Joanna Zając

The effects of cardiac rehabilitation on overall physical capacity and myocardial perfusion in women with microvascular angina

BACKGROUND Cardiac syndrome X (CSX) is linked with changes in microcirculation, without significant changes in main coronary vessels. According to European Society of Cardiology 2013 stable coronary artery disease (CAD) criteria, CSX was replaced by microvascular angina (MA). The main feature of MA should be regional myocardial ischaemia; however, there are several works on this subject which failed to demonstrate the presence of perfusion defects. AIM To determine the effect of non-pharmacological procedures (cardiac rehabilitation) in patients diagnosed with MA on changes in left ventricular perfusion as assessed by myocardial single photon emission computed tomography, along with potential related improvements in exercise capacity. METHODS Toward this goal we screened for the presence of CAD in a group of 528 women, of whom 55 were not only diagnosed with MA but also agreed to participate in our study, which involved myocardial perfusion imaging (MPI) studies, during which exercise tests and cardiac rehabilitation were performed. RESULTS Comparison of results obtained at the beginning of the study with data obtained after completion of a three month period of cardiac rehabilitation showed improvements in both exercise test parameters (length of test, metabolic equivalents, blood pressure control during extortion) and MPI parameters for the left ventricle (both at rest and stress, global and regional). CONCLUSIONS Cardiac rehabilitation is a very useful tool of choice in the treatment of patients with MA.

Prostate cancer in patients from rural and suburban areas – PSA value, Gleason score and presence of metastases in bone scan

INTRODUCTION Prostate cancer is the second most common neoplasm among men both worldwide and in Poland. In prostate cancer, bone metastasis is related to a poorer prognosis. A diagnosis of metastatic bone disease is important in prostate cancer patients prior to therapy. Prostate specific antigen (PSA) serum value is used both as a screening tool and for staging of prostate cancer. AIM To evaluate whether there is a link between symptoms presented by patients, pain in particular, and the presence, number and location of bone metastases as assessed by bone scan scintigraphy in concordance with PSA values and Gleason scores. MATERIAL A group of 186 patients (aged: 68.38±6.16) diagnosed with prostate cancer, from rural and suburban areas of Małopolska province, that was directed for bone scan scintigraphy to the Nuclear Medicine Dept, John Paul II Hospital in Kraków. METHODS Analysis of all laboratory findings (including PSA value) and a biopsy were performed. Then, bone scan scintigraphy was done with the use of methylene disphosphonate (MDP) labeled with Tc-99m. RESULTS In patients with a Gleason value≤7 and a PSA value≤20 ng/ml, the cutoff value for a negative bone scan with a confidence interval of 0.95 was established at a PSA value below 10 ng/ml (p<0.01). Correlations were established between PSA value and presence of metastases in bone scan (r=0.45, p=0.05), the number of metastases (r=0.66, p<0.01), and their presence in particular body regions. CONCLUSIONS The correlation between PSA value and both presence and number of metastases confirms the usefulness of bone scan scintigraphy in prostate cancer staging. The cutoff value for negative bone scan with a 95% confidence interval was established at PSA=10 ng/ml.

Overweight and obesity vs. simple carbohydrates consumption by elderly people suffering from diseases of the cardiovascular system

INTRODUCTION Overweight and obesity belong to the alarming and constantly increasing problems of the 21st century among all age groups. One of the major factors enhancing these problems are simple carbohydrates commonly found in popular sweet drinks. OBJECTIVE The aim of the study was to estimate the nutritional patterns of elderly people with diagnosed cardiovascular system diseases, and analysis of the relationship between consumption of simple carbohydrates and prevalence of overweight and obesity. MATERIAL AND METHODS From 233 individuals hospitalized in the Clinic of Cardiology and Hypertension in Krakow, Poland, a group of 128 elderly people was selected (66 women and 62 men). Actual food consumption for each individual was assessed using a 24-hour nutrition recall. BMI values was calculated for assessment of nutritional status. Statistical analysis was performed on two groups: one with BMI <25kg/m2 and other with BMI≥25kg/m2. RESULTS Overweight was stated among 33.8% of women and 50% of men, obesity among 27.7% of women and 17.7% of men. Results indicated that consumption of products rich in sucrose was associated with overweight and obesity. People with overweight and obesity statistically more often ate sweet products comparing to those with proper weight: 46.2 g vs 33.8g. The growing world-wide epidemic of overweight and obesity is one of the main priorities of preventive medicine remains changing eating patterns As observed in this study, one additional spoon of sugar consumed daily increases the risk of being overweight or obese by about 14%. CONCLUSIONS Overweight and obesity was found among 60% of the examined elderly people. Correlation was found between rise in risk of obesity or overweight by about 14% with each additional spoon of sugar (5g) eaten every day.

Relationship between dietary antioxidant index (DAI) and antioxidants level in plasma of Kraków inhabitants

BACKGROUND Some literature data indicate that antioxidant-rich food may significantly increase antioxidants in serum and decrease the oxidative stress but results are ambiguous. OBJECTIVES The aim of this study was to estimate the total antioxidant capacity of food intake among the inhabitants of Kraków, Poland on the basis of dietary antioxidant index (DAI) and evaluation the relation between DAI and the level of antioxidants in plasma. MATERIAL AND METHODS Examination included 70 (37 women and 33 men) non-smoking inhabitants of Krakow aged 46.4 ± 13.7 years. DAI was investigated on the basis of Food Frequency Questionnaire including 145 food items. DAI was measured using the method by Benzi and expressed as FRAP (mMol/L). In plasma samples total antioxidant status (TAS) expressed as FRAP and malondialdehyde (MDA) concentration as a marker of lipids peroxidation were measured. RESULTS The mean value of DAI of all examined persons was 46.74 ± 25.5 mMol/L (in female group: 54.13 ± 27.7 mMol/L; in male group: 37.83 ± 19.5 mMol/L; p < 0.05). The highest contribution in total DWA value had fruits (48.7%) opposite to vegetables (9.3%). Statistically significant positive correlations between DAI and FRAP in plasma was found in all: r = 0.42 and in female: r = 0.54 groups (not significant in men group: r = 0.20). Statistically significant negative correlation of DAI with MDA (malonylaldehyde) in female (-0.49) and male (-0.51) groups. CONCLUSIONS The obtained results confirmed the hypothesis that the intake of antioxidants in daily diet (measured as DAI) might increase antioxidants defense (measured by TAC as FRAP) and decrease oxidative stress (measured by MDA concentration in plasma). The dietary modification towards higher consumption of antioxidants (especially in men) should be highlighted in prevention of diseases in which oxidative stress play considerable role.

The Structure of Fats and Fatty Acid Consumption in Elderly People with Cardiovascular System Diseases

BACKGROUND Patients with cardiovascular system diseases having their origin in arteriosclerosis require special dietetic treatment. Among many nutritional components, fats in the diet (both their quantity and quality) play a very important role in primary and secondary prevention of these diseases. OBJECTIVES The aim of the study was the estimation of total fats participation (saturated fatty acids, mono- and polyunsaturated fatty acids and cholesterol) in the Daily Nutritional Ration (DNR) of elderly people with cardiovascular system diseases. MATERIAL AND METHODS The study included 128 persons (66 women and 62 men, mean age 73.2 ± 6.9) hospitalized in the 1st Clinic of Cardiology and Hypertension, UJCM in Kraków. Daily intakes of energy were estimated using the 24-h nutritional recall and Food Frequency Questionnaire. RESULTS A higher consumption of fats and fatty acids was observed in mens diet than in womens diet. The percentage of energy from saturated fatty acids (10.6% M and W) was higher than dietary recommendations. The consumption of monounsaturated fatty acids was in accordance with nutritional recommendations. The participation in the diet of polyunsaturated fatty acids was insufficient versus the newest nutritional recommendations and was determined as 4.6% of energy in DNR in men and 4.1% of energy of DNR in women. CONCLUSIONS The excessive amount of saturated fatty acids together with the insufficient amount of polyunsaturated fatty acids in the diet are the result of the excessive consumption of products which are a source of animal fat and insufficient consumption of plant fat, fish and seafood.