Influence of latent iron deficiency on cognitive abilities in students

The aim of the study is to assess the impact of latent iron deficiency on students' cognitive abilities. Material and methods. The study was conducted during 2018-2021 at the Department of Hygiene and Medical Ecology of Odessa National Medical University. A survey of 188 medical students aged 18-20 was conducted using a screening survey. Estimation of the qualitative content of iron compounds in the diet was performed by a calculation method using the USDA / FDA database. Persons with probable iron deficiency were examined for hemoglobin, erythrocytes, hematocrit (general clinical blood test) and serum ferritin. Additionally, the cognitive abilities of people with latent iron deficiency were assessed using MoSA, TMT, GPB, Schulte tables and TAS-20. As a control, 30 students aged 18-20 years who showed no signs of latent or overt iron deficiency were interviewed. Statistical processing was performed by methods of variance and correlation anamnesis using the software Statistica 13.0 (TIBCO, USA). Results. When evaluating diets, probable iron deficiency was identified in 69 (36.7%) students surveyed. A significant number of students reported signs of iron deficiency, namely general weakness (27 or 14.4%), increased fatigue (30 cases or 15.9%), pale skin and mucous membranes (6 or 3.2%), drowsiness (8 or 4.3%), dry mouth (11 or 5.9%), brittle hair (4 or 2.1%), bleeding gums (3 or 1.6%). In isolated cases, hyposmia, dysgeusia and dysphagia have occurred. Probable iron deficiency was found at the previous stage of the study in 29 (15.4%) patients, they subsequently underwent verifying laboratory tests. In the analysis of the obtained data, the diagnosis of mild iron deficiency anemia was confirmed in 2 (6.9%) girls. Latent iron deficiency was identified in 16 (55.2%) students, among whom girls predominated (10 people or 62.5%). Subsequent studies have shown that a significant number of students with latent iron deficiency showed moderate signs of decreased cognition. Conclusions: 1. The frequency of latent iron deficiency in the surveyed contingent was 8.5%, with an absolute predominance of girls (62.5%). 2. Latent iron deficiency in student youth can be manifested by cognitive impairment, and therefore affect academic performance. 3. The most pronounced correlation was found for ferritin content and severity of alexithymia (r = -0.61).

On the receiving end: have patient perceptions of the side-effects of cancer chemotherapy changed since the twentieth century?

Background Studies in 1983 and 1993 identified and ranked symptoms experienced by cancer patients receiving chemotherapy. We repeated the studies to obtain updated information on patient perceptions of chemotherapy-associated symptoms. Patients and methods A cross-sectional interview and patient-reported outcome questionnaires were administered to out-patients receiving chemotherapy. Patients selected from 124 cards to identify and rank the severity of physical and non-physical symptoms they had experienced and attributed to chemotherapy (primary endpoint). The patient’s medical oncologist and primary chemotherapy nurse were invited to rank the five symptoms they believed the patient would rank as their most severe. We analysed the association of symptoms and their severity with patient demographics, chemotherapy regimen, and patient-reported outcomes. Results were compared to the earlier studies. Results Overall, 302 patients completed the interview: median age 58 years (range 17–85); 56% female; main tumour types colorectal 81 (27%), breast 67 (22%), lung 49 (16%); 45% treated with curative intent. Most common symptoms (reported by >50%) were: alopecia, general weakness, effects on family/partner, loss of taste, nausea, fatigue, difficulty sleeping, effects on work/home duties, and having to put life on hold. The most severe symptoms (ranked by >15% in top five) were: concern about effects on family/partner, nausea, fear of the future, fatigue, not knowing what will happen, putting my life on hold, and general weakness. Perceptions of doctors and nurses of patients’ symptom severity closely matched patients’ rankings. Conclusions Compared to earlier studies, there was an increase in non-physical concerns such as effects on family and future, and a decrease in physical symptoms, particularly vomiting, but nausea, fatigue and general weakness remained bothersome. Highlights • Symptoms related to chemotherapy have changed over time, likely due to less toxic regimens and improvements in supportive care. • Effects on family/partner, fear of the future, not knowing what will happen, and “life on hold” were major issues for patients. • Vomiting has decreased but nausea, fatigue and general weakness remain common symptoms for chemotherapy patients.

Post-COVID-19 syndrome

The disease caused by new coronavirus infection (COVID-19) is a global problem not only because of its wide spread occurrance, but also due to the high incidence of post-COVID syndrome. The literature review presents the results of numerous observations of patients, who undergone COVID-19. The most common symptoms are: general weakness, impaired cognitive functions, memory loss, depression, anosmia, dysgeusia, shortness of breath, cough, chest pain, abdominal pain, anorexia, nausea, vomiting, diarrhea, less often — alopecia, skin rashes, etc. The most frequent symptoms of the post-COVID syndrome are described; the reasons and risk factors for its development are analyzed. The lack of views sameness on the term “postCOVID syndrome” makes it diffi cult to evaluate the frequency of certain symptoms development. Variants of the post-COVID syndrome are considered. It is proposed to distinguish between the post-COVID syndrome, developed after acute COVID-19 that lasts up to 12 weeks, and a prolonged variant of post-COVID clinical symptoms that last longer than 12 weeks, which should be distinguished from lingering COVID-19, its complications, and the consequences of intensive care. The questions of prognosis, diagnostics, and treatment of post-COVID syndrome are discussed.

Gaucher's disease

The article presents a rare clinical case of Gaucher's disease, a hereditary disease that belongs to lysosomal accumulation diseases. A 36-year-old patient was admitted to the clinic with complaints of pain in the left half of the abdomen, pain in the chest, cough with yellow sputum, difficulty breathing due to pain, general weakness. The mental underdevelopment, hepatosplenomegaly, anemia, thrombocytopenia, and the threat of rupture of the spleen were revealed in the process of collecting anamnesis and examination. The patient was transferred to the surgical department, and a splenectomy was performed. Histological examination of the spleen and genetic examination confirmed the diagnosis of Gaucher's disease.

Anaemia - a common syndrome in old age

Anaemia is a common syndrome in the elderly (age>65 years), combined with changes and diseases characteristic of ageing. There are currently nearly 500 million (7%) adults over the age of 65 in the world. According to statistics, there are about 15 million older people with anaemia in the European Union. This number is likely to increase in the coming years due to the ageing population in Western societies.1 The acute anaemic syndrome is dominated by symptoms of decreased circulatory volume, such as dizziness, syncope and hypotension. While in the chronic course, anaemia can be asymptomatic and be detected accidentally in a laboratory test. Suspicious signs are a reduced ability to carry oxygen, such as general weakness, fatigue and shortness of breath, for which age changes are often blamed. Worsening of concomitant conditions such as angina, heart failure, CKD and chronic obstructive pulmonary disease has been observed. Older people with anaemia of any degree have a deteriorating quality of life due to significantly higher morbidity and mortality. The purpose of this review is to summarize the most common etiological causes of anaemia in the elderly, clinical consequences, and guidelines for diagnosis.

Skeletal muscle damage in the course of coronavirus disease (COVID-19) in a pediatric practice. Own supervision: a clinical case

Background. Coronavirus disease (COVID-19) pandemic is still at the heart of healthcare in Ukraine and over the world. The nervous system and other human organs and systems can be affected by pathogenic nature of SARS-CoV-2. We purposed to pay physicians’ attention to the diagnosis of skeletal muscle damage, in particular rhabdomyolysis, to avoid possible complications in COVID-19. Materials and methods. We have examined a group of children with skeletal muscle damage on the background of COVID-19 during 2020–2021. A clinical case from own practice has been presented in the article. Results and conclusions. The patient, a 15-year-old boy, developed general weakness, severe pain in the right thigh and hip joint, fever 33 days after the acute phase of coronavirus disease. The differential diagnosis was carried out between skeletal muscle damage and osteomyelitis. Diffuse connective tissue diseases, oncohematological disorders, and hepatitis were excluded on the basis of clinical data and examinations. The inflammatory changes in m.iliopsoas, m.obturatorius internus and m.piriformis with abscess formation identified during clinical examination and magnetic resonance imaging, along with high levels of blood transaminases indicated the development of rhabdomyolysis. The detected positive IgG to SARS-CoV-2 confirmed the association of this pathological condition with the previous acute phase of COVID-19. Signs of coagulopathy, anemia in the hemogram simultaneously with the clinical symptoms of rhabdomyolysis confirmed the systemic lesions in the course of coronavirus disease in the child. Timely assessment of clinical symptoms (general weakness, muscle pain) and levels of creatine phosphokinase, transaminases, electrolytes, creatinine, blood urea will help make an early diagnosis of rhabdomyolysis, prescribe adequate therapy and prevent the deve-lopment of severe complications.

Features of clinical manifestations of new coronavirus infection in patients at hospitalization during the COVID-19 epidemic depending on the severity

The article presents a review of the literature sources and results of a personal study. It was found that in our group, there were more persons aged 18–30 years among those who were in inpatient treatment, and among those who were treated in the ICU, the patients were aged 60 years or over. On average, patients who were treated in the ICU were admitted on the 6th day of illness. Most patients complained of dry or unproductive cough, moderate general weakness. Relatively more often moderate general weakness was registered in patients with a moderate course, and moderate and pronounced was typical for patients with a severe course (p < 0.05). Dyspnea was predominantly found in severely ill patients (in one-third of patients during exercise, in 17.7 % patients at rest). In patients with a non-serious course, a small number of patients had dyspnea on exertion (4.3 to 12.1 %). On admission, the average temperature was within normal or subfebrile, which predominated in patients with a moderate course (p < 0.05). With a mild course, half of the patients had a temperature within the normal range. Febrile fever was more often registered in the moderate and severe course. Pyretic body temperature was most typical for a severe course (p < 0.05). It is noteworthy that even in those patients who were treated in the intensive care unit, at admission a quarter of the patients had a normal temperature, and 41.2 % — subfebrile. On ave-rage, the duration of fever before admission in critically ill patients was 5 days, and in those who died — 2 days. Dry cough was significantly more common in severe patients (p < 0.05). In the mild course, only one-fifth of patients complained of dry or unproductive cough. In the moderate course, the dry or unproductive cough was symptomatic for one-third of patients. There was no significant difference in the frequency of complaints of sore throat (p > 0.05). On average, a respiratory rate on admission in critically ill patients did not differ between those who survived and those who died, while those who died more often presented with a respiratory rate of 30/min or more, tachycardia, and more reduced saturation values.

An empirical study on quality of life and related factors of Pakistani breast cancer survivors

A comprehensive understanding of the quality of life (QoL) is essential to establish long-term survivor care plans. The present study was aimed at the assessment of QoL of BC survivors with special emphasis on post-treatment physical, emotional, social, and spiritual challenges. We have assessed the QoL of 250 female BC survivors of all age groups through demographic factors. Volunteer BC survivors were registered in the present study who had got treatment from the Institute of Nuclear Medicine and Oncology (INMOL) hospital and Mayo hospital Lahore. An informed consent form was signed by each participant. The physical, psychological, and spiritual well-being was evaluated by a questionnaire filled with the help of respondents. The average age of BC survivors was 52 ± 7.8 years. Most of them (83%) complained of fatigue during daily life activities, 75.1% body pain or headache, 77.1% had problems with appetite, 63.2% reported weight loss, 77.1% had sleep problems, and 90.5% were feeling general weakness. Only 16.2% were satisfied with their physical health and 2% were not satisfied with their medication. Psychologically, 74.4% were feeling different levels of anxiety, only 10% of them were hoping to achieve a desired life. Age group 21 to 40 years reported better physical health, those with 40–50 years of age and family history of BC have shown better mental strength. The physical and psychological health of survivors from rural areas was comparatively better than those from urban areas. The BC survivor women have to face several physical, psychological and social challenges. The majorities of them complain of anxiety, body pain, fatigue, sleep problems, general weakness, and fear about the future. Our findings suggest the need for psychological support, physical activity a comprehensive post-diagnosis and post-treatment physical and mental health assistance plan for all BC survivors. Implications for Cancer Survivors. Survivors of breast cancer experience various challenges including anxiety, sleep problems, body pain, fatigue, and fear about the future. The psychological, physical and social factors make a great difference in their quality of life.

Sudden Cardiac Death Caused by a Septic Coronary Artery Embolism as the First Clinical Presentation of Infective Endocarditis

This report describes an uncommon and fatal case of myocardial infarction due to coronary embolus arising from vegetation in the aortic valve with a background of infective endocarditis (IE). There are various causes of fatal IE. Myocardial infarction due to septic emboli is rare. We report a case of sudden death in a 69-year-old woman with hyperlipidemia and no known cardiac disease. She had severe general weakness and was hospitalized for colonoscopy. The patient unexpectedly presented with cardiac arrest and died. The autopsy showed total occlusion of the left anterior descending artery by an embolus, which originated from the septic vegetation of the aortic valve. Myocardial infarction from septic emboli associated with IE can be fatal and manifested as the first presentation. In autopsy practice of deceased patients with IE, careful examination of the coronary arteries is required.

Peculiarities of clinical manifestations of the new COVID-19 coronavirus infection in patients hospitalized during the epidemic depending on their age

This article presents a review of the literature and data from a personal study concerning the clinical manifestations of new coronavirus infection in patients hospitalized during the COVID-19 epidemic depending on their age. It was found that most patients complained about dry or low-productive cough, moderate general weakness. The patients aged 18–30 years old more frequently experienced no cough. The patients aged 31–40 years old significantly more frequently complained about dry cough (p < 0.05). Low-productive cough was less frequent but typical in all age groups and more frequent in patients aged 51–60 years. Moist cough was more frequent in patients over 60 years. Chest pain was registered in patients over 60 years (p < 0.05). The frequency of dyspnea was found to increase with age. More often dyspnea was registered in patients older than 60 years old. No dyspnea was noted in young patients aged 18–30 years. Half of the patients aged 18–30 years had no fever. At hospitalization, the average temperature was within normal or subfebrile, which predominated in patients aged 41–50 years (p < 0.05). The frequency of febrile fever increased in patients with age. There was no significant difference in the frequency of pyretic temperature among all age groups. The patients aged over 30 years complained more about moderate weakness, and patients aged over 40 years complained more about severe weakness. Younger patients more often complained about a sore throat, while older patients had practically no symptoms (p > 0.05). Thoracic pain was significantly more frequently registered in patients older than 60 years old. Young patients aged 18–30 years and 31–40 years had no chest pain.