Search

Background: In the CONVERT study, treatment with amikacin liposome inhalation suspension (ALIS) added to guideline-based therapy (GBT) met the primary end point of increased culture conversion by month 6 in patients with treatment-refractory Mycobacterium avium complex lung disease (ALIS plus GBT, 29% [65/224] vs GBT alone, 8.9% [10/112]; P < .0001). Research Question: In patients who achieved culture conversion by month 6 in the CONVERT study, was conversion sustained (negative sputum culture results for 12 months with treatment) and durable (negative sputum culture results for 3 months after treatment) and were there any additional safety signals associated with a full treatment course of 12 months after conversion? Study Design and Methods: Adults were randomized 2:1 to receive ALIS plus GBT or GBT alone. Patients achieving culture conversion by month 6 continued therapy for 12 months followed by off-treatment observation. Results: More patients randomized to ALIS plus GBT (intention-to-treat population) achieved conversion that was both sustained and durable 3 months after treatment vs patients randomized to GBT alone (ALIS plus GBT, 16.1% [36/224] vs GBT alone, 0% [0/112]; P < .0001). Of the patients who achieved culture conversion by month 6, 55.4% of converters (36/65) in the ALIS plus GBT treated arm vs no converters (0/10) in the GBT alone arm achieved sustained and durable conversion (P = .0017). Relapse rates through 3 months after treatment were 9.2% (6/65) in the ALIS plus GBT arm and 30.0% (3/10) in the GBT alone arm. Common adverse events among ALIS plus GBT-treated patients (dysphonia, cough, dyspnea, hemoptysis) occurred mainly within the first 8 months of treatment. Interpretation: In a refractory population, conversion was sustained and durable in more patients treated with ALIS plus GBT for 12 months after conversion than in those treated with GBT alone. No new safety signals were associated with 12 months of treatment after conversion. Trial Registry: ClinicalTrials.gov; No.: NCT02344004; URL: www.clinicaltrials.gov

Background Mycobacterial time to positivity (TTP) in liquid culture media has predictive value for longer term outcomes in pulmonary tuberculosis, but has not been thoroughly studied in nontuberculous mycobacterial pulmonary disease. This study sought to evaluate for association between TTP and sputum culture conversion to negative in pulmonary disease caused by Mycobacterium avium complex (MAC). Methods Data from the CONVERT trial (NCT02344004) that evaluated efficacy of guideline-based-therapy with or without amikacin liposome inhalation suspension in adults with refractory MAC-PD (Mycobacterium avium complex pulmonary disease) were analyzed. We evaluated TTP measures for sputum obtained prior to study treatment initiation and at monthly visits, assessing reproducibility of measures as well as association of TTP with culture conversion on treatment. Results Data from 71 participants with at least one screening visit TTP value were analyzed. For participants who provided more than one sputum sample at a given visit, there was moderate between-sample reliability, with median intraclass correlation coefficient 0.62 (IQR 0.50, 0.70). Median TTP at screening was longer in those participants who subsequently achieved vs. did not achieve culture conversion (10.5 [IQR 9.4] days vs. 4.2 [IQR 2.8] days, p = 0.0002). Individuals with culture conversion by study treatment month 6 were more likely to have a screening TTP > 5 days compared to those who did not achieve culture conversion (OR 15.4, 95% CI 1.9, 716.7, p = 0.0037) and had increasing TTPs over time. Conclusions TTP prior to and on treatment is associated with microbiological treatment response in patients with MAC-PD.

Contains fulltext : 238192.pdf (Publisher’s version ) (Open Access) Rationale: Patients with refractory Mycobacterium avium complex (MAC) lung disease have limited treatment options. In the CONVERT study, amikacin liposome inhalation suspension (ALIS) added to guideline-based therapy (GBT) increased culture conversion rates versus GBT alone by Month 6. Limited data are available regarding >6-month treatment in a refractory population.Objectives: Evaluate 12-month safety, tolerability, and efficacy of ALIS+GBT.Methods: Adults with refractory MAC lung disease not achieving culture conversion by CONVERT Month 6 could enroll in this open-label extension (INS-312) to receive 590 mg once-daily ALIS+GBT for 12 months. Two cohorts enrolled: the "ALIS-naive" cohort included patients randomized to GBT alone in CONVERT, and the "prior-ALIS" cohort included those randomized to ALIS+GBT in CONVERT. Safety and tolerability of ALIS over 12 months (primary endpoint) and culture conversion by Months 6 and 12 were assessed.Results: In the ALIS-naive cohort, 83.3% of patients (n = 75/90) experienced respiratory treatment-emergent adverse events (TEAEs), and 35.6% (n = 32) had serious TEAEs; 26.7% (n = 24) achieved culture conversion by Month 6 and 33.3% (n = 30) by Month 12. In the prior-ALIS cohort, 46.6% of patients (n = 34/73) experienced respiratory TEAEs, and 27.4% (n = 20) had serious TEAEs; 9.6% (n = 7) achieved culture conversion by Month 6 (≤14 mo ALIS exposure) and 13.7% (n = 10) by Month 12 (≤20 mo ALIS exposure). Nephrotoxicity-related TEAEs and measured hearing decline were infrequent in both cohorts.Conclusions: In up to 20 months of ALIS use, respiratory TEAEs were common, nephrotoxicity and hearing decline were infrequent, and culture conversion continued beyond 6 months of therapy.Clinical trial registered with www.clinicaltrials.gov (NCT02628600).

In the CONVERT study, treatment with amikacin liposome inhalation suspension (ALIS) added to guideline-based therapy (GBT) met the primary end point of increased culture conversion by month 6 in patients with treatment-refractory Mycobacterium avium complex lung disease (ALIS plus GBT, 29% [65/224] vs GBT alone, 8.9% [10/112]; P .0001).In patients who achieved culture conversion by month 6 in the CONVERT study, was conversion sustained (negative sputum culture results for 12 months with treatment) and durable (negative sputum culture results for 3 months after treatment) and were there any additional safety signals associated with a full treatment course of 12 months after conversion?Adults were randomized 2:1 to receive ALIS plus GBT or GBT alone. Patients achieving culture conversion by month 6 continued therapy for 12 months followed by off-treatment observation.More patients randomized to ALIS plus GBT (intention-to-treat population) achieved conversion that was both sustained and durable 3 months after treatment vs patients randomized to GBT alone (ALIS plus GBT, 16.1% [36/224] vs GBT alone, 0% [0/112]; P .0001). Of the patients who achieved culture conversion by month 6, 55.4% of converters (36/65) in the ALIS plus GBT treated arm vs no converters (0/10) in the GBT alone arm achieved sustained and durable conversion (P = .0017). Relapse rates through 3 months after treatment were 9.2% (6/65) in the ALIS plus GBT arm and 30.0% (3/10) in the GBT alone arm. Common adverse events among ALIS plus GBT-treated patients (dysphonia, cough, dyspnea, hemoptysis) occurred mainly within the first 8 months of treatment.In a refractory population, conversion was sustained and durable in more patients treated with ALIS plus GBT for 12 months after conversion than in those treated with GBT alone. No new safety signals were associated with 12 months of treatment after conversion.ClinicalTrials.gov; No.: NCT02344004; URL: www.clinicaltrials.gov.

Rationale: Patients with refractory Mycobacterium avium complex (MAC) lung disease have limited treatment options. In the CONVERT study, amikacin liposome inhalation suspension (ALIS) added to guideline-based therapy (GBT) increased culture conversion rates versus GBT alone by Month 6. Limited data are available regarding >6-month treatment in a refractory population. Objectives: Evaluate 12-month safety, tolerability, and efficacy of ALIS+GBT. Methods: Adults with refractory MAC lung disease not achieving culture conversion by CONVERT Month 6 could enroll in this open-label extension (INS-312) to receive 590 mg once-daily ALIS+GBT for 12 months. Two cohorts enrolled: the “ALIS-naive” cohort included patients randomized to GBT alone in CONVERT, and the “prior-ALIS” cohort included those randomized to ALIS+GBT in CONVERT. Safety and tolerability of ALIS over 12 months (primary endpoint) and culture conversion by Months 6 and 12 were assessed. Results: In the ALIS-naive cohort, 83.3% of patients (n = 75/90) experienced respiratory treatment-emergent adverse events (TEAEs), and 35.6% (n = 32) had serious TEAEs; 26.7% (n = 24) achieved culture conversion by Month 6 and 33.3% (n = 30) by Month 12. In the prior-ALIS cohort, 46.6% of patients (n = 34/73) experienced respiratory TEAEs, and 27.4% (n = 20) had serious TEAEs; 9.6% (n = 7) achieved culture conversion by Month 6 (≤14 mo ALIS exposure) and 13.7% (n = 10) by Month 12 (≤20 mo ALIS exposure). Nephrotoxicity-related TEAEs and measured hearing decline were infrequent in both cohorts. Conclusions: In up to 20 months of ALIS use, respiratory TEAEs were common, nephrotoxicity and hearing decline were infrequent, and culture conversion continued beyond 6 months of therapy. Clinical trial registered with www.clinicaltrials.gov (NCT02628600).

Background . In CLEAR-108—a phase 3, randomised, open-label study—once-daily amikacin liposome inhalation suspension (ALIS) was noninferior to twice-daily tobramycin inhalation solution (TIS) in improving lung function in patients with cystic fibrosis (CF) and chronic Pseudomonas aeruginosa infection after 3 treatment cycles (28 days on/28 days off). The CLEAR-110 extension study (ClinicalTrials.gov: NCT01316276; EudraCT: 2011-000443-24) assessed long-term safety, tolerability, and efficacy of ALIS in eligible patients who completed CLEAR-108. Methods . Patients received once-daily ALIS 590 mg for 12 treatment cycles (96 weeks). Patients were grouped by prior treatment: the “prior-ALIS” cohort received ALIS in CLEAR-108, and the “ALIS-naive" cohort received TIS in CLEAR-108. Results . Overall, 206 patients (prior-ALIS, n=92; ALIS-naive, n=114) entered CLEAR-110 and received ≥1 dose of ALIS. Most patients (88.8%) experienced ≥1 treatment-emergent adverse event (TEAE) through day 672 (end of year 2). Most TEAEs (72.3%) were mild or moderate in severity. Severe TEAEs were reported in 31 patients (15.0%). Two life-threatening TEAEs (haemoptysis; intestinal obstruction) and 1 death (cardiac failure) were reported. Twenty-one patients (10.2%) discontinued treatment due to a TEAE (mostly infective pulmonary exacerbation of CF). Mean change from baseline in forced expiratory volume in 1 second percent predicted at day 672 was −3.1% (prior-ALIS, −4.0%; ALIS-naive, −2.3%). Mean change from baseline in sputum density of P. aeruginosa at day 672 was 0.02 (prior-ALIS, −0.16; ALIS-naive, 0.19) log CFU/g. Conclusions . Long-term treatment with ALIS was well tolerated with a favourable adverse event profile and demonstrated continued antibacterial activity in CF patients with chronic P. aeruginosa infection.

Background: Systemic mastocytosis (SM) is a disorder of neoplastic mast cells ranging from indolent to aggressive multi-system disease. We previously reported our large single centre experience managing SM. Since 2019 patients have had access to new treatments within trials. Prognostic scoring systems developed in SM to improve outcome predictions and guide treatment have been a focus of recent studies, although are yet to be validated in real-world setting. We sought to apply these scoring systems within our UK cohort, with a particular focus on the international prognostic score (IPSM) and the mutation-adjusted risk score (MARS). Methods: We performed a retrospective study of 192 adult patients diagnosed with SM between 2009 and 2021 including demographics, clinical data, as well as next generation sequencing (NGS) based myeloid gene panels carried out in advanced SM patients (AdvSM) where available. Prognosis for all patients was calculated based on IPSM (Sperr et al. [2019]) in all our SM patients and MARS scores in those with AdvSM (Jawhar et al. [2019]). Results: There was no gender bias in our cohort with 87 (46%) males and 105 (54%) females. Median age at diagnosis was 52 years (range 5-84) and majority of patients had indolent SM (ISM; 129/192 [67%]), 8/192 (4%) smouldering SM (SSM) and 55/192 (29%) advanced SM (AdvSM). In those with AdvSM, 43/55 (78%) had an associated haematological neoplasm (SM-AHN); 9/55 (17%) aggressive SM (ASM) and 3/55 (5%) mast cell leukaemia. As expected, AHN sub-types were myeloid with majority being CMML (16/55; 29%) [Table 1]. Median tryptase at diagnosis in ISM patients was 41ug/L (range 3-351ug/L), while in SSM it was 494ug/L (range 174-682ug/L) and in AdvSM it was 155ug/L (range 10-1551). Most patients were positive for the KIT D816V mutation (131/192; 68%). As expected, ISM and SSM (non-AdvSM) patients had better prognosis compared to those with AdvSM [Figure 1a], with median overall survival (OS) not reached in the former and 12 months in the latter with 11-year follow-up. We next applied the IPSM score to the AdvSM cohort, with the largest proportion categorised as AdvSM-3 (25/55; 45%) while 10/55 (18%) were AdvSM-4 [Table 1]. Survival outcome was notably higher in the AdvSM-1 group (4/55; 7%) with no deaths recorded, while 6/25 (24%) and 4/10 (40%) deaths were reported in AdvSM-3 and AdvSM-4 groups respectively [Figure 1b]. SM patients are known to carry somatic mutations in addition to KIT, in particular SRSF2, ASXL1 and RUNX1 (S/A/R) which are associated with adverse outcome. In our AdvSM cohort, 10/55 (18%) of patients were positive for one of these mutations on NGS-based myeloid gene panel and 8/55 (15%) carried ≥2. Additional clinically significant mutations are summarised in Table 1. We next examined the MARS score; most of our AdvSM patients categorised as low-risk (28/55, 51%), 21/55 (38%) were intermediate-risk and 6/55 (13%) high-risk [Table 1]. Survival outcome as expected in the low-risk group was higher compared to the intermediate- and high-risk groups, with 10-year OS of 87% versus 35% and 30% respectively [Figure 1c]. On reviewing our AdvSM cohort, 6/55 (11%) had progressive disease: 5 transforming to acute myeloid leukaemia (AML) and 1 to mast cell leukaemia (MCL). Interestingly, when reviewing cause of death, the highest proportion were due to AHN progression (6/16; 38%) while 2/16 (13%) were from transformation to AML [Table 1]. As expected within our cohort, there was a discrepancy between the IPSM and MARS scores as the latter includes the presence of S/A/R mutations. 2 patients diagnosed with MCL in 2016 and 2019 respectively, were categorised high risk based on both scores. Both are alive to date having received the KIT inhibitor avapritinib, with one continuing on this treatment. The other progressed to AML and underwent allogeneic stem cell transplant, with ongoing complete remission. Other treatments received by our AdvSM patients are summarised in Table 1. Conclusion: Application of the IPSM and MARS prognostic scores to our data reflects findings of other groups with better outcomes seen in non-AdvSM compared to AdvSM patients. Furthermore, although our AdvSM cohort is small, the presence of adverse risk factors could be overcome through recent advances in treatments and consolidation with stem cell transplant. Hence, identification of high-risk patients using these prognostic scores can direct targeted first-line therapy and improve outcomes. Figure 1 Figure 1. Disclosures Sriskandarajah: Celgene: Speakers Bureau; Novartis: Other: Education. Green: Novartis: Other: Education. Ong: Novartis: Other: Education. Harrison: Novartis: Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; CTI BioPharma: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Gilead Sciences: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Abbvie: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Incyte Corporation: Speakers Bureau; Celgene: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Constellation Pharmaceuticals: Research Funding; BMS: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Geron: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Keros: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Shire: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Galacteo: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Sierra Oncology: Honoraria; AOP Orphan Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Promedior: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Janssen: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Roche: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Grattan: Novartis: Speakers Bureau. Radia: Blueprint Medicines Corporation: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: Study steering group member, Research Funding; Cogent Biosciences Incorporated: Other: Study Steering Committee; Novartis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Education events; EXPLORER and PATHFINDER studies: Other: Member of the Response Adjudication Committee.

We present a beautiful but relatively unknown theorem that every differentiable function f : P → R , with P ⊂ R being closed, admits differentiable extension F : R → R . We present an elementary proof of this result based on a construction sketched in a hard-to-access 1923 paper [4] of V. Jarnik. Using this construction, we also obtain an elegant version of Whitney extension theorem characterizing when such an f admits continuously differentiable extension.

Introduction: Systemic mastocytosis (SM) is a heterogeneous disorder of neoplastic mast cells ranging from an indolent to aggressive multi-system disease. We registered our UK Mastocytosis Centre of Excellence with the European Competence Network of Mastocytosis (ECNM) in 2005. Our multidisciplinary team (MDT) includes haematologists, haematopathologists, dermatologist, immunologist and molecular diagnosticians. Over 500 patients have been reviewed in our quarterly SM-MDT. We present a large single centre experience of a rare disorder. Method: We have reviewed prospective and retrospectively collected clinical data for 125 adult patients from 2009. The data captures clinical, laboratory, diagnostic results and management. Local patients with a tryptase level of >20ug/L are offered haematology review and bone marrow investigation with KIT D816V mutation analysis using digital PCR. Patients seen for a second opinion have their diagnostic material reviewed. Since 2018, next generation sequencing (NGS) based myeloid gene panels are carried out on patients with advanced SM (AdvSM). Results: Classification of mastocytosis patients: In 125 patients no gender bias was seen: 56 (44.8%) were male and 69 (55.2%) female. Median age of patients with indolent SM (ISM) was 49 years (range 22-78); and for AdvSM: (aggressive SM, SM with an associated haematological neoplasm and mast cell leukaemia) was 64years (range 5-77). The median serum tryptase level was 48.9ug/L for ISM patients (range 4-682) and 120ug/L for AdvSM patients (range 24-854). 112/125 patients had a bone marrow biopsy. 13 patients chose not to have a biopsy. 88% (110/125) of patients had a mast cell disorder. 4% (5/125) had no marrow involvement. 84% (105/125) met WHO criteria for a diagnosis of SM - Figure 1.These were sub-classified: 71/105 (67%) ISM; 2/105 (2%) smouldering SM (SSM); 3/105 (3%) aggressive SM (ASM); 2/105 (2%) mast cell leukaemia (MCL) and 27/105 (26%) SM with an associated hematologic neoplasm (SM-AHN). The most frequent associated haematological neoplasms were MPN and CMML. Lymphomas (n=3) and plasma cell dyscrasias (n=1) were seen patients. In 10/27 (37%) cases of SM-AHN the SM was the initial diagnosis with subsequent development of an AHN. In 5/27(19%) cases the AHN component preceded the SM and in 12/27 (44%) cases the 2 components were co-diagnosed. Mutation status : 24/32 patients with AdvSM were noted to be positive for an activating KIT mutation (D816V, n=23; D816L, n=1). 15/32 AdvSM patients had NGS myeloid gene panel analysis for the SAR panel (SRSF2, ASXL1 and RUNX1) which confers poor prognosis. 4 of the15 patients harboured at least 2 out of 3 SAR mutations. JAK2 V617F mutation was detected in 7 of 8 classical MPN patients and in 1 of 4 patients with MPNu/MDS overlap. 4 patients had a TET2 mutation. 1 patient with mast cell leukaemia had a GATA2 mutation in addition to all 3 in the SAR panel. Cutaneous involvement: 70% (88/125) of patients had skin involvement: 62% (78/125) urticaria pigments, 3% (4/125) telangiectasia macularis eruptiva perstans and 5% (6/125) having non-specific involvement. Skin involvement was more common in ISM (78%) than AdvSM (54% in SM-AHN, none in the 2 patients with MCL). Management : Treatments in ISM are usually for symptom control. Antihistamines, anti-inflammatory agents, anti-leukotriene agents, mast cell stabilising agents, bisphosphonates, proton-pump inhibitors, PUVA and steroids are used. Various cytoreductive therapies have been used in AdvSM (hydroxycarbamide, pegylated interferon-α, cladrabine, cytarabine, azacitadine alone/combination with midostaurin). Patients with SM-AHN have tailored management depending on the disease component that requires treatment. Access to targeted therapies for AdvSM patients in a trial or compassionate use programme has been successful: 7/32 patients with advanced SM have been enrolled into trials (midostaurin 1; avapritinib 6). Conclusions: Our data reflects the heterogeneous nature of the SM classification spectrum clinically and diagnostically. An experienced MDT provides holistic high standard of care within a comprehensive centre for good patient outcomes (Figure 2). Development of a portfolio of novel therapeutic options in multi-centred, international collaborative trials is beneficial to patients and pivotal for research in this rare disorder. Disclosures Cross: Novartis: Consultancy, Research Funding; Incyte: Consultancy. McLornan:Jazz Pharmaceuticals: Honoraria, Speakers Bureau; Novartis: Honoraria. Radia:Blueprint Medicines: Consultancy; Novartis: Consultancy, Speakers Bureau. OffLabel Disclosure: There are very few medications available in mastocytosis and various off label medications have been used including pegylated interferon alpha.

Introduction. Hypertension constitutes a great problem in modern medicine. Due to it being widespread in the society, it seems justified to introduce complex treatment and prevent from this disease. Hypotensive qualities of yoga exercise described in literature constitute an interest as an alternative form of cardiological rehabilitation. Material and methods. In order to evaluate its influence on the values of blood pressure and pulse, a group of people attending hatha yoga classes was studied. It was assumed that circulatory system parameters would decrease when influenced by training, and the size of those changes would depend on age, health condition and selected environmental factors. Before, during and after the classes arterial blood pressure and pulse were measured. The study was supplemented by the author's questionnaire consisting of 15 questions with given response categories. Results. Great age difference, majority of female subjects and those with higher education and white collar jobs were observed during the study. The results proved good perception of subjects' own health condition and their little knowledge concerning realistic parameters of their circulatory system. Decrease of arterial blood pressure and pulse due to hatha yoga exercise were detected during the study, as well as a greater decreasing tendency in subjects with high arterial blood pressure. Conclusions formulated as a consequence of the study concern the influence of hatha yoga exercise on circulatory system parameters and its possible use in order to obtain better hypotensive effect. Nadciśnienie tętnicze stanowi duży problem dla współczesnej medycyny. Z uwagi na znaczne rozpowszechnienie w społeczeństwie zasadne wydaje się wdrożenie kompleksowego leczenia i przeciwdziałania tej chorobie. Wykazane w piśmiennictwie właściwości hipotensyjne treningu jogi spowodowały zainteresowanie możliwością wykorzystania go jako alternatywnej formy rehabilitacji kardiologicznej. Materiał i metody. W celu oceny jego wpływu na wartości ciśnienia tętniczego i częstość tętna badaniu poddano grupę osób uczęszczających na zajęcia hatha jogi. Założono, że parametry układu krążenia ulegną obniżeniu pod wpływem treningu, a wielkość tych zmian będzie uzależniona wiekiem, stanem zdrowia i wybranymi czynnikami środowiskowymi. Dokonano pomiaru ciągłego ciśnienia tętniczego i częstości tętna przed rozpoczęciem zajęć, w trakcie trwania oraz po ich zakończeniu. Badania uzupełniono autorską ankietą, składającą się z 15 pytań z podanymi kategoriami odpowiedzi. Wyniki. Zaobserwowano duże różnice wieku osób podejmujących trening hatha jogi oraz przewagę płci żeńskiej, wyższego wykształcenia i umysłowego charakteru pracy. Stwierdzono stosunkowo dobre odczucie stanu zdrowia badanych osób i małą świadomość o rzeczywistych parametrach własnego układu krążenia. Wykazano obniżenie wartości ciśnienia tętniczego i częstości tętna pod wpływem treningu hatha jogi, oraz większą tendencję spadkową badanych parametrów u osób z wysokimi wartościami ciśnienia tętniczego. Wnioski. Sformułowano wnioski dotyczące wpływu treningu hatha jogi na parametry układu krążenia oraz możliwości jego stosowania w celu uzyskania efektu hipotensyjnego.

Depending on the specific region, the unmanned exploration of the planetary bodies can be divided into three groups: operations above the surface, operations on the surface and operations under the surface. In this chapter we will focus on the operations under the surface, connected with them requirements, available technology and possible output from such research. In this context we will present mole KRET device as a one of the possible solutions for low power consuming device which can be treated as a sub-surface end-effector of a more complicated robotic system. The experimental results of the functional tests of the mole in a 5 m test-bed system will be provided for different regolith analogue. The detailed investigation of lunar analogue will show how the progress of the mole depends on the compaction ratio of the material.

Introduction: The role of rehabilitation therapists in treating people with disabilities undertaking sports activity should be significant. However, their training is realized by colleges providing various profiles of specialization education, which could result in inconsistent preparation of graduates in this field. The aim of this paper was to evaluate how aware physiotherapy students from different colleges are of sports and physical activity of people with disabilities as well as to establish students’ attitude towards the role of sport in rehabilitation process and the direction of its development. A hypothesis was posed concerning inconsistent attitudes, awareness and knowledge in student groups from various colleges as far as taking advantage of sport in rehabilitation process was concerned. Moreover, it was assumed that those indicators would to a greater extent predispose students from colleges of physical education. Materials and Methods: The study was conducted in 2011 and it included 134 female and male students graduating from Collegium Medicum in Bydgoszcz and the Academy of Physical Education in Poznań. The method of diagnostic poll (questionnaire) was used. Studied groups realized different curricula as far as adaptive motor activity and sports activity of people with disabilities is concerned. Collected data was differentiated according to sex and type of college of subjects; the significance of differences of multipartite variables was evaluated by Chi-squared test. Results: Similar sex, age and basic environmental conditions structure was observed in studied groups, as well as minor differences in views and attitudes in the studied male and female groups in Bydgoszcz. Differences in the studied indicators in groups from both colleges were established only concerning the evaluation of the possibility of sports competition among athletes without or with disabilities. It was ascertained that students from a medical college associated sports activity of people with disabilities with the Foundation of Active Rehabilitation, while students from the physical education college in Poznań associated it with the Polish Sport Association of People with Disabilities “Start”. Conclusions: This study allows a conclusion that the awareness and knowledge of physiotherapy students concerning the place of sport and motor activity in the rehabilitation process are shaped to a similar extent in colleges with different profiles of specialization education, therefore, self-identification of the college candidates and a calling for this profession are significant factors in this process. Wstęp: Rola rehabilitantów w podejmowaniu aktywności sportowej przez osoby niepełnosprawne powinna być znacząca. Ich kształcenie realizują jednak uczelnie o różnych profilach kierunkowego kształcenia, co może powodować nierówne przygotowanie absolwentów w tym zakresie. Celem pracy uczyniono ocenę świadomości studentów kierunku fizjoterapii z różnych uczelni, w zakresie sportu i aktywności fizycznej osób niepełnosprawnych oraz poznanie postaw studentów wobec roli sportu w procesie rehabilitacji, a także kierunków jego rozwoju. Postawiono hipotezę o nierównych postawach, świadomości i wiedzy, grup studenckich z różnych uczelni, na temat wykorzystywania sportu w procesie rehabilitacji oraz założono, że wyznaczniki te w większym stopniu będą predysponowały młodzież studiującą w uczelni wychowania fizycznego. Materiał i metody: Badania zrealizowano w 2011 roku obejmując nimi młodzież kończącą studia fizjoterapii w Collegium Medicum w Bydgoszczy i Akademii Wychowania Fizycznego w Poznaniu. Zastosowano metodę sondażu diagnostycznego wykorzystując technikę ankietową, co pozwoliło na zbadanie 134 studentów i studentek. Badane zespoły realizowały różniące się programy dydaktyczne z zakresu aktywności ruchowej adaptacyjnej i sportu osób niepełnosprawnych. Zebrany materiał zróżnicowano płcią badanych osób i rodzajem uczelni, a do oceny istotności różnic zmiennych wielodzielnych zastosowano test Chi-kwadrat. Wyniki badań: Zaobserwowano podobną strukturę płci, wieku i podstawowych uwarunkowań środowiskowych badanych grup młodzieży oraz niewielkie różnice w poglądach i postawach grup młodzieży męskiej i żeńskiej z uczelni bydgoskiej. Różnice badanych wyznaczników zespołów młodzieży obu uczelni stwierdzono jedynie w ocenie możliwości rywalizacji sportowej sportowców sprawnych i niepełnosprawnych. Ustalono, że młodzież z uczelni medycznej aktywność sportową osób niepełnosprawnych łączy z działalnością Fundacji Aktywnej Rehabilitacji, a młodzież poznańskiej uczelni wychowania fizycznego z Polskim Związkiem Sportu Osób Niepełnosprawnych „Start”. Wnioski: Zrealizowane badania pozwalają wnioskować, że świadomość oraz wiedza studentów fizjoterapii o miejscu sportu i aktywności ruchowej w procesie rehabilitacyjnym są w podobnym stopniu kształtowane w uczelniach o różnych profilach kierunkowego kształcenia, a tym samym samoidentyfikacja kandydatów do studiów oraz powołanie do zawodu są istotnym elementem w tym procesie.