Association between Malnutrition and Quality of Life in Elderly Patients with Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a progressive articular disease. In addition to damaging the joints, it may cause multiple organ complications, and considerably impair the patient’s functioning. Elderly patients with RA report pain, fatigue, mood disorders, sleep disorders and insomnia, accompanied by weakness, poor appetite, and weight loss. All these factors combined have an adverse effect on the patient’s perceived quality of life (QoL). Due to the chronic nature of RA and the high risk of malnutrition in this patient group, the present study investigated QoL, activities of daily living, and frailty syndrome severity in relation to MNA (Mini Nutritional Assessment) questionnaire scores among elderly RA patients. The study included 98 patients (aged over 60) diagnosed with RA per the ARA (American Rheumatism Association) criteria. The following standardized instruments were used: WHOQoL-BREF for QoL, the Edmonton Frail Scale for frailty syndrome severity, MNA for nutritional status assessment, and MMSE (Mini-Mental State Examination) to assess any cognitive impairment. Medical data were obtained from hospital records. Patients with a different nutritional status differed significantly in terms of limitations in activities of daily living (ADL) and instrumental activities of daily living (IADL). Higher levels of malnutrition were associated with greater limitations in activity. An adverse impact of lower body weight on cognitive function was also observed (dementia was identified in 33.33% of malnourished patients vs. 1.79% in patients with a normal body weight). Likewise, frailty was more common in malnourished patients (mild frailty syndrome in 33.3%, moderate in 16.67%, and severe in 16.67%). Malnourished patients had significantly lower QoL scores in all WHOQoL-BREF questionnaire domains than those with a normal body weight, and multiple-factor analysis for the impact of selected variables on QoL in each domain demonstrated that frailty was a significant independent determinant of poorer QoL in all domains: perceived quality of life (β = −0.069), perceived health (β = −0.172), physical domain (β = −0.425), psychological domain (β = −0.432), social domain (β = −0.415), environmental domain (β = −0.317). Malnutrition was a significant independent determinant of QoL in the “perceived health” domain (β = −0.08). In addition, regression analysis demonstrated the positive impact of male sex on QoL scores in the psychological (β = 1.414) and environmental domains (β = 1.123). Malnourished patients have a lower QoL than those with a normal body weight. Malnutrition adversely affects daily functioning, cognitive function, and the severity of frailty syndrome. Frailty syndrome is a significant independent determinant of poorer QoL in all WHOQoL BREF domains

Cavitation - Selected Issues

Cavitation erosion is one of the most popular phenomena of the destruction of engineering materials working in water conditions and various kinds of liquids. The cavitation effect is defined as a physical effect, induced by a variable field of liquid pressures, where bubbles or other voids (caverns) - containing steams of a given liquid, gas, or a steam-gas mixture - are formed, expanded, and disappear. A better understanding of all aspects related to cavitation wear will allow for more thoughtful analysis in the selection of innovative engineering materials additionally protected by various technologies or techniques in the field of surface engineering, and optimization of the design of constructional elements used in the cavitation environment. The novelty of this book is the presentation of extensive knowledge related to cavitation, erosion, and how to protect engineering materials against this phenomenon supported by the results of thorough research by the authors

Magnesium Alloys - Selected Issue

Classical magnesium alloys are a combination of aluminium, magnesium, manganese and zinc. Magnesium combined with lithium forms ultralight alloys that have many uses. Since it is a reasonable material, it offers great possibilities and is constantly tested at various angles of applications and properties. Magnesium, previously used for military purposes, seems to fit perfectly to the requirements of the currently prevailing technology. Low density with appropriate mechanical properties (strength, high operating temperature), good foundry properties (high castability and low shrinkage), vibration damping ability and cost-effectiveness of recycling seem to be an ideal response to market needs. All things considered, magnesium alloys are the perfect material used in various industries starting from the automotive industry, through sport, electronics up to the space industry and defence. This book is written by experts in various areas of magnesium science and technology. It gives a general idea of modern advancements in theory and practical purposes of magnesium alloys. The book reports fundamental aspects of corrosion types and details about magnesium alloys designed to work in elevated temperatures and superplastic behaviour. Fundamentals, broad experience, theory as well as complex technological aspects make this work helpful for engineers and scientists from all over the world

Structure and properties of AlMg alloy after combination of ECAP and post-ECAP ageing

Equal channel angular pressing technique (ECAP) was used before and after solution heat treatment to obtain grain refinement and strengthening of commercial Al–Mg casting alloys. The experiments were performed to investigate the strengthening effect of the alloy after various post-ECAP ageing treatments. The alloys were severely deformed at room temperature following route Bc and die channel angle of 120°. It was found that heat treatment before and after ECAP significantly affect and improves mechanical properties of aluminium alloys. It was also proven that the severe plastic deformation causes grain refinement which directly influence on properties of AlMg alloys. An increase of strength and ductility was achieved by appropriate selection of post-ECAP ageing. It is also proven that the good strengthening effect is also achieved at temperatures lower than those usually used for ageing. Based on the findings above, the tensile properties and hardness of Al–Mg alloys are discussed.Web of Science16333432

Sexual Dysfunction and Quality of Life in Patients with Rheumatoid Arthritis

Background: Sexual health is a major component of human well-being. As repeatedly shown in research, satisfaction with sex life and sexual fulfillment correlate positively with quality of life (QoL) in most of its aspects. It is thus true that a reduced quality of one’s sex life and lack of sexual fulfillment can contribute to poorer QoL overall. The aim of this study is to describe an assessment of sexual dysfunction and factors affecting sexual dysfunctions of patients with rheumatoid arthritis (RA). Material and methods: 171 consecutive RA patients (mean age 48.3 ± 14.6) attending the rheumatology outpatient clinic. Standardized questionnaires used in the study were the sexological questionnaire, WHOQOL-BREF to assess QoL level, Disease Acceptance Scale, and VAS scale to assess pain intensity. Results: The mean duration of the disease in the study group was 13 ± 9 years, mean score of subjective assessment of mobility was 6.2 ± 1.6, and the mean score of the DAS-28 was 4.0 ± 1.9. The study group presented a mean level of disease acceptance (AIS 29.6 ± 11.6). The comparative analysis showed significant differences in reaching orgasm and declared sexual dysfunctions. These problems occurred more often in women than in men (34.2% vs. 18% and 43% vs. 40%, respectively). In univariate analysis, factors correlating positively with the frequency of declaring sexual dysfunction were subjective motor score less < 6 points, AIS < 36 points, WHOQOL-BREF < 59 points, disease activity ≥3.5 points, and VAS > 3. In multivariate logistic regression analysis, independent factors positively correlating with frequency of sexual dysfunction declaration were general QoL (β = 1.255; p = 0.035) and pain limiting social life (β = 1.564; p = 0.030). The absence of comorbidities correlated negatively and reduced the prevalence of sexual dysfunction (β = −1.030; p = 0.043). Patients with reduced QoL and patients with pain limiting social life had 3.5 and 4.8 times higher risk of sexual dysfunction than other patients, respectively. In contrast, those without comorbidities were 2.8 times more likely to be free of sexual dysfunction than those diagnosed with other chronic diseases besides RA. Conclusions: Sexual dysfunction is an emerging problem in both men and women with RA. The absence of comorbidities is an independent determinant of sexual dysfunction, whereas poor QoL and pain limiting social life are independent determinants that exacerbate sexual dysfunction in both genders

The Relationship between Fatty Acids and the Development, Course and Treatment of Rheumatoid Arthritis

For this systematic review, a search of the relevant literature was conducted in the EMBASE and PubMed databases. We used the following terms: ‘rheumatoid arthritis’ in conjunction with ‘fatty acid’. The following inclusion criteria had to be satisfied for the studies to be included in the analysis: an RCT/observational/cohort study published in English. A total of seventy-one studies were analysed. The presented systematic review of the available data indicates that increased consumption of omega-3 fatty acids (FAs) may have a beneficial effect on human health by decreasing pain and disease activity in patients with RA. The beneficial effect of unsaturated FA on the clinical parameters of RA was demonstrated in all 71 studies analysed. The content of omega-3 FAs in the diet and the consumption of fish, which are their main source, may contribute to a reduced incidence of RA. FAs are an essential component in the synthesis of eicosanoids that exhibit anti-inflammatory properties. Due to the documented positive influence of unsaturated FAs on treatment outcomes, the use of a diet rich in long-chain unsaturated FAs should be the standard of care, along with pharmacotherapy, in the treatment of RA patients. An important element in the control of the treatment process should be the routine assessment of the quality of life of RA patients