Mesko (Poland)

Abstract. This study presents a comparative analysis of two shafts on which material feeder discs were mounted. In the first configuration, a bronze sleeve bushing was used, whereas in the second one, two needle roller bearings (SKF, 40×47×16 mm) were applied. Both shafts operated under identical service conditions on equivalent machines positioned side by side, in a two-shift system over a period of five years, corresponding to approximately 15,000 operating hours. Both maintenance and service of the systems were carried out in accordance with the manufacturer’s recommendations, which ensured comparable operating conditions. The conducted study aimed to determine the differences in wear, reliability, and maintenance costs between the shaft equipped with a bronze bushing and the one fitted with needle roller bearings, as illustrated by the condition of the components shown in Fig.1. The obtained results may serve as a basis for optimizing design solutions in similar drive systems used in industrial applications [1-3].

Key Teaching Points1. Patients with vagally mediated bradyarrhythmias (VMB) referred for n (ECVS)-guided cardioneuroablation (CNA) typically require retrograde and bilateral cannulation of the internal jugular veins (IJV) via the superior vena cava (SVC).However, rare anomalies in SVC and brachiocephalic vein drainage can hinder the implementation of ECVS for CNA guidance, necessitating alternative vascular access for ECVS, preferably bilateral but at minimum unilateral.2. Preprocedural multimodality imaging (CT, MRI, TEE), complemented by targeted venography, is crucial for identifying SVC and brachiocephalic venous interruptions enabling individualized ECVS-guided CNA strategies and coordinated Heart Team planning.3.This case series describes the incidence of these anomalies, explores alternative vascular access routes, and provides technical tips, procedural strategies, and imaging guidance for successful IJV cannulation in patients with VMB and interrupted SVC drainage into the right atrium (RA) referred for complex ECVS-guided CNA.Access via unilateral or bilateral subclavian veins, a persistent left SVC, the azygos vein, or retrograde puncture with ultrasonography-guided IJV cannulation can facilitate ECVS-guided CNA in patients with complex upper thoracic venous anatomy due to adult congenital heart disease or iatrogenic interruption of SVC-RA drainage.

Abstract Introduction Sinus tachycardias (ST) may be associated with symptomatic, functional, vagally mediated bradyarrhythmis referred for cardioneuroablation (CNA). Moreover, the incidence of de novo pathological ST (defined as ST within the first 6 months after CNA), inappropiate sinus tachycardia (IST) and postural orthostatic tachycardia syndrome (POTS)] are a potential side effects of the procedure and require innovative management strategies including SN sparing hybrid ablation (SNS). The study sought to validate the prevalence, co-incidence and management of ST/IST/POTS in patients with VMB referred for CNA. Methods Data were collected from the Polish multicenter CNA (POL-CA) registry (POL-CA). All consecutive patients referred for the first extra cardiac vagal nerve stimulation (ECVS)-guided CNA with symptomatic VMB were retrospectively analyzed. In all patients standardized cardiovascular autonomic test (CAT) and active standing test were performed off-drugs before and when neccessary after CNA procedure to classified patients with the symptoms of IST/POTS. During shared-decision making several options were discussed with the patients (CNA only, CNA+drugs, SNS only, CNA+SNS, Pacemaker+drugs+SN ablation, etc). Patients requiring treatment for de-novo symptomatic ST within 6 months after CNA were classified as CNA-induced pathological ST. Patients with persistent (>12 months), symptomatic and drug-resistant CNA-induced IST/POTS were referred for SNS. Results A total of consecutive 380 adult patients (mean age: 54+/-15 years; 45% women) referred for the first ECVS-guided CNA with symptomatic VMB and who completed at least 12-month follow-up were included into analysis. In 1,6% (6/380) of patients pre-procedural IST/POTS associated with VMB were documented. Those patients were classified as bidirectional (uninodal or binodal) arrhythmic syndrome. In 6/6 of patients primarily CNA were performed to establish adequate control of symptoms with (1/6) or without (5/6) drug treatment. After CNA procedure the incidence of CNA-induced de novo pathological ST were observed and treated in 23% (88/380) of patients, however additional 8% (31/380) of patients were shortly managed by ivabradine and/or bisoprolol to control tendency for borderline ST symptoms. Finally, only 0,5% (2/380) of patients with de novo CNA-induced long-standing persistent drug-resistant IST/POTS were referred for SNS. Conclusions Prevalence and co-incidence of IST/POTS with VMB referred for CNA is rare (1,5%), however 3-times higher than long-standing persistent, drug-resistant symptomatic CNA-induced IST/POTS (0,5%) requiring SNS hybrid ablation. Symptomatic CNA-induced pathological ST disappeared in majority of patients within the first 12 months. Bidirectional (uni- or binodal tachycardia-bradycardia) arrhythmic syndrome require comprehensive management with shared-decision making and including complex and hybrid non-invasive and invasive treatment.

Electrical discharge machining is one of the main methods of manufacturing technological equipment used in the foundry industry, plastics processing, plastic working, etc. Important elements determining its quality are, apart from the properties of the materials used, the features imparted in the manufacturing processes.The paper presents a brief study of electro-discharge alloying process of surface with using rod vibrating electrode.It is also economically justified to use EDM (Electrical Discharge Machining) to produce machine parts from materials that are easily machined, but with very complex geometry, and therefore difficult and labor-intensive to produce using conventional methods.Spark discharges are created between the working electrode and the workpiece, the entire process takes place in a working medium with dielectric properties.As a result of the local increase in temperature, melting and partial evaporation of the microvolume of the material occurs.The main factors influencing the formation of the surface layer in the process of its modification are the melting process, diffusion processes, rapid heating and cooling of the material, phase transitions and changes in the structure of the layers adjacent to the crater formation site.In the tested process, the modified surface layer with improved properties reached a thickness of up to 90 micrometers, and the material resolidified on the surface of the workpiece contains about 50% of alloying elements.The geometric structure of the surface resulting from the modification is similar to that obtained by EDM.The distribution of inequality vertices is random.For typical machining conditions, the obtained roughness Sa is approximately 3.5 m.

ObjectiveIntravenous thrombolysis (IVT) with recombinant tissue plasminogen activator is the core medical therapy of acute ischaemic stroke (AIS). COVID‐19 infection negatively modifies acute stroke procedures and, due to its pro‐coagulative effect, may potentially impact on IVT outcome. Thus, short‐term efficacy and safety of IVT were compared in patients with and without evidence of SARS‐CoV‐2.MethodsAn observational, retrospective study included 70 patients with AIS, including 22 subjects (31%) with evidence of acute COVID‐19 infection, consecutively treated with IVT in 4 stroke centres between 15 September and 30 November 2020.ResultsPatients infected with COVID‐19 were characterized by higher median of National Institute of Health Stroke Scale (NIHSS) score (11.0 vs. 6.5; p < .01) and D‐dimers (870 vs. 570; p = .03) on admission, higher presence of pneumonia (47.8% vs. 12%; p < .01) and lower percentage of ‘minor stroke symptoms’ (NIHSS 1–5 pts.) (2% vs., 18%; p < .01). Hospitalizations were longer in patients with COVID‐19 than in those without it (17 vs. 9 days, p < .01), but impact of COVID‐19 infection on patients’ in‐hospital mortality or functional status on dismission has been confirmed neither in uni‐ or multivariate analysis.ConclusionSARS‐CoV‐2 infection prolongs length of stay in hospital after IVT, but does not influence in‐hospital outcome.

The aim of this study was to report the course and outcome of SARS-CoV-2 infection in multiple sclerosis (MS) patients treated with disease-modifying therapies (DMTs) in Poland. A major concern for neurologists worldwide is the course and outcome of SARS-CoV-2 infection in patients with MS treated with different DMTs. Although initial studies do not suggest an unfavourable course of infection in this group of patients, the data is limited. This study included 396 MS patients treated with DMTs and confirmed SARS-CoV-2 infection from 28 Polish MS centres. Information concerning patient demographics, comorbidities, clinical course of MS, current DMT use, as well as symptoms of SARS-CoV-2 infection, need for pharmacotherapy, oxygen therapy, and/or hospitalisation, and short-term outcomes was collected up to 30 January 2021. Additional data about COVID-19 cases in the general population in Poland was obtained from official reports of the Polish Ministry of Health. There were 114 males (28.8%) and 282 females (71.2%). The median age was 39 years (IQR 13). The great majority of patients with MS exhibited relapsing-remitting course (372 patients; 93.9%). The median EDSS was 2 (SD 1.38), and the mean disease duration was 8.95 (IQR 8) years. Most of the MS patients were treated with dimethyl fumarate (164; 41.41%). Other DMTs were less frequently used: interferon beta (82; 20.70%), glatiramer acetate (42; 10.60%), natalizumab (35;8.84%), teriflunomide (25; 6.31%), ocrelizumab (20; 5.05%), fingolimod (16; 4.04), cladribine (5; 1.26%), mitoxantrone (3; 0.76%), ozanimod (3; 0.76%), and alemtuzumab (1; 0.25%). The overall hospitalisation rate due to COVID-19 in the cohort was 6.81% (27 patients). Only one patient (0.3%) died due to SARS-CoV-2 infection, and three (0.76%) patients were treated with mechanical ventilation; 106 (26.8%) patients had at least one comorbid condition. There were no significant differences in the severity of SARS-CoV-2 infection regarding patient age, duration of the disease, degree of disability (EDSS), lymphocyte count, or type of DMT used. Most MS patients included in this study had a favourable course of SARS-CoV-2 infection. The hospitalisation rate and the mortality rate were not higher in the MS cohort compared to the general Polish population. Continued multicentre data collection is needed to increase the understanding of SARS-CoV-2 infection impact on the course of MS in patients treated with DMTs.

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Kamiński B, Jasikowska MM, Millak-Wojtan D, Nowak-Wrzoskiewicz M, Pióro P. Early diagnosis of basal cell naevus syndrome: genetic predisposition, clinical presentation and treatment. Dermatology Review/Przegląd Dermatologiczny. 2021;108(5):422-425. doi:10.5114/dr.2021.113160. APA Kamiński, B., Jasikowska, M. M., Millak-Wojtan, D., Nowak-Wrzoskiewicz, M., & Pióro, P. (2021). Early diagnosis of basal cell naevus syndrome: genetic predisposition, clinical presentation and treatment. Dermatology Review/Przegląd Dermatologiczny, 108(5), 422-425. https://doi.org/10.5114/dr.2021.113160 Chicago Kamiński, Bartłomiej, Mariola M Jasikowska, Dorota Millak-Wojtan, Marcelina Nowak-Wrzoskiewicz, and Paweł Pióro. 2021. "Early diagnosis of basal cell naevus syndrome: genetic predisposition, clinical presentation and treatment". Dermatology Review/Przegląd Dermatologiczny 108 (5): 422-425. doi:10.5114/dr.2021.113160. Harvard Kamiński, B., Jasikowska, M., Millak-Wojtan, D., Nowak-Wrzoskiewicz, M., and Pióro, P. (2021). Early diagnosis of basal cell naevus syndrome: genetic predisposition, clinical presentation and treatment. Dermatology Review/Przegląd Dermatologiczny, 108(5), pp.422-425. https://doi.org/10.5114/dr.2021.113160 MLA Kamiński, Bartłomiej et al. "Early diagnosis of basal cell naevus syndrome: genetic predisposition, clinical presentation and treatment." Dermatology Review/Przegląd Dermatologiczny, vol. 108, no. 5, 2021, pp. 422-425. doi:10.5114/dr.2021.113160. Vancouver Kamiński B, Jasikowska M, Millak-Wojtan D, Nowak-Wrzoskiewicz M, Pióro P. Early diagnosis of basal cell naevus syndrome: genetic predisposition, clinical presentation and treatment. Dermatology Review/Przegląd Dermatologiczny. 2021;108(5):422-425. doi:10.5114/dr.2021.113160.

Homo et Societas » Nr 4/2019 » Sprawozdanie z konferencji naukowej pt. "Rola i miejsce rodziny w procesie wychowania, profilaktyki uzależnień i resocjalizacji". Skarżysko-Kamienna 26 marca 2019 roku A A A

The authors present the case of a 41-year-old patient with hereditary hemorrhagic telangiectasia (HHT), who in the past had an aortic valve replacement surgery, currently takes anticoagulant drugs and has sustained an extensive trauma to the nose as a result of a dog bite. The HHT is diagnosed basing on the presence of at least three out of four symptoms or signs: spontaneous epistaxis, vascular lesions in the internal organs, skin telangiectasias and a family history of the disease. The presented patient showed hepatic angioma, history of recurrent bleeding from the tongue and spontaneous epistaxis as well as numerous skin telangiectasias. In his case, HHT coincided with chronic treatment with coagulants implemented after an implantation of the artificial aortic replacement valve, what substantially modified the clinical picture and course of treatment.

Investigations of characteristics the ferroelectric crystals of A 2 MX 4 and AMX 3 type with incommensurate phases are very interesting both from a scientific and practical point of view. Some aspects of behaviour phase transitions of these crystals are discussed. Special attention is paid to the temperature dependence of series of different type phase transitions. Analysis of the literature data and results of our research let us to consider potential possibilities of practical applications of these materials for optoelectronic devices. Observed temperature hysteresis of birefringence and absorption coefficient in incommensurate phases are especially important for application as optical memories.