REcomMEndations for DIAgnostics and MaNagemenT of Arterial Hypertension in Adults Aged 65 Years and Older for General Practitioners — REMEDIA NT 65+ GP

This text referring directly to the diagnosis and treatment of hypertension in elderly patients is a translation of a fragment of REMEDIA NT 65+ GP published in the “Lekarz POZ” (GP Practitioner) journal 4/2018

Państwo i społeczeństwo w XXI wieku. Sztuka - społeczeństwo - edukacja

Ze wstępu: "Tradycyjnie Krakowska Szkoła Wyższa im. Andrzeja Frycza Modrzewskiego organizuje w pierwszych dniach czerwca Międzynarodową Konferencję Naukową. Tegorocznym przedmiotem obrad, czwartej już konferencji, było „Państwo i społeczeństwo w XXI wieku”. W tej różnorodności problemów i zagadnień związanych z życiem społecznym, ideą naszej części konferencji była wielka opowieść 0 wychowaniu przez sztukę."(...

Relationship Between Anti-DFS70 Autoantibodies and Oxidative Stress

Background: The anti-DFS70 autoantibodies are one of the most commonly and widely described agent of unknown clinical significance, frequently detected in healthy individuals. It is not known whether the DFS70 autoantibodies are protective or pathogenic. One of the factors suspected of inducing the formation of anti-DFS70 antibodies is increased oxidative stress. We evaluated the coexistence of anti-DFS70 antibodies with selected markers of oxidative stress and investigated whether these antibodies could be considered as indirect markers of oxidative stress. Methods: The intensity of oxidative stress was measured in all samples via indices of free-radical damage to lipids and proteins such as total oxidant status (TOS), concentrations of lipid hydroperoxides (LPH), lipofuscin (LPS), and malondialdehyde (MDA). The parameters of the non-enzymatic antioxidant system, such as total antioxidant status (TAS) and uric acid concentration (UA), were also measured, as well as the activity of superoxide dismutase (SOD). Based on TOS and TAS values, the oxidative stress index (OSI) was calculated. All samples were also tested with indirect immunofluorescence assay (IFA) and 357 samples were selected for direct monospecific anti DFS70 enzyme-linked immunosorbent assay (ELISA) testing. Results: The anti-DFS70 antibodies were confirmed by ELISA test in 21.29% of samples. Compared with anti-DFS70 negative samples we observed 23% lower concentration of LPH (P =.038) and 11% lower concentration of UA (P =.005). TOS was 20% lower (P =.014). The activity of SOD was up to 5% higher (P =.037). The Pearson correlation showed weak negative correlation for LPH, UA, and TOS and a weak positive correlation for SOD activity. Conclusion: In samples positive for the anti-DFS70 antibody a decreased level of oxidative stress was observed, especially in the case of samples with a high antibody titer. Anti-DFS70 antibodies can be considered as an indirect marker of reduced oxidative stress or a marker indicating the recent intensification of antioxidant processes

Neurological symptoms in hospitalised patients with COVID-19 and their association with in-hospital mortality

Objectives. To evaluate the spectrum of neurological symptoms in patients with COVID-19 during the first 14 days of hospitalisation and its association with in-hospital mortality. Material and methods. We included 200 patients with RT-PCR-confirmed COVID-19 admitted to University Hospital in Krakow, Poland. In 164 patients, a detailed questionnaire concerning neurological symptoms and signs was performed prospectively within 14 days of hospitalisation. In the remaining 36 patients, such questionnaires were completed retrospectively based on daily observations in the Department of Neurology. Results. During hospitalisation, 169 patients (84.5%) experienced neurological symptoms; the most common were: fatigue (62.5%), decreased mood (45.5%), myalgia (43.5%), and muscle weakness (42.5%). Patients who died during hospitalisation compared to the remainder were older (79 [70.5–88.5] vs. 63.5 [51–77] years, p = 0.001), and more often had decreased level of consciousness (50.0% vs. 9.3%, p < 0.001), delirium (33.3% vs. 4.4%, p < 0.001), arterial hypotension (50.0% vs. 19.6%, p = 0.005) or stroke during (18.8% vs. 3.3%, p = 0.026) or before hospitalisation (50.0% vs. 7.1, p < 0.001), whereas those who survived more often suffered from headache (42.1% vs. 0%, p = 0.012) or decreased mood (51.7% vs. 0%, p = 0.003). Conclusions. Most hospitalised patients with COVID-19 experience neurological symptoms. Decreased level of consciousness, delirium, arterial hypotension, and stroke during or before hospitalisation increase the risk of in-hospital mortality

I Międzynarodowy Kongres Medyczny „KOBIETA I MĘŻCZYZNA. ZDROWE STARZENIE” 12–13.10.2012, Hotel Hilton, Warszawa

Szanowni Państwo!Mamy przyjemność zaprosić Państwa do udziału w I edycji Kongresu „Kobieta i Mężczyzna. Zdrowe starzenie”, który odbędzie się w dniach 12–13 października 2012 roku w Hotelu Hilton w Warszawie. Honorowy Patronat nad Kongresem objęło Polskie Towarzystwo Gerontologiczne

Methicilin-resistant Staphylococcus aureus discitis in 84-old year woman

Septyczne zapalenie krążka międzykręgowego (discitis) obejmuje przestrzeń międzykręgową, sąsiadujące trzony kręgowe, często penetruje do tkanek miękkich okołokręgowych (spondylodiscitis). Szacuje się, że choroba występuje z czętością 0,4-2 przypadków na 100 000 mieszkańców na rok. Rozpowszechnienie discitis w populacji wykazuje rozkład bimodalny - w dzieciństwie i wieku starszym. Ze względu na coraz większy udział osób starszych w populacji należy spodziewać się wzrostu rozpoznań tej choroby w tej grupie pacjentów. Jednak uwzględniając wielochorobowość, w tym złożoną patologię kręgosłupa, rozpoznanie discitis u tych pacjentów jest utrudnione lub odroczone, co pogarsza rokowanie. Najczęstszym czynnikiem etiologicznym jest Staphylococcus aureus. Prawidłowa diagnoza zapalenia krążka międzykręgowego opiera się na stwierdzeniu silnego bólu kręgosłupa, któremu towarzyszy stan gorączkowy i wzrost parametrów zapalnych, wyizolowaniu z posiewu krwi czynnika etiotropowego oraz na obecności specyficznych dla discitis objawów w obrazie rezonansu magnetycznego. Prezentowany przypadek 84-letniej kobiety z wielochorobowością ilustruje trudności diagnostyczne związane z ustaleniem diagnozy oraz efekty leczenia opartego na długoterminowej antybiotykoterapii celowanej, co umożliwiło powrót funkcji życiowych pacjentki do stanu sprzed choroby.Septic discitis is an inflammatory process of the intervertebral disc which usually involves the discovertebral junction, and may extend in to the verterbral bodies, epidural space and paraspinal soft tissues (spondylodiscitis). The incidence rate of spondylodiscitis ranges from 0.4 to 2 cases in 100 000 population per year. Children and older people are the most prone to infection. In recent years the incidence of discitis has seemed to increase, especially in older persons. The reasons for this are due to an ageing population, multiply comorbidity, including spinal pathology, which may result in delayed diagnosis and worse prognosis. Staphylococcus aureus is the most common organism cultured in vertebral discitis. The proper diagnosis of spondylodiscitis is based on: (1) severe back pain with fever and inflammatory markers elevation (2) isolation of the pathogen from the blood cultures (3) confirmation with magnetic resonance imaging. The presented case of 84-year old female with commorbidity reveals the diagnostic and therapeutic challenges. The typical prolonged course of therapy with proper antibiotics prevented the serious spinal and neurological complications and resulted in full recovery

Identification of Mortality Risks in the Advancement of Old Age: Application of Proportional Hazard Models Based on the Stepwise Variable Selection and the Bayesian Model Averaging Approach

Identifying factors that affect mortality requires a robust statistical approach. This study’s objective is to assess an optimal set of variables that are independently associated with the mortality risk of 433 older comorbid adults that have been discharged from the geriatric ward. We used both the stepwise backward variable selection and the iterative Bayesian model averaging (BMA) approaches to the Cox proportional hazards models. Potential predictors of the mortality rate were based on a broad range of clinical data; functional and laboratory tests, including geriatric nutritional risk index (GNRI); lymphocyte count; vitamin D, and the age-weighted Charlson comorbidity index. The results of the multivariable analysis identified seven explanatory variables that are independently associated with the length of survival. The mortality rate was higher in males than in females; it increased with the comorbidity level and C-reactive proteins plasma level but was negatively affected by a person’s mobility, GNRI and lymphocyte count, as well as the vitamin D plasma level

Cognitive Functioning of Geriatric Patients: Is Hypovitaminosis D the Next Marker of Cognitive Dysfunction and Dementia?

The study objective is to investigate whether vitamin D is associated with the cognitive function of geriatric patients. This cross-sectional study involved 357 patients hospitalized in the geriatric ward who complained of memory problems (mean age: 82.3 years). The level of cognitive function was measured with the Mini-Mental State Examination (MMSE) and the clinical diagnosis of dementia was established according to the International Classification of Diseases (ICD-10) criteria. The serum 25-hydroxy vitamin D was measured with liquid chromatography-tandem mass spectrometry. The iterative Bayesian model averaging (BMA) procedure was applied to linear and logistic regression models in order to identify the best set of factors describing cognitive dysfunction and dementia, respectively. According to BMA, there is strong evidence that higher vitamin D levels, higher body mass index (BMI), and higher mobility function measured with the Timed Up and Go (TUG) test are independently associated with better cognitive performance and lower risk of dementia. Additionally, there is strong evidence that fewer years of education and lower vitamin B12 plasma levels independently describe worse cognitive performance. However, vitamin B12 levels higher than 800 pg/mL is negatively associated with the MMSE performance. Hypovitaminosis D in geriatric patients is an underrated marker of cognitive dysfunction and dementia