Monitoring Expression of Balance during Therapy in Children with Postural Disorders.

In the literature, we find information about the impact of changes in the shape of the spine on the efficiency of equivalent reactions, and we also find information about the methods and effects of physiotherapy in improving equivalent reactions. However, there is a lack of publications showing the process of changes taking place over time and defining their nature at individual stages of treatment. The aim of this study is to present the process of monitoring the expression of balance in patients aged 8-12 years with postural disorders, in the course of the therapeutic process. The shape of the spine and the efficiency of equilibrium reactions in standing posture and during gait were assessed in all the subjects. The subjects were put into two groups: with a shape-of-spine disorder and without one. The recommended set of therapeutic activities in home conditions lasted about 20 min and was performed by the child with a parent's supervision. The therapeutic program was based on elements of neurophysiological methods: Vojta and PNF. The following parameters were measured: the maximum movement of the center of pressure (CoP) in the frontal plane during gait, the maximum movement of the CoP in the sagittal plane, the movement of the CoP in the frontal plane in static conditions and the movement of the CoP in the sagittal plane in static conditions. Six statistically significant differences were recorded, and all of them were related to measurement I. The Friedman test result was statistically significant for all the indexes. Post hoc analyses were performed using the Dunn-Bonferroni test. The children with shape-of-spine disorders had a lower efficiency of equivalent reactions in relation to the children without disorders. The therapy with the application of neurophysiological methods in the treatment of shape-of-spine disorders improved equilibrium reactions in these patients. Long-lasting and thorough observations of the therapeutic process in children with shape-of-spine disorders should include the monitoring of the efficiency of equilibrium reactions.

Validation Study of the Revised Spirituality and Spiritual Care Rating Scale (SSCRS): A Cross-Sectional Survey in Poland.

Introduction: The use of a validated scale, Spirituality and Spiritual Care Rating Scale (SSCRS) to measure nurses' perceptions of spirituality and spiritual care. Aim: The purpose of this study was to analyse selected psychometric properties of the Polish version of the SSCRS, among them the applicability of the dimensions of spiritual care in nursing, ie, spirituality, spiritual care, religiosity and personalized care, to Polish conditions. Methods: Poland-wide multicentre study with a cross-sectional validation design. The study was conducted between March and June 2019. Seven Polish Nursing Faculties accepted the invitation to participate in the study. A representative sample of 853 nurses enrolled in MSc (postgraduate) programs in nursing participated. After translation and cultural adaption of the SSCRS, the instrument underwent a full psychometric evaluation of its construct validity using (exploratory and confirmatory factor analysis), internal consistency (Cronbach's alpha and correlation analysis), reliability (test-retest analysis), known-group validity (Student's t-test) analysis. Results: The exploratory and confirmatory factor analysis demonstrated that the Polish version of the SSCRS was a three-factor model with "Activity-centred spiritual care" (9 items), "Emotional support-centred spiritual care" (5 items) and "Religiosity" (3 items) domains. The Cronbach's alpha coefficient for the whole scale was 0.902, and the alpha values for the individual domains were 0.898, 0.873 and 0.563, respectively. The three domains mentioned above seemed to provide a comprehensive understanding of spiritual care perceived subjectively by Polish MSc in nursing students. Conclusion: This study demonstrated a substantial degree of similarity in the selected psychometric characteristics of the Polish version of SSCRS and the original scale.

Reproducibility of the German and Slovakian Versions of the Dietary Habits and Nutrition Beliefs Questionnaire (KomPAN).

PURPOSE: The aim of this study was to assess the reproducibility and reliability of the KomPAN questionnaire among two groups of university students from Germany and Slovakia. METHODS: A total of 422 individuals (mean age 21.4 years, SD 4.0), including 197 from Slovakia (men 26.2%) and 225 from Germany (men 22.3%), were tested using the self-administered (SA-Q) version of the KomPAN questionnaire and then retested two weeks later. A cross-classification analysis, kappa coefficients, Cronbach's ɑ coefficients, and a test-retest result comparison were conducted separately for each group of students to assess the reproducibility and reliability of the questionnaire. RESULTS: The cross-classification values were higher than 46.2% among the German students and higher than 55.8% among the Slovakian students. The kappa coefficients ranged from 0.21 to 0.90 in the German students and from 0.38 to 0.94 in the Slovakian students. Cronbach's ɑ ranged from 0.58 to 0.78. CONCLUSION: The questionnaire displayed a moderate to very good reproducibility, which was slightly higher in the Slovakian group than in the German group. Therefore, the questionnaire can be recommended for further analysis and comparison of the dietary habits among Germans and Slovakians on a larger scale.

Determinants of the Impact of Fatigue on the Health of Polish Nursing Students during the COVID-19 Pandemic.

(1) Lockdown-related fatigue occurring during the COVID-19 pandemic is a complex problem that can be experienced in different social groups. The objective of the current study is to attempt to identify socio-demographic and lifestyle-related factors that determine the impact of fatigue on health in general as well as in physical, cognitive, and psychosocial terms and to determine whether, and to what extent, these were predictors of fatigue in nursing students during the COVID-19 pandemic. (2) The study was conducted by the diagnostic poll method between 20 March and 15 December 2021 among 894 nursing students at six Polish universities. To collect the data, a validated Modified Fatigue Impact Scale (MFIS) was used. (3) Students from the age group of ≤20 experienced a significantly greater impact of fatigue on health in general as well as in physical and cognitive terms. The study demonstrated a significant negative relationship between the year of study and the impact of fatigue on health in general terms (r = −0.12; p < 0.0001) and the analyzed health terms, on physical (r = −0.12; p < 0.0001), cognitive (r = −0.10; p < 0.002), and psychosocial (r = −0.07; p < 0.041). In predicting the impact of fatigue on health in general and physical terms, it was the variable related to a reduction in physical activity during the COVID-19 pandemic that had the greatest contribution, while for the cognitive and psychosocial functions, it was the number of meals consumed per day. (4) It is recognized that action is needed to reduce the impact of fatigue on student health by modifying the predictors related to student lifestyles.

Caring Ability and Professional Values of Polish Nursing Students-A Cross-Sectional Study.

Caring ability and professional values developed and shaped during nursing university studies are often recognised as fundamental components of education and professional nursing attitudes. The aim of this study was to analyse the relationship between caring ability and professional values among nursing students and their correlation with selected sociodemographic variables. A cross-sectional study was conducted among a convenience sample of 379 nursing students. During the research, the Polish versions of the Caring Ability Inventory and the Professional Values Scale were used. The overall result in the Professional Values Scale was 108.78 (SD = 16.17)-which is considered average, and in the Caring Ability Inventory 189.55 (SD = 18.77)-which is considered low. Age correlated negatively with the professional values of students in total and in the subscale "care"; in contrast, "gender", "place of residence" and "financial situation" did not show any correlation with the level of students' professional values and caring ability. The professional values and caring abilities of nursing students depended on the year and mode of study and the type of university. The results of the study revealed that the caring ability and professional values of nursing students undergo changes during their education.

Health Behaviours among Nursing Students in Poland during the COVID-19 Pandemic.

(1) Background: An individual's health status can be perceived as a consequence of their health behaviours. This research aimed to determine the intensity of health-promoting behaviours and to identify factors determining the health behaviours of nursing students during the COVID-19 pandemic. (2) Methods: This study included 894 nursing students from six universities in Poland, and it was conducted between 20 March and 15 December 2021. A diagnostic survey was applied as the research method, and the data were collected using the Health Behaviour Inventory and the Satisfaction With Life Scale. (3) Results: Nearly half of the students participating in the study (48.43%) declared that the intensity of their general health behaviours was low. A positive and significant correlation (r = 0.426) was found between general health behaviours and satisfaction with life. A regression model demonstrated general satisfaction with life to be a predictor of taking up health-related behaviours (18%; ß = 0.34), as well as in terms of proper eating habits (4%; ß = 0.15), prophylactic behaviours (6%; ß = 0.21), positive mental attitudes (26%; ß = 0.44) and applied pro-health practices (10%; ß = 0.25). (4) Conclusions: Most nursing students showed low levels of health-promoting behaviours. More research is needed on health behaviours and their determinants among nursing students, as it may be important in explaining the mechanisms of health behaviour formation.

Loneliness and Optimism among Polish Nursing Students during the COVID-19 Pandemic: The Mediatory Role of Self-Efficacy.

(1) The COVID-19 pandemic is a global epidemic crisis situation with negative health consequences. This study aimed to determine the mediatory role of self-efficacy in correlations between dispositional optimism and loneliness (both general loneliness and social and emotional loneliness) among Polish nursing students during the COVID-19 pandemic. (2) The study involved 894 students from six Polish universities. A diagnostic survey was used as the research method, and the Scale for the Measurement of Loneliness Scale (DJGLS), Life Orientation Test (LOT-R), and the Generalized Self-Efficacy Scale (GSES) were used to collect data. (3) The mean subject age was 20.73 years (SD = 1.81). More than half (51.01%) of the respondents scored high on the GSES scale, indicating an individual's belief in the self-efficacy in coping with difficult situations and obstacles. However, 40.60% scored low on the LOT-R scale, indicating that the respondents were pessimistic. The mediation analysis revealed that self-efficacy plays a partial mediatory role in correlations between dispositional optimism and loneliness in general, social and emotional loneliness. (4) It is important to undertake loneliness prophylactic and prevention activities among nursing students and to develop personal resources, i.e., optimism and self-efficacy, to effectively offset the effects of the COVID-19 pandemic.

Loss-of-function variant in chymotrypsin like elastase 3B (CELA3B) is associated with non-alcoholic chronic pancreatitis.

BACKGROUND: Genetic alterations in digestive enzymes have been associated with chronic pancreatitis (CP). Recently, chymotrypsin like elastase 3B (CELA3B) emerged as a novel risk gene. Thus, we evaluated CELA3B in two European cohorts with CP. METHODS: We analyzed all 8 CELA3B exons in 550 German non-alcoholic CP (NACP) patients and in 241 German controls by targeted DNA sequencing. In addition, we analyzed exons 6 and 7 by Sanger sequencing and the c.129+1G>A variant by melting curve analysis in 1078 further German controls. As replication cohort, we investigated up to 243 non-German European NACP patients and up to 1665 controls originating from Poland, Hungary, and Sweden. We assessed the cellular secretion and the elastase activity of recombinant CELA3B variants. RESULTS: In the German discovery cohort, we detected a splice-site variant in intron 2, c.129+1G>A, in 9/550 (1.64%) CP patients and in 5/1319 (0.38%) controls (P=0.007, OR=4.4, 95% CI=1.5-13.0). In the European replication cohort, this variant was also enriched in patients (9/178 [5.06%]) versus controls (13/1247 [1.04%]) (P=0.001, OR=5.1, 95% CI=2.1-12.0). We did not find the two previously reported codon 90 variants, p.R90C and p.R90L. CONCLUSIONS: Our data indicate that CELA3B is a susceptibility gene for CP. In contrast to previous reports suggesting that increased CELA3B activity is associated with CP risk, the splice-site variant identified here is predicted to cause diminished CELA3B expression. How reduced CELA3B function predisposes to pancreatitis remains to be elucidated.

Positive Orientation and Fatigue Experienced by Polish Nursing Students during the COVID-19 Pandemic: The Mediatory Role of Emotional Control.

This study aimed to investigate the mediatory role of emotional control with respect to the control of anger, depression, and anxiety in the relationship between positive orientation and tiredness/fatigue occurring in a group of Polish nursing students during the COVID-19 pandemic. The study included 894 nursing students from six universities in Poland. A diagnostic survey was applied as the research method, and the data were collected using the Fatigue Severity Scale (FSS), the Courtauld Emotional Control Scale (CECS) and the Positive Orientation Scale (SOP). The mean participant age was 20.73 years (SD = 1.81). More than half of the students in the study showed a low level of positive orientation. Correlational analyses revealed a significant negative correlation between positive orientation and tiredness/fatigue experienced by the students participating in the study (r = −0.336; p < 0.001), and correlation between positive orientation and the overall emotional control index (r = −0.317; p < 0.001), and the indices of control of anger (r = −0.154; p < 0.01), depression (r = −0.376; p < 0.001), and anxiety (r = −0.236; p < 0.01). Analysis of the results also revealed the occurrence of significant, positive links between the controlled emotions and their components and the tiredness/fatigue experienced by nursing students. It is important to take action associated with the prevention of tiredness/fatigue among students and to reinforce a positive orientation and the capacity to control emotions to effectively minimize the effects of the COVID-19 pandemic on nursing students.

Burden of COVID-19 Mortality and Morbidity in Poland in 2020.

In 2020 COVID-19 caused 41,442 deaths in Poland. We aimed to estimate the burden of COVID-19 using years of potential life lost (YPLL) and quality-adjusted years of life lost (QALYL). YPLL were calculated by multiplying the number of deaths due to COVID-19 in the analyzed age/sex group by the residual life expectancy for that group. Standard and country-specific (local) life tables were used to calculate SPYLL and LPYLL, respectively. QALYL were calculated adjusting LPYLL due to COVID-19 death by age/sex specific utility values. Deaths from COVID-19 in Poland in 2020 caused loss of 630,027 SPYLL, 436,361 LPYLL, and 270,572 QALYL. The loss was greater among men and rose with age reaching the maximum among men aged 65-69 and among women aged 70-74. Burden of COVID-19 in terms of YPLL is proportionate to external-cause deaths and was higher than the burden of disease in the respiratory system. Differential effects by sex and age indicate important heterogeneities in the mortality effects of COVID-19 and justifies policies based not only on age, but also on sex. Comparison with YPLL due to other diseases showed that mortality from COVID-19 represents a substantial burden on both society and on individuals in Poland.

Variants in the pancreatic CUB and zona pellucida-like domains 1 (CUZD1) gene in early-onset chronic pancreatitis - A possible new susceptibility gene.

OBJECTIVE: Non-alcoholic chronic pancreatitis (NACP) frequently develops in the setting of genetic susceptibility associated with alterations in genes that are highly expressed in the pancreas. However, the genetic basis of NACP remains unresolved in a significant number of patients warranting a search for further risk genes. DESIGN: We analyzed CUZD1, which encodes the CUB and zona pellucida-like domains 1 protein that is found in high levels in pancreatic acinar cells. We sequenced the coding region in 1163 European patients and 2018 European controls. In addition, we analyzed 297 patients and 1070 controls from Japan. We analyzed secretion of wild-type and mutant CUZD1 from transfected cells using Western blotting. RESULTS: In the European cohort, we detected 30 non-synonymous variants. Using different prediction tools (SIFT, CADD, PROVEAN, PredictSNP) or the combination of these tools, we found accumulation of predicted deleterious variants in patients (p-value range 0.002-0.013; OR range 3.1-5.2). No association was found in the Japanese cohort, in which 13 non-synonymous variants were detected. Functional studies revealed >50% reduced secretion of 7 variants, however, these variants were not significantly enriched in European CP patients. CONCLUSION: Our data indicate that CUZD1 might be a novel susceptibility gene for NACP. How these variants predispose to pancreatitis remains to be elucidated.

Vitamin D supplementation to treat SARS-CoV-2 positive patients. Evidence from meta-analysis.

BACKGROUND: Vitamin D is a likely candidate for treatment as its immune modulating characteristics have effects on coronavirus disease 2019 (COVID-19) patients. It was sought herein, to summarize the studies published to date regarding the vitamin D supplementation to treat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive patients. METHODS: A systematic review and meta-analysis were performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The primary outcome were 14-day and in-hospital mortality reported as an odds ratio (OR) with the associated 95% confidence interval (CI). RESULTS: Eight articles were included in the review with a combined total of 2,322 individual patients, 786 in the vitamin D supplementation group and 1,536 in the control group. The use of vitamin D compared to the group without vitamin D supplementation was associated with a lower 14-day mortality (18.8% vs. 31.3%, respectively; OR = 0.51; 95% CI: 0.12-2.19; p = 0.36), a lower in-hospital mortality (5.6% vs. 16.1%; OR = 0.56; 95% CI: 0.23-1.37; I2 = 74%; p = 0.20), the rarer intensive care unit admission (6.4% vs. 23.4%; OR = 0.19; 95% CI: 0.06-0.54; I2 = 77%; p = 0.002) as well as rarer mechanical ventilation (6.5% vs. 18.9%; OR = 0.36; 95% CI: 0.16-0.80; I2 = 0.48; p = 0.01). CONCLUSIONS: Vitamin D supplementation in SARS-CoV-2 positive patients has the potential to positively impact patients with both mild and severe symptoms. As several high-quality randomized control studies have demonstrated a benefit in hospital mortality, vitamin D should be considered a supplemental therapy of strong interest. Should vitamin D prove to reduce hospitalization rates and symptoms outside of the hospital setting, the cost and benefit to global pandemic mitigation efforts would be substantial.

GERD-A Burning Problem after Sleeve Gastrectomy?

BACKGROUND: Surgical treatment is the most effective method of treatment for obesity; and laparoscopic sleeve gastrectomy (LSG) is the most frequently performed bariatric surgery. OBJECTIVE: The aim of the study was evaluation of the frequency of occurrence and the degree of progression of changes characteristic of GERD in patients who had undergone LSG in clinical; endoscopic; and microscopic images in the obtained bioptats; and an attempt to correlate the results obtained with the effectiveness of bariatric treatment. MATERIALS AND METHOD: The anonymized clinical data concerning 214 patients who had undergone LSG were collected from the database. Invitations for check-up examinations were distributed, to which 37 patients responded. Two patients were excluded from the study. In 35 patients after LSG check-up clinical examination, bariatric endoscopy (BE) and bariatric microscopy (BM) were performed on bioptats collected from the site of the gastro-esophageal junction; and 3 specimens collected at 2 cm intervals from the Z-line. The study was performed according to the standard protocol. RESULTS: In the analyzed group, clinical symptoms of GERD occurred in 12 patients (34.5%), including 10 females and 2 males. The symptom reported by all patients was retrosternal pain/burning (heartburn). In BE, foci of ectopic mucosa in the epicardial part of the esophagus were found in 16 patients (14 F and 2 M). No correlation was observed between the analyzed parameters and the occurrence of the above-mentioned changes. In BM, only in three patients were the changes described as normal esophageal mucosa; while in another three, as foci of intestinal metaplasia, Barrett's esophagus. In this group no foci of dysplasia were found. In eight patients, the changes were described as inflammatory. In ten patients from this group, microscopic changes occurred without clinical symptoms of the disease. CONCLUSIONS: GERD is an important clinical problem in patients after LSG; therefore; the problem of occurrence or exacerbation of symptoms of the disease should be discussed with the patient during qualification for bariatric surgery. The bariatric effectiveness of LSG does not correlate with the occurrence of the symptoms of GERD after the procedure. However; the lack of clinical symptoms of the disease does not mean the lack of its occurrence. Therefore; the endoscopic check-up after LSG should be routinely performed. During the qualification for LSG screening, histopathologic examinations of the esophagus may be useful for the assessment of the microscopic symptoms of GERD in oligosymptomatic patients; and exclusion of rare pathologies of the esophagus (e.g., eosinophilic esophagitis), which may complicate post-operative course.

A New Aberration in the VPS33B Gene Leads to Full-Symptom ARCS1.

BACKGROUND ARCS1 is an acronym for arthrogryposis, renal dysfunction, and cholestasis. It is a congenital malfunction with autosomal recessive inheritance, and, unfortunately, its prognosis is still poor. It is believed that VPS33B is altered in 75% of cases and that the VIPAR gene is altered in approximately 25% of them. CASE REPORT An affected child was born from the first pregnancy of 26-year-old mother and a 30-year-old father with no previous medical history and no genetic conditions. The first clinical symptoms were observed at the end of the child's second week of life. The mother reported the child has decreasing body weight and loss of appetite. After admission to the ward, the child was apathetic and sleepy. Symptoms of conjunctivitis, pale and dry skin, and mild face and mild body dysmorphia were observed. CONCLUSIONS Laboratory tests revealed proteinuria of up to 1.36 g/l and glycosuria of up to 28 mmol/l, as well as fluctuating metabolic acidosis. The bilirubin level reached 6.62 mg/dl, along with alkaline phosphatase at 470 U/l. Moreover, hypothyroidism with TSH at 16.71 uU/ml was observed. Because of the co-occurrence of cholestasis and renal dysfunction, molecular testing was done. The 17th exon of VPS33B was sequenced by Sanger DNA sequencing method. To the best of our knowledge, this is the first report of homozygotic mutation c.1235_1236delinsG (p.Pro412ArgfsTer7) in the VPS33B gene. The risk of transfer of the mutation to future descendants was calculated as 25%. Due to the wide landscape of molecular alternation in the 17th exon of the VPS33B gene, we propose using Sanger whole-exon sequencing as a first-choice diagnostic test.

Loss of function TRPV6 variants are associated with chronic pancreatitis in nonalcoholic early-onset Polish and German patients.

PURPOSE: Loss of function variants of the transient receptor potential cation channel, subfamily V, member 6 (TRPV6) have been recently associated with chronic pancreatitis (CP) in Japanese, German and French patients. Here, we investigated the association of TRPV6 variants with CP in independent European cohorts of early-onset CP patients from Poland and Germany. PATIENTS AND METHODS: We enrolled 152 pediatric CP patients (median age 8.6 yrs) with no history of alcohol/smoking abuse and 472 controls from Poland as well as 157 nonalcoholic young CP patients (median age 20 yrs) and 750 controls from Germany. Coding regions of TRPV6 were screened by Sanger and next generation sequencing. Selected, potentially pathogenic TRPV6 variants were expressed in HEK293T cells and TRPV6 activity was analyzed using ratiometric Ca2+ measurements. RESULTS: Overall, we identified 10 novel (3 nonsense and 7 missenses) TRPV6 variants in CP patients. TRPV6 p.V239SfsX53 nonsense variant and the variants showing significant decrease in intracellular Ca2+ concentration in HEK293T cells (p.R174X, p.L576R, p.R342Q), were significantly overrepresented in Polish patients as compared to controls (6/152, 3.9% vs. 0/358, 0%; P = 0,0007). Nonsense TRPV6 variants predicted as loss of function (p.V239SfsX53 and p.R624X) were also significantly overrepresented in German patients (3/157; 2.0% vs 0/750; 0%, P = 0.005). CONCLUSIONS: We showed that TRPV6 loss of function variants are associated with elevated CP risk in early-onset Polish and German patients confirming that TRPV6 is a novel CP susceptibility gene.

Analysis of the Nutritional Status in Homeless People in Poland Based on the Selected Biochemical Parameters.

The aim of the study was to assess the nutritional status of adult homeless people using both anthropometric and biochemical measurements. The analysis comprised anthropometric indicators, i.e., body mass index and waist circumference, and the following biomarkers: red blood cells, hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration, mean corpuscular hemoglobin, white blood cells, complete lymphocyte count, neutrophils-to-lymphocytes ratio, platelets-to-lymphocytes ratio, platelets-to-leukocytes ratio, C reactive protein level, serum iron concentration, serum albumin concentration, total serum protein, fasting lipids and blood glucose level. There were representative Polish homeless people enrolled (n = 580). The analysis of the conducted studies proved that there is a greater frequency of overweight and obesity than underweight in the target population. The major problem was abdominal obesity that was present statistically more frequently in women than men (p < 0.001). In the majority of cases, homeless people were found to have normal complete blood count parameters. In obese people, there were statistically significant both elevated and decreased hematocrit levels, a significant decrease in red blood cells, elevated serum glucose, triglycerides and total protein level (p < 0.05). The presence of abdominal obesity, elevated glucose concentration, low-density lipoprotein cholesterol, and triglycerides, and decreased high-density lipoprotein cholesterol in serum together with smoking increase the risk of cardiovascular disease.

Diet Quality Compared to the Nutritional Knowledge of Polish, German, and Slovakian University Students-Preliminary Research.

The eating habits of students differ significantly from those recommended by health practitioners. The aim of this study was to find differences related to diet quality and knowledge on nutrition among Polish, German, and Slovakian students as well as to examine which factors differentiate the diet quality of students from these three countries. The study was conducted on a group of 394 university students from Poland, Germany, and Slovakia. The assessment of diet quality and knowledge on food and nutrition was done with the use of the Dietary Habits and Nutrition Beliefs Questionnaire. The diet of German students was characterized by a significantly higher consumption of legume-based foods, vegetables, and fruit compared to Polish students and Slovakian participants (p < 0.001). The diet of the Poles was characterized by a high consumption of cured meat, smoked sausages, hot dogs, white bread and bakery products, butter, fried foods, and energy drinks. The most important factors significantly associated with diet quality involved the country, place of residence, Body Mass Index (BMI), physical activity, and time spent watching TV or using a computer. Polish students were characterized by the highest level of knowledge on food and nutrition (p < 0.001). However, it was not reflected in their diet. The authorities of universities should aim to provide students with access to canteens on campuses which would offer the possibility of consumption of both affordable and healthy meals.

The Effect of Bariatric Surgery on Weight Loss and Metabolic Changes in Adults with Obesity.

Methods of treating obesity, such as changes in lifestyle, physical activity, restrictive diets, and psychotherapy, are not sufficient. Currently, it is considered that in the case of patients who meet the eligibility criteria for surgery, the treatment of choice should be bariatric surgery. The aim of this study was to assess the weight loss and metabolic changes in a group of adults with obesity undergoing bariatric surgery. The study involved 163 patients whose body mass index (BMI) exceeded 40 or 35 kg/m2, concurrent with at least one metabolic sequelae. In 120 of the cases (74%), sleeve gastrectomy was used; in 35 (21%), gastric bypass was used; and in 8 (5%), laparoscopic Roux-en-Y bypass was used. Metabolic parameters such as total cholesterol, LDL-cholesterol (low-density lipoprotein cholesterol), HDL-cholesterol (high-density lipoprotein cholesterol), triglycerides, and glucose were measured preoperatively and postoperatively, as well as the creatinine, creatine kinase (CK-MB), and leptin activity. In patients undergoing bariatric surgery, a significant decrease in excess weight (p < 0.001) was observed at all the analyzed time points, compared to the pre-surgery value. Weight loss after surgery was associated with a significant improvement in glycemia (109.6 ± 48.0 vs. 86.6 ± 7.9 mg/dL >24 months after surgery; p = 0.003), triglycerides (156.9 ± 79.6 vs. 112.7 ± 44.3 mg/dL >24 months after surgery; p = 0.043) and leptin (197.50 ± 257.3 vs. 75.98 ± 117.7 pg/mL 12 months after surgery; p = 0.0116) concentration. The results of the research confirm the thesis on the effectiveness of bariatric surgery in reducing excess body weight and improving metabolic parameters in patients with extreme obesity.

Anthropometric indices and cut-off points in the diagnosis of metabolic disorders.

OBJECTIVE: Identifying metabolic disorders at the earliest phase of their development allows for an early intervention and the prevention of serious consequences of diseases. However, it is difficult to determine which of the anthropometric indices of obesity is the best tool for diagnosing metabolic disorders. The aims of this study were to evaluate the usefulness of selected anthropometric indices and to determine optimal cut-off points for the identification of single metabolic disorders that are components of metabolic syndrome (MetS). DESIGN: Cross-sectional study. PARTICIPANTS: We analyzed the data of 12,328 participants aged 55.7±5.4 years. All participants were of European descent. PRIMARY OUTCOME MEASURE: Four MetS components were included: high glucose concentration, high blood triglyceride concentration, low high-density lipoprotein cholesterol concentration, and elevated blood pressure. The following obesity indices were considered: waist circumference (WC), body mass index (BMI), waist-to-height ratio (WHtR), body fat percentage (%BF), Clínica Universidad de Navarra-body adiposity estimator (CUN-BAE), body roundness index (BRI), and a body shape index (ABSI). RESULTS: The following indices had the highest discriminatory power for the identification of at least one MetS component: CUN-BAE, BMI, and WC in men (AUC = 0.734, 0.728, and 0.728, respectively) and WHtR, CUN-BAE, and WC in women (AUC = 0.715, 0.714, and 0.712, respectively) (p<0.001 for all). The other indices were similarly useful, except for the ABSI. CONCLUSIONS: For the BMI, the optimal cut-off point for the identification of metabolic abnormalities was 27.2 kg/m2 for both sexes. For the WC, the optimal cut-off point was of 94 cm for men and 87 cm for women. Prospective studies are needed to identify those indices in which changes in value predict the occurrence of metabolic disorders best.

Global peak left atrial longitudinal strain assessed by transthoracic echocardiography is a good predictor of left atrial appendage thrombus in patients in sinus rhythm with heart failure and very low ejection fraction - an observational study.

BACKGROUND: Peak left atrial longitudinal strain (PALS) can help identify left atrial appendage thrombus (LAAT) in patients with atrial fibrillation. Nevertheless, few studies have been performed in patients in sinus rhythm without established indications for anticoagulation but with increased risk of LAAT, such as heart failure (HF) with severe left ventricular systolic dysfunction patients. The primary aim of this study was to identify clinical and transthoracic echocardiography predictors of LAAT in HF patients with very low left ventricular ejection fraction and sinus rhythm. The secondary objective was to analyze frequencies and predictors of a composite clinical endpoint of death or hospitalization for ischemic stroke. METHODS: We included 63 patients with HF, left ventricular ejection fraction < 25%, sinus rhythm at presentation, no history of atrial fibrillation, and without any established indications for anticoagulation. We determined whether clinical and transthoracic echocardiography parameters, including left atrial strain analysis, predicted LAAT. Transesophageal echocardiography was performed in all patients. When LAAT was detected, anticoagulation was recommended. The participants were followed for a median of 28.6 months (range 4-40) to determine the composite endpoint. RESULTS: LAAT was found in 20 (31.7%) patients. Global PALS was the best independent predictor of LAAT in univariate and multivariate logistic regression analyses (Gini coefficient 0.65, area under the receiver-operating characteristic curve 0.83). A global PALS value below 8% was a good discriminator of LAAT presence (odds ratio 30.4, 95% CI 7.2-128, p <  0.001). During follow-up, 18 subjects (28.6%) reached the composite clinical endpoint. CHA2DS2-VASc score, use of angiotensin-converting-enzyme inhibitors or angiotensin receptor blockers, and body surface area were significant predictors for the composite endpoint of death or hospitalization for ischemic stroke in the multivariate regression model. CONCLUSIONS: LAAT was relatively common in our group of HF patients and PALS has shown prognostic potential in LAAT identification. Further research is needed to determine whether initiation of anticoagulation or additional screening supported by PALS measurements will improve clinical outcomes in these patients.