BackgroundHospital-based data on the impact of socioeconomic environment on long-term survival after myocardial infarction (MI) are lacking. We compared outcome and quality of secondary prevention in patients after MI living in three different socioeconomic environments including patients from three tertiary-care teaching hospitals with similar service population size in Switzerland, Poland and Ukraine.MethodsThis is a prospective cohort study of patients with a first MI in three different tertiary-care teaching hospitals in Bern (Switzerland), Gdansk (Poland) and Lutsk (Ukraine) during the acute phase in the year 2010 and follow-up of these patients with a questionnaire and, if necessary, telephone interviews 3.5 years after the acute event. The study cohort comprises all consecutive patients hospitalised in every one of the three study centres during the year 2010 for a first MI in the age ≤75 years who survived ≥30 days.ResultsThe proportion of patients with ST-segment elevation myocardial infarction (STEMI) was high in Gdansk (Poland) (80%) and in Lutsk (Ukraine) (74%), while the ratio of STEMIs to non-STEMIs was nearly 50:50 in Bern (Switzerland) (50.6% STEMIs). Percutaneous coronary intervention (PCI) was the first choice therapy both in Bern (Switzerland) (100%) and in Gdansk (Poland) (92%), while it was not performed at all in Lutsk (Ukraine). We found substantial differences in treatment and also in secondary prevention interventions including cardiac rehabilitation. All-cause mortality at 3.5 year follow-up was 4.6% in Bern (Switzerland), 8.5% in Gdansk (Poland) and 14.6% in Lutsk (Ukraine).ConclusionSubstantial differences in treatment and secondary prevention measures according to low-income, middle-income and high-income socioeconomic situation are associated with a threefold difference in mortality 3.5 years after the acute event. Countries with low socioeconomic environment should increase efforts and be supported to improve care including secondary prevention in particular for MI patients. A greater number of PCIs per million inhabitants itself does not guarantee lower mortality scores.
Poland was one of the first European countries to adopt a national regulatory framework for the operation of drones. During its first years (2013-2016), the national regulator was more focused on VLOS operations, and BVLOS operations were possible only in segregated airspace. Since 2019, a new law has allowed for certain types of BVLOS operations to be conducted outside of segregated airspace, at very low levels. This paper will analyze how national legislation is dealing with this new technology, focusing on the new law on BVLOS operations. As the national regulation will be replaced in June 2020 by common European rules that have been adopted 2019, this paper also aims to highlight the most important provisions of the EU regulation. Keywords drones. UAV. UAS. Polish regulations. EU regulations. air law Research financed by National Science Center, Poland. Project No 2017/ 27 /B/HS5/0008 "Unmanned Aircraft. A new era in aviation law".
Introduction. This paper examines regulations which govern procedures for reporting incidents other than accidents or serious incidents related to unmanned aircraft system (UAS) operations. The regulations are discussed in the context of available data and the paper included an analysis of them from both a European and national perspective. The goal of the paper is to provide a series of recommendations with regard to the procedures for reporting and analyzing UAS incidents in order to improve the safe integration of unmanned and manned aviation. This article also explores the legal consequences that arise from the midair collision between a UAS and a manned aircraft. Material and methods: The method of study comprises a content analysis of existing legislations. The current doctrine was confronted with existing regulations, documents and materials. Results: The results of the study show that there is a practical problem of objectively identifying operators of a UAS as well as in defining what exactly constitutes an “incident”. It can be reasonably concluded that reporting and analyzing UAS-related incidents allows for the assessment and development of strategies for integrating manned and unmanned aviation. It is worth mentioning that drones and UAS technology requires refinement, especially in technological terms. It is reasonable to take action aimed at raising awareness amongst UAS users of the need to report incidents, as well as engaging UAS users in the investigative process which follows such occurrences.
ObjectivesLung cancer screening using low-dose CT may be not effective without considering the presence of comorbidities related to chronic smoking. The aim of the study was to establish the prevalence of chronic obstructive pulmonary disease (COPD) in group of phighlight the potential benefits atients participating in the largest Polish lung cancer screening programme MOLTEST-BIS and attempt to confirm the necessity of combined lung cancer and COPD screening.DesignCohort, prospective study.SettingMedical University of Gdańsk, PolandParticipantsThe study included 754 participants in lung cancer screening trial from the Pomeranian region, aged 50–70 years old, current and former smokers with a smoking history ≥30 pack-years.Primary and secondary outcome measuresQuestionnaire, physical examination, anthropometric measurements, spirometry test before and after inhaled bronchodilator (400 µg of salbutamol)ResultsObstructive disorders were diagnosed in 186 cases (103 male and 83 female). In the case of 144 participants (19.73%), COPD was diagnosed. Only 13.3% of participants with COPD were known about the disease earlier. According to classification of airflow limitation 55.6% of diagnosed COPD were in Global Initiative for Chronic Obstructive Lung Disease (GOLD) 1 (mild), 38.9% in GOLD 2 (moderate), 4.9% in GOLD 3 (severe) and 0.7% in GOLD 4 (very severe) stage. Women with recognition of COPD were younger than men (63.7 vs 66.3 age) and they smoked less cigarettes (41.1 vs 51.9 pack-years).ConclusionsPrevalence of COPD in Polish lung cancer screening cohort is significant. The COPD in this group is remarkably under-diagnosed. Most diagnosed COPD cases were in the initial stage of advancement. This early detection of airflow limitation highlights the potential benefits arising from combined oncological-pulmonary screening.NKBBN
The development of UA is one of the most important challenges for the future of aviation. Consequently, this is one of the major challenges for the future of aviation law, particularly for those legal regulations that aim to provide an adequate level of civil aviation safety. The main goal is to show the results of the analysis of the legal framework created in Europe and to show where Europe is going in the nearest future. The method of study comprised content analysis of existing legislation. Results of the study shows inter alia that although the analysis of the adopted solutions is necessary for a better understanding, a comprehensive assessment of these solutions will be possible at the earliest after the end of the adopted transition periods, i.e. after 2023.
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