Physicochemical characteristics of lakes along the southern Baltic Sea coast.

We present a unique data set of selected physicochemical parameters characterizing the environment of the Baltic coastal lakes within Polish borders. The peculiarity of the system derives principally from the interaction of the lakes with a sea of relatively low salinity. In contrast to our best understanding of the state of biological knowledge, the abiotic parameters of coastal lakes along the southern Baltic Sea have never previously been so comprehensively supplemented. The database consists of physicochemical properties of 13 coastal lakes based on the analytical assessment of 419 water samples collected seasonally between 2014 and 2019. Water properties were analyzed according to the connection of the lakes to the Baltic Sea using a total of 23 predictors. The lakes were classified as closed, intermittently connected, or open. Based on the physicochemical data, a relationship between the hydrological connection between the lakes and the sea was determined. The data collected could be used to monitor ongoing global climate change at the biosphere level.

Heat and cold stress increases the risk of paroxysmal supraventricular tachycardia.

Paroxysmal supraventricular tachycardia (PSVT) is a common arrhythmia in adults. Its occurrence depends on the presence of the reentry circuit and the trigger of the paroxysm. Stress, emotional factors, and comorbidities favour the occurrence of such an episode. We hypothesized that the occurrence of PSVT follows extreme thermal episodes. The retrospective analysis was based on the data collected from three hospital emergency departments in Poland (Olsztyn, Radom, and Wroclaw) involving 816 admissions for PSVT in the period of 2016-2021. To test the hypothesis, we applied the Universal Climate Thermal Index (UTCI) to objectively determine exposure to cold or heat stress. The risk (RR) for PSVT increased to 1.37 (p = 0.006) in cold stress and 1.24 (p = 0.05) in heat stress when compared to thermoneutral conditions. The likelihood of PSVT during cold/heat stress is higher in women (RR = 1.59, p< 0.001 and RR = 1.36, p = 0.024, respectively) than in men (RR = 0.64 at p = 0.088 and RR = 0.78, p = 0.083, respectively). The susceptibility for PSVT was even higher in all groups of women after exclusion of perimenopausal group of women, in thermal stress (RR = 1.74, p< 0.001, RR = 1.56, p = 0.029, respectively). Females, particularly at the perimenopausal stage and men irrespective of age were less likely to develop PSVT under thermal stress as compared to thermoneutral conditions. Progress in climate change requires searching for universal methods and tools to monitor relationships between humans and climate. Our paper confirms that the UTCI is the universal tool describing the impact of thermal stress on the human body and its high usefulness in medical researches.

Comparison of Safety and Efficacy of Hydrus and iStent Combined with Phacoemulsyfication in Open Angle Glaucoma Patients: 24-Month Follow-Up.

The paper presents the results of a 24-month-long observation comparing the effectiveness and safety of two micro-invasive glaucoma surgery (MIGS) devices: Hydrus Microstent and iStent Trabecular Bypass in combination with cataract phacoemulsification in the treatment of open-angle glaucoma. We also analyzed the impact of preoperative factors on achieving surgical success in both surgical methods. The prospective, comparative, non-randomized study included 65 glaucoma surgeries. In 35 patients (53.8%), an iStent implant procedure was performed, while 30 patients (46.2%) underwent a Hydrus implant procedure. The demographic data was similar in both treatment groups. At 24 months after surgery, the mean IOP in the iStent group was 15.9 ± 3.0 mmHg and in the Hydrus group 16.2 ± 1.8 mmHg. The difference between the mean iStent vs Hydrus after two years of treatment was -0.3 (p = 0.683). At the 24 month follow-up, the average change in the number of antiglaucoma medications used was 71.7% in the iStent group and 79.6% in the Hydrus group. The difference in mean percentage change between groups was 7.9% in favor of Hydrus. Patients under the age of 70 may benefit from a greater risk reduction in the Hydrus group (HR = 0.81), while those over the age of 70 may benefit from a risk reduction in the iStent group (HR = 1.33). IOP cases with >18 mmHg before the surgery have a better chance of surgical success with the Hydrus method (HR = 0.28), and with IOP < 18 mmHg in the iStent group (HR = 1.93). Cases with more drugs (≥3 drugs) are more favorable in the Hydrus group (HR = 0.23), while those with a maximum of two drugs have a better prognosis in the iStent group (HR = 2.23). The most common postoperative complication was the presence of erythrocytes in the anterior chamber (AC), found in 40.0% of operated eyes in the Hydrus group. The profile of observed complications and significant improvement in visual acuity allows us to consider both implants as a safe way of treating patients with early or moderate glaucoma and co-existing cataracts.

Response of Macrophyte Diversity in Coastal Lakes to Watershed Land Use and Salinity Gradient.

Coastal lakes are subject to multiple stressors, among which land use, hydrological connectivity, and salinity have the greatest effect on their biodiversity. We studied the effects that various land cover types (CORINE) of coastal lake watersheds had on macrophyte diversity in ten coastal lakes along the southern Baltic coast as characterised by twelve phytocenotic indices: these being a number of communities, Shannon-Wiener diversity, evenness, and indices of taxonomic distinctiveness of plant communities: vegetation coverage; colonisation index; share of the phytolittoral area in the total lake area, as well as shares of nympheides, pondweeds, charophytes, marine, emerged and submerged communities in the total lake area. The effects were checked for three groups of lakes distinguished by differences in salinity-freshwater (F, 5), transitional (T, 4), and brackish (B, 1)-in which a total of 48 macrophyte communities were identified. The most abundant in aquatic phytocoenoses were lakes of T type. A partial least squares regression model (PLS-R) showed a stronger impact of land-use types in immediate vicinities and entire watersheds than the impact of physico-chemical properties of water on phytocenotic indices in the lakes. Macrophyte diversity was relatively low in urban and agricultural catchments and relatively high in forest and wetland areas. Agriculture had a negative impact on the number of macrophyte communities in F lakes and, in T lakes, on the number of macrophyte communities, biodiversity, evenness, and proportion of emerged, submerged, and marine communities. Urban areas contributed to lower values of evenness, vegetation coverage, and share of marine communities in F, but, in T, to lower the number of macrophyte communities, evenness, and proportion of submerged and marine communities. Our results confirm the significant impact of land use on macrophyte diversity in coastal aquatic ecosystems. Combined analysis of anthropogenic and natural descriptors is a prerequisite for analysing human threats to biodiversity in coastal lakes. Macrophyte community-based measures of biodiversity are sensitive indicators of anthropogenic impact on the ecological condition of coastal ecosystems.

Refractive astigmatism in phaco-canaloplasty vs phaco-non-penetrating deep sclerectomy.

This study aimed to assess refractive astigmatism, in phaco-canaloplasty (PC) vs phaco-non-penetrating deep sclerectomy (PDS) in a randomized, prospective study within 24 months. Patients were randomized pre-operatively, 37 underwent PC and 38 PDS. The following data was collected: BCVA, IOP, number of antiglaucoma medications, refraction with autokeratorefractometry. The assessment of astigmatism was simple arithmetic and vector analysis (calculations included cylinder with axis in form of centroids) and included double angle plots and cumulative refractive astigmatism graphs. Pre-operative mean BCVA in PC was 0.40 ± 0.43 and was comparable to BCVA in PDS 0.30 ± 0.32logMAR (P = 0.314). In the sixth month follow-up, mean BCVA showed no difference (P = 0.708) and was 0.07 ± 0.13 and 0.05 ± 0.11, respectively. However, 2 years after the intervention mean BCVA was better in PC 0.05 ± 0.12 than in PDS 0.12 ± 0.23 and it was statistically significant (P = 0.039). Mean astigmatism in PC at baseline was 1.13 ± 0.73Dcyl, at 6 months it was 1.09 ± 0.61 and at 2 years 1.17 ± 0.51. In PDS at baseline 1.35 ± 0.91 at 6 months 1.24 ± 0.86 and at 2 years 1.24 ± 0.82. There were no differences between the groups in mean astigmatism throughout the study. Centroids (mean of a cylinder with axis) in PC were pre-operatively 0.79D@172˚ ± 1.10Dcyl, at 6 months 0.75D@166˚ ± 1.01 and at 24-months 0.64D@164˚ ± 1.11 and in PDS pre-operatively 0.28D@10˚ ± 1.63D at 6 months 0.26D@11˚ ± 1.5 and at 24-months 0.47D@20˚ ± 1.43. The direction of mean astigmatism was against the rule in all analyzed time points. The mean baseline IOP in PC was 19.4 ± 5.8 mmHg and 19.7 ± 5.4 mmHg in PDS(P = 0.639). From the 6-month IOP was lower in PC, at 24-months it was 13.8 ± 3.3 mmHg in PC and 15.1 ± 2.9 mmHg in PDS(P = 0.048). In both groups preoperatively patients used median(Me) of three antiglaucoma medications(P = 0.197), at 24-months in PC mean 0.5 ± 0.9 Me = 0.0 and 1.1 ± 1.2 Me = 1.0 in PDS(P = 0.058). Both surgeries in mid-term observation are safe and effective. They do not generate vision-threatening astigmatism and do not even change the preoperative direction of mean astigmatism. Refractive astigmatism is stable throughout the observation.

Salinity as a Determinant Structuring Microbial Communities in Coastal Lakes.

The response of bacterioplankton structure to salinity level in coastal lakes (n = 9) along the southern Baltic Sea coastline was studied. In terms of mean salinity levels (0.2−5.2 PSU), the lakes represented freshwater, transitional, and brackish types. Results showed that salinity determines the spatial and seasonal distribution patterns of microorganisms in costal lakes. Increased salinity contributed to a significant decline in total bacterial numbers (TBN). The TBN was lowest in brackish lakes in autumn (4 × 106 cells/mL) and highest in freshwater lakes in summer (7.11 × 106 cells/mL). The groups of Proteobacteria are appropriate bioindicators in any classifications of coastal ecosystems, particularly at low-haline stress. Alpha- and Gamma- subclasses of Proteobacteria are identifiers for brackish habitats, while Betaproteobacteria, due to their intolerance to haline stress, prefer freshwater habitats. Counts of euryhaline Actinobacteria, the dominant group of bacterioplankton (31.8%), decreased significantly with increased salinity. Actinobacteria and Deltaproteobacteria were identifiers of transitional lakes. Cytophaga-Flavobacteria showed affinity with freshwater ecosystems, but this relation was not statistically significant (p > 0.05). The bacteria groups correlated with other physico-chemical parameters of water, such as oxygenation (Actinobacteria) or organic carbon (Betaproteobacteria, Deltaproteobacteria). The impact of hydrological connectivity and salt-water interference on the microbiota structure and biogeochemistry of coastal waters should be considered in the assessment of the ecological status of coastal lakes.

Phytoplankton Sensitivity to Heavy Metals in Baltic Coastal Lakes.

This study aimed to compare concentrations of chlorophyll-a between individual phytoplankton groups for four shallow Baltic coastal lakes, varying in type of connection with the sea. For two years, the research focused on quantifying the effects of abiotic factors-concentrations of heavy metals (Ba, Bi, Cr, Cu, Mn, Fe, Ni, Pb, and Zn) and hydrological connectivity-on phytoplankton composition, biomass, and photosynthetic activity. Our results show that hydrological factors are the main predictors of phytoplankton structure. The lakes differed in salinity: freshwater vs. brackish vs. transitional lakes. Irrespective of lake type, the dominant group was that of Cyanobacteria (~80%), but their percentage contribution was lower in the brackish lake. Baltic seawater intrusion resulted in a decrease in heavy-metal concentrations in lake water for Fe, Zn, Pb, and Bi. Redundancy analysis (RDA) suggested positive effects of some heavy metals on the biomass of the Chlorophyta and Bacillariophyta. For the Cryptophyta only, a slight decrease in biomass was linked with increased metal concentrations in open water.

Universal Climate Thermal Index as a prognostic tool in medical science in the context of climate change: A systematic review.

The assessment of the impact of meteorological factors on the epidemiology of various diseases and on human pathophysiology and physiology requires a comprehensive approach and new tools independent of currently occurring climate change. The thermal comfort index, i.e., Universal Climate Thermal Index (UTCI), is gaining more and more recognition from researchers interested in such assessments. This index facilitates the evaluation of the impact of cold stress and heat stress on the human organism and the assessment of the incidence of weather-related diseases. This work aims at identifying those areas of medical science for which the UTCI was applied for scientific research as well as its popularization among clinicians, epidemiologists, and specialists in public health management. This is a systematic review of literature found in Pubmed, Sciencedirect and Web of Science databases from which, consistent with PRISMA guidelines, original papers employing the UTCI in studies related to health, physiological parameters, and epidemiologic applications were extracted. Out of the total number of 367 papers identified in the databases, 33 original works were included in the analysis. The selected publications were analyzed in terms of determining the areas of medical science in which the UTCI was applied. The majority of studies were devoted to the broadly understood mortality, cardiac events, and emergency medicine. A significant disproportion between publications discussing heat stress and those utilizing the UTCI for its assessment was revealed.

Water as a Source of Indoor Air Contamination with Potentially Pathogenic Aeromonas hydrophila in Aquaculture.

Human activities influence the presence of potentially pathogenic bacteria in indoor air. The aim of this study was to determine the effect of the experimental rearing of European grayling and European perch in a recirculating aquaculture system on the contamination of indoor air with potentially pathogenic Aeromonas hydrophila (PPAH) and the resulting health risks to humans. The PPAH counts, their resistance to seven antibiotics, and the multiple antibiotic resistance (MAR) index were determined in samples of indoor air and water from rearing tanks. The PPAH counts were highest in the laboratory bioaerosol where two fish species were reared. The calculated indoor/outdoor ratio (I/O > 1) demonstrated that tank water was the internal source of PPAH emissions. The unconstrained PCA revealed strong positive relationships (p ≤ 0.05) between the PPAH counts in the indoor air and water samples. Most of the PPAH strains isolated from laboratory air were resistant to tetracycline, cefotaxime, and erythromycin, and 26-82% of the isolates exhibited multiple drug resistance. The values of the MAR index were similar in samples of laboratory air and water (0.23-0.34 and 0.24-0.36, respectively). Agglomerative clustering revealed two clusters of strains isolated from laboratory air and tank water. The results of this study indicate that aquaculture can be a source of indoor air contamination with PPAH.

Are the levels of uric acid associated with biometeorological conditions?

Hyperuricemia is an independent risk factor for renal and cardiovascular diseases and is closely associated with gout episodes. It is caused, inter alia, by nutritional habits and genetic factors, and also displays seasonal variability conditioned by meteorological factors. The impact of meteorological factors, including both cold and heat stress, on the human physiology is presented based on the Universal Thermal Climate Index (UTCI) - a biometeorological index derived from an analysis of human thermal balance. The aim of our study was to establish whether seasonal variations significantly affect routinely measured urine acid (UA) levels and could eventually support the clinical decision making process, as well as assessing whether UTCI values are correlated with UA levels in blood serum. This work presents a retrospective epidemiological study of data collected in Olsztyn (Poland). Study material comprised 54,536 results of ambulatory tests measuring UA levels, performed during the period 2016-2019. The analysis concerned correlations between UA and the ages of female and male subjects as well as existing biometeorological conditions as represented by UTCI values in an annual cycle. UA levels in females were found to be lower (4.94 ± 1.37 SD) as compared to those of males (6.13 ± 1.43 SD) and demonstrated a strong positive correlation with age. UA values differed significantly (p < 0.05) on days characterized by cold stress and heat stress, for the oldest age group. UA levels were found to differ depending on the season, but these relationships were not statistically significant, except for significantly higher UA levels in females in autumn (p < 0.001). However, there was an evident difference in population UA levels under cold stress conditions (lower) and heat stress conditions (higher) in the elderly. The UTCI is an adequate predictor of population variations in UA levels since it takes into account the variability of local meteorological conditions.

Schlemm's canal: the outflow 'vessel'.

In a healthy eye, the aqueous humour (AH) flows via the ciliary body and trabecular meshwork into the collector channels, which carry it to the episcleral veins. In glaucoma, a heterogeneous group of eye disorders affecting approximately 60 million individuals worldwide, the juxtacanalicular meshwork offers greater resistance to the outflow of the AH, leading to an increase in outflow resistance that gradually results in elevated intraocular pressure (IOP). The present review comprehensively covers the morphology of Schlemm's canal (SC) and AH pathways. The path of the AH from the anterior chamber through the trabeculum into suprascleral and conjunctival veins via collector channels is described, and the role of SC in the development of glaucoma and outflow resistance is discussed. Finally, channelography is presented as a precise method of assessing the conventional drainage pathway and facilitating localization of an uncollapsed collector and aqueous veins. Attention is also given to the relationship between aqueous and episcleral veins and heartbeat. Possible directions of future research are proposed.

Microinvasive glaucoma surgery: a review and classification of implant-dependent procedures and techniques.

The aim of this article is to discuss how physiology and anatomical background affect the effectiveness of implant-dependent microinvasive glaucoma surgery (MIGS). First, we provide a micro view of aqueous outflow and tissue behaviour. Second, we review studies exploring the mechanisms of the pressure-lowering effect of MIGS, as well as tissue behaviour during aqueous flow and tissue motion. We also describe and classify microinvasive surgical procedures and the most important types of implants, as well as their mechanisms of action, implantation techniques and efficacy. Further, we summarize the indications and surgical results presented in recent studies, providing an evidence-based update on novel and emerging MIGS techniques for the treatment of open-angle glaucoma. These data can help surgeons to personalize the management of glaucoma and to choose the best MIGS option for individual glaucoma patients.

Salinity as a Key Factor on the Benthic Fauna Diversity in the Coastal Lakes.

Benthic communities were studied in nine Polish coastal lakes of the Baltic Sea; representing three levels of hydrological connection with the sea (isolated, periodically connected, and permanently connected), with resultant differences in salinity (freshwater, transitional, and brackish). The lakes classified in this way allowed us to investigate biodiversity in relation to the degree of environmental pressure. Stress intensity in coastal water bodies, resulting from contrasting marine and terrestrial influences, varied from mild to severe. Spatial variation in environmental predictors affected species richness more strongly than seasonal fluctuations. The broader the spatial salinity gradient, the smaller the species number recorded. Differences in the intensity of natural instability only slightly affected species number and α-diversity. In Baltic coastal lakes, characterized by low salinity (max. 7.5 PSU), benthic faunal communities were dominated by large populations of opportunistic species. This applied primarily to closed systems and those periodically influenced by seawater intrusion. The marine component of fauna played a more important role in increasing the diversity of benthos in permanently open water bodies (brackish). The highest density of benthic fauna was recorded in them, whereas low values were associated with the strongest instability, observed in lakes periodically linked with the sea (transitional).

XEN Glaucoma Implant for the Management of Glaucoma in Naïve Patients versus Patients with Previous Glaucoma Surgery.

This retrospective study analyzed the surgical and refractive outcomes of a XEN Gel Implant (Allergan, Abbvie Company, Irvine, CA, USA) in naïve patients versus those with previous glaucoma surgery. We evaluated the efficacy of XEN implantation in 86 glaucoma patients during a long-term follow-up period. Patients were divided into two groups: naïve patients (Group 1) and patients with previous glaucoma surgery (Group 2). Eyes that received a XEN Gel Stent placement from December 2014 to October 2019 were included. Intraocular pressure (IOP) change, corrected distance visual acuity (CDVA), change in glaucoma medications, frequency of slit lamp revision procedures, and frequency of secondary glaucoma surgeries were the primary outcomes. In Group 1, the mean IOP before surgery was decreased significantly from 25.00 ± 7.52 mmHg to 16.83 ± 5.12 mmHg by the end of the study. In Group 2, the mean IOP decreased significantly from 25.35 ± 7.81 mmHg to 17.54 ± 5.34 mmHg. The mean IOP decrease from baseline was 29% in Group 1 and 27% in Group 2 (p = 0.567). There were no significant differences between the groups in the IOP baseline level, the final level, or the change between preoperative and final levels. The qualified success rate for Group 2 was 68.7% versus 76.5% for Group 1 for the initial procedure and 15.4% vs. 20.2%, respectively, for complete success rate (p > 0.05). However, at the end of the follow-up, more patients achieved an IOP < 18 mmHg in Group 1 than in Group 2. Despite the need for more anti-glaucoma medications, repeat XEN Gel implantation appears to show promising results in patients with previously failed anti-glaucoma procedures, owing to its minimal invasiveness.

Response of Benthic Fauna to Habitat Heterogeneity in a Shallow Temperate Lake.

We investigated the response of benthic macroinvertebrates in the eulittoral, infralittoral, and sublittoral zones, in two segments of the freshwater Lake Wicko on the coast of the Baltic Sea. Our results showed that the morphometry of lakes plays a major role as a factor structuring the macroinvertebrates communities. Two parts of the lake, different in size and depth, show decreasing differences in the trophic state, abundance, diversity and number of indicator species of benthic fauna with the depth gradient. The most significant differences were observed between the littoral zones of both segments. Similar environmental conditions in the sublittoral zones corresponded to the simplified structure of the benthic macroinvertebrates communities. In the infralittoral zone, the most significant differences between the two segments, were recorded for mollusks and large crustaceans as well as the Oligochaeta/Chironomidae abundance ratio. In the sublittoral zone, the diversity of chironomids differed most strongly. Lower species diversity was found in the part of the lake with a slight depth decrease. Shredders reached significantly higher values in eulittoral and infralittoral of the deeper lake segment. Average Score Per Taxon increased with a depth gradient. We recommend testing benthic macroinvertebrates in lakes with different morphometrics individually for each depth zone.

XEN Glaucoma Implant for the Management of Operated Uncontrolled Glaucoma: Results and Complications during a Long-Term Follow-Up.

This study aimed to analyze the surgical and refractive outcomes of XEN glaucoma implant (Allergan, an Abbvie company, Irvine, CA, USA), a minimally invasive surgical device for the treatment of operated uncontrolled glaucoma. Eyes that received XEN Gel Stent placement from December 2014 to October 2019 were retrospectively investigated. Intraocular pressure (IOP) change, best-corrected visual acuity (BCVA), change in glaucoma medications, frequency of slit lamp revision procedures, and frequency of secondary glaucoma surgeries were the primary outcomes. Seventy-two eyes of 72 subjects were included in the study: 32 (44%) men and 40 (56%) women. The follow-up period ranged from 1 to 50 months (median, 26.13 months). The mean IOP before surgery was 24.82 ± 8.03 mmHg and decreased to 17.45 ± 5.84 mmHg at the end of the study (mean difference [MD] = -7.48, 95% confidence interval [CI]: -10.04, -4.93; p < 0.001). The mean decrease from baseline was 23%. BCVA before surgery was 0.38 ± 0.30, and that at the end of the follow-up period improved to 0.47 ± 0.37, MD = 0.09, 95% CI: 0.04, 0.13; p < 0.001. Additional procedures (fluorouracil injection and bleb needling) were performed in 11/72 patients (15%). Further glaucoma surgery was necessary for 23.9% of the patients. XEN Gel Stent implantation is both safe and reasonably effective for lowering IOP in operated uncontrolled glaucoma patients.

The association between the biometeorological indicators and emergency interventions due to fainting: A retrospective cohort study.

The association of fainting with specific situations and circumstances, such as the sight of blood, response to pain, prolonged standing position and fatigue, is well recognized and described in medical literature. Clinical experience also indicates that specific, local physical conditions, such as exposure to heat or remaining in a small, stuffy room may also trigger fainting. This paper verifies the hypothesis concerning the association between atmospheric conditions and the incidence of fainting. This is a retrospective cohort study of data relating to fainting collected in the city of Olsztyn (Poland). In total, 10,449 emergency service interventions in the period 2012-2019 that concluded with the R55 (syncope and collapse) diagnosis according to the ICD 10 were analyzed. The obtained data were matched with meteorological data, including basic parameters (temperature, humidity, atmospheric pressure) and complex parameters, with special attention given to the Universal Thermal Climate Index (UTCI). This index is derived from an analysis of human thermal balance and is particularly useful for describing the organism's response to thermal stress. Statistically significant differences in the occurrences of fainting depending on the season were revealed (more in the summer), but only for women. Among the analyzed meteorological and biometeorological parameters, statistical significance was found for parameters relating to temperature, with the greatest usefulness revealed for the UTCI. Periods with heat stress were more conducive to fainting, whereas the result for the general population was influenced by women in two age groups: 25-45 and 46-60. To our best knowledge, this is the first attempt worldwide to utilize the UTCI as a predictor of fainting. Our results confirmed the applicability of the UTCI as a universal biometeorological tool for the assessment of relationships between atmospheric conditions and the incidence of fainting.

Microinvasive Glaucoma Surgery: A Review of Schlemm's Canal-Based Procedures.

Microinvasive glaucoma surgery has gained popularity over the past decade. It can be performed using three different mechanisms. In the present review, we focused on Schlemm's canal (SC)-based surgery, which increases aqueous humor (AH) outflow into the aqueous veins by either removal of the trabecular meshwork (TM) or an increase in the tension in the TM. In primary open-angle glaucoma (POAG), the TM is the most likely region for increased AH outflow resistance. Theoretically, removal of the TM can improve the AH outflow; hence, glaucoma specialists focus on microsurgical dissection of the TM. In this review, we analyzed the available literature to examine SC-related microsurgical modalities based on the histopathological proofs of the localization of resistance of the AH outflow. First, we considered the role, anatomy, and physiology of the TM and SC. We referred to studies that describe the mechanisms and potential pathways, related to increased intraocular pressure in the POAG, that are targeted using the SC-related microsurgical interventions. Next, we took a closer look at the gonioscopic tools necessary for an ab-interno approach and explored incision canal surgery: ab-interno trabeculectomy using different instrumentation (Trabectome®, Kahook Dual Blade) and variations of the technique. Thereafter, we discussed ab-interno canaloplasty, explaining the technique and reviewing its effectiveness. Finally, we presented the scope for future research in the field. Although the iStent also targets SC by bypassing it, this device has been reviewed extensively elsewhere.

Assessment of the Consultation Rate with General Practitioners in the Initial Phase of the COVID-19 Pandemic.

Background: The COVID-19 pandemic affected the functioning of healthcare systems (HSs) in a way that was difficult to foresee earlier. It quickened the introduction of e-medicine, and changed the manner and number of services provided in the open medical setting. Aim: To assess variations in the consultation rate of patients in primary healthcare centers (PHCs) in consecutive months of the pandemic. Method: Data collected from two PHCs located in Olsztyn (Poland) were analyzed retrospectively. Collectively, these two centers provide care for approximately 20,000 inhabitants and perform approximately 100,000 medical services annually. The analysis was based on data covering the period April-July of the years 2010-2020, consisting in total of 337,510 medical services records. Results: A large, statistically significant decrease in the consultation rate (consultation rate understood as the number of individuals seeking consultation in relation to the number of people under care in a given time period) was revealed in each age group in the initial phase of the pandemic. In consecutive months, the approximated consultation rate achieved mean long-term values. Conclusions. The largest reduction in the consultation rate was revealed in the youngest age group, with the smallest occurring in the oldest. In the group of patients older than 65 years of age, the consultation rate after 3 months of the pandemic was the same as before the outbreak. Variations in the consultation rate were independent of the epidemiological situation. During the study, we observed an increased level of the administrative and paperwork activities carried out by PHC physicians.

Relationship between biometeorological factors and the number of hospitalizations due to asthma.

The incidence of asthma exacerbation depends on atmospheric conditions, including such meteorological factors as the ambient temperature, relative air humidity or concentration of atmospheric aerosols. An assessment of relations between the frequency of asthma exacerbation and environmental conditions was made according to the meteorological components, the biometeorological index UTCI (Universal Thermal Climate Index), as well as selected air quality parameters, including concentrations of PM10 and PM2.5. The study was conducted on the basis of a retrospective analysis of medical data collected at the Independent Public Hospital of Tuberculosis and Pulmonary Diseases in Olsztyn (Poland). Our analysis of patient data (from 1 January 2013 until 31 December 2017) showed a significant correlation between the number of asthma exacerbation and the UTCI value. More frequent asthma exacerbations are observed in patients aged over 65 years when air humidity increases. The UTCI values contained within class 5, describing thermoneutral conditions, correspond to an average frequency of asthma exacerbation. A decline in the UTCI value leads to a reduced number of asthma exacerbation, while a rise makes the cases of asthma exacerbations increase.