Flecainide in clinical practice.

Flecainide, similar to encainide and propafenone, is IC class antiarrhythmic, inhibiting Nav1.5 sodium channels in heart muscle cells and modulates cardiac conduction. Despite its over 40-year presence in clinical practice, strong evidence and well-known safety profile, flecainide distribution in Europe has not always been equal. In Poland, the drug has been available in pharmacies only since October this year, and previously it had to be imported on request. Flecainide can be used successfully in both the acute and chronic treatment of cardiac arrhythmias. The main indication for flecainide is the treatment of paroxysmal supraventricular tachycardias, including atrial fibrillation, atrioventricular nodal re-entrant tachycardia, atrioventricular re-entrant tachycardia and ventricular arrhythmias in patients without structural heart disease. Beyond that, it may be used in some supraventricular tachycardia in children and for sustained fetal tachycardia. Many studies indicate its efficacy comparable to or better than previously used drugs such as propafenone and amiodarone, depending on the indication. This review aims to highlight the most important clinical uses of flecainide in the light of the latest scientific evidence and to provide an overview of the practical aspects of treatment, including indications, off-label use, contraindications, areas of use, monitoring of treatment and most common complications, taking into account special populations: children and pregnant women.

The Assessment of Body Composition and Nutritional Awareness of Football Players According to Age.

The optimal body composition for health is an individual trait and is determined by genetic factors, sex, age, somatotype, physical activity, and individual variability. The present study aims to assess how professional football players' body composition has changed over the training macrocycle in various age groups and to determine the correlation between nutritional awareness and body composition maintenance. Thirty-eight football players participated in the study, with 16 players classified in the younger age group (19-25) and 22 in the older age group (26-31). Using the direct segmented multi-frequency electrical impedance analysis technique, the athletes' body composition was assessed six times across a training macrocycle made up of preparatory, competitive, and transitional periods. The Sports Nutrition Knowledge Questionnaire was used to evaluate nutrition knowledge. The above correlations show that both younger and older athletes with higher awareness are better able to adjust their nutrition to meet the goals of the preparation period and can achieve greater gains in muscle mass and greater reductions in body fat. According to the study's results, athletes who are better conscious of their nutritional needs during competition experience less muscle loss and exhibit more consistent body weight and BMI levels. Football players' body composition suffers detrimental alterations throughout the transition period. Higher body mass, lean body mass content, and skeletal muscle mass are traits of older players. Higher nutritional knowledge reduces the negative modifications of body composition consisting of muscle mass reduction and fat gain. Nutritional knowledge influences the stability of body composition in both age groups during all the analyzed periods: Preparation, competition, and transition.

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.

Changes in body composition during the macrocycle of professional football players in relation to sports nutrition knowledge.

Professional football players are obligated to meet the physical demands and maintain the best possible performance throughout the whole macrocycle. It is important to assess the players' nutrition knowledge, identify areas that require increased nutrition awareness and identify the impact of knowledge on changes in body composition as this can affect the players' health and performance. This study aimed to assess changes in the body composition of professional football players during the macrocycle of the spring round of the football championship and to identify the correlation between nutrition knowledge and maintaining body composition. The study included 38 football players. The players' body compositions were analyzed 6 times during the macrocycle consisting of preparatory, competitive, and transition periods using the Direct Segmental Multi-Frequency Bioelectrical Impedance Analysis method. Athletes completed the Nutrition for Sport Knowledge Questionnaire to assess their nutrition knowledge. During the preparatory period, a statistically significant negative correlation was demonstrated between the players' knowledge about the subsections of micronutrients in the diet and the dispersion of the adipose percentage tissue content (r = -0.36, p = 0.03). In the competitive period, there was a statistically significant negative correlation between the players' knowledge of sports nutrition and the dispersion of lean body mass (r = -0.46, p = 0.004), and skeletal muscle mass (r = -0.36, p = 0.03). During the transition period, a statistically significant negative correlation between the players' knowledge of weight control and the dispersion of body mass (r = -0.47, p = 0.00) and BMI values (r = -0.48, p = 0.00) was identified. The player's knowledge about the subsection of macronutrients significantly negatively correlated with the dispersion of skeletal muscle mass content (r = -0.33, p = 0.05). Nutrition knowledge has an impact on the stability of body composition during all analyzed periods: preparatory, competitive, and transition periods.

Traditional complementary feeding or BLW (Baby Led Weaning) method? - A cross-sectional study of Polish infants during complementary feeding.

Baby-led weaning (BLW) is an increasingly well-known method of complementary feeding for infants. The BLW method is based on the fact that the baby becomes physically ready to eat on its own and can henceforth effectively supplement its diet, which was previously based on breast milk or formula milk. The aim of the study was to compare complementary feeding among mothers using and not using the BLW method. The study took into account, among other things, the frequency of spoon feeding, eating from the family table, and eating meals with a pulpy consistency. The study also determined the frequency of the risk of choking/gagging, food regurgitation or the occurrence of vomiting during a meal in the study groups. Material and method: a cross-sectional survey was conducted among mothers of children from 6 months to 36 months of age residing throughout Poland. Results: The study group was divided into three subgroups: mothers using BLW (M-BLW), mothers not familiar with the BLW method (M-NoBLW)), mothers not using the BLW method - mothers using the spoon-feeding method) (M-TS). Among the mothers surveyed, 413 women (63.93%) used the BLW method, 222 mothers (34.36%) did not use the BLW method of which 50 (7.73%) of these were unfamiliar with the method, and 172 (26.62%) simply did not use it. Among M-TS mothers, the child was most often entirely or mostly spoon-fed by an adult (73.84%), and the same was true for the M-NoBLW group (70.0%). In the M-BLW group, 58.60% of children were half-fed by an adult with a spoon. half ate independently. Conclusions: Infants fed by the BLW method were more likely to have their diets expanded after 6 months of age, they were also more likely to be given products from the family table than children fed traditionally with a spoon. Full BLW was implemented by only 29% of children in the BLW group. The vomiting reflex, spitting food out of the mouth, and gagging, were more common among children fed by the BLW method. In contrast, choking occurred comparably often in both groups - in 5.4% of spoon-fed children and 6.9% of BLW-fed children.

The implantation of AV leadless pacemaker - a case report.

In early 2020 Food and Drug Administration (FDA) approved Micra AV - a new type of leadless pacemaker with atrioventricular synchrony, to treat patients with atrio-ventricular (AV) blocks. We describe one of the first in Poland case of a patient who was implanted with Micra AV pacemaker. CASE REPORT: A 38-year-old female patient was admitted to the clinic due to the 29-seconds event of a complete AV block without an escape rhythm and was implanted with a dual chamber pacemaker without any complications. After several months she was admitted again with suspicion of ventricular perforation by the pacemaker electrode and underwent a replacement procedure of both pacemaker's leads. Nevertheless, one week later the patient developed a fever with significantly elevated inflammatory markers. The blood cultures were negative but in the transesophageal echocardiography features of cardiac device-related infective endocarditis were observed. Empirical antibiotic therapy was administered, and the device was removed. The Heart Team qualified the patient for the implantation of a MicraTM AV leadless pacemaker. The procedure was performed without any complications and the device was implanted to the right ventricle. All parameters were correct, and the patient was discharged. CONCLUSIONS: Micra AV may be a feasible and safe option for young patients with paroxysmal AV block after device-related complications.

Body Composition and Its Perception among Professional Female Volleyball Players and Fitness Athletes (Silesia, Poland).

Female athletes experience both sociocultural and sport-specific pressures of an ideal body and appearance and are vulnerable to dissatisfaction with their bodies. Among sport-specific pressures, the type of sport is a predictor of body image dissatisfaction. The study included 150 females: 50 volleyball players, 50 bodybuilding and fitness athletes, and 50 female students, who were the control group. Body composition and perception and evaluation of one's own body were assessed. BMI was similar in the study group of female athletes and the control group, but the bodybuilding and fitness athletes had the lowest body fat, while the control group had the highest. Perception of one's own body in the aspect of the evaluation of specific body parts was highest among bodybuilding and fitness athletes, while in the aspect of body condition, the best results were obtained by volleyball players. Most female volleyball players were dissatisfied with their current body weight, as were women in the control group, in contrast to female bodybuilding and fitness athletes, who were most often satisfied with their current body weight.

Nutrition and mental health: A review of current knowledge about the impact of diet on mental health.

Applied psychopharmacotherapy and psychotherapy do not always bring the expected results in the treatment of mental disorders. As a result, other interventions are receiving increasing attention. In recent years, there has been a surge in research on the effects of nutrition on mental status, which may be an important aspect of the prevention of many mental disorders and, at the same time, may lead to a reduction in the proportion of people with mental disorders. This review aims to answer whether and to what extent lifestyle and related nutrition affect mental health and whether there is scientific evidence supporting a link between diet and mental health. A review of the scientific evidence was conducted based on the available literature by typing in phrases related to nutrition and mental health using the methodological tool of the PubMed database. The literature search yielded 3,473 records, from which 356 sources directly related to the topic of the study were selected, and then those with the highest scientific value were selected according to bibliometric impact factors. In the context of current changes, urbanization, globalization, including the food industry, and changes in people's lifestyles and eating habits, the correlations between these phenomena and their impact on mental state become important. Knowledge of these correlations creates potential opportunities to implement new effective dietary, pharmacological, therapeutic, and above all preventive interventions. The highest therapeutic potential is seen in the rational diet, physical activity, use of psychobiotics, and consumption of antioxidants. Research also shows that there are nutritional interventions that have psychoprotective potential.

Implementation of sugar-sweetened beverages tax and its perception among public health stakeholders. A study from Poland.

Background: One of tools to tackle growing problem of overweight and obesity are the taxation mechanisms applied to sugar-sweetened beverages, which are expected to influence the common eating behaviors, but also they have impact on the market and public finances. The solution is therefore highly entangled in the complex of social and intersectoral interests generating a number of opportunities and threats affecting its feasibility. Aims: The study aims to depict the views of Polish stakeholders on the implementation of the sugar tax in Poland, particularly the perception of success determinants, barriers, as well as views on the features of the implemented solutions and possible alternatives. Methods: We used semi-structured interviews with 18 individuals representing key public health stakeholders in Poland. The interview consisted of four parts, where first concentrated on the advantages and disadvantages of the SSB tax, the second part explored stakeholder involvement and stances, third concerned the feasibility of the project, and in the fourth part respondents were asked for suggestions for decision-makers regarding the content of the project and its implementation process. To reconstruct position of 4 main political parties we applied desk research. We used MAXQDA v2020 to analyse the collected data. Results: Stakeholders tend to expressed conflicting views on the effectiveness, relevance and socio-economic impact of the SSB tax. All of them agreed that the tax may appear severe for the poorest groups, children and adolescents, while disagreeing about the economic impact of the levy. The allocation of additional tax revenues was raising doubts, with stakeholders believing that the fiscal aim is the basic reason for implementing the tax, while these resources should be primarily dedicated to health promotion intervention and prevention of diet-related diseases. On the other hand, the political debate on the tax was highly superficial with strong populism arising of the presented positions. Conclusions: There is a need to conduct a thorough public debate and improvements in terms of public communication to increase social awareness, sealing and refining the implemented solutions. Close cooperation with market players and non-governmental organizations is highly recommended.

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.

Practical Implementation of the BLW Method During the Expansion of the Infant Diet-A Study Among Polish Children.

The aim of the study was to verify the knowledge of mothers of children under 3 years of age about the Baby Led Weaning (BLW) feeding model and their practical implementation of this method. The study involved 761 mothers and their children. After analysis of the inclusion and exclusion criterion, the information provided by women 699 aged 21-48 years was included in the final data analysis. In the study group, most children were breastfed for 6 months to 1 year (n = 256, 36.7%), 1 year to 2 years (n = 179, 25.6%) and over 2 years (n = 71, 10.2%). Starting dietary expansion before 17 weeks of age was implemented in 47 (6.7%) children, between and 17-26 weeks of age in 328 (46.9%) children, and after 26 weeks of age in 324 (46.3%) children. Feeding food and dishes from the family table was practiced by 518 (74.1%) mothers. Spoon-feeding was practiced by 529 (75.6%) children, 157 (22.4%) children were fed this way sometimes. Taking into account the above data, feeding with the BLW method was used in 170 children (24.2%). In the examined group of mothers the use of the BLW method in feeding their children, especially during diet expansion, was declared by 408 women (74.8%). The child's independent decision concerning what the child will eat and what is according to the BLW method is accepted by 434 (62.1%) mothers. Among the positive aspects of using the BLW method, the women surveyed indicated the child's independence, while among the disadvantages, the omnipresent mess and chaos when eating meals.

Use of the Baby-Led Weaning (BLW) Method in Complementary Feeding of the Infant-A Cross-Sectional Study of Mothers Using and Not Using the BLW Method.

Baby-led weaning (BLW) is an increasingly popular way of expanding a baby's diet. It is based on the baby becoming physically ready to feed himself, effectively supplementing his diet, which until now has been based on breast milk or modified milk. The aim of the study was to assess mothers' knowledge about the use of the BLW method to expand the diet of a young child. The essence of the study assumed the analysis of the advantages and disadvantages of using this method indicated by mothers. MATERIALS AND METHODS: A total of 320 mothers participated in the study. Data for the study were collected anonymously using the CAWI method. The research tool was the original questionnaire relating to the knowledge about the BLW method and the application of the BLW method in practice. RESULTS: The BLW method was used by 240 (75%) women. The reasons for not using the BLW method were: the child did not cooperate n = 30 (37.5%) and was not ready to use the BLW method n = 20 (25%). In total, 182 (75.8%) mothers using BLW and 63 (78.8%) mothers not using BLW started extending the diet before the child was 6 months old. According to 270 (84.4%) mothers, including 205 (85.4%) using BLW, stable sitting in a highchair/on the lap is a decisive factor for starting the dietary expansion with the BLW method. CONCLUSIONS: Mothers' knowledge of the BLW method as a way of expanding a young child's diet was insufficient. It seems important to implement appropriate educational activities on the methods of expanding children's diets to broaden parents' knowledge of the influence of nutrition on infant development.

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.

Quality of life in patients with a subcutaneous vs. transvenous implantable cardioverter-defibrillator.

BACKGROUND: The implantable cardioverter-defibrillator (ICD) and subcutaneous ICD (S-ICD) are well-accepted life-saving devices for treating potentially lethal ventricular arrhythmia, but little is known about quality of life (QoL) in patients with S-ICD and ICD. AIMS: Our study aimed to compare QoL in patients with S-ICD and ICD. METHODS: All consecutive patients who had S-ICD implanted between October 2015 and September 2021 were included in the study. A cohort of transvenous ICD (TV-ICD) patients was matched to S-ICD subjects by sex, age, indications for the device, and type of prevention. All patients were requested to fulfill two standardized questionnaires to assess QoL: 36-Item Short Form Health Survey (SF-36) and Minnesota Living with Heart Failure Questionnaire (MLHFQ) 6 months after device implantation. RESULTS: Patients with S-ICD (n = 49) and TV-ICD (n = 49) did not differ regarding baseline characteristics. There were no statistically significant differences between S-ICD and TV-ICD subgroup, both for mental and physical QoL assessed in SF-36 and MLHFQ (all P = NS). The median MLHFQ total score was 24 (9-41) for S-ICD and 28 (14-43) for TV-ICD (P = 0.83). The median total score for the SF-36 questionnaire was 62.5 (29-86) vs. 59 (38-77) for S-ICD and TV-ICD, respectively (P = 0.78). CONCLUSIONS: Quality of life after device implantation does not differ significantly between the groups of patients with subcutaneous and conventional implantable cardioverter-defibrillator.

Neophobia-A Natural Developmental Stage or Feeding Difficulties for Children?

Food neophobia is the tendency to reject or be reluctant to try new and unfamiliar foods. Due to the period of its occurrence, which falls in the years of early childhood, it can significantly affect the child's food choices, shape taste preferences, and significantly influence the quality of the child's diet. The neophobic attitude has an important evolutionary significance because it protects the individual from ingesting potentially dangerous substances. On the other hand, it fosters avoidance behaviors that can also relate to the beneficial aspects of obtaining and consuming food. Currently, the strong emphasis placed on food safety means that neophobia may be less adaptive; nevertheless, a conservative attitude toward new foods still prevails. There is a strong association between food neophobia and the diversity of a person's diet and previous exposure to different foods. This review describes behaviors associated with food neophobia and analyzes other feeding and eating difficulties in children that should be differentiated from food neophobia. Management approaches affecting the reduction in food neophobia in children through various dietary and psychological interventions are also proposed.

Cardiac implantable electronic devices procedures and their recipients characteristic during COVID-19 pandemic: 3.8 million population analysis.

BACKGROUND: Coronavirus disease 2019 (COVID-19) pandemic disorganised healthcare systems and has caused a reduction in the number of hospitalizations and procedures. Cardiac implantable electronic device (CIED) procedure rates and clinical characteristics of their recipients were compared in corresponding weeks of 2019 and 2020 were analyzed. METHODS: The database of the National Health Fund (NHF) in Poland was retrospectively analyzed. 3206 patients who underwent CIED implantation in the Silesia - a region in Southern Poland comprising an adult population of 3.8 million between 12th and 31st week of 2020. Patients were classified into groups: the recipient of an implantable cardioverter-defibrillator or cardiac resynchronization therapy group (ICD/CRT) or pacemaker group (PM). RESULTS: During the pandemic a reduction of 39.38% of implantations was observed compared to the same period in 2019 (1210 vs. 1996 patients) and had impacted both groups. Two phases lasting 10 weeks each could be distinguished: total lockdown (maximal reduction) and the recovery phase with growing numbers of procedures. Patient baseline characteristics (sex, age, comorbidities) who were implanted during the COVID-19 pandemic did not differ from the 2019 period. The rate of peri-procedural mortality was also similar. CONCLUSIONS: During COVID-19 pandemic period a reduction in CIED implantations of all types was observed. Despite the decreased number of performed CIED implants, no differences in baseline patient characteristics were observed.

Nutrition as Prevention of Diet-Related Diseases-A Cross-Sectional Study among Children and Young Adults with Down Syndrome.

BACKGROUND: The aim of this study was to assess the diet of children with Down syndrome (DS) and to identify potential dietary mistakes made by their parents. MATERIALS AND METHODS: The study was conducted among 195 parents of people with DS between November 2020 and March 2021. Data for the study were collected anonymously using the CAWI method. RESULTS: 122 (62.6%) people with DS did not eliminate any nutrient from their diet. By contrast, in the study group, the following numbers of people reported the following dietary restrictions: 51 (26.2%) gluten, 56 (28.7%) lactose, 17 (8.7%) casein, 26 (13.3%) sucrose, 2 (1.0%) histamine, 2 (1.0%) lectins, and 1 (0.5%) dairy. The most frequent response for vegetable and fruit consumption was once a day, with 83 (42.6%) and 87 (44.6%) parents indicating this. The most frequent response for dairy product consumption was every day, with 72 (36.9%) parents indicating this, while 36 (20%) parents stated that their children do not eat dairy products at all. In the study group, the most frequent response for meat consumption was several times a week, this was indicated by 107 (54.9%) parents, while 1 (0.5%) of them said that their children do not eat meat products at all. The most frequent response for fish consumption was 1-2 times a week, this answer was indicated by 101 (51.8%) parents, while 13 (6.7%) said that their children do not eat these products at all. CONCLUSIONS: A majority of the subjects with DS are usually fed in a normal way, but nutritional mistakes are made by the parents. Special attention should be paid to prolonging the period of natural feeding.