Profilaktyka nowotworów u kobiet w Polsce. Sukces, czy niepowodzenie? Opinie pacjentów, lekarzy i instytucji odpowiedzialnych za stan zdrowia – metaanaliza = Prevention of cancer in women in Poland. Success or failure? Opinions of patients, physicians and institutions responsible for health – meta-analysis

Kołłątaj Witold, Karwat Irena Dorota, Kołłątaj Barbara, Piecewicz-Szczęsna Halina, Sowa Magda. Profilaktyka nowotworów u kobiet w Polsce. Sukces, czy niepowodzenie? Opinie pacjentów, lekarzy i instytucji odpowiedzialnych za stan zdrowia – metaanaliza = Prevention of cancer in women in Poland. Success or failure? Opinions of patients, physicians and institutions responsible for health – meta-analysis. Journal of Education, Health and Sport. 2016;6(6):318-328. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.55608 http://ojs.ukw.edu.pl/index.php/johs/article/view/3585 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 755 (23.12.2015). 755 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Author (s) 2016; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 05.05.2016. Revised 25.05.2016. Accepted: 10.06.2016. Profilaktyka nowotworów u kobiet w Polsce. Sukces, czy niepowodzenie? Opinie pacjentów, lekarzy i instytucji odpowiedzialnych za stan zdrowia – metaanaliza Prevention of cancer in women in Poland. Success or failure? Opinions of patients, physicians and institutions responsible for health – meta-analysis Witold Kołłątaj1, Irena Dorota Karwat2, Barbara Kołłątaj2, Halina Piecewicz‑Szczęsna2, Magda Sowa3 1Klinika Endokrynologii i Diabetologii Dziecięcej, Uniwersytet Medyczny w Lublinie 2Katedra i Zakład Epidemiologii i Metodologii Badań Klinicznych, Uniwersytet Medyczny w Lublinie 3Katedra i Zakład Zdrowia Publicznego, Uniwersytet Medyczny w Lublinie Adres do korespondencji: dr hab. n. med. Witold Kołłątaj Klinika Endokrynologii i Diabetologii Dziecięcej z Pracownią Metaboliczną UM w Lublinie ul. Profesora Antoniego Gębali 6, 20-093 Lublin e-mail: [email protected] Słowa kluczowe: nowotwory, profilaktyka, kobiety, opinie, metaanaliza. Keywords: cancer prevention, women, opinions, meta-analysis. Streszczenie Wstęp Choroby nowotworowe od wielu lat stanowią w Polsce drugą przyczynę zgonów. Co roku, z tego powodu, umiera niemal 100 000 osób, a liczba zgonów ma tendencję rosnącą. Wyniki leczenia nowotworów w Polsce są gorsze, niż w krajach Europy, diagnostyka często spóźniona, a profilaktyka niewystarczająco skuteczna. W celu poprawy stanu zdrowa społeczeństwa, rosną nakłady na leczenie i profilaktykę. W Polsce profilaktykę koordynuje Narodowy Program Zwalczania Chorób Nowotworowych. Cel pracy Celem pracy jest próba rzetelnej oceny stanu profilaktyki nowotworów u kobiet w Polsce, uwzględniającej opinie zarówno organów odpowiedzialnych za ochronę zdrowia, lekarzy, organów kontroli, jak i pacjentów. Materiał i metody Materiał stanowiły sprawozdania podmiotów odpowiedzialnych za realizację profilaktyki nowotworów u kobiet, akty prawne, publikacje naukowe oceniające realizację profilaktyki nowotworów u kobiet w Polsce oraz dane z Audytu Społecznego Narodowych Programów Profilaktyki Nowotworowej. Wyniki i omówienie Ministerstwo Zdrowia oraz Narodowy Fundusz Zdrowia publikują dane, które podkreślają osiągnięcia profilaktyki nowotworów u kobiet w Polsce, natomiast opinie fachowych pracowników służby zdrowia (wyrażone w konkluzji realizowanych prac badawczych) oraz pacjentów wskazują na znaczne dysproporcje między założeniami programów profilaktycznych a ich faktyczną realizacją. Wśród niedociągnięć wymieniane są przede wszystkim niewystarczające działania edukacyjne, niedociągnięcia organizacyjne (nieuwzględnianie w harmonogramie badań grafiku pracy pacjentek, niewłaściwe informowanie o terminach badań, błędy w dystrybucji wezwań na badanie, nieprzyjazne kobietom warunki badania) oraz inne czynniki, które kobiety określają, jako podważające zaufanie do jakości badania. Najwięcej negatywnych emocji budzi stan komunikacji z grupami docelowymi kobiet oraz zaniedbania z zakresu edukacji. Wnioski Optymistyczne oceny osiągnieć Narodowego Programu Zwalczania Chorób Nowotworowych ogłoszone przez Ministerstwo Zdrowia nie znajdują pełnego pokrycia w opiniach zarówno organów kontrolnych, pacjentów, jak i środowiska medycznego. Liczne negatywne oceny programów profilaktycznych oraz sugestie głębokich reform Narodowego Programu Zwalczania Chorób Nowotworowych nie mają wpływu na plany Ministerstwa Zdrowia. Celowym wydaje się analiza przyczyn takiego stanu rzeczy, kiedy to opinie świata nauki, wyrażane między innymi w publikacjach naukowych, nie skłaniają Ministerstwa Zdrowia do refleksji lub przynajmniej do wszczęcia polemiki ze środowiskiem naukowym i lekarzami praktykami. Summary Introduction For many last years, neoplastic diseases have been the second cause of death in Poland. Every year, such diseases are the reasons for almost 100 000 cases of death. The mortality because of neoplasms has got the increasing tendency. The results of cancer treatment in Poland are worse than in many European countries, diagnoses often delayed and the prevention insufficiently effective. In order to improve the health status of Polish population, the expenditures on treatment and prevention have been slightly raised. In Poland, the prevention is coordinated by the National Cancer Control Program. Aim The aim of the study was the assessment of cancer prevention in women in Poland, taking into account opinions of both Polish Ministry of Health, audit institutions, patients and the medical community. Material and methods The material consists of the reports of entities responsible for the implementation of cancer prevention in women, legislative acts, scientific publications evaluating the implementation of the prevention of cancer in women in Poland as well as data from the National Social Audit Program Cancer Prevention. Results and Discussion While the Ministry of Health and the National Health Fund publish data that highlight the achievements, medical community's opinions (expressed as the conclusions of ongoing researches) as well as the opinions of patients show a significant disparity between the objectives of prevention programs and their actual implementations. Among mentioned shortcomings there are: educational and organizational negligence (working hours of facilities dealing with the prevention are coinciding with the working hours of women, incorrect information about the terms of preventive procedures, improper schemes of distribution of calls for screenings, embarrassing and unpleasant conditions of screenings) as well as other factors that women define as those that prejudice them to take part in such medical procedures. The most negative emotions concern the mechanisms of communication between screening centers and the target groups of women and educational negligence. Conclusions 1. The optimistic assessment of achievements of the National Cancer Control Program proclaimed by the Polish Ministry of Health are not fully covered in the opinions of audit institutions, patients and the medical community. 2. Numerous negative opinions concerning prevention programs and suggestions of deep reform of the National Cancer Control Program have no effect on the plans of the Polish Ministry of Health. 3. It seems appropriate to analyze the causes of this state of affairs, when the opinions expressed by medical community, among others, published as scientific publications, do not tend to reflect the Ministry of Health, or at least to initiate a polemic with the medical-scientific experts and practitioners

Nutritional and Sensory Quality of Two Types of Cress Microgreens Depending on the Mineral Nutrition

The present study addressed the combination of nutritional and sensory quality assessment of radish and garden cress as microgreens cultivated in different amounts of mineral nutrients under conditions that can be realized in a private household. The content of value adding compounds was determined by means of chemical analyses. Total flavor impression and visual appearance were rated by untrained consumer tests. In cotyledons of radish cress (Raphanus sativus L.), carotenoid, total phenols, nitrate contents, and antioxidant capacity decreased significantly with decreasing mineral content in the nutrient solution, whereas, in stems, total phenols and anthocyanin contents rose and nitrate content decreased significantly with decreasing mineral content. In garden cress (Lepidium sativum L.), carotenoid and nitrate contents decreased and anthocyanin content increased significantly with decreasing mineral content, indicating that the response of value adding compounds to changing amounts of minerals in the nutrient solution depends on the compound of interest, plant species, and even the plant organ of a species. The sensory quality of the studied microgreens was generally rated highest when mineral content in the nutrient solution was highest, indicating that sensory quality is not necessarily identical with nutritional quality. Considering the common practice in private households, cultivation with tap water represents an attractive compromise for nutritional and sensory quality in case of garden cress, whereas, for radish cress, the application of 25% modified Hoagland solution is recommended

Samoleczenie wśród studentów medycyny Uniwersytetu Medycznego w Lublinie = Self-medication practice among medical students of Medical University in Lublin

Sowa Magda, Kołłątaj Witold, Kołłątaj Barbara, Karwat Irena Dorota, Szakuła Justyna. Samoleczenie wśród studentów medycyny Uniwersytetu Medycznego w Lublinie = Self-medication practice among medical students of Medical University in Lublin. Journal of Education, Health and Sport. 2015;5(7):439-452. ISSN 2391-8306. DOI 10.5281/zenodo.20851 http://ojs.ukw.edu.pl/index.php/johs/article/view/2015%3B5%287%29%3A439-452 https://pbn.nauka.gov.pl/works/589949 http://dx.doi.org/10.5281/zenodo.20851 Formerly Journal of Health Sciences. ISSN 1429-9623 / 2300-665X. Archives 2011–2014 http://journal.rsw.edu.pl/index.php/JHS/issue/archive   Deklaracja. Specyfika i zawartość merytoryczna czasopisma nie ulega zmianie. Zgodnie z informacją MNiSW z dnia 2 czerwca 2014 r., że w roku 2014 nie będzie przeprowadzana ocena czasopism naukowych; czasopismo o zmienionym tytule otrzymuje tyle samo punktów co na wykazie czasopism naukowych z dnia 31 grudnia 2014 r. The journal has had 5 points in Ministry of Science and Higher Education of Poland parametric evaluation. Part B item 1089. (31.12.2014). © The Author (s) 2015; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland and Radom University in Radom, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 20.06.2015. Revised 15.07.2015. Accepted: 15.07.2015.   Samoleczenie wśród studentów medycyny Uniwersytetu Medycznego w Lublinie Self-medication practice among medical students of Medical University in Lublin   Magda Sowa1, Witold Kołłątaj2, Barbara Kołłątaj3, Irena Dorota Karwat3, Justyna Szakuła4   1Katedra i Zakład Zdrowia Publicznego Uniwersytetu Medycznego w Lublinie 2Klinika Endokrynologii i Diabetologii Dziecięcej z Pracownią Endokrynologiczno - Metaboliczną Uniwersytetu Medycznego w Lublinie 3Katedra i Zakład Epidemiologii Uniwersytetu Medycznego w Lublinie 4Katedra Zdrowia Publicznego, Wydział Nauk o Zdrowiu Uniwersytetu Medycznego w Lublinie   Adres do korespondencji: dr hab. n. med. Witold Kołłątaj Klinika Endokrynologii i Diabetologii Dziecięcej z Pracownią Metaboliczną UM w Lublinie ul. Profesora Antoniego Gębali 6, 20-093 Lublin e-mail: [email protected]   Słowa kluczowe: samoleczenie, studenci medycyny, leki OTC.   Streszczenie   Wstęp Samoleczenie polega na samodzielnie podjętym przez chorego działaniu, polegającym na stosowaniu leków lub aplikowaniu metod leczniczych, bądź mających potencjalne właściwości  lecznicze, w celu przywrócenia zdrowia lub poprawy jakości życia. Głównymi powodami, dla których ludzie sami podejmują próby leczenia są uwarunkowania kulturowe, brak czasu, niedostatki finansowe, trudny dostęp do lekarzy specjalistów (kolejki), przekonanie, iż błahe dolegliwości nie wymagają pomocy specjalisty, oraz łatwy dostęp do wielu środków leczniczych. Cel pracy Celem pracy była ocena zjawiska samoleczenia wśród studentów medycyny Uniwersytetu Medycznego w Lublinie. Materiał i metody Badaniem zostali objęci studenci medycyny Uniwersytetu Medycznego w Lublinie. Dobór próby dokonany został metodą doboru proporcjonalnego reprezentatywnego. Liczba osób poddana badaniu była proporcjonalna do liczby osób z poszczególnych lat studiów.  W badaniu udział wzięło 267 studentów w wieku 19-32 lat życia, w tym 168 kobiet (62,9%) i 99 mężczyzn (37,1%). Metodą badawczą był sondaż diagnostyczny, a narzędziem badawczym Autorski Kwestionariusz Ankiety. Badanie przeprowadzono w październiku 2014. Wyniki Termin samoleczenie kojarzy się studentom medycyny na ogół z samodzielnym (bez konsultacji z lekarzem) stosowaniem leków do odręcznej sprzedaży – OTC (over-the-counter drugs) (71% ankietowanych) oraz ze stosowaniem tak zwanych domowych sposobów leczenia (60%). Spośród badanych, 23% studentów metody samoleczenia stosowało „zawsze” lub „niemal zawsze” w razie pojawienia się objawów chorobowych, 58% – okazyjnie,  11% nigdy. Wśród osób decydujących się na samoleczenie, najpopularniejsze było stosowanie leków OTC (99% ankietowanych), fitoterapia (27%), ciepłe okłady i plastry rozgrzewające (24.8%)  oraz środki spożywcze używane w sposób niekonwencjonalny (21%). Studenci medycyny bardzo chętnie sięgają po leki OTC. Niemal 90% przyznało, iż zdarza im się z takich leków korzystać, chociaż tylko 6% wyraziło opinię, że takie leki są w pełni bezpieczne i nie stwarzają żadnego zagrożenia dla pacjenta. Stosowanie leków OTC tłumaczą najczęściej łatwością ich zakupu (56% ankietowanych), wcześniej uzyskanymi dobrymi  efektami terapeutycznymi (36%) i atrakcyjną ceną (16%). Wśród OTC studenci medycyny preferują leki „na przeziębienie i grypę”, przeciwbólowe i przeciwzapalne, leki z innych grup stosowane są zdecydowanie rzadziej. Wnioski • Studenci medycyny chętnie korzystają z metod samoleczenia. Tylko 11% ankietowanych studentów medycyny nigdy nie korzystało z tych metod leczenia. • Studenci najchętniej sięgają po leki grupy OTC i fitoterapię. • Ze względu na wysoką liczbę osób stosujących metody samoleczenia, należy podjąć próby skutecznej edukacji młodzieży akademickiej w zakresie zalet i wad stosowania takiej formy terapii.   Keywords: self-treatment, students of medicine, OTC drugs.   Summary   Introduction The phenomenon of self-medication is defined as using drugs or applying treatment methods with potential therapeutic properties without consultation or consent of a doctor in order to restore health or improve quality of life. The main reasons why people attempt to treat themselves are cultural factors, lack of time, financial shortcomings, difficult access to specialists (queues), the belief that trivial ailments do not require a specialist, and easy access to a variety of medications. Aim of the study The aim of the study was to assess the scope of phenomenon of self-medication among medical students of the Medical University of Lublin. Materials and methods The survey were conducted among medical students of the Medical University of Lublin. The study group consisted of representative samples of all 1-6 year study groups.  The study involved 267 students aged between 19-32 years, including 168 women and 99 men. There was used the diagnostic survey method based on the author's questionnaire. The study was conducted in October 2014. Results Medical students, usually, define the term self-treatment as an independent (without consulting a doctor) use of OTC (over the counter) medications (71% of respondents) or so-called home treatment (60%) applied to restore health or improve quality of life. Among the surveyed  students 23% of respondents use methods of self-treatment "always" or "almost always" in case of any symptoms of the disease appearance, 58% – of polled do it occasionally, 11% have never applied such methods of treatment. Among those opting for self-treatment, the most common was the use of OTC drugs (99% of respondents), herbal medicine (27%), warm poultices and warming plasters applying (24.8%) and foodstuffs used in an unconventional way (21%). Medical students are very eager to use OTC drugs. Almost 90% polled confessed that they had been using such drugs in the past, although only 6% of them checked the opinion that such drugs are completely safe and do not pose any danger to the patient. The attitude towards use of OTC drugs has been explained by students by ease of purchase (56%), previously obtained good therapeutic effects (36%) and attractive price (16%). Polled medical students prefer OTC "cold and flu", analgesic and anti-inflammatory medications. Other OTC drugs are used by them much less frequently. Conclusions • Medical students are willing to use methods of self-treatment. Only 11% of polled medical students have never applied such methods of treatment. • While opting for self-medication, they usually use OTC drugs and herbal medicine methods. • Due to the high number of medical students using self-medications methods, it should be made attempts to improve education of students on the advantages and disadvantages of using of these forms of therapy

Elderly Peoples' Perception of Young People - A Preliminary Study.

Aging is becoming a more noticeable phenomenon in Poland and Europe. We analysed the perception of youth by elderly and compared attitudes of students of the University of the Third Age (SU3A) with nursing homes residents (NHR) to young people.Our questionnaire was distributed to 140 people over the age of 50 (70 SU3A and 70 NHR).85.0% of all respondents answered positively to the question "Do you enjoy contact with young people?", even though their contacts are usually limited and mostly confined to a few s a year. Vast majority of NHR (62.9%) and almost half SU3A (48.6%) believe that there is a need to integrate seniors and youth to achieve mutual benefits.Young people would benefit from the life experience of the elderly; the elderly could become more active in many areas of life

Left ventricular diastolic dysfunction in a general population-based sample without previous cardiac disease: concomitant physical and laboratory variables

Introduction. Left ventricular diastolic dysfunction (LVDD) is described as impaired left ventricular (LV) relaxation and reduced chamber compliance. Misleading data on the prevalence of LVDD are available in the literature due to various definitions. This study aimed to assess the frequency of LVDD in a population without severe cardiovascular disease (CVD), as well as to identify factors associated with it. Material and methods. Overall, 648 individuals without severe CVD were included. LVDD was assessed using the last 2016 guidelines (LVDD2016) together with the previous recommendations from 1998 (LVDD1998). Results. In total, 35 participants (5.4%) met the LVDD2016 criteria, and 29 people (4.5%) fulfilled only the LVDD1998 criteria. The strongest factors independently associated with LVDD2016 were body mass index (BMI), high-sensitivity C-reactive protein, high-sensitivity troponin T, ejection fraction and circumference of neck and waist. LVDD2016 presents a significant association with the anthropometric measures (BMI, neck and waist circumference), LV function and overload as well as the inflammatory parameter. Conclusions. In the population without overt CVD the frequency of LVDD as defined by the latest 2016 guidelines is 5.4%. It was associated with inflammatory, cardiac damage and anthropometric parameters.Introduction. Left ventricular diastolic dysfunction (LVDD) is described as impaired left ventricular (LV) relaxation and reduced chamber compliance. Misleading data on the prevalence of LVDD are available in the literature due to various definitions. This study aimed to assess the frequency of LVDD in a population without severe cardiovascular disease (CVD), as well as to identify factors associated with it. Material and methods. Overall, 648 individuals without severe CVD were included. LVDD was assessed using the last 2016 guidelines (LVDD2016) together with the previous recommendations from 1998 (LVDD1998). Results. In total, 35 participants (5.4%) met the LVDD2016 criteria, and 29 people (4.5%) fulfilled only the LVDD1998 criteria. The strongest factors independently associated with LVDD2016 were body mass index (BMI), high-sensitivity C-reactive protein, high-sensitivity troponin T, ejection fraction and circumference of neck and waist. LVDD2016 presents a significant association with the anthropometric measures (BMI, neck and waist circumference), LV function and overload as well as the inflammatory parameter. Conclusions. In the population without overt CVD the frequency of LVDD as defined by the latest 2016 guidelines is 5.4%. It was associated with inflammatory, cardiac damage and anthropometric parameters

A Similar Lifetime CV Risk and a Similar Cardiometabolic Profile in the Moderate and High Cardiovascular Risk Populations: A Population-Based Study

Background: Cardiovascular disease (CVD) is a major, worldwide problem that remains the dominant cause of premature mortality in the world, and increasing rates of dysglycaemia are a major contributor to its development. The aim of this study was to investigate the cardiometabolic profile among patients in particular cardiovascular risk classes, and to estimate their long term CV risk. Methods: A total of 931 individuals aged 20–79 were included. The study population was divided into CV risk classes according to the latest European Society of Cardiology recommendations. Results: Most of the analyzed anthropometric, body composition and laboratory parameters did not differ between the moderate and high CV risk participants. Interestingly, estimating the lifetime risk of myocardial infarction, stroke or CV death, using the LIFEtime-perspective model for individualizing CardioVascular Disease prevention strategies in apparently healthy people, yielded similar results in moderate and high CV risk classes. Conclusion: The participants who belonged to moderate and high CV risk classes had very similar unfavorable cardiometabolic profiles, which may result in similar lifetime CV risk. This may imply the need for more aggressive pharmacological and non-pharmacological management of CV risk factors in the moderate CV risk population, who are often unaware of their situation. New prospective population studies are necessary to establish the true cardiovascular risk profiles in a changing society

Effectiveness of Lifestyle Modification vs. Therapeutic, Preventative Strategies for Reducing Cardiovascular Risk in Primary Prevention—A Cohort Study

Background: Cardiovascular diseases (CVD) are still the leading cause of death in developed countries. The aim of this study was to calculate the potential for CV risk reduction when using three different prevention strategies to evaluate the effect of primary prevention. Methods: A total of 931 individuals aged 20–79 years old from the Bialystok PLUS Study were analyzed. The study population was divided into CV risk classes. The Systematic Coronary Risk Estimation (SCORE), Framingham Risk Score (FRS), and LIFE-CVD were used to assess CV risk. The optimal prevention strategy assumed the attainment of therapeutic goals according to the European guidelines. The moderate strategy assumed therapeutic goals in participants with increased risk factors: a reduction in systolic blood pressure by 10 mmHg when it was above 140 mmHg, a reduction in total cholesterol by 25% when it was above 190 mg/dL, and a reduction in body mass index below 30. The minimal prevention strategy assumed that CV risk would be lowered by lifestyle modifications. The greatest CV risk reduction was achieved in the optimal model and then in the minimal model, and the lowest risk reduction was achieved in the moderate model, e.g., using the optimal model of prevention (Model 1). In the total population, we achieved a reduction of −1.74% in the 10-year risk of CVD death (SCORE) in relation to the baseline model, a −0.85% reduction when using the moderate prevention model (Model 2), and a −1.11% reduction when using the minimal prevention model (Model 3). However, in the low CV risk class, the best model was the minimal one (risk reduction of −0.72%), which showed even better results than the optimal one (reduction of −0.69%) using the FRS. Conclusion: A strategy based on lifestyle modifications in a population without established CVD could be more effective than the moderate strategy used in the present study. Moreover, applying a minimal strategy to the low CV risk class population may even be beneficial for an optimal model

Impact of Pulse Wave Velocity and Parameters Reflecting Android Type Fat Distribution on Left Ventricular Diastolic Dysfunction in Patients with Chronic Coronary Syndromes

Background: Left ventricular diastolic dysfunction (LVDD) is caused by a decreased left ventricle relaxation and is associated with an increased risk of symptomatic heart failure (HF) and excessive mortality. Aim: To evaluate the frequency and factors related to LVDD in the population with chronic coronary syndromes (CCS). Methods: 200 patients (mean age 63.18 ± 8.12 years, 75.5% male) with CCS were included. LVDD was diagnosed based on the recent echocardiography guidelines. Results: LVDD was diagnosed in 38.5% of CCS population. From the studied factors, after adjustment for age, sex, and N-terminal pro-brain natriuretic peptide (NT-proBNP), LVDD associated positively with android/gynoid (A/G) fat mass ratio, left ventricular mass index (LVMI), and negatively with Z-score and left ventricular ejection fraction (LVEF). In stepwise backward logistic regression analysis, the strongest factors associated with LVDD were pulse wave velocity value, handgrip strength and waist to hip ratio (WHR). Conclusions: LVDD is common among CCS patients and it is associated with parameters reflecting android type fat distribution regardless of NT-proBNP and high-sensitivity troponin T concentrations. Deterioration in diastolic dysfunction is linked with increased aortic stiffness independently of age and sex. Further studies evaluating the effects of increasing physical fitness and lowering abdominal fat accumulations on LVDD in CCS patients should be considered

Assessment of Pulmonary Function Tests in COVID-19 Convalescents Six Months after Infection

Background: The aim of the study was to investigate the impact of COVID-19 on the pulmonary function tests (PFT) in COVID-19 convalescents six months after recovery. Additionally, the research question was whether PFT should be performed routinely in post-COVID-19 patients. Methods: A total of 39 patients with a history of COVID-19 6 months prior to the study were included in the study (Group I). Individuals were hospitalized or treated in the outpatients department. The control group (Group II) consisted of 39 healthy patients without a COVID-19 history. Each subject completed a questionnaire interview and underwent laboratory and pulmonary function examinations. Results: Six months after COVID-19 recovery, patients mainly complained about cough (46%, n = 18), shortness of breath (23%, n = 9), weakness (13%, n = 5), and memory/concentration disorders (8%, n = 3). In the group of patients complaining of persistent cough present 6 months after COVID-19, the following PFT parameters were decreased: FEV1, FVC, FRC, TLC, and DLCO (p < 0.05) in comparison with patients without this symptom. Conclusions: Persistent shortness of breath is not necessarily associated with pulmonary function impairment in patients 6 months after SARS-CoV-2 infection, and hence it requires appropriate differential diagnosis. Patients with a cough persisting 6 months after the acute phase of COVID-19 may benefit from PFT