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Abstract Aging is a biological event that influences many organs and systems. Both sarcopenia and frailty syndrome refer to geriatric conditions with overlapping phenotypes. Many mechanisms are involved in the aging process such as DNA methylation telomeres which are susceptible to oxidative stress, and inflammations which result in telomere shortening, leading to chromosomal instability. The study aimed to determine the associations between these processes, frailty and sarcopenia syndrome. Global DNA methylation was analyzed using the ELISA method. Telomere length was analyzed using qPCR. Total oxidative status (TOS) was analyzed using a colorimetric method. The present study revealed that the main factor affecting methylation, telomeres length and level of total oxidant stress was age.

Introduction Ankylosing spondylitis (AS) is a chronic inflammatory, progressive disease, which leads to deterioration of chest and spine mobility and decrease of physical capacity with abnormal chest movement patterns. We aimed to assess the usefulness of the 4DBODY technology for evaluation of the effectiveness of AS treatment. Material and methods The 4DBODY technology was assessed on single AS patient with axial involvement. The patient was examined twice, before and after 14 days of rehabilitation. Physiotherapeutic and plethysmographic examinations were used, as well as angular measurement of spine curvatures and measurement of chest mobility. Chest activity measured using the 4DBODY system and the quality of movement were visualized. Results There was observed an increase of chest mobility from 18 mm to 27.9 mm (up 55%) in the 4DBODY system measurement. The quality of the chest movement also improved, the required phases of inspiration were synchronized. The angular position of the spine has also changed. The chest expansion improved from 25 mm to 50 mm measured on the level of the fourth intercostal space and from 30 mm to 50 mm at the Th10 level. Inspiratory and expiratory muscle strength increased respectively from 80% to 93% and from 46% to 86% of the predicted values. Total airway resistance (Rtot) – increase from 59% to 67%, whereas functional residual capacity (FRC) and total lung capacity (TLC) did not change significantly. Conclusions The new 4DBODY technology was found to be an effective method of examination and assessment of the effectiveness of rehabilitation of patients with AS.

Introduction The authors of the study assessed the emotional and cognitive state of geriatric patients during the COVID-19 pandemic and tried to answer the question: were there any differences in this state in geriatric patients at different stages of the pandemic? Material and methods The study included 518 patients of 60 years old and above of the Department of Geriatrics in Warsaw. To collect data, the following tools of psychological measurement were applied: the Mini-Mental State Examination scale and Geriatric Depression Scale. In order to test the differences in the means between the groups, a Chi-square test (with Yates’s correction for continuity when the class size did not exceed 8 items) was used. For the comparison of the three groups, the Kruskal-Wallis (ANOVA) test was performed. Results It was found that the majority of geriatric patients (73% of respondents) do not show symptoms of depressed mood. But there are statistically significant differences in the results of the patients’ cognitive state tests depending on the time of examination. Patients examined before the pandemic tended to demonstrate a better cognitive state than patients at the beginning of the pandemic and in its later stages. Nevertheless, there are no significant differences in the cognitive functioning of patients examined at the beginning and later in the pandemic. Conclusions The number of geriatric patients with symptoms of depression significantly increased when visits of relatives prohibition were introduced. However, the number of patients with depression returned to its previous level later in the pandemic. This phenomenon may indicate psychological adaptation to the situation. The presented results of observation suggest that the introduction of limitations is less important than the particular perception of one’s situation and adaptation to that.

Abstract Pleural effusion (PE) is excess fluid in the pleural cavity that stems from lung cancer, other diseases like extra-pulmonary tuberculosis (TB) and pneumonia, or from a variety of benign conditions. Diagnosing its cause is often a clinical challenge and we have applied targeted proteomic methods with the aim of aiding the determination of PE etiology. We developed a mass spectrometry (MS)-based multiple reaction monitoring (MRM)-protein-panel assay to precisely quantitate 53 established cancer-markers, TB-markers, and infection/inflammation-markers currently assessed individually in the clinic, as well as potential biomarkers suggested in the literature for PE classification. Since MS-based proteomic assays are on the cusp of entering clinical use, we assessed the merits of such an approach and this marker panel based on a single-center 209 patient cohort with established etiology. We observed groups of infection/inflammation markers (ADA2, WARS, CXCL10, S100A9, VIM, APCS, LGALS1, CRP, MMP9, and LDHA) that specifically discriminate TB-PEs and other-infectious-PEs, and a number of cancer markers (CDH1, MUC1/CA-15-3, THBS4, MSLN, HPX, SVEP1, SPINT1, CK-18, and CK-8) that discriminate cancerous-PEs. Some previously suggested potential biomarkers did not show any significant difference. Using a Decision Tree/Multiclass classification method, we show a very good discrimination ability for classifying PEs into one of four types: cancerous-PEs (AUC: 0.863), tuberculous-PEs (AUC of 0.859), other-infectious-PEs (AUC of 0.863), and benign-PEs (AUC: 0.842). This type of approach and the indicated markers have the potential to assist in clinical diagnosis in the future, and help with the difficult decision on therapy guidance.

Abstract Background Frailty is increasingly reported among older adults with cardiovascular diseases and it has been demonstrated to increase negative health outcomes and mortality. To date, no systematic review of the evidence is available regarding the association between frailty and ischemic heart disease (IHD). We performed a systematic review of literature and a meta-analysis to assess the association between frailty and IHD. Methods We selected all the studies that provided information on the association between frailty and IHD, regardless of the study setting, study design, or definition of IHD and frailty. PubMed, Web of Science and Embase were searched for relevant papers. Studies that adopted the Fried definition for frailty were included in the meta-analyses. For each measure of interest (proportions and estimates of associations), a meta-analysis was performed if at least three studies used the same definition of frailty. Pooled estimates were obtained through random effect models and Mantel-Haenszel weighting. Results Thirty-seven studies were included. Of these, 22 adopted the Fried criteria to define frailty and provided estimates of prevalence and therefore they were included in meta-analyses. The pooled prevalence of IHD in frail individuals was 17% (95% Confidence Interval [95%CI] 11–23%) and the pooled prevalence of frailty in individuals with IHD was 19% (95% CI 15–24%). The prevalence of frailty among IHD patients ranged from 4 to 61%. Insufficient data were found to assess longitudinal association between frailty and IHD. Conclusions Frailty is quite common in older persons with IHD. The identification of frailty among older adults with IHD should be considered relevant to provide individualized strategies of cardiovascular prevention and care. Further research should specifically explore the association between frailty and IHD and investigate the potential common biological ground.

Artery stiffness is a risk factor for cardiovascular disease (CVD). The measurement of pulse wave velocity (PWV) between the carotid artery and the femoral artery (cfPWV) is considered the gold standard in the assessment of arterial stiffness. A relationship between cfPWV and regional PWV has not been established. The aim of this study was to evaluate the influence of gender on arterial stiffness measured centrally and regionally in the geriatric population. The central PWV was assessed by a SphygmoCor XCEL, and the regional PWV was assessed by a new device through the photoplethysmographic measurement of multi-site arterial pulse wave velocity (MPPT). The study group included 118 patients (35 males and 83 females; mean age 77.2 ± 8.1 years). Men were characterized by statistically significantly higher values of cfPWV than women (cfPWV 10.52 m/s vs. 9.36 m/s; p = 0.001). In the measurement of regional PWV values using MPPT, no such relationship was found. Gender groups did not statistically differ in the distribution of atherosclerosis risk factors. cfPWV appears to be more accurate than regional PWV in assessing arterial stiffness in the geriatric population.

Rheumatoid arthritis (RA) is one of the most common rheumatic diseases, associated with cooccurrence of serious side effects. This study discusses the problems associated with chronic RA, well-known as osteoporosis, but also recently recognized as sarcopenia. Relationships between sarcopenia and rheumatic diseases are not yet fully understood. Co-occurrence of osteoporosis and sarcopenia, referred to as osteosarcopenia, is becoming increasingly important. The overlap of the effects of RA and osteosarcopenia and the adverse effects of glucocorticosteroids leads to progressive impairment of the musculoskeletal system, increasing the risk of falls, fractures, institutionalization and death, and it is a source of dramatic socioeconomic burden on society. Very limited options for effective treatment of developed osteosarcopenia, as well as the severity of complications caused by it, advocates for the need of broad education and raising public awareness, especially among health care workers, in order to implement the prevention of osteosarcopenia as early as possible.

The paper aims to investigate the usefulness of training in improving mobility and reducing the risk of falls of patients with osteoarthritis by using a force plate and virtual reality as rehabilitation tools. The study involved 72 women randomly divided into two equal groups: the force plate training group, which underwent virtual balance training with visual motor feedback, and the gym training group, which received conventional balance training only. The functional balance assessment was performed before and after the rehabilitation by computerized posturography in a relaxed upright position with open and closed eyes, with visual motor feedback. In the FPT group in the feedback measurement, the mean radius of sways was 30% smaller after rehabilitation (p < 0.00002); the feedback coordination coefficient was more than 10% bigger after rehabilitation (p < 0.001) and reached 92%, which is excellent for elderly people. Total stagnation and stumbling reported by patients decreased after rehabilitation compared to the first examination. Both tested forms of training can contribute to reducing the risk of falls. However, a more significant improvement was obtained in the force plate training group perhaps because the physical effort on a force plate trains the precise movements needed to reposition the centre of gravity without generating excessive inertia forces responsible for loss of balance and falls. Perhaps the most desirable method of intervention is to train a person’s ability to perform slow but definite body movements.

Chronic leg ulceration is a frequent condition in elderly patients. Chronic wounds that are nonresponsive to 3-month therapy affect approximately 6.5 million people in the United States with a prevalence of 1% and costs estimated at 25 billion dollars per year. Although the main causes are venous insufficiency, lower extremity arterial disease and diabetes, in many cases the etiology is multi-factorial. Approximately 20–23% of non-healing wounds that are refractory to vascular intervention have other etiologies including vasculitis, rheumatoid arthritis and Sjögren syndrome. Adverse drug interactions are the least commonly considered, especially those which involve disease-modifying anti-rheumatic drugs. The authors present a report on a female patient with reported Sjögren syndrome, multiple morbidities and non-healing lower limb ulceration that developed during treatment with methotrexate, and no significant improvement after discontinuation of the drug and after vascular surgery. Microvascular deterioration caused by beta-blockers was considered decisive. Calcium-blocker replacement brought complete healing in the follow-up.

In October 2016 a new independent disease called sarcopaenia (according to ICD-10 classification) appeared. According to the recommendation of the European Working Group on Sarcopenia in Older People (EWGSOP), sarcopaenia is defined as abnormally low muscle mass plus low skeletal muscle strength or low physical performance. Sarcopaenia, as a primary disease, is mainly observed in older people, but it can also appear in younger adults in the course of many clinical chronic conditions. One of the most frequent chronic diseases associated with chronic inflammation and functional limitation of skeletal system is rheumatoid arthritis. In the present article, current knowledge on the epidemiology of sarcopaenia and its association with rheumatoid arthritis is presented.

Acoustocerebrography is a novel, non-invasive, transcranial ultrasonic diagnostic method based on the transmission of multispectral ultrasound signals propagating through the brain tissue. Dedicated signal processing enables the estimation of absorption coefficient, frequency-dependent attenuation, speed of sound and tissue elasticity. Hypertension and atrial fibrillation are well known factors correlated with white matter lesions, intracerebral hemorrhage and cryptogenic stroke numbers. The aim of this study was to compare the acoustocerebrography signal in the brains of asymptomatic atrial fibrillation patients with and without hypertension. The study included 97 asymptomatic patients (40 female and 57 male, age 66.26 ± 6.54 years) who were clinically monitored for atrial fibrillation. The patients were divided into two groups: group I (patients with hypertension) n = 75, and group II (patients without hypertension) n = 22. Phase and amplitude of all spectral components for the received signals from the brain path were extracted and compared to the phase and amplitude of the transmitted pulse. Next, the time of flight and the attenuation of each frequency component were calculated. Additionally, a fast Fourier transformation was performed and its features were extracted. After introducing a machine learning technique, the ROC plot of differentiations between group I and group II with an AUC of 0.958 (sensitivity 0.99 and specificity 0.968) was obtained. It can be assumed that the significant difference in the acoustocerebrography signals in patients with hypertension is due to changes in the brain tissue, and it allows for the differentiating of high-risk patients with asymptomatic atrial fibrillation and hypertension.

Introduction. Eosinophils play an important role in development ofallergic diseases. Recent studies indicate their many relevant functionsin the development of allergic inflammation related to both an effectorand immunomodulatory role. The recognition of factors responsible foreosinophil recruitment to tissues may be significant for understandingallergic diseases’ regulatory processes, including mechanisms leadingto skin changes in atopic dermatitis (AD). The most prominent chemotacticfactors influencing eosinophil accumulation are those actingselectively via the CCR3 eotaxin receptor. Many reports indicate a relevantrole of these chemokines in pathogenesis of allergic diseases.Objective. To measure the level of serum concentrations of eotaxin1/CCL11, eotaxin 2/CCL24 and eotaxin 3/CCL26 in AD patients andhealthy subjects in relation to disease intensity assessed by the SCORADscale.Material and methods. Hundred and one AD patients and 21 healthysubjects as the control group were investigated. The concentrations ofeotaxin 1/CCL11, eotaxin 2/CCL24 and eotaxin 3/CCL26 were measuredusing enzyme-linked immunosorbent assay (ELISA) with R&DSystems kits (USA).Results. It was found that in the group of AD patients the average serumconcentration of 1/CCL11 eotaxin was 123.86 pg/ml. The average serumconcentration of 2/CCL24 eotaxin was 1064.52 pg/ml and of 3/CCL26eotaxin 16.93 pg/ml. In healthy volunteers (control group), the meanserum concentration of 1/CCL11 eotaxin was 195.64 pg/ml, the meanserum concentration of 2/CCL24 eotaxin was 965.58 pg/ml, and of3/CCL26 eotaxin 0.79 pg/ml. Comparative analysis of serum eotaxin levelsbetween the group of AD patients and the healthy controls showedthat the mean serum concentration of 1/CCL11 eotaxin in patients withatopic dermatitis is significantly lower (p = 0.002), and of 3/CCL26 eotaxinhigher (p = 0.0000001) than in healthy controls. In the group of ADpatients the average severity of illness rated with the SCORAD scale was53.17. Regression analysis between the exacerbation of disease rated withthe SCORAD scale and serum levels of 1/CCL11 eotaxin, 2/CCL24 eotaxinand 3/CCL26 eotaxin showed a statistically significant correlation forall measured parameters (respectively p = 0.001, p = 0.01, p = 0.00001).Conclusions. The analysis of results showed that in the researchedgroup: 1. Mean eotaxin 3/CCL26 and eotaxin 2/CCL24 serum concentrationis higher in AD patients as compared to healthy subjects and inthe case of eotaxin 3/CCL26 the difference is statistically significant.2. Mean eotaxin 1/CCL11 serum concentration is statistically lower inAD patients as compared to healthy subjects. 3. Eotaxin 1/CCL11,eotaxin 2/CCL24 and eotaxin 3/CCL26 serum concentrations correlatewith AD intensity assessed by SCORAD.

BACKGROUND: One of the most promising markers of allergic inflammation is eotaxin, which has a selective influence on the migration of eosinophils. Its serum content significantly correlates with the intensity of allergic symptoms, so it might be interesting to know whether vaccination has any influence on serum expression of this chemokine.

Questions and commentary on the article ‘Daily changes of peak expiratory flow and respiratory symptom occurrence around a soy processing factory’