Factors Determining the Functional Efficiency of Patients After Ischemic Stroke After Neurological Rehabilitation.

Introduction: The factors determining the level of functional efficiency in patients after ischemic stroke are: age, sex, physical condition, mental activity before stroke, previous neurological deficits, comorbidities, nutritional status and the course of the stroke. Aim: Assessment of the functional efficiency of patients before and after rehabilitation due to ischemic stroke and determination of the influence of selected factors on the effects of rehabilitation measured by functional efficiency. Material and Methods: The study was conducted in neurological rehabilitation centers among 82 people diagnosed with ischemic stroke. The examination was performed twice: on admission to the ward and after a month of neurological rehabilitation. The diagnostic survey method, the Barthel scale, the NRS 2002 scale were used, and the BMI was calculated. Results: The functional efficiency level of the patients was varied, higher after one month of rehabilitation (p <0.05). Among the patients who achieved a lower level of functional efficiency, the following factors had a significant influence: underweight and overweight (p = 0.002), risk of malnutrition (p = 0.002), right-sided paresis (p = 0.016), limited physical activity before stroke (p = 0.01) and the later rehabilitation period (p = 0.01). There was no correlation between sociodemographic data and the level of efficiency of patients after a stroke after one month of rehabilitation. Conclusion: The level of functional efficiency after rehabilitation improved in all patients, however, to a different extent depending on the nutritional status and physical activity. Therefore, it is important to to undertake rehabilitation in the shortest possible time.

Life satisfaction, generalized sense of self-efficacy and acceptance of illness in rheumatoid arthritis patients depending on age and severity of the disease.

Introduction: Rheumatoid arthritis (RA) is a chronic autoimmune condition characterized by periods of exacerbation (physical limitations, depressed mood, depressive states and decreased life satisfaction) and remission (hope of health improvement). Our objective was to present social functioning of RA patients taking into consideration their age and employing selected determinants: satisfaction with life, generalized sense of self-efficacy and acceptance of illness. Material and methods: Standardized tools were employed: the Satisfaction with Life Scale, Generalized Self Efficacy Scale and Acceptance of Illness Scale. The study group included 46 RA patients aged 18-45 years and 54 RA patients aged over 60 years. The control group consisted of 24 non-RA subjects in every group. Results: Rheumatoid arthritis patients in the period of disease exacerbation reported low and moderate levels of satisfaction with life, in the patients in remission period the score was moderate, while the control group subjects described their level of satisfaction with life as high and moderate. The level of acceptance of illness was described by the RA patients in the period of disease exacerbation as 20.4/40 points; the patients in remission defined their level of acceptance of illness as 29.38/40 points. The patients with RA exacerbation showed a low sense of self-efficacy, yet a large group of such patients also presented high self-efficacy levels and the majority of the RA subjects in remission reported a high sense of self-efficacy. Conclusions: In the RA patients, satisfaction with life, generalized sense of self-efficacy and acceptance of illness were closely related and affected their general psychosocial functioning.

Interleukin-6 and Melatonin as Predictors of Cognitive, Emotional and Functional Ageing of Older People.

BACKGROUND: The ageing process causes a number of changes in the human immune and endocrine systems. The aim of this study was to assess the relationship between cognitive, emotional and functional skills as well lifestyle, versus selected biochemical indicators of the ageing process. METHODS: The cross-sectional study was conducted in a group of 121 people aged 60-90 residing in the Lesser Poland voivodship. The study used standardized research tools including the Barthel scale, Instrumental Activities of Daily Living (IADL) scale, Mini-Mental State Examination (MMSE), Life Orientation Test (LOT-R) and inventory of health behaviors (IHB). In addition, the concentration of IL-6 and melatonin in the blood plasma was determined. RESULTS: We determined the correlation between the level of IL-6 in a group of people over 75 years of age (requiring medical care), and results of the IADL scale. There was also a correlation between melatonin levels and the MMSE results in a group of people aged 60-75 who did not require constant medical care. CONCLUSIONS: IL-6 can be treated as a predictor of functional skills of people over 75 years of age, and melatonin can be perceived as a factor for recognizing cognitive impairment in elderly people who do not require constant medical assistance.

Nutritional Status of Elderly Patients after Coronary Artery Bypass Surgery.

Surgical trauma can result in immobilization of biological material, degradation of muscle proteins, synthesis of acute-phase proteins in the liver, occurrence of catabolism phase and anabolism simultaneously, and as a consequence weight loss and nutritional deficiencies. The aim of this study was to assess the nutritional status of patients with ischemic heart disease subjected to coronary artery bypass surgery and physical activity and postoperative complications. The analysis among 96 men included total number of lymphocytes (TNL), body mass index (BMI), case history of a patient and results of laboratory tests. The activities of daily living (ADL) and the mini nutritional assessment (MNA) questionnaires were used. According to TNL, before the procedure malnutrition occurred in 46% of patients. BMI revealed overweight in 62.5% and obesity in 26.0%. After the surgery, no changes were observed. According to MNA, 59% of patients before the surgery were at risk of malnutrition. After the operation, the number of people at risk of malnutrition increased by 50% (p < 0.0001). The correlation was noted between BMI and patients' efficiency in the fifth day after the surgery (p = 0.0031). Complications after the surgery occurred in 35.4% of patients. After the surgery, the risk of malnutrition increased, decreased activity and complications occurred more frequently in people with underweight, obesity, and overweight than in people with normal BMI.

The influence of bariatric surgery on serum levels of irisin and nesfatin-1.

Introduction: Bariatric surgery is associated with multiple endocrine and metabolic changes. Irisin and nesfatin-1 have recently been described as regulatory peptides involved in obesity-related insulin resistance. Our aim was to analyze the changes of those two molecules observed in patients after bariatric procedures. Materials and methods: This prospective study involved 40 patients treated for morbid obesity. Irisin and nesfatin-1 were measured before, 6 months and 1 year after surgical intervention. We also gathered demographic data, information concerning comorbidities, factors related to the surgery and outcomes of bariatric treatment. Results: Twenty-seven patients completed the study (15 females). The mean age of the group was 43.5 ± 10.4 years. Six (22.2%) patients were submitted to Laparoscopic Sleeve Gastrectomy and 21 (77.8%) patients were submitted to Laparoscopic Roux-en-Y Gastric Bypass. The participants in our study achieved significant weight loss. The irisin level remained stable in the whole study group during all three measurements included in our study protocol (p = .71). Our study group presented a reduction of the nesfatin-1 level 6 months after bariatric surgery and a slight further decrease after one-year observation, although these changes were also not significant (p = .17). Conclusions: We did not find any significant correlation between changes of irisin or nesfatin-1 level and bariatric surgery, as an aid in the regulation of glucose metabolism.