The costs of treating heart failure in Poland are high; proper allocation of resources to diagnostic procedures and treatment may contribute to rationalisation of the relevant expenditure.
Aim It is crucial to identify factors contributing to malnutrition risk in older persons in order to prevent malnutrition as far as possible. Findings Factors that increased the risk of malnutrition were: increased levels of IL-8, osteoprotegerin (OPG), and Soluble-Receptor-For-TNF-alfa (sTNFRII; log transformed). In comparison with previous studies, in our study there was no significant difference in hsCRP and IL-6 in participants at risk of malnutrition and those who were well-nourished, nevertheless, those at risk of malnutrition had significantly higher IL-8, OPG and sTNFRII concentrations, but higher levels of IL-18. Message The etiopathogenesis of malnutrition in older persons is complex and our study indicated that chronic inflammation plays a probable role and should be considered in evaluating nutritional status in the geriatric population; however, it also exposes an avenue where further research is needed in order to enhance our understanding and guide comprehensive patient care.
Background Limited evidence exists on sex differences in post‐COVID fatigue among non‐hospitalized patients. Therefore, aim of the study was to evaluate the course of chronic fatigue symptoms in non‐hospitalized subjects with the SARS‐CoV‐2 infection, according to sex. Methods Patients and staff from the University Hospital in Krakow anonymously and retrospectively completed neuropsychological questionnaire that included eight symptoms of chronic fatigue syndrome. The presence of these symptoms was assessed before COVID‐19 and 0–4, 4–12, and >12 weeks postinfection. The inclusion criteria were as follows: age 18 or more years, >12 weeks since the onset of the SARS‐CoV‐2 infection, and diagnosis confirmed by the RT‐PCR from anasopharyngeal swab. Results We included 303 patients (79.53% women, 47.52% medical personnel) assessed retrospectively after a median of 30 (interquartile range: 23–35) weeks since the onset of symptoms. A higher prevalence of at least one chronic fatigue symptom was found in females in all time intervals after the onset of COVID‐19 compared to males (p < .036). Women, compared to men, more often experienced persistent fatigue, not caused by effort and persisting after rest (for <4 weeks, odds ratio [OR] = 2.31, 95% confidence interval [CI]: 1.13–4.73; for 4–12 weeks, OR = 1.95, 95% CI: 1.06–3.61), non‐restorative sleep (for <4 weeks, OR = 2.17, 95% CI: 1.23–3.81; for >12 weeks, OR = 1.95, 95% CI: 1.03–3.71), and sore throat (for <4 weeks, OR = 1.97, 95% CI: 1.03–3.78; for 4–12 weeks, OR = 2.76, 95% CI: 1.05–7.27). Sex differences in headache, arthralgia, and prolonged postexercise fatigue were observed only during the first 4 weeks (OR = 2.59, 95% CI: 1.45–4.60, OR = 2.97, 95% CI: 1.02–8.64, and OR = 1.87, 95% CI: 1.01–3.51, respectively). There were no differences between women and men in myalgia and self‐reported lymph node enlargement. Conclusions The course of post‐COVID fatigue differs significantly between sexes in non‐hospitalized individuals with COVID‐19, with women more often suffering from persistent fatigue, not caused by effort and persisting after rest, non‐restorative sleep, and sore throat.
Background Sarcopenia is a potentially reversible condition, which requires proper screening and diagnosis. Aims To validate a Polish version of sarcopenia screening questionnaire (SARC-F), and assess its clinical performance. Methods Cross-sectional validation study in community-dwelling subjects ≥ 65 years of age. Diagnosis of sarcopenia was based on the 2018 2nd European Working Group on Sarcopenia in Older People (EWGSOP2) consensus. Hand grip and 4-m gait speed were measured, and the Polish version of SARC-F was administered. Results The mean (SD) age of 73 participants (21.9% men) was 77.8 (7.3) years. Seventeen participants (23.3%) fulfilled the EWGSOP2 criteria of sarcopenia, and 9 (12.3%) criteria for severe sarcopenia. Fourteen (19.2%) participants fulfilled the SARC-F criteria for clinical suspicion of sarcopenia. The Cronbach’s alpha coefficient for internal was 0.84. With EWGSOP2 sarcopenia as a gold standard, the sensitivity of SARC-F was 35.3% (95% CI 14.2–61.7, p = 0.33), specificity was 85.7% (95% CI 73.8–93.6, p < 0.0001). The corresponding positive and negative predictive values were 42.9% (p = 0.79) and 81.4% (p < 0.0001), respectively. The probability of false-positive result was 14.3% (95% CI 6.4–26.2, p < 0.0001) and the probability of false-negative result was 64.7% (95% CI 38.3–85.8, p = 0.33). Overall the predictive power of SARC-F was low (c-statistic 0.64). Discussion SARC-F is currently recommended for sarcopenia case finding in general population of older adults. However, its sensitivity is low, despite high specificity. Conclusions At present SARC-F is better suited to rule out sarcopenia then to case-finding. Further refinement of screening for sarcopenia with the use of SARC-F seems needed.
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