Institute of Fundamental Technological Research

Abstract: BackgroundDiet-related diseases remain leading causes of death in most developed countries around the world. The aim of the study was to compare opinions of patients and family physicians on receiving and providing recommendations about physical activity, diet and use of medication. Methods: The questionnaire study was conducted among patients of 36 primary health care clinics in Poland between September 2018 and February 2019. Patients and physicians were interviewed separately by trained researchers. Data from 509 patients and 167 family doctors were analyzed. Results: The median age of patients was 44 years (interquartile range: 29–55) and 70% were women. The majority of physicians were women (59%) and the median age was 37 years (IQR: 31–50). There was a significant difference between physicians’ declarations on providing recommendations on diet (92% vs. 39%) and activity (90% vs. 37%) versus patients’ declarations on receiving them. Conclusions: The results indicate that there is significant room for improvement in providing patients with proper recommendations on diet and physical activity by their family physicians. Primary care physicians should put more emphasis on clear communication of recommendations on diet and physical activity.

diet

Background. Blood flow-mediated dilation (FMD) is a noninvasive assessment of vascular endothelial function in humans. The study of the FMD in hypertensive (HT) patients is an important factor supporting the recognition of the early mechanisms of cardiovascular pathologies, and also of the pathogenesis related to hypertension. Objectives. To investigate whether FMD measured on the radial artery (FMD-RA) using high-requency ultrasounds can be used asan alternative to FMD assessed with the lower frequency system onthe brachial artery in patients with HT. Materials and methods. The simultaneous measurements of FMD-RA and FMD measurements in the brachial artery (FMD-BA) were performed on 76 HT patients using 20 MHz and 7–12 MHz linear array probes, and were compared to the FMD measured in healthy groups. All quantitative data are presented as mean ± standard deviation (SD); the p-values of the normality and tests for variables comparisons are listed. The agreement of the FMD-RA and FMD-BA in HT patients was assessed with the Bland–Altman method, and using the intraclass correlation coefficient (ICC). In some statistical calculations, the FMD-RA values were rescaled by dividing them by a factor of 2. Results. The mean FMD-RA and FMD-BA in HT patients were 5.16 ±2.18% (95% confidence interval (95% CI): [4.50%, 5.82%]) and 2.13 ±1.12% (95% CI: [1.76%, 2.49%]), respectively. The FMD-RA and FMD-BA values of HT patients were significantly different than those in respective control groups. The p-values of Mann–Whitney–Wilcoxon tests were less than 0.05. The Bland–Altman coefficient for both measurement methods, FMD-RA and FMD-BA, was 3%, and the ICC was 0.69. Conclusions. Our findings show that FMD-RA, supplementary to FMD-BA measurements, can be used to assess endothelial dysfunction in the group of HT patients. In addition, the FMD-RA measurements met the criteria of high concordance with the FMD-BA measurements.

hypertension, brachial artery, radial artery, endothelial function

Cardiovascular disease (CVD) is one of the major causes of perioperative complications. Screening of patients referred to major surgery is a costly and time and resources- consuming process. The study aimed to assess the usefulness of an electronic stethoscope with dedicated analytical software operated by a nurse for detecting heart disease in patients prepared for major orthopedic surgery. The study group consisted of 137 patients aged (46 – 91) with defined cardiovascular diseases qualified for hip or knee replacement surgery and 94 healthy age-matched volunteers. Heart auscultation with Littmann lectronic stethoscope using Littmann® StethAssist™ Heart and Lung Sound Visualization Software software was conducted and analyzed by a trained nurse. The signal recorded was analyzed by the blinded researcher using dedicated custom- made algorithm. Finally, 91 signals (52 CVD (+) patients, 39 CVD (-) patients) were analyzed. Eventually a classifier with a sensitivity of 92% and a specificity of 97% was obtained in a group. The global accuracy of the classifier was 95%. Heart auscultation by nursing staff using Littmann® StethAssist™ Heart and Lung Sound Visualization Software with dedicated custom- made can be cheap and noninvasive method of identifying patients with cardiovascular disease made algorithm for arthroplasty.

electronic stethoscope, heart auscultation, nurse, arthroplasty, cardiovascular disease

Acoustocerebrography is a novel, non-invasive, transcranial ultrasonic diagnostic method based on the transmission of multispectral ultrasound signals propagating through the brain tissue. Dedicated signal processing enables the estimation of absorption coefficient, frequency-dependent attenuation, speed of sound and tissue elasticity. Hypertension and atrial fibrillation are well known factors correlated with white matter lesions, intracerebral hemorrhage and cryptogenic stroke numbers. The aim of this study was to compare the acoustocerebrography signal in the brains of asymptomatic atrial fibrillation patients with and without hypertension. The study included 97 asymptomatic patients (40 female and 57 male, age 66.26 +/- 6.54 years) who were clinically monitored for atrial fibrillation. The patients were divided into two groups: group I (patients with hypertension) n = 75, and group II (patients without hypertension) n = 22. Phase and amplitude of all spectral components for the received signals from the brain path were extracted and compared to the phase and amplitude of the transmitted pulse. Next, the time of flight and the attenuation of each frequency component were calculated. Additionally, a fast Fourier transformation was performed and its features were extracted. After introducing a machine learning technique, the ROC plot of differentiations between group I and group II with an AUC of 0.958 (sensitivity 0.99 and specificity 0.968) was obtained. It can be assumed that the significant difference in the acoustocerebrography signals in patients with hypertension is due to changes in the brain tissue, and it allows for the differentiating of high-risk patients with asymptomatic atrial fibrillation and hypertension.

changes in the brain, hypertension in atrial, acoustocerebrography

Hydrogenated oils containing trans fatty acids (TFA) are used to produce margarine and various processed foods. TFA affect serum lipid levels, fatty acids metabolism, and endothelial function. High TFA intake is linked to increased all-cause mortality, coronary heart disease mortality and cardiovascular disease (CVD) incidence. Denmark was first to introduce law that limited TFA content in food; this action led to lower CVD mortality. Seven European countries have followed this practice until now, in a few others the food industry voluntarily reduced TFA use. The issue remains unaddressed in Poland. Legal TFA limit should be established, as it is the optimal solution considering both CVD prevention and the associated cost savings in public healthcare.

Poland, cardiovascular disease, nutrition policy, trans fatty acids

Hydrogenated oils containing trans -fatty acids (TFA) are used to produce margarine and various processed foods. TFA affect serum lipid levels, fatty acid metabolism, and endothelial function. High TFA intake is linked to increased allcause mortality, coronary heart disease mortality, and cardiovascular disease (CVD) incidence. Denmark was the first country to introduce a law that limited TFA content in food; this action led to lower CVD mortality. So far 7 European countries have followed this practice, in a few others the food industry voluntarily reduced TFA use. The issue remains mostly unaddressed in the rest of the world. Legal TFA limits should be commonly established as they are the optimal solution considering both CVD prevention and the associated cost savings in public healthcare.

Trans -fatty acids, Cardiovascular disease, Nutrition policy

Wprowadzenie i cel pracy. Rozwój technologii informacyjno-komunikacyjnej może doprowadzić do poprawy sytuacji w służbie zdrowia. Telepielęgniarstwo pozwoli na rozszerzenie praktyki pielęgniarskiej oraz wielu funkcji takich jak: opiekuńczo-pielęgnacyjna, profilaktyczna, diagnostyczna, rehabilitacyjna i związana z promocją zdrowia. Celem pracy jest ukazanie telepielęgniarstwa w ortopedii, a także zaprezentowanie wielu korzyści, jakie niesie zarówno dla pacjenta, jak i dla personelu medycznego. Skrócony opis stanu wiedzy. Starzejące się społeczeństwo potrzebuje zarówno wykwalifikowanego personelu pielęgniarskiego, jak i możliwości uzyskania szybkiej konsultacji lekarskiej i pielęgniarskiej. Udzielanie wskazówek, porad i opieki pielęgniarskiej przez pielęgniarki specjalistki w swej profesji m.in. za pomocą wideokonferencji przysporzy znaczących korzyści zarówno pacjentom, lekarzom, pielęgniarkom, jak i rehabilitantom. Podsumowanie. Wdrożenie wirtualnych wizyt może doprowadzić do poprawy sytuacji w ochronie zdrowia. Telepielęgniarstwo rozszerzyłoby kompetencje pielęgniarki, a także podniosłoby jakość świadczonych przez nie usług. Być może zatrzymałoby również emigrację zarobkową pielęgniarek w Polsce.

telepielęgniarstwo, ortopedia, edukacja pacjenta, nowe technologie, kształcenie, niedobór personelu pielęgniarskiego

Background: Hypertension (HT) is the leading cause of global disease burden and overall health loss. The brain is one of the main target organs affected by HT. HT is a potentially modifiable risk factor that leads to the formation of large vessel macroangiopathy, small vessel disease, microangiopathy, and microhemorrhages. Early detection of the brain changes (BC) gives a chance to receive appropriate treatment and protection from irreversible damage. Acoustocerebrography (ACG) is a set of techniques to capture the states of human brain tissue, and its changes on its molecular and cellular level. It is based on noninvasive measurements of various parameters obtained by analyzing an ultrasound pulse emitted across the human's skull. The main idea of this method relies in the relation between the tissue density, bulk modulus, and speed of propagation, for ultrasound waves in this medium. In our previous studies we showed that ACG is an effective method for detecting white matter lesions compared to the Magnetic Resonance Imaging. Additionally we showed that ACG allows to obtain a differentiated signal originates from atrial fibrillation (AF) patients and high-risk patients wit AF and HT.
Aim: The aim of the study was early detection of the BC in patients with HT using ACG.
Methods: The study included 136 female and 98 male patients (age 43.6±15.7 years) who were surveyed in the clinical research. The patients were divided into two groups: group I (patients with HT) n=33, and control group II (patients without HT) n=201. Phase and amplitude of all frequency components of the received signals from the brain path were extracted and compared to the phase and amplitude of the transmitted pulse. By doing so, the time of flight and the attenuation of each frequency component were calculated. Additionally, a fast Fourier transformation (FFT) was performed and its features were extracted.
Results: After introducing a machine learning technique, the ROC plot with an AUC of 0.929 with sensitivity 0.879 and specificity 0.831 was obtained (Fig. 1).
Conclusion: ACG is new promising method, which allows for early detection of change in the brain in the patients with HT.