Heart failure (HF) significantly reduces physical capacity and harms the overall functioning. In the end-stage cases of HF, the only options are surgical procedures including left ventricular assist devices (LVAD) implantation and heart transplant. Due to the insufficient number of available organs for transplantation, LVAD are used more and more frequently. Rehabilitation of patients with LVAD is a crucial element of therapy because of long-term immobilization of patients awaiting transplant or heart muscle regeneration. Purpose The aim of the study was to evaluate the impact of early hospital rehabilitation on exercise tolerance, muscles strength and complex coordination in LVAD patients. Methods The total of 20 LVAD patients were recruited to the study (all male, aged 19–66 years). All patients underwent standard cardiac rehabilitation in the postoperative and medical treatment wards. After the end of hospitalization, patients were admitted to the rehabilitation department for 4–5 weeks. During that period they performed endurance training, conditioning exercises with elements of resistance and coordination exercises. All patients were tested before and after the rehabilitation program using ergospirometry (CPX), 6-MWT, upper and lower limbs muscle strength (30 Second Chair Stand) and complex coordination (Up&Go test). Results A significant increase in the values of most of studied parameters was observed after exercise training in comparison to the results before rehabilitation process (VO2 peak) [ml/kg/min]: 11.1±2.2 vs. 12.5±2.7, p<0.001; Watt: 42.6±12.4 vs. 54.1±13.1, p<0.0001; 6- MWT [m]: 300.1±102.2 vs. 404.8±105.9, p<0.0001; 30 Seconds Chair Stand [number of stands] 8.4±3.3 vs. 11.6±4.8, p<0.0001; Up&Go [sec] 9.0±1.7 vs. 7.1±1.5, p<0.0001; left hand grip strength [kg]: 31.5±8.4 vs. 34.8±8.1, ns; right hand grip strength [kg]: 33.6±11,2 vs. 36.0±9.0, ns. No adverse effects were observed during rehabilitation process. Conclusions Hospital-based rehabilitation is safe and effective in LVAD patients. Rehabilitation after LVAD implantation brings significant benefits in terms of exercise capacity and tolerance, muscle strength and complex coordination in this group of patients. Funding Acknowledgement Type of funding source: Public grant(s) – EU funding. Main funding source(s): NATIONAL RESEARCH AND DEVELOPMENT CENTER

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Background: Exercise training (ExT) in patients with heart failure and reduced ejection fraction (HFrEF) improves clinical condition and prognosis. Data are scarce regarding the efficacy and safety of ExT in patients with HFrEF and atrial fibrillation (AFib) and with a cardiac resynchronization therapy defibrillator (CRT-D) or an implantable cardioverter-defibrillator (ICD). Purpose: The aim of the study was to evaluate the impact of exercise training in patients with HFrEF (ejection fraction

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Reumatoidalne zapalenie stawów (RZS) jest przewlekłą układową chorobą tkanki łącznej o podłożu autoimmunologicznym. Etiologia choroby nie jest znana. Charakteryzuje się ona nieswoistym zapaleniem symetrycznych stawów, a także występowaniem zmian pozastawowych i powikłań układowych. Przebiega z okresami zaostrzeń i remisji, prowadzi do niepełnosprawności i zwiększonej śmiertelności. Lekiem pierwszego rzutu w RZS jest metotreksat (MTX), który w erytrocytach ulega transformacji do poliglutaminianu metotreksatu (MTXPG). Aktywność procesu chorobowego RZS oraz wyniki leczenia są silnie skorelowane ze stężeniem MTXPG w erytrocytach. W artykule przedstawiono zależność między drogą podania leku, stężeniem MTXPG w erytrocytach a wynikami leczenia u chorych na RZS. Zwrócono także uwagę na badania dotyczące wpływu polimorfizmu genów kodujących szlaki biosyntezy puryn na efekt działania MTX. S u m m a r y Rheumatoid arthritis (RA) is a chronic autoimmune disease of unknown etiology, characterized by inflammation of the symmetrical joints, multi-organ complications, flares and complete or partial remission periods, which results in disability and increased mortality. Methotrexate (MTX) remains the first-line therapy for active RA. In red blood cells (RBC) MTX is transformed into methotrexate polyglutamates (MTXPG). Disease activity and treatment results are strongly associated with methotrexate polyglutamate concentrations in red blood cells. The article presents the correlation between the route of administration of the treatment, RBC MTXPG concentration and disease activity in patients with rheumatoid arthritis. Also, the impact of genetic polymorphism in the folate-purine-pyrimidine pathway on effects of MTX therapy is stressed. A Ad dr re es s d do o k ko or re es sp po on nd de en nc cj ji i: :