64 results on '"Natkaniec M"'
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2. Final report on practical assessment of the RESCUE architecture:ICT-619555 RESCUE D4.4 Version 1.0
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Schneider, C. (Christian), Skoblikov, O. (Oleksii), Lorenz, M. (Mario), Hollmach, N. (Nils), Käske, M. (Martin), Natkaniec, M. (Marek), Sikora, M. (Marek), Kosek-Szott, K. (Katarzyna), Szott, S. (Szymon), Wszołek, J. (Jacek), Gozdecki, J. (Janusz), Łoziak, K. (Krzysztof), Prasnal, Ł. (Łukasz), Sośnik, S. (Sebastian), Trzeciakowski, Ł. (Łukasz), Adigun, O. (Olayinka), Pavlatos, N. (Nikos), Khalife, H. (Hicham), Seddar, J. (Jawad), Tervo, V. (Valtteri), Paatelma, A. (Anton), He, J. (Jiguang), and Jokinen, M. (Markku)
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validation ,wireless networks ,OTAinVEE ,VANET ,demonstration ,V2V ,channel modelling ,public safety operations ,channel sounding ,lossy links ,multi-hop communication ,SDR ,verification - Abstract
This deliverable summarizes the practical assessment of the links-on-the-fly concept. To do so, a software and hardware integration based on GNU Radio and SDR devices has been performed. Intensive verification and validation within three different testing facilities provided a stable framework for the subsequent assessment. The evaluation strategy comprises experiments under controllable and reproducible test conditions considering the OTAinVEE approach followed by field trials in an indoor testbed emulating the public safety use case, as well as outdoor tests emulating the V2V scenario. Finally, the outcomes of the practical evaluations are compared and analyzed jointly. These results are also analyzed in the light of previous outcomes from other work packages within the RESCUE project. Executive summary D4.4 is the final report of WP4. It presents the software and hardware integration into the selected SDR platform as well as the functional validation and first results within the OTAinVEE test facility. Moreover, two real field experimental trials have been planned and conducted for an indoor and outdoor scenario respectively. The deliverable aims to close the performance validation circle envisaged within the RESCUE project: increasing degree of realistic assumptions during the specific validation stages starting from WP1 over to WP2 and WP3 and finally to WP4. However, real field experiments are usually limited by the number of device deployments, capabilities of the selected software and hardware platform as well as limits in the available experimental time-frame. Therefore, the reported experiments cover the basic scenarios TS0 and TS1, consisting of two and three nodes, respectively. The deliverable consists of four main parts. The first part gives a detailed technical background of the software and hardware framework used to incorporate the RESCUE architecture. For this reason, and in order to obtain stable, reproducible and trustable results, the open-source GNU Radio framework and USRPs from Ettus/National Instruments have been selected as a compromise between flexibility, performance, and costs. Standard building blocks from GNU Radio have been customized to provide a basic physical and MAC layout. Contributions from WP2 and WP3 in terms of implemented software blocks were integrated, including the RESCUE coding algorithms (from WP2) and the network protocols (from WP3). Besides iterative bug fixing and code optimization, the challenging tasks during the testbed verification were the frame synchronization, SNR estimation, and calibration of the testbeds between different WP4 partners. The second part summarizes the verification and experiments based on the OTAinVEE (over-the-air in a virtual electromagnetic environment) concept. Within RESCUE, this specific validation stage turned out to be very valuable since the controllable and reproducible test conditions allowed for deep software and hardware verification followed by intensive performance validation before the real field experiments were conducted. The third part of the deliverable focuses on the real field experiments. Initially, trials were planned only for the public safety scenario with a focus on an indoor deployment. For the V2V use case, performance studies based on the OTAinVEE framework had been programmed. However, following the recommendation from the RESCUE reviewers suggesting to study the RESCUE architecture not only under synthesized traffic and propagation conditions but also to conduct real field experiments, the consortium deployed additional efforts for this purpose. Consequently, for both deployments the technical configuration and experimental test plan are detailed in this document. Whereby for the V2V setup one of the challenging parts was to integrate an efficient hence remote access to each mobile node in such a way that the individual measurements could be configured and started while the vehicles were moving. Numerous experiments have been conducted in particular for TS0 PHY and MAC as well as for TS1. However, other scenarios or more intense trials have been limited by the enormous time consumption of each single test to provide enough datasets fulfilling statistical means. The fourth part of D4.4 provides final assessments and conclusions. It aims to bridge the research and validation methods used within the RESCUE project and their subsequent performance results. The considered stages of performance validation balance between realism and simplification while moving from theory to practice. Results from three different WPs: WP2, WP3 as well as WP4 are discussed and related among each other. From the validation method perspective it can be concluded that this project was able to research the capabilities of the links-on-the-fly concept with a very ambitious approach bridging the ineluctable gap between theory and practice. It was found that the gains of this new architecture are impacted by the implementation of more practical-oriented validation methods of increasing complexity. A detailed analysis identifying the potential impact of the validation methodologies on the given results, e.g., the small number of nodes during the experiments or constraints by the software and hardware implementation and integration of the test platform, are left for future study.
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- 2016
3. Final dissemination, standardization and exploitation report:ICT- 619555 RESCUE D5.6 Version 1.0
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Yi, N. (Na), Natkaniec, M. (Marek), Tervo, V. (Valtteri), He, J. (Jiguang), Wolf, A. (Albrecht), Kuehlmorgen, S. (Sebastian), Matsumoto, T. (Tad), Kaeske, M. (Martin), and Khalife, H. (Hicham)
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workshop ,journal ,Academic ,dissemination ,exploitation ,conference - Abstract
This document summaries the information on the dissemination and exploitation activities that have taken place during the RESCUE project. Through the academic dissemination and exploitation activates, RESCUE has (co)-organised and participated at workshops, organised summer school, published research results, engaged in teaching and training of students, participated in EC activities, and setup a project website, twitter account, LinkedIn group and YouTube channel. Among the dissemination and exploitation in standardisation and regulation, RESCUE has provided contributions to ITU-R and 3GPP meeting, and delivered the impact of RESCUE research to industry and economics. Executive summary This document describes the activities for dissemination and exploitation of academic research that has been conducted in the RESCUE project. The project proposes the integrated “links-on-the-fly” concept, which encompasses the key technologies of distributed joint source/channel coding, to achieve successful and robust information transfer through multi-path networks, such as public safety scenario or vehicle-to-vehicle (V2V) scenario, which are constructed from lossy point-to-point links. The research results have been published in many world leading journals, conferences and workshops. The number of publications is 17 journal papers and 51 conference/workshop papers. This report lists the details of where the results of RESCUE project have been published, and where the research has been disseminated. For instance, RESCUE has (co)-organised a workshop with DIWINE in conjunction with ICC 2015, and organised summer school in 2015 in Oulu, Finland. Moreover, RESCUE has engaged in teaching and training of students in the form of lectures, tutorials, and by conducting research work in M.Sc. and Ph.D. courses. In addition, RESCUE has participated in EC activities, set up a project website, Twitter account, LinkedIn group and YouTube channel. These activities were successfully conducted and providing great publicity to the project. Among the dissemination and exploitation in standardisation and regulation, RESCUE has also provided its contributions to ITU-R and 3GPP meeting, and delivered the impact of RESCUE research to industry and economics.
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- 2016
4. The Risks of WiFi Flexibility: Enabling and Detecting Cheating
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Szott, S., Gozdecki, J., Kosek-Szott, K., Łoziak, K., Natkaniec, M., Ilenia TINNIRELLO, Szott, S, Gozdecki, J, Kosek-Szott, K, Loziak, K, Natkaniec, M, and Tinnirello, I
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flexibility ,misbehavior ,Settore ING-INF/03 - Telecomunicazioni ,WiFi ,cheating - Abstract
Flexibility is an important paradigm for future WiFi networks. However, it also opens the possibility for diverse methods of cheating, which users can perform to increase their throughput. Therefore, it is important to develop the necessary tools to mitigate such efforts. In this paper we first discuss the risks of flexibility in terms of misbehaviour. We then propose an architecture to detect misbehaviour and react by punishing the cheaters. The proposed architecture utilizes advanced passive monitoring, flexible WiFi software, and appropriate reasoning to detect cheating. We validate its performance and discuss means of punishment
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- 2013
5. Supporting carrier grade services over wireless mesh networks
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Azcorra, A., Banniza, T., Chieng, D., Fitzpatrick, J., Hugo, D. von, Natkaniec, M., Robitzsch, S., Zdarsky, F., and Publica
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- 2009
6. 3D Markov chain-based saturation throughput model of IEEE 802.11 EDCA
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Gas, M., primary, Natkaniec, M., additional, Pach, A.R., additional, and Kosek-Szott, K., additional
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- 2011
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7. Detecting backoff misbehaviour in IEEE 802.11 EDCA
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Szott, S., primary, Natkaniec, M., additional, and Canonico, R., additional
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- 2010
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8. Supporting carrier grade services over wireless mesh networks: The approach of the European FP-7 STREP CARMEN [Very Large Projects]
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Azcorra, A., primary, Banniza, T., additional, Chieng, D., additional, Fitzpatrick, J., additional, Von-Hugo, D., additional, Natkaniec, M., additional, Robitzsch, Sebastian, additional, and Zdarsky, Frank, additional
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- 2009
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9. Ubiquitous Access through the Integration of Mobile Ad-hoc Networks
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Sargento, S., primary, Sarro, R., additional, Duarte, R., additional, Stupar, P., additional, Gallera, F., additional, Natkaniec, M., additional, Vilela, J.P., additional, and Barros, J., additional
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- 2007
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10. High-fidelity Multichannel Audio Coding / OFDM for Wireless Communications Systems [Book Reviews
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Natkaniec, M., primary and Wagrowski, M., additional
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- 2005
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11. Voice Over 802.11 (Ohrtman, F.; 2004) [Book Review]
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Natkaniec, M., primary
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- 2005
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12. Protocols for high-efficiency wireless networks [Book Review
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Natkaniec, M., primary
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- 2004
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13. BusySiMOn - A New Protocol for IEEE 802.11 EDCA-Based Ad-Hoc Networks with Hidden Nodes.
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Kosek-Szott, K., Natkaniec, M., and Pach, A.R.
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- 2010
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14. Monitoring system for carrier grade mesh networks.
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Loziak, K., Natkaniec, M., Gozdecki, J., Chin, E., Chieng, D., and Teh, V.
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- 2010
15. CARMEN: Delivering carrier grade services over wireless mesh networks.
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Banchs, A., Bayer, N., David Chieng, de la Oliva, A., Gloss, B., Kretschme, M., Murphyk, S., Natkaniec, M., and Zdarsky, F.
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- 2008
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16. An Analysis of Star Topology IEEE 802.11e Networks in the Presence of Hidden Nodes.
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Kosek, K., Natkaniec, M., Vollero, L., and Pach, A.R.
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- 2008
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17. Impact of Contention Window Cheating on Single-Hop IEEE 802.11e MANETs.
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Szott, S., Natkaniec, M., Canonico, R., and Pach, A.R.
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- 2008
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18. Wireless LAN standards and applications [Book Review]
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Natkaniec, M., primary
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- 2002
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19. A QoS architecture integrating mobile Ad-Hoc and infrastructure networks.
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Crisostomo, S., Sargento, S., Natkaniec, M., and Vicari, N.
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- 2005
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20. An analysis of the backoff mechanism used in IEEE 802.11 networks.
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Natkaniec, M. and Pach, A.R.
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- 2000
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21. Detecting backoff misbehaviour in IEEE 802.11 EDCA.
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Szott, S., Natkaniec, M., and Canonico, R.
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- 2011
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22. Standardization of an Autonomicity-Enabled Mesh Architecture Framework, from ETSI-AFI Group perspective: Work in Progress (Part 2 of 2)
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Szott, S., Wodczak, M., Chaparadza, R., Ben Meriem, T., Tsagkaris, K., Kousaridas, A., Radier, B., Mihailovic, A., Natkaniec, M., Loziak, K., Katarzyna Kosek-Szott, Wagrowski, M., and Ieee
23. An analysis of the backoff mechanism used in IEEE 802.11 networks
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Natkaniec, M. and Andrzej Pach
24. CLF-MAC: A Coordinated MAC Protocol Supporting Lossy Forwarding in WLANs
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Katarzyna Kosek-Szott, Natkaniec, M., Prasnal, L., Szott, S., and Ieee
25. PUMA - a new channel access protocol for wireless LANs
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Natkaniec, M., primary and Pach, A.R., additional
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26. An analysis of the backoff mechanism used in IEEE 802.11 networks
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Natkaniec, M., primary and Pach, A.R., additional
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27. An analysis of the influence of the threshold parameter on the IEEE 802.11 network performance
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Natkaniec, M., primary and Pach, A.R., additional
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28. A QoS architecture integrating mobile Ad-Hoc and infrastructure networks
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Crisostomo, S., primary, Sargento, S., additional, Natkaniec, M., additional, and Vicari, N., additional
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29. Performance Analysis of 802.11e Networks with Hidden Nodes in a Star Topology.
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Kosek, K., Natkaniec, M., Vollero, L., and Pach, A.R.
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- 2008
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30. An IEEE 802.11 EDCA Model with Support for Analysing Networks with Misbehaving Nodes
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Szott Szymon, Natkaniec Marek, and Pach AndrzejR
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Telecommunication ,TK5101-6720 ,Electronics ,TK7800-8360 - Abstract
We present a novel model of IEEE 802.11 EDCA with support for analysing networks with misbehaving nodes. In particular, we consider backoff misbehaviour. Firstly, we verify the model by extensive simulation analysis and by comparing it to three other IEEE 802.11 models. The results show that our model behaves satisfactorily and outperforms other widely acknowledged models. Secondly, a comparison with simulation results in several scenarios with misbehaving nodes proves that our model performs correctly for these scenarios. The proposed model can, therefore, be considered as an original contribution to the area of EDCA models and backoff misbehaviour.
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- 2010
31. PUMA - a new channel access protocol for wireless LANs.
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Natkaniec, M. and Pach, A.R.
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- 2002
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32. An analysis of the influence of the threshold parameter on the IEEE 802.11 network performance.
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Natkaniec, M. and Pach, A.R.
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- 2000
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33. What's New for QoS in IEEE 802.11?
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Andrey Lyakhov, Ilenia Tinnirello, Marek Natkaniec, Artem Krasilov, Alexander A. Safonov, Szymon Szott, Katarzyna Kosek-Szott, Kosek-Szott, K., Krasilov, A, Lyakhov, A., Natkaniec, M., Safonov, A., Szott, S., and Tinnirello, I.
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Multicast ,Computer Networks and Communications ,business.industry ,Computer science ,Settore ING-INF/03 - Telecomunicazioni ,Quality of service ,Quality of Service ,Provisioning ,Mobile QoS ,IEEE 802.11 ,Hardware and Architecture ,Reliable multicast ,IEEE 802.11e-2005 ,Video streaming ,business ,Software ,Wireless network ,Information Systems ,Computer network - Abstract
Two amendments to IEEE 802.11 have recently been published: 802.11aa and 802.11ae. Both enhance Quality of Service (QoS) provisioning in Wi-Fi networks by providing support for multicast transmission, enhanced audio video streaming, coping with inter-network interference, and improved prioritization of management frames. The proposed solutions either extend mechanisms already existing in the standard or introduce new ones. Therefore, it is important for researchers to understand the new functionalities. To this end we provide the first description of these latest mechanisms: we present the motivation behind them, explain their design principles, provide examples of usage, and comment on compatibility issues. Finally, we identify new research challenges related to the two new amendments.
34. Wireless Local Area Networks Threat Detection Using 1D-CNN.
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Natkaniec M and Bednarz M
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- Communication, Floods, Food, Local Area Networks, Algorithms
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Wireless Local Area Networks (WLANs) have revolutionized modern communication by providing a user-friendly and cost-efficient solution for Internet access and network resources. However, the increasing popularity of WLANs has also led to a rise in security threats, including jamming, flooding attacks, unfair radio channel access, user disconnection from access points, and injection attacks, among others. In this paper, we propose a machine learning algorithm to detect Layer 2 threats in WLANs through network traffic analysis. Our approach uses a deep neural network to identify malicious activity patterns. We detail the dataset used, including data preparation steps, such as preprocessing and division. We demonstrate the effectiveness of our solution through series of experiments and show that it outperforms other methods in terms of precision. The proposed algorithm can be successfully applied in Wireless Intrusion Detection Systems (WIDS) to enhance the security of WLANs and protect against potential attacks.
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- 2023
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35. An Analysis of the Mixed IEEE 802.11ax Wireless Networks in the 5 GHz Band.
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Natkaniec M and Bieryt N
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This paper presents an analysis of the IEEE 802.11ax networks' coexistence with legacy stations, namely IEEE 802.11ac, IEEE 802.11n, and IEEE 802.11a. The IEEE 802.11ax standard introduces several new features that can enhance network performance and capacity. The legacy devices that do not support these features will continue to coexist with newer devices, creating a mixed network environment. This usually leads to a deterioration in the overall performance of such networks; therefore, in the paper, we want to show how we can reduce the negative impact of legacy devices. In this study, we investigate the performance of mixed networks by applying various parameters to both the MAC and PHY layers. We focus on evaluating the impact of the BSS coloring mechanism introduced to the IEEE 802.11ax standard on network performance. We also examine the impact of A-MPDU and A-MSDU aggregations on network efficiency. Through simulations, we analyze the typical performance metrics such as throughput, mean packet delay, and packet loss of mixed networks with different topologies and configurations. Our findings indicate that implementing the BSS coloring mechanism in dense networks can increase throughput by up to 43%. We also show that the presence of legacy devices in the network disrupts the functioning of this mechanism. To address this, we recommend using an aggregation technique, which can improve throughput by up to 79%. The presented research revealed that it is possible to optimize the performance of mixed IEEE 802.11ax networks.
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- 2023
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36. The ChoCO-W prospective observational global study: Does COVID-19 increase gangrenous cholecystitis?
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De Simone B, Abu-Zidan FM, Chouillard E, Di Saverio S, Sartelli M, Podda M, Gomes CA, Moore EE, Moug SJ, Ansaloni L, Kluger Y, Coccolini F, Landaluce-Olavarria A, Estraviz-Mateos B, Uriguen-Etxeberria A, Giordano A, Luna AP, Amín LAH, Hernández AMP, Shabana A, Dzulkarnaen ZA, Othman MA, Sani MI, Balla A, Scaramuzzo R, Lepiane P, Bottari A, Staderini F, Cianchi F, Cavallaro A, Zanghì A, Cappellani A, Campagnacci R, Maurizi A, Martinotti M, Ruggieri A, Jusoh AC, Rahman KA, Zulkifli ASM, Petronio B, Matías-García B, Quiroga-Valcárcel A, Mendoza-Moreno F, Atanasov B, Campanile FC, Vecchioni I, Cardinali L, Travaglini G, Sebastiani E, Chooklin S, Chuklin S, Cianci P, Restini E, Capuzzolo S, Currò G, Filippo R, Rispoli M, Aparicio-Sánchez D, Muñóz-Cruzado VD, Barbeito SD, Delibegovic S, Kesetovic A, Sasia D, Borghi F, Giraudo G, Visconti D, Doria E, Santarelli M, Luppi D, Bonilauri S, Grossi U, Zanus G, Sartori A, Piatto G, De Luca M, Vita D, Conti L, Capelli P, Cattaneo GM, Marinis A, Vederaki SA, Bayrak M, Altıntas Y, Uzunoglu MY, Demirbas IE, Altinel Y, Meric S, Aktimur YE, Uymaz DS, Omarov N, Azamat I, Lostoridis E, Nagorni EA, Pujante A, Anania G, Bombardini C, Bagolini F, Gonullu E, Mantoglu B, Capoglu R, Cappato S, Muzio E, Colak E, Polat S, Koylu ZA, Altintoprak F, Bayhan Z, Akin E, Andolfi E, Rezart S, Kim JI, Jung SW, Shin YC, Enciu O, Toma EA, Medas F, Canu GL, Cappellacci F, D'Acapito F, Ercolani G, Solaini L, Roscio F, Clerici F, Gelmini R, Serra F, Rossi EG, Fleres F, Clarizia G, Spolini A, Ferrara F, Nita G, Sarnari J, Gachabayov M, Abdullaev A, Poillucci G, Palini GM, Veneroni S, Garulli G, Piccoli M, Pattacini GC, Pecchini F, Argenio G, Armellino MF, Brisinda G, Tedesco S, Fransvea P, Ietto G, Franchi C, Carcano G, Martines G, Trigiante G, Negro G, Vega GM, González AR, Ojeda L, Piccolo G, Bondurri A, Maffioli A, Guerci C, Sin BH, Zuhdi Z, Azman A, Mousa H, Al Bahri S, Augustin G, Romic I, Moric T, Nikolopoulos I, Andreuccetti J, Pignata G, D'Alessio R, Kenig J, Skorus U, Fraga GP, Hirano ES, de Lima Bertuol JV, Isik A, Kurnaz E, Asghar MS, Afzal A, Akbar A, Nikolouzakis TK, Lasithiotakis K, Chrysos E, Das K, Özer N, Seker A, Ibrahim M, Hamid HKS, Babiker A, Bouliaris K, Koukoulis G, Kolla CC, Lucchi A, Agostinelli L, Taddei A, Fortuna L, Agostini C, Licari L, Viola S, Callari C, Laface L, Abate E, Casati M, Anastasi A, Canonico G, Gabellini L, Tosi L, Guariniello A, Zanzi F, Bains L, Sydorchuk L, Iftoda O, Sydorchuk A, Malerba M, Costanzo F, Galleano R, Monteleone M, Costanzi A, Riva C, Walędziak M, Kwiatkowski A, Czyżykowski Ł, Major P, Strzałka M, Matyja M, Natkaniec M, Valenti MR, Di Vita MDP, Sotiropoulou M, Kapiris S, Massalou D, Veroux M, Volpicelli A, Gioco R, Uccelli M, Bonaldi M, Olmi S, Nardi M, Livadoti G, Mesina C, Dumitrescu TV, Ciorbagiu MC, Ammendola M, Ammerata G, Romano R, Slavchev M, Misiakos EP, Pikoulis E, Papaconstantinou D, Elbahnasawy M, Abdel-Elsalam S, Felsenreich DM, Jedamzik J, Michalopoulos NV, Sidiropoulos TA, Papadoliopoulou M, Cillara N, Deserra A, Cannavera A, Negoi I, Schizas D, Syllaios A, Vagios I, Gourgiotis S, Dai N, Gurung R, Norrey M, Pesce A, Feo CV, Fabbri N, Machairas N, Dorovinis P, Keramida MD, Mulita F, Verras GI, Vailas M, Yalkin O, Iflazoglu N, Yigit D, Baraket O, Ayed K, Ghalloussi MH, Patias P, Ntokos G, Rahim R, Bala M, Kedar A, Sawyer RG, Trinh A, Miller K, Sydorchuk R, Knut R, Plehutsa O, Liman RK, Ozkan Z, Kader SA, Gupta S, Gureh M, Saeidi S, Aliakbarian M, Dalili A, Shoko T, Kojima M, Nakamoto R, Atici SD, Tuncer GK, Kaya T, Delis SG, Rossi S, Picardi B, Del Monte SR, Triantafyllou T, Theodorou D, Pintar T, Salobir J, Manatakis DK, Tasis N, Acheimastos V, Ioannidis O, Loutzidou L, Symeonidis S, de Sá TC, Rocha M, Guagni T, Pantalone D, Maltinti G, Khokha V, Abdel-Elsalam W, Ghoneim B, López-Ruiz JA, Kara Y, Zainudin S, Hayati F, Azizan N, Khei VTP, Yi RCX, Sellappan H, Demetrashvili Z, Lekiashvili N, Tvaladze A, Froiio C, Bernardi D, Bonavina L, Gil-Olarte A, Grassia S, Romero-Vargas E, Bianco F, Gumbs AA, Dogjani A, Agresta F, Litvin A, Balogh ZJ, Gendrikson G, Martino C, Damaskos D, Pararas N, Kirkpatrick A, Kurtenkov M, Gomes FC, Pisanu A, Nardello O, Gambarini F, Aref H, Angelis ND, Agnoletti V, Biondi A, Vacante M, Griggio G, Tutino R, Massani M, Bisetto G, Occhionorelli S, Andreotti D, Lacavalla D, Biffl WL, and Catena F
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- Male, Humans, Middle Aged, Female, Pandemics, SARS-CoV-2, Postoperative Complications epidemiology, COVID-19 epidemiology, Cholecystitis epidemiology, Cholecystitis surgery, Cholecystitis, Acute epidemiology, Cholecystitis, Acute surgery, Sepsis
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Background: The incidence of the highly morbid and potentially lethal gangrenous cholecystitis was reportedly increased during the COVID-19 pandemic. The aim of the ChoCO-W study was to compare the clinical findings and outcomes of acute cholecystitis in patients who had COVID-19 disease with those who did not., Methods: Data were prospectively collected over 6 months (October 1, 2020, to April 30, 2021) with 1-month follow-up. In October 2020, Delta variant of SARS CoV-2 was isolated for the first time. Demographic and clinical data were analyzed and reported according to the STROBE guidelines. Baseline characteristics and clinical outcomes of patients who had COVID-19 were compared with those who did not., Results: A total of 2893 patients, from 42 countries, 218 centers, involved, with a median age of 61.3 (SD: 17.39) years were prospectively enrolled in this study; 1481 (51%) patients were males. One hundred and eighty (6.9%) patients were COVID-19 positive, while 2412 (93.1%) were negative. Concomitant preexisting diseases including cardiovascular diseases (p < 0.0001), diabetes (p < 0.0001), and severe chronic obstructive airway disease (p = 0.005) were significantly more frequent in the COVID-19 group. Markers of sepsis severity including ARDS (p < 0.0001), PIPAS score (p < 0.0001), WSES sepsis score (p < 0.0001), qSOFA (p < 0.0001), and Tokyo classification of severity of acute cholecystitis (p < 0.0001) were significantly higher in the COVID-19 group. The COVID-19 group had significantly higher postoperative complications (32.2% compared with 11.7%, p < 0.0001), longer mean hospital stay (13.21 compared with 6.51 days, p < 0.0001), and mortality rate (13.4% compared with 1.7%, p < 0.0001). The incidence of gangrenous cholecystitis was doubled in the COVID-19 group (40.7% compared with 22.3%). The mean wall thickness of the gallbladder was significantly higher in the COVID-19 group [6.32 (SD: 2.44) mm compared with 5.4 (SD: 3.45) mm; p < 0.0001]., Conclusions: The incidence of gangrenous cholecystitis is higher in COVID patients compared with non-COVID patients admitted to the emergency department with acute cholecystitis. Gangrenous cholecystitis in COVID patients is associated with high-grade Clavien-Dindo postoperative complications, longer hospital stay and higher mortality rate. The open cholecystectomy rate is higher in COVID compared with non -COVID patients. It is recommended to delay the surgical treatment in COVID patients, when it is possible, to decrease morbidity and mortality rates. COVID-19 infection and gangrenous cholecystistis are not absolute contraindications to perform laparoscopic cholecystectomy, in a case by case evaluation, in expert hands., (© 2022. The Author(s).)
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- 2022
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37. Laparoscopic adrenalectomy - is it safe in hands of residents in training?
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Dworak J, Wysocki M, Rzepa A, Natkaniec M, Pędziwiatr M, Budzyński A, and Major P
- Subjects
- Adrenalectomy adverse effects, Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Retrospective Studies, Young Adult, Adrenal Gland Neoplasms surgery, Adrenalectomy methods, Clinical Competence, General Surgery education, Internship and Residency, Laparoscopy adverse effects
- Abstract
Background: Laparoscopic adrenalectomy (LA) has become the "gold standard" for treating most adrenal tumors in the past decade. However, it is still considered a relatively complicated procedure requiring experience from surgeon. The aim of the study was to evaluate the safety of laparoscopic adrenalectomy performed by residents who are undergoing training in general surgery., Methods: A prospectively collected database containing all 300 transperitoneal laparoscopic adrenalectomies performed in II Department of General Surgery JU MC, Krakow between January 2013 and March 2018 was retrospectively reviewed. Patients were divided into two groups; patients operated on by residents (group 1, 54 operations) and by attending general surgeons (group 2, 246 operations). We compared the course of the operation and patient hospitalization in these two groups. If the operation was completed by a different person than the one who started the procedure, we refer to this as "operator conversion"., Results: We found no differences in demographic factors or comorbidities between the two groups. The mean operative time was similar in the residents' and the specialists' groups (p = 0.5761). Median blood loss did not differ between the groups (p = 0.4325). The overall ratio of intraoperative adverse events was similar in both groups (p = 0.8643). The difference in the ratio of perioperative complications between the groups was not statistically significant (p = 0.6442). The average mean hospital stay after surgery was 2 days for both groups. We identified 25 cases (8.33%) of operator conversion; the difference in operator conversions between two groups was not statistically significant (p = 0.1741)., Conclusions: Laparoscopic transperitoneal adrenalectomy performed by a supervised resident is a safe procedure. The course of the operation and patient hospitalization did not differ importantly when comparing procedures performed by residents and attending surgeons. Liberal use of operator conversions from resident to attending surgeon and from a surgeon to a senior surgeon provides reasonable safety and prevents complications. In high-volume centers performing minimally invasive techniques, closed supervision allows residents to safely perform LA.
- Published
- 2019
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38. Short- and long-term results of laparoscopic adrenalectomy for Conn's syndrome.
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Wierdak M, Sokołowski G, Natkaniec M, Morawiec-Sławek K, Małczak P, Major P, Hubalewska-Dydejczyk A, Budzyński A, and Pędziwiatr M
- Abstract
Introduction: The primary treatment of Conn's syndrome (CS) is laparoscopic adrenalectomy and aims to normalize arterial blood pressure and biochemical parameters., Aim: To analyse short- and long-term results of laparoscopic adrenalectomy for Conn's syndrome (CS)., Material and Methods: The analysis included 44 consecutive patients, who underwent laparoscopic adrenalectomy between 2004 and 2015 for CS. We analysed short- and long-terms results of operations. All patients were followed up 6 and 24 months after surgery to determine changes in the biochemical parameters, and clinical regression of arterial hypertension. We also evaluated the aldosteronoma resolution score (ARS) in predicting the resolution of hypertension., Results: No conversions were needed. Complications occurred in 5 (11.4%) patients. Preoperative hypokalaemia and hypernatraemia were present in 83.4% and 15.8% of patients, respectively. After surgery, both hypokalaemia and hypernatraemia resolved in all patients. At the follow-up 6 months after the surgery, only 11.3% of patients had complete remission (CR) of hypertension. In 43.2% of cases we observed partial remission (PR). After 24 months CR was found in 13.6% of patients, 45.5% patients fulfilled criteria for PR, and 29.5% of patients changed the group of remission comparison to the first follow-up visit. Only 50% of patients with an ARS of 4 or 5 points achieved CR 6 months after surgery., Conclusions: Laparoscopic adrenalectomy is a safe method of treatment for CS. Although it effectively eliminates electrolyte imbalance, it does not allow for the CR of hypertension in the majority of patients, especially in the elderly group. We did not find ARS to be an effective tool in predicting postoperative resolution of hypertension.
- Published
- 2018
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39. Analysis of Laparoscopic Sleeve Gastrectomy Learning Curve and Its Influence on Procedure Safety and Perioperative Complications.
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Major P, Wysocki M, Dworak J, Pędziwiatr M, Pisarska M, Wierdak M, Zub-Pokrowiecka A, Natkaniec M, Małczak P, Nowakowski M, and Budzyński A
- Subjects
- Adult, Humans, Middle Aged, Obesity, Morbid surgery, Retrospective Studies, Gastrectomy adverse effects, Gastrectomy statistics & numerical data, Laparoscopy adverse effects, Laparoscopy statistics & numerical data, Postoperative Complications epidemiology
- Abstract
Purpose: Laparoscopic sleeve gastrectomy (LSG) has become an attractive bariatric procedure with promising treatment effects yet amount of data regarding institutional learning process is limited., Materials and Methods: Retrospective study included patients submitted to LSG at academic teaching hospital. Patients were divided into groups every 100 consecutive patients. LSG introduction was structured along with Enhanced Recovery after Surgery (ERAS) treatment protocol. Primary endpoint was determining the LSG learning curve's stabilization point, using operative time, intraoperative difficulties, intraoperative adverse events (IAE), and number of stapler firings. Secondary endpoints: influence on perioperative complications and reoperations. Five hundred patients were included (330 females, median age of 40 (33-49) years)., Results: Operative time in G1-G2 differed significantly from G3-G5. Stabilization point was the 200th procedure using operative time. Intraoperative difficulties of G1 differed significantly from G2-G5, with stabilization after the 100th procedure. IAE and number of stapler firings could not be used as predictor. Based on perioperative morbidity, the learning curve was stabilized at the 100th procedure. The morbidity rates in the groups were G1, 13%; G2, 4%; G3, 5%; G4, 5%; and G5, 2%. The reoperation rate in G1 was 3%; G2, 2%; G3, 2%; G4, 1%; and G5, 0%., Conclusion: The institutional learning process stabilization point for LSG in a newly established bariatric center is between the 100th and 200th operation. Initially, the morbidity rate is high, which should concern surgeons who are willing to perform bariatric surgery.
- Published
- 2018
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40. Risk factors for prolonged hospitalization in patients undergoing laparoscopic adrenalectomy.
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Pisarska M, Dworak J, Natkaniec M, Małczak P, Przęczek K, Wysocki M, Major P, Radkowiak D, Budzyński A, and Pędziwiatr M
- Abstract
Introduction: Even though laparoscopic adrenalectomy is currently a standard, there are important variations between different centres in short-term treatment results such as length of hospital stay (LOS) or morbidity., Aim: To determine the factors affecting LOS in patients after laparoscopic transperitoneal lateral adrenalectomy (LTA)., Material and Methods: The study enrolled 453 patients (173 men and 280 women, mean age 57 years) who underwent LTA between 2009 and 2017. Discharge from hospital after more than median hospital stay was considered as prolonged LOS. We evaluated factors that potentially may influence LOS (primary length of stay after surgery, excluding readmissions). Logistic regression models were used in univariate and corrected multivariate analyses, in order to identify the factors related to prolonged LOS., Results: The median LOS after LTA in the studied group was 2 days. One hundred seventy-five (38.5%) patients required prolonged hospitalization. Univariate logistic regression showed that the following factors were related to prolonged LOS: presence of any comorbidity, cardiovascular disease, intraoperative complications, postoperative complications, day of the week of operation (surgery on Thursday or Friday), intraoperative blood loss, need for transfusion, hormonal activity, postoperative drainage, ASA (III-IV) and histological type - pheochromocytoma. Multivariate logistic regression showed that only complications (OR = 3.86; 95% CI: 1.84-8.04), day of the week of operation (Thursday or Friday) (OR = 4.85; 95% CI: 3.04-7.73), need for drainage (OR = 3.63; 95% CI: 1.55-8.52), and histological type - pheochromocytoma (OR = 2.48; 95% CI: 1.35-4.54) prolonged LOS., Conclusions: Prolonged length of hospital stay following laparoscopic transperitoneal lateral adrenalectomy is strongly associated with the presence of postoperative complications, day of the week of operation (Thursday or Friday), need for drainage, and histological type - pheochromocytoma.
- Published
- 2018
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41. Influence of TNF-α promoter variability on stage and grade in individuals with colorectal cancer.
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Natkaniec M, Dworak J, Hankus J, Sanak M, Pędziwiatr M, Major P, Lichołai S, and Budzyński A
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- Case-Control Studies, Genetic Predisposition to Disease, Genotype, Humans, Polymorphism, Single Nucleotide, Colorectal Neoplasms genetics, Promoter Regions, Genetic, Tumor Necrosis Factor-alpha genetics
- Abstract
Carcinogenesis is a multistep process in which inflammation plays an important role. Tumour necrosis factor a (TNF-α) is a cytokine that plays a major role in inflammation. Activity of the TNF cytokine family could influence progression of colorectal cancer (CRC). The aim of the study was to establish an association between TNF-α promoter variability and stage/grade in individuals with sporadic CRC. The study included 152 CRC patients and 107 healthy volunteers. Four single nucleotide polymorphisms (rs361525, rs1800629, rs1799724, and rs1799964) located at the promoter of TNFA gene were genotyped using commercially available TaqMan allelic discrimination assays by real-time PCR. CRC stage was described on the basis of preoperative imaging studies and postoperative histopathological report. The grade was described on the basis postoperative pathological examination of the specimen. In the case of rs361525, there was a statistically significant association with M-score (p = 0.0209). Rs361525 has significant association with tumour grade (p = 0.0260). We failed to demonstrate significant association between the other 3 SNPs and cancer grade. Rs361525 potentially could be under consideration when the survival rate and prognosis is assessed.
- Published
- 2018
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42. Patients criteria determining difficulty of the laparoscopic lateral transperitoneal adrenalectomy. A retrospective cohort study.
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Natkaniec M, Dworak J, Pędziwiatr M, Pisarska M, Major P, Dembiński M, Winiarski M, and Budzyński A
- Subjects
- Adrenalectomy methods, Adult, Aged, Blood Loss, Surgical statistics & numerical data, Body Mass Index, Conversion to Open Surgery statistics & numerical data, Female, Humans, Intraoperative Complications epidemiology, Intraoperative Complications etiology, Laparoscopy methods, Logistic Models, Male, Middle Aged, Multivariate Analysis, Operative Time, Peritoneum surgery, Retrospective Studies, Risk Factors, Adrenal Gland Neoplasms surgery, Adrenalectomy adverse effects, Laparoscopy adverse effects, Patient Selection
- Abstract
Background: Identification of patients in whom adrenalectomy may be more difficult, can help in decision making in borderline and doubtful cases. The aim of the study was to determine patients criteria influencing difficulty of laparoscopic lateral transperitoneal adrenalectomy (LTA)., Material and Methods: The study enrolled 275 patients who underwent LTA. We analyzed the impact of gender, age, history of previous abdominal surgery, body mass index, risk of anesthesia measured as ASA scale, size, localization (left/right), and histological type of the tumor on parameters reflecting the level of difficulty of the procedure: operative time, intraoperative blood loss, conversion rate and intraoperative complications rate., Results: Multivariate logistic regression showed that following factors were associated with longer operative time: gender, tumor size and malignant lesions. In another model it was shown that age, size of the tumor and malignancy were associated with more excessive blood loss. Moreover, it was shown, that tumor size predictive factor for conversion. Univariate analysis showed a relation with malignancy, but multivariate analysis revealed no significance., Conclusions: Patient age, gender, size and histological type of the tumor are criteria influencing parameters reflecting the level of difficulty. This criteria could be considered as predictors of the difficulty of LTA. Surgery in case of patients with combination of this risk factors should be handled by surgeon with sufficient experience to minimalize the risk of adverse events., (Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2017
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43. Laparoscopic transperitoneal adrenalectomy in morbidly obese patients is not associated with worse short-term outcomes.
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Pędziwiatr M, Major P, Pisarska M, Natkaniec M, Godlewska M, Przęczek K, Dworak J, Dembiński M, Zub-Pokrowiecka A, and Budzyński A
- Subjects
- Adrenal Gland Neoplasms complications, Adrenal Glands surgery, Adrenalectomy methods, Adult, Aged, Blood Loss, Surgical statistics & numerical data, Body Mass Index, Conversion to Open Surgery statistics & numerical data, Feasibility Studies, Female, Humans, Laparoscopy methods, Length of Stay statistics & numerical data, Male, Middle Aged, Operative Time, Peritoneal Cavity surgery, Postoperative Complications etiology, Retrospective Studies, Treatment Outcome, Adrenal Gland Neoplasms surgery, Adrenalectomy adverse effects, Laparoscopy adverse effects, Obesity, Morbid complications, Postoperative Complications epidemiology
- Abstract
Objectives: To evaluate the impact of obesity and morbid obesity on short-term outcomes after laparoscopic adrenalectomy., Methods: The study included 520 consecutive patients undergoing laparoscopic adrenalectomy for adrenal tumor. The entire study group was divided depending on the body mass index: group 1 (normal weight), <25 kg/m
2 ; group 2 (overweight), 25-30 kg/m2 ; and group 3 (obese) 30-40 kg/m2 . Additionally, group 4 (morbidly obese) was distinguished. Study end-points were: operative time, intraoperative blood loss, total length of hospital stay, morbidity rate and 30-day readmission rate., Results: The mean operative times were 88.8, 94.7, 93.5, and 99.9 min in groups 1, 2, 3 and 4, respectively (P = 0.1444). Complications were comparable between groups (12.8% vs 8.8% vs 8.2% vs 11.5%, P = 0.5295). The mean intraoperative blood loss was 66.8 versus 78.3 versus 60.7 versus 92.4, P = 0.1399. There were no differences in conversion rate between groups., Conclusions: Obesity has no influence on short-term outcomes of laparoscopic transperitoneal adrenalectomy. This procedure is feasible regardless of the body mass index. Therefore, it can be offered to all patient groups including those morbidly obese individuals in whose case preoperative weight loss seems unnecessary., (© 2016 The Japanese Urological Association.)- Published
- 2017
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44. Gastrointestinal obstruction in patients previously treated for malignancies.
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Budzyński P, Pędziwiatr M, Kenig J, Lasek A, Winiarski M, Major P, Wałęga P, Natkaniec M, Rubinkiewicz M, Rogala J, and Budzyński A
- Subjects
- Aged, Female, Humans, Male, Middle Aged, Poland, Retrospective Studies, Abdominal Neoplasms complications, Abdominal Neoplasms surgery, Digestive System Surgical Procedures adverse effects, Intestinal Obstruction etiology, Intestinal Obstruction surgery, Postoperative Complications etiology, Tissue Adhesions surgery
- Abstract
Unlabelled: Bowel obstruction is a common condition in acute surgery. Among the patients, those with a history of cancer consist a particular group. Difficulties in preoperative diagnosis - whether obstruction is benign or malignant and limited treatment options in patients with reoccurrence or dissemination of the cancer are typical for this group. The aim of the study was to analyze causes of bowel obstruction in patients with history of radical treatment due to malignancy., Material and Methods: Patients with symptoms of bowel obstruction and history of radical treatment for malignancy who were operated in 2nd and 3rd Department of General Surgery JUCM between 2000 and 2014 were included into the study. The patients were divided into 2 groups based on type of mechanical bowel obstruction (group 1 - adhesions, group 2 - malignant process)., Results: 128 patients were included into the study - group 1: 67 (52.3%) and group 2: 61 (47.7%). In the second group bowel obstruction was caused by reoccurrence in 25 patients (40.98%) and dissemination in 36 (59.02%). The mean time between onset of the symptoms of bowel obstruction and the end of treatment for the cancer was 3.7 and 4.4 years, respectively in group 1 and 2 (p>0.05). Median time between onset of the symptoms and admission to Emergency Department was significantly longer in patients with malignant bowel obstruction compared to those with adhesions (11.6 ±17.8 days vs 5.1 ± 6.9 days, p=0.01). Considering type of surgery due to bowel obstruction, in first group in most patients (69.2%) bowel resection was not necessary and in the second group creation of jejuno-, ileo- or colostomy was the most common procedure. Morbidity was significantly higher in second group (45.9% vs 28.26%, p<0.05) but there was no difference in mortality (26% vs 24%, p>0.05). In both groups the most common localization of primary malignancy was colon., Conclusions: In analyzed group of patients frequency of bowel obstruction caused by adhesions and malignancy was similar. However, in patients with bowel obstruction caused by malignancy morbidity was significantly higher and duration of symptoms was longer. There was no diagnostic procedure which would allow to differentiate the cause of bowel obstruction preoperatively and the diagnosis was made during the operation.
- Published
- 2016
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45. Laparoscopic Transperitoneal Lateral Adrenalectomy for Large Adrenal Tumors.
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Natkaniec M, Pędziwiatr M, Wierdak M, Major P, Migaczewski M, Matłok M, Budzyński A, and Rembiasz K
- Subjects
- Adrenal Gland Neoplasms pathology, Female, Humans, Male, Middle Aged, Peritoneum, Tumor Burden, Adrenal Gland Neoplasms surgery, Adrenalectomy methods, Laparoscopy
- Abstract
Background: Laparoscopic adrenalectomy is the gold standard for treatment of benign adrenal lesions. Tumor size is a factor that might influence decision-making concerning the use of laparoscopic approach. The aim of this study was to analyze the results of adrenalectomy for tumors ≥6 cm in diameter., Methods: Two groups of patients were analyzed: first group comprised 441 patients with tumors <6 cm in diameter and second group consisted of 89 patients with tumors ≥6 cm. Both groups were compared with regard to the duration of surgery, intraoperative blood loss, conversion and complications rate., Results: Median duration of surgery in groups 1 and 2 amounted to 86.6 and 111.9 min (p < 0.0001), respectively. Median intraoperative blood loss in groups 1 and 2 was 56.5 and 172.8 ml (p < 0.0001), respectively. There was a linear relationship between tumor size and the duration of surgery, and between tumor size and intraoperative blood loss (p < 0.0001). There were 2 (0.5%) and 6 (6.7%) conversions in groups 1 and 2, respectively. There were 41 (9.3%) and 14 (15.7%) complications in groups 1 and 2 (p = 0.0692), respectively., Conclusions: Laparoscopic adrenalectomy of tumors ≥6 cm is more difficult, but it can be regarded safe and beneficial for patients., (© 2016 S. Karger AG, Basel.)
- Published
- 2016
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46. Enhanced Recovery After Surgery (ERAS®) protocol in patients undergoing laparoscopic resection for stage IV colorectal cancer.
- Author
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Pędziwiatr M, Pisarska M, Kisielewski M, Major P, Matłok M, Wierdak M, Natkaniec M, and Budzyński A
- Subjects
- Aged, Colorectal Neoplasms pathology, Feasibility Studies, Female, Follow-Up Studies, Humans, Male, Neoplasm Staging, Perioperative Care, Postoperative Period, Prognosis, Prospective Studies, Colorectal Neoplasms surgery, Colorectal Surgery, Laparoscopy, Recovery of Function
- Abstract
Background: There is strong evidence for the use of Enhanced Recovery After Surgery (ERAS) protocol with colorectal surgery. However, in most studies on ERAS, patients with stage IV colorectal cancer (CRC) are commonly excluded. It is not certain if the ERAS protocol combined with laparoscopy improves outcomes in this group of patients as well. The aim of the study is to assess the feasibility of the ERAS protocol implementation in patients operated laparoscopically due to stage IV CRC., Methods: A prospective analysis of patients undergoing laparoscopic colorectal surgery was performed. Group 1 included patients with stages I-III, and group 2 included patients with stage IV CRC. Demographic, surgical factors, length of stay (LOS), complications, readmissions, ERAS implementation and early postoperative recovery were compared between the groups., Results: Group 1 included 168 patients, and group 2 included 20 patients. There was no difference in the age, sex, BMI, ASA, cancer localisation or surgical parameters. No statistically significant difference was noted in complications (26.8 vs 20 %, p = 0.51344), LOS (4.7 vs 5.7 days, p = 0.28228) or readmissions (6 vs 10 %, p = 0.48392). The ERAS protocol compliance was 86.3 and 83.0 %, respectively (p = 0.17158)., Conclusions: Implementation of the ERAS protocol and laparoscopic surgery among patients with stage IV CRC is feasible and provides similar short-term clinical outcomes and recovery as with patients with stages I-III.
- Published
- 2015
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47. Changing patterns in the surgical treatment of perforated duodenal ulcer - single centre experience.
- Author
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Budzyński P, Pędziwiatr M, Grzesiak-Kuik A, Natkaniec M, Major P, Matłok M, Stanek M, Wierdak M, Migaczewski M, Pisarska M, and Budzyński A
- Abstract
Introduction: Although the surgical treatment of patients with perforated duodenal ulcer is the method of choice, the introduction of effective pharmacotherapy has changed the surgical strategy. Nowadays less extensive procedures are chosen more frequently. The introduction of laparoscopic procedures had a significant impact on treatment results., Aim: To present our experience in the treatment of perforated duodenal ulcer in two periods, by comparing open radical anti-ulcer procedures with laparoscopic ulcer repair., Material and Methods: The analysis covered patients operated on for perforated duodenal ulcer. Two groups of patients were compared. Group 1 included 245 patients operated on in the period 1980-1994 with a traditional method (pyloroplasty + vagotomy) before introduction of proton pump inhibitors (PPI). Group 2 included 106 patients treated in the period 2000-2014 with the laparoscopic technique supplemented with PPI therapy. Groups were compared in terms of patients' demographic structure, operative time, complication rate and mortality., Results: The mean operative time in group 1 was shorter than in group 2 (p < 0.0001). Complications were noted in 57 (23.3%) patients in group 1 and 14 (13.5%) patients in group 2 (p = 0.0312). Reoperation was necessary in 13 (5.3%) cases in group 1 and in 5 cases in group 2 (p = 0.8179). The mortality rate in group 1 was significantly higher than in group 2 (10.2% vs. 2.8%, p = 0.0192). In group 1, median length of hospital stay was 9 days and differed significantly from group 2 (6 days, p < 0.0001)., Conclusions: Within the last 30 years, significant changes in treatment of perforated peptic ulcer (PPU) have occurred, mainly related to abandoning routine radical anti-ulcer procedures and replacing the open technique with minimally invasive surgery. Thus it was possible to improve treatment results by reducing complication and mortality rates, and shortening the length of hospital stay. Although the laparoscopic operation is longer, it improves outcomes. In the authors' opinion, in each patient with suspected peptic ulcer perforation, laparoscopy should be the method of choice.
- Published
- 2015
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48. Laparoscopic adrenalectomy for pheochromocytoma is more difficult compared to other adrenal tumors.
- Author
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Natkaniec M, Pędziwiatr M, Wierdak M, Białas M, Major P, Matłok M, Budzyński P, Dworak J, Buziak-Bereza M, and Budzyński A
- Abstract
Introduction: Laparoscopic adrenalectomy is the gold standard for the treatment of benign adrenal tumors. However, some authors raise the problem of differences in surgery for pheochromocytoma in comparison to other lesions., Aim: To compare laparoscopic adrenalectomy for pheochromocytoma and for other tumors., Material and Methods: Four hundred and thirty-seven patients with adrenal tumors were included in the retrospective analysis. Patients were divided into two groups: 1 (124 patients treated for pheochromocytoma) and 2 (313 patients with other types of tumor). The two groups were compared with respect to mean operative time, intraoperative blood loss, conversion rate, complication rate and the relationship of tumor size with operative time., Results: The mean operative time in group 1 was 91 min, and in group 2 it was 82 min (p = 0.016). In both groups 1 and 2, tumor size correlated with operative time (p < 0.0001 and p = 0.0003, respectively). The mean blood loss in groups 1 and 2 was 117 ml and 54 ml, respectively (p = 0.0011). The complication rate in groups 1 and 2 was 4% and 4.2%, respectively (p = 0.9542). In groups 1 and 2, conversion was necessary in 2 (1.6%) and 5 (1.6%) cases, respectively (p = 0.9925)., Conclusions: Longer operative time and higher blood loss after laparoscopic adrenalectomy for pheochromocytoma indicate its greater difficulty. However, despite these drawbacks, minimally invasive surgery still seems to be an effective and safe method.
- Published
- 2015
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49. Early implementation of Enhanced Recovery After Surgery (ERAS®) protocol - Compliance improves outcomes: A prospective cohort study.
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Pędziwiatr M, Kisialeuski M, Wierdak M, Stanek M, Natkaniec M, Matłok M, Major P, Małczak P, and Budzyński A
- Subjects
- Adult, Aged, Aged, 80 and over, Cohort Studies, Colon surgery, Female, Humans, Length of Stay, Male, Middle Aged, Patient Readmission statistics & numerical data, Poland, Postoperative Complications prevention & control, Rectum surgery, Clinical Protocols, Digestive System Surgical Procedures, Guideline Adherence, Recovery of Function
- Abstract
Enhanced Recovery After Surgery protocol in colorectal surgery allows shortening length of hospital stay and reducing complication rate. Despite the clear guidelines and conclusive evidence their full implementation and putting them into daily practice meets certain difficulties, especially in the early stage. The aim of the study was to analyse the course of implementation of the ERAS protocol into daily practice on the basis of adherence to the protocol. Group included 92 patients (43F/49M) with colorectal cancer submitted to laparoscopic resection during the years 2013-2014. Perioperative care in all of them based on ERAS protocol consisting of 16 items. Its principles and discharge criteria were based on the guidelines of the ERAS Society guidelines. The entire analysed group of patients was divided into 3 subgroups (30 patients) depending on the time from ERAS protocol implementation. We analysed the compliance with the protocol and its influence on length of hospital stay, postoperative complications and readmission rate in different subgroups. The average compliance with the protocol differed significantly between groups and was 65% in group 1, 83.9% in group 2 and 89.6% in group 3. The compliance with subsequent protocol elements was different. The length of stay and complication rate was statistically different in analysed subgroups. The whole group demonstrated an inverse correlation between compliance and length of stay. This analysis leads to the conclusion that the introduction of the ERAS protocol is a gradual process, and its compliance at the level of 80% or more requires at least 30 patients and the period of about 6 months. The initial derogation from the assumed proceedings is inevitable and should not discourage further action. Particular emphasis in the initial stage should be put on continuous training of personnel of all specialties and continuous evaluation of the results., (Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2015
- Full Text
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50. Quality of Life After Bariatric Surgery.
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Major P, Matłok M, Pędziwiatr M, Migaczewski M, Budzyński P, Stanek M, Kisielewski M, Natkaniec M, and Budzyński A
- Subjects
- Adult, Comorbidity, Female, Humans, Laparoscopy, Male, Treatment Outcome, Weight Loss, Bariatric Surgery, Obesity, Morbid surgery, Quality of Life
- Abstract
Introduction and Purpose: Morbid obesity together with obesity-related diseases has a negative impact on the quality of life. The aim of the study was to assess the quality of life amongst patients with morbid obesity as well as the impact of bariatric treatment on body weight and obesity-related diseases in addition to conducting an analysis of changes in the quality of life after surgical treatments, in the context of the surgical procedure type and degree of body weight loss., Material and Methods: Sixty-five patients were treated for morbid obesity. The sample group consisted of 34 patients treated with laparoscopic sleeve gastrectomy (LSG) and 31 persons qualified for laparoscopic Roux-en-Y gastric bypass (LRYGB). The average body weight before the procedure was 146.2 kg. In the sample group, 89 % of persons qualified for the surgical treatments were diagnosed with hypertension and 52 % persons that were operated on were diagnosed with diabetes type 2 before the surgical procedure. Before commencement of the surgical treatment, the quality of life was assessed, which in both groups qualified for given types of bariatric procedures was considerably low., Results and Conclusions: Percentage excessive weight loss (%EWL) was 58.8 %. No significant differences in body weight loss were noted between the two types of procedures. Improvement was observed in the treatment of obesity-related diseases. Also, the quality of life was enhanced significantly. No differences were noted in terms of the quality of life improvement between particular types of surgical procedures. No significant differences were observed during the analysis of body weight loss impact on the quality of life improvement.
- Published
- 2015
- Full Text
- View/download PDF
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