Hypercholesterolemia is the main cardiovascular (CV) risk factor with a large body of evidence. Our aim was to assess the achievement of the main therapeutic goal of Low-Density Lipoprotein Cholesterol (LDL-C) in patients with a very high CV risk and a high-dose statin therapy. The study group consisted of 1413 consecutive patients hospitalised at the Upper-Silesian Medical Centre in Katowice due to acute myocardial infarction (AMI) treated with atorvastatin ≥ 40 mg or rosuvastatin ≥ 20 mg. The lipid profile was performed on admission and within 12 months after AMI. The main therapeutic goal was defined as LDL-C < 55 mg%. The study group (n = 1413) included 979 males (69.3%) with arterial hypertension (83.3%), diabetes (33.5%), peripheral artery disease (13.6%) and nicotinism (46.2%). In the study group, only 61 patients (4.3%) were additionally taking ezetimibe. During hospitalisation, the primary LDL-C goal was found in only 186 patients (13.2%). Subsequently, a follow-up lipidogram within 12 months was performed in 652 patients (46%), and the therapeutic goal was achieved in 255 patients (39%). There were 258 (18.26%) patients who died within 12 months after myocardial infarction. The lowest mortality rate was found in the subgroup of patients with LDL-C < 55 mg% during follow-up (11.02%). The primary lipid goal attainment among patients with a high-dose statin and a very high CV risk is low and far from the expected rate. Patients hospitalised for AMI should be given a combination of statin and ezetimibe more frequently. Low LDL-C levels measured at follow-up predict a lower risk of death at 12-month follow-up in a large group of patients.

Background: The COVID-19 pandemic, which affected the entire global population, had an impact on our health and quality of life. Many people had complications, were hospitalised or even died due to SARS-CoV-2 infection. The health systems of many countries had to radically change their way of functioning and scientists around the world worked intensively to develop a vaccine for the SARS-CoV-2 virus. Aim: The aim of this work is to assess the quality of life of patients who were hospitalised for COVID-19, using the SF-36 questionnaire. Methods: Between May and August 2022, we conducted a telephone assessment of quality of life in patients who were hospitalised for COVID-19 at the Temporary Hospital in Pyrzowice (Silesia, Poland), between November 2021 and January 2022. Results: Quality of life was significantly lower in women (p = 0.040), those with DM2 (p = 0.013), CKD (p = 0.041) and the vaccinated (p = 0.015). Conclusions: People with chronic kidney disease, diabetes mellitus and women had a lower quality of life after COVID-19 disease. However, people who were vaccinated for SARS-CoV-2 had a lower quality of life than non-vaccinated people did. This is possibly due to the higher mean age, and probably the higher disease burden, in the vaccinated group.

Główną przyczyną zachorowalności i śmiertelności na świecie jest miażdżycowa choroba sercowo-naczyniowa (ASCVD), której częstość występowania w ciągu ostatnich kilku dziesięcioleciach istotnie wzrasta. Podwyższony poziom cholesterolu lipoprotein o małej gęstości (LDL-C) jest jednym z najważniejszych modyfikowalnych czynników ryzyka związanych z rozwojem ASCVD. Obniżenie stężenia LDL-C jest istotnym działaniem w pierwotnej i wtórnej profilaktyce zdarzeń sercowo-naczyniowych u pacjentów z ASCVD lub z ryzykiem ASCVD. Inklisiran to nowy preparat, zawierający małe interferujące RNA (siRNA), który hamuje wytwarzanie białka PCSK9 w wątrobie. Zmniejszenie produkcji PCSK 9 prowadzi do obniżenia stężenia LDL-C, poprzez zwiększenie powstawania receptorów, które odpowiadają za wychwyt LDL-C, co skutkuje zwiększonym wychwytem LDL-C, a w konsekwencji obniżeniem stężenia LDL-C we krwi. W niniejszym przeglądzie narracyjnym omówiono wpływ inklisiranu na stężenie LDL-C, celem oceny skuteczności działania, bezpieczeństwa stosowania oraz tolerowania dawek leku. Badania potwierdzają, że inklisiran jest skutecznym i bezpiecznym lekiem obniżającym stężenie LDL-C, zmniejszającym ryzyko ASCVD. Inklisiran jest kolejnym postępowaniem w standardach leczenia obniżającego stężenie LDL-C u pacjentów z ASCVD lub wysokim ryzykiem ASCVD.

The history of ketamine began in the 1960s. Ketamine is a specific anesthetic drug that exhibits analgesia, has a stabilizing impact on the cardiovascular system and does not significantly depress the respiratory system. It is responsible for causing the so-called dissociative effect. The effects of ketamine depend on the dose. Its mechanism of action is based primarily on the blockade of N-methyl D-aspartic acid receptors (NMDA) in the central nervous system. Due to its favorable action profile and small number of contraindications, ketamine is becoming an increasingly popular drug. In medicine, it is commonly used as an analgesic and an anesthetic. Studies conducted over recent years have noted that it can be effective in conditions such as: status epilepticus, status asthmaticus, agitation, alcohol dependence and alcohol withdrawal syndrome, depression, and suicidal thoughts. This paper reviews current reports on the uses of ketamine, beneficial especially to physicians with the Specialty in emergency medicine.

Critical conditions frequently involve disturbances in blood gas analysis and electrolyte imbalances. Sodium bicarbonate has seen expanded medical use in recent years. The European Resuscitation Council (ERC) Guidelines endorse sodium bicarbonate for hyperkalemia, malignant hyperthermia, and specific drug intoxications. Its potential roles in treating intracranial hypertension and symptomatic hyponatremia are also being explored. However, its application in emergency departments (ED) remains inconsistent, particularly in profound metabolic acidosis cases. We conducted a review of sodium bicarbonate’s therapeutic uses. The evolving understanding of sodium bicarbonate's role in emergency medicine and intensive care highlights both its potential applications and associated risks. While not universally beneficial, especially in lactic acidosis, it may aid specific patient subgroups, such as those with acute kidney injury. Its use in hyperkalemia, intracranial hypertension and diabetic ketoacidosis (DKA) also presents mixed results, with potential benefits in particular contexts. Further large-scale, randomized controlled trials are needed to develop precise guidelines, ensuring its safe and effective use tailored to individual patient needs.

Introduction and aim. Systemic lupus erythematosus (SLE) is a chronic, autoimmune disorder that may affect every organ. The use of immunosuppression has changed a natural course of the disease. Thereupon mortality in SLE is not only associated with implications of disease activity and its impact on cardiovascular system but also with treatment-related complications like cytopenia or increased risk of infection, which can lead to a life-threatening sepsis. Description of the case. We present a case of a 60-year-old Caucasian female patient with a long-time history of active SLE, who has first developed nephrotic syndrome and then acute lupus myocarditis (LM) complicated by dilated cardiomyopathy. Conclusion: The appearance of LM and its complications seem to be a landmark event in the further course of disease.