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Spiroergometryczna próba wysiłkowa – zastosowanie w kardiologii i medycynie pracy

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Kurpesa M., Jerka K., Bortkiewicz A.

Medycyna Pracy

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2014

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vol. 65

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issue 5

665-674

EN

Cardiopulmonary exercise testing is a method used to assess the exercise capacity. It is used in cardiology to define the diagnostic and prognostic information, the treatment and its effectiveness. This method is also useful in sport medicine and in occupational medicine. The cardiopulmonary exercise test involves measuring of gas exchange during exercise testing. The article presents the main parameters assessed during the test and the indications and contraindications for conducting the test. It also reveals the results of recently published clinical trials on the use of cardiopulmonary exercise test in patients with cardiovascular disease and in the working population. The study included variability of respiratory parameters during the cardiopulmonary exercise test and after its completion, as well as their impact on the prognostic value. In addition, the results of a study involving an optimal choice of interval training on the basis of oxygen consumption at peak exercise are summarized. Med Pr 2014;65(5):665–674

PL

Spiroergometryczna próba wysiłkowa jest wykorzystywana do oceny wydolności fizycznej. W kardiologii znajduje zastosowanie w diagnostyce, planowaniu terapii, ocenie jej skuteczności i ocenie rokowania. Badanie to jest również wykorzystywane przez lekarzy innych specjalizacji, np. medycyny sportowej i medycyny pracy. Test spiroergometryczny polega na bezpośrednim pomiarze wymiany gazowej podczas próby wysiłkowej. W artykule przedstawiono najważniejsze parametry oceniane podczas testu oraz wskazania i przeciwwskazania do jego przeprowadzenia. Opisano też wyniki, najciekawszych według autorów, opublikowanych w ostatnim czasie badań klinicznych dotyczących wykorzystania testu spiroergometrycznego u pacjentów z chorobami układu krążenia i osób narażonych na niekorzystne dla zdrowia czynniki związane z pracą zawodową. W publikacjach tych oceniano zmienność parametrów oddechowych podczas testu spiroergometrycznego i po jego zakończeniu oraz ich wpływ na wartość prognostyczną badania. W niniejszej pracy przedstawiono ponadto doniesienia na temat optymalnego doboru obciążenia w treningu interwałowym w oparciu o zużycie tlenu na szczycie wysiłku. Med. Pr. 2014;65(5):665–674

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Broken heart as work-related accident: Occupational stress as a cause of takotsubo cardiomyopathy in 55-year-old female teacher – Role of automated function imaging in diagnostic workflow

76%

Mielczarek A., Kasprzak J. D., Marcinkiewicz A., Kurpesa M., Uznańska-Loch B., Wierzbowska-Drabik K.

International Journal of Occupational Medicine and Environmental Health

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2015

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vol. 28

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issue 6

1031-1034

EN

Takotsubo cardiomiopathy (TTC) (known also as “ampulla cardiomyopathy,” “apical ballooning” or “broken heart syndrome”) is connected with a temporary systolic left ventricular dysfunction without the culprit coronary lesion. Takotsubo cardiomyopathy was first described in 1990 in Japan after octopus trapping pot with a round bottom and narrow neck similar in shape to left ventriculogram in TTC patients. The occurrence of TTC is usually precipitated by a stressful event with a clinical presentation mimicking myocardial infarction: chest pain, ST-T segment elevation or T-wave inversion, a rise in cardiac troponin, and contractility abnormalities in echocardiography. A left ventricular dysfunction is transient and improves within a few weeks. Takotsubo cardiomyopathy typically occurs in postmenopausal women and the postulated mechanism is catecholamine overstimulation. Moreover, the distribution of contractility impairments usually does not correspond with typical region supplied by a single coronary artery. Therefore, the assessment of regional pattern of systolic dysfunction with speckle-tracking echocardiography and automated function imaging (AFI) technique may be important in diagnosis of TTC and may improve our insight into its patophysiology. We described a 55-year-old female teacher with TTC diagnosed after acute psychological stress in workplace. The provoking factor related with occupational stress and pattern of contraction abnormalities documented with AFI technique including basal segments of left ventricle make this case atypical.

3

Cardiotoxic effect due to accidental ingestion of an organic solvent

64%

Cieślik-Guerra U. I., Rechciński T., Trzos E., Wierzbowska-Drabik K., Uznańska-Loch B., Winnicka R., Krakowiak A., Kasprzak J. D., Fröhlich C., Kurpesa M.

International Journal of Occupational Medicine and Environmental Health

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2015

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vol. 28

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issue 1

174-179

EN

Toxic myocardial injury can be misdiagnosed as a myocardial infarction, resulting in the patient undergoing standard treatment for cardiac rehabilitation. However, such inadequate therapeutic strategies can lead to cardiovascular complications including dilated cardiomyopathy. This study presents a case of a 65-year-old man after accidental ingestion of organic solvents (toluene and xylene), whose condition demonstrated all the criteria for diagnosis of myocardial infarction. The qualitative determinations of the above mentioned volatile organic compounds (VOCs) in whole blood were carried out using a headspace sampling by means of gas chromatography. Cardiac catheterization revealed no specific coronary lesions, only a muscular bridge causing a 30–50% stenosis in the middle of the circumflex branch of the left coronary artery.

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Takotsubo cardiomyopathy in the case of 72-year-old teacher after work-related psychological stress. Evolution of left ventricular longitudinal strain – Delayed but complete recovery in automated function imaging (AFI)

64%

Wierzbowska-Drabik K., Marcinkiewicz A., Hamala P., Trzos E., Lipiec P., Kurpesa M., Kręcki R., Plewka M., Kasprzak J. D.

International Journal of Occupational Medicine and Environmental Health

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2017

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vol. 30

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issue 4

681-683

EN

Takotsubo cardiomyopathy (TC) is related to a transient systolic dysfunction of left ventricle (LV), accompanied by clinical and electrocardiographic symptoms of myocardial ischemia in the absence of hemodynamically significant coronary artery disease. Takotsubo cardiomyopathy is usually provoked by a psychologically or/and physically stressful event which may be related to occupational activities. Although visually assessed evolution of LV function is well documented, the data concerning strain changes is sparse and various patterns of deformation abnormalities are suggested. We have described a 72-year-old woman with chest pain related to a lecture given at the meeting of the Senior University, fulfilling all the Mayo Clinic criteria of the TC. The longitudinal strain analysis with automated function imaging (AFI) documented severe impairment and stepwise recovery of regional and global LV contractility. The case described confirms that accurate diagnosis, treatment and documenting of functional improvement in takotsubo cardiomyopathy may enable the return to occupational activities even for elderly persons. Int J Occup Med Environ Health 2017;30(4):681–683

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Dietary habits and myocardial infarction in occupationally active men

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Bortkiewicz A., Gadzicka E., Siedlecka J., Szyjkowska A., Viebig P., Wranicz J. K., Kurpesa M., Trzos E., Makowiec-Dąbrowska T.

International Journal of Occupational Medicine and Environmental Health

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2019

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vol. 32

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issue 6

853-863

EN

Objectives Only a few studies have been undertaken to analyze the dietary habits of people with cardiovascular diseases. The aim of this study was to evaluate the dietary behaviors of working people who were hospitalized due to experiencing the first acute cardiovascular incident. Material and Methods In the study, the Functional Activity Questionnaire was used. The study was conducted in 2 groups. The first group included all the men hospitalized during 1 year (January–December 2009) in 2 clinics of cardiology, who were professionally active until the first myocardial infarction (MI). It comprised 243 men aged 26–70 years. The reference group consisted of 403 men, blue- and white-collar workers, aged 35–65 years. Results The body mass index of the MI patients was significantly higher (p = 0.006). The frequency of consumption of particular products in the MI group and in the reference group differed significantly for 11 of 21 products. The MI patients significantly less frequently reported the daily consumption of fruit, raw vegetables, cheese, vegetable oils and fish. In this group, the consumption of salty (p = 0.0226) or fatty (p < 0.0001) foods was significantly higher. It was shown that, after adjusting for age, education and the type of work, the daily consumption of fish, salads and cooked vegetables, as well as fruit and vegetable oils, significantly reduced the risk of myocardial infarction. An increased MI risk was, in turn, associated with obesity and preference for fatty foods. Conclusions The authors found that diet significantly modified the MI risk in the examined workers. This indicates that an important aspect of prevention activities among working people should involve education about proper dietary habits. Int J Occup Med Environ Health. 2019;32(6):853–63

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Evaluation of the impact of atmospheric pressure in different seasons on blood pressure in patients with arterial hypertension

52%

Kamiński M., Cieślik-Guerra U. I., Kotas R., Mazur P., Marańda W., Piotrowicz M., Sakowicz B., Napieralski A., Trzos E., Uznańska-Loch B., Rechciński T., Kurpesa M.

International Journal of Occupational Medicine and Environmental Health

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2016

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vol. 29

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issue 5

783-792

EN

Objectives Atmospheric pressure is the most objective weather factor because regardless of if outdoors or indoors it affects all objects in the same way. The majority of previous studies have used the average daily values of atmospheric pressure in a bioclimatic analysis and have found no correlation with blood pressure changes. The main objective of our research was to assess the relationship between atmospheric pressure recorded with a frequency of 1 measurement per minute and the results of 24-h blood pressure monitoring in patients with treated hypertension in different seasons in the moderate climate of the City of Łódź (Poland). Material and Methods The study group consisted of 1662 patients, divided into 2 equal groups (due to a lower and higher average value of atmospheric pressure). Comparisons between blood pressure values in the 2 groups were performed using the Mann-Whitney U test. Results We observed a significant difference in blood pressure recorded during the lower and higher range of atmospheric pressure: on the days of the spring months systolic (p = 0.043) and diastolic (p = 0.005) blood pressure, and at nights of the winter months systolic blood pressure (p = 0.013). Conclusions A significant inverse relationship between atmospheric pressure and blood pressure during the spring days and, only for systolic blood pressure, during winter nights was observed. Int J Occup Med Environ Health 2016;29(5):783–792

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Spiroergometryczna próba wysiłkowa – zastosowanie w kardiologii i medycynie pracy

Broken heart as work-related accident: Occupational stress as a cause of takotsubo cardiomyopathy in 55-year-old female teacher – Role of automated function imaging in diagnostic workflow

Cardiotoxic effect due to accidental ingestion of an organic solvent

Takotsubo cardiomyopathy in the case of 72-year-old teacher after work-related psychological stress. Evolution of left ventricular longitudinal strain – Delayed but complete recovery in automated function imaging (AFI)

Dietary habits and myocardial infarction in occupationally active men

Evaluation of the impact of atmospheric pressure in different seasons on blood pressure in patients with arterial hypertension