Background/Objectives: Cardiovascular diseases are the leading cause of death in developed countries. The most challenging clinical presentation of their natural history is heart failure with lifetime probability of 20% in both genders. It is recognized when typical symptoms such as exercise intolerance, shortness of breath in horizontal position together with signs comprising of lower limb oedema, crackles in the lungs, widening of the jugular veins and liver enlargement. The aim of the study is to assess the relationship between the change in non-oedematous body mass and the clinical and laboratory profile in patients with heart failure with reduced ejection fraction. Methods: The research material consists of 1029 patients with heart failure who were included in the Prospective Heart Failure Register maintained in the Third Department of Cardiology of the Silesian Center for Heart Diseases in Zabrze since 2003. The collected data was subjected to statistical analysis in Statistica 13. Conclusions: The highest median values of ejection fraction of the left ventricle were observed in patients with weight gain, and the lowest – in patients who lost more than 5% of body weight. Patients with the loss of> 5% of body weight are characterized by the lowest probability of survival. Change in non-oedematous body mass affects adversely the clinical and laboratory profile of patients with heart failure with reduced ejection fraction. Both weight loss above 5% and weight gain are associated with poorer prognosis and increased mortality in the study participants.

Background/Objectives: Body surface area is one of the most important anthropometric parameters in medicine. The study’s primary objective is to compare the consistency of the BSA estimation results through applying available formulas. Other objectives include determining the ability of these formulas to discriminate between death and survival in patients, comparing the formulas’ diagnostic features, and investigating whether the risk associated with a low BSA is independent of BMI. Methods: This study included 1029 patients (median age, 54 years; female, 13.7%; NYHA I/II/III/IV, 6.3%/36.5%/47.7%/9.5%) diagnosed with heart failure. For each patient, BSA was calculated using 25 formulas. Over the 3-year observation period, 31.2% of the patients died. Results: The average BSA value of the optimal discrimination thresholds was 1.79 m2 ± 0.084 m2 and the BSA difference between the estimators with the lowest (BSAMeeh1879) and the highest (BSANwoye1989) optimal discrimination thresholds was 0.42 m2. The lowest mortality rate was 35.2% and occurred in the subgroup of individuals with BSA values below the optimal discrimination threshold using the BSASchlich2010 estimator. The highest mortality was predicted when the estimator BSAMeeh1879 or BSALivingston&Lee2001 was used. Conclusions: Our study showed a relatively good concordance of 25 BSA estimators in BSA assessment in patients, without extremes of weight or height being known to disrupt it. All BSA estimators presented a significant, although weak, ability to discriminate death from survival at 3-year follow-up; however, BSA is not a very good predictor of HF mortality at 3 years. The higher risk of death in smaller patients, as shown by BSA, was independent of BMI in all but two BSA estimators.

Background: Low 24-h urinary excretion of creatinine in patients with heart failure (HF) is believed to reflect muscle wasting and is associated with a poor prognosis. Recently, spot urinary creatinine concentration (SUCR) has been suggested as a useful prognostic factor in selected HF cohorts. This more practical and cheaper approach has never been tested in an unselected HF population. Moreover, neither the relation between SUCR and body composition markers nor the association of SUCR with the markers of volume overload, which are known to worsen clinical outcome, has been studied so far. The aim of the study was to check the prognostic value of SUCR in HF patients after adjusting for body composition and indirect markers of volume overload. Methods: In 911 HF patients, morning SUCR was determined and body composition scanning using dual X-ray absorptiometry (DEXA) was performed. Univariable and multivariable predictors of log SUCR were analyzed. All participants were divided into quartiles of SUCR. Results: In univariable analysis, SUCR weakly correlated with fat-free mass (R = 0.09, p = 0.01). Stronger correlations were shown between SUCR and loop diuretic dose (R = 0.16, p < 0.0001), NTproBNP (R = −0.15, p < 0.0001) and serum sodium (R = 0.16, p < 0.0001). During 3 years of follow-up, 353 (38.7%) patients died. Patients with lower SUCR were more frequently female, and their functional status was worse. The lowest mortality was observed in the top quartile of SUCR. In the unadjusted Cox regression analysis, the relative risk of death in all three lower quartiles of SUCR was higher by roughly 80% compared to the top SUCR quartile. Apart from lower SUCR, the significant predictors of death were age and malnutrition but not body composition. After adjustment for loop diuretic dose and percent of recommended dose of mineralocorticoid receptor antagonists, the difference in mortality vanished completely. Conclusions: Lower SUCR levels in HF patients are associated with a worse outcome, but this effect is not correlated with fat-free mass. Fluid overload-driven effects may link lower SUCR with higher mortality in HF.

Psoriasis is a chronic inflammatory skin disease. Immunological, genetic, and environmental factors, including diet, play a part in the pathogenesis of psoriasis. Metabolic syndrome or its components are frequent co-morbidities in persons with psoriasis. A change of eating habits can improve the quality of life of patients by relieving skin lesions and by reducing the risk of other diseases. A low-energy diet is recommended for patients with excess body weight. Persons suffering from psoriasis should limit the intake of saturated fatty acids and replace them with polyunsaturated fatty acids from the omega-3 family, which have an anti-inflammatory effect. In diet therapy for persons with psoriasis, the introduction of antioxidants such as vitamin A, vitamin C, vitamin E, carotenoids, flavonoids, and selenium is extremely important. Vitamin D supplementation is also recommended. Some authors suggest that alternative diets have a positive effect on the course of psoriasis. These diets include: a gluten-free diet, a vegetarian diet, and a Mediterranean diet. Diet therapy for patients with psoriasis should also be tailored to pharmacological treatment. For instance, folic acid supplementation is introduced in persons taking methotrexate. The purpose of this paper is to discuss in detail the nutritional recommendations for persons with psoriasis.

1. Didkowska J, Wojciechowska U, Olasek P, et al. Nowotwory złośliwe w Polsce w 2019 roku. In: Warszawa: Krajowy Rejestr Nowotworów; 2021:. Google Scholar

Endometriosis is a chronic, painful, estrogen-related inflammatory disease that affects approximately 10% of the female population. Endometriosis has a significant negative impact on quality of life. Nutrition may be involved in the development and severity of endometriosis. The purpose of this paper is to discuss in detail the nutritional recommendations for patients with endometriosis. This article discusses the importance of nutrients such as polyphenols, vitamins C, D and E, PUFAs, and iron in the development of endometriosis. Alternative diets, such as the Mediterranean, anti-inflammatory, vegetarian, low-nickel and low-FODMAP diets, have also been presented in the context of their potential beneficial effects on the course of endometriosis.

Low spot urinary creatinine concentration (SUCR) is a marker of muscle wasting and clinical outcome. The risk factors for low SUCR in heart failure (HF) remain poorly understood. We explored the risk factors for low SUCR related to poor outcomes. In 721 HF patients (age: 52.3 ± 11 years, female: 14%, NYHA: 2.7 ± 0.7) SUCR and Dexa body composition scans were performed. BMI prior HF-onset, weight loss, and appendicular muscle mass were obtained. Each patient was classified as malnutrition or normal by GLIM criteria and three other biochemical indices (CONUT, PNI, and GRNI). Sarcopenia index (SI) as creatinine to cystatin C ratio was also calculated. Within 1 year, 80 (11.1%) patients died. In ROC curve we identified a SUCR value of 0.628 g/L as optimally discriminating surviving from dead. In low SUCR group more advanced HF, higher weight loss and catabolic components of weight trajectory (CCWT), more frequent under-nutrition by GLIM, and lower SI were observed. In multivariate analysis the independent predictors of low SUCR were SI, CCWT, and GNRI score. In conclusion: the risk of low SUCR was associated with a worse outcome. Low SUCR was associated with greater catabolism and sarcopenia but not with biochemical indices of malnutrition.

WstępEutanazja to pojęcie ogólnie definiowane jako czyn bądź zaniedbanie powodujące śmierć, a w konsekwencji przerwanie dotychczasowego cierpienia osoby nieuleczalnie chorej.Materiał i metodyAnalizę przeprowadzono na podstawie danych Europejskiego Instytutu Bioetyki. Główne źródło informacji stanowiły Raporty Belgijskiego Federalnego Komitetu ds. Kontroli i Oceny Eutanazji nr 1–8.WynikiJuż rok po zalegalizowaniu eutanazji w Belgii 235 osób zostało poddanych „wspomaganej śmierci”. W roku 2017 liczba eutanazji przekroczyła 2300. W latach 2002–2017 wykonano łącznie 17 063 eutanazje. Na przełomie ostatnich lat zmieniała się struktura wieku osób poddających się eutanazji. Zwiększa się liczba osób od 80 roku życia wzwyż, a zmniejsza w wieku 40–59 lat. Głównym miejscem śmierci pacjentów pozostaje dom i szpital.Wnioski1. Od momentu legalizacji eutanazji w Belgii liczba osób poddających się temu działaniu stale wzrasta. 2. W ostatnich latach częściej obserwuje się przeprowadzanie eutanazji w domu pacjenta oraz w domach opieki. 3. Spośród najczęstszych przyczyn eutanazji wymienia się choroby nowotworowe.