Impact of Alcohol Consumption, Smoking, and Diet on the Severity of Plaque Psoriasis: A Comprehensive Assessment using Clinical Scales and Quality of Life Measures.

BACKGROUND This study aimed to evaluate the effects of alcohol intake, assessed using the Alcohol Use Disorder Identification Test (AUDIT) questionnaire, on the severity of plaque psoriasis using the Body Surface Area (BSA) and Psoriasis Area and Severity Index (PASI) scales, and quality of life using the Dermatology Life Quality Index (DLQI) questionnaire. MATERIAL AND METHODS The diagnosis of psoriasis was made based on the clinical picture. We enrolled 24 patients with psoriasis vulgaris, and the AUDIT test conducted at the time of follow-up indicated a possible risky/harmful pattern of alcohol consumption or alcohol dependence syndrome among the patients (>8 points). The comparison group consisted of 20 psoriatic patients and AUDIT <8 points. The BSA and PASI scales were used to determine the severity of psoriasis, and the DLQI questionnaire assessed patients' quality of life and how they felt during the week preceding the survey. RESULTS As the amount and frequency of alcohol consumed increased, the exacerbation of lesions measured according to the PASI and BSA scales was significantly higher (P<0.05), and the quality of life decreased (P<0.05). We noted that inadequate and excessive dietary intake of total protein, total fat, and assimilable carbohydrates were associated with statistically significantly higher values of BSA and PASI scores and, thus, more severe psoriatic lesions (P<0.05). CONCLUSIONS An unbalanced diet, alcohol abuse, and smoking negatively affect the course of psoriasis vulgaris, hence the importance of patient education.

A crossroads between dietary habits, alcohol consumption, and smoking in the clinical course of psoriasis: a narrative review.

Psoriasis is a chronic autoimmune disease that affects 1-3% of the population. The pathomechanism of psoriasis development is complex, but genetic (non-modifiable) factors play a key role. However, the importance of environmental factors and lifestyle choices, such as the diet, alcohol consumption, and smoking, is increasing. The objective of this review was to analyse the influence of dietary habits, alcohol consumption, and smoking on the clinical course of psoriasis. Stress, a poor diet, alcohol abuse, and smoking can trigger psoriasis or cause its exacerbation. Therefore, in addition to the correct selection of therapy, it is extremely important to educate patients about the impact of these factors on the onset and progression of psoriasis. This literature review confirms that a holistic and multidisciplinary approach is required for patients with psoriasis, further emphasizing Hippocrates' thesis, "Let food be thy medicine, and medicine be thy food".

Influence of adalimumab on interleukin 12/23 signalling pathways in human keratinocytes treated with lipopolysaccharide A.

Introduction: The interleukin-12/23 (IL-12/23) signalling pathway plays an important role in the pathogenesis of psoriasis. In addition, even molecularly targeted therapy has been reported to lose adequate response to treatment. Aim: To determine the expression patterns of mRNAs and miRNAs related to IL-12/23 signalling pathways in the human keratinocyte culture exposed to liposaccharide A (LPS) and then adalimumab in comparison with untreated cells. Material and methods: Human, adult, low-Calcium, high-Temperature keratinocyte (HaCaT) cultures were exposed to 1 µg/ml LPS for 8 h, and then adalimumab was added to the cultures at a concentration of 8 µg/ml and incubated for 2, 8, and 24 h. We used mRNA and miRNA microarray, quantitative reverse transcription polymerase chain reaction, and enzyme-linked immunosorbent assay techniques. Results: STAT1, STAT3, STAT5, IL-6, IL-6R, SOCS3, and JAK3 genes differentiated HaCaT cultures with the drug from controls regardless of the time the cells were exposed to the drug. The addition of adalimumab to a culture previously exposed to LPS resulted in silencing of SOCS3 and IL-6 expression compared to the control, while for the other transcripts they were found to be overexpressed compared to the control culture. The assessment indicated the strongest connections between JAK3 and hsa-miR-373-5p (target score 96); SOCS3, STAT5, and hsa-miR-1827 (target score 96). Conclusions: Our study indicates that adalimumab has the strongest modulating effect on mRNA and miRNA expression of JAK/STAT and IL-6-dependent IL-12/23 pathways.

[Lactoferrin - a glycoprotein of great therapeutic potentials]. / Laktoferyna-glikoproteina o duzym potencjale terapeutycznym.

Lactoferrin is an iron-binding glycoprotein, which is present in most biological fluids with particularly high levels in colostrum and in mammalian milk. Bovine lactoferrin is more than 70% homologous with human lactoferrin. Most of the clinical trials have used bovine lactoferrin for supplementation. This review summarizes the recent advances in explaining the mechanisms, which are responsible for the multifunctional roles of lactoferrin, and presents its potential prophylactic and therapeutic applications. On the ground of the results of preliminary clinical observations, authors suggest beneficial effect of lactoferrin supplementation on the prevalence of necrotizing enterocolitis in infants with birth weight below 1250 grams.

Functioning in an Illness and Quality of Life versus the Prevalence of Depression and Anxiety Disorders in Patients with High Cardiovascular Risk.

BACKGROUND: A chronic disease occurring in a person's life is a stressor, disrupting every aspect of their life. OBJECTIVES: This study aims to assess the relationship between functioning in chronic illness and quality of life with the prevalence of symptoms of depression and anxiety in patients with high cardiovascular risk. MATERIAL AND METHODS: This study included 200 patients (aged 18-80 years) under the care of a primary care physician, diagnosed with hypertension and/or hypercholesterolemia, and/or diabetes between 6 and 24 months before the enrollment. The presented analysis assessed the symptoms of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS); and the quality of life of patients with cardiovascular disease using the Heart Quality of Life (HeartQoL) questionnaire and functioning in chronic illness using the Functioning in Chronic Illness Scale (FCIS). RESULTS: The HADS scores amounted to 4.34 ± 3.414 points for the HADS-Anxiety subscale and 3.20 ± 2.979 points for the HADS-Depression subscale. The score indicative of functioning in chronic illness assessed with the FCIS was 98.32 ± 13.89 points. The independent predictors of HADS-anxiety were HeartQoL Emotional and FCIS Global, while HeartQoL Global and FCIS Global were the independent predictors for HADS-depression. Better functioning in chronic illness (FCIS Global) was associated with less frequent symptoms of anxiety and depression based on the HADS: HADS-Anxiety (R Spearmann = -0.3969; p < 0.0001) and HADS-Depression (R Spearmann = -0.5884; p < 0.0001). Higher HeartQoL scores, both globally, as well as in emotional and physical dimensions, were associated with a lower severity of anxiety and depression assessed with the HADS: HADS-Anxiety (R Spearmann = -0.2909; p = 0.0001) and HADS-Depression (R Spearmann = -0.2583; p = 0.0002). CONCLUSIONS: The quality of life and functioning in chronic illness are connected with symptoms of depression and anxiety. When assessing the severity of the depression symptoms in relation to the individual aspects of functioning in chronic illness, the areas requiring supportive-educational intervention can be identified. The assessment of both functioning in a chronic disease and the severity of the depression symptoms should be included in a standard nursing diagnosis and further supportive and educational intervention.

Achieving Cardiovascular Risk Management Goals and Patient Quality of Life.

(1) Background: Eliminating or reducing the severity of modifiable risk factors of cardiovascular disease (CVD) and undertaking health-promoting behaviors is the basis for prevention. (2) Methods: This study included 200 subjects without a history of CVD, aged 18 to 80 years, who had been diagnosed with hypertension, hypercholesterolemia, or diabetes 6 to 24 months before study enrolment. (3) Results: The median 10-year CV risk assessed by the SCORE2 and SCORE2-OP algorithms was 3.0 (IQR 1.5-7.0). An increase in mean cardiovascular risk in the range from low and moderate to very high was associated with a decrease in quality of life both in individual subscales and the overall score. The median number of controlled risk factors was 4.0 (IQR 3.0-5.0). As the mean number of controlled risk factors increased, the quality of life improved in both of HeartQoL questionnaire subscales (emotional p = 0.0018; physical p = 0.0004) and the overall score (global p = 0.0001). The median number of reported health-promoting behaviors undertaken within 3 years before study enrolment was 3.0 (IQR 2.0-4.0). The highest quality of life in each of the studied dimensions was found in people who reported undertaking three health-promoting behaviors. (4) Conclusions: Controlling CVD risk factors and undertaking health-promoting behaviors has a positive impact on the quality of life of patients without a history of atherosclerotic CVD.

The Impact of Anxiety and Depression Symptoms on Cardiovascular Risk Factor Control in Patients Without a History of Atherosclerotic Cardiovascular Disease.

Background: Anxiety and depression by affecting lifestyle interfere with preventive actions aimed at eliminating or reducing modifiable risk factors for cardiovascular diseases (CVD). Purpose: The objective of the study was to assess the impact of anxiety and depression on the achievement of therapeutic goals regarding CVD risk factors in patients without a history of atherosclerotic CVD. Patients and Methods: The study included 200 patients (median age 52.0 [IQR 43.0-60.5] years). Control of the basic risk factors was assessed: blood pressure, BMI, waist circumference, physical activity, smoking status, LDL cholesterol, triglycerides, and blood glucose. The data analysis included a comparison of the number of controlled risk factors and the percentage of subjects who achieved the therapeutic goal for each of the cardiovascular risk factors. The risk of CVD was assessed with SCORE2 and SCORE2-OP. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). On both subscales (HADS Anxiety and HADS Depression), subjects could achieve normal, borderline, and abnormal scores. Results: The median number of controlled CVD risk factors was 4.0 (IQR 3.0-5.0), and the median CVD risk assessed with SCORE2 and SCORE2-OP was 3.0% (IQR 1.5-7.0%). Median scores for HADS Anxiety were 3.0 (IQR 2.0-6.0) and for HADS Depression 3.0 (1.0-5.0). Patients with symptoms of anxiety and depression had significantly fewer controlled risk factors (HADS Anxiety p=0.0014; HADS Depression p=0.0304). Among subjects with anxiety and depression, there was a significantly lower percentage of those with a normal waist circumference (HADS Anxiety p=0.0464; HADS Depression p=0.0200) and regular physical activity (HADS Anxiety p=0.0431; HADS Depression p=0.0055). Among subjects with anxiety, there was a significantly lower percentage of those with a normal BMI (p=0.0218) and normal triglyceride concentrations (p=0.0278). Conclusion: The presence of anxiety and depression may affect the control of CVD risk factors in individuals without a history of atherosclerotic CVD. Assessment of anxiety and depression symptoms should be part of a comprehensive examination of patients with high CVD risk.

Gender-Related Effectiveness of Personalized Post-COVID-19 Rehabilitation.

Background: Post-COVID-19 syndrome (PCS) may affect a substantial proportion of patients who have had COVID-19. The rehabilitation program might improve the physical capacity, functioning of the cardiopulmonary system, and mental conditions of these patients. This study aimed to investigate the effectiveness of personalized rehabilitation in patients with PCS according to gender. Methods: Adults who underwent a 6-week personalized PCS rehabilitation program were enrolled in a prospective post-COVID-19 Rehabilitation (PCR-SIRIO 8) study. The initial visit and the final visit included the hand-grip strength test, the bioimpedance analysis of body composition, and the following scales: modified Borg's scale, Modified Fatigue Impact Scale (MFIS), Functioning in Chronic Illness Scale (FCIS), modified Medical Research Council (mMRC) dyspnea scale, and tests: 30 s chair stand test (30 CST), Six-Minute Walk Test (6MWT), Short Physical Performance Battery test (SPPB)e. Results: A total of 90 patients (54% female) underwent the rehabilitation program. Rehabilitation was associated with an increase in skeletal muscle mass (24.11 kg vs. 24.37 kg, p = 0.001) and phase angle (4.89° vs. 5.01°, p = 0.001) and with a reduction in abdominal fat tissue volume (3.03 L vs. 2.85 L, p = 0.01), waist circumference (0.96 m vs. 0.95 m, p = 0.001), and hydration level (83.54% vs. 82.72%, p = 0.001). A decrease in fat tissue volume and an increase in skeletal muscle mass were observed only in females, while an increase in grip strength was noticed selectively in males. Patients' fatigue (modified Borg's scale, MFIS), physical capacity (30 CST, 6MWT), balance (SPPB), dyspnea (mMRC), and functioning (FICS) were significantly improved after the rehabilitation regardless of gender. Conclusions: Personalized rehabilitation improved the body composition, muscle strength, and functioning of patients diagnosed with PCS. The beneficial effect of rehabilitation on body composition, hydration, and phase angle was observed regardless of gender.

Lipoprotein (a) and the Occurrence of Lipid Disorders and Other Cardiovascular Risk Factors in Patients without Diagnosed Cardiovascular Disease.

Background: Elevated lipoprotein (a) [Lp(a)] concentrations are linked mainly to genetic factors. The relationship between Lp(a) and other lipid disorders or cardiovascular (CV) risk factors has been less investigated. The aim of this study was to assess the occurrence of lipid disorders and other CV risk factors according to Lp(a) concentrations. Methods: A cross-sectional analysis of 200 primary-care patients who had not been diagnosed with CV disease was conducted. The following risk factors were assessed: older age, history of hypertension, diabetes mellitus or dyslipidemia, smoking, lack of physical activity, body mass index (BMI), and waist circumference. The following lipid parameters were measured: total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and small, dense LDL (sdLDL-C). Patients were divided into two groups based on their Lp(a) concentrations: <30 mg/dL and ≥30 mg/dL. Results: In 70% of patients, the Lp(a) concentration was <30 mg/dL. The concentrations of lipid parameters did not differ between the groups. The rate of patients with sdLDL-C >1.0 mmol/L was higher in the low-Lp(a) group (10.0 vs. 1.7%, p = 0.04), with no significant differences regarding the other analyzed lipid disorders (p > 0.05). Both in the low- and high-Lp(a) group, most patients had two other abnormal lipid factors (45.0% and 60.0%, respectively). The distribution of impaired lipid parameters (p = 0.41) and other CV risk factors (p = 0.16) was similar in both groups. There was a lower rate of patients >60 years old (15.0% vs. 32.9%, p = 0.01) and with a BMI ≥ 25 kg/m2 (46.7% vs. 63.6%, p = 0.026) in the high-Lp(a) group, and previously diagnosed hyperlipidemia was more prevalent in this group (65.0% vs. 47.1%, p = 0.02). The occurrence of other cardiovascular risk factors did not differ significantly between the Lp(a) groups (p > 0.05). In the high-Lp(a) group, the highest proportion (25.0%) had two CV risk factors, and in the low-Lp(a) group, 31.4% had four CV risk factors. Conclusions: An elevated Lp(a) concentration is not related to the number of conventional CV risk factors or other impairment major lipid parameters.

The 123 COVID SCORE: A simple and reliable diagnostic tool to predict in-hospital death in COVID-19 patients on hospital admission.

BACKGROUND: Patients hospitalized due to Coronavirus disease 2019 (COVID-19) are still burdened with high risk of death. The aim of this study was to create a risk score predicting in-hospital mortality in COVID-19 patients on hospital admission. METHODS: Independent mortality predictors identified in multivariate logistic regression analysis were used to build the 123 COVID SCORE. Diagnostic performance of the score was evaluated using the area under the receiver-operating characteristic curve (AUROC). RESULTS: Data from 673 COVID-19 patients with median age of 70 years were used to build the score. In-hospital death occurred in 124 study participants (18.4%). The final score is composed of 3 variables that were found predictive of mortality in multivariate logistic regression analysis: (1) age, (2) oxygen saturation on hospital admission without oxygen supplementation and (3) percentage of lung involvement in chest computed tomography (CT). Four point ranges have been identified: 0-5, 6-8, 9-11 and 12-17, respectively corresponding to low (1.5%), moderate (13.4%), high (28.4%) and very high (57.3%) risk of in-hospital death. The 123 COVID SCORE accuracy measured with the AUROC was 0.797 (95% CI 0.757-0.838; p<0.0001) in the study population and 0.774 (95% CI 0.728-0.821; p<0.0001) in an external validation cohort consisting of 558 COVID-19 patients. CONCLUSIONS: The 123 COVID SCORE containing merely 3 variables: age, oxygen saturation, and percentage of lung involvement assessed with chest CT is a simple and reliable tool to predict in-hospital death in COVID-19 patients upon hospital admission.

A vicious circle? Longitudinal relationships between different modes of in-group identity and COVID-19 conspiracy thinking.

Since March 2020, when the World Health Organization declared the spread of COVID-19 a global pandemic, conspiracy theories have continued to rise. This research examines the role of different forms of in-group identity in predicting conspiracy thinking in the context of the coronavirus pandemic. We hypothesized that conspiracy thinking would be predicted positively by national narcissism (i.e., a belief in in-group's greatness which is contingent on its external validation and makes in-group members sensitive to psychological threats) but negatively by secure national identification (i.e., a confidently held ingroup evaluation, which serves as a buffer against psychological threats). In a three-wave longitudinal study conducted on a representative sample of adult Poles (N = 650), conspiracy thinking was positively predicted by national narcissism, but negatively by national identification. Further, we found evidence that conspiracy thinking strengthened national narcissism (but not national identification) over time. Implications for intra- and intergroup processes are discussed.

When the sun goes down: low political knowledge and high national narcissism predict climate change conspiracy beliefs.

The present research empirically examines the links between political knowledge, national narcissism, and climate change conspiracy beliefs. National narcissism (i.e., an unrealistic belief about in-group's greatness which is maladaptive both from the perspective of intra- and inter-group processes) was previously linked to conspiracy beliefs. In this research, we hypothesized that low theoretical political knowledge would boost national narcissism and further lead to adopting climate change conspiracy theories. METHODS: This hypothesis was tested in a two-wave study conducted among Polish participants (N = 558). RESULTS: We found negative effect of political knowledge on climate change conspiracy beliefs. Moreover, national narcissism mediated between theoretical political knowledge and conspiracy beliefs. CONCLUSION: People having low political knowledge are prone to believe in climate change conspiracy theories. Moreover, those less informed about the way political system works in their country are more narcissistically identified with their nation and, thus, deny the climate change.

Effects of Multidisciplinary Rehabilitation Program in Patients with Long COVID-19: Post-COVID-19 Rehabilitation (PCR SIRIO 8) Study.

Up to 80% of COVID-19 survivors experience prolonged symptoms known as long COVID-19. The aim of this study was to evaluate the effects of a multidisciplinary rehabilitation program in patients with long COVID-19. The rehabilitation program was composed of physical training (aerobic, resistance, and breathing exercises), education, and group psychotherapy. After 6 weeks of rehabilitation in 97 patients with long COVID-19, body composition analysis revealed a significant decrease of abdominal fatty tissue (from 2.75 kg to 2.5 kg; p = 0.0086) with concomitant increase in skeletal muscle mass (from 23.2 kg to 24.2 kg; p = 0.0104). Almost 80% of participants reported dyspnea improvement assessed with the modified Medical Research Council scale. Patients' physical capacity assessed with the 6 Minute Walking Test increased from 320 to 382.5 m (p < 0.0001), the number of repetitions in the 30 s Chair Stand Test improved from 13 to 16 (p < 0.0001), as well as physical fitness in the Short Physical Performance Battery Test from 14 to 16 (p < 0.0001). The impact of fatigue on everyday functioning was reduced in the Modified Fatigue Impact Scale from 37 to 27 (p < 0.0001). Cardiopulmonary exercise test did not show any change. The multidisciplinary rehabilitation program has improved body composition, dyspnea, fatigue and physical capacity in long COVID-19 patients.

Determinants of Lipid Parameters in Patients without Diagnosed Cardiovascular Disease-Results of the Polish Arm of the EUROASPIRE V Survey.

To assess the determinants of lipid parameters in primary care patients without diagnosed cardiovascular disease (CVD), a cross-sectional study was conducted during 2018-2019 with a total of 200 patients. The following lipid parameters were measured: total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), small, dense LDL (sdLDL-C), and lipoprotein (a) (Lp(a)). Predictors of elevated and adequately controlled lipid parameters were assessed with logistic regression analysis. Older age was related to higher risk of TC ≥ 6.2 mmol/L [OR 1.03 (95% CI 1.0-1.05)], sdLDL-C ≥ 1.0 mmol/L [OR 1.05 (95% CI 1.0-1.1)], and decreased risk of Lp(a) ≥ 50 mg/dL [OR 0.97 (95% CI 0.94-0.99)]. Patients with diabetes mellitus (DM) had increased probability of TG ≥ 2.25 mmol/L [OR 3.77 (95% CI 1.34-10.6)] and Lp(a) ≥ 50 mg/dL [OR 2.97 (1.34-6.10)] as well as adequate control of TG and Lp(a). Higher material status was related to lower risk of TC ≥ 6.2 mmol/L [OR 0.19 (95% CI 0.04-0.82)] and LDL-C ≥ 3.6 mmol/L [OR 0.33 (95% CI 0.12-0.92)]. High BMI was related to increased [OR 1.14 (95% CI 1.02-1.29)], and female gender [OR 0.33 (95% CI 0.12-0.96)] and hypertension [OR 0.29 (95% CI 0.1-0.87)] to decreased risk of TG ≥ 2.25 mmol/L [OR 1.14 (95% CI 1.02-1.29)]. Taking lipid-lowering drugs (LLD) was associated with LDL-C < 2.6 mmol/L [OR 2.1 (95% CI 1.05-4.19)] and Lp(a) < 30 mg/dL [OR 0.48 (95% CI 0.25-0.93)]. Physical activity was related to LDL-C < 2.6 mmol/L [OR 2.02 (95% CI 1.02-3.98)]. Higher abdominal circumference was associated with decreased risk of TG < 1.7 mmol/L [OR 0.96 (95% CI 0.93-0.99)]. Elevated lipid parameters were related to age, gender, material status, BMI, history of DM, and hypertension. Adequate control was associated with age, education, physical activity, LLD, history of DM, and abdominal circumference.

Inhibitors of sodium-glucose transport protein 2: A new multidirectional therapeutic option for heart failure patients.

Several mechanisms have been suggested to explain positive cardiovascular effects observed in studies with sodium-glucose co-transporter 2 (SGLT2) inhibitors. The reduction in glucose reabsorption in proximal tubuli induced by SGLT2 inhibitors increases urinary glucose and sodium excretion resulting in increased osmotic diuresis and consequently in decreased plasma volume, followed by reduced preload. In addition, the hemodynamic effects of SGLT2 inhibition were observed in both hyper and euglycemic patients. Due to the complex and multidirectional effects induced by SGLT2 inhibitors, this originally antidiabetic group of drugs has been successfully used to treat patients with heart failure as well as for subjects with chronic kidney disease. Moreover, their therapeutic potential seems to be even broader than the indications studied to date.

Preliminary Study on Mechanical Aspects of 3D-Printed PLA-TPU Composites.

Additive technologies using Fused Deposition Modeling (FDM) technology are currently a promising tool for the production of polymeric multicomposites. This paper presents the results of a static 3-point bending test carried out on 3D printed samples of the PLA-TPU composite. The article also discusses initial vibrodiagnostic research and Finite Element Method (FEM) analysis of the 3D-printed composite bushings. The data obtained from FEM analysis served as input data for motion simulation analysis, where the influence of the stiffness of the suspension on the trajectory has been verified.

From Individual Anxiety to Collective Narcissism? Adult Attachment Styles and Different Types of National Commitment.

National narcissism and national identification, two distinct types of national commitment, differ in terms of their psychological concomitants. Therefore, in the current article, we hypothesized that they would also relate to different adult attachment styles. Namely, we proposed that national narcissism would be positively associated with higher attachment anxiety, while national identification would be associated with lower attachment anxiety and avoidance. These hypotheses were tested in three cross-sectional surveys (Study 1 N = 570; Study 3 N = 558; Study 4 N = 649) and one longitudinal survey (Study 2 N = 808). In all studies, we found a consistent positive relationship between attachment anxiety and national narcissism, and a negative relationship between attachment avoidance and national identification. Finally, we also demonstrated indirect effects of attachment anxiety (via national narcissism) on maladaptive group-related outcomes: conspiracy beliefs, non-normative collective action, and willingness to conspire.

The influence of patient expectations on adherence to treatment regimen after myocardial infarction.

OBJECTIVE: In-hospital patient education is one of the elements affecting patient adherence to treatment regimen after myocardial infarction (MI). Its effectiveness is determined by educator and patient-dependent factors. Previous studies did not identify patient expectations as an independent determinant of successful education. The aim of this study was to assess whether patient knowledge and expectations affect adherence to treatment regimen in a 1-year follow-up. METHODS: This was a single-center, cohort study with a 1-year follow-up. Patient knowledge and expectations were evaluated using the Readiness for Hospital Discharge after Myocardial Infarction Scale (RHD-MIS scale). Medication adherence (including angiotensin converting enzyme inhibitors (ACEI), P2Y12 receptor inhibitors and statins) was verified based on prescription refill data extracted from The National Health Fund database. RESULTS: The study included 225 patients aged 30-91 years (mean age 62.9 ± 11.9 years). In the 4th quarter of follow-up, patients with the highest expectations had lower adherence regarding ACEI (p = 0.01), P2Y12 receptor inhibitors (p = 0.03) and the combination of all three analysed medications (p = 0.003). CONCLUSIONS: The initial results suggest presence of a relationship between patient expectations and long-term adherence to treatment. PRACTICE IMPLICATIONS: Post-MI patient education directed at fulfilling or modification of patient expectations could possibly improve execution of treatment regimen.

The impact of readiness to discharge from hospital on adherence to treatment in patients after myocardial infarction.

BACKGROUND: The healthcare professionals involved in in-hospital treatment of myocardial infarction (MI) are also responsible to patients for their education before leaving the hospital. This education aims to modify patient behaviour in order to reduce relevant risk factors and improve self-control and adherence to medications. The aim of the study was to analyse the relationship between readiness for discharge from hospital and adherence to treatment at follow-up in MI patients. METHODS: An observational, single-center, MI cohort study with 6-month follow-up was conducted between May 2015 and July 2016. The Readiness for Hospital Discharge after Myocardial Infarction Scale (RHD-MIS) and the Adherence in Chronic Diseases Scale (ACDS) were applied. RESULTS: Two hundred and thirteen patients aged 30-91 years (62.91 ± 11.26) were enrolled in the study. The RHD-MIS general score ranged from 29 to 69 points (51.16 ± 9.87). A high level of readiness was found in 66 patients (31%), intermediate in 92 (43.2%), and low in 55 (25.8%) of patients. Adherence level assessed with the ACDS 6-months after discharge from hospital ranged from 7 to 28 points (23.34 ± 4.06). An increase in objective assessment of patient knowledge according to RHD-MIS subscale resulted in significantly higher level of adherence at the follow-up visit (p = 0.0154); R Spearman = 0.16671, p = 0.015; p for trend = 0.005. During the 6-month follow-up 3 (1.41%) patients died and 17 (7.98%) were hospitalized for a subsequent acute coronary syndrome. CONCLUSIONS: This study provided preliminary evidence of a long-term association between the results of assessment of readiness for discharge from hospital and adherence to treatment in patients after MI.

The occurrence of cardiovascular risk factors and functioning in chronic illness in the Polish population of EUROASPIRE V.

BACKGROUND: The aim of this study was to assess the impact of cardiovascular risk on the functioning of patients without a history of atherosclerotic cardiovascular disease. METHODS: Two hundred patients diagnosed with arterial hypertension, hypercholesterolemia, or diabetes were enrolled in the study. The median age was 52.0 years (interquartile range [IQR] 43.0-60.0). The following risk factors were assessed: blood pressure, body mass index, waist circumference, physical activity, smoking, LDL-cholesterol, triglycerides, and fasting plasma glucose concentration. Total cardiovascular risk was determined as the number of uncontrolled risk factors, and with the Systemic Coronary Risk Evaluation Score (SCORE). The Functioning in the Chronic Illness Scale (FCIS) was applied to assess the physical and mental functioning of patients. RESULTS: The median number of measures of cardiovascular risk factors was 4.0 (IQR 3.0-5.0). The median of SCORE for the whole study population was 2.0 (IQR 1.0-3.0). Patients with lower total cardiovascular risk as defined by SCORE and number of uncontrolled risk factors had better functioning as reflected by higher FCIS (R = -0.315, p < 0.0001; R = -0.336, p < 0.0001, respectively). Multivariate logistic regression analysis identified abnormal blood pressure, abnormal waist circumference, tobacco smoking, and lack of regular physical activity to be negative predictors of functioning. Lack of regular physical activity was the only predictor of low FCIS total score (odds ratio 9.26, 95% confidence interval 1.19-71.77, p = 0.03). CONCLUSIONS: The functioning of patients worsens as the total cardiovascular risk increases. Each of the risk factors affects the functioning of subjects without coronary artery disease with different strength, with physical activity being the strongest determinant of patient functioning.