Publications by authors named "Joanna Kostka"

25 Publications

  • Page 1 of 1

Association of Lower Nutritional Status and Education Level with the Severity of Depression Symptoms in Older Adults-A Cross Sectional Survey.

Nutrients 2021 Feb 4;13(2). Epub 2021 Feb 4.

Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, 92-115 Lodz, Poland.

The study analyzes the relationship between nutritional status and depression symptoms severity in the older population. A total of 1975 older outpatients (1457 women and 518 men, median age 75) were included in the study. Depression symptoms severity was assessed using the Geriatric Depression Scale (GDS). Participants were divided into two subgroups according to GDS score. Group A: 0-5 points-without depression symptoms (1237, W:898, M:339), and group B: 6-15 points-with depression symptoms (738, W:559, M:179). The nutritional status of the patients was assessed with Mini Nutritional Assessment (MNA) and basic anthropometric variables (waist, hips, calf circumferences, body mass index (BMI), waist to hip ratio (WHR), and waist to height ratio (WHtR)). Education years and chronic diseases were also noted. Women with higher depression symptoms severity had significantly lower MNA scores [A: 26.5 (24-28) (median (25%-75% quartiles)) vs. B:23 (20.5-26)], shorter education time [A:12 (8-16) vs. B:7 (7-12)], smaller calf circumference [A:36 (33-38) vs. B: 34 (32-37)], and higher WHtR score [A:57.4 (52.3-62.9) vs. B:58.8 (52.1-65.6)]. Men with depression symptoms had lower MNA scores [A:26.5 (24.5-28) vs. B:24 (20.5-26.5)], shorter education [A:12 (9.5-16), B:10 (7-12)], and smaller calf circumference [A:37 (34-39), B:36 (33-38)]. In the model of stepwise multiple regression including age, years of education, anthropometric variables, MNA and concomitant diseases nutritional assessment, and education years were the only independent variables predicting severity of depression symptoms both in women and men. Additionally, in the female group, odds were higher with higher WHtR. Results obtained in the study indicate a strong relationship between proper nutritional status and education level with depression symptoms severity in older women and men.
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http://dx.doi.org/10.3390/nu13020515DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7914802PMC
February 2021

New Strategies for Rehabilitation and Pharmacological Treatment of Fatigue Syndrome in Multiple Sclerosis.

J Clin Med 2020 Nov 7;9(11). Epub 2020 Nov 7.

Department of Neurological Rehabilitation, Medical University of Lodz, Milionowa 14, 90-001 Lodz, Poland.

Multiple sclerosis (MS) is the most common autoimmune disease of the central nervous system (CNS), with an inflammatory demyelinating basis and a progressive course. The course of the disease is very diverse and unpredictable. Patients face many problems on a daily basis, such as problems with vision; sensory, balance, and gait disturbances; pain; muscle weakness; spasticity; tremor; urinary and fecal disorders; depression; and rapidly growing fatigue, which significantly influences quality of life among MS patients. Excessive fatigue occurs in most MS patients in all stages of this disease and is named MS-related fatigue. The crucial issue is the lack of effective treatment; therefore, this review focuses not only on the most common treatment methods, but also on additional novel therapies such as whole-body cryotherapy (WBC), functional electrical stimulation (FES), and non-invasive brain stimulation (NIBS). We also highlight the advantages and disadvantages of the most popular clinical scales used to measure fatigue. The entire understanding of the origins of MS-related fatigue may lead to the development of more effective strategies that can improve quality of life among MS patients. A literature search was performed using MEDLINE, EMBASE, and PEDro databases.
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http://dx.doi.org/10.3390/jcm9113592DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7695014PMC
November 2020

What is the most important determinant of cardiometabolic risk in 60-65-year-old subjects: physical activity-related behaviours, overall energy expenditure or occupational status? A cross-sectional study in three populations with different employment status in Poland.

BMJ Open 2019 07 30;9(7):e025905. Epub 2019 Jul 30.

Department of Geriatrics, Medical University of Łódź, Łódź, Poland.

Objectives: The aim of the study was to determine whether cardiovascular risk factors may differ according to occupational status and whether physical activity related to total energy expenditure (PA-EE) and related to health-related behaviours (PA-HRB) is associated with common cardiovascular risk factors or metabolic syndrome in pre-elderly subjects.

Methods: Three hundred subjects aged 60-65 were recruited and divided into three equal groups of white-collar, blue-collar workers and unemployed subjects; 50% were women. The subjects were tested for major cardiovascular risk factors such as smoking, anthropometric indices, blood pressure, lipid levels, glucose, uric acid and homocysteine. PA-EE and PA-HRB were assessed with PA questionnaires.

Results: Blue-collar workers displayed higher anthropometric indices, blood pressure and higher PA-EE in comparison with other two groups. PA-HRB had a positive impact on body mass indices, lipids, glucose, uric acid and the prevalence of metabolic syndrome, with no such relationship observed for PA-EE.

Conclusions: The greatest cardiovascular risk was observed in the blue-collar workers group. Only PA-HRB had a positive association with cardiometabolic risk profile. No relationship was observed for PA-EE. Thus, promoting everyday life and leisure time PA behaviours is crucial for preventing cardiometabolic risk in pre-elderly subjects, even in blue-collar workers with high work-related EE.
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http://dx.doi.org/10.1136/bmjopen-2018-025905DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6677988PMC
July 2019

Pharmacological Interventions and Rehabilitation Approach for Enhancing Brain Self-repair and Stroke Recovery.

Curr Neuropharmacol 2020 ;18(1):51-64

Department of Neurological Rehabilitation, Medical University of Lodz, Milionowa 14, 93-113 Lodz, Poland.

Neuroplasticity is a natural process occurring in the brain for the entire life. Stroke is the leading cause of long term disability and a huge medical and financial problem throughout the world. Research conducted over the past decade focused mainly on neuroprotection in the acute phase of stroke while very little studies target the chronic stage. Recovery after stroke depends on the ability of our brain to reestablish the structural and functional organization of neurovascular networks. Combining adjuvant therapies and drugs may enhance the repair processes and restore impaired brain functions. Currently, there are some drugs and rehabilitative strategies that can facilitate brain repair and improve clinical effect even years after stroke onset. Moreover, some of the compounds such as citicoline, fluoxetine, niacin, levodopa, etc. are already in clinical use or are being trialed in clinical issues. Many studies are also testing cell therapies; in our review, we focused on studies where cells have been implemented at the early stage of stroke. Next, we discuss pharmaceutical interventions. In this section, we selected methods of cognitive, behavioral, and physical rehabilitation as well as adjuvant interventions for neuroprotection including noninvasive brain stimulation and extremely low-frequency electromagnetic field. The modern rehabilitation represents a new model of physical interventions with the limited therapeutic window up to six months after stroke. However, previous studies suggest that the time window for stroke recovery is much longer than previously thought. This review attempts to present the progress in neuroprotective strategies, both pharmacological and non-pharmacological that can stimulate the endogenous neuroplasticity in post-stroke patients.
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http://dx.doi.org/10.2174/1570159X17666190726104139DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7327936PMC
May 2020

The Influence of an Eight-Week Cycloergometer-Based Cardiac Rehabilitation on Serum Antioxidant Status in Men with Coronary Heart Disease: A Prospective Study.

Medicina (Kaunas) 2019 Apr 18;55(4). Epub 2019 Apr 18.

Department of Geriatrics, Medical University of Lodz, 90-993 Lodz, Poland.

A body of evidence confirms the benefits of cardiac rehabilitation (CR) in coronary heart disease (CHD) patients, but it remains unclear whether it enhances the antioxidant potential. The aim of the study was to assess the influence of an eight-week aerobic cycloergometer-based CR program on serum total antioxidant capacity (TAC) and other CHD risk factors. The study involved 36 men with CHD (55.2 ± 9.0 years). TAC was assessed with two methods: ferric reducing ability of serum (TAC-FRAS) and 2.2-diphenyl-1-picryl-hydrazyl (TAC-DPPH). Aerobic capacity was evaluated during a submaximal exercise test. TAC and other anthropometric, biochemical and physical activity/fitness measures were performed twice: before the beginning and after termination of CR. Aerobic capacity was higher (7.0 ± 2.6 vs. 8.0 ± 2.5 MET-metabolic equivalents; < 0.01), but values of resting diastolic blood pressure were lower (81.9 ± 7.6 vs. 77.4 ± 8.9 mmHg; < 0.01) after termination of CR. Other classic cardiometabolic, anthropometric, and biochemical measures did not change with CR. No difference in TAC-FRAS was found after CR, whereas TAC-DPPH was significantly lower (16.4 ± 4.0 vs. 13.2 ± 3.7% reduction; < 0.01). Antioxidant potential measured as TAC-DPPH, but not as TAC-FRAS, decreased with the CR program. The recognized health benefits of CR are not related to augmented serum antioxidant status.
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http://dx.doi.org/10.3390/medicina55040111DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6524382PMC
April 2019

Muscle power, contraction velocity and functional performance after stroke.

Brain Behav 2019 04 28;9(4):e01243. Epub 2019 Feb 28.

Department of Physical Medicine, Medical University of Lodz, Lodz, Poland.

Objective: The goal of this study was to describe muscle function deficit in patients after stroke as well as to define the relationship between maximal muscle power (P ) and optimal shortening velocity (υ ) with functional efficiency in stroke survivors.

Material And Methods: A total of 134 participants were enrolled in the study, including 67 patients after a stroke and 67 volunteers, matched for age and sex (controls). Functional performance was measured with the timed Up and Go test (TUG) and additionally with Rivermead Motor Assessment (RMA) and Barthel Index (BI) in stroke survivors. To assess P and υ of the knee extensor muscles, a specially equipped Monark cycle ergometer was used.

Results: The power generated by stroke survivors was 49.6% that of their peers and muscle contraction velocity was 65.5%. P /kg and υ were associated with TUG outcomes in both groups. P /kg and υ were associated with age in the control group, but not in patients after stroke. In multivariate analysis in patients after stroke, TUG was better predicted by P /kg or υ than by the age. In stroke survivors, both P /kg and υ were related to the BI and to the RMA total results. Both BI and RMA total were not determined by age.

Conclusions: Muscle power and muscle contraction velocity in patients who have had a stroke within three months have reduced markedly. These factors significantly affect functional performance. Muscle power and optimal shortening velocity are more important determinants of functional status than age in these stroke survivors.
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http://dx.doi.org/10.1002/brb3.1243DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6456770PMC
April 2019

Force analysis of shoulder joint muscles in the early phase of brain stroke.

Acta Bioeng Biomech 2018 ;20(4):107-113

Department of Physical Medicine, Medical University of Lodz, Łódź, Poland.

Purpose: Upper limb impairment in the early phase of brain stroke is one of the key problems in rehabilitation. An estimation of muscle force can be a helpful factor for functional improvement after a stroke. The primary goals of this study were to determine the muscles with the lowest force in the affected (A) and non-affected (non-A) upper limb. Moreover, the differences between men and women were compared and these values were correlated with age.

Methods: One hundred (n = 35 female, n = 65 male) post-stroke pa- tients met the inclusion criteria. The mean age of the study participants was 66.1 years. Muscle force for external and internal rotators of shoulder was measured with handheld dynamometer. Moreover, the correlation coefficients for differences in muscular force with the patient's age were estimated.

Results: Our study reports that the force of the (A) side in relation to the (non-A) was by 37% weaker. We observed about a 40% decrease in the force of the shoulder's external rotation (female - 42%; male - 41%) and shoulder's flexion (by 38% - female; 40% - male). Significant correlations between the muscle force and the age of post-stroke patients were also found. It was concluded that about 4 weeks after the first stroke in the patient's life, the external rotators are the most affected group of shoulder muscles.

Conclusions: Neither sex nor the side of the ischemic brain injury influence the muscle force, whereas age determines both muscle force and muscle force deficits. Older post-stroke patients demonstrate fewer deficits in muscle strength than younger ones.
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March 2019

Relationship of muscle function to circulating myostatin, follistatin and GDF11 in older women and men.

BMC Geriatr 2018 08 30;18(1):200. Epub 2018 Aug 30.

Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, ul. Pieniny 30, 91-647, Łódź, Poland.

Background: Myostatin, its inhibitor follistatin, and growth/differentiation factor 11 (GDF11) have been proposed as factors that could potentially modify biological aging. The study aimed to test whether there is a relationship between these plasma circulating proteins and muscle strength, power and optimal shortening velocity (υ) of older adults.

Methods: The cross-sectional study included 56 women and 45 men aged 60 years and older. Every participant underwent examination which included anthropometric and bioimpedance analysis measurements, functional and cognitive performance tests, muscle strength of upper and lower extremities, muscle power testing with two different methods and blood analyses.

Results: Women had higher plasma levels of myostatin and GDF11 than men. Men had higher plasma level of follistatin than women. In women, plasma level of myostatin was negatively correlated with left handgrip strength and υ. Follistatin was negatively correlated with maximum power output (P), power relative to kg of body mass (P∙kg) (friction-loaded cycle ergometer) and power at 70% of the 1-repetition maximum (1RM) strength value (P70%) of leg press (Keiser pneumatic resistance training equipment), and positively correlated with the Timed Up & Go (TUG) test. GDF11 was negatively correlated with body mass, body mass index, waist circumference, fat mass and the percentage of body fat. In men, there were no significant correlations observed between circulating plasma proteins and muscle function measures.

Conclusions: The circulating plasma myostatin and follistatin are negatively associated with muscle function in older women. There is stronger relationship between these proteins and muscle power than muscle strength. GDF11 has a higher association with the body mass and composition than muscle function in older women.
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http://dx.doi.org/10.1186/s12877-018-0888-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6117873PMC
August 2018

Analysis of upper limb muscle strength in the early phase of brain stroke.

Acta Bioeng Biomech 2017 ;19(3):85-91

Department of Physical Medicine, Medical University of Łódź, Łódź, Poland.

Purpose: The aim of this study was to determine the muscles with the lowest strength in non-affected (non-A) and affected upper limb (A), to assess differences between men and women and to correlate these values with age in patients after stroke.

Methods: Sixty patients (40 male, 20 female), hospitalized in Neurorehabilitation Ward, 1-2 weeks after stroke, were included in the study. Their age ranged from 50 to 80 years with a mean (sd) of 65.5 (18.7) years. Muscle force values from upper limb muscles were measured using the MicroFet 2 hand-held dynamometer. The results are given in Newtons [N], mean values of muscular force, effect sizes and confidence intervals are displayed as Cohen's d and 95% CI were determined. Moreover, we made the coefficients correlation for differences in muscular force versus the Rivermead Motor Assessment (RMA) arm section.

Results: Strength of (A) upper limb in comparison to (non-A) was 39% weaker. The severely affected muscle groups were the shoulder flexion 41% (women) versus 46% (men); elbow flexion 39% (women) versus 31% (men); wrist extension 36% (women) versus 42% (men). No significant correlations were found between muscle strength results and RMA or age.

Conclusions: Muscle force of (A) upper limb after stroke demonstrates a 39% decrease. Men show more significant decrease than women (40% vs. 35%). Functional assessment in RMA values shows the better results in women (4.9 ± 4.1) than men (3.4 ± 3.2).
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January 2018

Relationship of quadriceps muscle power and optimal shortening velocity with angiotensin-converting enzyme activity in older women.

Clin Interv Aging 2017 19;12:1753-1760. Epub 2017 Oct 19.

Department of Geriatrics, Healthy Ageing Research Centre.

Background: The goal of this study was to assess whether angiotensin-converting enzyme (ACE) activity is related to muscle function (strength, power and velocity), as well as to assess if ACE inhibitors (ACEIs) and other angiotensin system blocking medications (ASBMs) influence muscle performance in elderly women.

Subjects And Methods: Ninety-five community-dwelling elderly women took part in this study. Anthropometric data, blood ACE activity analysis, maximum power (P) and optimal shortening velocity (υ) of the knee extensor muscles, handgrip strength, physical activity (PA) and functional performance were measured.

Results: Women taking ACEI were on average almost 2 years older than the women who did not take ACEI. They took more medicines and were also characterized by significantly lower level of ACE, but they did not differ in terms of PA level, results of functional performance and parameters characterizing muscle functions. No correlations of ACE activity with P and handgrip strength, as well as with PA or functional performance were found. Higher ACE activity was connected with lower υ for women who did not take any ASBMs (rho =-0.37; =0.01).

Conclusion: Serum ACE activity was not associated with muscle strength, power and functional performance in both ASBM users and nonusers, but was associated with optimal shortening velocity of quadriceps muscles in older women. Further prospective studies are needed to assess if ACEIs or other ASBMs may slow down the decline in muscle function and performance.
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http://dx.doi.org/10.2147/CIA.S146494DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5656348PMC
April 2018

Strength of knee flexors of the paretic limb as an important determinant of functional status in post-stroke rehabilitation.

Neurol Neurochir Pol 2017 May - Jun;51(3):227-233. Epub 2017 Mar 30.

Department of Physical Medicine, Medical University of Lodz, Pl. Hallera 1, 90-647 Lodz, Poland. Electronic address:

Objective: The purpose of the study was to assess the effectiveness of the multi-modal exercise program (MMEP) in patients after stroke, and to identify muscles that are the best predictors of functional performance and changes in functional status in a 3-week rehabilitation program.

Methods: Thirty-one post-stroke patients (60.6±12.7 years) participating in a 3-week MMEP took part in the study. Measurements of extensor and flexor strength of the knee (F, F) were done. Functional performance was measured using Timed Up & Go test (TUG), 6-Minute Walk Test (6-MWT) and Tinetti Test.

Results: The rehabilitation program improved all the results of functional tests, as well as the values of strength in the patients. Both baseline and post-rehabilitation functional status was associated with knee flexor and extensor muscle strength of paretic but not of non-paretic limbs. At baseline examination muscle strength difference between both Fkg and Fkg had an influence on functional status. After rehabilitation the effect of muscle strength difference on functional status was not evident for Fkg and, interestingly, even more prominent for Fkg.

Conclusions: MMEP can effectively increase muscle strength and functional capacity in post-stroke patients. Knee flexor muscle strength of the paretic limb and the knee flexor difference between the limbs is the best predictor of functional performance in stroke survivors.
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http://dx.doi.org/10.1016/j.pjnns.2017.03.004DOI Listing
August 2017

Inappropriate nutrients intake is associated with lower functional status and inferior quality of life in older adults with depression.

Clin Interv Aging 2016 21;11:1505-1517. Epub 2016 Oct 21.

Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland.

Objectives: The study is a case-control analysis of whether depression impairs physical and cognitive functioning and quality of life, and whether there is a relationship between nutrient deficiencies and these adverse changes.

Patients And Methods: A total of 130 older subjects participated in the study: 65 with diagnosed depression (16 men and 49 women) and 65 age- and sex-matched controls without depression. All patients underwent comprehensive geriatric assessment. Nutritional state was assessed with the Mini Nutritional Assessment, cognitive performance was evaluated by the Mini-Mental State Examination and physical functioning by the Timed "Up & Go" test and handgrip strength. The pattern of consumption of various nutrients was analyzed in detail.

Results: The differences in cognitive functioning observed between the groups were related to specific nutrient intake, as was handgrip strength to some extent. The differences in nutritional status, several functional tests and muscle strength were related to both the presence of depression and inappropriate consumption of certain nutrients.

Conclusion: The incidence of falls and poor quality of life may be partially associated with the presence of depression. The inappropriate intake of selected nutrients may impair the functioning and quality of life of older adults with depression, such as the excess consumption of sucrose and insufficient consumption of protein, fiber, eicosapentaenoic acid, niacin and vitamin B6. Particular nutrients should be translated into dietary patterns which allow the individual patient to address these nutrient deficiencies.
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http://dx.doi.org/10.2147/CIA.S114669DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5087705PMC
March 2017

Physical Activity in Older Adults in Relation to Place of Residence and Coexistent Chronic Diseases.

J Phys Act Health 2017 01 24;14(1):20-28. Epub 2016 Oct 24.

Background: The goal of this study was to assess the physical activity (PA) and its determinants of older people living in the 3 different environments.

Methods: Three equal (n = 693 each) groups of individuals aged ≥65 years living in urban, rural and institutional environments took part in this study. PA was measured by the Seven Day Recall PA Questionnaire (energy expenditure-PA-EE) and the Stanford Usual Activity Questionnaire (health-related behaviors-PA-HRB).

Results: PA-EE was highest in the rural environment and lowest in nursing homes. PA-HRB were most common in urban area. Older age, lower education level, several concomitant diseases and the number of systematically used medications were consistently related to lower PA-EE and PA-HRB. Smoking habit, presence of hypertension, musculoskeletal and gastrointestinal disorders had different association to PA-EE and PA-HRB in the 3 environments.

Conclusions: Subpopulations of older people differ from the general population with regard to their level of PA and its association with sociodemographic data and concomitant diseases. Concomitant serious diseases significantly decrease the level of PA of older subjects. The relationship between PA and nondebilitating disorders may vary depending on the living environment or PA assessment methodology.
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http://dx.doi.org/10.1123/jpah.2016-0097DOI Listing
January 2017

Physical Activity, Aerobic Capacity, and Total Antioxidant Capacity in Healthy Men and in Men with Coronary Heart Disease.

Oxid Med Cell Longev 2015 14;2015:197307. Epub 2015 Sep 14.

Department of Geriatrics, Medical University of Lodz, Plac Hallera 1, 90-647 Lodz, Poland ; Department of Preventive Medicine, Medical University of Lodz, Żeligowskiego Street 7/9, 90-752 Lodz, Poland.

Objective: The purpose of the study was to assess total antioxidant capacity (TAC) of blood serum in relation with habitual leisure time physical activity (LTPA) and aerobic capacity in a group of 90 men with coronary heart disease (CHD) aged 34.8-77.0 years and in 90 age-matched peers without CHD.

Methods: Two spectrophotometric methods were applied to assess TAC: Ferric Reducing Ability of Serum (TAC-FRAS) and 2.2-diphenyl-1-picryl-hydrazyl (TAC-DPPH) tests. Aerobic capacity was expressed as physical working capacity at 85% of the maximal heart rate (PWC(85%HRmax)).

Results: CHD patients had higher values of TACFRAS (1.37 ± 0.28 versus 1.27 ± 0.23 mmol FeCl2·L(-1); P < 0.05) but there were no group differences for TAC-DPPH and for uric acid (UA). Negative correlation was found between LTPA (also when calculated per kg of body mass) and TAC-DPPH in CHD patients. In CHD patients, TAC-FRAS and UA were lower in subjects with higher aerobic capacity expressed as PWC(85%HRmax/kg). Those associations were not found in healthy men.

Conclusions: We conclude that TAC of blood serum is moderately adversely related to LTPA and aerobic capacity in patients with CHD. UA, as the main determinant of serum TAC, may be partially responsible for those associations.
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http://dx.doi.org/10.1155/2015/197307DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4584233PMC
May 2016

[Comparison of the analgesic effect of interferential current (IFC) and TENS in patients with low back pain].

Wiad Lek 2015 ;68(1):13-9

Introduction: Electrotherapy, including theTENS and interferential current (IFC) is one of the most frequently used treatments in physical therapy in patients with low back pain. The aim of this study was to assess the influence of TENS and IFC on pain relief and to compare the analgesic efficacy of the two currents.

Material And Methods: Sixty patients aged 53.5 ± 12.5, with low back pain, were randomly divided into two groups: IFC (gr. I) and TENS (gr. II). Depending on the groups, patients were given series of ten 20-minute sessions using either IF orTENS currents. In all patients VAS and Laitinen modified scale were taken before and after treatment.

Results: After 2-weeks therapy there was improvement in the VAS and Laitinen scale (all components) in both groups, except for the part of the Laitinen scale on the reduction of activity in the group II (TENS). There was no statistically significant difference between the TENS and IF groups in reducing the intensity and other aspects of pain (frequency, pain medication and activity limitation) under the influence of therapy (p > 0.05).

Conclusions: Interferential current and TENS therapy are effective for pain relief in patients with low back pain. The study showed equal analgesic efficacy of both treatments.
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July 2015

[Patients' knowledge regarding modifiable risk factors of stroke].

Pol Merkur Lekarski 2015 Jan;38(223):16-9

Klinika Neurologii i Udarów Mózgu, Uniwersytecki Szpital Kliniczny im. WAM - Centralny Szpital Weteranów w Łodzi.

Unlabelled: Regular physical activity constitutes effective measure of both primary and secondary protection against modern-age diseases. The aim of the paper was to assess the level of patients' knowledge regarding the influence of low physical activity and other modifiable risk factors affecting the increase in stroke occurrence in early stages of rehabilitation (day 9 after the cerebrovascular accident).

Aim: The aim of the paper was to assess the level of patients' knowledge regarding the influence of low physical activity and other modifiable risk factors affecting the increase in stroke occurrence in early stages of rehabilitation (day 9 after the cerebrovascular accident).

Materials And Methods: The study group included 96 patients hospitalized in the Department of Neurology and Epileptology with Stroke Unit, who were diagnosed with a stroke with motion deficits and who were recommended kinesitherapy. All patients were interviewed, which was complemented with the authors' questionnaire including questions regarding the knowledge of modifiable risk factors of stroke.

Results: The risk factor of stoke which was most frequently mentioned by the patients was arterial hypertension - 87 patients (90.6%). Only 7 respondents indicated low physical activity. On average, less risk factors were known by women. No correlation between age and the number of indicated risk factors was found.

Conclusions: Majority of the patients after stroke do not know how important low physical activity is in terms of it being a risk factor of stroke. The most recognized stroke factors are: arterial hypertension, carotid artery stenosis and atrial fibrillation. The level of patients' knowledge regarding modifiable risk factors of stroke connected with the style of life is insufficient. It is necessary to intensify educational activities that promote physical activity as an important element of prevention of modern-age diseases, including stroke.
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January 2015

Comparative analysis of the expected demands for nursing care services among older people from urban, rural, and institutional environments.

Clin Interv Aging 2015 2;10:405-12. Epub 2015 Feb 2.

Department of Geriatrics, Medical University of Lodz, Poland.

Background: Demand for nursing and social services may vary depending on the socio-demographic variables, health status, receipt of formal and informal care provided, and place of residence.

Objectives: To conduct a comparative analysis of the expectations of older people from urban, rural, and institutional environments concerning nursing care with respect to the care provided and elements of a comprehensive geriatric assessment.

Material And Methods: The study comprised 2,627 individuals above the age of 65 years living in urban (n=935) and rural (n=812) areas as well as nursing homes (n=880).

Results: Family care was most often expected both in urban (56.6%) and rural (54.7%) environments, followed by care provided simultaneously by a family and nurse (urban - 18.8%; rural - 26.1%) and realized only by a nurse (urban - 24.6%; rural - 19.2%). Not surprisingly, nursing home residents most commonly expected nursing care (57.5%) but 33.1% preferred care provided by family or friends and neighbors. In the whole cohort of people living in the home environment (n=1,718), those living with family demonstrated willingness to use primarily care implemented by the family (62.0%), while respondents living alone more often expected nursing services (30.3%). In the logistic regression model, among the respondents living in the city, only the form of care already received determined the expectations for nursing care. Among the respondents living in the county, the presence of musculoskeletal disorders, better nutritional status, and current care provided by family decreased expectations for nursing care. Higher cognitive functioning, symptoms of depression, and living alone increased the willingness to obtain nursing care.

Conclusion: Older inhabitants of urban areas, rural areas, and those residing in institutions have different expectations for individual nursing care. Nearly 45% of seniors living in the community expect to obtain nursing care, while only 1.6% do not expect any social or nursing help. While the expectations for the provision of nursing care are significantly increased by living alone, they are decreased by having access to care provided by family. Support for families to take care of elderly relatives would appear to be essential for an effective nursing and social care system.
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http://dx.doi.org/10.2147/CIA.S72534DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4321418PMC
September 2015

Cardiovascular risk factors and total serum antioxidant capacity in healthy men and in men with coronary heart disease.

Biomed Res Int 2014 11;2014:216964. Epub 2014 Aug 11.

Department of Geriatrics, Medical University of Lodz, Pl. Hallera 1, 90-647 Lodz, Poland ; Department of Preventive Medicine, Medical University of Lodz, Zeligowskiego Street 7/9, 90-752 Lodz, Poland.

Whether the incidence of coronary heart disease (CHD) is related to a decrease in total antioxidant capacity (TAC) has not yet been completely clarified. We assessed TAC of blood serum in a group of 163 men with CHD aged 34.8-77.0 years and in 163 age-matched peers without CHD. Two spectrophotometric methods were applied to assess TAC: ferric reducing ability of serum (TAC-FRAS) and 2.2-diphenyl-1-picryl-hydrazyl (TAC-DPPH) tests. In the CHD group, multivariate analysis revealed that uric acid (UA), triglycerides, and systolic blood pressure contributed independently to the TAC-FRAS variance. TAC-DPPH was favorably predicted by UA concentration, but negatively so by current smoking and glucose levels. In men without CHD, UA was the only independent determinant of both TAC-FRAS and TAC-DPPH. Presence of CHD was not an independent predictor of TAC-observed between-group differences (higher TAC in CHD patients) disappeared after adjustment for other confounders. We conclude that UA is the main determinant of TAC of blood serum in men. TAC is not directly influenced by age or CHD but is related to several indices of overweight/obesity and laboratory measures of metabolic syndrome, especially in patients with CHD.
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http://dx.doi.org/10.1155/2014/216964DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4144148PMC
May 2015

Association of muscle strength, power, and optimal shortening velocity with functional abilities of women with chronic osteoarthritis participating in a multi-modal exercise program.

J Aging Phys Act 2014 Oct 4;22(4):564-70. Epub 2013 Dec 4.

Department of Physical Medicine, Medical University of Lodz, Poland.

We assessed the relative association of quadriceps muscle strength and power as well as optimal shortening velocity (υ(opt)) to physical functioning in 28 women aged 50-87 years with chronic osteoarthritis participating in a three-week multimodal exercise program. Quadriceps muscle strength, power, υ(opt), and functional performance using the Activities of Daily Living (ADL) scale, Timed Up & Go (TUG) test, Tinetti test, and 6-Minute Walking Test (6-MWT) were assessed pre- and postrehabilitation. With rehabilitation, patients improved the values of strength, power, and the results of all functional tests. Both at baseline and postrehabilitation, functional status was more strongly related to power and υ(opt) than to strength. Functional gains obtained with rehabilitation were not related to changes in power or υ(opt), and only very modestly related to changes in strength. Future studies should assess the benefits and feasibility of power- and velocity-oriented training in patients with osteoarthritis.
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http://dx.doi.org/10.1123/japa.2012-0125DOI Listing
October 2014

Association between respiratory tract infections and incidence of falls in nursing home residents.

Pol Arch Med Wewn 2013 12;123(7-8):371-7. Epub 2013 Apr 12.

Introduction: Falls are complex incidents caused by a combination of intrinsic impairments and disabilities with or without accompanying environmental hazards.

Objectives: The aim of the study was to assess the relationship between respiratory tract infections (RTIs) and the incidence of falls, and to further link the history of falls to functional status in nursing homes residents.

Patients And Methods: The study involved 255 residents at 3 nursing homes aged 65 years and older. Falls and RTIs were registered during 1 year, and, afterwards, a comprehensive geriatric assessment was performed in each subject.

Results: Falls occurred in 104 subjects, and 17 falls resulted in a fracture. The waist-to-hip ratio (WHR) was lower among subjects with fractures compared with those without fractures. Subjects with a fracture in history had a significantly worse functional status in terms both of basic and instrumental daily activities. Nursing home residents with a history of falls more often suffered from infections than those without such history (1.53 ±1.31 vs. 1.03 ±1.17, respectively, P <0.001). Similarly, subjects with a history of fractures more often suffered from infections than those without such history (1.82 ±1.07 vs. 1.19 ±1.26; P = 0.012). After adjustment for other covariates in a multivariate model, RTIs remained an independent predictor of falls and fractures.

Conclusions: The risk of falls and fractures in nursing home residents is associated with the occurrence of RTIs. A low WHR is a risk factor for falls with fractures. Older subjects with a history of fracture are characterized by a worse functional status. Preventing infections may probably reduce the number of falls and fractures in older nursing homes residents.
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http://dx.doi.org/10.20452/pamw.1823DOI Listing
September 2015

Physical activity and total antioxidant capacity across an adult lifespan of men.

Med Sci Sports Exerc 2012 Apr;44(4):575-82

Department of Geriatrics, Medical University of Lodz, Lodz, Poland.

Purpose: The aim of the study was to determine the association between the long-term physical activity (PA) and the total antioxidant capacity (TAC) of blood serum and their association with coexisting risk factors of cardiometabolic diseases in a group of relatively healthy men.

Methods: The research was conducted among 422 males age 19.2-89.8 yr, either sedentary or involved in recreational sports activities. Anthropometric measurements, lipid profile, and measurement of glucose and uric acid levels were performed in every man. Current PA, historical PA, and aerobic fitness (physical working capacity) were assessed. TAC was determined with two spectrophotometric methods: the ferric reducing ability of serum (TAC-FRAS) and 2,2-diphenyl-1-picryl-hydrazyl (TAC-DPPH) tests.

Results: TAC was not related to the age of the subjects. Higher current and historical PA were associated with a more favorable cardiometabolic risk profile but not TAC. In fact, current PA level was connected with lower values of TAC-FRAS. Values of both TAC-FRAS and TAC-DPPH decreased with an increase of aerobic capacity. Individuals with coexisting anthropometric and biochemical risk factors of cardiovascular diseases and with elevated values of arterial pressure had higher TAC. Values of both TAC-FRAS (r = 0.66) and TAC-DPPH (r = 0.39) were strongly positively correlated with uric acid level.

Conclusions: Overweight, obesity, higher blood pressure, unfavorable blood lipid profile, and especially higher uric acid levels are connected with greater TAC of blood serum across an adult man's life. High PA and fitness are associated with a more favorable overall risk profile of cardiovascular and metabolic diseases but are related to lower TAC.
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http://dx.doi.org/10.1249/MSS.0b013e318238b7f0DOI Listing
April 2012

Modified Equilibrium-Dispersive Model for the interpretation of the efficiency of columns packed with core-shell particle.

J Chromatogr A 2011 Aug 17;1218(32):5449-55. Epub 2011 Jun 17.

Department of Chemical and Process Engineering, Rzeszów University of Technology, 35-959 Rzeszów, Poland.

A modified Equilibrium Dispersive (ED) Model is proposed for the modeling of chromatographic processes in columns packed with shell-particle adsorbents and operated under very high pressures. This new model was validated on the basis of experimental results obtained with 2.1 mm × 150 mm columns packed with superficially porous 1.7 μm Kinetex-C(18) particles and with classical columns packed with 1.7 μm BEH-C(18) fully porous particles. The influence of the heat friction on the performance of these columns was analyzed by comparing the experimental and calculated peak profiles. Moreover a theoretical analysis of the influence the solid-core conductivity on the column efficiency was discussed.
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http://dx.doi.org/10.1016/j.chroma.2011.06.019DOI Listing
August 2011

Modeling of thermal processes in very high pressure liquid chromatography for column immersed in a water bath: Application of the selected models.

J Chromatogr A 2010 Jul;1217(28):4704-12

Department of Chemical and Process Engineering, Rzeszów University of Technology, Rzeszów, Poland.

Currently, chromatographic analyses are carried out by operating columns packed with sub-2 μm particles under very high pressure gradients, up to 1200 bar for 5 cm long columns. This provides the high flow rates that are necessary for the achievement of high column efficiencies and short analysis times. However, operating columns at high flow rates under such high pressure gradients generate a large amount of heat due to the viscous friction of the mobile phase stream that percolates through a low permeability bed. The evacuation of this heat causes the formation of significant or even large axial and radial gradients of all the physico-chemical parameters characterizing the packing material and the mobile phase, eventually resulting in a loss of column efficiency. We previously developed and successfully applied a model combining the heat and the mass balances of a chromatographic column operated under very high pressure gradients (VHPLC). The use of this model requires accurate estimates of the dispersion coefficients at each applied mobile phase velocity. This work reports on a modification of the mass balance model such that only one measurement is now necessary to accurately predict elution peak profiles in a wide range of mobile phase velocities. The conditions under which the simple equilibrium-dispersive (ED) and transport-dispersive (TD) models are applicable in VHPLC are also discussed. This work proves that the new combination of the heat transfer and the ED model discussed in this work enables the calculation of accurate profiles for peaks eluted under extreme conditions, like when the column is thermostated in a water bath.
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http://dx.doi.org/10.1016/j.chroma.2010.05.018DOI Listing
July 2010

Modeling of thermal processes in high pressure liquid chromatography: II. Thermal heterogeneity at very high pressures.

J Chromatogr A 2009 Sep 6;1216(38):6575-86. Epub 2009 Aug 6.

Department of Chemical and Process Engineering, Rzeszów University of Technology, Ul. W. Pola 2, 35-959 Rzeszów, Poland.

Advanced instruments for liquid chromatography enables the operation of columns packed with sub-2 microm particles at the very high inlet pressures, up to 1000 bar, that are necessary to achieve the high column efficiency and the short analysis times that can be provided by the use of these columns. However, operating rather short columns at high mobile phase velocities, under high pressure gradients causes the production of a large amount of heat due to the viscous friction of the eluent percolating through the column bed. The evacuation of this heat causes the formation of significant axial and radial temperature gradients. Due to these thermal gradients, the retention factors of analytes and the mobile phase velocity are no longer constant throughout the column. The consequence of this heat production is a loss of column efficiency. We previously developed a model combining the heat and mass balance of the column, the equations of flow through porous media, and a linear isotherm model of the analyte. This model was solved and validated for conventional columns operated under moderate pressures. We report here on the results obtained when this model is applied to columns packed with very fine particles, operated under very high pressures. These results prove that our model accounts well for all the experimental results. The same column that elutes symmetrical, nearly Gaussian peaks at low flow rates, under relatively low pressure drops, provides strongly deformed, unsymmetrical peaks when operated at high flow rates, under high pressures, and under different thermal environments. The loss in column efficiency is particularly important when the column wall is kept at constant temperature, by immersing the column in a water bath.
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http://dx.doi.org/10.1016/j.chroma.2009.07.049DOI Listing
September 2009

Modeling of thermal processes in high pressure liquid chromatography: I. Low pressure onset of thermal heterogeneity.

J Chromatogr A 2009 Sep 17;1216(38):6560-74. Epub 2009 Jul 17.

Department of Chemical and Process Engineering, Rzeszów University of Technology, 35-959 Rzeszów, Poland.

Heat due to viscous friction is generated in chromatographic columns. When these columns are operated at high flow rates, under a high inlet pressure, this heat causes the formation of significant axial and radial temperature gradients. Consequently, these columns become heterogeneous and several physico-chemical parameters, including the retention factors and the parameters of the mass transfer kinetics of analytes are no longer constant along and across the columns. A robust modeling of the distributions of the physico-chemical parameters allows the analysis of the impact of the heat generated on column performance. We developed a new model of the coupled heat and mass transfers in chromatographic columns, calculated the axial and radial temperature distributions in a column, and derived the distributions of the viscosity and the density of the mobile phase, hence of the axial and radial mobile phase velocities. The coupling of the mass and the heat balances in chromatographic columns was used to model the migration of a compound band under linear conditions. This process yielded the elution band profiles of analytes, hence the column efficiency under two different sets of experimental conditions: (1) the column is operated under natural convection conditions; (2) the column is dipped in a stream of thermostated fluid. The calculated results show that the column efficiency is remarkably lower in the second than in the first case. The inconvenience of maintaining constant the temperature of the column wall (case 2) is that retention factors and mobile phase velocities vary much more significantly across the column than if the column is kept under natural convection conditions (case 1).
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http://dx.doi.org/10.1016/j.chroma.2009.07.020DOI Listing
September 2009