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The impact of chronic exposure to air pollution on electrocardiographic parameters

100%
Kramarz E., Piotrowicz R., Stańczyk A.
International Journal of Occupational Medicine and Environmental Health
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2022
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vol. 35
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issue 3
353-360
EN
ObjectivesChronic exposure to air pollution caused by particulate matter (PM) with aerodynamic diameters of <10 μm (PM10) and <2.5 μm (PM2.5), dependent on “low emissions” resulting from the combustion of solid fuels in households, significantly increases the risk of cardiovascular events. The aim of the study was to assess the impact of chronic exposure to air pollution in the place of residence on the occurrence of coronary artery disease, hypertension and the presence of electrocardiographic abnormalities in 24-hour Holter ECG recording.Material and MethodsAfter considering the exclusion criteria, 100 consecutive patients of the cardiology outpatient clinic were enrolled in the study, including 50 patients living for ≥10 years in Warsaw districts with the lowest average concentrations of PM2.5 (group I) and 50 living in the districts with the highest recorded exposure (group II). All patients underwent clinical and physical examination, 12-lead ECG, 2D cardiac echo, and Holter ECG. To avoid the impact of acute exposure, the study was carried out in May – the month with statistically the lowest recorded PM2.5 concentrations.ResultsIn the group of patients exposed to higher concentrations of PM2.5 in the place of residence, coronary artery disease and arterial hypertension were significantly more frequent, while in the Holter ECG examination, ventricular arrhythmias, conduction disturbances and ST-segment and T-wave changes were independently associated with exposure to air pollution.ConclusionsChronic exposure to air pollution in the place of residence contributes to the occurrence of chronic coronary syndrome and hypertension. Chronic exposure to air pollution seems to be a significant factor increasing the incidence of ventricular arrhythmia, conduction disturbances and ST-segment depression episodes in Holter monitoring.
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Impact of exercise-based cardiac rehabilitation on attitude to the therapy, aims in life and professional work in patients after myocardial infarction

88%
Korzeniowska-Kubacka I., Bilińska M., Piotrowska D., Wolszakiewicz J., Piotrowicz R.
Medycyna Pracy
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2019
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vol. 70
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issue 1
EN
Background Comprehensive cardiac rehabilitation aims to restore pathophysiological and psychosocial consequences of myocardial infarction (MI). The aim of the study was to assess how exercise-only-based cardiac rehabilitation (ECR) influences the attitude to the therapy (ATT), to the aims in life and professional work (AAL) amongst men and women after MI. Material and Methods The study comprised 44 post-MI patients: 28 men and 16 women, mean age 58±10 years old, referred to ECR. Patients underwent 24 interval cycle ergometer trainings 3 times a week. At the beginning and after the training program (TP) each patient underwent exercise stress test (EST) and was scored to ATT and ALL based on the Psychological Effects of Rehabilitation Score Scale (PERSS) according to Tylka and Makowska. The analysis covered: 1) EST findings: maximal workload and test duration (min), 2) ATT and AAL based on PERSS, 3) resuming professional work. Results Exercise capacity improved significantly after TP. Attitude to the aims in life and professional work significantly increased in the whole group (4.4±2.8 vs. 5.1±2.4, p < 0.01) and separately in men (4.5±2.9 vs. 5.1±2.5, p < 0.05) and women (4.3±2.6 vs. 5.0±2.0, p < 0.05). Attitude to the therapy did not change significantly in the whole group (5.6±2.8 vs. 6.0±2.8) and in men (5.9±2.9 vs. 6.0±2.9), but increased significantly in women (5.0±2.5 vs. 6.1±2.7, p < 0.05). Professional work was resumed, averagely by 86.4% of all patients (85.7% men and 87.5% women). Conclusions Physical training beneficially influenced post-MI men’s and women’s attitude to the aims in life, professional work and attitude to the therapy in women. Med Pr. 2019;70(1):1–7
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Efekty hybrydowej kompleksowej telerehabilitacji kardiologicznej realizowanej w ramach prewencji rentowej Zakładu Ubezpieczeń Społecznych

76%
Piotrowicz E., Orzechowski P., Jasionowska A., Banaszak-Bednarczyk M., Rosłaniec M., Piotrowski W., Piotrowicz R.
Medycyna Pracy
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2017
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vol. 68
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issue 1
61-74
EN
Background The Polish Social Insurance Institution (SII), under its pension prevention initiative, has taken measures to support the patients return to work and thus developed a new model of hybrid, comprehensive, cardiac telerehabilitation (HCCT). The aim of the study was to analyze the effects of HCCT in terms of its acceptance, adherence to and influence on patients’ physical capacity and ability to return to work. Material and Methods The study included 99 patients, aged 54.6±6.3 years, who suffered from cardiovascular diseases. They participated in a 24-day HCCT consisting of preliminary and final examinations, 10 days of out-patients rehabilitation based on cycloergometer training (5 sessions) and Nordic walking training (10 sessions), and 12 days of home telerehabilitation based on Nordic walking training. The effectiveness of HCCT was assessed by comparing changes in functional capacity expressed by metabolic equivalent of task (MET) and a 6-min walking test (6-MWT) distance from the beginning and the end of HCCT. Acceptance of HCCT was evaluated using a questionnaire. Adherence to HCCT was assessed by the patients’ participation in the training sessions. Effectiveness of HCCT in terms of return to work was assessed according to SII definition. Results Hybrid, comprehensive, cardiac telerehabilitation resulted in significant improvement of functional capacity 7.6±2.0 vs. 8.1±2.4 MET (p < 0.0001) and distance in 6-MWT 448.5±79.2 m vs. 480.5±84.1 m (p < 0.0001). There were 82.8% of adherent, 16.2% of partially adherent and 1% of non-adherent patients. After HCCT 48 patients were able to return to work. Conclusions Hybrid, comprehensive, cardiac telerehabilitation was well accepted and led to the improvement of the patients’ physical capacity. Adherence to HCCT was high and allowed 48.48% of patients return to work. Med Pr 2017;68(1):61–74
PL
Wstęp Choroba może uniemożliwić samorealizację w zakresie wykonywania pracy zawodowej. Zakład Ubezpieczeń Społecznych (ZUS), w ramach inicjatywy prewencji rentowej, podjął działania wspierające powrót chorych do pracy przez wdrożenie nowego modelu hybrydowej kompleksowej telerehabilitacji kardiologicznej (HKTK). Celem pracy była analiza efektów HKTK z uwzględnieniem akceptacji i współpracy pacjentów oraz wpływu tej rehabilitacji na wydolność fizyczną chorych i możliwość ich powrotu do pracy. Materiał i metody Analizą objęto 99 chorych w wieku średnio 54,6±6,3 roku ze schorzeniami układu krążenia, skierowanych przez ZUS w celu przeprowadzenia HKTK. Chorzy realizowali 24-dniową HKTK, składającą się z badania wstępnego i końcowego, 10 dni rehabilitacji w ambulatorium opartej na treningu na cykloergometrach (5 sesji) i treningu nordic walkingu (10 sesji) oraz 12 dni domowej telerehabilitacji opartej na treningu nordic walkingu. Efektywność HKTK oceniono na podstawie zmian: jednostek obciążenia metabolicznego (metabolic equivalent of task – MET), dystansu 6-minutowego marszu (6-min walking test – 6-MWT), analizowanych na początku i na końcu HKTK. Akceptację HKTK oceniono na podstawie ankiety. Współpracę chorych oceniano na podstawie uczestnictwa w sesjach treningowych. Skuteczność HKTK w aspekcie powrotu do pracy oceniono według definicji ZUS. Wyniki Efektem HKTK była istotna poprawa wydolności fizycznej 7,6±2,0 vs 8,1±2,4 MET (p < 0,0001) i dystansu 6-MWT 448,5±79,2 m vs 480,5±84,1 m (p < 0,0001). Pacjenci dobrze przyjęli HKTK. Odnotowano 82,8% chorych współpracujących, 16,2% częściowo współpracujących, 1% niewspółpracujących. Po HKTK 48 chorych odzyskało zdolność do pracy. Wnioski Nowy model HKTK realizowany w ramach prewencji rentowej ZUS jest akceptowaną przez chorych formą rehabilitacji, odznacza się dobrą współpracą pacjentów, prowadzi do poprawy wydolności fizycznej i umożliwia 48,48% chorych podjęcie pracy. Med. Pr. 2017;68(1):61–74
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Telemedicine – changes in a way of delivering medical services

64%
Piotrowicz R., Balsam P., Grabowski M., Kempa M., Kotłowski Ł., Krzesiński P., Lewicka E., Piotrowicz E., Podolec J., Opolski G.
Nauka
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2016
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issue 4
PL
Telemedicine is very promising way of delivering medical services. At this moment telecardiology gives many possibilities of improving outcome of patient and very often it also decreases the costs, which makes it cost-effective solution. Unfortunately actually in Poland there are many difficulties in delivering telemedicine. There is no central refunding of procedures; hospitals are not ready with IT solutions etc. The article describes those problems in different fields of telecardiology.
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