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Biomedical subjects

Jan Kowalski

Publications and source records attributed to Jan Kowalski.

At least 19 recordsLinked to original sources

N-terminal brain natriuretic propeptide levels correlate with procalcitonin and C-reactive protein levels in septic patients.

The aim of this study was to find the relationship between N-terminal brain natriuretic propeptide (NT-proBNP), procalcitonin (PCT) and C-reactive protein (CRP) plasma concentrations in septic patients. This was a prospective study, performed at Medical University Hospital No. 5 in łódź. Twenty patients with sepsis and severe sepsis were included in the study. N-terminal brain natriuretic propeptide, procalcitonin and C-reactive protein concentrations, and survival were evaluated. In the whole studied group (128 measurements), the mean NT-proBNP, procalcitonin and C-reactive protein concentrations were, respectively: 140.80+/-84.65 pg/ml, 22.32+/-97.41 ng/ml, 128.51+/-79.05 mg/l. The correlations for the NT-proBNP level and procalcitonin and C-reactive protein levels were 0.3273 (p<0.001) and 0.4134 (p<0.001), respectively. NT-proBNP levels correlate with PCT and CRP levels in septic patients. In the survivor subgroup, the mean NT-proBNP plasma concentrations were significantly lower than in the non-survivor subgroup.

Adult↗

A comprehensive pain management programme comprising educational, cognitive and behavioural interventions for neuropathic pain following spinal cord injury.

OBJECTIVE: To assess whether a comprehensive multidisciplinary pain management programme could contribute to improvement regarding sleep quality, mood, life satisfaction, health-related quality of life, sense of coherence and pain for patients with a spinal cord injury and neuropathic pain. DESIGN: A prospective intervention study. PATIENTS: Twenty-seven patients with spinal cord injury and neuropathic pain participated in a pain management programme in parallel with 11 patients in a control group. METHODS: A comprehensive pain management programme comprising educational, cognitive, and behavioural interventions was created for patients with spinal cord injury and neuropathic pain. The pain management programme consisted of 20 sessions over a 10-week period and included educational sessions, behavioural therapy, relaxation, stretching, light exercise and body awareness training. All patients were followed-up 3, 6 and 12 months after completion of the programme. RESULTS: At the 12-month follow-up, levels of anxiety and depression in the treatment group decreased compared with baseline values, and a tendency towards better quality of sleep was seen. In comparison with the control group, patients in the treatment group improved regarding sense of coherence and depression. CONCLUSION: This study implies that a multidimensional pain management programme can be a valuable complement in the treatment of spinal cord injured patients with neuropathic pain.

Adaptation, Psychological↗

Neutrophil superoxide anion generation during atorvastatin and fluvastatin therapy used in coronary heart disease primary prevention.

Neutrophil superoxide anion generation was measured during atorvastatin and fluvastatin therapy in patients with coronary heart disease (CHD) risk. The patients were randomly allotted into three groups. The atorvastatin group comprised 17 patients who were administered the drug orally 10 mg a day at bed time. The fluvastatin group consisted of 18 patients on an oral dose of 40 mg once daily at bed time. The control group comprised 12 healthy subjects with no drug administration. Blood samples were collected from cubital vein before and after 6-week therapy with these drugs and once in the control group. Neutrophil superoxide anion generation in whole blood without and with opsonized zymosan (OZ) stimulation was determined using superoxide dismutase from bovine erythrocytes. In the atorvastatin group, statistically significant (P < 0.05) decrease in superoxide anion generation by nonstimulated and OZ-stimulated neutrophils was observed after 6 weeks of therapy. In fluvastatin group, no changes in neutrophil superoxide anion generation were observed after the 6-week treatment period. Our study has shown an additional nonlipid mechanism of atorvastatin used in CHD primary prevention.

Adult↗

[Pharmacological effects of flavonoids from Scutellaria baicalensis].

Scutellaria baicalensis is a plant widely used in Chinese and Japanese herbal medicine. Dry roots of Scutellaria baicalensis are used, especially as alcohol extracts. Flavonoids isolated from Radix Scutellariae have beneficial effects in hepatitis. Flavonoids derived from Scutellaria baicalensis produce antioxidative, antineoplastic, cardiomiocyte-protective activity. They inhibit agregation of platelets, permeability of capillary vessels, have antibacterial and anty-angiogenic effects.

Antineoplastic Agents, Phytogenic↗

NT-proBNP levels correlate with organ failure in septic patients: a preliminary report.

UNLABELLED: The aim of the study was to evaluate the relationship between N-terminal brain natriuretic propeptide (NT-proBNP) plasma concentrations and the severity of organ dysfunction assessed by the Sepsis-related Organ Failure Assessment (SOFA) score in septic patients MATERIAL/METHODS: NT-proBNP, SOFA score, and survival were evaluated in 20 consecutive septic patients. They were prospectively included in the study when the sepsis criteria according to the ACCP/SCCM definitions (modified by the Polish Working Group for Sepsis) were fulfilled. Blood serum NT-proBNP concentrations were determined in each patient at given time intervals and the severity of organ dysfunction was estimated according to the SOFA score. The first measurement was performed within 12 h after the patient's inclusion into the study, the second, third, and fourth at 12, 24, and 48 hours after the first, and then every 48 hours thereafter RESULTS: The mean NT-proBNP concentration and the mean SOFA score were 140.80+/-84.65 pg/ml and 6.31+/-3.75 points, respectively. The correlation coefficient between NT-proBNP level and SOFA score was R=0.5164 (p<0.05). The mortality in the studied group was 30%. CONCLUSIONS: NT-proBNP levels correlate with the severity of organ dysfunction as assessed by the SOFA score in septic patients.

Adult↗

Lack of interchangeability between visual analogue and verbal rating pain scales: a cross sectional description of pain etiology groups.

BACKGROUND: Rating scales like the visual analogue scale, VAS, and the verbal rating scale, VRS, are often used for pain assessments both in clinical work and in research, despite the lack of a gold standard. Interchangeability of recorded pain intensity captured in the two scales has been discussed earlier, but not in conjunction with taking the influence of pain etiology into consideration. METHODS: In this cross-sectional study, patients with their pain classified according to its etiology (chronic/idiopathic, nociceptive and neuropathic pain) were consecutively recruited for self-assessment of their actual pain intensity using a continuous VAS, 0-100, and a discrete five-category VRS. The data were analyzed with a non-parametric statistical method, suitable for comparison of scales with different numbers of response alternatives. RESULTS: An overlapping of the VAS records relative the VRS categories was seen in all pain groups. Cut-off positions for the VAS records related to the VRS categories were found lower in patients with nociceptive pain relative patients suffering from chronic/idiopathic and neuropathic pain. When comparing the VAS records transformed into an equidistant five-category scale with the VRS records, systematic disagreements between the scales was shown in all groups. Furthermore, in the test-retest a low percentage of the patients agreed to the same pain level on the VAS while the opposite hold for the VRS. CONCLUSION: The pain intensity assessments on VAS and VRS are in this study, not interchangeable due to overlap of pain records between the two scales, systematic disagreements when comparing the two scales and a low percentage intra-scale agreement. Furthermore, the lower VAS cut-off positions relative the VRS labels indicate different meaning of the rated pain intensity depending on pain etiology. It is also indicated that the scales have non-linear properties and that the two scales probably have different interpretation. Our findings are in favor of using the VRS in pain intensity assessments but if still the VAS is preferred, the VAS data should be analyzed as continuous using statistical methods suitable for ordinal data. Furthermore, our findings indicate a risk to over or under estimate the patient's perceived pain when interpreting condensed VAS data.

Adult↗

Neutrophils superoxide anion generation during carvedilol therapy in patients with stable angina.

Neutrophil superoxide anion (O(2)(*-)) generation was measured during carvedilol therapy in patients with stable angina. The carvedilol group comprised 27 patients (18 men and 9 women), aged 38-51 years (mean 47.6 years) with stable angina. Carvedilol was administered in increased every 4-week doses: 12.5, 25 and 50 mg/24 h, respectively. The control group included 12 healthy subjects, aged 39-49 years (mean 45.7 years) with no drug administered. Blood samples were collected from cubital vein before and 4, 8 and 12 weeks after the therapy and once in the control group. Neutrophil O(2)(*-) generation was determined in whole blood without and with opsonized zymosan (OZ) stimulation according to Bellavite et al. method using superoxide dismutase from bovine erythrocytes. O(2)(*-) generation by nonstimulated and OZ-stimulated neutrophils was significantly higher (p<0.05) in patients with stable angina than in the control group. In carvedilol group, statistically significant (p<0.05) decrease in superoxide anion generation by nonstimulated and OZ-stimulated neutrophils was observed 8 and 12 weeks after the therapy and it did not differ from that in healthy subjects. Carvedilol has been shown to inhibit neutrophil O(2)(*-) generation in patients with stable angina.

Adult↗

Amitriptyline and nortriptyline inhibit interleukin-1 release by rat mixed glial and microglial cell cultures.

Pro-inflammatory cytokines, such as interleukin (IL)-1beta and tumour necrosis factor (TNF)-alpha have been suggested to be involved in the pathophysiology of depression and in the mechanism of action of antidepressant drugs. Until now the effect of antidepressants on cytokines has been examined only in plasma, blood mononuclear cells and spleen, which reflect the activity of peripheral cytokine network. The aim of this study was to evaluate the effect of amitriptyline and its metabolite nortriptyline on the release of IL-1beta and TNF-alpha by lipopolysaccharide (LPS)-activated rat mixed glial and microglial cell cultures. LPS stimulated the release of both cytokines. The exposure of mixed glial culture to amitriptyline and nortriptyline led to a decrease in both IL-1beta and TNF-alpha release. Moreover, amitriptyline reduced LPS-stimulated IL-1beta release by microglial cultures. Although amitriptyline reduced secretion of both cytokines, the drug did not affect IL-1beta and TNF-alpha mRNAs in mixed cell cultures. Our study has shown for the first time that amitriptyline and nortriptyline administered at concentrations which may be achieved in plasma and brain structures during treatment, inhibit the secretion of IL-1beta and TNF-alpha in rat mixed glial and microglial cell cultures. The obtained results support the previous observations that antidepressants are able to reduce peripheral release of pro-inflammatory cytokines and suggest that the cytokine network may be involved in the central mechanism of action of amitriptyline and nortriptyline.

Amitriptyline↗

Chlorpromazine and loxapine reduce interleukin-1beta and interleukin-2 release by rat mixed glial and microglial cell cultures.

The cytokines IL-1beta and IL-2 are released from activated glial cells in the central nervous system and they are able to enhance catecholaminergic neurotransmission. There is no data concerning influence of antipsychotics on glial cell activity. Antipsychotics reaching the brain act not only on neurons but probably also on glial cells. The aim of this study was to evaluate the effect of chlorpromazine and loxapine on release of IL-1beta and IL-2 by mixed glial and microglial cell cultures. Chlorpromazine in concentrations 2 and 20 muM, and loxapine 0.2, 2 and 20 microM reduced IL-1beta secretion by LPS-activated mixed glia cultures after 1 and 3 days of exposure. Chlorpromazine in concentrations of 0.2, 2 and 20 microM reduced the IL-2 secretion in mixed glial cultures after 3 days of exposure. Loxapine in concentrations of 0.2, 2 and 20 microM reduced IL-2 secretion in mixed glia cultures after 1 and 3 days of exposure, and additionally loxapine decreased IL-1beta and IL-2 secretion in LPS-induced microglia cultures in concentrations of 2, 10 and 20 muM. Quinpirole-a D2 dopaminergic agonist increased LPS-induced IL-1beta and IL-2 secretion in mixed glia cultures only in the highest dose of 20 microM. These findings suggest the absence of functional dopamine receptors on cortical microglial cells. Mixed glia cultures deprived of microglia (by shaking and incubating with L-leucine methyl ester) did not release IL-1beta and IL-2. This observation suggests that microglia can be a source of assessed cytokines. Results of the present study support the view that antipsychotics act not only on neurons but also on glial cells. However, the clinical significance of these observations still remains unclear.

Analysis of Variance↗

Evaluating the reliability of multi-item scales: a non-parametric approach to the ordered categorical structure of data collected with the Swedish version of the Tampa Scale for Kinesiophobia and the Self-Efficacy Scale.

OBJECTIVE: To compare the ability of a rank-invariant non-parametric method with that of kappa statistics to evaluate the reliability of the Swedish version of the Tampa Scale for Kinesiophobia and the Self-Efficacy Scale by identifying systematic and random disagreement. The aim was, further, to compare 2 different statistical approaches to obtain a global value from multi-item scales. DESIGN: A test-retest study. SUBJECTS: A total of 46 patients with whiplash-associated disorders were enrolled and 39 (85%) completed the test-retest assessment. METHODS: Data from the multi-item scales were summarized using both sum and median scores. Paired data were evaluated with a rank-invariant statistical method to identify systematic and random disagreement. Data were also evaluated with kappa statistics. RESULTS: The non-parametric approach demonstrated that the Swedish version of the Tampa Scale for Kinesiophobia and the Self-Efficacy Scale are reliable for patients with whiplash-associated disorders. In contrast to the rank-invariant method, kappa statistics provided no information on disagreement between the 2 test occasions. Median scoring improved reliability due to lack of disagreement while the sum scores method was characterized by random individual disagreement. CONCLUSION: This study has increased understanding of the advantages and limitations of 2 non-parametric statistical methods and, it is hoped, will contribute to the development of reliable measurements.

Fear↗

Monocyte release of tumor necrosis factor-alpha and interleukin-1beta in primary type IIa and IIb dyslipidemic patients treated with statins or fibrates.

Both 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) as well as peroxisome proliferator-activated receptor (PPAR)alpha activators (fibrates) proved to be effective in the primary and secondary prevention of cardiovascular diseases. The benefits of hypolipemic therapy in cardiovascular diseases cannot be explained only by the lipid-lowering potential of these agents. The aim of this study was to clarify the effect of hypolipemic agents on proinflammatory cytokine release from human monocytes in relationship with their action on plasma levels of sensitive systemic marker of low-grade vascular inflammation. Plasma lipid and high-sensitivity C-reactive protein (hsCRP) levels, and the release of tumor necrosis factor-alpha (TNFalpha) and interleukin-1beta from monocytes were assessed at baseline and 30 and 90 days following randomization of IIa dyslipidemic patients into fluvastatin or simvastatin groups and randomization of type IIb dyslipidemic patients to the micronized form of either ciprofibrate or fenofibrate. Lipopolysaccharide-stimulated monocytes from dyslipidemic patients released significantly more TNFalpha (types IIa and IIb dyslipidemias) and interleukin-1beta (type IIa dyslipidemia) in comparison with monocytes in 59 age-, sex-, and weight-matched control subjects. Their baseline hsCRP levels were also higher. Both statins and fibrates reduced the release of TNFalpha and interleukin-1beta, and lowered plasma hsCRP levels. The effects of hypolipemic agents on cytokine release and plasma hsCRP were unrelated to their lipid-lowering action. Our results have demonstrated that type IIa and IIb dyslipidemic patients exhibit the abnormal pattern of TNFalpha and interleukin-1beta production by activated monocytes. Both HMG-CoA reductase inhibitors and PPARalpha activators normalize monocytic secretion of these cytokines, and this action may partially contribute to the systemic antiinflammatory effect of hypolipemic agents. The statin- and fibrate-induced suppression of proinflammatory cytokine release from monocytes seems to play a role in their beneficial effect on the incidence of cardiovascular events.

Adult↗

The influence of surgical treatment of periodontal disease on selected lymphocyte subpopulations important for cellular and humoral immune responses.

BACKGROUND: Periodontal disease is a complex pathological process involving a wide spectrum of immunological reactions. The aim of the study was to evaluate the influence of surgical periodontal treatments on peripheral blood lymphocyte subpopulations. METHODS: The study was performed in 40 generally healthy individuals diagnosed with generalized chronic periodontitis and a control group of 36 persons without periodontitis. Peripheral blood lymphocyte subpopulations were examined in both groups. Periodontal treatment was performed, using four different surgical procedures, in the study group. Peripheral blood lymphocyte subpopulations were re-evaluated again after 6 months. RESULTS: Periodontal treatment resulted in a significant improvement of all measured clinical parameters, regardless of the surgical procedure. When evaluated in the study group as a whole, percentages of all but CD8+ T lymphocyte subpopulations were significantly different from the control group at baseline. Values in both groups after treatment were similar. Correlation analysis suggests a connection between the presence of CD25+ cells and selected clinical parameters of periodontal disease (probing depth and clinical attachment loss). CONCLUSIONS: Statistically significant differences in the percentages of selected lymphocyte subpopulations in the peripheral blood of patients and healthy controls were found. The results suggest a correlation between selected clinical periodontal parameters and percentage of activated cells expressing the interleukin (IL)-2 receptor. Periodontal treatment resulted in significant improvement in the measured clinical and immunological parameters. It seems that the type of surgical treatment has little effect on the normalization of quantitative disturbances of the examined peripheral blood lymphocytes.

Adolescent↗

[The use of anthocyanins in the treatment of cardiovascular diseases].

Anthocyanins are common ingredients of human diet, and the rich source of them are: aronia fruits, black currant, raspberry, grapes and apples. Because of their chemical structure they are able to influence many active substances in human body having antioxidative, antiinflammatory and cardioprotective activity.

Anthocyanins↗

[Estimation of antioxidative effect of atorvastatin and fluvastatin used in primary prevention of coronary heart disease--effect on antioxidative enzymatic activity].

The effect of atorvastatin and fluvastatin on antioxidative enzymatic activity was studied in CHD risk patients. The study comprised 35 patients (20 men and 15 women) aged 35-47 years, who were allotted into two groups: I--18 patients were administered fluvastatin (Lescol) in a dose of 40 mg once daily at bed time for 6 weeks and II--17 patients were administered atorvastatin (Sortis) in a dose of 10 mg once daily at bed time for 6 weeks. The control group consisted of 12 clinically healthy subjects, aged 34-42 years. SOD-1, GSH-Px and CAT activity in erythrocytes was measured. Greater increase of low erythrocyte antioxidative enzymatic activity was observed in atorvastatin than in fluvastatin group.

Adult↗

[Assessment of oral cavity mucosa and teeth state in patients with chronic obstructive pulmonary disease--part I].

UNLABELLED: The aim of the study was to assess the state of oral cavity mucosa and teeth in patients with chronic obturative pulmonary disease (COPD). MATERIAL AND METHODS: The study comprised 100 patients with COPD (68 men and 32 women), aged 30-83 years (mean 63.1 +/- 10.17 years). All patients demonstrated II grade COPD (moderate COPD). FEV1/FVC<70% and FEV1 was within 79% and 50% of the predicted value. Beta2-adrenomimetic inhalants or in nebulization, theophylline were applied in the therapy. The control group consisted of 101 subjects (38 men and 63 women), aged 42-88 years (mean 65.3-10.36 years), with no respiratory tract ailments. The rate of smoking was similar in both groups. The examination of oral cavity mucosa and teeth state was performed in artificial lightening with the use of probe and mouth mirror. The number of lacking teeth and the advancement of caries were determined. RESULTS: Thrush appeared to be the most frequent oral cavity mucosa ailment in COPD patients. Toothlessness and reduced teeth number were observed significantly more often in COPD patients than in the control group (p<0.05). The frequency and the type of caries did not differ significantly between the two groups (p>0.05).

Adult↗

[Assessment of periodontal state in patients with chronic obstructive pulmonary disease--part II].

UNLABELLED: The aim of the study was to estimate the periodontal state in chronic obstructive pulmonary disease (COPD). MATERIAL AND METHODS: The study comprised 100 patients with COPD (68 men and 32 women), aged 30-83 years (mean 63.1 +/- 10.17 years). All patients were in the II grade COPD (moderate COPD). FEV1/FVC<70% and FEV1 was within 79% and 50% of the predicted value. Beta2-adrenomimetic inhalants or in nebulization, theophylline were applied in the therapy. The control group consisted of 101 subjects (38 men and 63 women), aged 42-88 years (mean 65.3-10.36 years), with no respiratory tract diseases. The rate of smoking was similar in both groups. To examine periodontal state, periodontal pocket depth was measured (with periodontal sound), Periodontal Index (PI) and dental plaque index were assessed. RESULTS: The frequency and severity of periodontal diseases in COPD patients were demonstrated to be significantly increased as compared to the control group (p<0.05). Adult chronic periodontitis (ACP) was observed significantly more frequently in COPD patients (84.21%) than in the control group (59.74%, p<0.05). A positive correlation was found between periodontal pocket depth and dental plaque index in patients with COPD. CONCLUSION: The frequency and intensification of periodontal diseases speak for their cause-and-effect relationship with COPD. The prophylaxis and treatment of periodontal diseases should be of great importance in the COPD therapy, which may increase its effectiveness.

Adult↗

[Estimation of antioxidative effect of atorvastatin and fluvastatin used in primary prevention of coronary heart disease--effect on lipid peroxidation].

The study comprised 35 patients with mixed hyperlipidaemia and coronary heart disease (CHD) risk factors (overweight or obesity, low physical activity, family history). Seventeen patients were administered atorvastatin in a dose of 10 mg and 18 -fluvastatin in a dose of 40 mg once daily at bed time for 6 weeks. The control group consisted of 12 clinically healthy subjects with no CHD risk factors. Blood samples for testing were collected from cubital vein of patients after hypolipaemic diet prior to and 6 weeks after drugs application and once in control group. Malondialdehyde (MDA) concentrations in erythrocytes and plasma were determined by the method of Placer et al. MDA concentrations in erythrocytes and plasma were significantly higher (p < 0.05) in patients than in healthy subjects. After 6-week atorvastatin therapy MDA concentrations in erythrocytes and plasma decreased to the values observed in healthy subjects. In fluvastatin group erythrocyte and plasma MDA concentrations were unchanged and still significantly higher in comparison to the healthy subjects. Atorvastatin, contrary to fluvastatin, decreases lipid peroxidation in CHD risk patients.

Adult↗