Objectives: Malnutrition (MN) is prevalent in older adults and closely related to sarcopenia, frailty, morbidity, mortality, and decreased quality of life. In this study, we aimed to evaluate the effects of a personalized diet combined with planned physical exercise on nutritional status, physical performance, and quality of life (QoL) in malnourished older adult patients. Methods: In this prospective study, 20 older adults with MN risk according to the Mini Nutritional Assessment—Short Form (MNA-SF) were randomized into (i) personalized diet (PD) and (ii) personalized diet with physical exercise (PDE) groups, and followed up with for 12 weeks. The physical exercise included warm-up, strengthening, balance, and cooldown phases, with a frequency of 3–4 days per week. Anthropometric measurements, physical performance, and quality of life were assessed using standardized tools at baseline and at the 4th, 8th, and 12th weeks. QoL was measured using the EQ–5D index and EQ–5D visual analog scale (VAS) scores. Results: A total of 20 patients (55% male) participated in the study. During the study, BMIs, MNA-SF scores, and hand grip strength were increased, and the patients’ average duration on the Timed Up and Go (TUG) test decreased significantly in both groups. The EQ–5D index score of the PD group and the EQ–5D VAS scores of both groups were increased. Conclusions: A personalized diet with or without physical exercise therapy was associated with improved nutritional status, physical performance, and QoL.

Introduction and Aim: Renal transplant recipients face significant long-term graft and patient loss due to post-transplant malignancies. This study aimed to characterize post-transplant malignancies, determine mortality risk factors, and evaluate patient outcomes. Materials and Methods: This retrospective study included 2052 kidney transplant recipients who underwent transplantation between 1976 and 2019 at our institution, other national centers, or international facilities, and who had at least six months of follow-up. Regardless of the transplant center, all patients were followed exclusively at our nephrology department for post-transplant care. A comprehensive review of patient files was conducted, encompassing demographic data, malignancy type and treatment, mortality rates, tissue compatibility assessments, viral serology results, immunosuppression protocols, acute rejection history, and pre-transplant malignancies. The relationships between these variables and mortality were examined. Results: A total of 167 malignant events were observed in 163 patients out of 2052 renal transplant patients (7.9%). The female patients comprised 34.4% (n = 56) of the participants. Ages at transplantation and malignancy diagnosis had medians of 40.0 (13–72) and 50.0 (23–78) years, respectively. The leading malignancy was skin cancer at 30.0%, with Kaposi sarcoma at 11.3% and post-transplant lymphoproliferative disease at 10.6% following. Of the patients followed up, 58.9% (93 patients) had mortality. In univariate analysis, older age at transplant, older age at malignancy diagnosis, and male sex were associated with mortality; however, no independent predictors were identified in the multivariate model (all p > 0.05), likely due to sample size limitations and inter-variable collinearity. Mortality showed statistically significant associations (p < 0.05) with increased age at transplantation, increased age at malignancy diagnosis, and male gender. Conclusions: Post-transplant malignancies significantly compromise both graft longevity and patient survival. Particularly aggressive skin cancers demand heightened clinical vigilance. Early detection through regular dermatological screening, patient education, and timely biopsies must become integral to long-term transplant care protocols.

Purpose: The effects of different COVID-19 therapeutic strategies on cardiac function are uncertain. Therefore, this study aimed to evaluate the effects of different medical treatments on biventricular function in patients who had recovered from COVID-19. Materials and Methods: Speckle-tracking echocardiography was performed to examine the biventricular myocardial function of patients at follow-up visits after recovery from COVID-19. The patients were divided into two groups based on the medication they used during the active disease: favipiravir (FAV; n = 60) or hydroxychloroquine (HCQ; n = 60). A comparison was made with risk factor–matched controls (n = 41). Results: A total of 161 patients were included in the study. The left ventricular end-diastolic volume, end-systolic volume, end-diastolic diameter, and end-systolic diameter were higher in the HCQ and FAV groups compared to the controls, while the left ventricular ejection fraction was similar between all the groups. The right ventricular diameter was increased, and the systolic pulmonary artery pressure was higher in the HCQ and FAV groups compared to the controls. The left ventricular global longitudinal strain (-18±6.6 vs. -19.7±4.4 vs. -20.4±5, respectively), the right ventricular global longitudinal strain (-19.8±7.5 vs. -22.2±6 vs. -23.4±6.2, respectively), and the right ventricular free wall strain (-16.9±3.6 vs. -18.2±2.4 vs. -19.6±4.7, respectively) were worse in the HCQ group compared to the FAV and control groups. Conclusion: This study found echocardiographic evidence of subclinical cardiac involvement in both the HCQ and FAV groups compared to the controls. However, HCQ treatment was associated with an increased risk of biventricular subclinical systolic dysfunction in COVID-19 survivors compared with FAV treatment.

Atrial Fibrillation Doesn’t Come Alone: The Geriatric Syndromes Behind the Arrhythmia - European Journal of Geriatrics and Gerontology