Proper Dietary and Supplementation Patterns as a COVID-19 Protective Factor (Cross-Sectional Study-Silesia, Poland).

BACKGROUND: The COVID-19 pandemic has become a challenge for the world today, so it is very important to create healthy eating habits in society to support immunity and raise awareness of the benefits of supplementation. OBJECTIVE: The purpose of this study is to evaluate diet and dietary supplementation, since previous studies indicate the protective nature of these in building immunity during the pandemic and post-pandemic period (COVID-19). The hypothesis of the study is whether the dietary regimen presented by the COVID-19 respondents can be considered protective in building immunity against SARS-CoV-2. MATERIAL AND METHODS: The study included 304 subjects, with an average age of 39.04 ± 23.59. The main criteria for inclusion in the study were that the respondent was ≥18 years old and participated voluntarily. The study was conducted using an original questionnaire. RESULTS: In the study group, no change was noticed in the previous diet during the COVID-19 pandemic, while the level of physical activity among the respondents decreased. Too low a percentage of people regularly consumed, among other foods. legume seeds-only 10.5% of respondents consumed them several times a week-and citrus fruits-the largest number of respondents, as many as 39.8%, only consumed them several times a month. The largest percentage of respondents with mild/scanty COVID-19 disease regularly took vitamin C-containing preparations (n = 61; 59.80%). Statistical analysis showed that there was a correlation between the incidence of mild/scanty COVID-19 and the regularity of taking vitamin C-containing preparations (T = 11.374; r = 0.611; p = 0.04603). A statistical significance level was also obtained for the regularity of supplementation of multivitamin preparations, which were taken by 68% (34) of respondents affected by mild/scanty COVID-19 (T = 13.456; r = 0.711; p = 0.02191). CONCLUSIONS: The study's hypothesis was supported. Respondents characterized by a normal dietary pattern and taking supplements commonly recognized as immune "boosters" were more likely to mildly survive COVID-19. Moreover, it was shown that the pandemic in most of the respondents did not significantly affect their dietary strategy. It is reasonable to conclude that the dietary patterns adopted may be a common way to prevent SARS-CoV-2 infections and their possible complications.

Dietary Therapy in Prevention of Cardiovascular Disease (CVD)-Tradition or Modernity? A Review of the Latest Approaches to Nutrition in CVD.

The development of cardiovascular diseases is undoubtedly influenced by improper dietary behavior. The most common mistakes include irregularity of meal consumption, high dietary atherogenicity: snacking on sweets between meals, low supply of dietary fiber, unsaturated fatty acids, legume seeds, and high supply of meat and meat products. Among many food components, some are characterized by a specific cardioprotective effect, which means that their supply of food may prevent the occurrence of cardiovascular disease or improve the health of the sick. Coenzyme Q10 (CoQ10) is one of the ingredients showing cardioprotective effects on the heart and blood vessels. Antioxidant and lipid profile-enhancing effects are also attributed to sitosterol which is one of the plant-derived sterols. A very important argument indicating the necessity of a varied diet rich in a variety of plant products is the beneficial effect of polyphenols, which are most abundant in multicolored vegetables and fruits. Numerous studies show their effectiveness in lowering blood pressure, improving lipid profile, and regeneration of vascular endothelium. The collected publications from the field of lifestyle medicine can be a source of knowledge for dieticians, physicians, and people associated with physical culture and human mental health to prevent the development of cardiovascular diseases and reduce the risk of death from this cause.

ARFID-Strategies for Dietary Management in Children.

Avoidant/Restrictive Food Intake Disorder (ARFID) is a relatively new disease entity in DSM-5 and ICD-11. This disorder continues to pose a diagnostic and therapeutic challenge for many professionals. This disorder can affect people of all ages. The most characteristic pattern is considered to be a lack of interest in eating or avoidance of food intake, which may result in nutritional deficiencies, weight loss or lack of expected weight gain, dependence on enteral feeding or dietary supplements, and impaired psychosocial functioning. This disorder cannot be explained by a current medical condition or co-occurring other psychiatric disorders, but if ARFID co-occurs with another disorder or illness, it necessarily requires extended diagnosis. Its treatment depends on the severity of the nutritional problem and may include hospitalization with multispecialty care (pediatrician, nutritionist, psychologist, psychiatrist, neurologist). The nutritional management strategy may include, inter alia, the use of Food Chaining, and should in the initial stage of therapy be based on products considered "safe" in the patient's assessment. The role of the dietitian in the management of a patient with ARFID is to monitor weight and height and nutritional status and analyze the foods that should be introduced into the food chain first.

Patients with cardiac implantable electronic devices undergoing radiotherapy in Poland. Expert opinion of the Heart Rhythm Section of the Polish Cardiac Society and the Polish Society of Radiation Oncology.

Older age and high morbidity of the society contribute to a growing number of patients with cardiac implantable electronic devices (CIEDs) requiring effective cancer treatment, including radiotherapy (RT). The effect of RT on a CIED may vary depending on the type and physical parameters of radiation, location of the treated lesion, indications for electrotherapy, and the type of CIED. In the most dramatic scenarios, it may cause an irreversible damage to the CIED, with serious clinical consequences. The lack of precise guidelines may limit the access to RT for many patients with CIEDs who would otherwise benefit from the therapy or may lead to a therapy without taking the necessary precautions, which may worsen the prognosis. Therefore, clear and unequivocal recommendations for assessing patient eligibility for RT are aimed at ensuring that adequate precautions are taken as well as at providing patients with concomitant cardiovascular and oncologic diseases with access to safe and effective RT.

Can we rely on machines? Device-detected atrial high rates correspond well with atrial arrhythmias in cardiac resynchronization recipients.

AIMS: The aim of the study was to verify in what proportion of patients, device-detected atrial high rate (AHR) episodes are indeed atrial arrhythmias (AAs). We investigated also the reasons for inappropriate arrhythmia classification and assessed if patients with misdiagnosed arrhythmias have distinct characteristics that would help to identify them. METHODS AND RESULTS: The study population consisted of 304 consecutive patients implanted with cardiac resynchronization therapy defibrillators (CRT-Ds) and subsequently monitored via remote monitoring for a median follow-up (FU) of 30.5 months. Intracardiac electrograms of every recorded AHR episode were assessed and classified (AA vs. no AA) by two experienced cardiologists. During FU, 14 386 episodes of AHR were recorded and classified in 176 (57.9%) patients. In 89.2% of them, these episodes were true AA (94% atrial fibrillation, 62% de novo). The reasons for AHR misdiagnosis were atrial far-field signals (89.5%) and noise (10.5%). The mean per cent of day spent in AHR (54.9 vs. 5.86%; P < 0.001) and the occurrence of periods with low CRT pacing (82.8 vs. 55%; P = 0.003) were significantly higher in AA subjects than in those with misdiagnosed AHR. Episode duration of properly detected AHRs was longer than that of misdiagnosed AHRs. Higher per cent of time spent in AHR was an independent marker of appropriate arrhythmia detection [adjusted hazard ratio (HR) 1.04; P = 0.023]. CONCLUSION: Nearly two-thirds of CRT-D patients had AHR episodes within 2.5 years after implantation. Almost 90% of AHRs were indeed AA. Misdetections were caused by far-field sensing or noise. A two-step diagnostic algorithm (>9% of time spent in AHRs and episode duration >36 s) allowed for proper detection of AA with a high hit-rate and specificity.

Implantation feasibility, procedure-related adverse events and lead performance during 1-year follow-up in patients undergoing triple-site cardiac resynchronization therapy: a substudy of TRUST CRT randomized trial.

INTRODUCTION: This substudy was to assess implantation feasibility and long-term safety of triple-site resynchronization therapy (CRT) in a series of consecutive patients included in a randomized trial. METHODS AND RESULTS: One hundred consecutive patients enrolled into Triple-Site Versus Standard Cardiac Resynchronization Therapy Randomized Trial were analyzed. Eligibility criteria included NYHA class III-IV, sinus rhythm, QRS ≥ 120 milliseconds, left ventricular ejection fraction ≤35%, and significant mechanical dyssynchrony. Patients were randomized in a 1:1 ratio to conventional or triple-site CRT with defibrillator-cardioverter. After 12 months of resynchronization 30% of patients with conventional resynchronization and 12.5% with triple-site CRT were in NYHA functional class III or IV (P < 0.05). Implantation of triple-site systems was significantly longer (median 125 minutes vs 96 minutes; P < 0.001), with higher fluoroscopic exposure, especially in patients with very enlarged left ventricle or pulmonary hypertension. Implantation success-rate was similar in the triple-site and conventional group (94% vs 98%; P = NS); however, additional techniques had to be used in a greater proportion of the triple-site patients (33.3% vs 16%; P < 0.05). Long-term lead performance tests revealed significantly higher pacing threshold and lower impedance in the triple-site group. The 1-year incidence of serious, CRT-related adverse events was similar in triple-site and conventional group (20.8% vs 30%; P = NS). CONCLUSIONS: Triple-site CRT is associated with more pronounced functional improvement than standard resynchronization. This form of pacing is equally safe and feasible as the conventional CRT. However, triple-site procedure is more time-consuming, associated with higher radiation exposure and the need to use additional techniques. Triple-site resynchronization is associated with less favorable electrical lead characteristics.

Immediate ventricular tachycardia after abnormal microvolt T-wave alternans.

Microvolt T-wave alternans (MTWA) is a promising non-invasive method of evaluating repolarization abnormalities. Its presence is strongly related to the occurrence of malignant ventricular tachyarrhythmias and is therefore regarded as a risk marker for sudden cardiac death. Most recent studies have described the usefulness of MTWA in selecting patients who may benefit from a cardioverter-defibrillator. This study presents two cases of patients suffering from ischemic cardiomyopathy, who underwent an MTWA test. Episodes of ventricular tachycardia occurred immediately after the end of the tests, with abnormal results.

Electrophysiological features of orthodromic atrioventricular reentry tachycardia in patients with wolff-Parkinson-white syndrome and atrial fibrillation.

The aim of this study was to compare the electrophysiological features of tachycardia between WPW patients with and without AF. The study population consisted of 114 patients with WPW syndrome and reciprocating tachycardia during electrophysiological study. Two groups were selected: group I with AF during the procedure(n = 42)and the control group n = 72 without AF (group II). Cycle length (V-V interval), antero A-V, retrograde V-A conduction time during tachycardia and indexes V-A/V-V were analyzed. In addition, the relation between antero-, retrograde conduction time, and V-V was evaluated. Selection of the most predictive factor for AF presence was performed using regression analysis. Significant differences between the two groups were observed. These included a higher rate of tachycardia, shorter anterograde conduction time, A-V/V-V-indexes, longer retrograde conduction time, and V-A/V-V-indexes in group I compared with group II. Significant, positive correlations between anterograde conduction time and V-V were present in both groups, but retrograde conduction correlated significantly with the V-V-interval only in group II and group I (r = 0.37 vs r =-0.01, respectively). Significant, negative correlations between A-V and V-A conduction time in all analyzed points has been found to exist in group I (r =-0.45 for the point of maximal preexcitation [PMP]), whereas there were no significant correlations between these parameters in group II (r = 0.04). The most powerful AF predictor has been identified as the V-A/V-V index. The presence of AF in WPW syndrome may be associated with discrete patient characteristics. Ventricular activation occurs earlier, and atrial later, in the tachycardia cycle in AF than in patients free of AF. The different ability of the accessory pathway for adaptation to tachycardia rate changes in group I causes prolonged retrograde conduction over the pathway while the tachycardia rate increases.