Pioglitazone in treatment of patients with comoribidity of psoriatic disease and alimentary obesity

2021 ◽  
pp. 5-14
Author(s):  
Ya.О. Yemchenko ◽  
K.E. Ishcheikin ◽  
I.P. Kaidashev ◽  
I.G. Gajduchok
Keyword(s):  
Systemic Inflammation ◽  
Severity Index ◽  
Comprehensive Treatment ◽  
Immunological Study ◽  
Complex Treatment ◽  
Duration Of Treatment ◽  
Interleukin 33 ◽  
Reactive Protein ◽  
Alimentary Obesity ◽  
Frequent Exacerbation

An indisputable link between psoriasis and obesity has recently been proven. Alimentary obesity exacerbates systemic inflammation in patients with psoriasis, complicating the course of dermatosis, causing deterioration of the dermatological index of quality of life of patients and frequent exacerbation of psoriasis, which leads to ineffectiveness of standard treatments. PPAR-activated receptors are the link between lipids and inflammation because lipids stimulate the chronic form of systemic inflammation and are ligands that activate PPAR. Thus, PPAR can be used as the main target when choosing a treatment for this comorbidity. To date, the literature has accumulated a large number of prospective observations indicating a positive effect of pioglitazone (PG) on systemic inflammation. The mechanism of action of this drug is aimed at suppressing chronic systemic delayed inflammation of low intensity. The anti-inflammatory effect of PG is associated with its activating effect on nuclear transcription factors of PPAR. Objective — to determine the effectiveness of the inclusion of different doses of pioglitazone in the complex treatment of patients with advanced psoriasis vulgar with concomitant alimentary obesity of I—II degree. Materials and methods. Clinical and immunological study of systemic inflammation. Results and discussion. The results of the study showed the effectiveness of this method of treatment, which depended on the dose of PG and the duration of treatment. The use of PG in the complex treatment of patients with vulgar psoriasis of moderate severity with concomitant alimentary obesity of I—II degree for 26 weeks led to a decrease in inflammation both locally, according to the Psoriatic Area and Severity Index, and at the systemic level due to reduction in the level of systemic inflammation, namely the level of interleukin-33, interleukin-6 and highly sensitive C-reactive protein in the blood serum.Conclusions. Long-term use of PG can be recommended for the personalized and comprehensive treatment of patients with comorbidity of psoriasis and alimentary obesity of I—II degree.

scholarly journals APPLICATION OF PIOGLITAZONE IN THE COMPREHENSIVE TREATMENT OF PSORIATIC PATIENTS WITH CONCOMITANT ALIMENTARY OBESITY

2020 ◽  
Vol 24 (5-6) ◽  
pp. 7-10
Author(s):  
Ya.O. Yemchenko ◽  
K.Ye. Ishcheikin ◽  
I.P. Kaidashev
Keyword(s):  
Systemic Inflammation ◽  
Molecular Mechanisms ◽  
Pathological Process ◽  
Current Data ◽  
The Body ◽  
Comprehensive Treatment ◽  
Single View ◽  
Multifactorial Diseases ◽  
Alimentary Obesity

Psoriasis is one of the most common chronic recurrent systemic autoimmune multifactorial diseases, in which the skin, joints, internal organs and systems of the body are involved in the pathological process. Despite the significant prevalence of psoriasis and a large number of studies on this problem, there is still no single view on the pathogenesis of this dermatosis. To objectively understand the pathogenesis of psoriasis, it is necessary to take into account the insufficiently studied comorbidity of this pathology. Recently, an indisputable link between psoriasis and obesity has been proven. The scientific literature widely covers the issue of identical pathogenetic mechanisms of inflammatory processes in psoriasis and obesity. Given the current data on the role of systemic inflammation underlying the development of both psoriasis and obesity, the study of molecular mechanisms of its development and taking into account the role of proinflammatory nuclear transcription factors, thiazolidinediones are the pathogenetically justified drugs of choice for treatment of these diseases. In this study, we determined the effectiveness of using 15 mg of pioglitazone once a day for 6 months in the treatment of patients with extensive psoriasis vulgaris of moderate severity and concomitant grade І-ІІ alimentary obesity by clinical and immunological examination of systemic inflammation. Analyzing the results of the study, it was found that long-term use of pioglitazone, even in small doses, led to a decrease in systemic inflammation and contributed to a milder course of psoriasis in recurrence of the disease.

Complex treatment of periodontitis: patient’s reaction to the therapy

2020 ◽  
Vol 25 (2) ◽  
pp. 97-100
Author(s):  
A. K. Iordanishvili ◽  
V. A. Guk ◽  
A. A. Golovko
Keyword(s):  
Elderly People ◽  
Periodontal Diseases ◽  
Personal Characteristics ◽  
The Elderly ◽  
Comprehensive Treatment ◽  
Complex Treatment ◽  
Middle Aged ◽  
Aged People ◽  
Dental Rehabilitation ◽  
Success Of Treatment

Relevance. The success of treatment of periodontal diseases directly depends on the patient’s response to the therapy, therefore, the characteristics of the person’s personal characteristics can affect both the effectiveness of treatment and the prevention of relapse of the disease.Purpose. To study the features of the internal picture of the disease in the process of complex treatment of adult patients suffering from chronic generalized periodontitis.Materials and methods. The generally accepted comprehensive treatment of chronic generalized periodontitis in 69 middle-aged and elderly men was carried out taking into account the personal response of patients Solovyov «Psychosensory-anatomical-functional maladaptation syndrome».Results. When patients were discharged from the hospital, there was a difference in the phenomena of maladaptation among the elderly and middle-aged: in middle-aged people, sufficient adaptation to the conditions of existence was determined; in elderly people, due to the existing comorbid pathology, a state of maladaptation was diagnosed, which was caused by the presence of complaints of defects in the dentition.Conclusion. In elderly people, as soon as possible after completion of treatment in a hospital, dental rehabilitation cannot be considered completed, which requires the adoption of organizational measures for their timely provision of dentures.

scholarly journals Effects of Obesity on Airway and Systemic Inflammation in Asthmatic Children

2021 ◽  
pp. 1-11
Author(s):  
Emine Vezir ◽  
Ersoy Civelek ◽  
Emine Dibek Misirlioglu ◽  
Muge Toyran ◽  
Murat Capanoglu ◽  
...  
Keyword(s):  
Airway Inflammation ◽  
Systemic Inflammation ◽  
Adiponectin Level ◽  
Inflammatory Cells ◽  
Prick Test ◽  
Asthmatic Children ◽  
Asthmatic Patients ◽  
Reactive Protein ◽  
Type 2 Cytokines ◽  
Asthma In Children

Background: Obese asthma is a complex syndrome with certain phenotypes that differ in children and adults. There is no clear evidence regarding the presence of additive or synergistic pathological interaction between obesity and asthma in children. Objectives: Our aim was to demonstrate the interaction of obesity and asthma in children in terms of airway and systemic inflammation by a controlled observational study. Methods: Four groups were formed: asthma obese (AO), asthma nonobese (ANO), non-AO (NAO), nonasthma nonobese (NANO). Spirometry test, fractional exhaled nitric oxide (FeNO) test, skin prick test, serum inflammatory biomarkers (C-reactive protein, C3, C4, adiponectin, leptin, resistin, periostin, YKL-40, Type 1, and Type 2 cytokines) were conducted and evaluated in all participants. Sputum inflammatory cells (sputum eosinophils and neutrophils) were evaluated in patients who could produce induced sputum and obesity-asthma interactions were determined. Results: A total of 153 participants aged 6–18 years were included in the study, including the AO group (n = 46), the ANO group (n = 45), the NAO group (n = 30), and the NANO group (n = 32). IL-4 (p < 0.001), IL-5 (p < 0.001), IL-13 (p < 0.001), resistin (p < 0.001), and YKL-40 (p < 0.001) levels were higher in patients with asthma independent of obesity. The lowest adiponectin level was found in the AO group and obesity-asthma interaction was detected (p < 0.001). Sputum eosinophilia (p < 0.01), sputum neutrophilia (p < 0.01), and FeNO levels (p = 0.07) were higher in asthmatic patients independent of obesity. In the group with paucigranulocytic inflammation, resistin and YKL-40 levels were significantly lower than in the group without paucigranulocytic inflammation (p < 0.01). Conclusion: No interaction was found between obesity and asthma in terms of airway inflammation. Interaction between obesity and asthma was shown in terms of adiponectin level and resistin/adiponectin and leptin/adiponectin ratios. It was found that serum YKL-40 and resistin levels could be associated with airway inflammation.

scholarly journals Systemic Inflammation (C-Reactive Protein) in Older Chinese Adults Is Associated with Long-Term Exposure to Ambient Air Pollution

2021 ◽  
Vol 18 (6) ◽  
pp. 3258
Author(s):  
Mona Elbarbary ◽  
Artem Oganesyan ◽  
Trenton Honda ◽  
Geoffrey Morgan ◽  
Yuming Guo ◽  
...  
Keyword(s):  
Air Pollution ◽  
Systemic Inflammation ◽  
Ambient Air ◽  
Ambient Air Pollution ◽  
Chinese Adults ◽  
Reactive Protein ◽  
Hs Crp ◽  
Older Chinese ◽  
Older Chinese Adults

There is an established association between air pollution and cardiovascular disease (CVD), which is likely to be mediated by systemic inflammation. The present study evaluated links between long-term exposure to ambient air pollution and high-sensitivity C reactive protein (hs-CRP) in an older Chinese adult cohort (n = 7915) enrolled in the World Health Organization (WHO) study on global aging and adult health (SAGE) China Wave 1 in 2008–2010. Multilevel linear and logistic regression models were used to assess the associations of particulate matter (PM) and nitrogen dioxide (NO2) on log-transformed hs-CRP levels and odds ratios of CVD risk derived from CRP levels adjusted for confounders. A satellite-based spatial statistical model was applied to estimate the average community exposure to outdoor air pollutants (PM with an aerodynamic diameter of 10 μm or less (PM10), 2.5 μm or less (PM2.5), and 1 μm or less (PM1) and NO2) for each participant of the study. hs-CRP levels were drawn from dried blood spots of each participant. Each 10 μg/m3 increment in PM10, PM2.5, PM1, and NO2 was associated with 12.8% (95% confidence interval; (CI): 9.1, 16.6), 15.7% (95% CI: 10.9, 20.8), 10.2% (95% CI: 7.3, 13.2), and 11.8% (95% CI: 7.9, 15.8) higher serum levels of hs-CRP, respectively. Our findings suggest that air pollution may be an important factor in increasing systemic inflammation in older Chinese adults.

scholarly journals Evaluation of Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and C-Reactive Protein in Tension-Type Headache Patients

2021 ◽  
Author(s):  
Hasan Hüseyin Özdemir ◽  
Ahmet Dönder
Keyword(s):  
Systemic Inflammation ◽  
Tension Type Headache ◽  
Neutrophil To Lymphocyte Ratio ◽  
Control Group ◽  
C Reactive Protein ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Significant Difference ◽  
Type Headache

Abstract Objectives A tension headache is the most common type of headache, and its causes are multifactorial. A relationship has been shown between migraine headaches and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP). In this study, we investigated the NLR, PLR, and serum CRP levels in frequent episodic tension-type headache (FETTH) and chronic tension-type headache (CTTH) patients. Materials and Methods This retrospective study included 64 patients with FETTH, 80 patients with CTTH, and 60 healthy controls who were followed up in the neurology clinic. Hematological parameters were compared between the patient and control groups. Results In CTTH patients, platelets, NLR, PLR, and CRP values were statistically higher than in FETTH patients and patients in the control group. In FETTH patients, the PLR value was higher than in patients in the control group, but there was no statistically significant difference in NLR and CRP values between FETTH patients and patients in the control group. Also, there was no correlation between these values and age and gender. Conclusion Increase platelet count might have an effect on tension-type headache pathophysiology. Systemic inflammation parameters were shown to be significantly higher in CTTH patients. More comprehensive studies are needed to evaluate the effect of systemic inflammation on the chronicity of tension headaches.

scholarly journals Confocal laser endomicroscopy reveals alterations in duodenal permeability in patients with acute pancreatitis

2019 ◽  
Vol 47 (3) ◽  
pp. 1279-1287
Author(s):  
Lingjia Sun ◽  
Min Yue ◽  
Yining Dai ◽  
Chaohui Yu ◽  
Chunxiao Chen
Keyword(s):  
Acute Pancreatitis ◽  
Large Scale ◽  
Duodenal Bulb ◽  
Severity Index ◽  
Duodenal Mucosa ◽  
Confocal Laser Endomicroscopy ◽  
Confocal Laser ◽  
Mucosal Permeability ◽  
Reactive Protein ◽  
Severity Index Score

Objective Intestinal permeability increases during the course of acute pancreatitis (AP). We assessed duodenal permeability alterations in patients with AP by confocal laser endomicroscopy (CLE). Methods Thirty patients with AP underwent CLE evaluation of the antral and duodenal mucosa. Images were graded based on the appearance of capillaries and the degree of fluorescein leakage. Results Patients with AP had increased duodenal mucosal permeability that could be detected by CLE. The mucosal permeability progressively increased in the gastric antrum, duodenal bulb, and descending duodenum. The CLE parameters in the antrum and duodenal bulb were not significantly different between patients with mild and severe AP. The CLE grades in the descending duodenum were higher in patients with severe than mild AP. The C-reactive protein level in AP was positively correlated with the permeability in the duodenal bulb and descending duodenum, while the computed tomography severity index score was positively correlated with the mucosal permeability in the duodenal bulb and descending duodenum. Conclusion CLE revealed increased duodenal permeability in patients with AP. Higher permeability in the descending duodenum was observed in severe than mild AP. Further large-scale studies are needed to confirm the relationship between altered duodenal permeability and the severity of AP.

scholarly journals Duration of orthodontic treatment with fixed appliances in adolescents and adults: a systematic review with meta-analysis

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Allen Abbing ◽  
Vasiliki Koretsi ◽  
Theodore Eliades ◽  
Spyridon N. Papageorgiou
Keyword(s):  
Treatment Duration ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Adult Patients ◽  
Comprehensive Treatment ◽  
Orthodontic Appliances ◽  
Duration Of Treatment ◽  
Quality Of Evidence ◽  
Fixed Appliances

Abstract Objectives Adults with fixed orthodontic appliances are increasing nowadays. Compared with adolescents, adults present biological differences that might influence treatment duration. Therefore, the aim of the study was to compare duration of treatment with fixed appliances between adults and adolescents. Materials and methods Eight databases were searched up to September 2019 for randomized and non-randomized clinical studies comparing treatment duration with fixed appliances in adolescents and adult patients. After duplicate study selection, data extraction, and risk of bias assessment with the Cochrane ROBINS-I tool, random effects meta-analyses of mean differences (MD) and their 95% confidence intervals (CIs) were performed, followed by assessment of the quality of evidence with GRADE. Results A total of 11 unique studies (one prospective and 10 retrospective non-randomized) with 2969 adolescents and 1380 adult patients were finally included. Meta-analysis of 7 studies found no significant difference in the duration of comprehensive treatment with fixed appliances (MD = − 0.8 month; 95% CI = − 4.2 to 2.6 months; P = 0.65; I2 = 92%) between adults and adolescents. Similarly, both distalization of upper first molars with skeletal anchorage for class II correction and the retraction of canines into the premolar extraction spaces lasted similarly long among adults and adolescents. On the other hand, alignment of palatally displaced canines lasted considerably longer in adults compared to adolescents (1 study; MD = 3.8 months; 95% CI = 1.4 to 6.2 months; P = 0.002). The quality of evidence for the meta-analysis was low due to the inclusion of non-randomized studies with considerable risk of bias. Conclusions While existing evidence does not indicate a difference in the overall duration of treatment with fixed appliances between adults and adolescents, the alignment of palatally displaced canines lasted significantly longer in adults. However, our confidence in these estimates is low due to the risk of bias in the included studies. Trial registration PROSPERO: (CRD42019148169)

P1279INSULIN RESISTANCE IN HEMODIALYSIS PATIENS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Pavel Filinyuk ◽  
Aleksander Rumyantsev
Keyword(s):  
Insulin Resistance ◽  
Systemic Inflammation ◽  
Clinical Manifestations ◽  
Biological Response ◽  
Fold Increase ◽  
Atherogenic Dyslipidemia ◽  
Model Assessment ◽  
Peripheral Tissues ◽  
Reactive Protein ◽  
Homeostatic Model Assessment

Abstract Background and Aims insulin resistance (IR) is a decrease in the biological response of sensitive tissues to insulin. IR is known as an adverse risk factor in cardiovascular disease, which largely determines the prognosis of patients receiving hemodialysis (HD). But this issue is not well understood. For the screening of IR, special indices have been developed that characterize the sensitivity of tissues to insulin. The aim of the study was to compare the methods of screening for IR in patients receiving HD in relation to the markers of systemic inflammation and atherogenic dyslipidemia (AtD). Method 124 patients receiving HD for 75.4 ± 44.5 months were examined including 66 men and 58 women aged 57.6 ± 13.6 years. For IR screening, the Homeostatic Model Assessment-1 and 2 indices (HOMA-1 and HOMA-2), the Quantitative Insulin Sensitivity Check Index (QUICKI) and triglycerides / glucose (Tri/G) were used. Patients were examined in accordance with the recommendations of KDIGO. Data analysis was carried out using “STATISTICA 10.0”. Results fasting insulin levels were elevated in 19% of patients. But, the calculated indices were consistent with the idea that IR is much more common. So, the IR index in the HOMA -1 model was increased in 47%, in the HOMA -2 model - in 33%, in the QUICKI model - in 36%, the TriH indicator - in 91%. The sensitivity of peripheral tissues in the HOMA-1 and HOMA-2 models was equally reduced by 35-40%. The results of the correlation analysis between indicators of IR and plasma concentration of C-reactive protein and lipid profile are presented in table 1. Informativeness of IR indicators depending on the presence of obesity is presented in table 2 We were also interested in whether insulin resistance affects the development of clinical manifestations of atherosclerosis, cardiac arrhythmias, and heart failure. An analysis of this relationship did not reveal. Only the IR index in the HOMA-1 model with a value of more than 2.7 units was associated with a 4.5-fold increase in the risk of developing clinical manifestations of atherosclerotic lesions (χ2 = 4.582 p = 0.032). Statistically significant it was only in men. Given our data, perhaps IR is one of the reasons for the higher morbidity and mortality of men at HD. Conclusion a comparison of IR models allows us to distinguish HOMA-2 as the most accurate index. The highest correlation with systemic inflammation and AtD was in the HOMA-1 and HOMA-2 indices.

P4679Changes in systemic inflammation and endothelial dysfunction after balloon pulmonary angioplasty

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
W Magon ◽  
J Stepniewski ◽  
K Jonas ◽  
M Waligora ◽  
P Podolec ◽  
...  
Keyword(s):  
Endothelial Dysfunction ◽  
Serum Concentration ◽  
Systemic Inflammation ◽  
Interleukin 6 ◽  
C Reactive Protein ◽  
Pulmonary Hemodynamics ◽  
Endothelin 1 ◽  
Reactive Protein ◽  
Balloon Pulmonary Angioplasty

Abstract Introduction Pulmonary endarterectomy leads to a decrease in systemic inflammation and improvement in endothelial function in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Balloon pulmonary angioplasty (BPA) improves pulmonary hemodynamics in patients with inoperable CTEPH. Aim To assess changes in systemic inflammation and endothelial dysfunction after a single BPA session and after completion of the treatment. Methods We enrolled consecutive, inoperable CTEPH patients who underwent BPA. Interleukin 6, 10 (IL-6, IL-10), and C-reactive protein (hsCRP) constituted markers of systemic inflammation. Endothelin-1 (ET-1) served as a marker of endothelial dysfunction. Serum concentration of selected markers was assessed in every patient before, 24 hours after the first BPA session and 6 months after completion of the BPA treatment. Age- and sex-matched healthy subjects served as a control group. Results We recruited 20 patients with inoperable CTEPH (6 males [30%]), aged 67 [61–74] years in New York Heart Association class III (n=19 [95%]) and II (n=1 [5%]). BPA treatment was completed with a median of 5 [2–8] BPA sessions per patient. Before starting the treatment CTEPH patients, as compared to controls (n=10), had raised serum level of IL-6 (3.82 [2.75 - 6.03] vs. 2.64 [0.88 - 4.75] pg/ml; p=0.04), hsCRP (2.47 [0.93 - 4.27] vs. 1.23 [0.48–3.21] ng/ml; p=0.02) and ET-1 (2.68 [2.24 - 3.64] vs. 1.47 [1.4 - 1.82] pg/ml; p=0.004). There was no difference in IL-10 level. 24 hours after a BPA session we observed an increased level of IL-6, IL-10 and hsCRP. (Tab.) 6 months after completion of the BPA treatment there was a reduced level of IL-6, hsCRP and ET-1 (Tab.) Table 1. Changes (Δ) in serum concentration of analyzed markers 24 hours after a single BPA session and at 6-months assessment after completion of the BPA treatment (n=20) Initial Δ at 24 hours after single BPA p Δ at 6-months follow-up p ET-1 [pg/ml] 2.68 [2.24; 3.64] −0.2 [−0.5; 0.23] 0.21 −0.47 [−0.96; 0.05] 0.004 IL-6 [pg/ml] 3.82 [2.75; 6.03] 3.67 [1.41; 7.16] 0.008 −0.82 [−3.11; 0.54] 0.04 IL-10 [pg/ml] 0.53 [0.44; 0.58] 0.32 [0.21; 0.87] 0.006 −0.11 [−0.33; 0.14] 0.94 hsCRP [ng/ml] 2.47 [0.93; 4.27] 5.4 [3.96; 10.59] 0.008 −0.36 [−0.94; 0.16] 0.02 ET-1, endothelin 1; hsCRP, C-reactive protein; IL-6, interleukin 6; IL-10, interleukin 10. Conclusions Patients with inoperable CTEPH, as compared to healthy controls, exhibit an increased systemic inflammation and endothelial dysfunction, which both improve after completion of the BPA treatment. At short-term follow-up after single BPA session there is an increase in systemic inflammatory response.

scholarly journals Systemic inflammation and nutritional insufficiency in palliative cancer patients

2021 ◽  
Vol 102 (4) ◽  
pp. 446-452
Author(s):  
O V Kurchenkova ◽  
U V Kharlamova ◽  
A V Vazhenin ◽  
A O Abdalov
Keyword(s):  
Cancer Patients ◽  
Body Mass ◽  
Systemic Inflammation ◽  
Risk Index ◽  
Nutritional Risk ◽  
Albumin Concentration ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Nutritional Risk Index ◽  
Nutritional Insufficiency

Aim. To study the relationship between the symptoms of nutritional insufficiency and systemic inflammation in cancer palliative patients. Methods. 106 palliative cancer patients were examined at Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine: 54 (50.9%) men and 52 (49.1%) women aged 61 [54; 67] years. All patients underwent laboratory and instrumental examination within the approved standards of specialized medical care. Systemic inflammation was assessed by the levels of acute phase proteins (C-reactive protein, fibrinogen). The study of integrated clinical and laboratory, somatometric parameters was carried out. The nutritional risk index was assessed. Results. Palliative cancer patients showed a statistically significant decrease in the concentration of hemoglobin, lymphocytes, and albumin. The activation of systemic inflammation that manifested by hyperfibrinogenemia and an increase in the level of C-reactive protein was revealed. The study of somatometric parameters revealed a statistically significant decrease in body mass index, shoulder circumference, subscapular skinfold thickness, and a tendency to reduce lean body mass. The nutritional risk index assessment showed mild nutritional insufficiency in 22 (20.8%) of the examined patients and severe nutritional insufficiency in 28 (26.4%) patients. The maximum diagnostic significance of the level of C-reactive protein for prediction the nutritional insufficiency was achieved at 80.4% sensitivity and 52.7% specificity (AUC=0.671, 95% confidence interval [0.573; 0.759], p=0.001), which corresponded to a C-reactive protein threshold of 31 mg/l. Conclusion. 50 (47.2%) of the examined patients showed signs of nutritional insufficiency, a statistically significant decrease in hemoglobin and albumin concentration, as well as lymphocyte count, activation of systemic inflammation, manifested by hyperfibrinogenemia, and an increase in the level of C-reactive protein; it was revealed a statistically significant relationship between C-reactive protein level and malnutrition.

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