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Biomedical subjects

A Wiecek

Publications and source records attributed to A Wiecek.

At least 91 records · Page 5Linked to original sources
PubMed1995

[Etiology and outcome of acute renal failure in elderly patients].

Etiology, clinical course and prognosis were analysed in 346 patients with anuric/oliguric acute renal failure (ARF) treated in the Department of Nephrology, Silesian University School of Medicine in Katowice from January 1984 to December 1993. 41 of them were over 65 years of age (mean age 70.9 +/- 0.7 years) while 305 were younger (mean age 40.6 +/- 0.7 years). According to etiology patients with ARF of both groups were allocated into following subgroups: medical, urological, obstetric, rhabdomyolysis, toxic, traumatic and surgery. Total mortality was similar in both groups of patients (34.0% in older and 40.6% in younger patients respectively). Mean hospitalization time was also similar in both groups of patients with ARF (23.8 +/- 2.3 and 22.0 +/- 0.8 days respectively). Medical, urological and surgical factors were the most frequent causes of ARF in the elderly while traumatic causes and intoxications were extremely rare in these patients. Mortality in the individual etiological groups of ARF was of similarly magnitude in both examined groups. These results suggest that older age does not significantly worsen the outcome of ARF.

Acute Kidney Injury↗
PubMed1995

[Influence of long-term treatment with human recombinant erythropoietin on secretion of hormones regulating carbohydrate metabolism in hemodialyzed patients with chronic uremia].

The study aimed to assess the influence of long-term rhuEPO treatment on secretion of pancreatic hormones (insulin, glucagon). A total of 27 haemodialyzed and 9 healthy subjects were examined. Nine patients with uraemic anaemia were treated with rhuEPO for 12 months (EPO group) while another nine patients did not receive rhu-EPO (non-EPO group), but were monitored biochemically and clinically as patients of the EPO group. The third group (HD) comprised nine haemodialyzed patients with a haematocrit value of > 30%, without rhu-EPO therapy. In all subjects plasma levels of glucose, insulin (IRI) and glucagon (Glu) were estimated before and after administration of the test meal. Patients of the EPO and non-EPO group were examined before and after 6 and 12 months of rhu-EPO treatment (EPO group) or clinical monitoring (non-EPO group) respectively, while only one test was performed in patients of the HD group and healthy subjects. During the observation period fasting glicaemia did not change. Six months of rhu-EPO therapy was followed by an increase of fasting insulinaemia and decrease of basal plasma level of glucagon. At that time point rhu-EPO therapy also increased the response of IRI and Glu to the test meal and the insulin/glucose index. After 12 months of rhu-EPO therapy basal insulinaemia and insulin/glucose index returned to the pretreatment value while plasma level of glucagon and the response to the test meal were lower than pretreatment one. Our results suggest that rhu-EPO treatment exerts a profound effect on carbohydrate metabolism and secretion of IRI. Glu, which seems to be dependent upon duration of rhu-EPO therapy and not only, or exclusively to improvement of the haematological status.

Adult↗
PubMed1995

[Imidazol receptor agonists--new possibilities for treating hypertension].

Adrenergic alpha 2-receptors mediate important regulatory functions in both the brain and the periphery. Activation of these receptors lowers blood pressure through a decrease in sympathetic and vasomotor nerve activity. Agonists of the alpha 2-adrenoceptors are often used in the treatment of arterial hypertension. As recently discovered, their chemical structure includes so called "imidazoline ring" and compounds with such chemical structure bind to nonadrenergic sites known as imidazoline receptors. These receptors are localized in midportions of the brain but they are also present in other organs such as lungs, heart, adrenal medulla, liver and kidneys. Their selective activation lowers blood pressure without inducing sedation typical for alpha 2-agonists. Several substances binding with high selectivity to imidazoline receptors have recently been synthesized. Some of them as rilmenidine and moxonidine have successfully been introduced to the treatment of arterial hypertension in humans.

Adrenergic alpha-Agonists↗
PubMed1995

[Improvement of sexual function in hemodialyzed male patients with chronic renal failure treated with erythropoietin (rHuEPO)].

The present study aimed to assess the influence of long-term recombinant human erythropoietin therapy on selected parameters of sexual function in haemodialyzed males with chronic renal failure and severe nephrogenic anaemia. All patients were randomized into two groups. The first one consisted of 11 patients treated for 12 months with rHuEPO in order to achieve and maintain a target Hct value of 30-35% (EPO group). The other 9 male patients were only carefully monitored clinically and biochemically for 12 months similarly as patients of the EPO group but were not treated with rHuEPO (No-EPO group). After 12 months of monitoringan an anonimous questionnaire was completed by the patients describing selected parameters of quality of life and sexual function. Haemodialyzed males treated with rHuEPO showed a significantly higher score of improvement of well-being, exercise tolerance, erection quality and libido as compared with patients not treated with rHuEPO. Results obtained in this study suggest, that EPO therapy shows a beneficial effect on sexual function in haemodialyzed patients with chronic renal failure.

Adult↗
PubMed1995

[Influence of long-term human recombinant erythropoietin treatment on secretion of pancreatic polypeptide and gastrin in hemodialysed patients with chronic renal failure].

The study aimed to assess the influence of long-term rhu-EPO treatment on secretion of pancreatic polypeptide (PP) and gastrin. A total of 27 haemodialysed patients and nine healthy subjects were examined. Nine patients with uraemic anaemia were treated with rhu-EPO for 12 months (EPO group), while another nine patients did not receive rhu-EPO (non-EPO group), but were monitored biochemically and clinically as patients of the EPO group. The third group (HD) comparised nine haemodialysed patients with a haematocrit value > or = 30% without rhu-EPO therapy. In all subjects plasma levels of PP and gastrin were estimated before and after administration of a test meal. Patients of the EPO and non-EPO group were examined before and after 6 and 12 months of rhu-EPO therapy (EPO group) or clinical monitoring (non-EPO group) respectively, while only one test was performed in patients of the HD group and healthy subjects. Six months rhu-EPO therapy was followed by an decrease of basal plasma level of PP and increased response of gastrin to the test meal. After 12 months of rhu-EPO therapy basal plasma level of PP was still lower, the response of PP secretion to a test meal was higher, while that of gastrin secretion lower that the pretreatment ones. Our results suggest, that rhu-EPO treatment exerts effect on secretion of PP and gastrin. These alterations seem not to be related to improvement of the haematological status.

Adult↗
PubMed1995

[The concentration of ferritin in blood serum of patients with neoplasms of the larynx and the maxillary-ethmoidal complex].

The increased level of ferritin is known as a nonspecific marker of inflammatory processes and neoplasms. A purpose of the article was to indicate concentration of ferritin in blood serum before treatment of 33 patients with cancer of larynx and 16 patients with malignant neoplasms of maxillo-ethmoid complex. The patients with cancer of larynx were characterized by significantly high level of ferritin in comparison to patients with malignant neoplasms of maxillo-ethmoid complex (p < 0.05) and to healthy people (p < 0.05) (respectively 241.9 +/- 154.9; 106.9 +/- 45.4 and 125.0 +/- 30.4 ng/ml). Contrary to patients with cancer of larynx patients with malignant neoplasms of maxillo-ethmoid complex did not differ in significant level of ferritin from healthy people. The concentration of hemoglobin in blood in both groups of patients was similar and was characteristically lower than values obtained in healthy people. The results achieved suggest that indicating of ferritin can be helpful while making a differentiation between cancer of larynx and malignant neoplasms of maxillo-ethmoid complex.

Aged↗
PubMed1994

[Erythropoietin secretion in patients with chronic obstructive lung diseases during normobaric oxygen inhalation].

BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) are characterized by compensatory polycythaemia probably induced by increased erythropoietin (EPO) secretion in the kidneys. METHODS AND RESULTS: As the regulatory mechanisms of erythropoietin secretion in chronic obstructive pulmonary disease are scarcely known we studied plasma EPO levels in 14 patients with COPD (pO2 = 61.9 +/- 1.4 mm Hg, Hct = 47.8 +/- 1.1%) under basal conditions, after two hours of isobaric oxygen breathing and two and four hours after discontinued oxygen breathing. The control group consisted of 12 healthy subjects (pO2 = 87.5 +/- 2.2 mm Hg, Hct = 43.7 +/- 1.6%). Under basal conditions patients with COPD showed significantly higher plasma erythropoietin levels as compared with healthy controls. Oxygen breathing was followed by a significant decline of plasma EPO levels both in patients with COPD as in the control group. This decline was significantly more marked and of longer duration in COPD patients than in healthy controls. CONCLUSIONS: 1. Patients with chronic obstructive pulmonary disease are characterized by significantly higher plasma EPO levels as compared with healthy subjects. 2. The renal oxygen sensor function involved in the regulation of EPO secretion seems to be altered in COPD patients.

Erythropoietin↗
PubMed1994

Pathophysiology and treatment of hypertension and oedema due to renal failure.

Hypertension and oedema resulting from sodium retention are the main indications for diuretic treatment in patients with chronic renal failure. The pharmacokinetics of most loop diuretics and their active metabolites are altered in chronic renal failure, due both to reduced transtubular transport via the proximal tubular anion transporter and to protein binding within the tubule. In chronic renal failure, the reduced number of nephrons leads to adaptive reduction of tubular sodium reabsorption, i.e. high baseline fractional natriuresis and increased absolute distal tubular sodium reabsorption. These processes interfere with the pharmacodynamic actions of diuretics. Therapeutic strategies to overcome the partial resistance to the action of diuretics in patients with chronic renal failure include the use of high doses, continuous administration and the combination of loop and thiazide compounds.

Diuretics↗
PubMed1994

Erythropoietin concentration in cyst fluid in patients with simple renal cysts.

High erythropoietin (EPO) levels in cyst fluid and blood plasma in patients with autosomal dominant polycystic kidney disease (ADPKD) have been reported. In the present study we assessed EPO levels and the biochemical composition of cyst fluid obtained from 50 simple renal cysts. Basing on cyst fluid/plasma sodium ratio 38 cysts were classified as cysts of proximal origin, and 12 as cysts of undetermined origin. EPO concentrations in cyst fluid obtained from proximal cysts were significantly higher than in fluid from cysts of undetermined origin (472.9 +/- 116.2 vs. 112.1 +/- 33.3 mU/ml, p < 0.05). Patients with proximal cysts had significantly higher plasma EPO levels (31.8 +/- 3.5 mU/ml) than healthy subjects (17.3 +/- 1.96 mU/ml, p < 0.005). We conclude that: (1) simple renal cysts of distal origin seem to be rare; (2) the presence of high EPO level in cyst fluid suggests its proximal origin; (3) estimation of cyst fluid EPO levels seems to be of similar pathogenetic value as the assessment of the cyst fluid/plasma sodium ratio.

Adult↗
PubMed1994

Erythropoietin secretion in patients with chronic renal failure after pure oxygen breathing.

The present study aimed to assess the relationship between erythropoietin (EPO) secretion and hyperoxemia in uremic patients. In 19 patients with chronic renal failure (10 were hemodialyzed and 9 were not dialyzed) and in 13 healthy subjects plasma erythropoietin levels were assessed during 6 h of air breathing and a second time during 2 h of pure oxygen breathing and during 4 h after discontinued oxygen breathing. Under basal conditions, uremic patients showed higher plasma erythropoietin levels (39.85 +/- 5.86 mU/ml in hemodialyzed and 29.05 +/- 4.94 mU/ml in nondialyzed patients) as compared with healthy controls (21.04 +/- 1.77 mU/ml). Pure oxygen breathing was followed by a significant decline of plasma EPO levels both in patients with chronic renal failure and in the control group. However, this decline was significantly less marked and of longer duration in chronic renal failure patients than in healthy controls.

Administration, Inhalation↗
PubMed1994

Effect of isobaric hyperoxemia on erythropoietin secretion in hypertensive patients.

We assessed the influence of hyperoxemia on erythropoietin secretion in patients with various etiological forms of arterial hypertension (essential, n = 15; renoparenchymal, n = 16; renovascular, n = 15) and in 15 healthy subjects. On the first day of the study, blood was withdrawn at 1-hour intervals for the estimation of erythropoietin during a total of 6 hours and at 2-hour intervals for the assessment of PO2. Three days later the same parameters were assessed again at identical time intervals, but the subjects were breathing pure oxygen during the first 2 hours. Breathing with pure oxygen resulted in a significant increase of blood PO2 (184.85 +/- 4.47 versus 85.92 +/- 2.28 in essential, 185.21 +/- 5.52 versus 84.55 +/- 3.04 in renoparenchymal, and 181.7 +/- 3.14 versus 87.49 +/- 2.25 in renovascular hypertension groups and 189.84 +/- 5.2 versus 85.89 +/- 1.73 mm Hg in healthy subjects; P < .001 in all groups). Baseline plasma erythropoietin was not different among the groups (29.33 +/- 4.14 in essential, 24.56 +/- 3.09 in renoparenchymal, and 27.77 +/- 3.29 in renovascular hypertension groups and 24.23 +/- 2.70 mU/mL in the control group). The pattern of erythropoietin decline was different in the groups of hypertensive patients. In patients with essential hypertension, unlike in healthy subjects and patients with other etiological forms of arterial hypertension, only a very short-term suppression of erythropoietin levels was observed during hyperoxemia. No significant changes in blood pressure during breathing with pure oxygen were found in any of the studied groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[A case of kidney stone with unusual frequency of renal colic--possible influence of environment on lithogenesis].

In the present paper we described a 36 years old female, who expelled approximately 2000 stones from the urinary tract during the last 18 years. According to the clinical and laboratory tests the lithogenic factors such as abnormalities of calcium, phosphate, oxalate, magnesium and purine metabolism were excluded. The cystinuria and other forms of tubular nephropathies did not exist. Taking into account two following facts: 1) no evidence of renal calculi when the patient was outside her own house and 2) very high concentration of calcium in her home tap water, the role of environmental factors in the pathogenesis of nephrolithiasis in presented patient is very likely.

Adult↗
PubMed1994

Excess cardiovascular mortality in the uremic patient--what does it teach for other risk factors in the non-renal patient?

A high rate of cardiovascular death in renal patients, particularly patients with endstage renal failure, has not been well appreciated in the past. It is obvious that cardiovascular lesions are more severe than can be explained by the classical risk factors of elevated blood pressure and dyslipidemia. In renal failure, a number of pathomechanisms are operative which may be paradigms of more general relevance, e.g. activation of the renin and sympathetic system, inhibition of the vasoconstrictor NO system, left ventricular hypertrophy in excess of what is expected for high blood pressure. A paradox inverse relation between lipid concentrations and cardiovascular death, i.e. a protective effect of hyperlipidemia, in dialysed patients, presumably results from the confounding effect of malnutrition, high lipid levels being a substitute marker of adequate nutrition.

Animals↗
PubMed1994

Role of infection in the genesis of acute renal failure.

While most experimental models of acute renal failure (ARF) involve ischaemic or toxic damage to the kidney in non-infected animals, a surprisingly large proportion of patients with ARF exhibit signs of septicaemia or systemic reaction to local infections. This clinical observation suggests an important role of infection-related mediator mechanisms in the genesis of ARF. Another important aspect is the occurrence of ARF in the context of infections with nephrotropic viruses (e.g. hantavirus accounting for approximately 5% of non-surgical ARF in Germany) and nephrotropic bacteria (e.g. leptospirosis).

Acute Kidney Injury↗