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Abstract Aims In recent years, survival in patients with breast cancer has increased. Despite the improvement in outcomes of those patients, the risk of treatment‐related cardiotoxicity remains high, and its presence has been associated with a higher risk of treatment termination and thus lower therapeutic efficacy. Prior trials demonstrated that a preventive initiation of heart failure drugs, including the renin–angiotensin–aldosterone inhibitors, might reduce the risk of treatment‐related cardiotoxicity. However, to date, no study investigated the efficacy of sacubitril/valsartan, a novel antineurohormonal drug shown to be superior to the previous therapies, in the prevention of cardiotoxicity in patients with early‐stage breast cancer, which is the aim of the trial. Methods and results MAINSTREAM is a randomized, placebo‐controlled, double‐blind, multicentre, clinical trial. After the run‐in period, a total of 480 patients with early breast cancer undergoing treatment with anthracyclines and/or anti‐human epidermal growth factor receptor 2 drugs will be randomized to the highest tolerated dose of sacubitril/valsartan, being preferably 97/103 mg twice daily or placebo in 1:1 ratio. The patients will be monitored, including routine transthoracic echocardiography (TTE) and laboratory biomarker monitoring, for 24 months. The primary endpoint of the trial will be the occurrence of a decrease in left ventricular ejection fraction by ≥5% in TTE within 24 months. The key secondary endpoints will be the composite endpoint of death from any cause or hospitalization for heart failure, as well as other imaging, laboratory, and clinical outcomes, including the occurrence of the cancer therapy‐related cardiac dysfunction resulting in the necessity to initiate treatment. The first patients are expected to be recruited in the coming months, and the estimated completion of the study and publication of the results are expected in December 2027, pending recruitment. Conclusions The MAINSTREAM trial will determine the efficacy and safety of treatment with sacubitril/valsartan as a prevention of cardiotoxicity in patients with early breast cancer (ClinicalTrials.gov number: NCT05465031).

Introduction: Bariatric surgery is the mainstay of treatment of obesity, with a proven, long-lasting effect on body weight reduction and remission of co-morbidities. Sleep disorders, including insomnia, and deteriorated sleep quality and duration are associated with obesity, and a reduction in body weight can be associated with a reduction in prevalence of sleep disorders. The purpose of this study was to assess the influence of laparoscopic sleeve gastrectomy (LSG) on the prevalence and intensity of different sleep disturbances. Methods: This observational prospective study included 80 patients qualified for bariatric surgery who filled in a questionnaire with a set of structured questions about different sleep disturbances, such as difficulties in falling asleep, night awakenings, early morning awakenings, snoring, and nightmares, as well as eating at night and daytime dysfunction, supplemented with Athens Insomnia Scale (AIS), before and 6 months after bariatric surgery. Results: There was a statistically significant reduction in incidence of night awakenings, with 40.00% of participants reporting night awakenings before surgery and, respectively, 25.00% after surgery. A significant reduction was also observed in the rate of patients who reported snoring, with 60.00% before the surgery and 38.75% after the surgery (p < 0.05). There was a correlation present between estimated weight loss % (EWL%) and reduction in snoring (p < 0.05). The mean total AIS score before surgery was 7.21 and 5.99 after surgery, and the change was statistically significant (p < 0.05). A total AIS score of 8 or more, the cutoff score for insomnia diagnosis according to the Polish validation of the Athens Insomnia Scale, was present in 44.16% of cases before surgery and in 38.00% after surgery (p = 0.52). There was a significant difference in the incidence of awakening during the night score before and after surgery (p < 0.05; CI 0.022–0.341), sleep quality (p < 0.05; CI 0.0105–0.4311), well-being during the day (p < 0.05; CI 0.0273–0.4143), and sleepiness during the day (p < 0.05; CI 0.101–0.444). Conclusions: LSG is observed to have a positive effect on selected sleep disturbances and insomnia remission in patients with obesity, measured by a significant reduction in Athens Insomnia Scale scores in follow-up 6 months after surgery. Additionally, patients after bariatric surgery reported less night awakenings and there was a lower rate of snoring. Therefore, LSG can be considered an effective therapeutic tool for insomnia in patients with obesity.

(1) Background: Advanced heart failure often accompanies ventricular arrhythmias, necessitating antiarrhythmic therapies. Amiodarone, commonly used for this purpose, may induce thyroid dysfunction due to its high iodine content. However, the prevalence and correlation of thyroid dysfunction with amiodarone in end-stage heart failure patients remain unclear. Aim: This study aimed to evaluate the prevalence and types of thyroid dysfunction and their association with amiodarone among 200 patients diagnosed with advanced heart failure eligible for transplantation. (2) Methods: Consecutively enrolled patients received treatment following the European Society of Cardiology guidelines and were followed-up for two years. Ventricular arrhythmias affected 58.5% of the cohort, with 24.5% receiving amiodarone therapy. (3) Results: Thyroid metabolism dysfunction was evident in 61 patients, notably overrepresented in women (p = 0.0028). Hyperthyroidism (34 patients) and hypothyroidism (27 patients) were observed, with a significant amiodarone-related correlation. Despite this, thyroid dysfunction was not associated with increased mortality among the studied group. (4) Conclusions: Thyroid dysfunction is prevalent in advanced heart failure patients, with a notable proportion linked to amiodarone. However, its presence does not correspond to higher mortality rates. Understanding these associations is crucial for effective management in this patient population. Further exploration is warranted to refine approaches to thyroid dysfunction in refractory heart failure.

Torque Teno Virus (TTV), first discovered in 1997, is a non-pathogenic, highly prevalent virus with a notable presence in the human virome. TTV has garnered attention as a potential indicator of immunocompetence in recipients of solid organ transplants. In this review, we discuss the role of TTV as a potential marker for immunosuppression optimization, prediction of graft rejection, and as an indicator of opportunistic infections. We discuss TTV’s behavior over the course of time after transplantation, TTV’s implications in different immunosuppressive regimens, and potential utility in vaccinations. The review synthetizes findings from various studies depicting its potential clinical utility for future personalized patient care.

Applied theology is the scientific reflection on the daily “growth” of man, who lives every day in the world and there fulfils himself and realizes his existential vocation, and Christians build the Kingdom of God. From the perspective of applied theology, three main principles can be distinguished that link ecclesiology and socialization: respect for truth, social justice and charity. In applied theology, it is possible to undertake scientific reflection on ecclesiology without violating pastoral theology's right to study the Church and its salvific mission. However, in the search for knowledge about the dimensions of human social life, authoritarian and abstract universalism should be avoided.

The article discusses the problem of new pastoral communication that, due to the changes taking place in the Church and in the world, should have a communal character. Nowadays, pastoral communication is a significant research area of Pastoral Theology whose aim is to study the life and activity of the modern Church. Today’s Christians very often feel afraid and lost. For this reason, the teaching of the Gospel does not yield the expected fruit. This is why, the teaching of Christ should be proclaimed in the community in which the confused will experience love and find the meaning and purpose in their lives.

W artykule zaprezentowane są aktualne problemy Kościoła związane z komunikacją medialną. Kościół wypełnia swoją misję w świecie realnym. Znakiem czasów współczesnych jest powstanie świata wirtualnego. Teologia pastoralna poszukuje odpowiedzi na pytanie: w jaki sposób Kościół może wypełniać swoja misję pastoralną w świecie wirtualnym. Współpraca Kościoła z mediami powinna być oparta na prawdzie. Główne zadanie Kościoła w świecie wirtualnym to budowanie wspólnoty kościelnej. Natomiast chrześcijanie powinni wykorzystywać swoją wiarę do odnowy życia codziennego.

Artykuł przedstawia zadania pastoralne parafii w Polsce w dziedzinie ekologii. Z powodu degradacji środowiska naturalnego cierpią przede wszystkim ludzie. Ponieważ to działalność człowieka przyczynia się do dewastacji natury, dlatego najbardziej skuteczne w ochronie środowiska będą działania podejmowane w obrębie parafii, których „domem” jest terytorium, na którym zamieszkują jej członkowie. Pierwszym za­daniem jest działalność na rzecz uświadomienia proekologicznego, dalej nawrócenie ekologiczne i zmiana stylu życia parafian na co dzień. W praktycznych wskazaniach zostały zaproponowane konkretne działania w parafiach na rzecz ochrony środowiska w Polsce, ze szczególnym uwzględnieniem ochrony życia osoby ludzkiej od poczęcia do naturalnej śmierci.

The aim of the article is to indicate new possibilities of health protection from the perspective of pastoral theology. The Church’s teaching on the protection of human life and health is very rich. It should also be pointed out that the Church supports all social initiatives to reform health care, especially is humanisation and personalisation, which can lead to better care for the sick, but also create new opportunities in the field of health prevention, in promoting healthy lifestyles and in supporting the pursuit of daily life hygiene. Thanks to the humanisation and personalisation of health care, it will be more effective to deformalize it, so that money, profit or savings do not obscure the most important goal: to provide comprehensive care for the sick person. The good of an ill person is body health and mental balance, but the greatest gift is always to be close to God, according to the principle that people are closest to God when they give health to other people.

The human gut microbiota include over 10 trillion microorganisms, such as bacteria, fungi, viruses, archaea, and protozoa. Many reports indicate the strong correlation between dysbiosis and the severity of cardiovascular diseases. Microbiota seem to interact with the host’s alloimmunity and may have an immunomodulatory role in graft rejection processes. In our study, we present the current state of the knowledge of microbiota in heart transplant recipients. We present up-to-date microbiota diagnostic methods, interactions between microbiota and immunosuppressive drugs, the immunomodulatory effects of dysbiosis, and the available strategies (experimental and clinical strategies) to modulate host microbiota.

This article deals with the problematic aspects relating to aviation crash victim identification in Poland and the specific nature of participation of a forensic medicine expert in activities undertaken as part of an external examination group and a Disaster Victim Identification (DVI) team. It describes in a concise manner the course of the process of identification of the victims’ bodies, beginning with the actions undertaken at the incident site and ending with the public prosecutor’s decision to allow for the interment of dead bodies or human remains. It presents a catalogue of identification methods by grouping them from the most credible ones to the ones that merely suggest the victim’s identity. It concisely describes the tasks faced by the forensic pathologist, who plays a double role at a crash site, i.e. as a member of an external examination group and of a DVI team.

Serum amyloid A (SAA) is a good systemic marker of the exacerbations of chronic obstructive pulmonary disease (COPD), but the significance of SAA in stable patients with COPD has not been widely investigated. We aimed to evaluate the SAA level in peripheral blood from stable patients with COPD and to search for correlations between SAA and other inflammatory markers and clinical characteristics of the disease. Serum SAA, IL-6, IL-8, TNF-alpha, basic blood investigations, pulmonary function testing and a 6-min walk test were performed. The correlations between SAA and other inflammatory markers, functional performance and the number of disease exacerbations were evaluated. A total of 100 consecutive patients with COPD were analyzed. No correlations between SAA and inflammatory markers as well as pulmonary function were found. Hierarchical clustering identified two clusters incorporating SAA: one comprised SAA, PaO2 and FEV1 and the second was formed of SAA and nine other disease markers. The SAA level was higher in patients with blood eosinophils < 2% when compared to those with blood eosinophils ≥ 2% (41.8 (19.5–69.7) ng/mL vs. 18.9 (1.0–54.5) ng/mL, respectively, p = 0.04). We conclude that, in combination with other important disease features, SAA may be useful for patient evaluation in stable COPD.

Patients with pulmonary arterial hypertension (PAH) become candidates for lung or lung and heart transplantation when the maximum specific therapy is no longer effective. The most difficult challenge is choosing one of the above options in the event of symptoms of right ventricular failure. Here, we present two female patients with PAH: (1) a 21-year-old patient with Eisenmenger syndrome, caused by a congenital defect—patent ductus arteriosus (PDA); and (2) a 39-year-old patient with idiopathic PAH and coexistent PDA. Their common denominator is PDA and the hybrid surgery performed: double lung transplantation with simultaneous PDA closure. The operation was performed after pharmacological bridging (conditioning) to transplantation that lasted for 33 and 70 days, respectively. In both cases, PDA closure effectiveness was 100%. Both patients survived the operation (100%); however, patient no. 1 died on the 2nd postoperative day due to multi-organ failure; while patient no. 2 was discharged home in full health. The authors did not find a similar description of the operation in the available literature and PubMed database. Hence, we propose this new treatment method for its effectiveness and applicability proven in our practice.

Treatment of patients with advanced heart failure (HF) with the use of left ventricular assist devices (LVADs) improves the quality of life and the length of survival. Despite the undeniable benefits associated with improved physical performance, as a result of the decrease of the underlying disease symptoms, it carries the risk of complications in the area of the patient's somatic and psychological status. Long-term circulatory failure can contribute to a weakening of the adaptative mechanism and consequently lead to a variety of emotional disruptions. Patients must face the fear of imminent physical, family, and social changes that LVAD requires. They may experience sleep disorders, mood disorders, anxiety disorders, and in the early postoperative period also disorders of consciousness with a pattern of delirium. For this reason, it is advisable to provide multidisciplinary medical care for the patient at all stages of treatment, including regular monitoring of general health and mental health. This article presents risk factors for psychiatric disorders in patients with LVADs and ways of pharmacological and non-pharmacological management when these factors are identified and disorders are diagnosed. [ABSTRACT FROM AUTHOR]

The qualification of new knowledge is one of the oldest problems in experimental medicine that provides a link between fundamental discovery, hypothesis, ‘proof of concept’ preclinical studies and development of clinical trials. The biggest challenge in animal models is the proper evaluation of all the aspects that are crucial in specific studied pathologies as well as the prediction of their progression. The aim of this review was to describe and discuss the rat animal model of heart transplant. The rat model of heart transplantation is an excellent yet underestimated method of research of prevention, monitoring and treatment of acute and chronic, immune and nonimmune response to organ transplantation. Despite being a technically and logistically demanding model, it provides a tool for reproducible experiments with longterm animal survival and excellent graft survival.

Humanity is exceeding planetary boundaries, and it seems that it is unlikely to meet internationally agreed sustainable development goals. Current trends and challenges in the domain of urban sustainability assessment have proven that measuring and interpreting results regarding quality of life requires a complex analysis. The aim of this paper is to investigate the possibility of comparing, in a transparent way, urban quality of life using sustainable development indicators based on the ISO 37120 standard, taking as case studies seven selected cities: Amsterdam, Buenos Aires, Dubai, Gdynia, London, Los Angeles and Zagreb. The hypothesis reads as follows: the ISO 37120 indicators, converted into partial and total utility value, then grouped within sustainable development dimensions (environmental, economic and social) may be used to measure the level of urban quality of life. Research results indicate that there are some significant and interesting differences between the compared cities within the environmental, economic and social pillars. The analysis, conducted with the use of utility method, may facilitate taking the right decisions on urban management, planning and investment. Thus, this tool may be useful for decision makers and help cities and communities of all sizes to become more safe, resilient, prosperous, inclusive, smart and sustainable.

Orthotopic heart transplantation (OHT) is the standard-of-care for end-stage heart disease. Although a significant improvement in the prognosis of patients after OHT has been observed in recent years, their overall mortality remains relatively high, with a median survival of approximately 10 years after transplantation. One of the primary causes of death in patients after OHT is cardiac allograft vasculopathy (CAV), the condition developing specifically in the coronary vasculature after OHT, the pathophysiology of which is still inadequately known. It is estimated that CAV development and progression is responsible for approximately 30% of deaths within five years post-OHT. According to the International Society for Heart and Lung Transplantation (ISHLT) Nomenclature for CAV, its presence should be assessed primarily by the coronary angiography performed routinely after OHT, mostly due to its wide availability, reproducibility, and low complication rate. However, the analysis of CAV in coronary angiography has limitations, mostly concerning its – sometimes inadequate – sensitivity and specificity. Hence, there is a growing need for the introduction of more accurate methods of CAV assessment, such as intravascular imaging, which through a thorough evaluation of the arterial wall structure and thickness allows the drawbacks of routine angiography to be minimised. The aim of the article was to critically summarise the current findings derived from the analysis of CAV by optical coherence tomography, the other intravascular imaging modalities, such as intravascular ultrasound (IVUS) and IVUS-derived virtual histology, along with physiological assessment with the use of the fractional flow reserve.

Professor Marian Zembala, MD, PhD — an outstanding Polish cardiac surgeon and transplant surgeon, scientist, long-time academic teacher and educator of young people, director, and also a great lover of music, poetry, theater, painting, and sailing. He was born on February 11, 1950, in Krzepice near Częstochowa. He graduated from the Medical University of Wrocław in 1974 with honors and received the Primus Inter Pares award of the Polish Minister of Health, with a possibility to choose the place of work. He chose the Heart Surgery Department of the Medical Academy in Wrocław, which was his dream. Alongside his clinical work, he developed his scientific interests. In 1979, at the age of 29, he defended his doctorate with honors. His work in the Wrocław Clinic also provided an opportunity to go for his dream internship abroad, e.g. to the hospital in Utrecht, the Netherlands, where he worked under the supervision of Prof. F. Hitchcock (1981–1985). During his stay in the Netherlands, he initiated the largest post-World War II program of Polish Heart Poolse hartpatientjes naar Nederland, under which more than 500 Polish children with severe congenital heart defects were operated on free of charge between 1981 and 1992. For this ambitious project, he received an honorary award from Utrecht University and an award from the Primate of Poland, Cardinal Józef Glemp.

Left ventricular assist devices are a treatment option for end-stage heart failure patients. Despite advancing technologies, bleeding and thromboembolic events strongly decrease the survival and the quality of life of these patients. Little is known about prognostic factors determining these adverse events in this group of patients. Therefore, we plan to investigate 90 consecutive left ventricular assist device (LVAD) patients and study in vitro fibrin clot properties (clot lysis time, clot permeability, fibrin ultrastructure using a scanning electron microscope) and the calibrated automated thrombogram in addition to the von Willebrand factor antigen, fibrinogen, D-dimer, prothrombin time/international normalized ratio (PT/INR), and activated partial thromboplastin time (APTT) to identify prognostic factors of adverse outcomes during the course of therapy. We plan to assess the hemostasis system at four different time points, i.e., before LVAD implantation, 3–4 months after LVAD implantation, 6–12 months after LVAD implantation, and at the end of the study (at 5 years or at the time of the adverse event). Adverse outcomes were defined as bleeding events (bleeding in general or in the following subtypes: severe bleeding, fatal bleeding, gastrointestinal bleeding, intracranial bleeding), thromboembolic events (stroke or transient ischemic attack, pump thrombosis, including thrombosis within the pump or its inflow or outflow conduits, arterial peripheral thromboembolism), and death.

One of the important causes of the ecological crisis is the egoistic mentality of contemporary people and the lack of respect for the natural order and immanent purpose of the creation. In order to shape a new pro-ecological consciousness a new concept of man and his relations with the environment is needed. One of the proposals is Catholic anthropology, whose ecological foundations were indicated by Pope Francis in his Encyclical Laudato si’. It is a proposal to describe man applying religious concepts, but also including the up-to-date knowledge about man and the environment. It is a concept open to dialogue, the aim of which should be the development of a pro-ecological lifestyle for contemporary people. Catholic anthropology postulates to combine “external” ecology with “moral” ecology, which can help modern man not only to have control over nature, but also to become its defender through small, everyday activities. In ecologically oriented anthropology, the created world is treated as a common home, and Pope Francis calls it our sister, with whom we share existence, and a beautiful mother, who takes us in her arms.

Diseases of the throat and tonsils are one of the most frequent causes of patient visits to pediatricians and family doctors. It should be emphasized that to protect the vast majority of them, symptomatic management is sufficient. When applying for pharmacological interventions, the physician should be guided by experience, while supporting himself with objective scientific data confirming the effectiveness of the recommended treatment. It is worth emphasizing the necessity to implement the vaccination calendar as a proven effective method of protecting patients from serious complications of infectious diseases.

Background: Obstructive sleep apnea is associated with an increased prevalence of cardiovascular disease. The mechanism of these associations is not completely understood. We aimed to investigate the association of the apnea hypopnea index and the degree of airflow limitation with endothelial dysfunction. Methods: This was a single-center prospective study of patients admitted for diagnostic coronary angiography (CAG). Endothelial function was assessed by the non-invasive EndoPAT system by reactive hyperemia index (RHI) and divided into two groups: endothelial dysfunction and normal endothelial function. Sleep apnea signs were detected by WatchPAT measuring the respiratory disturbance index (pRDI), the apnea and hypopnea index (pAHI), and the oxygen desaturation index (ODI). Patients underwent spirometry and body plethysmography. Based on CAG, the severity of coronary artery disease was assessed as follows: no significant coronary artery disease, single-, two- and three-vessel disease. Results: A total of 113 patients were included in the study. Breathing disorders measured by WatchPAT and spirometry were more severe in patients with endothelial dysfunction: pRDI (27.3 vs. 14.8, p = 0.001), pAHI (24.6 vs. 10.3, p < 0.001), ODI (13.7 vs. 5.2, p = 0.002), forced expiratory volume in one second (FEV1) (81.2 vs. 89, p = 0.05). In a multivariate regression analysis, pAHI and FEV1 were independent predictors of endothelial dysfunction assessed by RHI. There was no correlation between the severity of coronary artery disease and endothelial dysfunction. Conclusions: Obstructive sleep apnea signs and greater airflow limitation were associated with endothelial dysfunction regardless of the severity of the coronary artery disease.

Improving quality of life still remains the main goal of strategic documents and is promoted by leaders on the global, national, regional, and local levels. Moreover, this ambitious challenge should be consistent with the principles of sustainable development, including the social, economic, and environmental aspects. The ISO 37120 indicators within the World Council on City Data (WCCD) database may be used to monitor the urban performance over time. However, the interpretation of the results is not always easy and sometimes requires a complex analysis. The aim of this paper was to investigate the possibility of illustrating in a transparent way the urban quality of life using the utility method. This study also presents that this method may facilitate making data-driven decisions on urban management, planning and investment. Thus, it may be useful for decision makers and help cities and communities of all sizes to become more sustainable, safe and resilient, prosperous, inclusive, and smart. The analysis has been carried out using the examples of selected European cities: Amsterdam, Gdynia, London, and Zagreb. The hypothesis reads as follows: it is possible to use the total and partial utility method in order to assess the level of urban quality of life with regard to the three dimensions of sustainable development in order to monitor progress and results and prioritize and implement the changes within urban policy. Research results indicate that there are significant differences between the compared cities within the economic, social, and ecological aspects. This analysis may constitute an introduction to the development of more complex models in the future.

BackgroundAccording to the medical literature, both on-pump and off-pump coronary artery surgery is safe and effective in octogenarians.ObjectivesThe aim of our study was to examine the epidemiology, in-hospital outcomes and long-term follow-up results in octogenarians undergoing off-pump and on-pump coronary artery surgery utilizing nationwide registry data.MethodsAll octogenarians (≥ 80 years) enrolled in the Polish National Registry of Cardiac Surgical Procedures (KROK Registry), who underwent isolated coronary surgery between January 2006 and September 2017 were identified. Preoperative data, perioperative complications, hospital mortality and long-term mortality were analyzed. Unadjusted and propensity-matched comparisons were performed between octogenarians undergoing off-pump and on-pump coronary artery bypass surgery.ResultsOctogenarians accounted for 4.1% of the total population undergoing coronary artery surgery in Poland during the analyzed period (n = 152,631) and this percentage is increasing. Among 6,006 analyzed patients, 2,744 (45.7%) were operated on-pump and 3,262 (54.3%) were operated off-pump. Propensity-matched analysis revealed that patients operated on-pump were more often reoperated due to postoperative bleeding and their in-hospital mortality was higher (6.6% vs 4.5%, p = 0.006 and 8.7% vs 5.8%, p = 0.001, respectively). Long-term all-cause mortality was lower among patients operated off-pump (p = 0.013).ConclusionOn the basis of our findings we suggest that off pump technique should be considered as perfectly acceptable in octogenarians.

Introduction. The data assessing the impact of beta blocker (BB) medication on survival in patients after heart transplantation (HTx) are scarce and unequivocal; therefore, we investigated this population. Methods. We retrospectively analyzed the HTx Zabrze Registry of 380 consecutive patients who survived the 30-day postoperative period. Results. The percentage of patients from the entire cohort taking BBs was as follows: atenolol 24 (17%), bisoprolol 67 (49%), carvedilol 11 (8%), metoprolol 28 (20%), and nebivolol 8 (6%). The patients receiving BBs were older (56.94 ± 14.68 years vs. 52.70 ± 15.35 years, p=0.008) and experienced an onset of HTx earlier in years (11.65 ± 7.04 vs. 7.24 ± 5.78 p≤0.001). They also had higher hematocrit (0.40 ± 0.05 vs. 0.39 ± 0.05, p=0.022) and red blood cells (4.63 (106/μl) ± 0.71 vs. 4.45 (106/μl) ± 0.68, p=0.015). Survival according to BB medication did not differ among the groups (p=0.655) (log-rank test). Univariate Cox proportional hazard regression analysis revealed that the following parameters were associated with unfavorable diagnosis: serum concentration of albumin (g/l) HR: 0.87, 95% CI (0.81–0.94), p=0.0004; fibrinogen (mg/dl) HR: 1.006, 95% CI (1.002–1.008), p=0.0017; and C-reactive protein (mg/l) HR: 1.014, 95% CI (1.004–1.023), p=0.0044. Conclusions. The use of BBs in our cohort of patients after HTx was not associated with survival benefits.

The article discusses the causes of conflict in the dialogue between Christian religion and new culture. The main cause is in the mind of man, who is today threatened nationalism, racism, and religious fundamentalism. There is an inseparable link between culture and religion, and the dialogue between them is the way to truth, of which God is the source. Man creates culture and benefits from it, but must be open to full communion with God in religion. Culture cannot replace religion, it cannot satisfy the spiritual needs of man and in does not direct man towards the ultimate goal of eternal life. Dialogue between Christianity and the new culture, which can promote integral human development and sustainable progress, requires that account be taken of Christian humanism, which respects human dignity and human rights. Thanks to this, man builds awareness of his own values and can look for his own ways to reach God.

Celem artykułu jest wskazanie nowych możliwości ochrony zdrowia z perspektywy teologii pastoralnej. Nauczanie Kościoła na temat ochrony życia i zdrowia człowieka jest bardzo bogate. Kościół popiera wszelkie inicjatywy społeczne służące reformie ochrony zdrowia, zwłaszcza jej humanizację i personalizację, co może przełożyć się na lepszą opiekę nad ludźmi chorymi, ale też stworzy nowe możliwości w dziedzinie profilaktyki zdrowotnej, w propagowaniu zdrowego stylu życia i wspieraniu działań na rzecz przestrzegania zasad higieny życia na co dzień. Dzięki humanizacji i personalizacji służby zdrowia bardziej skuteczne będą działania na rzecz jej odkomercjalizowania, aby pieniądz, zysk lub oszczędności nie przesłaniały najważniejszego celu: otoczenia kompleksową opieką osoby chorej. Dobrem osoby chorej jest zdrowie ciała i równowaga psychiczna, ale największym darem jest być zawsze blisko Boga, według zasady, że ludzie są najbliżej Boga, gdy dają zdrowie innym ludziom.

Motivation: Sustainable urban development is the current global priority; however, most cities lack the capacity and resources to ensure that the city develops in a sustainable manner. Mobility is one of the most difficult topics to face in metropolitan large areas. It involves both environmental and economic aspects, and needs both high technologies and virtuous people behaviours. Dynamical urban development and inhabitants lifestyle changes, especially in the heavy congested port agglomerations, result in a continuous increase of their transport needs. As transport behaviours change, the number of vehicles on streets grows resulting in congestion, an increased number of accidents, exhaust and noise emissions and, consequently, a lowered quality of life. Thus a sustainable approach to urban mobility and transport planning is becoming increasingly common in all EU countries. The study is based on the literature sources analysis and survey research results obtained with a questionnaire for stakeholders to assess particular areas and activities related to mobility issues.Aim: The aim of the paper is to present the urban sustainable development challenges, taking as a case study the Sustainable Urban Mobility Plan (SUMP) elaboration process selected issues in the city of Gdynia within the CIVITAS DYN@MO being a European project implemented under the CIVITAS II PLUS initiative (funded from the 7th Framework Programme of the European Commission).Results: It is quite a challenge to ensure a sustainable urban mobility pattern which requires a high level of stakeholders’ participation and establishing a detailed complex planning process. Key stakeholders of Gdynia, representing the public administration sector, the transport market and university researchers (including the author), included in the planning process earlier, invited to the assessment gave the highest priority to the tariff and ticket integration in the Metropolitan Area, parking issues, the inclusion of pedestrian traffic in project planning and public spaces. The promotion among inhabitants and students or city bicycle system were given a medium priority and the lowest was given to carpooling, environmental-friendly vehicules and such mobility management tools as Mobility centre or the Officer for Mobility.

Left ventricular assist device (LVAD) is well established as an alternative treatment for end-stage heart failure (HF) patients. The aim of the study was to determine the prognostic value of oxidative stress markers and the modified Model for End-Stage Liver Disease (modMELD) in patients receiving bridged therapy with continuous-flow LVAD. We prospectively analyzed 36 end-stage HF patients who received LVAD therapy between 2015 and 2018. The total antioxidant capacity (TAC) and total oxidant status (TOS) were measured by the methods described by Erel. The oxidative stress index (OSI) was defined as the ratio of the TOS to TAC levels. The modMELD scores were calculated based on the serum bilirubin, creatinine, and albumin levels. The patients’ median age was 58 (50–63.0) years. During the 1.5-years follow-up, a major adverse cardiac event—MACE (death, stroke, or pump thrombosis) was observed in 17 patients (47.2%). The area under the receiver operating characteristics curves (AUCs) indicated a good prognostic power of TAC (AUC 0.7183 (0.5417–0.8948)), TOS (AUC 0.9149 (0.8205–0.9298)), OSI (AUC 0.9628 (0.9030–0.9821)), and modMELD (AUC 0.87 (0.7494–0.9905)) to predict a MACE. Oxidative stress markers serum concentrations, as well as the modMELD score, allow the identification of patients with a risk of MACE.

Artykuł przedstawia zadania pastoralne parafii w Polsce w dziedzinie ekologii. Z powodu degradacji środowiska naturalnego cierpią przede wszystkim ludzie. Ponieważ to działalność człowieka przyczynia się do dewastacji natury, dlatego najbardziej skuteczne w ochronie środowiska będą działania podejmowane w obrębie parafii, których „domem” jest terytorium, na którym zamieszkują jej członkowie. Pierwszym za­daniem jest działalność na rzecz uświadomienia proekologicznego, dalej nawrócenie ekologiczne i zmiana stylu życia parafian na co dzień. W praktycznych wskazaniach zostały zaproponowane konkretne działania w parafiach na rzecz ochrony środowiska w Polsce, ze szczególnym uwzględnieniem ochrony życia osoby ludzkiej od poczęcia do naturalnej śmierci.

W artykule zaprezentowane są aktualne problemy Kościoła związane z komunikacją medialną. Kościół wypełnia swoją misję w świecie realnym. Znakiem czasów współczesnych jest powstanie świata wirtualnego. Teologia pastoralna poszukuje odpowiedzi na pytanie: w jaki sposób Kościół może wypełniać swoja misję pastoralną w świecie wirtualnym. Współpraca Kościoła z mediami powinna być oparta na prawdzie. Główne zadanie Kościoła w świecie wirtualnym to budowanie wspólnoty kościelnej. Natomiast chrześcijanie powinni wykorzystywać swoją wiarę do odnowy życia codziennego.

The article discusses the problem of new pastoral communication that, due to the changes taking place in the Church and in the world, should have a communal character. Nowadays, pastoral communication is a significant research area of Pastoral Theology whose aim is to study the life and activity of the modern Church. Today’s Christians very often feel afraid and lost. For this reason, the teaching of the Gospel does not yield the expected fruit. This is why, the teaching of Christ should be proclaimed in the community in which the confused will experience love and find the meaning and purpose in their lives.

In the contemporary world, despite the growing importance and scale of the use of renewable energy , conventional energy resources still play a huge role. The European Union countries are dependent on the oil imports and the their main supplier of crude oil and natural gas has been the Russian Federation. After the collapse of the Soviet Union , the Caspian Sea region has become an alternative to Russian energy resources. The Unit-ed States , European Union, China and many other countries have shown their interest about this region. Despite a relatively large oil and natural gas reserves, the export of the-se commodities to the West is still problematic. Based on the available data and infor-mation, the publication explores the issue of energy resources transport directions with a particular emphasis on the crude oil from the Caspian Sea region to Europe.