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Biomedical subjects

K Ostrowski

Publications and source records attributed to K Ostrowski.

At least 55 records · Page 3Linked to original sources
PubMed1998

Recovery of the immune system after exercise.

In the recovery phase after intense exercise is found suppressed blood concentration of lymphocytes, suppressed natural immunity of blood lymphocytes, decreased concentration of secretory IgA in mucosa, but increased blood concentration of neutrophils and increased levels in the blood of inflammatory cytokines. Thus, after intense long-term exercise, the immune system is characterized by concomitant inflammation and temporary suppression of the cellular immune system, the most pronounced findings being 2-4 h after the exercise. The underlying mechanisms are multifactorial and include neuroendocrinological and metabolic factors. High levels of cytokines, especially interleukin-6, are found in the recovery period after eccentric exercise, and it has been demonstrated that a close association exists between muscle damage and increased levels of interleukin-6.

Humans↗
PubMed1998

Normalization of periodontal tissues in osteopetrotic mib mutant rats, treated with CSF-1.

The osteopetrotic mib mutation in rats causes defects in the skeletal bone tissue in young animals. These defects, i.e. slow bone remodelling, changes in both crystallinity and mineral content, are transient and undergo normalization, even without any treatment in 6-wk-old animals. Treatment with CSF-1 (colony stimulating factor-1) accelerates the normalization process in skeletal bones. The periodontal tissues around the apices of incisors show abnormalities caused by the slow remodelling process of the mandible bone tissue, the deficiency of osteoclasts and their abnormal morphology, as well as the disorganization of periodontal ligament fibres. In contrast to the skeletal tissues, these abnormalities would not undergo spontaneous normalization. Under treatment with colony stimulating factor 1 (CSF-1), the primitive bone trabeculae of mandible are resorbed and the normalization of the number of osteoclasts and their cytology occurs. The organization of the periodontal ligament fibres is partially restored, resembling the histological structure of the normal one.

Animals↗
PubMed1998

The cytokine response to strenuous exercise.

Strenuous exercise is accompanied by an increase in circulating proinflammatory and inflammation responsive cytokines, having some similarities with the response to sepsis and trauma. The sequential release of tumour necrosis factor-alpha, interleukin (IL) 1 beta, IL-6, and IL-1 receptor antagonist (IL-1ra) in the blood is comparable to that observed in relation to bacterial diseases. Eccentric exercise is associated with an increase in serum IL-6 concentrations and is significantly correlated with the concentration of creatine kinase (CK) in the following days, whereas no changes are found after the concentric exercise; this demonstrates a close association between exercise-induced muscle damage and increased serum levels of IL-6. The time course of cytokine production, the close association with muscle damage, and the finding of mRNA-IL-6 in skeletal muscle biopsies after intense exercise all support the idea that during eccentric exercise myofibers are mechanically damaged and that this process stimulates the local production of inflammatory cytokines. It remains to be shown whether systemic endotoxemia during exercise is also a cause of elevated levels of cytokines in the plasma. The present review also discusses the possible roles of protein breakdown, delayed onset muscle soreness, and clinical implications of the acute-phase response following exercise.

Cytokines↗
PubMed1998

[Microalbuminuria as a risk factor for diabetic osteopathy in patients with IDDM and renal sufficiency].

Disturbances in bone marrow vascularisation can be one of the causes of diabetic osteopathy. The aim of the study was to answers the question if microalbuminuria as a results of capillary injury can be a sign of bone mineralisation disorders in IDDM renal sufficient patients. We examined 60 IDDM patients (30 women without menstruation disturbances; 30 men; age 25-36 years old). All the observed subjects were divided into groups: I-30 normoalbuminuric patients (0-29 mg/24 h); II-30 microabuminuric patients (30-295 mg/24 h). Bone mineral density (BMD) of femoral neck, lumbar spine (L2-L4) and total body was measured by dual energy X-ray absorptiometry (DEXA, Lunar). The biochemical parameters of bone turnover were measured both in serum and urine as follows: osteocalcine, total hydroxyproline (HPR, HPR/Cr), total alkaline phosphatase (AP) with bone fraction, total calcium (Ca, Ca/Cr) and inorganic phosphor (P). Microalbuminuric patients presented more severe bone turnover disturbances, shown by differences in: BMD and Z-score for femoral neck (p < 0.05), serum HPR (p < 0.05), AP (p < 0.05), AP (p < 0.01) and its bone fraction (p < 0.05). We proved the presence of statistically significant correlation coefficients for albuminuria and some densytometric and biochemical bone parameeters. Our results suggest that microalbuminuria can indirectly indicate the dynamic of bone turnover derangement in IDDM course. They are present mostly in the femoral neck, which because of the vascularisation type is particularly susceptible to subalimentation in the diabetic microangiopathy course.

Absorptiometry, Photon↗
PubMed1997

[Bone mineralization in insulin-dependent diabetes mellitus].

One of insulin-dependent diabetes mellitus (IDDM) complications are bone mineral disorders called diabetic osteopathy. Because of many controversies of this subject we took a research of bone mineralisation in IDDM patients before 40 years old. The evaluation of BMD was performed with the use of X-ray dual energy absorptiometry--DEXA in the AP projection for lumbar part of vertebral column (BMD L2-L4), left femur neck (BMD-neck) and total skeleton (BMD-total). Bone tissue metabolism was evaluated with the aid of biochemical tests. The examined group consisted of 99 patients with IDDM (45 women and 54 men), without any other risk factors for changes in bone metabolism. The results were related to: sex, age in which IDDM was diagnosed, duration of IDDM, metabolic control of diabetes and to some IDDM complications. The control group consisted of 113 healthy subjects matched for age, sex, weight, height and calcium diet. We observed that BMD in IDDM patients before 40 years old was significantly lower than in healthy subject. One of some diabetic osteopathy pathomechanism seems to be an advantage of bone resorption over bone formation. Bone demineralisation which was observed to be most pronounced in femur neck, was not related to age, differed in accordance to sex and was higher of age when IDDM appeared was lower. BMD was also related to duration of IDDM and metabolic control of IDDM.

Absorptiometry, Photon↗
PubMed1996

[Long-term treatment with large doses of alphacalicidol in secondary hyperparathyroidism of patients dialyzed for end stage renal failure].

The purpose of the study was to evaluate the effectiveness of the long-term oral pulse therapy with high doses of alphacalcidol (1 alpha (OH)D3) in severe uremic hyperparathyroidism. 43 hemodialysis patients with at least 5-fold 1-84 PTH serum elevation were given thrice a week oral (1 alpha (OH) D3) in doses up to 5 micrograms, according to serum calcium levels (monitored weekly). The drug was given in the evenings (Group A; 18 pts) or during hemodialysis sessions (Group B; 25 pts). The dialysate calcium was reduce to 1.40-1.45 mmol/l and CaCO3 was used as a main phosphate binder in doses up to 6 g/day; 13 pts received additionally small doses of Al (OH)3 (up to 3 g/day). After one month the PTH levels decreased by 67 +/- 7.7% (p < 0.001), while serum total calcium increased by 0.27 < or = 0.05 mmol/l. The parathyroid activity suppression progressed to 81 +/- 6.9% serum PTH reduction after 4 months and 74 +/- 6.1% fall after 8 months. Only 3 pts occurred to be non-responders; in 19 pts PTH levels normalized. A decrease of serum hydroxyproline and alkaline phosphatase with its bone isoenzyme activity was also observed with a direct correlation between those changes and parathyroid suppression. (1 alpha (OH) D3) dose at first month of therapy was 3.4 +/- 0.15 micrograms, but it was successively reduced because of hypercalcemia to a final dose of 2.2 +/- 0.22 micrograms. The frequency of hyperkalcemia was 7.6%; no difference between Group A and group B was noted. We conclude that oral (1 alpha (OH)D3) pulse therapy is very effective in the long-term parathyroid activity suppression in hemodialysis patients with severe hyperparathyroidism. To avoid dangerous hypercalcemia and relative hypoparathyroidism serum PTH and calcium levels should be carefully monitored.

Administration, Oral↗
PubMed1996

[Combined therapy with calcitonin and high doses of active vitamin D3 metabolites in uremic hyperparathyroidism].

Active vitamin D3 pulse therapy effectively suppresses parathormone (PTH) synthesis in uremic hyperparathyroidism but high serum levels of calcitriol achieved can induce direct osteoclastic resorption and block bone formation. Therefore we found it interesting to examine whether an addition of the osteoclast inhibitor, calcitonin (CT), could reduce those unwanted effects. 75 hemodialysis patients with at least 5-fold 1-84 PTH serum level elevation were divided into 4 treatment groups: I (n = 19)-CT and 1 alpha-OH-D3; II (n = 20)-CT; III (n = 19)-1 alpha-OH-D3 (n = 10) or 1.25 (OH)2D3 (n = 9) alone; IV (n = 17)-none of these drugs. CT (200 IU) and 1 alpha-OH-D3/1.25(OH)2D3 (up to 5 micrograms) were given 3 times a week. Dialysate Ca was 1.40-1.45 (Group I, III) or 1.95-2.00 mmol/l (Group II, IV). Within 8 months serum 1-84 PTH fell by 75% (p < 0.001) in Group I and by 77% (p < 0.001) in Group II, serum Ca increased by 0.22 +/- 0.05 mmol/l in Group I (p < 0.005) and by 0.25 +/- 0.05 mmol/l in Group III (p < 0.005), alkaline phosphatase activity decreased by 35% in Group I (p < 0.01) and 31% in Group III (p < 0.005) whereas in Groups II and IV no significant changes were noted. In Group III no differences between patients taking 1 alpha-OH-D3 or 1.25 (OH)2D3 were observed. The significant reduction of serum hydroxyproline (37%; p < 0.001) was seen only in Group 1. The increase in bone mineral density (BMD) measured by dual-energy X-ray absorptiometry was greater in Group I than in Group III (p < 0.05). In Group II the effect was mostly insignificant, whereas in Group IV a substantial decrease (p < 0.001) in BMD was observed. These data suggest that combined therapy with CT and oral 1 alpha-OH-D3 pulses is more effective than pulses alone in inhibiting bone resorption and in increasing BMD in hemodialysis patients with uremic hyperparathyroid bone disease.

Adult↗
PubMed1996

[Effect of low-dose recombinant humane erythropoietin therapy on the quality of life in patients with anemia in the course of end-stage renal failure treated with dialysis].

The aim of the study was to assess the efficacy of low-dose subcutaneous recombinant human erythropoietin (rHuEpo) therapy in hemodialysis patients with particular emphasis on their quality of life. Twenty five anemic (Ht25%) patients (14 males and 11 females, age 39-13 years) with end-stage renal disease were given rHuEpo (initial dose: 52.5 +/- 2.5 IU/kg/week; maintenance dose: 67.0-10.5 IU/kg/week) once or twice weekly for 12 months. Quality of life, assessed by self-administered questionnaire (1-3 scale), was measured every month. Additionally, sexual functions (-1 up to 3 scale, basal level 0), including libido and sexual satisfaction, and serum sex hormones (testosterone, LH, FSH, prolactin) were evaluated every 6 months. During first 4 months of the therapy there was a significant increase of Ht (21.1 +/- 0.5% vs 28.5 +/- 0.6%; p < 0.0001), which was maintained for the whole study period. From the 3rd month in majority of patients a marked (p < 0.01) improvement in their physical fitness, mood and cold tolerance was noted. Despite a substantial increase in sexual satisfaction (p < 0.01) and libido (p < 0.001), no significant changes in serum sex hormones profile, except transient rise in serum prolactin level, were observed. It is concluded that low-dose rHuEpo therapy for the renal anemia of hemodialysis patients is associated with a sustained significant improvement in their quality of life and sexual functions, despite no significant changes in sex hormones serum levels.

Adolescent↗
PubMed1996

[Bone mineral disorders in patients with multiple myeloma].

The aim of the study was to evaluate bone mineralization in the patients with multiple myeloma. The examinations were performed in 49 patients (25 men and 24 women). Seven patients were before chemotherapy and 42 patients were treated with chemotherapy. All of them received prednisone. The bone mineral density was measured by dual-energy X-ray absorptiometry with Lunar spine (L2-L4) in AP projection, femoral neck and total body were examined. There was a decrease of bone mineral density in 35 patients in at least one place (T-score more than 2 SD below normal of young healthy persons). There was no correlation between densitometric results and the duration of multiple myeloma, or chemotherapy. The decrease of bone mineral density (expressed es T-score) of lumbar spine (for the patients without spinal degenerative changes) was higher than that of femoral neck (p < 0.05). The decrease of bone mineral density (expressed as T-score) of lumbar spine and femoral neck was more pronounced than that of total body (p < 0.001). Bone densitometry, especially of lumbar spine and femoral neck and less of total body is indicated in the patients with multiple myeloma. The result of this examination may be considered as an independent parameter of disease intensity.

Adult↗
PubMed1996

Factors limiting renal transplantation program in Poland.

The shortage of donor organs has been the main obstacle to the expansion of transplantation programs. Recent public opinion survey documented acceptance of the cadaveric kidney procurement in our country but some reluctance to brain death and presumed consent concepts. Recently, the survey was carried out within the medical community to find out whether the level of knowledge and the attitude toward donation has an influence on the slow development of the transplantation program. A questionnaire was addressed to: 1010 general practitioners, neurosurgeons and anesthesiologists; 926 ICU and neurosurgical nurses and 1760 students of 12 medical schools of the country. Vast majority of doctors, nurses and last year medical students accept retrieval and transplantation of kidneys and the heart, but not of the liver. Acceptance of this procedure among junior medical students and university students was lower (78% vs 98%). Most of the respondents would agree to donate their kidneys and other organs, but 20% would protest against harvesting of the organs from their relatives. 100% of the physicians and 80% of medical students and nurses accept the brain death concept(which is accepted only by 60% of non medical university students) but only 44% of the doctors are prepared to switch off the respirator after diagnosis of brain death if harvesting is not taking place. Only half of the physicians would notify the transplantation unit about the possibility of organ retrieval. The reasons mentioned for such decision included fear of negative judgment of the local community and problems with deceased relatives. 60% of physicians talking to the family about retrieval would ask for the relatives' consent despite the fact, that the transplantation law in Poland is based on the presumed consent of each individual. The results of the knowledge survey among medical students documented inadequate medical education concerning problems of transplantation. Educational campaign is needed to promote and extend the cadaveric organ transplantation in our country.

Attitude of Health Personnel↗
PubMed1995

[Effect of calcitonin treatment on bone mineralization in patients with multiple myeloma].

The aim of the study was to evaluate the efficacy of half-year treatment of bone mineral disturbances with calcitonin in the patients with multiple myeloma. Thirty five patients (11 men and 24 women) were examined. They were treated among other with prednisone. Nineteen patients (15 patients with normal bone mineral density of lumbar spine and femoral neck and 4 with low bone mineral density who could not be treated with calcitonin) were treated only with chemotherapy. Other 16 patients with low bone mineral density have received also calcitonin (100 units subcutaneous daily) with vitamin D3 and calcium carbonate. Bone mineral density was evaluated with dual energy X-ray absorptiometry in lumbar spine and femoral neck. After treatment with calcitonin there was more pronounced influence on bone mineral density in lumbar spine and femoral neck than after treatment with chemotherapy only but the difference was not statistically significant. Because the bone mineral disturbances in the patients with multiple myeloma is the big problem there is a need for further and longer evaluation of the treatment of these disturbances.

Aged↗