Studied Group Research Articles

Evaluation of the Results of Left Bundle Branch Pacing after Atrioventricular Junction Ablation in Patients with Chronic Atrial Fibrillation

Atrioventricular junction ablation (AVJA) together with the implantation of cardiac pacemaker has become a recognized and effective treatment strategy for patients with symptomatic tachysystolic atrial fibrillation that does not respond to heart rate control drug therapy. Left bundle branch pacing (LBBP) is a physiological alternative to right ventricular and biventricular pacing. The aim. To analyze the clinical results of the average duration with the use of LBBP and AVJA. Materials and methods. Over the period from January 2023 to July 2024, LBBP with subsequent AVJA was applied at the National Amosov Institute of Cardiovascular Surgery in 18 patients as a method of treatment of chronic tachysystolic atrial fibrillation to achieve heart rate control. Results. Mid-term results (at least 1 month) could be monitored in 15 out of 18 patients (84%); in the other three (16%) patients the time between pacemaker implantation and AVJA was too short. The mean period from pacemaker implantation to control examination was 5.07 ± 2.79 months (minimum period 1 month, maximum 12 months). During the period from implantation and ablation to the control observation in the study group, it was possible to observe an increase in left ventricular ejection fraction from 39.12 ± 10.56% to 46.38 ± 7.09%, p = 0.035; decrease in the values of end-diastolic volume from 184.22 ± 76.76 to 167.85 ± 36.93 ml, p = 0.074; decrease in the right ventricular pressure from 43.07 ± 8.29 to 34.38 ± 4.78 mm Hg, p = 0.013. It was also possible to observe a decrease in the left bundle branch capture thresholds from 1.27 ± 0.58 to 0.7 ± 0.39 V at 0.4 ms, p = 0.016; and a decrease in the average LBBP endocardial lead resistance from 638 ± 172.83 to 529.4 ± 120.15 Ohm, p = 0.012. Conclusions. Implantation of the LBBP pacemaker and AVJA was not associated with the occurrence of complications both in the intraoperative and postoperative periods, as well as in the remote period of the average duration in the studied group. The use of this approach in patients with chronic atrial fibrillation made it possible in a series of consecutive patients to improve the systolic function of the left ventricle, to reduce the values of the end-diastolic volume of the left ventricle and the right ventricular pressure at optimal pacing parameters.

Occurrence of adverse events following vaccination in patients with allergies: a prospective study.

Allergic patients may be concerned about more frequent and/or more severe adverse events following vaccination, which may lead to the refusal of vaccines among these patients. The aim of this study is to assess whether allergic patients have more frequent adverse events (AEs) after vaccination than healthy individuals. Study participants (N = 591) underwent vaccination of their choice at a selected Vaccination and Travel Medicine Centre. At a 10 to 14-day interval, they were contacted for a telephone questionnaire survey on the occurrence of AEs after vaccination. A group of allergic patients (n = 188) and healthy controls (n = 403) were followed in the study. No significant difference was found in the occurrence of AEs between study and control group. Only in redness and swelling, which was more common in allergic patients, but only in a few individuals. All side effects were minor, such as pain at the injection site or fatigue. No participant experienced a serious or life-threatening adverse event. In the studied group, no statistically significant differences were found even in the occurrence of AEs after singular vs. simultaneous administration of vaccines (p = 0.094), nor after vaccination with inactivated vs. attenuated vaccines (p = 0.655), or after vaccination against bacterial vs. viral infections (p = 0.140). Vaccination of allergic patients did not cause more frequent and/or more serious adverse events in our study compared to healthy people. If general contraindications are observed, then vaccination of allergic patients is considered safe.

Suppurative Cervicomediastinitis From the Perspective of the Head and Neck Surgeon in a Tertiary Treatment Unit.

Introduction Cervical suppurations represent an emergency pathology, with a dramatic evolution in the absence of adequate treatment. It frequently affects young people, hence the medico-legal implications of these cases. The anatomical substrate for the development of these deep cervical suppurations is represented by the cervical fascia and spaces. A distinct and extremely serious sub-chapter within diffuse cervical suppurations is necrotic cervical fasciitis, a polymicrobial infection with the most common oropharyngeal or odontogenic starting point, with rapidly progressive, destructive evolution in the deep fascial planes of the neck. Materials and method We will present a retrospective clinical study carried out on 26 cases diagnosed and treated between September 2013 and September 2018 in the ENT Clinic Department of the Bucharest University Emergency Hospital. Results Our retrospective analysis of a cohort of 26 patients in a tertiary referral center showed that deep cervical suppurations are slightly more common in men than in women. The most affected age groups were 50-59 years, followed by 20-29 years, representing a percentage of 53.84% of all cases. Also, 53.84% of the studied patients with deep cervical suppurations had a precarious and modest status. The most common clinical signs at presentation were malaise, cervical swelling, neck pain, dysphagia, fever, dysphonia, dyspnea, and cervical erythema. More than 60% of suppurations were odontogenic and 23% were caused by a traumatic element. Diabetes mellitus represents a comorbidity in 30.8% of patients, while 42.3% of patients had no personal pathological history, and thus this pathology has a lethal potential also in a patient in full health. In the study group, 46 (15%) had cervicomediastinitis, and 61.53% developed necrotizing fasciitis. One-third (34.61%) of our patients had undergone previous drainage surgery. Bacteriological examinations of the wound were with group C, D, G betahemolytic streptococcus, while 61.53% of the cultures were negative. Most patients required at least two cervicotomies. The average duration of hospitalization was 28.26 days, and the mortality rate was 23.07%; therefore, practically, one out of four cases resulted in death. In the studied group, no direct relationship can be established between the length of hospitalization and the favorable and unfavorable evolution of the patient. We propose a 10-step management protocol for the management of a cervical suppuration. Conclusion The multidisciplinary approach to these suppurations by the head and neck surgeon, the thoracic surgeon, the oromaxillofacial surgeon, anesthetist, imagist, specialist in infectious diseases, pathologist, psychologist, and so on, is the key to success in a patient who presents not only a suppuration in the throat but also a disease with systemic resonance and significant lethal potential.

Naso-mucociliary Clearance Time among Patients with Chronic Rhinosinusitis in Ilorin, North-central Nigeria.

The mucociliary clearance system is an important component in the prevention of chronic inflammation of the nasal and paranasal sinus. The study aims to establish the normal values of mucociliary clearance in our region and to study the variation in mucociliary activity in patients with chronic rhinosinusitis in Ilorin, North-central Nigeria. This was a prospective, cross-sectional study using consecutive consenting participants in both the control and study groups carried out at both family medicine and otorhinolaryngology clinics among patients attending the clinics. After ethical approval was sought, informed consent was obtained from patients, a modified version of the validated health questionnaire was filled, semi-structured questionnaires were also filled after which patient undergo anterior rhinoscopy, nasal patency test and spirometry was done. The saccharine test has been used to measure nasal-mucociliary clearance time in the past. All information were entered into SPSS version 20 and analysed descriptively, and results were presented in tables and figures. Consecutive consenting 125 patients with rhinosinusitis (study group) and those without rhinosinusitis (control group) underwent naso-mucociliary clearance test. There were 34 males and 91 females with a male:female ratio of 1:2.6 among the study group and 55 males and 70 females with a male:female ratio of 1:1.3 for the control group. The age range was from 18 to 68 years with 18-40 years constituting the modal age group. The mean age for the studied group was 35.7 years while that of the control group was 33.1 years. The mean naso-mucociliary clearance time among the study group was 35.1 min standard deviation (SD = 12.32 ± 1.63), while among the control group, it was 14.8 min (SD = 5.59 ± 0.43). Compared to the control group, there was a roughly 200% prolonged increase in the duration of naso-mucociliary clearance time among patients with rhinosinusitis. There was also a positive correlation with increasing age. Future studies comparing the pre-operative and post-operative treatment of rhinosinusitis will contribute to knowledge.

Do the Gender and the Number of Comorbidities and the Use of Tertiary Prevention Play a Role in the Severity of Anxiety and Depression in Patients with Coronary Artery Disease? A POLASPIRE II Study.

Background/Objectives: The need to conduct research on anxiety and depression in patients with coronary artery disease in connection with factors such as gender or implemented tertiary prevention is very important for drawing practical conclusions and, consequently, implementing new recommendations and procedures. The aim of the study was to attempt to answer the question whether gender and the number of comorbidities, as well as the application of tertiary prevention principles, play a role in the severity of anxiety and depression in the studied group of patients with coronary artery disease. Material: The study involved 765 patients from 11 Polish cardiology centers. The presented material is part of the multicenter POLASPIRE II study. Methods: All patients completed The Hospital Anxiety and Depression Scale (HADS) questionnaire, and a medical interview was conducted with them. Conclusions: Although the intensity of anxiety and depression in the studied group of patients was low, gender differentiated them, which, however, did not influence undertaking tertiary prevention activities. In the study group of patients, the number of comorbidities and cardiac incidents/procedures after the event qualifying for the study, as well as preventive actions undertaken, were not associated with the severity of anxiety and depression. In the studied group of patients with coronary heart disease, there was still a large group of people who did not take preventive measures. Therefore, there is a need for systematic education regarding the benefits of implementing them to prevent the progression of the disease and premature death.

The Impact of Early Rehabilitation and the Acceptance of the Disease on the Quality of Life of Patients after Hip Arthroplasty: An Observational Study.

Background: The early introduction of physiotherapy significantly shortens the time required for a patient to regain full mobility after hip arthroplasty. Obtaining the expected result is determined by cooperation with a physiotherapist and the patient's involvement in the rehabilitation process. The aim of this study was to assess the quality of life, life satisfaction, and motor ability of patients after hip arthroplasty. Methods: This study included 147 patients who underwent hip arthroplasty at the Orthopedic and Trauma Department. The research material was collected using questionnaires, and the study used the Barthel Index (BI), Harris Hip Score (HHS), Visual Analogue Scale (VAS), Acceptance of Illness Scale (AIS), and Quality of Life Assessment Questionnaire (WHOQOL-BREF). In the studied group of patients, the Excia cementless endoprosthesis was primarily used (69.39%), as well as the Metha Short Hip prosthesis (15.65%), AM hip prosthesis (10.20%), and bipolar hip prosthesis (4.76%). Results: The analyzed group of patients included 95 women (64.63%) and 52 men (35.37%); the average age was 67 years. Six weeks after hip arthroplasty, mild disability occurred in 53.74% of the patients, while the remaining 46.26% had no disability, and 95.24% of the patients achieved a high level of acceptance of the disease and quality of life. Conclusions: Early improvement after hip replacement surgery contributes to eliminating the disability of the hip joint in the following areas: pain sensation, functionality, lack of deformation, and range of motion. Each subsequent stage of treatment increased the level of acceptance of the disease in the study group. The applied surgical treatment increased satisfaction with overall health and quality of life.

No Association of Polymorphisms in the Genes Encoding Interleukin-6 and Interleukin-6 Receptor Subunit Alpha with the Risk of Keloids in Polish Patients.

A keloid is a benign fibroproliferative hypertrophy of scar tissue that extends outside the original wound and invades adjacent healthy skin. Keloid formation is thought to be a complex process including overactivity of the interleukin-6 signaling pathway and genetic susceptibility. The aim of the study was to investigate possible associations between rs1800797, rs1800796, and rs1800795 polymorphisms in the promoter of the IL6 gene encoding interleukin-6 and the rs2228145 polymorphism in the IL6R gene encoding the interleukin-6 receptor subunit alpha with the predisposition to keloids in Polish patients. The genetic polymorphisms were identified either using Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) or sequencing of samples of genomic DNA extracted from blood leukocytes of 86 adult patients with keloids and 100 newborns comprising a control group. No significant differences in the distributions of IL6 or IL6R alleles or genotypes were found between keloid patients and newborn controls. There were also no significant differences between both groups in the distribution of IL6 haplotypes. The IL6 rs1800797, rs1800796 and rs1800795 and IL6R rs2228145 polymorphisms were not found to predispose individuals in the study group to keloids. IL6 promoter haplotypes were not found to be associated with a higher risk of keloids in the studied group.

Frequency of Spinal Pain Symptoms Among Nursing Staff

Introduction. Individuals working in the nursing profession are particularly prone to experiencing spinal discomfort. This is due to the nature of their work, which involves lifting and carrying heavy loads, as well as working in constrained positions. Furthermore, nurses are also exposed to stress and excessive mental health strain. All of these factors can contribute to the occurrence of overloads and injuries to the spine. Aim. The aim of the study was to analyze the frequency of spinal pain symptoms among nursing staff. Material and Methods. The study group consisted of 155 individuals actively practicing the nursing profession. The Polish version of the Revised Oswestry Low Back Pain Disability Scale (OLBPDS-PL) and own questions were used to conduct the study. Results. The frequency of spinal pain symptoms among nursing staff was 96.64%. 55.6% of the respondents reported mild disability, while 16.6% reported severe disability. A correlation was established between gender (p=0.026), the number of hours spent at work (p=0.049), BMI index (p=0.020), and the frequency of spinal pain symptoms. Age was borderline to statistically significant (0.050). Conclusions. Spinal pain symptoms affect a significant portion of the studied group. Lower back pain worsens the daily functioning of nurses, primarily in terms of pain intensity, lifting objects, standing, and social life. Mild disability was observed in over half of the respondents with lower back pain symptoms. (JNNN 2024;13(1):3–8)

Predictive efficiency of phoenixin, spexin and kisspeptin neuropeptides concentration levels in diagnosis of bipolar disorder in paediatric population.

The aim of the study was to assess concentrations of the following neuropeptides: phoenixin, spexin and kisspeptin in venous blood serum of children and adolescents suffering from bipolar disorder, and by this their predictive efficiency in this disorder. The study covered 75 individuals with a mean age of 15.26 years (95% CI: 14.86-15.67), of which the study group comprised of 57 individuals diagnosed with bipolar affective disorder and the control group - 18 individuals with no psychiatric diagnosis and no pharmacological treatment. Phoenixin, spexin and kisspeptin levels were determined in the peripheral venous blood serum. Neuropeptide concentrations were measured with the enzyme-linked immunosorbent assay (ELISA). The mean phoenixin concentration in the studied group equalled 1.57 ng/ml (95% CI: 1.35-1.79), while in the control group - 2.69 ng/ml (95% CI: 2.38-3; U Mann-Whitney test p-value < 0.05). For spexin, these results were 639.65 pg/ml (95% CI: 558.86-720.44) in the studied group, and 354.28 pg/ml (95% CI: 310.33-398.22; U Mann-Whitney test p-value < 0.05) in the control group. The observed differences were statistically significant. The mean concentration of kisspeptin levels in the studied group was 126.02 pg/ml (95% CI: 39.82-212.23; median: 59.85), while in the control group - 54.83 pg/ml (95% CI: 39.23-70.43; median: 51.3; U Mann-Whitney test p-value = 0.29), and the observed difference was not statistically significant. The occurrence of bipolar disorder symptoms is statistically significantly linked with a decreased phoenixin concentration and to a small degree - with an increased spexin concentration in blood serum of patients. However, it is not linked with the kisspeptin concentration.

MicroRNA-126 selected with broad-spectrum analysis of microRNAs - a new predictive factor for the effectiveness of immunotherapy or chemoimmunotherapy in advanced NSCLC patients?

Expression of PD-L1 on cancer cells is the only validated predictive factor for immunotherapy in NSCLC (Non-Small Cell Lung Cancer) patients. However, on this basis, it is difficult to predict the occurrence of resistance to immune checkpoint inhibitors (ICIs). MicroRNAs are widely studied as biomarkers of cancers. Our study was designed to determine whether microRNAs can be sensitive predictive factors in the qualification of NSCLC patients to first-line immunotherapy or chemoimmunotherapy. The two-stage research on validation group (n=20) and study group (n=35) of patients with advanced NSCLC was conducted. Analysis of microRNAs expression by qPCR in plasma collected prior to the start of immunotherapy (pembrolizumab) or chemoimmunotherapy (combination ofpembrolizumab with chemotherapy) was made. Broad-spectrum analysis of microRNAs expression was used in the studied group. Three microRNAs selected in that group as important for the effectiveness of ICIs were then examined in the validation group. In the studied group, significantly higher expression of miRNA-126-3p, miR-144-3p and miR-146-5p was observed in patients with long PFS compared to those with short PFS. In the validation group, low miRNA-126 expression indicated lower median progression-free survival and overall survival (2.3 vs. 5.0 months and 5.2 vs 11.2, respectively). These patients had a significantly higher risk of progression (HR= 2.92, 95% CI: 1.01 to 8.40, p=0.04) and death (HR=3.64, 95% CI: 1.22 to 10.84, p=0.02). Our study showed that the expression of miR-126 in blood plasma may be a predictive factor for the effectiveness of first-line immunotherapy or chemoimmunotherapy in advanced NSCLC patients.

Association of Three Genetic Loci with Molar Incisor Hypomineralization in Polish Children

Background: Molar incisor hypomineralization (MIH) is a qualitative, demarcated enamel defect of hypomineralization affecting one to four first permanent molars, often with incisor involvement. Its etiology is complex. However, evidence suggests the influence of genetic factors, potentially including the single nucleotide polymorphisms (SNPs) rs2889956, rs4811117 and rs13058467, which were previously linked to MIH in a genome-wide association study of German children. The aim was to replicate analyses of possible associations between the SNPs and molar incisor hypomineralization in Polish children. Methods: The final study group consisted of 778 children aged 126–168 months old. Saliva samples were taken, and genomic DNA was extracted and genotyped using beadchip microarrays. Results: Among the 778 subjects, there were 68 (8.7%) subjects with MIH and 710 (91.3%) subjects without MIH. There were no significant differences in distributions in age, sex, or the frequency of caries in permanent dentition between the MIH and non-MIH groups. The rs2889956, rs4811117, and rs13058467 genotype distributions in the studied group conformed to the expected Hardy–Weinberg equilibria, and there were no significant differences in the distributions of their alleles or genotypes between the MIH and non-MIH groups. Conclusion: Our replication study did not confirm highly significant associations between the single nucleotide polymorphisms rs2889956, rs4811117, and rs13058467 with molar incisor hypomineralization in Polish children.

Early kidney damage in diabetic adolescents with increased blood pressure and glomerular hyperfiltration.

The early impact of type 1 diabetes mellitus (DM1), increased blood pressure and glomerular hyperfiltration (GHF) on kidney damage in adolescents using two urinary markers of kidney injury - neutrophil gelatinase-associated lipocalin (uNGAL) and transferrin (uTransf) - was assessed. The study group consisted of 80 adolescents with DM1, of whom 42 were patients with increased blood pressure (IBP), and 38 were patients with normal blood pressure (NBP). Blood pressure was assessed by 24-hour ambulatory blood-pressure monitoring. All patients showed estimated glomerular-filtration rates (eGFRs) above 90 mL/min/1.73 m2. The control group consisted of 19 healthy, age and gender-matched adolescents. All diabetic children showed a significant increase in uNGAL (P<0.001). This increase was not related to blood pressure. The uNGAL was elevated in all patients with normal albuminuria, normal eGFR and NBP. The concentration of uTransf was not increased in the entire studied group and was not related to blood pressure. Children with GHF had significantly higher levels of both uTransf (P=0.010) and uNGAL (P<0.001). In patients with GHF, blood pressure was normal. Patients with IBP showed a significantly higher value for triglycerides (r=0.247; P=0.032) and a longer duration of diabetes (r=0.264; P=0.019). Diabetes is the leading risk factor for early kidney injury. However, increased blood pressure does not lead to kidney damage, at least in the early stage of DM1. The uNGAL is the early indicator of kidney injury and increases in patients with normal albuminuria, normal glomerular filtration and normal blood pressure. Glomerular hyperfiltration seems to be a marker of diabetic-kidney involvement.

Association between Body Mass Index and Depressive Symptoms among Adolescent Females in Baghdad, AlKarkh during 2022

Background: Due to their high prevalence rates, adolescent obesity and depression are among the most renowned public health concerns globally. Obesity is considered the leading cause of morbidity and death in Iraq in 2019. There is scarce research and surveys regarding the relationship between BMI and depression, especially in young Iraqi females. Objectives: To explore the level of depression among adolescent girls, and to determine its association with Body Mass Index in the studies group. Methods: Beck’s depression inventory questionnaire was used in 11 high schools for girls that were selected randomly from the schools in Baghdad/ AlKarkh from 1st of January 2023 till end of May 2023. A sample of 350 adolescent girls was included in the study. The height and weight of each participant was measured and BMI was calculated. Tables and graphs were constructed to describe the data. The Chi-square test was used to test the association between categorical data. A P value of less than 0.05 was considered statistically significant. Results: Of the studied group, 14% were underweight, 59% were normal weight, 21% overweight and 6% obese. As for mood status, 16% had mild mood disturbance, 24.3% had borderline clinical depression, 13.4% had moderate depression and 3.1% had severe depression. Severe depressive symptoms were found in 15% of obese girls, significantly higher than that among overweight (1.4%), normal weight (2.4%), and underweight (3.4%), P = 0.003. Conclusions: There was a significant association between obesity and severe depression and a positive significant correlation between BMI and depression. Received: April,, 2023 Accepted: June, 2023 Published: Jan2024

A COMPREHENSIVE STUDY OF DURA MATER BIOMINERALIZATION: MORPHOLOGICAL, CRYSTALLOGRAPHIC, AND IMMUNOHISTOCHEMICAL ASPECTS

Biomineralization is a process of formation of biominerals widespread among living organisms. This phenomenon occurs in the central nervous system in normal and pathological conditions. Typically, this can manifest age-related changes, and the prevalence of biominerals increases with age. At the same time, it can be a sign of pathology – tumour growth, dystrophy, metabolic disorders, etc. This work aims to study the morphological features of the dura mater with signs of biomineralization. In this work, we examined 30 samples of the dura mater with signs of biomineralization (group I) and 30 samples without these signs (group II) obtained during autopsies in the pathology department of the Sumy Regional Clinical Hospital. For the morphological characteristics of the dura mater, we used histological, histochemical and immunohistochemical methods, as well as scanning electron microscopy. Statistical processing of the results of the immunohistochemical study was carried out in the GraphPad Prism 8.0 statistical package using parametric and non-parametric research methods. To divide the samples into groups, we relied on the histological method – staining with hematoxylin-eosin. Histochemical methods (alizarin red staining, von Koss method) confirmed the presence of calcium compounds in the studied group. Van Gieson staining visualized the collagen fibres of the dura mater, and the PAS reaction did not reveal the presence of glycosaminoglycans in the mineral deposits. Immunohistochemical examination of the dura mater with antibodies against osteopontin revealed a significant difference between the study and control groups (p&lt;0.001), confirming the critical role of osteopontin in the biomineralization process in this tissue. With the help of scanning electron microscopy, it was found that biominerals in the dura mater are represented by tens to hundreds of formations of various shapes (rounded, oval and irregular), varying from tens of nanometers to 50 micrometres. Their composition was analyzed using maps and spectra of energy-dispersive X-ray spectroscopy and most probably corresponded to calcium hydroxyapatite. So, the dura mater is characterized by biomineralization, manifested by the formation of microscopic calcium hydroxyapatite composites.

Nursing-based intervention to optimize the self-prescribed and the misuse of antibiotics among mothers of children less than 5 years

BackgroundThe fact that bacteria have no geographical boundaries has made bacterial resistance to antibiotics a worldwide issue that requires collaboration and unity to address. Aimevaluate the effect of nursing-based intervention to optimize the self-prescribed and the misuse of antibiotics among mothers of children less than 5 years. MethodsA quasi-experimental design was used to conduct this study. The study was conducted in Maternal Child Health Centers in Mansoura City & Beni-Suef City, Egypt, 100 participants were included in the study. A structured interview questionnaire was used to collect the data, which consisted of five parts; socio-demographic data, knowledge questions about antibiotics and their resistance, attitude scale towards self-prescribed antibiotics, questionnaire on safe use of antibiotics, and patterns of self-prescribed antibiotic use. Results41 % of the study group used self-prescribed antibiotics more than 6 times in the previous 6 months and 100 % of them used them to treat fever and sore throat, followed by 76 % for vomiting and diarrhea. There were significant improvements in participants' knowledge, attitudes towards self-prescribed antibiotics, and safe use of antibiotics after implementing the nursing intervention. ConclusionThe nursing-based intervention was successful in attaining its objectives in improving the total knowledge, attitudes and practices of the studied group. RecommendationHealth education about appropriate antibiotic use should be approved as a part of the preventive services obtained for the mothers.

Cholesterol-Years and the risk of the first MI

Abstract Background Low-density lipoprotein cholesterol (LDL-C) has been determined as one of the causal factors of Atherosclerotic Cardiovascular Disease (ASCVD). The term "cholesterol-years" represents the cumulative exposure of the arterial wall to LDL-C during the lifetime, and is measured by multiplication of patient’s age, and LDL-C level. According to the theory, exceeding a certain number of "cholesterol-years" increases the risk of myocardial infarction (MI) [1]. So far, there are no studies that assess the effect of "cholesterol-years" on the risk of the first MI. Purpose We aimed to determine whether "cholesterol-years", as an indicator of cumulative exposure to LDL-C, is associated with the risk of development of the first MI in Polish patients. Method Data were extracted from patients from years 2016-2022, who were participants of the Polish Registry of Acute Coronary Syndromes (PL-ACS), a national, multicenter, ongoing, prospective observational registry that includes all patients hospitalized with the acute coronary syndrome (ACS) in Poland. The study group consisted of patients who had not previously been treated with lipid-lowering therapy, with first MI, and had the available data for LDL-C. The association between the "cholesterol-years" and the occurrence of the first MI was assessed using the Spearman’s correlation. All continuous variables were presented as mean (SD), and categorical variables were shown as absolute numbers and percentages. Results The studied group constituted 35,747 patients, with the mean age of 66.5 years, of whom 36% were women. 25,6% of patients had diabetes, 70,8% arterial hypertension, and 62.6% were past-or-present smokers. In patients with the first myocardial infarction, there is a significant linear correlation between cholesterol-years and the age at which the first myocardial infarction occurs. In our observation, exceeding 6,000 "cholesterol-years" at the age of 40 increases the risk of the first myocardial infarction. Conclusion In the large, real-world population, the risk of the first myocardial infarction was linearly correlated with the number of "cholesterol-years", which supports the "cholesterol-years" theory of the risk of development of the first MI.Baseline Characteristics of PatientsCholesterol-years in the study group

The role of hereditary thrombophilia in the development of venous thrombosis in combat trauma

Introduction. Combat trauma is one of the factors causing hemostasis disorders in the wounded. Currently, there is insufficient information about the significance of hereditary thrombophilia in the development of venous thromboembolic complications in the wounded.Aim. To study the effect of polymorphism of genes of components of the hemostasis system on the development of venous thrombosis in wounded with combat trauma.Materials and methods. The prospective study included men (n = 81) of young age (the average age was 36.0 ± 8.5 years) who received a combat wound and were treated at the Military Medical Academy named after S.M. Kirov. The subjects were divided into 2 groups: the main group included 40 victims (49.4%) who were diagnosed with venous thrombosis during treatment, the control group included 41 patients without signs of thrombosis (50.6%). The study of allelic polymorphism of genes associated with the formation of blood clots was carried out using a real-time polymerase chain reaction based on the study of human DNA in peripheral blood material.Results. Comparative analysis revealed no statistically significant differences in the frequency of occurrence of the studied genetic variants between the study group and the control group. When assessing the prevalence of polymorphism of the MTHFR and MTRR genes, it was found that the combination of the genotypes “MTHFR 677 CT” and “MTRR 66 GG” is associated with an 8.5-fold increase in the risk of developing VTEO [OR = 8.5; p = 0.029].Conclusion. Analysis of the test results showed that no relationship was found between individual genetic variants and the risk of developing venous thrombosis in the studied group of wounded despite the high prevalence (prothrombogenic alleles of various genes were detected in 79 servicemen (97.5%)). At the same time, the combination of MTHFR 677 CT and MTRR 66 GG genotypes in that patient population was shown to be associated with a significant increase in the risk of thrombosis.

ИЗУЧЕНИЕ ВЛИЯНИЯ НАСЛЕДСТВЕННЫХ ТРОМБОФИЛИЙ В РАЗВИТИИ ВЕНОЗНЫХ ТРОМБОЗОВ ПРИ БОЕВОЙ ТРАВМЕ

Introduction. Combat trauma is one of the factors that cause impaired hemostasis in the wounded. Currently, there is not enough information about the significance of hereditary thrombophilia in the development of venous thromboembolic complications in the wounded. Target. Study of the effect of polymorphism of the genes of the components of the hemostasis system on the development of venous thrombosis in the wounded with a combat injury. Materials and methods. The prospective study included young men (n=81) (mean age 36.0 ± 8.5 years) who received a combat wound and were treated at the Military Medical Academy. CM. Kirov. The subjects were divided into 2 groups: the main group included 40 patients (49.4%) who were diagnosed with venous thrombosis during treatment, the control group included 41 patients without signs of thrombosis (50.6%). The study of allelic polymorphism of genes associated with the process of thrombus formation was carried out using a real-time polymerase chain reaction based on the study of human DNA in peripheral blood material. Results. In a comparative analysis, no statistically significant differences were found in the frequency of occurrence of the studied genetic variants between the study group and the control group. When assessing the prevalence of polymorphisms in the MTHFR and MTRR genes, it was found that the combination of the MTHFR 677 CT and MTRR 66 GG genotypes is associated with an 8.5-fold increase in the risk of developing venous thromboembolic complications [OR=8.5; p=0.029]. Conclusion. The analysis of the obtained results showed that, despite the high prevalence (the presence of prothrombogenic alleles of various genes was detected in 79 military personnel (97.5%)), it was not possible to establish a relationship between individual genetic variants and the risk of developing venous thrombosis in the studied group of wounded. At the same time, it has been shown that the combination of the MTHFR 677 CT and MTRR 66 GG genotypes is associated with a significant increase in the risk of thrombosis.

Results of Nailfold Videocapillaroscopy in Patients with Pseudoexfoliative Glaucoma.

The studied group consisted of 39 Caucasian patients with XFG and 32 patients in a control group. The patients were classified into two subgroups: the hypertensive pseudoexfoliative glaucoma (hXFG) subgroup and the normotensive pseudoexfoliative glaucoma (nXFG) subgroup. The nailfold videocapillaroscopy (NVC) was performed on all participants. The results of each NVC were classified as having a normal or abnormal pattern. There was no statistical difference between the results of an abnormal NVC pattern in the study group vs. the control group (p = 0.8773). Microhemorrhages were shown in 30.0% of patients with nXFG vs. the control group (6.25%) (p = 0.0520). Microhemorrhages tended to be more frequent in the XFG group (p = 0.1221). A prevalent number of tortuous capillaries was observed in hXFG patients with advanced glaucomatous neuropathy. Dilatation in the capillaries and microbleedings were observed in the group of patients with lower IOP values. Tortuosity in the capillaries was significantly more frequent in PEXG patients (XFG vs. control: p = 0.0386). No relationships between the results of NVC and age, c/d, BCVA, time of treatment, and visual field defect were found. Specific features of NVC examination differentiate nXFG from hXFG patients. Some capillaroscopic features may correlate with the patient's clinical status of XFG.

Assessment of the body posture of junior high school students in the context of their physical activity

Introduction. Posture defects constitute a social problem and can cause negative changes in many aspects of our lives – in both physical and mental health. Prophylaxis and an appropriate degree of physical activity, which affects harmonious development, are very important here. Objective. The objective of the study was to assess the body posture of junior high school students and to determine the degree of their physical activity, and then to check whether there is a correlation between them. The study group consisted of 53 people from a junior high school in Wrocław, aged 14 to 17. Material and methods. To assess physical activity, the International Physical Activity Questionnaire (IPAQ) was used, which contains 7 questions regarding activity in the last 7 days. Body posture in the sagittal plane was examined using photogrammetry, and typology classification was based on Wolański’s method modified according to Zeyland-Malawka. Results. The results of the study were subjected to a statistical analysis, which shows that the studied group of adolescents is mostly characterized by a kyphotic type of body posture, while the least common is the balanced type. The level of physical activity of the study group can be described as sufficient, but it is worth noting that only 6% of the respondents are characterized by an insufficient level of physical activity, and only 7.5% are characterized by a high level of physical activity. Conclusions. In further analyses, it was examined whether there is a correlation between body posture and physical activity. It was found that there are no statistically significant differences between these two features in the study group.