Modifiable risk factors for erectile dysfunction: an assessment of the awareness of such factors in patients suffering from ischaemic heart disease.

Up to 40% of cases of erectile dysfunction (ED) originate from vascular disturbances associated with atherosclerotic disease, leading to the previously proven concomitance between ischaemic heart disease (IHD) and ED. The aim of this study was to evaluate patients' knowledge about modifiable risk factors for ED. The evaluated group of patients was composed of 502 male patients undergoing cardiac rehabilitation and receiving treatment for IHD. The patients' knowledge of risk factors for ED linked to IHD was assessed with an original survey. The presence of ED was assessed using an abridged version of the International Index of Erectile Function-5 questionnaire. Increase in leisure-time physical activity was estimated using a leaflet based on the Framingham questionnaire. In all, 189 participants were unable to name any modifiable ED risk factors, and only 31 patients knew all 6 of them. The most frequently mentioned ED risk factor was smoking, whereas the least frequently mentioned was sedentary lifestyle. Awareness of smoking as an ED risk factor was closely related to the patients' level of education, place of residence, smoking and underlying ED in the individual patient. The ability to classify diabetes as a risk factor for ED was significantly related to the patients' level of education, place of residence, and the prevalence of diabetes in the evaluated group of respondents. The same relations were observed regarding hyperlipidaemia. Awareness of the negative impact a sedentary lifestyle has on the erectile process was found to be closely related to the patients' age, as well as their level of education. The performed study demonstrates the poor knowledge of IHD patients about the modifiable risk factors for ED. The factor that patients are the least aware of is sedentary lifestyle, which, simultaneously, is the risk factor that most frequently affects the respondents.

The influence of endurance training intensity on dynamics of post-exertional heart rate recovery adaptation in patients with ischemic heart disease.

PURPOSE: The intensity of post-exertion heart rate recovery, evaluated in the first minute of the recovery period (HRR60), is considered to be a strong predictor of risk for cardiac death. Intensification of physical activity performed as part of cardiac rehabilitation (CR) increases the HRR60 value in ischemic heart disease (IHD) patients. In this context, the impact of endurance training intensity (ETI) on change in HRR60 intensity seems to be an interesting issue. MATERIAL/METHODS: The study group consisted of 251 patients who were subjected to a CR cycle. 45 patients of this group participated in CR twice. The control group consisted of 35 patients who were not subjected to any CR. ETI was estimated by the training work. In all patients an exertion test on a treadmill was performed twice within six months, analyzing the initial and final HRR60 value and ΔHRR60. RESULTS: After a six-month observation, there was a statistically significant increase in the HRR60 value (17.98±8.33/min vs. 22.72±7.72/min, p<0.01) in the test group, which was not observed in the control group. Mean ΔHRR60 value in the test group was statistically significantly greater than in the control group. In the subgroup subjected to the two CR cycles, only the first cycle led to a statistically significant increase in the mean HRR60 value. CONCLUSIONS: A six-month CR cycle significantly increased the HRR60 value, while cardiac training intensity did not affect the exertion-evoked change in its intensity. Continuation of the CR cycle beyond 6 months no longer significantly affected the change in the HRR60 value.

[Distribution of extrema on body surface isointegral maps in RBBB]. / Lokalizacja ekstremów na powierzchniowych mapach izointegralnych w bloku prawej odnogi peczka Hisa.

The investigations were undertaken in order to assess the characteristic features of the isointegral maps obtained from the patients demonstrating on the standard ECG complete and incomplete right bundle branch block (RBBB). The body surface potential mapping (BSPM) procedure was performed using Fukuda Denshi system enabling to record electrocardiographic signals simultaneously from the 87 leads arranged over anterior and posterior thoracic surfaces. The isointegral maps of QRST, QRS, early portion of QRS complex (from QRS onset to R wave peak), and of late portion of QRS (from R wave peak to QRS offset) were created. The distribution of extrema (maxima and minima) was found to be specific for RBBB cases and the characteristic differences between RBBB group and the controls were observed.

The influence of locally implanted high doses of gentamicin on hearing and renal function of newborns treated for acute hematogenous osteomyelitis.

BACKGROUND: [corrected] Osteomyelitis and arthritis still present a serious diagnostic and therapeutic problem. Difficulties arise in particular in the treatment of acute hematogenic osteomyelitis (AHO) in newborns where mega-doses of gentamicin are administered locally for about 3 weeks. Gentamicin possesses strong oto- and nephrotoxicity and the occurrence of these adverse effects depends on the duration of treatment and the serum drug concentration. OBJECTIVE: Aim of the study was to evaluate the influence of local gentamicin application on auditory and kidney functions. MATERIAL AND METHODS: Twenty newborns (14 boys and 6 girls) with AHO were treated at the Department of Pediatric Surgery, Marciniak Hospital, Wroclaw, Poland, by local implantation of miniseptopal or gentamicin sponge. Serum urea, creatinine, antibiotic concentrations and NAG activity/g creatinine ratio in urine were estimated before and 1, 4, 8, 16 days after the operation and compared to values in the control group. Brainstem-evoked auditory potentials (BAEP) were examined before, during the first 3 weeks, and 6-11 months after gentamicin implantation. RESULTS: Mean gentamicin serum concentrations were: 0.67 +/- 0.98 mg/l on the 1st day, 0.16 +/- 0.37 mg/l on the 4th day, 0.03 +/- 0.09 mg/l on the 8th day, 0.01 +/- 0.03 mg/l on the 16th day after operation and did not exceed the upper limit of the therapeutic range. N-acetyl-beta-D-glucosaminidase (NAG)/g creatinine in urine ratios were satisfactory: 77.91 +/- 36.22 UI/g before the operation, 146.51 +/- 82.27 UI/g on the 4th, 162 +/- 111 UI/g on the 8th, 168 +/- 59.83 UI/g on the 16th day after operation and were statistically significantly (p < 0.05) higher than values in the control group. Serum urea and creatinine levels were in the normal range in all groups. Initial BAEP were well in the normal range in 15 of 16 children before treatment and in 14 of 16 children after treatment. CONCLUSIONS: Locally applied gentamicin as miniseptopal or sponge in newborns produces gentamicin concentrations close to the minimal therapeutic serum concentration which are present over a prolonged period. The raised NAG values in urine and normal serum urea and creatinine levels during treatment with gentamicin without concomitant clinical symptoms of renal failure suggest subclinical destruction of the renal tubules. Lack of change in BAEPs shows that there is no impairment of auditory function.

[The effect of the gender of the examined subjects on the course of the visual potentials evoked by the checker board pattern stimulation]. / Wplyw plci badanych osób na przebieg wzrokowych potencjalów wywolanych wzorem szachownicy.

A goal of the present work was to analyze the correlation between a course of visual potentials elicited with the pattern stimulation and gender of the examined subjects. VEPs (Visual Evoked Potentials) recordings were performed using STELLA system in a group of 65 healthy adult subjects, with the age ranging from 18 to 70 years, consisting of the age-matched subgroups of 37 females and 28 males, applying a checkerboard as the pattern-reversal stimulation. In result of the analysis of the individual VEPs parameters, no effect of gender on the P100 latency was found. The discrepancies in the course of VEPs concerned P100 amplitudes, likewise a difference of the maximum and minimum amplitude, which proved to be significantly greater in the recordings collected from the left hemisphere in women than in men. Moreover, there was the appreciably greater symmetry between the responses registered over the both cerebral hemispheres, reflected by the higher correlation coefficients, in the male subgroup compared to the female subjects. The herein reported differences in the VEPs characteristics recorded in the male and female subjects can be elucidated on the ground of the documented discrepancies regarding the structural and functional cerebral organisation in women and men with regards to visual perception.

[The evaluation of central visual fatigue in computer terminal users by visual evoked potentials]. / Ocena osrodkowego zmeczenia ukladu wzrokowego u operatorów terminali komputerowych metoda wywolanych potencjalów wzrokowych.

Visual evoked potentials (VEPs) were recorded in a group of 20 operators aged 25-45 years during two sessions, before and after a 5-hour work at computer terminals, in order to assess visual system fatigue. The outcomes were referred to the norms established for the age-matched population of 30 subjects not exposed to professional contact with computers. Most of the examined operators suffered various complaints concerning not only the organ of vision but the central nervous system as well. VEPs were elicited by means of monocular stimulation using the reversal checkerboard pattern and recorded simultaneously from the scalp electrodes placed over the right and the left cerebral hemisphere. Only recording acquired after finishing of a working day demonstrated significant statistically abnormalities of the VEPs waveforms, which suggests their transient character. The changes mentioned above included prolongation of peaks P100 and N2 latency with concomitant attenuation of their amplitudes and a decrease of the correlation coefficient values for the recordings from the hemispheres. The preliminary findings presented in this paper seem to justify a conclusion that the non-invasive VEPs method can be considered as the objective indicator of the central visual fatigue induced by the workload at computer terminals.

[Exercise test in the neurotic patients]. / Przebieg próby wysilkowej u pacjentów chorych na nerwice.

While testing neurotic patients it was noted that almost all of their complaints concerned physical weakness, easy tiredness, chest pain, heart beating and palpitation. In order to evaluate objectively their physical efficiency, the patients were subjected to exercise test on a treadmill, their ECG, HR and blood pressure being monitored. The exercise test was carried out twice, i.e. before and after 3-month psychotherapy. The average physical efficiency coefficient before treatment was significantly lower than after the treatment, but repolarization disorders were significantly higher before the treatment. ECG analysis proved non-specific repolarization changes induced by excitability of sympathetic system. 8 patients showed changes in ST-T before the treatment and 4 persons after it. Another kind of changes (that appeared in 14 cases before the treatment) were extrasystoles mainly supraventricular. After psychotherapy they were noted only in 1 case. The analysis of HR and blood pressure proved a significantly higher HR and lower blood pressure before the treatment. The obtained results may become an argument supporting the functional character of the changes mentioned.

[Analysis of peak 1st latency in brainstem auditory evoked potentials in newborns aged 1 to 14 days]. / Analiza latencji zalamka i w wynikach badan sluchowych potencjalów pniowych u noworodków w wieku od 1 do 14 doby zycia.

BAEPs examinations performed in healthy newborns aged up to 14 days of life revealed that in the youngest group (up to 4 days of life) the percentage of the results with delayed peak I latency was relatively high -57.8%. In the further age group (5-7 days of life) the number of the abnormal results decreased considerably down to 14.1%.

[Evaluation of hearing in children with Down syndrome in light of brain-stem auditory evoked potentials]. / Ocena sluchu u dzieci z zespolem Downa w swietle badan sluchowych potencjalów pniowych.

Down's syndrome is the most frequently occurring chromosomal aberration which causes, among others, central nervous system (CNS) impairment leading to mental retardation as well as lesions of the sensory analyzers. Contrary to former reports, lesions concerning the hearing organ are relatively common and appear, according to various authors, in 40-78% of patients manifesting Down's syndrome. Simultaneously, the low intellectual level of these children is why the results of audiometry are not fully reliable. A method of brain-stem auditory evoked potentials that is objective and does not require the subject's cooperation is a valuable tool for checking the hearing level. The use of this method in a group of children with Down's syndrome permitted an increased hearing levels to be demonstrated in 47% of examined subjects.