T. A. Revensson and G. A. Hinrichsen was used., Results: Socio-economic (education, place of residence, income, professional status) and medical (occurrence of metastases, type of treatment used) factors affect the level of acceptance of illness by patients. Stent standards were developed to determine the level of acceptance of illness in the low-average-high categories., Conclusions: The Acceptance of Illness Scale (AIS) should be used in the case of cancer patients. Assessment of the patient's acceptance of illness, as well as the factors affecting acceptance, will allow for the planning of appropriate treatment and psychotherapeutic support for specific patients, whose level of acceptance of illnes is the lowest.

BACKGROUND During the current Coronavirus Disease 2019 (COVID-19) pandemic, falls have been identified as a potential presenting symptom in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection; however, data on factors increasing fall risk in this patient population are limited. This study aimed to examine the factors that may predispose hospitalized COVID-19 disease patients to falls. MATERIAL AND METHODS In this retrospective observational study, hospitalized COVID-19 disease patients were examined for fall incidence, as well as demographics, comorbidities, and clinical and laboratory data. Patients were stratified according to their fall status and their characteristics were compared using Fisher's exact test or Mann-Whitney U test. A total of 312 hospitalized COVID-19 disease patients were enrolled (median age, 75 years; males, 51.3%), of whom 11 (3.5%) fell. RESULTS There was a greater prevalence of falls among patients who experienced arrhythmias than those that did not (28.6% vs 1.7%; P<0.001). Additionally, a significantly greater proportion of those that were discharged to the internal ward and to the intensive care unit fell (10.3% and 10.0%, respectively) compared to those that were discharged home (1.6%, P=0.008). Thyroid-stimulating hormone (TSH) was significantly elevated in patients who fell (5.3 vs 0.97 µIU/mL, P=0.013), while alanine aminotransferase (ALT) was significantly lower in those who fell (17.1 vs 33.5 IU/L, P=0.041). CONCLUSIONS Arrhythmias may be an important predisposing factor for falls in COVID-19 disease patients and fall prevention programs should prioritize interventions directed at this vulnerable patient population.

The manifestation of a new pathogen, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), constitutes a new problem for modern health care systems. Developing updated standards for all emergency services working at an accident site during the pandemic has been a continuous challenge. The principal method of preventing the transmission of the SARS-CoV-2 virus is the use of personal protective equipment, such as protective suits, masks and goggles, or face shields. The study aims to present the recommended on-site procedures during the coronavirus pandemic based on the description of an accident of an ambulance transporting a patient with confirmed SARS-CoV-2 infection, emphasizing the actions taken by the emergency services sent to the accident site.

Background: Breast, ovarian, and endometrial cancer are among the most common causes of morbidity and mortality of women in Poland. In 2016, breast cancer was the most common cause of morbidity and the second leading cause of cancer deaths in women, endometrial cancer was the third most common cause of morbidity and the seventh leading cause of death, and ovarian cancer was the fifth most common cause of morbidity and the fourth leading cause of cancer deaths in women. The aim of the study was to assess the strategy of pain control, acceptance of the cancer and adjustment to life with disease in women with ovarian cancer, endometrial and breast cancer. This study shows how level of pain control, acceptance, and adjustment can differ among patients with the three kinds of cancer and which factors have the most influence on patients' adjustment to the disease., Methods: The study was carried out with 481 patients diagnosed with ovarian cancer, endometrial and breast cancer. In the study BPCQ, CSQ, AIS and Mini-MAC questionnaires were used., Results: In the BPCQ questionnaire the highest result was acquired in the scope of the impact of doctors (M = 16.45, SD = 4.30), differentiated by cancer location and socio-economic variables. In the CSQ test, the highest result was achieved by praying/hoping, differentiated by cancer location and socio-economic variables. The average AIS acceptance score was M = 27.48 (SD = 7.68). The highest result of the Mini-Mac scale was obtained by patients in the area of fighting spirit (M = 22.94, SD = 3.62), and these results depended on socio-economic and treatment-related variables but were not differentiated by cancer location., Conclusions: Patients attribute the highest importance in the disease to the influence of physicians, praying/hoping, and fighting spirit. The awareness of the pain management strategies of patients with cancer allows appropriate psychological support to be designed for specific groups of patients.

Background: Granulomatous lymphocytic interstitial lung disease (GLILD) has been increasingly recognized in children affected with primary immunodeficiencies (PIDs). In this study, we aimed to better characterize the spectrum of pediatric PIDs coexisting with GLILD including clinical and immunological predictors, thoracic imaging findings, and histopathologic features., Methods: We respectively reviewed records of six representative cases of children, three of them affected with common variable immunodeficiency (CVID) and three with syndromic immunodeficiencies, in whom a diagnosis of GLILD was established based on clinical, radiological, and histopathologic findings. Clinical and immunological predictors for GLILD were also analyzed in the patients studied., Results: All the children with GLILD had a history of autoimmune phenomena, organ-specific immunopathology, and immune dysregulation. Defective B-cell maturation and deficiency of memory B cells were found in all the children with GLILD. The radiological and histopathological features consistent with the diagnosis of GLILD, granulomatous disease, and lymphoid hyperplasia, were accompanied by chronic airway disease with bronchiectasis in children with CVID and syndromic PIDs., Conclusions: Our study shows that both CVID and syndromic PIDs may be complicated with GLILD. Further studies are required to understand the predictive value of coexisting autoimmunity and immune dysregulation in the recognition of GLILD in children with PIDs.

Introduction: Although falls occur extremely frequently, they are still one of the least investigated causes of death. According to the World Health Organization, around 37.3 million falls occur globally every year resulting in the deaths of over 660,000 adults and almost 30,000 children., Objective: The aim of this review is to evaluate the most up-to-date and comprehensive knowledge on falls and their consequences, especially in populations at the highest risk of fatal falls., Brief Description of State of Knowledge: Currently, there is a limited amount of literature which analyzes falls. Falls affect all age groups, but their location, cause, and severity vary among different populations. Individuals who are particularly at risk of falling at home include younger children and the elderly. Research indicates that falls are one of the main causes of work-related injuries and deaths, especially those occurring at significant heights. Falls in the home environment are the second most common cause of death in over 33% of accidents and the main cause of injury in 41.2% of accidents. During patient hospitalizations, falls generate additional burdens and costs on the healthcare system., Conclusions: This review elaborated on the nature of falls in different populations and analyzed the influence falls have on the healthcare system, in society, and on the economy. This knowledge is particularly important in an aging society, which will inevitably face increasing problems due to falls in the near future. As the emphasis on falls increases, leaders and lawmakers will be pushed to establish individualized prevention measures, as described in this review, for specific risk groups to effectively prevent falls and their consequences.

Background: Inpatient falls are common hospital adverse events. We aimed to determine inpatient fall rates in an urban public hospital and analyzed their characteristics across clinical departments., Methods: The study was conducted in a 350-bed urban, multi-specialty public hospital in the 2013-2019 period. Patient data were retrieved from the hospital's standardized falls reporting system. Descriptive statistics and statistical tests: chi2 and ANOVA tests with multiple comparison tests (post-hoc analysis) were used. For fall incidence estimation a joint-point regression was applied. p -value of 0.05 was considered as statistically significant for all the calculations., Results: The highest prevalence of falls was reported in the rehabilitation and internal medicine wards (1.915% and 1.181%, respectively), the lowest in the orthopedic (0.145%) and rheumatology wards (0.213%) ( p < 0.001). The vast majority of falls took place in the late evening and during the night (56.711%) and were classified as bed falls (55.858%). The crude incidence rate (cIR) of falls was 6.484 per one thousand hospitalizations. In the 2013-2017 period, an increase in total cIR was observed, reaching the peak value in 2016; it was followed by a slight decline from 2017 to 2019, however, differences in changes were observed between the wards., Conclusion: Fall rates and trends as well as circumstances of inpatient falls varied significantly among clinical departments, probably due to differences in patient characteristics., Competing Interests: The authors declare no conflicts of interest.

Falls are associated with increased morbidity and mortality, rising hospital readmission rates, decreased patient independence, and strained healthcare resources. In aged populations and individuals with multimorbidity, cardiovascular conditions may contribute towards an increased propensity to fall. The prevalence of cardiovascular conditions generally increases with age, and understanding potential fall risk factors may help to minimize the risk of falls and develop preventive interventions. Acting on even one such risk factor or introducing an appropriate intervention may reduce the overall propensity for a patient to fall. Further prevention strategies primed towards cardiovascular ailments should be elucidated and trialed.

Introduction: Currently, invasive cardiology techniques are the preferred method of treatment for patients with ST-elevation myocardial infarction (STEMI). Improving the care of patients with STEMI is possible by minimizing the time that elapses from the onset of pain to the start of treatment. As studies indicate, early pharmacotherapy, especially with antiplatelet and anticoagulant medications, allows for their early effectiveness., Aim: To assess the influence of early administration of antiplatelet (clopidogrel) and anticoagulant medications in the pre-hospital period in patients with ST-elevated myocardial infarction on the frequency of in-hospital deaths and on the left ventricular ejection fraction evaluated at hospital discharge., Material and Methods: In this study, a retrospective analysis of 573 patients hospitalized due to ST-segment elevation myocardial infarction in one of Krakow's hospitals from January 2011 to December 2015 (excluding the whole of 2013) was used as a research method., Results: As many as 97% of patients received pre-hospital pharmacotherapy, but only 46.0% of respondents received unfractionated heparin, and 19.2% received clopidogrel. The in-hospital mortality rate was 6.7%, but among patients prehospitally treated with clopidogrel and unfractionated heparin, the in-hospital mortality rate was 1.1%. Prehospital administration of clopidogrel significantly decreased the possibility of reduced left ventricular ejection fraction (OR = 0.27; 95% CI: 0.09-0.90)., Conclusions: Among pre-hospital procedures, only administration of a second antiplatelet drug (clopidogrel) significantly decreased the risk of reduced left ventricular ejection fraction, and administration of clopidogrel or heparin, or a combination of both, significantly decreased the risk of in-hospital death in patients with STEMI., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2021 Termedia Sp. z o. o.)