Optimal management of severe carotid in-stent restenosis remains unknown. Prevalence and risk factors of first and recurrent carotid in-stent restenosis in the multi-stent approach have not been ...established yet.
To evaluate the safety of different methods of endovascular treatment of carotid in-stent restenosis/recurrent restenosis and to establish its rate and risk factors.
Between January 2001 and June 2016, 2637 neuroprotected carotid artery stenting (CAS) procedures were performed in 2443 patients (men: 67.0%; mean age: 67.9 ±8.8 years, symptomatic: 45.5%). Doppler ultrasound (DUS) evaluation was performed at discharge, after 3-6 months, 12 months, and then annually. Peak systolic velocity of 2-3 and > 3.0 m/s as well as end diastolic velocity of 0.5-0.9 and > 0.9 m/s were DUS criteria for 50-69% and ≥ 70% carotid in-stent restenosis (ISR) respectively. For angiographically confirmed ≥ 70% stenosis balloon re-angioplasty was first line treatment.
Out of 95 DUS detected > 50% ISR (95/2637; 3.6%), 53 were confirmed in angiography as ≥ 70% (53/2637; 2.0%, one total occlusion). All patients were treated with bare balloon (
= 19), drug-eluting balloon (
= 27) or stent-supported (
= 6) angioplasty. One procedure was complicated with stroke (1.9%). Angiographic diameter stenosis (DS) was reduced from 83 ±8.3% to 13 ±7.6% (
< 0.001). There were 13 cases of ≥ 70% recurrent ISR. Bilateral and high-grade stenosis were independent risk factors of restenosis. Initial Carotid Wallstent implantation was a risk factor of first and recurrent in-stent restenosis.
Endovascular treatment of carotid in-stent restenosis is safe. Bilateral and high-grade carotid artery stenosis may increase the risk of restenosis. Initial Carotid Wallstent implantation may increase the risk of first and recurrent restenosis.
Celem pracy było zbadanie ochrony prawa pacjenta do świadczeń zdrowotnych finansowanych ze środków publicznych zapewnianej przez uprawnienia kontrolne NFZ realizujące określone standardy ...konstytucyjne zawarte w treści art. 68 ust. 2 Konstytucji. Przy opracowaniu artykułu zastosowano metodologię doktrynalną, tj. opartą na analizie stanowisk przedstawicieli doktryny prawniczej prezentowanych w literaturze przedmiotu, oraz metodologię jurydyczną polegającą na analizie orzecznictwa polskich sądów, w tym Trybunału Konstytucyjnego. W celu wykazania wpływu praktycznego uprawnień kontrolnych NFZ przeprowadzono również analizę sprawozdań z działalności NFZ za lata 2020 i 2021 oraz strategii NFZ. Przeprowadzone rozważania wykazały, że uprawnienia kontrolne NFZ realizują standardy konstytucyjne NFZ poprzez zapewnienie pacjentom równego dostępu do świadczeń zdrowotnych finansowanych ze środków publicznych, umożliwiając bezpośrednią reakcję na wykryte nieprawidłowości i przywrócenie prawidłowej realizacji standardów i norm zakodowanych w treści art. 68 ust. 2 Konstytucji.
In developing the article, a doctrinal methodology was applied, involving the analysis of the positions of the representatives of legal doctrine in the literature on the subject. Additionally, a juridical methodology was employed, consisting in the analysis of the jurisprudence of Polish courts, including the Constitutional Tribunal. In order to demonstrate the impact of the practical exercise of the NFZ’s control powers, an analysis of the NFZ activity reports for 2020 and 2021, as well as the NFZ strategy, was also carried out. The considerations carried out in the article showed that the NFZ’s control powers realise the NFZ’s constitutional standards by ensuring that patients have equal access to health services financed from public funds. These powers enable a direct response to the detected irregularities and restoring the correct implementation of the standards and norms encoded in the content of Article 68(2) of the Constitution.
In developing the article, a doctrinal methodology was applied, involving the analysis of the positions of the representatives of legal doctrine in the literature on the subject. Additionally, a ...juridical methodology was employed, consisting in the analysis of the jurisprudence of Polish courts, including the Constitutional Tribunal. In order to demonstrate the impact of the practical exercise of the NFZ’s control powers, an analysis of the NFZ activity reports for 2020 and 2021, as well as the NFZ strategy, was also carried out. The considerations carried out in the article showed that the NFZ’s control powers realise the NFZ’s constitutional standards by ensuring that patients have equal access to health services financed from public funds. These powers enable a direct response to the detected irregularities and restoring the correct implementation of the standards and norms encoded in the content of Article 68(2) of the Constitution.
This article discusses the question of the presence of the category of the family
in the media, which most often operate as commercial enterprises these days.
At the same time the influence of media ...communication on the family is
underlined. The analysis results in distinguishing between two ways of presenting
and treating the family in media broadcasting. The first – objective – resembles
the authentic nature and character of this basic social group, while the second –
subjective – distorts the image and uses the category of the family as merely
material for an producing media offer of any kind.
Among other issues, stress is put on the business model of media enterprises,
which seriously influences the social communication character of mass media,
which results, for example, in the transformation of information into a commodity
and the media public into customers.
The entry of influenza virus into the host cell requires fusion of its lipid envelope with the host membrane. It is catalysed by viral hemagglutinin protein, whose fragments called fusion peptides ...become inserted into the target bilayer and initiate its merging with the viral membrane. Isolated fusion peptides are already capable of inducing lipid mixing between liposomes. Years of studies indicate that upon membrane binding they form bend helical structure whose degree of opening fluctuates between tightly closed hairpin and an extended boomerang. The actual way in which they initiate fusion remains elusive. In this work we employ atomistic simulations of wild type and fusion inactive W14A mutant of influenza fusion peptides confined between two closely apposed lipid bilayers. We characterise peptide induced membrane perturbation and determine the potential of mean force for the formation of the first fusion intermediate, an interbilayer lipid bridge called stalk. Our results demonstrate two routes through which the peptides can lower free energy barrier towards fusion. The first one assumes peptides capability to adopt transmembrane configuration which subsequently promotes the creation of a stalk-hole complex. The second involves surface bound peptide configuration and proceeds owing to its ability to stabilise stalk by fitting into the region of extreme negative membrane curvature resulting from its formation. In both cases, the active peptide conformation corresponds to tight helical hairpin, whereas extended boomerang geometry appears to be unable to provide favourable thermodynamic effect. The latter observation offers plausible explanation for long known inactivity of boomerang-stabilising W14A mutation.
Crisis, sometimes associated with historically distant times or centrally planned economies, has turned out to be one of the main contemporary issues. Hence different systems like socialism and ...capitalism become similar in their inability to reply to expectations for a safe, peaceful and abundant life. It means that economic problems are more complex in their nature.
Thorough analysis of the roots of different crises should therefore reach deeper than just economic explanations. This is the point where ethical and cultural explanations may be useful because they strive to explore the socio-cultural fabric at its foundations in the hierarchy of values and vision of human beings and society.
When it comes to contemporary crisis the problem is twofold: firstly, there is the threat that the crisis will be treated inadequately and not realistically in consequence. Secondly, the roots of the crisis may not be diagnosed properly, which may lead to false ‘treatment’.
This article is an attempt to highlight the above issues and analyse them in the context of the common good approach, which seems to offer valuable potential to understand the difficulties properly and offer a reasonable plan for recovery.
Parkinson disease (PD) is the common neurodegenerative disease with motor and numerous non-motor symptoms, including cognitive impairment. Mutation of glucocerebrosidase (GBA) gene is the most common ...genetic risk factor of sporadic PD. The aim of this study was to assess clinical features of PD associated with GBA mutation.
One hundred and thirty-eight PD patients were involved and examined by the movement disorder specialist using several scales including Unified Parkinson Disease Rating Scale (UPDRS) part II and III, Hoehn and Yahr (H&Y) staging, Mini-Mental State Examination (MMSE) and Hamilton Depression Scale (HDS). The exons 8 and 9 of GBA was sequenced and screened for variants.
The GBA variants were found in 16 (11.6%) PD patients: N370S mutation in 5 (3.6%) and T369M variant in 11 (7.9%). No significant differences between the group of mutation carriers and non-carriers were found in relation to clinical features except for dementia (MMSE score<26) occurring more often in N370S mutation carriers (60.0% vs 19.6%, p=0.03).
The N370S GBA mutation is the risk factor for cognitive impairment in PD patients.
Genetic background of cryptogenic ischemic stroke (IS) and transient ischemic attack (TIA) remains uncertain. Alpha-2-antiplasmin (α2AP) Arg407Lys polymorphism has been shown to be less common in ...patients with abdominal aortic aneurysm (AAA) compared with healthy controls. We investigated associations of α2AP Arg407Lys polymorphism with cryptogenic IS and TIA.
We studied 165 consecutive Caucasian patients who experienced cryptogenic IS (n=123) or TIA (n=42). Neurological outcomes were assessed using the modified Rankin Scale (mRS) in the acute phase of cerebral ischemia and 8 (6–12) months after the index episode. Patients were genotyped for α2AP Arg407Lys polymorphism (rs1057335) using real time PCR technique.
The allele frequency of Arg407Lys polymorphism was: 0.82/0.18. The 407Lys allele was more frequent in TIA patients compared to the IS group (0.29 vs. 0.14, p=0.003). In the whole group, as well as in IS and TIA patients analyzed separately, possession of the 407Lys allele was associated with excellent outcome (mRS 0–1) during follow-up (p<0.05) but not in the acute phase of ischemic events both in thrombolyzed and nonthrombolyzed IS patients.
The multivariate logistic regression model showed that the excellent outcome (mRS 0–1) assessed after 8 (6–12) months since the index cerebral ischemia was predicted by the occurrence of Lys407 allele (OR 6.18, 95% CI, 2.01–18.98, p=0.001).
The presence of 407Lys allele is associated with better prognosis in cryptogenic cerebrovascular events. Our findings suggest that the α2AP Arg407Lys polymorphism could be involved in the pathogenesis of cerebral ischemia and its outcomes.
Current demographic trends indicate that the process of aging is more and more advanced in Western societies. While available literature addressing this issue most often concentrates on developing ...effective tools for socio-economic policy ,this paper aims at exploring dominating assumptions of economics and culture to find how they may influence the demographic process that was mentioned. The purpose of the analysis undertaken here is to verify the thesis which claims that basic anthropological assumptions present in neoclassical economics and modern culture somehow ignore or underestimate such essential aspects of human life as old age and helplessness or weakness connected to it.The conclusions of the paper indicate that there is the need for intergenerational balance within society which e.g. facilitates socio-economic development.Some of the most important factors influencing this may or may not be present within economic theory and culture it is based on. It means that without the adequate vision of human being and phases of human life the process of building a sane and vibrant society where everyone has his or her place is hardly possible.
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