Assessment of Lipid Balance Parameters after Laparoscopic Sleeve Gastrectomy in 1-Year Observation.

Introduction: Currently, the increase in the percentage of obese people observed along with the development of civilization, reaching the level of a global pandemic, has forced a search for methods of effective and permanent obesity treatment. Obesity is a multifactorial disease; it coexists with many disease entities and requires multidisciplinary treatment. Obesity leads to metabolic changes in the form of metabolic syndromes, which include, among others, atherogenic dyslipidemia. The proven relationship between dyslipidemia and cardiovascular risk enforces the need to effectively improve the lipid profile of obese patients. Laparoscopic sleeve gastrectomy is a method of surgical treatment of morbid obesity which improves bariatric and metabolic parameters. The aim of the study was to assess the effectiveness of laparoscopic sleeve gastrectomy (LSG) at improving lipid profile parameters upon a 1-year follow up. Material and Methods: Bariatric parameters of 196 patients who underwent laparoscopic sleeve gastrectomy as well as the lipid profile of total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), non-NDL, and triglycerides (TG) in a 1-year observation were analyzed. Results: Improvements in bariatric parameters were observed in patients after LSG. Total cholesterol, low-density lipoprotein (LDL), triglycerides and non-HDL level decreases were observed along with an increase in high-density lipoprotein (HDL) cholesterol levels. Conclusions: Sleeve gastrectomy is an effective method of treating obesity and improving the lipid profile in obese patients.

Epidemiology, management, and survival rate of out-of-hospital cardiac arrest in Upper Silesia, Poland: an Utstein-style report.

INTRODUCTION: Despite the growing number of studies on the epidemiology of out-of-hospital cardiac arrest (OHCA) in Poland, this issue has not been sufficiently studied. Notably, there has been a lack of uniform Utstein-style data reporting. AIM: To evaluate the epidemiology of OHCA, patient characteristics, the laypeople and emergency medical service (EMS) response to cardiac arrest, and outcomes of OHCA patients, based on a prospective registry encompassing a population of 2.7 million Poles. MATERIAL AND METHODS: Consecutive, adult, EMS-treated OHCA cases in 2018 were analyzed. Prehospital data were collected using case report forms by EMS. Information on in-hospital procedures and outcomes was based on data from the public payer of health care services. Multivariable logistic regression analysis was performed to find independent predictors of survival to discharge. RESULTS: A total of 1392 patients were included. Most OHCA occurred at home (74.7%). In 66.8% of OHCA cases, the cardiac arrest was witnessed by bystanders and in another 20.4% by EMS. Laypeople performed cardiopulmonary resuscitation (CPR) in 54.4% of non-EMS-witnessed events, and an automated external defibrillator (AED) was used in 4.6% of patients who received bystander CPR. Finally, 30.7% of all patients were transported to the hospital, and 9.2% survived to hospital discharge. Epinephrine administration, unwitnessed OHCA, longer response time, older age, and initial non-shockable rhythm were independently associated with lower survival to discharge. CONCLUSIONS: The prognosis of OHCA patients in Poland is poor. There is still room for improvement in increasing the prevalence of bystander CPR and AED use before EMS arrival.

Operational and Financial Considerations of Using Drones for Medical Support of Mass Events in Poland.

OBJECTIVE: The implementation of drones in the medical security system requires a proper planning of the cooperation of different services, dividing the area into sectors, assessing potential risks, and other factors. This study refers to the cost analysis of using drones in the medical support of mass events. The aim of this research is to analyze the costs of unmanned aerial vehicle (UAV) implementation in the mass event medical support system. METHODS: The description includes purchase and maintenance costs of UAVs. The analysis also involves ways of raising funds for projects related to the UAV sector. Apart from the financial aspect, staff and drone operator training issues are the subjects of this analysis as well. RESULTS: This study is based on a specialist research involving drones and referring to reports on the current situation in Poland and in the world. CONCLUSIONS: The presented funds required for such projects and the way of raising these funds illustrate the range of the project and its requirements. (Disaster Med Public Health Preparedness. 2019;13:527-532).

[An assessment of medical rescue actions performed by the students in the sixth year of medicine at the national medical universities in Lviv and ivano-frankivsk in an out-of-hospital cardiac arrest (ohca) patient. a simulation study].

OBJECTIVE: Introduction: Sudden cardiac arrest is a condition that requires the implementation of advanced emergency medical procedures. It constitutes a significant medical, economic and social issue. The aim: To assess the medical rescue actions performed by the students in the sixth year of medicine at the National Medical Universities in Lviv and Ivano-Frankivsk in an out-of-hospital cardiac arrest (OHCA) patient. PATIENTS AND METHODS: Material and methods: The research involved students in the sixth year of medicine at the National Medical Universities in Lviv and Ivano-Frankivsk. Participation was voluntary and all students were adult. Consequently, no written parental consent was required. The number of participating students amounted to 17 in Lviv and 16 in Ivano-Frankivsk. There were two stages of the study. The research was conducted in compliance with the 2015 guidelines formulated by the European Resuscitation Council. The adopted level of statistical significance was p<0.05. RESULTS: Results: The pre-test percent average amounted to 60.27% whereas the final test average values were 82.39% in the first stage and 77.96% in the second stage. Higher scores were reported in the case of Lviv students which especially refers to the final tests (p< 0.001). The most important element influencing the effectiveness of the procedures is chest compression (compression location, depth, frequency and relaxation). A higher chest compression effectiveness was reported in each subsequent stage of the research. A higher effectiveness rate was observed in students in Ivano-Frankivsk (p<0.028). The other element with a significant impact on the effectiveness of procedures is ventilation. A higher rate of successful ventilation (breath frequency, volume and strength) was noted in Ivano-Frankivsk, especially as far as the first stage after training was concerned (p<0.038). CONCLUSION: Conclusion: The education of students of medicine in Ukraine is insufficient. The results of the effectiveness of resuscitation are not satisfactory and do not prepare future doctors to perform high quality resuscitation procedures.

Pharmaceutical markets regulation overview of the selected European Union countries.

OBJECTIVE: Introduction: Pharmacy markets, operating in the European Union are regulated by national laws. In many of them, the main restrictions concern the process of creating a new pharmacy - institutions. They are basic criteria for entities that can carry out this form of business, as well as demographic and geographic factors regulating the possible location of a new pharmacy. In Poland, the Act of from the 7th of April 2017 has changed the pharmaceutical law and introduced new legal restrictions so far unknown on the Polish market. The aim: To analyze the main changes in the Polish legal requirements focused on opening process of new pharmacies and review of regulations on European markets. PATIENTS AND METHODS: Materials and Methods: The materials used in the study were concentrating on legal acts regulating the pharmacy markets of the European Community countries, as well as EU directives issued by the European Union Parliament. The analysis of the Polish market took place on the basis of the adopted amendment to the Pharmaceutical Law in the Act from April 7th 2017 (Journal of Laws 2017, No. 0, item 1015). CONCLUSION: Conclusions: The amendment to the Pharmaceutical Law, brings the Polish pharmaceutical market standard to European conditions. The introduction of the restrictions on the pharmaceutical market in Polish will contribute to the fulfillment of the obligation to guarantee permanent and equal access to benefits for all citizens.