Comparison of Regadenoson and Dipyridamole Safety Profiles During Stress Myocardial Perfusion Imaging.

Objectives: The pharmacological stress test with vasodilator agents is an alternative cardiological diagnostic tool for patients with contraindications to the classical stress test provided by physical activity during single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). The study compared the frequency of the side effects of regadenoson and dipyridamole during a SPECT MPI. Methods: This retrospective study included data of 283 consecutive patients who underwent pharmacological stress tests in years 2015-2020. The study group consisted of 240 patients who had received dipyridamole and 43 patients who had received regadenoson. The collected data included the patients' characteristics, the occurrence of side effects (divided into mild: headache, vertigo, nausea, vomiting, dyspnea, chest discomfort, hot flushes, general weakness and severe: bradycardia, hypotension, loss of consciousness), and blood pressure values/measurements. Results: Overall, complications occurred relatively often (regadenoson: 23.2%, dipirydamol: 26.7%, p=0.639). Procedure discontinuation was necessary in 0.7% of examinations, whereas pharmacological support was necessary in 4.7%. There was no difference in the prevalence of mild (regadenoson: 16.2%, dipirydamol: 18.3%, p=0.747) and severe complications (regadenoson: 11.6%, dipyridamole: 15.0%, p=0.563). However, regadenoson has been found to cause a significantly smaller mean decrease of systolic blood pressure (SBP) (regadenoson: -2.6±10.0 mmHg, dipyridamole: -8.7±9.6 mmHg, p=0.002), diastolic blood pressure (DBP) (regadenoson: -0.9±5.4 mmHg, dipyridamole: -3.6±6.2 mmHg, p=0.032), as well as mean arterial pressure (MAP) (regadenoson: -1.5±5.6 mmHg, dipyridamole: -5.4±6.5 mmHg, p=0.001). Conclusion: Regadenoson and dipyridamole presented a similar safety profile during SPECT MPI. However, regadenoson has been found to cause significantly smaller decreases in SBP, DBP, and MAP.

Screening diagnosis of dementia in patients following heart failure decompensation is associated with a higher relative wall thickness.

BACKGROUND: The usefulness of echocardiographic characteristics for dementia prediction in patients with heart failure decompensation (HFD) is not determined. Therefore, we sought to investigate the echocardiographic features of patients with HFD and screening diagnosis of dementia (SDD). METHODS: 139 patients aged over 65 years were hospitalized with the diagnosis of HFD. Clinical characteristics and echocardiographic characteristics were recorded during hospitalization. SDD was defined based on the result of ALFI- MMSE of <17 points. RESULTS: Patients with SDD were older (p=0.013), had thicker IVSd (p=0.021), thicker PWd (p=0.005) and had a higher RWT (0.40 vs 0.35, p=0.004) than patients without SDD, without differences in LVMI (p=0.13). There was no correlation between RWT and LVMI (r=-0.01, p=0.88). In the multivariate analysis, an older age (ß=-0.116, 95% CI -0.224 - -0.008, p=0.035, per year) and a higher RWT (ß=-0.069, 95% CI -0.137 - -0.002, p=0.045, per 0.01) influenced a lower ALFI-MMSE. For a prediction of SDD, the RWT reached the area under a ROC curve of 0.67 (95% CI 0.56-0.77, p=0.004 with sensitivity of 60% and specificity of 70% for RWT of ≥0.375). CONCLUSIONS: Apart from age, RWT reflecting left ventricular geometry changes but not hypertrophy was independently but moderately associated with SDD in patients following HFD (Tab. 4, Fig. 1, Ref. 35).

Fatal complications of illegal abortions performed in 1920-1939 based on the archival material of the Department of Forensic Medicine in Krakow. / Smiertelne powiklania nielegalnego spedzenia plodu w latach 1920-1939 w materiale archiwalnym Zakladu Medycyny Sadowej w Krakowie.

Aim: Analysis of different methods of performing illegal abortions and causes of death in women who underwent the procedure during the interwar period. Material and methods: The study was based on the autopsy protocols from 1920-1939 archived at the Department of Forensic Medicine, Jagiellonian University Collegium Medicum in Krakow, Poland. The analysis comprised the deaths of women during pregnancy or in the perinatal period. The cases in which abortion was performed legally, for medical indications, were excluded. Results: A total of 101 cases of illegal abortion were identified during the period studied, including 21 abortions performed by midwives, and three abortions carried out by qualified medical personnel. In 19 cases, abortion was done using a catheter or wire, while in eight cases the procedure was performed by injecting an abortion-inducing substance into the uterus or administering an injection into the foetus. Vaginal or uterine injury (27 cases), or vaginal or uterine wall perforation (10 cases), were the most common genital tract lesions indicative of abortion. Conclusions: The majority of deaths (71) were caused by peritonitis or sepsis originating from an infection involving the genital tract.

Which sources of electromagnetic field are of the highest concern for electrosensitive individuals? - Questionnaire study with a literature review.

The primary goal of the study was to identify sources of electromagnetic field (EMF) which are attributed to negative health outcomes by a general population of electrohypersensitive (EHS) individuals. Secondary goal was to investigate the differences in indicated sources in subgroups distinguished based on gender, sex, place of living, place of work and the distance between place of living and the nearest mobile phone base station (MPBS). The cross-sectional study aiming to describe and analyze the population of EHS subjects was performed using a web-based questionnaire. The full survey consisted of 32 questions and concerned participants' baseline characteristics and details on sensitivity to electronic devices. Participants were regarded as EHS if they answered "yes" to the question "Do the electric/electronic/telecommunication devices negatively affect your well-being?" and indicated at least one device which in their opinion had such an impact. We identified 408 EHS subjects, out of which 288 (70.73%) were females and 120 (29.27%) were males. Phones, especially mobile devices, were attributed to negative health outcomes by the highest number of subjects (309, 75.74% and 267, 65.44% for phones and mobile phones, respectively). Additional subgroup analysis indicated that older participants and participants who live closer to MPBS more often complained of physical symptoms attributed to MPBS impact (p = .02 and p < .01, respectively). Phones, especially mobile devices, are the most important source of EMF influencing EHS subjects. People who self-reported living closer to MPBS and older individuals seem to be remarkably more concerned about MPBS health impact.