Niewydolność serca — niekorzystne rokowanie u pacjenta ze współistnieniem wielu chorób

Due to its incidence (approx. 750,000 patients in Poland) and simultaneous short survival time (only approx. 50% of patients survive 4 years after the diagnosis), heart failure (HF) poses a serious problem in contemporary cardiology. The clinical case presented below concerns a HF patient with multiple comorbidities which make prognosis significantly more difficult. Clinical assessment is of key importance with regard to the determination of treatment and the decision to implement palliative care. Despite the administration of optimal pharmacological treatment of HF, the condition of the patient in question deteriorated significantly within two months — to such extent that treatment characteristic of the end-of-life period had to be implemented. Such procedure is supported by the current scientific reports suggesting the implementation of palliative treatment already at earlier stages of HF advancement, particularly in patients with severe comorbidities.Niewydolność serca (HF) jest poważnym problemem współczesnej kardiologii ze względu na częstość występowania (w Polsce ok. 750 tys.) przy jednoczesnym krótkim czasie przeżycia (tylko ok. 50% pacjentów przeżywa 4 lata od rozpoznania). Przedstawiony przypadek kliniczny dotyczy pacjenta z HF obciążonego wieloma chorobami współistniejącymi, które znacząco utrudniają określenie rokowania. Ocena kliniczna jest kluczowa w ustaleniu właściwego postępowania i podjęciu ewentualnej decyzji o wdrożeniu leczenia paliatywnego. W opisywanym przypadku mimo optymalnej farmakoterapii HF stan pacjenta w ciągu 2 miesięcy znacząco się pogorszył — do tego stopnia, że trzeba było wdrożyć leczenie charakterystyczne dla schyłkowego okresu życia. Takie postępowanie znajduje potwierdzenie w aktualnych doniesieniach naukowych sugerujących stosowanie leczenia paliatywnego już na wcześniejszych etapach zaawansowania HF, a w szczególności gdy współistnieją ciężkie choroby towarzyszące

Niewydolność serca — niekorzystne rokowanie u pacjenta ze współistnieniem wielu chorób

Niewydolność serca (HF) jest poważnym problemem współczesnej kardiologii ze względu na częstość występowania (w Polsce ok. 750 tys.) przy jednoczesnym krótkim czasie przeżycia (tylko ok. 50% pacjentów przeżywa 4 lata od rozpoznania). Przedstawiony przypadek kliniczny dotyczy pacjenta z HF obciążonego wieloma chorobami współistniejącymi, które znacząco utrudniają określenie rokowania. Ocena kliniczna jest kluczowa w ustaleniu właściwego postępowania i podjęciu ewentualnej decyzji o wdrożeniu leczenia paliatywnego. W opisywanym przypadku mimo optymalnej farmakoterapii HF stan pacjenta w ciągu 2 miesięcy znacząco się pogorszył — do tego stopnia, że trzeba było wdrożyć leczenie charakterystyczne dla schyłkowego okresu życia. Takie postępowanie znajduje potwierdzenie w aktualnych doniesieniach naukowych sugerujących stosowanie leczenia paliatywnego już na wcześniejszych etapach zaawansowania HF, a w szczególności gdy współistnieją ciężkie choroby towarzyszące

Powikłania przezskórnej interwencji wieńcowej u 70-letniego pacjenta z wielonaczyniową chorobą wieńcową i rakiem prostaty

A 70-year-old man with chronic coronary artery disease (CAD), disseminated atherosclerosis, heart failure with mildly reduced ejection fraction, hypertension, diabetes mellitus type 2 and prostate cancer was admitted to the Department of Cardiology because of low effort tolerance for further cardiological assessment before chemotherapy of prostate cancer. Due to the progression of CAD in coronarography, he was consulted at the Heart Team meeting and classified for two-step percutaneous coronary intervention (PCI). After PCI of the left anterior descending artery, he had a myocardial infarction with the ejection fraction decreased from 43% to 28%.70-letni mężczyzna z przewlekłą chorobą wieńcową, rozsianą miażdżycą, niewydolnością serca z umiarkowanie obniżoną frakcją wyrzutową, nadciśnieniem tętniczym, cukrzycą typu 2 i rakiem prostaty został przyjęty do Kliniki Kardiologii z powodu niskiej tolerancji wysiłku celem dalszej oceny kardiologicznej przed chemioterapią raka prostaty. Po wykonaniu koronarografii, która ujawniła progresję choroby wieńcowej, pacjent został skonsultowany na spotkaniu "Heart Team" i zakwalifikowany do dwuetapowej przezskórnej interwencji wieńcowej (PCI). Po PCI gałęzi przedniej zstępującej lewej tętnicy wieńcowej wystąpił zawał mięśnia sercowego oraz obniżenie frakcji wyrzutowej lewej komory z 43% do 28%

The consumption of nuts is associated with better dietary and lifestyle patterns in polish adults : results of WOBASZ and WOBASZ II surveys

In recent years, the concept of the health benefits of synergistic dietary patterns as opposed to individual foods or food constituents has been developed. The aim of this study was to determine whether nut consumption is associated with healthier nutrition and lifestyle. The research was based on complete data obtained during two Polish National Multi-Centre Health Examination Surveys—WOBASZ (2003–2005) and WOBASZ II (2013–2014). Of the 12,946 participants who completed dietary assessments, 299 subjects reported consuming any quantity of whole nuts. A control group of 1184 non-nut consumers from both surveys was randomly selected for the study, with age, gender, study (WOBASZ, WOBASZ II), educational level, and season-related interactions taken into account. In this study, nut consumption was associated with favorable food and lifestyle choices, excluding smoking. Better dietary quality consisted of having a higher Healthy Diet Indicator score, an increased intake of polyphenols and antioxidants, lower intake of red meat, but higher of poultry and fruit, more frequent consumption of antiatherogenic food products, and less frequent consumption of processed meats. There was also greater interest in special diets, such as weight-loss diet. In addition, nut eaters were more physically active in their leisure time. While limited by 24-h recall of nut intake and possible misclassification of nut/non-nut consumer status, this research supports the synergistic health-promoting attitudes of those who were classified as nut consumers

The effects of diversified phosphorus nutrition on the growth of oat (Avena sativa L.) and acid phosphatase activity

We studied the effect of differential phosphorus (P) supply on the development of oat seedlings (Avena sativa L. ‘Arab’) as well as localization and activity of acid phosphatases in tissues and root exudates. Plants were grown for 1–3 weeks on nutrient media with inorganic phosphate (+P, control), reduced Pi (0.1 P), phytic acid (PA) as organic P source, and without P addition (−P), in standard conditions or in a split-root culture system. Phosphate starvation reduced shoot growth but increased root elongation and root/shoot ratio, whereas 0.1 P and PA oat plants had similar growth parameters to +P plants. The growth on −P medium significantly decreased Pi content in all tissues, but only a slight Pi decrease was observed in plants grown on 0.1 P and PA media or various split-root system conditions. Pi starvation led to an increase in acid phosphatase (APase) activity in root exudates when compared to +P, 0.1 P, and PA plant samples. APase activity was especially intensive in root cross sections in rhizodermis and around/in vascular tissues of −P plants. For plants grown on 0.1 P medium and on phytic acid, APase activity did not change when compared to the control. Three major isoforms of APases were detected in plant tissues (similar in all studied conditions, with a higher activity of one isoform under Pi deficit). Generally, lowered Pi content (0.1 P) was not stressful to oat plants for up to 3 weeks of culture. Oat plants grew equally well on nutrient media with Pi and on media with phytate, although phytate was considered not available for other plants. The oat plants activated mainly extracellular APases, but also intracellular enzymes, rather via nonlocal signals, to acquire Pi from external/internal sources under Pi deficiency

Diet quality in the population of Norway and Poland: differences in the availability and consumption of food considering national nutrition guidelines and food market

Adequate nutrition is a public health challenge due to the increase in the incidence of diet-related diseases. The aim of this study was to examine food and nutrient intakes in the light of the current dietary guidelines of Poland and Norway. This is a suitable model for studying the diet quality in countries with different degrees of government intervention in the food market, which may affect food diversity available for citizens.publishedVersio

Dietary Polyphenol Intake, but Not the Dietary Total Antioxidant Capacity, Is Inversely Related to Cardiovascular Disease in Postmenopausal Polish Women: Results of WOBASZ and WOBASZ II Studies

The aim of the study was to assess the relationship between the dietary polyphenol intake (DPI) and the dietary total antioxidant capacity (DTAC) and the prevalence of cardiovascular disease (CVD) in postmenopausal women. Participants were 916 postmenopausal women diagnosed with CVD and 1683 postmenopausal women without history of CVD, who took part in the population-based studies carried out in Poland: WOBASZ (2003–2005) and WOBASZ II (2013-2014). Nutritional data were collected using a single 24-hour dietary recall. DPI and DTAC in the CVD women were significantly lower and accounted for 1766.39 mg/d and 10.84 mmol/d, respectively, versus 1920.57 mg/d and 11.85 mmol/d in the women without CVD, but these differences disappeared after the standardization for energy input. Also, in the multiple-adjustment model, higher DPI, but not DTAC, was associated with the reduced odds ratio for the prevalence of CVD. Beverages, mainly coffee and tea, contributed in more than 40% to DPI and in more than a half to DTAC. In this study, higher dietary polyphenol intake, but not the dietary total antioxidant capacity, was inversely associated with CVD in postmenopausal women, which points to the health benefits of increased polyphenol intake from food sources for these women

Unveiling the anti-inflammatory potential of olive leaf phenolic extracts in diabetes-related endothelial dysfunction

IntroductionDiabetes mellitus is a severe metabolic disorder strongly linked to vascular complications driven by endothelial dysfunction, chronic inflammation, and oxidative stress. Novel strategies to mitigate endothelial activation are urgently needed. In this context, phenolic compounds derived from olive leaves, a byproduct of olive oil production, have shown promising potential in counteracting diabetes- associated endothelial inflammation. This study investigates the potential anti-inflammatory effect of polyphenol-rich extracts derived from two olive leaves Spanish monocultivars, Picual and Changlot Real, in human umbilical vein endothelial cells from healthy pregnancies (C-HUVEC) and gestational diabetes (GD-HUVEC), which serve as a relevant in vitro model of hyperglycemia-induced endothelial dysfunction.MethodsOlive leaf extracts were characterized by HPLC-ESI-TOF-MS. C-HUVEC and GD-HUVEC were treated with the extracts, and pro-inflammatory markers expression (NF-kB p65, MCP-1, and VCAM-1), NF-kB p65 phosphorylation, and monocyte adhesion were assessed under basal and TNFα-stimulated conditions using RT-PCR, flow cytometry, and adhesion assays.ResultsBoth Picual and Changlot Real extracts showed no cytotoxicity at concentrations up to 50 mg/mL. Treatment with 10 mg/mL of both extracts significantly reduced NF-kB p65 and MCP-1 gene expression, as well as NF-kB p65 phosphorylation, particularly in GD-HUVEC. VCAM-1 protein expression and TNFα-induced monocyte adhesion were also significantly decreased following extract treatment. Notably, Changlot Real exhibited a broader anti-inflammatory effect across both cell types, while Picual exerted a more selective effect in GD-HUVEC.DiscussionThese findings support the anti-inflammatory activity of olive leaf polyphenols and highlight the potential of Changlot Real and Picual extracts in mitigating endothelial dysfunction associated with diabetes. By modulating the NF-kB–VCAM-1 axis, these compounds may attenuate endothelial activation, warranting further investigation into their possible role in the prevention or mitigation of diabetes-related vascular complications