Joanna Zalewska’s research while affiliated with Cardinal Stefan Wyszyński University in Warsaw and other places

Głównym celem artykułu jest przetestowanie teorii udomowienia urządzeń w kontekście gospodarki realnego socjalizmu oraz rozwinięcie wiedzy o związkach między udomowieniem AGD a podziałem obowiązków domowych. Na podstawie historycznych danych GUS oraz 24 wywiadów diadycznych i 39 indywidualnych pogłębionych analizujemy udomowienie pralki wirnikowej w Polsce w środowisku wielkomiejskim. Pokazujemy, że forma etapów udomowienia pralki wirnikowej w PRL różni się od etapów udomowienia urządzeń w państwie kapitalistycznym opartym na gospodarce rynkowej. Odmienny był etap pierwszy – dostępność pralki była bodźcem wystarczającym do jej nabycia ze względu na oddziaływanie dyskursu postępu i gospodarkę niedoboru. Rozbudowany był etap ostatni, czyli przewalutowania, co można wiązać z gospodarką niedoboru i renaturalizacją konsumpcji. Pokazujemy również, że wymagające fizycznego wysiłku pranie we Frani sprzyjało podtrzymaniu charakteru prania jako wspólnego, rodzinnego rytuału i włączaniu w nie mężczyzn, podczas gdy upowszechnieniu pralki automatycznej towarzyszył zanik rytuału i przekazanie tej czynności w gestię kobiet.

Background Rhythm control strategy in patients with persistent atrial fibrillation refractory to electrical cardioversion (AF-REC) poses an important clinical problem. Little is known about the effect of amiodarone therapy given periprocedurally with catheter ablation on maintaining sinus rhythm in this group of patients. Purpose This study aimed to determine whether initial amiodarone therapy introduced prior to AF ablation and continued for one month after the procedure affects the long-term effectiveness of the rhythm control strategy in patients with AF-REC. Methods We conducted a retrospective case-control study of medical records of AF-REC patients treated periprocedurally with amiodarone in addition to pulmonary vein isolation. Data on comorbidities, transthoracic echocardiogram results, and short- and long-term effectiveness of ablation was extracted. Patients were followed up in the out patient clinic with the use of a 72-hour Holter monitoring and telephone interviews. AF recurrence was defined as ≥ 30s episode of atrial tachyarrhythmia. Results The analysis comprised 56 patients: 37 in the amiodarone and 19 in the control group; 12 women, mean age 57 years, mean follow-up of 39.5 months. Amiodarone was discontinued after 1 month at the most after the ablation in all of the patients. The primary endpoint (AF-free survival) was achieved in 17 (45,9%) pts in the amiodarone group and 3 (15,8%) pts in the control group (p=0.026). On multivariable analysis, amiodarone therapy was the only variable correlating with the primary endpoint: OR 6.8 (95% CI: 1.4 - 33.9), p=0.019. Conversion of AF from persistent to paroxysmal or no AF in the follow-up was achieved in 32 pts (86,5%) in the amiodarone group and 9 pts (47,4%) in the control group: OR 8.0 (95% CI: 2.1 - 30.0), p=0.002. Patients in the amiodarone group experienced a borderline better increase of left ventricular ejection fraction: ∆ 5.2% (95% CI: -0.1 - 10.5), p= 0.054. Conclusion Periprocedural use of amiodarone in patients ablated due to persistent atrial fibrillation refractory to electrical cardioversion may lead to significantly better long-term efficacy of catheter ablation in this group of patients.

Objective This study assesses the prevalence and characteristics of extracoronary vascular abnormalities (EVA) in patients with spontaneous coronary artery dissection (SCAD), a distinct form of acute coronary syndrome primarily affecting younger women. EVA include conditions like fibromuscular dysplasia (FMD) and aneurysms in non-coronary vessels. Design and method A cohort of 87 patients (97.7% female, average age 44.5±9.1 years) with a history of SCAD enrolled in the SCAD-POL Registry was analyzed. The study included comprehensive reviews of medical records and angiographic imagery. All participants underwent head-to-pelvis computed tomography angiography for FMD and aneurysm screening, with EVA defined as the presence of any of these conditions in any vascular bed. Results EVA was identified in 49.4% of the cohort, with 37.9% diagnosed with FMD and 23% with aneurysms. A minority (5.8%) presented with both conditions. FMD predominantly affected renal (23%) and cervical arteries (18.4%), while aneurysms were most prevalent in cervical (9.2%), intracranial and splenic arteries (6.9% each), with renal arteries less affected (5.7%). The EVA and non-EVA groups showed no significant laboratory differences. Concerning medical history, diabetes mellitus appeared in 1.2% EVA patient versus 5.8% non-EVA patients (p>0.05). Hyperlipidemia was noted in 20.9% EVA and 18.2% non-EVA patients (p>0.05). Hypertension was non-significantly more common in EVA patients (41.9% vs 29.5%, p=>0.05). Treatment modalities, including conservative management, percutaneous coronary intervention, and coronary artery bypass grafting, showed no significant differences between the groups. SCAD characteristics and outcomes, like left ventricular ejection fraction (LVEF) at discharge and recurrence rates, were similar (53.7% LVEF in EVA vs. 52.4% in non-EVA; with 2 recurrences in each group). Conclusions This study reveals a significant prevalence of EVA in SCAD patients, with aneurysms being more common than previously reported. These findings emphasize the need for comprehensive vascular assessment in SCAD patients, considering the variable prevalence of FMD, aneurysms. This study contributes to a deeper understanding of EVA in SCAD, potentially influencing clinical management strategies.

Objective Pregnancy associated spontaneous coronary artery dissection (P-SCAD) remains poorly characterized cause of acute coronary syndrome during pregnancy and in postpartum period. The aim of the study was to assess clinical presentation, comorbidities and the outcomes of P-SCAD as compared with spontaneous coronary artery dissection not associated with pregnancy (SCAD). Design and method The study group consisted of 83 women (aged 44.8 ± 9.7y, 36% with hypertension) with a history of at least one pregnancy, including 11 P-SCAD and 72 SCAD cases registered in SCAD-POL Registry. All medical information and angiography images were reviewed. Patients underwent echocardiography for left ventricle ejection fraction (LVEF) assessment and head-to pelvis computed tomography angiography for fibromuscular dysplasia (FMD) screening. Results P-SCAD occurred between 2 and 32 weeks after delivery. Women with P-SCAD were younger (33.1 ± 4.9 vs 46.4 ± 9.1y, p<0.001), were characterized by higher number of pregnancies (3.6 ± 1.2 vs 2.5 ± 1.1, p<0.01) and more often experienced at least 1 miscarriage (63.5% vs 27.8%, p<0.05). The course of pregnancies in the P-SCAD group was more frequently complicated with hypertension (45.5% vs 6,9% p<0.005) and pre-eclampsia (27.3 vs 1.4% p<0.01), non-significantly with diabetes (27.3 vs 6.9%, p=0.07). All P-SCAD patients had at least one pregnancy terminated by caesarean section as compared to 35.8% in SCAD group (p<0.0001). The prevalence of ST-segment elevation at presentation was comparable between P-SCAD and SCAD patients (43.1% vs. 63.6%, p=ns). However P-SCAD patients more often required coronary bypass grafting (18.2% vs 1.6%, p <0.05). At discharge, left ventricle dysfunction (EF<50%) was observed in 50% of P-SCAD and 29% of SCAD subjects (p=ns). The frequency of FMD was non-significantly higher in P-SCAD subjects (45.5% vs 29.5%). Recurrent SCAD occurred in 2 P-SCAD (18.2%) and 2 SCAD (3.4%) patients. Conclusions P-SCAD patients required more frequently surgical treatment than women with SCAD. Pregnancies in patients with P-SCAD were more often complicated by hypertension, eclampsia and miscarriage, that potentially could have impact on P-SCAD occurrence. Further studies are warranted to explore the results of this hypothesis-generating analysis.

Objective Spontaneous coronary artery dissection (SCAD) is one of the causes of acute coronary syndrome of unknown etiology. Potential risk factors and comorbidities are female gender, fibromuscular dysplasia (FMD) and increased tortuosity. HTN is associated with increased coronary tortuosity and both have been shown to increase the risk of recurrence after SCAD. The aim of this study was to assess angiographic data and clinical course of SCAD in patients with HTN. Design and method the study group comprised of 94 consecutive patients (97.8% females, aged 44.4 ± 9.3 years) with a history of angiographically confirmed SCAD, included in nationwide SCAD-POL registry. All medical records were gathered and angiography images reviewed, classifying SCAD type according to ESC classification. Patients (n=87) underwent head-to pelvis computed tomography angiography for FMD screening. Results 34 patients (97.1% females) had HTN. Hypertensive patients were characterized by increased age (48.5 ± 10.0 vs 42.1 ± 8.1 years, p<0.005), had more often hyperlipidemia (32.3 vs 11.7%, p<0.05) and more frequently were diagnosed with NSTEMI (70.6 vs 48.43%, p<0.05). FMD was diagnosed more often in patients with HTN (48.5% vs 23.7%, p<0.05). Looking at the distribution of FMD, the prevalence of FMD in cervical arteries was significantly higher in patients with HTN (28.1% vs 8.5%, p<0.05). In patients with HTN, proximal segments of coronary arteries were much less frequently affected by SCAD (11.8 vs 31.7%, p<0.05) and type 2b SCAD was more often observed (26.5 vs 10.0%, p<0.05). There were no differences in terms of PCI (32.3 vs 36.7%) and conservative management (67.6 vs 58.3%) between hypertensive and non-hypertensive subjects. Although, the left ventricle dysfunction (EF<50%) was less frequently observed at discharge in patients with HTN (10.7 vs 41.8%, p<0.01). Conclusions patients with HTN were characterized by more favorable angiographic characteristics and clinical course of SCAD and higher prevalence of FMD. Further investigation of the relationship between hypertension, coronary tortuosity and the course of SCAD is merited.