Zygmunt Domagała

Association between physical exercise and quality of erection in men with ischaemic heart disease and erectile dysfunction subjected to physical training

BACKGROUND In addition to a beneficial effect on exercise tolerance and an associated reduction of global cardiovascular risk, modification of physical activity has a positive effect on the quality of life, reducing, among other things, the severity of erectile dysfunction (ED). AIM The specific nature of sexual activity, which combines the need to maintain appropriate exercise tolerance and good erection quality, prompted us to evaluate the association between exercise tolerance and severity of ED in an intervention group of subjects with ischaemic heart disease (IHD) and ED in the context of cardiac rehabilitation (CR). METHODS A total of 138 men treated invasively for IHD (including 99 treated with percutaneous coronary intervention and 39 treated with coronary artery bypass grafting) who scored 21 or less in the initial IIEF-5 test were investigated. Subjects were randomised into two groups. The study group included 103 subjects (mean age 62.07 ± 8.59 years) who were subjected to a CR cycle. The control group included 35 subjects (mean age 61.43 ± 8.81 years) who were not subjected to any CR. All subjects filled out an initial and final IIEF-5 questionnaire and were evaluated twice with a treadmill exercise test. The CR cycle was carried out for a period of 6 months and included interval endurance training on a cycle ergometer (three times a week) and general fitness exercises and resistance training (twice a week). RESULTS The CR cycle in the study group resulted in a statistically significant increase in exercise tolerance (7.15 ± 1.69 vs. 9.16 ± 1.84 METs,p < 0.05) and an increase in erection quality (12.51 ± 5.98 vs. 14.39 ± 6.82, p < 0.05) which was not observed in the control group. A significant effect of age on a progressive decrease in exercise tolerance and erection quality was found in the study group. Exercise tolerance and erection quality were also negatively affected by hypertension and smoking. A significant correlation between exercise tolerance and erection quality prior to the rehabilitation cycle indicates better erection quality in patients with better effort tolerance. The improvement in exercise tolerance did not correlate significantly with initial exercise tolerance or age of the subjects. In contrast, a significantly higher increase in erection quality was observed in younger subjects with the lowest baseline severity of ED.The relative increase in exercise tolerance in the group subjected to CR was significantly higher than the relative increase in erection quality but these two effects were not significantly correlated with each other. CONCLUSIONS 1. In subjects with IHD and ED, erection quality is significantly correlated with exercise tolerance. 2. Exercise training had a positive effect on both exercise tolerance and erection quality but the size of these two effects was different and they ran independently of each other.

Effect of Endurance Cardiovascular Training Intensity on Erectile Dysfunction Severity in Men With Ischemic Heart Disease.

The protective effect of physical activity on arteries is not limited to coronary vessels, but extends to the whole arterial system, including arteries, in which endothelial dysfunction and atherosclerotic changes are one of the key factors affecting erectile dysfunction development. The objective of this study was to report whether the endurance training intensity and training-induced chronotropic response are linked with a change in erectile dysfunction intensity in men with ischemic heart disease. A total of 150 men treated for ischemic heart disease, who suffered from erectile dysfunction, were analyzed. The study group consisted of 115 patients who were subjected to a cardiac rehabilitation program. The control group consisted of 35 patients who were not subjected to any cardiac rehabilitation. An IIEF-5 (International Index of Erectile Function) questionnaire was used for determining erectile dysfunction before and after cardiac rehabilitation. Cardiac training intensity was objectified by parameters describing work of endurance training. The mean initial intensity of erectile dysfunction in the study group was 12.46 ± 6.01 (95% confidence interval [CI] = 11.35-13.57). Final erectile dysfunction intensity (EDI) assessed after the cardiac rehabilitation program in the study group was 14.35 ± 6.88 (95% CI = 13.08-15.62), and it was statistically significantly greater from initial EDI. Mean final training work was statistically significantly greater than mean initial training work. From among the parameters describing training work, none were related significantly to reduction of EDI. In conclusion, cardiac rehabilitation program–induced improvement in erection severity is not correlated with endurance training intensity. Chronotropic response during exercise may be used for initial assessment of change in cardiac rehabilitation program–induced erection severity.

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.

In memory of professor Czesław Niżankowski, Head of the Department of Anatomy, Wroclaw Medical University

Professor Czesław Niżankowski was an academic teacher and researcher at several universities; head of the Department of Anatomy at Wroclaw Medical University (1966-1982); and head of the Department of Biological Sciences at the Wrocław School of Physical Education (since 1972 University School of Physical Education in Wrocław), as well as the chancellor there. He contributed greatly to the development of morphological sciences, supervising many doctoral and post-doctoral works. He dedicated considerable time to the preparation of anatomical specimens of lungs, hearts and organs of the gastrointestinal tract. At the Museum of Anatomy, there are over 100 specimens of lungs prepared using the forced air technique improved by Professor Niżankowski, along with specimens of the bronchial tree and vascular system prepared using a corrosive technique. Professor Niżankowski was an active member of scientific societies in Wrocław and in other cities in Poland. For his accomplishments, he received a number of ministerial and state awards, including the Knights Cross of the Order of Polonia Restituta, and was granted an honorary doctorate by Wroclaw Medical University.

Remembrance of Professor Tadeusz Marciniak – Lviv Tradition in Wrocław

After the seizure of Lviv by the Soviets, in the years 1944-1946, Tadeusz Marciniak worked in the Descriptive Anatomy Department in the State-Medical Institute of Lviv and also performed the function of the dean of the Medical Faculty. On receiving a proposal to assume the Chair of the Anatomy Department in Wrocław, he made the decision to leave Lviv. By July 2nd, 1946, prof. Tadeusz Marciniak had taken over the duties of full professor of the Descriptive Anatomy Department of the Medical Faculty of the University and the Technical College of Wrocław. On taking his job in Wrocław, prof. Marciniak undertook attempts to restore the worn out parts of the Anatomy Department building. Due to the lack of Polish manuals, he also took to the preparation of scripts for medical students. Professor Marciniak was a member of the Wrocław Section of the Polish Anthropological Association and a regular member of the Wroclaw Association of Science. His main scientific interests referred to the morphogenesis of the central nervous system and urinary system. He concentrated on circulatory system and muscular system tetralogies. Professor Marciniak also actively participated in administrative work at the university. In the years 1947-1948, he held the office of associate dean of the Medical Faculty, and till 1950 was a member of the Senate of the University and Technical College of Wrocław. In the years 1959-1962, he was a vice rector of the Medical University of Wrocław.

The relationship between the use of combined hormonal contraception with a predominance of gestagens and the selected types of female body in young women from the region of Lower Silesia

Abstract Oral contraceptive agents are currently the most popular and one of the most effective methods for preventing pregnancy. The data shows that over 300 million women in the world use contraceptive drugs containing synthetic hormones to avoid an unwanted pregnancy. Their effects may affect other systems, leading to the occurrence of various problems associated with the use of the drug. The aim of the study is to estimate the frequency of prevalence of subjective effects associated with the use of combined hormonal contraception with a predominance of gestagens by young women Surveys were conducted among female students of Wrocław universities from December 2010 to January 2011. They covered 257 women aged statistically 23.58 (SD=2.95). They were divided into three age classes: 19-22, 23-24, 25-28. The individual age of menarche and the hormonal type of body were determined. Only persons with a gestagenic or estrogenic type of body were qualified for the study. Results: 64.6% of all respondents declared the use of hormonal contraception. Combined agents with a predominance of gestagens constituted 87% in this group. Their use brings both positive (90%) and negative (65%) aspects. The most common positive effects include high contraceptive effectiveness, regulation of menstruation and minimisation of skin problems. The most frequent negative effects include: weight gain, spotting, breast swelling and decreased libido. Surprisingly, the study did not show any correlation between the hormonal type and the occurrence of side effects. There was no significant statistical relationship between the type of hormonal contraception used and the hormonal type.

Measured versus self-reported body height and body mass in patients after an acute coronary syndrome

Abstract The basic anthropometric data describing a person in the broadest context are body weight and height, two of the most frequently analyzed somatometric parameters. The same is true I in relation to clinical patients. The aim of the present study was to compare the self-reported and actual body weight, height and BMI in patients suffering from coronary artery disease and undergoing cardiac rehabilitation. The study sample consisted of 100 patients treated for coronary artery disease. The patients were asked to state their body weight and height. At the same time a three-person study team took measurements, which were later the basis for verification and objective assessment of the data provided by the patients. Statistical analysis was performed with Statistics 11.0 PL software. The analysis of mean results for the assessed group of patients has shown the presence of statistically significant differences between declared and actual data. The differences were observed for both male and female study population. It has been proven that the subjects declare greater body height (mean value 1.697 m vs. 1.666 m) and lower body weight (80.643 kg vs. 82.051 kg). Based on the data from surveys and direct measurements, the body mass index for the self-reported and actual data was calculated. A comparison of these values has shown considerable statistically significant differences. The differences between declared and actual data point to highly subjective self-assessment, which disqualifies the declared data in the context of monitoring of treatment and rehabilitation processes. The authors believe that actual data should be used in direct trial examination of patients suffering from coronary artery disease who presented with acute coronary syndrome.

Fetal sigmoid colon mesentery – In relevance in fetal ultrasound application. A pilot study

INTRODUCTION Ultrasound examinations during pregnancy are routine procedures used to detect fetal congenital malformations. Ultrasound monitoring of sigmoid colon mesenterial development could be useful for early detection of subjects at risk of sigmoid colon volvulus. OBJECTIVE The aim of our paper was to assess the sigmoid colon length, and sigmoid colon mesentery width and height in the late fetal period, and, using the results, to estimate the surface area of the mesocolon (in mm2) in living fetuses. Moreover, we attempted to repeat some of these measurements in living fetuses using ultrasound imaging. METHODS The study was carried out on 209 formalin fixed human fetuses (100 female and 109 male) aged from 4th to 7th gestational months (102-203 days), with a crown-rump length of 132-342mm. The length of the sigmoid colon, as well as the height and width of its mesentery were measured. The surface area of the mesocolon was estimated. Correction for formalin induced shrinkage was applied. Pilot ultrasound examinations of live fetuses were performed. RESULTS Mean values of sigmoid colon length, mesenteric width and height (formalin fixed fetuses) for respective gestational ages were: month 4: 21.46±6.7mm, 6.80±2.1mm, 5.5±1.49mm; month 5: 27.32±1.2mm, 7.62±2.01mm, 7.33±2.17mm; month 6: 47.56±9.57mm, 11.68±3.8mm, 10.3±3.05mm; month 7: 56.92±17.48mm. 15.32±8 mm, 12.81±3.16mm. The surface area ranges of the sigmoid colon mesentery found for respective gestational months (intrauterine fetuses) were as follows: month 4: 33.24-51.95mm2; month 5: 49.63-77.6mm2; month 6: 106.89-167.15mm2 and month 7: 145.69-272.53mm2. CONCLUSION The surface area of the sigmoid colon mesentery can be used as a simple parameter applied in fetal ultrasonographic evaluation. The development of the sigmoid colon accelerates in the 6th gestational month, and decelerates in the 7th gestational month. The sigmoid colon mesentery width was larger than its height between the 4th and 7th gestational months.

The sequence of lanugo pattern development on the trunk wall in human fetuses

BACKGROUND Due to a growing interest in developmental disorders, and in the long-term skin appendage diseases, both in the cosmetic industry and among specialists in dermatology (broadly defined), there is an increasing number of papers on hair development. The publications by the present team of authors are part of this trend. OBJECTIVES The aim of the study was to describe the topography and typology of skin pilosity patterns in human fetuses. MATERIAL AND METHODS A total of 278 fetuses (141 male and 137 female) were qualified for the study. The gestational age ranged from 69 to 226 days after conception. All fetuses were taken from a local collection. RESULTS The study revealed that the first single hairs occur on the posterior wall of the trunk in the 17th week of fetal life, and on the anterior wall between the 18th and 19th week. It was found that in human fetuses lanugo appears statistically significantly later on the skin of the anterior of the trunk than on its posterior. The difference in absolute time is almost 2 weeks of fetal life. No other differences were found in the development cycle of lanugo on the anterior and posterior walls of the trunk. A full pattern was first observed on the posterior wall of the trunk in a fetus in the 19th week, and on the anterior wall in the 21st week. It was found that the process of lanugo development was completed on the posterior wall in the 23rd week, and on the surface of the abdomen in the 26th week. CONCLUSIONS The lanugo developmental cycle, consisting in the appearance of the first single hairs, then partial hair and subsequently the formation of final patterns, is the same on both walls of the trunk.

Branching patterns of the foetal popliteal artery

BACKGROUND The objective of the study is to evaluate the popliteal artery topography and the origin variability of its branches in human foetuses at the gestational age of from 4 to 9 months. The basis for the analysis are direct observations of classic anatomic dissections of the popliteal fossa. Possible dimorphic and bilateral differences, as well as the gestational age variability at the foetal period, were considered. Atypology of popliteal artery branches will be made on the basis of the studies. MATERIAL AND METHODS The research material of this study comprises 231 foetuses (including 116 males and 115 females). The foetuses were divided into five 28-day age classes. The vessels of the lower extremity were injected with LBSK 5545 latex through the femoral artery. The bilateral dissection of the popliteal artery along with its branches was performed. No visible malformations were found in the research material, and the foetuses came from spontaneous abortions and premature births. RESULTS AND CONCLUSIONS 10% of the cases featured the variations of popliteal artery terminal branches. Three most commonly seen variations are the trifurcation, anterior tibial-peroneal trunk, and high terminal division of the popliteal artery. The most common course of the superior muscular branches is that there are two large branches which are distributed from the popliteal artery at the height of the knee joint cavity and they do not distribute cutaneous branches. Sural branches are also present as two large vessels without cutaneous branches. The genicular anastomosis branches that run on their own are a typical topographic system of these branches.