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EN
In some patients with atrial fibrillation (AF), the causative agent of attack is stress (AF associated with adrenergic activity). In others, AF usually begins during relax or sleep (AF associated with vagal nerve dominance). This study aimed to investigate the individual factors associated with the adrenergic or vagal type of AF. This study included 138 patients with paroxysmal atrial fibrillation (AF). Sixty-eight patients reported that AF was frequently triggered by stress (sympathetic-type AF) and 70 patients reported that AF usually began during relaxation or sleep (vagal-type AF). Gender, age, ejection fraction, and temperament were compared across the two groups. Temperament was evaluated using the Formal Characteristics of Behaviour-Temperament Inventory. The groups differed only in temperament. Patients with sympathetic-type AF had a higher score for emotional reactivity (p = 0.002) and perseverance (p = 0.002) temperament traits and a lower score for endurance (p = 0.003) than patients with vagal-type AF and than the average in population.
EN
Introduction: Atrial fibrillation (AF) is one of the most frequent arrhythmias. In Poland, there is a risk of developing AF in about 400,000 people. Atrial fibrillation occurs most frequently as a result of disorders of physiological automatism and afterdepolarization and triggered activity. The treatment strategy of AF is based on pharmacological treatment and procedures such as ablation or cardioversion. The quality of life as defined by the WHO is an individual perception of one's well-being. On the other hand, the assessment of the quality of life in illness is modified regarding health problems. Purpose: The main goal of the study was to get to know the quality of life of people with atrial fibrillation. Materials and methods: The research was carried out using a diagnostic survey, based on a survey among 100 patients diagnosed with AF. The place of the research was the Regional Specialist Hospital in Biała Podlaska, in the Emergency Department. Results: Increased morbidity was observed among women and people over the age of 60. The majority of patients with AF declared the quality of life at the medium level. The respondents most often followed medical recommendations. The majority of respondents did not follow healthy lifestyle rules, because as many as 68% of respondents did not do any physical activity and a significant part of the respondents smoked cigarettes and had an inflated BMI. Conclusion: AF affects the quality life by causing sadness, irritation and insomnia.
PL
W badaniach medycznych do przewidywania przynależności pacjentów do jednej z wyróżnionych dwóch klas zwykle wykorzystuje się model regresji logistycznej. Algorytmy minimalnoodległościowe, takie jak np. algorytm najbliższego sąsiada, mimo ich prostoty i intuicyjnej interpretacji, są wykorzystywane bardzo rzadko. W referacie podjęto próbę zastosowania algorytmów opartych na odległościach (NN, k-NN, DB oraz k-NN Tree) do prognozowania wystąpienia migotania przedsionków wśród 300 pacjentów po zabiegu wymiany zastawki aortalnej.
EN
Logistic regression is the most popular method used to classify patients into 2 selected subgroups in medical research. Distance-based algorithms, such as nearest neighbor algorithm, simple and intuitive, are rarely used in practice. In the study some selected distance-based algorithms (NN, k-NN, DB and k-NN Tree) were applied to predict atrial fibrillation (AF) incidents among 300 patients with aortic valve defects, who underwent aortic valve replacement.
EN
Introduction: Persistent atrial fibrillation is a chronic illness. Its recurrence is remarkably burdensome and its somatic symptoms often invoke the feeling of fear. Present among treatment methods, aside from pharmacotherapy, is electrical cardioversion, composed of analgosedation and attempts at restoring the correct heart rhythm using electric current. Dissertation goal: This dissertation’s goal was the assessment of quality of life and level of illness acceptance among people suffering from persistent atrial fibrillation. Resources and methods: The research had a sectional-range character and was undertaken with the aid of diagnostic poll and estimation methods. To accomplish it, a survey technique, alongside two standardised scales of self-evaluation and an own poll’s questionnaire were used. Fifty people with diagnosed persistent atrial fibrillation have partaken in the study. Beyond medical diagnosis, the inclusion to the research group depended on the occurrence of electrical cardioversion treatment. Acquired results were examined via statistical analysis. Conclusions: Overall quality of life of the patients was average. Physical issues proceeding with limiting of role fulfilment significantly lowered the quality’s general self-evaluation. Respondents were characterized with good quality of life regarding social functioning and mood. Researched subjects averagely accepted their illness. In the researched aspects, except general health, higher levels of acceptation were connected with better self-evaluation of the quality of life.
PL
Wprowadzenie: Przetrwałe migotanie przedsionków jest chorobą przewlekłą, której nawrotowość jest niezwykle uciążliwa, a objawy somatyczne wywołują niejednokrotnie uczucie lęku. Do metod jej leczenia, obok farmakoterapii, należy kardiowersja elektryczna, która polega na analgosedacji i próbie przywrócenia prawidłowego rytmu zatokowego z wykorzystaniem prądu elektrycznego. Cel pracy: Celem pracy była ocena jakości życia i stopnia akceptacji choroby wśród osób z przetrwałym migotaniem przedsionków oraz analiza zależności pomiędzy obiema zmiennymi. Materiał i metody: Badania przeprowadzono metodą sondażu diagnostycznego i metody szacowania z wykorzystaniem techniki ankiety (własny kwestionariusz) wraz z dwiema wystandaryzowanymi skalami samooceny, w grupie 50 chorych z rozpoznaniem przetrwałego migotania przedsionków. O włączeniu do grupy badanej decydowało rozpoznanie kliniczne oraz przebyty zabieg kardiowersji elektrycznej. Wyniki: Ogólna jakość życia badanych pacjentów była zadowalająca, choć problemy fi zyczne w zakresie realizacji aktywności codziennej i pracy zawodowej obniżały jej globalną samoocenę. Respondenci wskazywali dobrą jakość życia w zakresie funkcjonowania społecznego i samopoczucia. Chorobę najlepiej akceptowały osoby w średnim wieku, tj. 41–59 lat. Wyższy poziom akceptacji towarzyszył lepszej samoocenie jakości życia w jej badanych aspektach, z wyjątkiem zdrowia ogólnego
EN
Atrial fibrillation (AF) is one of the most common causes of sudden death, cerebral stroke and heart failure. AF morbidity will increase in the coming years. The disease is precipitated by gene predisposition, diabetes, heart failure, obesity, coronary disease, hypertension and aging. Pathophysiological changes include atrial and coronary arteries remodelling, inflammation, and cardiomyocyte calcium metabolism disorders. Life quality in AF patients is significantly impaired, as compared to healthy people, due to weakness, heart palpitation, dyspnea, chest discomfort and sleep disorders; psychosocial stress occurs as well. Integrated AF management requires 4 areas: patient involvement, multidisciplinary teams, technological tools and access to all currently possible therapies. Diagnosis and control of coexisting diseases, anticoagulant treatment, heart rhythm and heart rate control, as well as education, remarkably improve AF prognosis and life quality. Casual recovery and maintaining the sinus rhythm is important as a part of the integral approach. Prevention of AF recurrence include non-antiarrhythmic medicines (ACEI/ARB, LBA) in heart failure with decreased ejection fraction, as well as in hypertensive cardiomyopathy (ACEI/ ARB). Surgical treatment aims the total isolation of pulmonary veins with more efficient heart rhythm control, as compared to pharmacological management. In paroxysmal AF, percutaneous intervention is a treatment of choice. Surgery can be necessary, if percutaneous intervention either pharmacotherapy is unsuccessful. Coexisting diseases elevate the risk of AF, including AF recurrence and complications. They need to be properly identified and treated in order to optimize the patient management.
PL
Migotanie przedsionków (atrial fibrillation, AF) należy do najczęstszych przyczyn nagłych zgonów, udarów mózgu i niewydolności serca, a zapadalność na AF w najbliższych latach jeszcze wzrośnie. Przyczynami choroby są: predyspozycje genetyczne, cukrzyca, niewydolność serca, otyłość, choroba wieńcowa, nadciśnienie tętnicze i starzenie się. Zmiany patofizjologiczne AF obejmują przebudowę przedsionków i naczyń wieńcowych, odczyn zapalny, niedokrwienie oraz zaburzenia gospodarki wapniowej kardiomio- cytów. Jakość życia chorych z AF jest istotnie gorsza niż u osób zdrowych. Dzieje się tak wskutek osłabienia, kołatania serca, duszności, ucisku w klatce piersiowej i zaburzeń snu. Chorobie towarzyszy także stres psychospołeczny. Zintegrowane leczenie AF obejmuje 4 filary: zaangażowanych chorych, zespoły wielodyscyplinarne, narzędzia technologiczne i dostęp do wszystkich możliwych terapii. Rozpoznanie oraz kontrola chorób współistniejących, leczenie przeciwzakrzepowe, kontrola rytmu serca i jego częstotliwości, a także edukacja istotnie poprawiają rokowanie i jakość życia chorych. Doraźne przywrócenie rytmu zatokowego i jego utrzymanie pozostaje integralną częścią postępowania. W celu zapobiegania nawrotowi AF, w razie współistniejącej niewydolności serca ze zmniejszoną frakcją wyrzutową, stosuje się leki nieanty- arytmiczne (ACEI/ARB, LBA), podobnie jak ma to miejsce w kardiomiopatii nadciśnie- niowej (ACEI/ARB). Leczenie zabiegowe w AF ma na celu całkowitą izolację żył płucnych, co przynosi skuteczniejszą kontrolę rytmu serca niż farmakoterapia. Zabieg przezcewnikowy jest leczeniem z wyboru, a gdy jest on nieskuteczny lub przyjmowane leki nie pomagają, przeprowadza się zabieg chirurgiczny. Wiele współistniejących chorób zwiększa ryzyko wystąpienia, nawrotów i powikłań AF. Ich identyfikacja i leczenie odgrywają ważną rolę w zapobieganiu AF oraz w optymalnym prowadzeniu chorych.
EN
Objectives For the purpose of flight safety military aircrew must be healthy. P-wave dispersion (PWD) is the p-wave length difference in an electrocardiographic (ECG) examination and represents the risk of developing atrial fibrillation. In the study we aimed at investigating PWD in healthy military aircrew who reported for periodical examinations. Material and Methods Seventy-five asymptomatic military aircrew were enrolled in the study. All the subjects underwent physical, radiologic and biochemical examinations, and a 12-lead electrocardiography. P-wave dispersions were calculated. Results The mean age of the study participants was 36.15±8.97 years and the mean p-wave duration was 100.8±12 ms in the whole group. Forty-seven subjects were non-pilot aircrew, and 28 were pilots. Thirteen study subjects were serving in jets, 49 in helicopters, and 13 were transport aircraft pilots. Thirty-six of the helicopter and 11 of the transport aircraft aircrew were non-pilot aircrew. P-wave dispersion was the lowest in the transport aircraft aircrew, and the highest in jet pilots. P-wave dispersions were similar in the pilots and non-pilot aircrew. Twenty-three study subjects were overweight, 19 had thyroiditis, 26 had hepatosteatosis, 4 had hyperbilirubinemia, 2 had hypertension, and 5 had hyperlipidemia. The PWD was significantly associated with thyroid-stimulating hormone (TSH) levels. Serum uric acid levels were associated with p-wave durations. Serum TSH levels were the most important predictor of PWD. Conclusions When TSH levels were associated with PWD, uric acid levels were associated with p-wave duration in the military aircrew. The jet pilots had higher PWDs. These findings reveal that military jet pilots may have a higher risk of developing atrial fibrillation, and PWD should be recorded during periodical examinations.
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