Gender and age-dependent differences in body composition changes in response to cardiac rehabilitation exercise training in patients after coronary artery bypass grafting

Cardiac rehabilitation (CR) is the standard procedure in persons after coronary artery bypass grafting (CABG). Its basic aim is to combat coronary heart disease (CHD) risk factors through physical activity and normalization of body mass. Many authors highlight the differences in response to training in CR as dependent on gender, age and occurrence of accompanying disease. The aim of this study is to assess the effectiveness of a three-week early CR in reference to changing body composition parameters in patients over 50 years of age. The study involved a random group of 65 patients (44 men and 21 women) between the ages of 50–76 (average: 62.6 ± 7.2) years with CHD following CABG. Anthropometric and body composition (bioelectrical impedance method) measurements were taken at the commencement of CR and after the training programme. After CR, body mass and body mass index were reduced in men < 65 and ≥ 65 years, and in women <65 years. A reduction % body fat and increase % fat free mass and % total body water was observed only in patients <65. years. Furthermore, in men < 65 years, an increase in % body cell mass was observed. In women ≥ 65 years, no statistically significant changes were observed in body fat indices and body composition features between initial and final study. Patients ≥ 65 years of age following surgery over a period of hospital cardiac rehabilitation do not experience the same significant improvement in body composition parameters associated with risk of CHD as middle-aged adults. Older women post-cardiac surgery are characterized by a higher disability index in relation to tolerance to physical stress in comparison with men of the same age and persons < 65 years of age

Nieprawidłowe odejście prawej tętnicy podobojczykowej od tętnicy płucnej

Opisano przypadek pacjenta z nieprawidłowym odejściem prawej tętnicy podobojczykowej od tętnicy płucnej rozpoznanym w wieku 10 lat. Jest to rzadka, ale znana nieprawidłowość łuku aorty powodująca zespół podkradania. (Folia Cardiol. 2004; 11: 771&#8211;774

Nieprawidłowe odejście prawej tętnicy podobojczykowej od tętnicy płucnej

Opisano przypadek pacjenta z nieprawidłowym odejściem prawej tętnicy podobojczykowej od tętnicy płucnej rozpoznanym w wieku 10 lat. Jest to rzadka, ale znana nieprawidłowość łuku aorty powodująca zespół podkradania. (Folia Cardiol. 2004; 11: 771&#8211;774

Gender and age-dependent differences in body composition changes in response to cardiac rehabilitation exercise training in patients after coronary artery bypass grafting

Cardiac rehabilitation (CR) is the standard procedure in persons after coronary artery bypass grafting (CABG). Its basic aim is to combat coronary heart disease (CHD) risk factors through physical activity and normalization of body mass. Many authors highlight the differences in response to training in CR as dependent on gender, age and occurrence of accompanying disease. The aim of this study is to assess the effectiveness of a three-week early CR in reference to changing body composition parameters in patients over 50 years of age. The study involved a random group of 65 patients (44 men and 21 women) between the ages of 50–76 (average: 62.6 ± 7.2) years with CHD following CABG. Anthropometric and body composition (bioelectrical impedance method) measurements were taken at the commencement of CR and after the training programme. After CR, body mass and body mass index were reduced in men < 65 and ≥ 65 years, and in women <65 years. A reduction % body fat and increase % fat free mass and % total body water was observed only in patients <65. years. Furthermore, in men < 65 years, an increase in % body cell mass was observed. In women ≥ 65 years, no statistically significant changes were observed in body fat indices and body composition features between initial and final study. Patients ≥ 65 years of age following surgery over a period of hospital cardiac rehabilitation do not experience the same significant improvement in body composition parameters associated with risk of CHD as middle-aged adults. Older women post-cardiac surgery are characterized by a higher disability index in relation to tolerance to physical stress in comparison with men of the same age and persons < 65 years of age

Change in movement patterns asymmetry in infants with central coordination disorder in continuous studies

Study aim: the aim of the study was to observe the dynamics of changes in postural symmetry in infants during the first year of life, undergoing a therapy using the NDT-Bobath method

Czynniki ryzyka występowania zmian miażdżycowych w tętnicach szyjnych u chorych zakwalifikowanych do pomostowania naczyń wieńcowych

Background: Carotid artery disease is thought to be a risk factor for neurological complications after cardiac surgery. Routine ultrasonographic screening is still not performed in every patient scheduled for coronary artery bypass grafting (CABG). Aim: To assess factors which may facilitate the selection for elective carotid artery ultrasound examination in patients undergoing CABG. Methods: 682 patients (mean age 63.2 &#177; 8.7, range: 37&#8211;85 years) scheduled for CABG underwent preoperative duplex ultrasound examination of the carotid arteries. The following factors were collected and analysed: age, sex, LVEF, history of cerebrovascular accidents (stroke and/or TIA), myocardial infarction, and presence of hypertension, diabetes, unstable angina, chronic obstructive pulmonary disease, chronic kidney disease, left main stenosis &#8805; 50%, lower-extremity peripheral arterial disease, and obesity (BMI > 30 kg/m2). Logistic regression analysis was used to determine the risk factors for carotid artery stenosis. Results: Internal or common carotid artery stenosis &#8805; 50% was detected in 123 (18%) patients. Bilateral stenosis occurred in 35 (5.1%) patients, of whom 29 (4.5%) presented at least a monolateral vessel diameter reduction of &#8805; 70%. History of cerebrovascular accidents, presence of lower-extremity peripheral arterial disease, and unstable angina were independent risk factors for at least monolateral vessel diameter reduction &#8805; 50%. Although older age was also an independent predictor (Exp(B) = 1.035, p < 0.05), the ROC curve analysis did not reveal an age threshold above which the probability of detecting carotid disease increases significantly with satisfying sensitivity and specificity. The predictors of bilateral stenosis (at least one of them &#8805; 70%) were a history of stroke, presence of left main disease, and lower-extremity peripheral arterial disease. Conclusions: Carotid disease is common in patients scheduled for CABG. Preoperative carotid artery ultrasound examination should be performed, regardless of age, in all patients with more advanced symptomatic atherosclerosis, such as a history of cerebrovascular accidents, presence of lower-extremity peripheral arterial disease, left main disease, or unstable angina. Kardiol Pol 2010; 68, 7: 789-794Wstęp: Istotne hemodynamicznie miażdżycowe zwężenia w tętnicach szyjnych są uznanym czynnikiem ryzyka powikłań neurologicznych po zabiegach kardiochirurgicznych. Badanie ultrasonograficzne tętnic dogłowowych nie zawsze jest rutynowo przeprowadzane u wszystkich chorych zakwalifikowanych do pomostowania naczyń wieńcowych. W szczególności dyskusyjne jest wykonywanie badania u chorych młodszych. Cel: Celem niniejszej pracy było określenie czynników ryzyka występowania zwężeń w tętnicach szyjnych mogących ułatwiać dobór chorych do badań ultrasonograficznych. Metody: Ultrasonograficznemu badaniu z opcją doplerowską tętnic szyjnych poddano 682 chorych (wiek: 63,2 &#177; 8,7, 37-85 lat) zakwalifikowanych do pomostowania naczyń wieńcowych. Stworzono bazę danych uwzględniającą następujące czynniki demograficzne i kliniczne: wiek, płeć, frakcję wyrzutową lewej komory, wywiad w kierunku przebytych incydentów naczyniowo-mózgowych (udar lub TIA), zawału serca, występowanie nadciśnienia tętniczego, cukrzycy, dławicy niestabilnej, przewlekłej obturacyjnej choroby płuc, przewlekłej choroby nerek, zwężenia pnia lewej tętnicy wieńcowej &#8805; 50%, miażdżycy zarostowej kończyn dolnych i otyłości. Wykorzystano analizę regresji logistycznej w celu określenia czynników ryzyka występowania zwężeń w tętnicach szyjnych. Wyniki: Zwężenie w tętnicy szyjnej wspólnej lub wewnętrznej &#8805; 50% stwierdzono u 128 (18%) chorych. Obustronną stenozę tętnic szyjnych wykryto u 35 (5,1%) pacjentów, przy czym u 29 (4,5%) z nich przynajmniej po jednej stronie redukcja światła naczynia była większa niż 70%. Przebyte incydenty naczyniowo-mózgowe, obecność miażdżycy zarostowej kończyn dolnych i dławicy niestabilnej stanowiły niezależne czynniki ryzyka wystąpienia istotnych zwężeń w tętnicach szyjnych w badanej populacji chorych. Mimo że podeszły wiek był również czynnikiem ryzyka (Exp(B) = 1,035; p < 0,05), to w analizie krzywej ROC nie udało się wyznaczyć wartości progowej, powyżej której to ryzyko znacząco by wzrastało. Predyktorami występowania obustronnych zwężeń w tętnicach szyjnych (w tym co najmniej jedno &#8805; 70%) były: przebyty udar, istotne zwężenia pnia lewej tętnicy wieńcowej i miażdżyca kończyn dolnych. Wnioski: Istotne hemodynamicznie zmiany miażdżycowe w tętnicach szyjnych występują u znacznego odsetka chorych kierowanych na zabieg pomostowania naczyń wieńcowych, dlatego też uzasadnione jest wykonywanie oceny ultrasonograficznej tętnic szyjnych u wszystkich chorych kwalifikowanych do chirurgicznej rewaskularyzacji wieńcowej, jeśli tylko istnieją takie możliwości. Natomiast badanie to powinno być przeprowadzone obligatoryjnie, niezależnie od wieku pacjenta, w grupie obciążonej czynnikami ryzyka, takimi jak: wywiad w kierunku incydentów naczyniowo-mózgowych, niestabilnej dławicy piersiowej, miażdżycy zarostowej tętnic kończyn dolnych lub istotnego zwężenia pnia lewej tętnicy wieńcowej. Kardiol Pol 2010; 68, 7: 789-79

Results of screening in Lublin Province, Poland, for colorectal cancer and neoplastic polyps - the role of environmental factors

Introduction Screening colonoscopy is a recommended tool, and the most sensitive and cost-effective method for reducing the incidence of colorectal cancer (CRC). Objective The purpose of the study was to present the results of a 5-year screening for early detection of CRC carried out among the population of the central-eastern regions of Poland, primarily in Lublin Province. Material and Methods Screening colonoscopy was conducted in a group of 1,009 patients – 636 women and 373 men, aged 40–65 years. Results Neoplastic polyps were found in 275 patients, advanced adenomas in 49 patients and adenocarcinoma in 13. 70.55% of neoplastic polyps was located in the distal colon, 18.9% in the proximal part and 10.55% in both regions, advanced adenomas in 79.59%, 8.16% and 12.25%, respectively. Adenocarcinoma was located in the proximal colon in 2 cases and in the distal region in 11 cases. Neoplastic polyps and advanced adenomas occurred significantly more frequently in smokers than in non-smokers. Neoplastic polyps were found statistically more frequent in males than in females, among the overweight and obese patients, than in subjects with normal BMI, and more frequently in the group of urban, compared to rural patients. However, the frequency of advanced adenomas and CRC was not statistically different in those groups. The incidence of CRC was statistically more frequent in males than in females. Smoking and male gender were significant risk factors for developing neoplastic polyps. Male gender seemed to predispose to CRC. Obesity was found to favour advanced adenomas. Conclusions The results of screening found neoplastic polyps in every third person (mean) who did not have any symptoms suggestive of colon pathology. Advanced adenomas were found in 5% of the examined and CRC was detected in 1.29% of participants. Smoking, male gender and overweight were significant risk factors for developing neoplastic polyps. No correlation was found between gender and the location of neoplastic polyps and advanced adenomas in the colon

Results of screening in Lublin Province, Poland, for colorectal cancer and neoplastic polyps - the role of environmental factors

Introduction Screening colonoscopy is a recommended tool, and the most sensitive and cost-effective method for reducing the incidence of colorectal cancer (CRC). Objective The purpose of the study was to present the results of a 5-year screening for early detection of CRC carried out among the population of the central-eastern regions of Poland, primarily in Lublin Province. Material and Methods Screening colonoscopy was conducted in a group of 1,009 patients – 636 women and 373 men, aged 40–65 years. Results Neoplastic polyps were found in 275 patients, advanced adenomas in 49 patients and adenocarcinoma in 13. 70.55% of neoplastic polyps was located in the distal colon, 18.9% in the proximal part and 10.55% in both regions, advanced adenomas in 79.59%, 8.16% and 12.25%, respectively. Adenocarcinoma was located in the proximal colon in 2 cases and in the distal region in 11 cases. Neoplastic polyps and advanced adenomas occurred significantly more frequently in smokers than in non-smokers. Neoplastic polyps were found statistically more frequent in males than in females, among the overweight and obese patients, than in subjects with normal BMI, and more frequently in the group of urban, compared to rural patients. However, the frequency of advanced adenomas and CRC was not statistically different in those groups. The incidence of CRC was statistically more frequent in males than in females. Smoking and male gender were significant risk factors for developing neoplastic polyps. Male gender seemed to predispose to CRC. Obesity was found to favour advanced adenomas. Conclusions The results of screening found neoplastic polyps in every third person (mean) who did not have any symptoms suggestive of colon pathology. Advanced adenomas were found in 5% of the examined and CRC was detected in 1.29% of participants. Smoking, male gender and overweight were significant risk factors for developing neoplastic polyps. No correlation was found between gender and the location of neoplastic polyps and advanced adenomas in the colon