CRACoV-HHS: an interdisciplinary project for multi-specialist hospital and non-hospital care for patients with SARS-CoV-2 infection as well hospital staff assessment for infection exposure.

The complex course of the COVID-19 and the distant complications of the SARS-CoV-2 infection still remain an unfaded challenge for modern medicine. The care of patients with the symptomatic course of COVID-19 exceeds the competence of a single specialty, often requiring a multispecialist approach. The CRACoV-HHS (CRAcow in CoVid pandemic - Home, Hospital and Staff) project has been developed by a team of scientists and clinicians with the aim of optimizing medical care at hospital and ambulatory settings and treatment of patients with SARS-CoV-2 infection. The CRACoV project integrates 26 basic and clinical research from multiple medical disciplines, involving different populations infected with SARS-CoV-2 virus and exposed to infection. Between January 2021 and April 2022 we plan to recruit subjects among patients diagnosed and treated in the University Hospital in Cracow, the largest public hospital in Poland, i.e. 1) patients admitted to the hospital due to COVID-19 [main module: 'Hospital']; 2) patients with signs of infection who have been confirmed as having SARS-CoV-2 infection and have been referred to home isolation due to their mild course (module: 'Home isolation'); 3) patients with symptoms of infection and high exposure to SARS- CoV-2 who have a negative RT-PCR test result. In addition, survey in various professional groups of hospital employees, both medical and non-medical, and final-fifth year medical students (module: 'Staff') is planned. The project carries both scientific and practical dimension and is expected to develop a multidisciplinary model of care of COVID-19 patients as well as recommendations for the management of particular groups of patients including: asymptomatic patient or with mild symptoms of COVID-19; symptomatic patients requiring hospitalization due to more severe clinical course of disease and organ complications; patient requiring surgery; patient with diabetes; patient requiring psychological support; patient with undesirable consequences of pharmacological treatment.

Knowledge of antithrombotic prophylaxis among patients with atrial fibrillation.

BACKGROUND: Effective and safe anticoagulative therapy needs close co-operation between doctor and patient, the latter being well-informed. The aim of the study was to assess knowledge of oral anticoagulation in a group of patients with atrial fibrillation (AF) treated with acenocoumarol and to determine the relationship between knowledge and INR value. METHOD: The study group consisted of patients with AF who were continuously using anticoagulative therapy and who were admitted to hospital (for different reasons). The questionnaire comprised questions about their knowledge of various aspects of the treatment used. In the assessment of knowledge a numerical scale was introduced (0-9 points) and the patients were given one point for each correct answer. RESULTS: The study group consisted of 61 patients aged 46-91 (mean 70.18). The level of knowledge of oral anticoagulation among the group of patients examined was low (the mean number of points achieved was 4.19 in the 9-point scale). Sex, education and the reason for admission had no relationship with the level of knowledge. Younger patients (4.85 +/- 1.94 vs. 3.56 +/- 1.86, p = 0.01) and those who had INR within the therapeutic limits at the moment of admission to the hospital (5.50 +/- 1.79 vs. 3.56 +/- 1.79 points, p = 0.0003) had a higher level of knowledge of the antithrombotic treatment. CONCLUSIONS: Knowledge of treatment with acenocoumarol among the patients with atrial fibrillation using oral anticoagulation is low and inversely correlated with age. The greater the knowledge, the better is the value of INR controlled. (Cardiol J 2007; 14: 44-49).

[The management of Helicobacter pylori infection in adults--statement of the Polish Working Group and the Maastricht Consensus 2-2000]. / Postepowanie w zakazeniu Helicobacter pylori u doroslych--stanowisko Polskiej Grupy Roboczej a Konsensus Maastricht 2-2000.

Current standards in the management of Helicobacter pylori infection according to the guidelines by European (Maastricht 2-2000 Consensus Report) and Polish Study Group (IX Congress of Polish Gastroenterology Association) were presented in this paper. The comparison analysis was performed as well as the diagnostic methods were described. The indications for Helicobacter pylori infection treatment especially in gastric and duodenal ulcer disease (also complicated by bleeding), gastric precancerous conditions, functional dyspepsia, gastroesophageal reflux disease, non-steroidal anti-inflammatory therapy were discussed. The acceptable schedules of the first and second-line therapy as well as the problem of drug resistance were presented. The special attention was drown to differences between the two sets of guidelines with respect to latest scientific reports.

[Effect of a meal on electrocardiographic features in patients with coronary artery disease]. / Wplyw posilku na obraz elektrokardiogramu u osób z choroba niedokrwienna serca.

The aim of the study was to assess the relationship between gastric motility and extent of coronary insufficiency in males with and without stabile coronary artery disease (CAD). The study group consisted of 30 males with CAD (mean age 56 +/- 12 years) and 10 healthy males in control group (mean age 52 +/- 14 years). In both groups we performed exercise treadmill test (ETT) in interdigestive period (IP) and postprandially after ingestion of a standard meal (775 kcal) after 30 and 120 min. Gastric emptying was determined as antral area evaluated in ultrasonography before, 30 and 120 min. after meal. A period of time to ST depression > or = 1 mm, mean time of exercise, and a maximal voltage of ST depression were measured and compared between studied group of patients in t-test. In healthy individuals there was no influence of meal on ETT, thus in men in CAD group postprandially we observed shortening of time to ST depression > or = 1 mm (p < 0.001) and mean time of exercise (p < 0.001). These findings were parallel to observed enlarged gastric antral area reflecting gastric filling in postprandial period. ST depression during ETT 30 min. after meal was deeper than in interdigestive period (p < 0.001). In contrast to healthy individuals intake of standard meal in CAD group increased symptoms of coronary insufficiency during stress testing. Relationship between exercise-induced coronary insufficiency and degree of gastric filling appears as increasing of coronary insufficiency connected with gastric filling and graduate decreasing during digestion.

[Exogenous nitric oxide and gallbladder contractility in humans]. / Kurczliwosc pecherzyka zólciowego a egzogenny tlenek azotu.

The physiological function of the gallbladder (GB) is to deliver concentrated bile to the duodenum after a meal. This requires a complex coordination of the motor, secretory, and absorptive functions of the gallbladder. Control of GB motor functions involves a constant interplay between a large number of stimulatory and inhibitory hormones and neurotransmitters. With regard to intrinsic neurotransmitters, nitric oxide (NO) acts as a neurotransmitter in nonadrenergic, noncholinergic (NANC) pathways of the gallbladder. This compound has been found to inhibit GB tone and contraction in both animal and human studies. The Purpose of the present study was to examine the effects of exogenous NO donors such as glyceryl trinitrate (GTN), molsidomine (MO) and L-arginine (L-Arg) on fasting GB volume and on meal-stimulated gallbladder contraction expressed as ejection fraction (EF). The healthy subjects (13 men and 17 women), age range 19-41 years participated in this study. GB volume was examined by means of an ultrasonographic method. Volumes of GB were calculated using the sum of cylinders method as described by Dodds. EF was measured every 15 min up to a total observation period of 2 h. After recording of control values, 0.5 mg GTN was administered sub-lingually, or 4 mg MO orally or L-Arg (12.63 g of L-Arg in 300 ml of 0.9% NaCl) was infused i.v. over 120 min. It was found that the fasted GB volume was increased after GTN by 22 +/- 10% and after MO by 28 +/- 4% (p < 0.05). Post-prandial EF was reduced maximally by 22 +/- 9% (p < 0.05) after pretreatment with GTN and by 32 +/- 8% (p < 0.01) after MO. Whereas L-Arg was without any effect on resting GB, however it reduced significantly stimulated EF. These findings support the earlier knowledge that NO, released from its exogenous donors has the potent inhibitory effect on human gallbladder motor activity.