Piotr Chmielewski

Height loss with advancing age in a hospitalized population of Polish men and women: magnitude, pattern and associations with mortality

Abstract The connection between the rate of height loss in older people and their general health status has been well documented in the medical literature. Our study was aimed at furthering the characterization of this interrelationship in the context of health indices and mortality in a hospitalized population of Polish adults. Data were collated from a literature review and from a longitudinal study of aging carried out in the Polish population which followed 142 physically healthy inmates, including 68 men and 74 women, for at least 25 years from the age of 45 onwards. Moreover, cross-sectional data were available from 225 inmates, including 113 men and 112 women. These subjects were confined at the same hospital. ANOVA, t-test, and regression analysis were employed. The results indicate that the onset of height loss emerges in the fourth and five decade of life and there is a gradual acceleration of reduction of height at later stages of ontogeny in both sexes. Postmenopausal women experience a more rapid loss of height compared with men. The individuals who had higher rate of loss of height (≥3 cm/decade) tend to be at greater risk of cardiovascular events and all-cause mortality. In conclusion, our findings suggest that a systematic assessment of the rate of loss of height can be useful for clinicians caring for elderly people because of its prognostic value in terms of morbidity and mortality.

The association between total leukocyte count and longevity: Evidence from longitudinal and cross-sectional data.

The aim of the study was to evaluate the relationship between age-dependent changes in total leukocyte count (TLC) and certain selected differential counts expressed as frequencies (granulocytes, band cells, eosinophils, lymphocytes, and monocytes) and longevity in physically healthy men and women aged 45+. Longitudinal data on cell counts from 142 subjects (68 men and 74 women; all aged 45-70 and examined for 25 years) were compared with cross-sectional data from 225 subjects (113 men and 112 women; this group was divided into four categories of average lifespan; i.e.: 53, 63, 68, and 76+ years of age). ANOVA, t-test, and regression analysis were employed. Secular changes in leukocyte count were controlled. Men had continuously higher TLC compared with women. Moreover, sex differences in patterns of changes with age were found. The longitudinal assessment revealed a U-shaped pattern of changes in TLC in men (y=0.0026x(2)-0.2866x+14.4374; R(2)=0.852) and women (y=0.0048x(2)-0.5386x+20.922; R(2)=0.938), whereas the cross-sectional comparison showed an inverted U-shaped pattern in men (y=-0.0021x(2)+0.2421x; R(2)=0.417) and women (y=-0.0017x(2)+0.2061x; R(2)=0.888). In general, the comparison of longitudinal and cross-sectional data on changes with age in TLC indicates that longevity favors individuals with lower yet normal TLC and this correlation is more pronounced in men. In conclusion, our findings are in line with previous longitudinal studies of aging and suggest that lower TLC within the normal range (4.0-10.0 × 10(3)μL(-1)) can be a useful predictor of longevity in physically healthy individuals.

Longitudinal and cross-sectional changes with age in selected anthropometric and physiological traits in hospitalized adults: an insight from the Polish Longitudinal Study of Aging (PLSA)

Abstract Longitudinal studies of aging concerning individuals with comparable lifestyle, diet, health profile, socioeconomic status, and income remain extraordinarily rare. The purposes of our ongoing project are as follows: (i) to collect extensive data on biological and medical aspects of aging in the Polish population, (ii) to determine factors affecting the rate and course of aging, (iii) to understand how aging unfolds as a dynamic and malleable process in ontogeny, and (iv) to find novel predictors of longevity. Our investigation followed 142 physically healthy asylum inmates, including 68 males and 74 females, for at least 25 years from the age of 45 years onward. Cross-sectional assessment involved 225 inmates, including 113 males and 112 females. All the patients lived for a very long time under similar and good environmental conditions at the hospital in Cibórz, Lubuskie Province. They maintained virtually the same daily schedule and lifestyle. The rate and direction of changes with age in selected anthropometric and physiological traits were determined using ANOVA, t-test, and regression analysis. There were sex differences in the rate and pattern of age-related changes in certain characteristics such as relative weight, red blood cell count, monocyte count, thymol turbidity value, systolic blood pressure, and body temperature. Body weight, the body mass index (BMI), and total bilirubin level increased with advancing age, while body height decreased with age in both sexes. In conclusion, the aging process was associated with many regressive alterations in biological traits in both sexes but the rate and pattern of these changes depended on biological factors such as age and sex. There were only few characteristics which did not change significantly during the period under study. On the basis of comparison between the pattern of longitudinal changes with aging and the pattern of cross-sectional changes with age in the analyzed traits, we were able to predict which pattern of changes is associated with longer lifespan.

The Terminologia Anatomica matters: examples from didactic, scientific, and clinical practice.

The proper usage of the anatomical terminology is of paramount importance to all medical professionals. Although a multitude of studies have been devoted to issues associated with the use and application of the recent version of the anatomical terminology in both theoretical medicine and clinical practice, there are still many unresolved problems such as confusing terms, inconsistencies, and errors, including grammar and spelling mistakes. The aim of this article is to describe the current situation of the anatomical terminology and its usage in practice, as well as explain why it is so important to use precise, appropriate, and valid anatomical terms during the everyday communication among physicians from all medical branches. In this review, we discuss some confusing, obsolete, and erroneous terms that are still commonly used by many clinicians, and surgeons in particular, during the process of diagnosis and treatment. The use of these ambiguous, erroneous, and obsolete terms enhances the risk of miscommunication. We also provide some edifying examples from everyday clinical practice.

Contemporary views on human aging and longevity

Abstract Aging is currently stimulating intense interest of both researchers and the general public. In developed countries, the average life expectancy has increased by roughly 30 years within the last century, and human senescence has been delayed by around a decade. Although aging is arguably the most familiar aspect of human biology, its proximate and ultimate causes have not been elucidated fully and understood yet. Nowadays there are two main approaches to the ultimate causes of aging. These are deterministic and stochastic models. The proximate theories constitute a distinct group of explanations. They focus on mechanistic causes of aging. In this view, there is no reason to believe that there is only one biological mechanism responsible for aging. The aging process is highly complex and results from an accumulation of random molecular damage. Currently, the disposable soma theory (DST), proposed by Thomas Kirkwood, is the most influential and coherent line of reasoning in biogerontology. This model does not postulate any particular mechanism underpinning somatic defense. Therefore, it is compatible with various models, including mechanistic and evolutionary explanations. Recently, however, an interesting theory of hyper-function of mTOR as a more direct cause of aging has been formulated by Mikhail Blagosklonny, offering an entirely different approach to numerous problems and paradoxes in current biogerontology. In this view, aging is quasi-programmed, which means that it is an aimless continuation of developmental growth. This mTOR-centric model allows the prediction of completely new relationships. The aim of this article is to present and compare the views of both parties in the dispute, based on the results of some recent experimental studies, and the contemporary knowledge of selected major aspects of human aging and longevity

Association of serum bilirubin with longevity: Evidence from a retrospective longitudinal study and cross-sectional data

Abstract Bilirubin is a potent antioxidant and an important anti-inflammatory factor. Therefore, there has been an increasing focus on serum bilirubin as a negative risk factor of cardiovascular mortality in men and an indicator of improved survival in both sexes, but the direct mechanisms of these links and the causes of sex differences are not well understood. Moreover, the evidence from longitudinal studies on effects of bilirubin on longevity is limited. In this study, we retrospectively analyzed two groups of older adults to explore age-dependent changes in serum bilirubin levels and their associations with long-term survival in both sexes. Longitudinal data from 142 individuals (68 men and 74 women) aged 45 to 70 years were compared with cross-sectional data from 225 individuals (113 men and 112 women). The latter group was divided into four categories of survival, i.e. 53, 63, 68, and 76+ based on data on lifespan. ANOVA, t-test, and regression analysis were run. The analysis of the longitudinal data showed an increase in serum total bilirubin levels in men (0.3038e0.093x, R2 = 0.667) and women (0.1838e0.0187x, R2 = 0.950), while the analysis of cross-sectional data revealed a U-shaped pattern of age-related changes in men (0.001x2 - 0.1263x + 4.4524, R2 = 0.999) but an inverted U-shaped pattern in women (0.0006x2 + 0.072x - 1.6924, R2 = 0.195). On balance, these results suggest that elevated but normal bilirubin levels might confer a survival advantage in older men but not women. Alternatively, the positive relationship between serum total bilirubin and lifespan was not causal but coincidental. Further studies are needed to elucidate the direct mechanisms of the association between serum bilirubin levels and longevity in elderly people of both sexes.

Profilaktyka i leczenie raka żołądka – aktualny problem interdyscyplinarny

Rak żołądka jest piątym najczęstszym rakiem na świecie i stanowi bardzo duże wyzwanie dla służby zdrowia, gdyż wymaga wielodyscyplinarnego leczenia, w którym chirurgia odgrywa nadrzędną rolę [1]. Mimo że zapadalność na ten nowotwór maleje, nadal stanowi on stosunkowo częstą przyczynę zgonów, nawet w krajach wysoko rozwiniętych, takich jak USA i Japonia [2, 3], w których zarówno świadomość społeczna dotycząca znaczenia zdrowego stylu życia i profi laktyki chorób PROFILAKTYKA I LECZENIE RAKA ŻOŁĄDKA – AKTUALNY PROBLEM INTERDYSCYPLINARNY

Leukocyte count, systemic inflammation, and health status in older adults: a narrative review

Abstract Epidemiological and clinical studies suggest that elevated leukocyte count within the normal range can predict cardiovascular and total mortality in older adults. These findings are remarkable because this simple and common laboratory test is included in routine medical check-ups. It is well known that chronic systemic inflammation (inflammaging) is one of the hallmarks of aging and an important component of obesity-associated insulin resistance that can lead to type 2 diabetes and other health problems in both overweight individuals and elderly people. To understand the molecular mechanisms linking increased systemic inflammation with aging-associated diseases and elevated leukocyte counts in the elderly is to unravel the multiplicity of molecular factors and mechanisms involved in chronic low-grade systemic inflammation, the gradual accumulation of random molecular damage, age-related diseases, and the process of leukopoiesis. There are several possible mechanisms through which chronic low-grade systemic inflammation is associated with both higher leukocyte count and a greater risk of aging-associated conditions in older adults. For example, the IL-6 centric model predicts that this biomediator is involved in chronic systemic inflammation and leukopoiesis, thereby suggesting that elevated leukocyte count is a signal of poor health in older adults. Alternatively, an increase in neutrophil and monocyte counts can be a direct cause of cardiovascular events in the elderly. Interestingly, some authors assert that the predictive ability of elevated leukocyte counts with regard to cardiovascular and allcause mortality among older adults surpass the predictive value of total cholesterol. This review reports the recent findings on the links between elevated but normal leukocyte counts and the increased risks of all-cause, cardiovascular, and cancer mortality. The possible molecular mechanisms linking higher but normal leukocyte counts with increased risk of aging-associated diseases in the elderly are discussed here.

Association between body size and selected hematological parameters in men and women aged 45 and above from a hospitalized population of older adults: an insight from the Polish Longitudinal Study of Aging (1960–2000)

Abstract In elderly people, anemia occurs with increasing frequency with each advancing decade and can be a harbinger of very serious health conditions, including gastrointestinal bleeding, gastric and duodenal ulcers, and cancer. Therefore, age-dependant changes in hematological parameters deserve special attention. Nonetheless, very few longitudinal studies of aging have focused on possible associations between basic anthropometric characteristics and hematological parameters in older people. Here, we present some evidence that body size can be associated with red blood cell count as well as some other selected hematological parameters in adults aged 45 to 70 years. Longitudinal data on anthropometric and hematological parameters have been obtained from physically healthy residents at the Regional Psychiatric Hospital for People with Mental Disorders in Cibórz, Lubuskie Province, Poland (142 individuals, including 68 men and 74 women). The residents who took psychoactive drugs were excluded from the study. To evaluate the studied relationships, three anthropometric traits were used and three dichotomous divisions of the study sample were made. The medians of body height, body weight, and body mass index at the age of 45 years were used to divide the sample into: shorter and taller, lighter and heavier, and slimmer and stouter individuals, respectively. Student’s t-test, Pearson’s correlation, and regression analysis were employed. The results of the present study suggest that the relationship between body size and red blood cell count is slightly more pronounced in men and its strength depends on age. However, the correlations between body size and red blood cell count proved to be weak in both sexes. With aging, the strength of the relation decreased gradually, which might have been caused by the aging-associated changes in the hematopoietic system, anemia, or was an artifact. Further studies are needed to elucidate the unclear association between body size and hematological parameters in older adults.

Rethinking modern theories of ageing and their classification: the proximate mechanisms and the ultimate explanations

Abstract For a very long time, ageing has been an insurmountable problem in biology. The collection of age-dependent changes that render ageing individuals progressively more likely to die seemed to be an intractable labyrinth of alterations and associations whose direct mechanisms and ultimate explanations were too complex and difficult to understand. The science of ageing has always been fraught with insuperable problems and obstacles. In 1990, Zhores Medvedev presented a list of roughly 300 different hypotheses to illustrate this remarkable complexity of the ageing process and various approaches to understanding its mechanisms, though none of these hypotheses or aspect theories could be the general theory of senescence. Moreover, in the light of current data some of these ideas are obsolete and inapplicable. Nonetheless, the misconception that there are hundreds of valid theories of ageing persists among many researchers and authors. In addition, some of these obsolete and discarded hypotheses, such as the rate of living theory, the wear and tear theory, the poisoning theory, or the entropy theory still can be found in today’s medical textbooks, scientific publications aimed at the general public, and even in scientific writing. In fact, there are only several modern theories of ageing supported by compelling evidence that attempt to explain most of the data in current gerontology. These theories are competing to be a general and integrated model of ageing, making it unlikely that all of them could be true. This review summarises briefly several selected modern theories of senescence in the light of the contemporary knowledge of the biological basis for ageing and current data.