Kardiol Pol
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Diffuse brain injury is a key component of post-cardiac arrest syndrome reported in 30-80% of survivors of out-of-hospital cardiac arrest (OHCA). It is responsible for a high mortality rate, and is a common cause of cognitive and neurological deficits and disability. Symptom variability and dynamics and the rehabilitation potential remain poorly understood. ⋯ Cognitive and neurological symptoms are common after cardiac arrest brain injury. Establishing specialised neurorehabilitation centres is essential for treating these patients.
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Optimal treatment of ST segment elevation myocardial infarction (STEMI) should be initiated immediately. System delay is considered an important indicator of quality of care in STEMI, and at the same time it is an independent predictor of clinical outcomes. It can be modified largely by introducing organisational changes. Although conditions have been created in Poland for common use of electrocardiogram (ECG) teletransmission and direct transfer of all STEMI patients to cardiac catheterisation laboratories, no uniform management algorithms have been introduced. ⋯ An ECG teletransmission and teleconsultation system reduces the system delay. ECG teletransmission systems work well in rural areas with low population density and a single large PCI-capable hospital. With increasing experience, a gradual increase in the effectiveness of management protocols involving ECG teletransmission is seen.
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Comparative Study
Secondary prevention in patients after hospitalisation due to coronary artery disease: what has changed since 2006?
The evidence concerning the quality of secondary prevention of coronary artery disease (CAD) in Poland in recent years is scarce. ⋯ We noted a modest improvement in the implementation of CAD secondary prevention guidelines in everyday clinical practice: blood pressure was better controlled, although the control of all other main risk factors did not change significantly. Our data provides evidence that there is a considerable potential for further reduction of cardiovascular risk in CAD patients.
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Obstructive sleep apnoea (OSA) and atrial fibrillation (AF) are two conditions highly prevalent in the general population. OSA is known to cause haemodynamic changes, oxidative stress, and endothelial damage, and therefore promote vascular and heart remodelling which results in AF triggering and exacerbation. Coexistence of OSA and AF influences the course of both diseases, and therefore should be taken into consideration in patient management strategy planning. ⋯ OSA is highly prevalent in patients with AF in the Polish population, and affects approximately half of the patients. OSA patients are more likely to be older, have higher BMI, and greater waist and neck circumference. Persistent AF is the most common form of the arrhythmia in patients with OSA, while patients without OSA are more likely to have paroxysmal AF.
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The Patient Perception of Arrhythmia Questionnaire (PPAQ) is a disease-specific questionnaire designed to measure symptoms and health-related quality of life in patients suffering from a group of arrhythmias collectively known as supraventricular tachycardias (SVT). There is no valid translation of PPAQ available in Poland, which hinders research in this area with Polish arrhythmia patients. ⋯ The Polish translation was well accepted by patients during this translation and initial content validity testing. Issues arising during the translation process may recur in other translations and be resolved in a similar manner.