24 results on '"Węgiel M"'
Search Results
2. Simulation of water turbine integrated with electrical generator
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Borkowski Dariusz, Węgiel Michał, Ocłoñ Paweł, and Węgiel Tomasz
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Engineering (General). Civil engineering (General) ,TA1-2040 - Abstract
The paper presents the analysis of the small hydropower plant working at variable speed. The hydro-set that consists of the guide vanes and propeller turbine integrated with the permanent magnet synchronous generator is simulated by using Computational Fluid Dynamics (CFD) in Ansys Fluent v18.0. The k-ε and k-ω SST models, as well as the one-equation Spalart-Allmaras (SA) model, were tested. The comparison showed the significant divergence of the calculation results. The turbulence model selection influences the average value of the power and also the speed for which the power is maximal. more...
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- 2018
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3. In search for cause of systolic murmur. A case study of MYH7 positive hypertrophic cardiomyopathy with right ventricular flow obstruction.
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Rajtar-Salwa R, Węgiel M, Sorysz D, Chyrchel B, Bartuś S, and Rakowski T
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- 2025
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4. Polycyclic aromatic hydrocarbons in human granulosa cells: first in vivo presence and positive correlation with body mass index and in vitro ovarian cell steroidogenesis regulation.
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Kurowska P, Berthet L, Ramé C, Węgiel M, Maślanka A, Guérif F, Froment P, Rak A, and Dupont J
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Polycyclic Aromatic Hydrocarbons (PAHs) exposure leads to disorders reported in female infertility patients. Our hypothesis is that PAHs accumulate in granulosa cells (Gc) according to body mass index (BMI) and directly affects its functions. All 16 high-priority PAHs were in human FF, Gc and blood plasma with the highest concentration in Gc (GC-MS/MS). Their highest concentration was in obese Gc, except for acenaphthene and acenaphthylene, and positively correlated with BMI. In FF, we noted only positive correlation between naphthalene and BMI, whereas in blood plasma positive correlation between naphthalene, acenaphthene, pyrene and BMI. Phenanthrene and naphthalene but not fluoranthene inhibited totally steroidogenesis (ELISA), CYP19A1 mRNA expression (real-time PCR) and increased oxidative stress index and catalase expression in Gc independently on BMI. While all studied PAHs decreased Gc proliferation (BrdU assay) and viability (Cell Count kit-8 assay). Thus, Gc PAHs concentrations are positively correlated with BMI and alter ovarian functions., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.) more...
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- 2024
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5. Characteristics of patients diagnosed for cardiac cause of ischemic neurological events and prescreened with a transcranial Doppler examination.
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Węglarz P, Węgiel M, Kuszewski P, Konarska-Kuszewska E, Staszel M, Mizia-Stec K, Dziewierz A, and Rakowski T
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- Humans, Female, Male, Middle Aged, Adult, Aged, Migraine Disorders diagnostic imaging, Stroke etiology, Stroke diagnostic imaging, Stroke epidemiology, Ischemic Stroke diagnostic imaging, Ischemic Stroke etiology, Ischemic Stroke epidemiology, Risk Factors, Foramen Ovale, Patent diagnostic imaging, Foramen Ovale, Patent complications, Foramen Ovale, Patent epidemiology, Ultrasonography, Doppler, Transcranial, Ischemic Attack, Transient etiology, Ischemic Attack, Transient diagnostic imaging, Ischemic Attack, Transient epidemiology
- Abstract
Introduction: Screening for patent foramen ovale (PFO) in patients with ischemic neurological events is becoming more common., Objectives: This study aimed to evaluate clinical characteristics and atrial septum anatomy in relation to age and presence of PFO, as well as factors associated with a history of stroke in patients assessed for cardiac causes of ischemic neurological events., Patients and Methods: A total of 817 patients with a history of neurological episodes (stroke, transient ischemic attack [TIA], or migraine) were prescreened using transcranial Doppler ultrasound. Transesophageal contrast echocardiography (TEE) was employed to confirm PFO and assess the anatomy of the atrial septum and right atrium., Results: Among the patients, 28% had ischemic stroke, 31% had TIA, and 49% had migraines. PFO was confirmed in 79% of the patients. Regardless of the analyzed age group, PFO was associated with higher prevalence of TIA, migraine and syncope history, atrial septal aneurysm (ASA), and Chiari network. There were fewer women in the PFO group, but only in the population aged 45 years or under. Patient age, male sex, typical cardiovascular risk factors, and the presence of ASA were associated with a history of stroke., Conclusions: In patients with ischemic neurological events who were prescreened for PFO, confirmation of PFO on TEE was associated with a higher prevalence of TIA, migraine, syncope, Chiari network, and ASA. Advanced age, typical cardiovascular risk factors, and ASA were associated with stroke history in the study population. more...
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- 2024
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6. In-Hospital Levels of Circulating MicroRNAs as Potential Predictors of Left Ventricular Remodeling Post-Myocardial Infarction.
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Węgiel M, Surmiak M, Malinowski KP, Dziewierz A, Surdacki A, Bartuś S, and Rakowski T
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- Humans, Ventricular Remodeling, Syndrome, Hospitals, Biomarkers, Circulating MicroRNA, MicroRNAs, Myocardial Infarction genetics
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Background and Objectives : Biochemical and molecular regulation of both adaptive and pathological responses of heart tissue to ischemic injury is widely investigated. However, it is still not fully understood. Several biomarkers are tested as predictors of left ventricle (LV) remodeling after myocardial infarction (MI). The aim of this study was to assess the relationship between selected microRNAs (miRNAs) and LV function and morphology in patients after MI. Materials and Methods : Selected miRNAs related to heart failure were assessed in the acute phase of MI: miR-150-3p, miR-21-5p, miR-19b-3p, miR-155-5p, miR-22-5p. Echocardiography with 3D imaging was performed at baseline and after 6 months. Remodeling was defined as >20% increase in LV end-diastolic volume, whereas reverse remodeling was defined as >10% reduction in LV end-systolic volume. Results : Eighty patients entered the registry. Remodeling occurred in 26% and reverse remodeling was reported in 51% of patients. In the presented study, none of the analyzed miRNAs were found to be a significant LV remodeling predictor. The observed correlations between miRNAs and other circulating biomarkers of myocardial remodeling were relatively weak. Conclusions : Our analysis does not demonstrate an association between the analyzed miRNAs and LV remodeling in patients with MI. more...
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- 2024
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7. Atrial septum anatomy as a predictor of ischemic neurological episodes in patients with a patent foramen ovale.
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Węglarz P, Węgiel M, Kuszewski P, Konarska-Kuszewska E, Staszel M, Nowok M, Bajor G, Mizia-Stec K, Dziewierz A, and Rakowski T
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- Humans, Female, Heart Atria diagnostic imaging, Echocardiography, Transesophageal adverse effects, Foramen Ovale, Patent complications, Foramen Ovale, Patent diagnostic imaging, Atrial Septum diagnostic imaging, Ischemic Attack, Transient etiology, Ischemic Attack, Transient complications, Stroke etiology, Stroke complications
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Background: The correlation between atrial septum anatomy and the risk of ischemic neurological events remains underexplored., Aims: This study aimed to examine both the functional and anatomical attributes of the atrial septum and identify predictors of stroke and/or transient ischemic attack (TIA) in patients diagnosed with patent foramen ovale (PFO)., Methods: A total of 155 patients diagnosed with PFO, with a cardiological cause of neurological events, were enrolled. Transesophageal echocardiography was utilized to assess the anatomy of the PFO canal, size of the right-to-left shunt, thickness of the primary and secondary atrial septum, presence of atrial septum aneurysm, and anatomical structures of the right atrium., Results: Regression analysis showed that factors such as female sex, hypercholesterolemia, PFO canal width, and a large right-to-left shunt were significantly associated with stroke and/or TIA. Receiver operating characteristic analysis indicated that the width of the PFO canal holds a relatively weak, although significant predictive, value for ischemic neurological episodes (area under the curve = 0.7; P = 0.002). A PFO canal width of 4 mm was associated with 70% sensitivity and 55% specificity for predicting stroke and/or TIA., Conclusions: The atrial septum's anatomy, especially the dimensions of the PFO canal and the magnitude of the right-to-left shunt, combined with specific demographic and clinical factors, are linked to ischemic neurological incidents in PFO patients. more...
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- 2024
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8. Experience in patent foramen ovale closure with the CERA Lifetech occluder in patients with cryptogenic stroke.
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Węglarz P, Węgiel M, Konarska-Kuszewska E, Kuszewski P, Staszel M, Dziewierz A, and Rakowski T
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Introduction: Nowadays, percutaneous closure of patent foramen ovale (PFO) in patients after cryptogenic stroke is becoming a dominating strategy. The most commonly used and investigated device is the Amplatzer occluder. However, several other devices have been designed for transcatheter closure of PFO, which are not so well examined., Aim: To assess the effectiveness and safety of PFO closure with the Lifetech CERA occluder., Material and Methods: A prospective, single-arm registry of patients with PFO treated with CERA occluder (Lifetech Scientific, Shenzhen, China) implantation was conducted. We assessed peri-procedural and 12-month follow-up. Patients were screened for the residual shunt in transcranial Doppler/transesophageal echocardiography., Results: Ninety-six patients entered the registry. Most patients were women (76%) and the analyzed group was relatively young (mean age of 42.3 ±13.6 years). Before closure, most patients had a large shunt through the PFO. Procedures of PFO closure were performed under TEE guidance. All procedures were made under local anesthesia and all patients had the PFO successfully closed. No device-related complications were reported in the peri-procedural period or during follow-up. No recurrent neurological ischemic events were reported at 12 months. During follow-up we observed a 9% rate of residual shunts, which were mostly small., Conclusions: The study confirmed excellent immediate and 12-month results of CERA occluder implantation in patients with PFO., Competing Interests: Przemysław Węglarz and Ewa Konarska-Kuszewska are members of the board and shareholders of Lifetech Scientific distributor and received remuneration for consultations, research and workshops., (Copyright: © 2023 Termedia Sp. z o. o.) more...
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- 2023
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9. Thrombus containing lesions strategies during primary percutaneous coronary interventions in ST-segment elevation myocardial infarction: insights from ORPKI National Registry.
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Rakowski T, Węgiel M, Malinowski KP, Siudak Z, Zasada W, Zdzierak B, Tokarek T, Rzeszutko Ł, Dudek D, Bartuś S, Surdacki A, and Dziewierz A
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- Humans, Platelet Aggregation Inhibitors therapeutic use, Ticagrelor therapeutic use, Prasugrel Hydrochloride, Registries, Treatment Outcome, Platelet Glycoprotein GPIIb-IIIa Complex, ST Elevation Myocardial Infarction therapy, ST Elevation Myocardial Infarction etiology, Percutaneous Coronary Intervention adverse effects, Thrombosis etiology
- Abstract
In the era of potent P2Y
12 inhibitors, according to current guidelines, treatment with glycoprotein IIb/IIIa inhibitors (GPIs) should be limited to bail-out and/or highly thrombotic situations. Similarly, the recommendation for aspiration thrombectomy (AT) is downgraded to very selective use. We examine the prevalence, and predictors of GPI and AT use in STEMI patients referred to primary percutaneous coronary intervention (PCI). Data on 116,873 consecutive STEMI patients referred to primary PCI in Poland between 2015 and 2020 were analyzed. GPIs were administered in 29.3%, AT was used in 11.6%, and combined treatment with both in 6.1%. There was a mild trend toward a decrease in GPI and AT usage during the analyzed years. On the contrary, there was a rapid growth of the ticagrelor/prasugrel usage rate from 6.5 to 48.1%. Occluded infarct-related artery at baseline and no-reflow during PCI were the strongest predictors of GPI administration (OR 2.3; 95% CI 2.22-2.38 and OR 3.47; 95% CI 3.13-3.84, respectively) and combined usage of GPI and AT (OR 4.4; 95% CI 4.08-4.8 and OR 3.49; 95% CI 3.08-3.95 respectively) in a multivariate logistic regression model. Similarly, the administration of ticagrelor/prasugrel was an independent predictor of both adjunctive treatment strategies. In STEMI patients in Poland, GPIs are selectively used in one in four patients during primary PCI, and the combined usage of GPI and AT is marginal. Despite the rapid growth in potent P2Y12 inhibitors usage in recent years, GPIs are selectively used at a stable rate during PCI in highly thrombotic lesions., (© 2023. The Author(s).) more...- Published
- 2023
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10. Diffuse large B-cell lymphoma as a rare cause of acute de novo heart failure.
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Sorysz D, Węgiel M, Wiktorowicz A, Rajtar-Salwa R, Bobrowska B, and Bartuś S
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- Humans, Lymphoma, Large B-Cell, Diffuse diagnosis, Lymphoma, Large B-Cell, Diffuse diagnostic imaging, Heart Failure diagnostic imaging, Heart Failure etiology
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- 2023
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11. Concentration of Polycyclic Aromatic Hydrocarbons (PAHs) in Human Serum and Adipose Tissues and Stimulatory Effect of Naphthalene in Adipogenesis in 3T3-L1 Cells.
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Mlyczyńska E, Bongrani A, Rame C, Węgiel M, Maślanka A, Major P, Zarzycki P, Ducluzeau PH, De Luca A, Bourbao-Tournois C, Froment P, Rak A, and Dupont J
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- Animals, Mice, Humans, 3T3-L1 Cells, Adipogenesis, Pilot Projects, Naphthalenes pharmacology, Naphthalenes metabolism, Adipose Tissue metabolism, Obesity metabolism, Polycyclic Aromatic Hydrocarbons metabolism, Environmental Pollutants metabolism
- Abstract
Polycyclic aromatic hydrocarbons (PAHs) are one of the most prevalent classes of environmental pollutants. Some evidence shows that PAHs could be involved in human obesity. However, little is known about the distribution patterns of PAHs in human adipose tissue (AT) and the role of PAHs on adipogenesis/lipogenesis. The aims of this pilot study were to determine concentrations of 16 PAHs defined as high-priority pollutants in the plasma and adipose tissue of French and Polish bariatric patients, as well as their correlation with body mass index (BMI), plasma and AT adipokines expression levels. We finally investigated the role of naphthalene on cell proliferation, viability, and differentiation in 3T3-L1 preadipocytes. The concentration of most PAHs was similar in the three types of AT and it was significantly higher in AT as compared to plasma, suggesting bioaccumulation. Polish patients had higher PAH levels in AT than French ones. Only the concentration of naphthalene in AT was positively correlated with the BMI and serum or adipose chemerin, adiponectin and resistin expression, in French but not in Polish patients, who had significantly higher BMIs. Moreover, naphthalene exposure increased the cell proliferation of 3T3-L1 preadipocytes and lipogenesis, and increased the expression of genes involved in adipogenesis after cell differentiation. Taken together, PAHs and more particularly naphthalene could be an obesogenic molecule and increase the risk of obesity. more...
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- 2023
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12. Frailty as a Predictor of In-Hospital Outcome in Patients with Myocardial Infarction.
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Węgiel M, Kleczyński P, Dziewierz A, Rzeszutko Ł, Surdacki A, Bartuś S, and Rakowski T
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(1) Background: Frailty is a condition associated with aging, co-morbidity, and disability. We aimed to investigate the relationship between frailty and in-hospital outcome in patients with myocardial infarction (MI), including the occurrence of delirium, hospital-acquired pneumonia (HAP), and length of hospital stay. (2) Methods: We analyzed 55 patients ≥ 75 years old with ST-elevation and non-ST-elevation MI. Assessment with Abbreviated Mental Test Score (AMTS), Activity of Daily Living (ADL), Instrumental Activity of Daily Living (IADL) and Clinical Frailty Scale (CFS) was performed. (3) Results: In ROC analysis, IADL and CFS presented good predictive values for the occurrence of delirium (AUC = 0.81, p = 0.023, and AUC = 0.86, p = 0.009, respectively). For predicting HAP, only AMTS showed a significant value (AUC = 0.69, p = 0.036). In regression analyses, all tests presented significant predictive values for delirium. For predicting HAP, only IADL and CFS presented significant values (in an analysis adjusted for age, gender and type of MI). Frail patients (≥5 points in CFS) had longer hospital stays (10 days IQR: 8-17 vs. 8 days IQR: 7-10; p = 0.03). (4) Conclusions: While recognizing the limitations of our study associated with the relatively low sample size, we believe that our analysis shows that frailty is a predictor of poorer in-hospital outcomes in patients with MI, including higher rates of delirium, HAP and longer hospital stay. more...
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- 2022
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13. Mid-regional pro-adrenomedullin and lactate dehydrogenase as predictors of left ventricular remodeling in patients with myocardial infarction treated with percutaneous coronary intervention.
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Węgiel M, Wojtasik-Bakalarz J, Malinowski K, Surmiak M, Dziewierz A, Sorysz D, Tokarek T, Dudek D, Bartuś S, Surdacki A, and Rakowski T
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- Adrenomedullin, Biomarkers, C-Reactive Protein metabolism, Humans, L-Lactate Dehydrogenase, Prospective Studies, Ventricular Function, Left physiology, Ventricular Remodeling physiology, Myocardial Infarction complications, Myocardial Infarction surgery, Percutaneous Coronary Intervention adverse effects, Ventricular Dysfunction, Left complications
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Introduction: The main impact of myocardial infarction (MI) is shifting from acute mortality to adverse remodeling, chronic left ventricular (LV) dysfunction, and heart failure., Objectives: The aim of this study was to assess relationships between levels of circulating biomarkers and the function of LV after MI., Patients and Methods: This was a prospective study of 80 patients with MI treated with percutaneous coronary intervention. Novel biomarkers including mid‑regional pro‑adrenomedullin (MR‑proADM), Notch‑1, syndecan‑4, myeloperoxidase, S‑100 protein, soluble ST‑2, as well as markers of inflammatory response and tissue injury: galectin‑3, C‑reactive protein (CRP), lactate dehydrogenase (LDH), and interleukin‑6 (IL‑6) were assessed in the acute phase of MI. Echocardiography was performed at baseline and 6 month Results: Adverse remodeling, defined as more than 20% increase in LV end‑diastolic volume, occurred in 26% of patients. Reverse remodeling (>10% reduction in LV end‑systolic volume) was observed in 52% of patients. In the univariable analysis, higher levels of MR‑proADM and LDH were predictors of adverse remodeling and higher levels of MR ‑proADM, LDH, CRP, and IL ‑6 were negative predictors of reverse remodeling. In the multivariable model, LDH remained an independent predictor of adverse remodeling (odds ratio [OR], 3.13; 95% CI, 1.42-8.18; P = 0.003) and a negative predictor of reverse remodeling (OR, 0.37; 95% CI, 0.17-0.8; P = 0.005)., Conclusions: LDH and MR ‑proADM seem to be promising biomarkers of adverse remodeling. On the other hand, higher levels of these biomarkers were associated with reduced chance of occurrence of favorable reverse remodeling in MI patients. However, further studies on larger groups of patients are necessary to confirm these data. more...
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- 2022
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14. Risk factors of contrast-induced nephropathy in patients with acute coronary syndrome.
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Rakowski T, Dziewierz A, Węgiel M, Siudak Z, Zasada W, Jąkała J, Dykla D, Matysek J, Surdacki A, Bartuś S, Dudek D, and Wojdyła R
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- Contrast Media adverse effects, Creatinine, Humans, Risk Factors, Acute Coronary Syndrome therapy, Kidney Diseases chemically induced, Percutaneous Coronary Intervention adverse effects, ST Elevation Myocardial Infarction etiology
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Background: Patients with acute coronary syndrome (ACS) are at high risk of contrast-induced nephropathy (CIN), which is associated with prolonged hospitalization, higher morbidity and mortality after angiographic procedures. The occurrence of CIN is regarded as a transient and reversible condition. However, the persistence of CIN until hospital discharge in patients with ACS has not been thoroughly analyzed., Aims: We aimed to analyze CIN persistent until hospital discharge in contemporary ACS population referred to invasive diagnostics and treatment., Methods: A total of 2638 consecutive patients with ACS were included in a prospective registry. The occurrence of CIN was defined as a 25% increase in serum creatinine from baseline or a 0.5 mg/dl (44 μmol/l) increase in the absolute value., Results: Criteria of CIN at hospital discharge were met in 10.7% of patients. Immediate percutaneous coronary intervention (PCI) after angiography (67% of patients) was associated with higher rates of CIN compared to patients referred for other treatment strategies (P < 0.001). The logistic regression model showed that anemia at baseline (8.7% of patients) was an independent predictor of CIN, which occurred in 17.9% of anemic patients and 10% of patients without anemia (P < 0.001). Also, ST-segment elevation myocardial infarction (STEMI) presentation and immediate PCI were independent predictors of CIN., Conclusions: Despite intravenous fluid administration during the hospital stay, CIN persisted until hospital discharge in more than 10% of patients with ACS. Anemia at baseline, STEMI presentation, and immediate PCI strategy were independent predictors of CIN. Thus, preventive actions should be specially aimed at those groups of patients. more...
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- 2022
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15. Circulating biomarkers as predictors of left ventricular remodeling after myocardial infarction.
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Węgiel M and Rakowski T
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Introduction: The main impact of myocardial infarction is shifting from acute mortality to adverse remodeling and chronic left ventricle dysfunction. Several circulating biomarkers are explored for better risk stratification of these patients. Biomarker testing is a very attractive idea, since it is non-invasive, not operator-dependent and widely available., Aim: In the present paper we analyze data from the years 2005-2020 about circulating biomarkers of remodeling after myocardial infarction., Material and Methods: We assessed 53 articles, which examined 160 relations between biomarkers and remodeling. We analyze inclusion criteria for individual studies, time points of serum collection and remodeling assessment as well as imaging methods., Results: The main groups of assessed biomarkers included B-type natriuretic peptides, markers of cardiomyocyte injury and necrosis, markers of inflammatory response, markers of extracellular matrix turnover, microRNAs and hormones. The most common method of remodeling assessment was echocardiography and the most frequent time point for remodeling evaluation was 6 months., Conclusions: The present analysis shows that although a relatively large number biomarkers were tested, selecting one ideal marker is still a challenge. A combination of biomarkers from different groups might be appropriate for predicting remodeling. Data presented in this analysis might be helpful for designing future studies, evaluating clinical use of an individual biomarker or a combination of different biomarkers., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2021 Termedia Sp. z o. o.) more...
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- 2021
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16. Frequency of occurrence of metabolic syndrome risk factors in children and adolescents from the city of Wrocław and surroundings
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Piotrowska E, Figurska-Ciura D, Łoźna K, Bienkiewicz M, Mazurek D, Wyka J, Węgiel M, Biernat J, and Godyla-Jabłoński M
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- Adolescent, Age Factors, Child, Female, Humans, Male, Metabolic Syndrome epidemiology, Pediatric Obesity epidemiology, Poland epidemiology, Prevalence, Risk Factors, Sex Factors, Exercise physiology, Metabolic Syndrome diagnosis, Metabolic Syndrome physiopathology, Pediatric Obesity diagnosis, Pediatric Obesity physiopathology
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Background: A recently growing number of children and adolescents with overweight or obesity is indicative of the need for diagnosing their complications that may appear in the early childhood. For this reason, diagnostic criteria were developed for components of the metabolic syndrome (MS) also for these groups of the population., Objective: This study was aimed at evaluating the frequency of metabolic syndrome risk factors occurrence in children and adolescents from the city of Wrocław and surroundings depending on gender, age and physical activity., Material and Methods: Investigations on the frequency of occurrence of dietary and non-dietary risk factors of the metabolic syndrome were carried out in the years 2010-2017 among 771 children and adolescents aged 10-18 year, attending to primary schools, gymnasiums and secondary schools in Wrocław., Results: The lack of any components of the metabolic syndrome was demonstrated in 14.78% of the children aged 10-12 years as well as in 17.38% of both adolescents aged 13-15 and 17-18 years. One risk factor was most frequently diagnosed in children aged 10-12 years (17.89%) and it was arterial hypertension (16.08% of the whole surveyed population). Three MS components were demonstrated in 15 persons (1.95% of the whole surveyed population), including in 7 girls and 8 boys. The persons with three MS risk factors from the age category 13-15 years constituted 0.26% whereas these from the age category 17-18 years constituted 1.69% of the whole surveyed group., Conclusions: It shall be concluded that the incidence of the fully symptomatic MS depended significantly on the age of the surveyed, but not on their gender. Among the three adopted components of MS, the most frequently demonstrated disorders included: arterial hypertension, abdominal obesity and increased concentration of triglycerides in blood serum., Competing Interests: The authors declare no conflict of interest, (Copyright by the National Institute of Public Health - National Institute of Hygiene) more...
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- 2020
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17. Prevalence and Predictors of Coronary Artery Perforation During Percutaneous Coronary Interventions (from the ORPKI National Registry in Poland).
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Rakowski T, Węgiel M, Siudak Z, Plens K, Dziewierz A, Birkemeyer R, Kleczyński P, Tokarek T, Rzeszutko Ł, and Dudek D
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- Aged, Atherectomy, Coronary adverse effects, Coronary Angiography, Coronary Occlusion diagnosis, Coronary Vessels diagnostic imaging, Coronary Vessels surgery, Female, Follow-Up Studies, Humans, Intraoperative Complications diagnosis, Intraoperative Complications etiology, Male, Middle Aged, Poland epidemiology, Prevalence, Prospective Studies, Risk Factors, Survival Rate trends, Time Factors, Vascular System Injuries diagnosis, Vascular System Injuries etiology, Coronary Occlusion surgery, Coronary Vessels injuries, Intraoperative Complications epidemiology, Percutaneous Coronary Intervention adverse effects, Registries, Risk Assessment methods, Vascular System Injuries epidemiology
- Abstract
Coronary artery perforation (CAP) is a rare but potentially life-threatening complication of percutaneous coronary intervention (PCI). With a growing number of PCIs in complex lesions, the problem of CAP becomes even more important nowadays. Data on CAP rates in Poland are lacking. Presented study is an analysis of 344,517 consecutive patients treated with PCI between 2014 and 2017. Data were gathered from the Polish National PCI Registry (ORPKI). During 4 years of data collection CAP was observed in 595 (0.17%) cases. Patients diagnosed with CAP were older (69 years Q1:63; Q3:78 vs 66 years Q1:60; Q3:75; p <0.001), more often female (44% vs 32%; p <0.001), with arterial hypertension (77% vs 71%; p = 0.002), and chronic kidney disease (8.9% vs 5.4%; p <0.001). In the CAP group, a higher rate of PCIs within chronic total occlusions (8.7% vs 2.3%; p <0.001) and saphenous vein graft lesions (2.7% vs 1.3%; p = 0.002), as well as rotational atherectomy procedures (2.2% vs 0.4%; p <0.001) was observed. Patients with CAP had higher rate of no-reflow phenomenon (5.5% vs 0.5%; p <0.001) and greater periprocedural mortality (4.2% vs 0.5%; p <0.001). In conclusion, our study confirms that CAP is more common during complex PCI procedures in high-risk patients. CAP occurrence is associated with worse immediate outcomes including increased periprocedural mortality., (Copyright © 2019 Elsevier Inc. All rights reserved.) more...
- Published
- 2019
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18. Characteristics of patients presenting with myocardial infarction with non-obstructive coronary arteries (MINOCA) in Poland: data from the ORPKI national registry.
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Rakowski T, De Luca G, Siudak Z, Plens K, Dziewierz A, Kleczyński P, Tokarek T, Węgiel M, Sadowski M, and Dudek D
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- Aged, Coronary Angiography, Coronary Artery Disease diagnosis, Coronary Vessels diagnostic imaging, Female, Humans, Male, Middle Aged, Multimodal Imaging, Myocardial Infarction diagnostic imaging, Myocardial Infarction epidemiology, Myocardial Infarction mortality, Poland, Registries, Risk Factors, Coronary Vessels physiopathology, Myocardial Infarction etiology
- Abstract
Myocardial infarction (MI) with non-obstructive coronary arteries (MINOCA) is an important clinical problem especially in the era of extensive utilization of coronary angiography in MI patients. Its pathophysiology is poorly understood which makes diagnostics and treatment of MINOCA challenging in everyday clinical practice. The aim of the study was to assess characteristics of MINOCA patients in Poland based on data from the Polish National ORPKI Registry. In 2016, 49,893 patients with non-ST-segment elevation (NSTEMI) or ST-segment elevation (STEMI) myocardial infarction entered the ORPKI registry. MINOCA was defined as a non-obstructive coronary artery disease (CAD) and a lack of previous coronary revascularization. MINOCA was identified in 3924 (7.8%) patients and clinical presentation was more often NSTEMI than STEMI (MINOCA: 78 vs. 22%; obstructive CAD 51.1 vs. 48.9%; p < 0.0001). MINOCA patients were younger and more often females with significantly lower rates of diabetes, smoking, arterial hypertension, kidney disease, previous MI and previous stroke comparing to patients with obstructive CAD. Myocardial bridge was visualized in angiography more often in the MINOCA group (2.2 vs. 0.4%; p < 0.0001). Additional coronary assessment inducing fractional flow reserve, intravascular ultrasound, optical coherence tomography was marginally (< 1%) used in both groups. Periprocedural mortality was lower in MINOCA group (0.13% vs. 0.95%; p < 0.0001). MINOCA patients represent a significant proportion of MI patients in Poland. Due to multiple potential causes, MINOCA should be considered rather as a working diagnosis after coronary angiography and further efforts should be taken to define the cause of MI in each individual patient. more...
- Published
- 2019
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19. Hospitalization Length after Myocardial Infarction: Risk-Assessment-Based Time of Hospital Discharge vs. Real Life Practice.
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Węgiel M, Dziewierz A, Wojtasik-Bakalarz J, Sorysz D, Surdacki A, Bartuś S, Dudek D, and Rakowski T
- Abstract
According to guidelines, it is safe for low-risk patients with myocardial infarction (MI) to be discharged within 72 h of hospitalization. However, results coming from registries show that the hospital stay is often much longer in a real-life situation. Data on the length of the hospital stay (LOS) of MI patients in Polish centers are lacking. We enrolled 212 consecutive patients with acute MI. Low-risk patients were defined according to PAMI II criteria: age <70 years, left ventricular ejection fraction (LVEF) >45%, no persistent ventricular arrhythmia, and no multi-vessel disease (MVD). The median of the hospitalization length was eight days (Q1: 6; Q3: 9). In low-risk patients (25%), the median of LOS was six days (Q1: 5; Q3: 7) ( p < 0.001). In a logistic regression analysis patients age, LVEF, ST-segment-elevation MI and the presence of MVD were independent predictors of longer hospitals stay (≥8 days). During follow up, there were no significant differences in the rates of clinical events between patients with shorter (<8 days) and longer (≥8 days) hospitalization. In a real-life situation, the LOS, even in low-risk patients is much longer than recommended in the guidelines. more...
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- 2018
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20. Seasonal variations of PCDD/Fs congeners in air, soil and eggs from a Polish small-scale farm.
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Węgiel M, Chrząszcz R, Maślanka A, and Grochowalski A
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- Animals, Chickens, Dibenzofurans, Polychlorinated analysis, Poland, Air Pollutants analysis, Dioxins analysis, Eggs analysis, Farms, Polychlorinated Dibenzodioxins analysis, Seasons, Soil Pollutants analysis
- Abstract
The transfer of dioxin from the environment to the food is a problem in a consumers' health protection. The study aimed to determine the concentration of dioxins in free-range chicken eggs, air and soil samples, collected during 12 months on an individual small farm, located in Małopolska region, Poland. In the majority of analyzed eggs, the concentrations of dioxin exceeded several times the legal limit of 2.5 pg WHO-TEQ g-1fat. Seasonal changes in the PCDD/Fs congeners in egg, air and soil samples were studied. During the winter season, when the combustion processes of the solid fuel in domestic furnaces are intensive, the PM10 concentration in the Małopolska region exceeds the legal limit (50μg/m3) even eight times. In this period, eggs, air and soil samples showed a higher share of PCDFs with a specific contribution of 2,3,7,8-TCDF. During the summer months, in the egg, air and soil samples, the share of PCDDs is higher with dominant OCDD and 1,2,3,4,6,7,8-HpCDDs, showing the effect of other combustion processes such as grass utilization or burning plastic wastes in controlled fires. In August, the month of the highest average air temperature and lowest rainfall amount, the highest toxicity of PCDD/Fs in eggs (9.52pgWHO-TEQ g-1fat) was found. Due to the similarity of the shares of PCDD/Fs congeners in total WHO-TEQ value we can take into account the influence of toxicity of PCDD/Fs in the air and soil on the toxicity in the eggs., (Copyright © 2018. Published by Elsevier Ltd.) more...
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- 2018
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21. Direct Absorb bioresorbable scaffold implantation in acute coronary syndrome.
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Rzeszutko Ł, Węgiel M, Kleczyński P, Zasada W, Depukat R, Rakowski T, Legutko J, Surdacki A, Dudek D, and Bartuś S
- Subjects
- Aged, Coronary Vessels surgery, Female, Humans, Male, Middle Aged, Tissue Scaffolds, Treatment Outcome, Absorbable Implants, Acute Coronary Syndrome surgery, Percutaneous Coronary Intervention
- Abstract
Background: Direct stent implantation is a preferred technique for primary percutaneous coronary intervention (PCI). For the deployment of a bioresorbable vascular scaffold (BVS), the current guidelines recommend aggressive predilatation. Data about direct BVS implantation in patients with acute coronary syndrome (ACS) are scarce., Aim: We sought to assess procedural characteristics and immediate outcomes of direct Absorb BVS implantation in ACS patients., Methods: A total of 91 patients with acute myocardial infarction (MI) requiring urgent coronary revascularisation were enrolled. Among them, 50 patients underwent an attempt of direct Absorb implantation. The control group consisted of 41 patients treated with PCI with BVS deployment after elective predilatation., Results: In the direct group BVS deployment was successful in 91% of lesions, and in the remaining 9% of lesions direct implantation failed. In the control group scaffolds were successfully deployed after predilatation in 98% of lesions. In one case Absorb implantation failed even after balloon angioplasty. Type C lesions with severe tortuosity and angulation > 90° were associated with failure in direct Absorb deployment. Quantitative coronary analysis showed similar final percentages of diameter stenosis in the study and control groups. Flow analyses did not show significant differences between both methods. During hospitalisation no recurrent MI, scaffold thrombosis, or target lesion revascularisation was reported in either group., Conclusions: Direct Absorb implantation in ACS patients may be feasible in a suitable lesion anatomy. more...
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- 2018
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22. CHA 2 DS 2 -VASc and R 2 -CHA 2 DS 2 -VASc scores predict in-hospital and post-discharge outcome in patients with myocardial infarction.
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Węgiel M, Rakowski T, Dziewierz A, Wojtasik-Bakalarz J, Sorysz D, Bartuś S, Surdacki A, and Dudek D
- Abstract
Introduction: The CHA
2 DS2 -VASc and R2 -CHA2 DS2 -VASc scores were initially designed to evaluate the risk of cerebrovascular events in patients with atrial fibrillation. However, these scales consist of parameters which are well known as general risk factors for cardiovascular events., Aim: To assess the role of the CHA2 DS2 -VASc and R2 -CHA2 DS2 -VASc scores in predicting outcome of patients with myocardial infarction (MI)., Material and Methods: We enrolled 212 consecutive patients with both ST-elevation and non-ST-elevation MI referred for primary percutaneous coronary intervention (PCI). Patients were divided into two groups depending on the CHA2 DS2 -VASc score: ≤ 3 (low score) and > 3 points (high score)., Results: The group with a CHA2 DS2 -VASc score > 3 points consisted of 93 (44%) patients. Follow-up was available in 200 (94.3%) patients with median duration of 10 (Q1: 6; Q3: 13) months. During the follow-up all-cause mortality was greater in patients from the high score group (21%) compared to patients with lower scores (8%) ( p = 0.009). Recurrent MI was found in 4% of patients from the low score group and in 13% of patients from the high score group ( p = 0.024). The combined endpoint of cardiovascular mortality, recurrent non-fatal MI and non-fatal stroke occurred in 13% of lower score patients and in 30% of patients with a score > 3 points ( p = 0.002). In a Cox regression model both scores were predictors of all-cause mortality with a hazard ratio of 1.31 per 1 point increase for the CHA2 DS2 -VASc score ( p = 0.004) and 1.36 for the R2 -CHA2 DS2 -VASc score ( p < 0.001)., Conclusions: The CHA2 DS2 -VASc and R2 -CHA2 DS2 -VASc scores predict in-hospital and post-discharge outcome in patients with acute MI undergoing primary PCI. more...- Published
- 2018
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23. Study on the impact of industrial flue gases on the PCDD/Fs congener profile in ambient air.
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Węgiel M, Chrząszcz R, Maślanka A, and Grochowalski A
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- Air analysis, Dibenzofurans, Polychlorinated, Incineration, Industry, Medical Waste analysis, Poland, Polychlorinated Dibenzodioxins analysis, Sewage analysis, Air Pollutants analysis, Benzofurans analysis, Gases analysis, Polychlorinated Dibenzodioxins analogs & derivatives
- Abstract
The aim of this study was to examine the impact of emissions from combustion processes from sinter, medical, waste and sewage waste incineration plants on the PCDD and PCDF congener profile in ambient air in Krakow (city in Poland). The subject matter of the study were air samples from the outskirts and the city center. It was found that in flue gases from industrial sources and in ambient air the share of PCDF congeners in relation to the total content of PCDD/Fs was higher than the share of PCDDs. However, in air samples collected in the city center, this relationship was reversed. The PCDD congener profiles in flue gases and in air samples are comparable. However, in the samples from the city centre, the share of OCDD is significantly higher and amounts to about 80%. The PCDF congener shares show higher spatial diversity, although in all the analyzed air samples, ODCF and 1,2,3,4,6,7,8 HpCDF dominated. Analyzing the share of congeners in regard to the sum of PCDDs/Fs a mutual resemblance of air from the suburbs, exhaust gases from the sinter ore and sewage sludge incinerator plant was observed. The study showed a similarity between the profile of congeners in air from the city centre and exhaust gases from the medical waste incinerator., (Copyright © 2014 Elsevier Ltd. All rights reserved.) more...
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- 2014
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24. Study on the determination of PCDDs/Fs and HCB in exhaust gas.
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Węgiel M, Chrząszcz R, Maślanka A, and Grochowalski A
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- Chromatography, Gas, Dibenzofurans, Polychlorinated, Incineration, Industrial Waste, Polychlorinated Dibenzodioxins analysis, Polyurethanes chemistry, Air Pollutants analysis, Benzofurans analysis, Gases analysis, Hexachlorobenzene analysis, Polychlorinated Dibenzodioxins analogs & derivatives
- Abstract
The subject of this study was to develop a method of simultaneous determination of PCDDs/PCDFs and HCB in exhaust gases from industrial installations. Sampling to determine PCDDs/PCDFs was conducted using the method described in PN-EN 1948-1: 2006, where the sorption material is polyurethane foam (PUF). In order to simultaneously collect PCDDs/PCDFs and HCB and to avoid sorbent bed breakthrough, it was necessary to apply an additional polyurethane sorption layer. Twenty-seven samples of exhaust gases from various cement plants and 40 samples of exhaust gases from hospital and industrial waste incineration plants collected in 2009/2010 in the entire territory of Poland were examined. The average content of PCDDs/Fs in samples from cement plants amounted to 0.076 ng I-TEQ N m(-3) (range of 0.002-0.62 ng I-TEQ N m(-3)), while the average content of HCB amounted to 10 ng N m(-3) (range of 0.98-60.5 ng N m(-3)). In the case of samples collected from waste incineration plants, the average concentration of PCDDs/Fs was 0.39 ng I-TEQN m(-3) (range of 0.002-5.68 ng I-TEQ N m(-3)). In the case of HCB, the average concentration was 238 ng N m(-3) (range of 3.21-2500 ng N m(-3)). Also, the interdependence of the concentration of PCDDs/PCDFs and HCB was determined in the analysed samples, with the ranges of low and high content of PCDDs/PCDFs being examined separately. In all cases, the determined values of the r correlation coefficient were within the range of 0.7-1.0, which indicates a good correlation between the concentrations of PCDDs/PCDFs and HCB., (Copyright © 2011 Elsevier Ltd. All rights reserved.) more...
- Published
- 2011
- Full Text
- View/download PDF
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