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Biomedical subjects

M Szczepanski

Publications and source records attributed to M Szczepanski.

At least 19 recordsLinked to original sources

Mid-term effectiveness of behavioral and psychodynamic inpatient treatments of severe obesity based on a randomized study.

BACKGROUND: The objective of this study was to compare the effectiveness of psychodynamic and behavioral inpatient treatments of severely obese patients regarding weight and distress. METHODS: In a longitudinal study obese patients (body mass index, BMI >or=35) were randomly assigned to behavioral or to psychodynamic inpatient treatment. Mostly female (n = 267; 85%) obese patients with psychiatric and somatic comorbidity (age 20-64 years, BMI 35-74) were examined with standardized self-report scales on distress (SCL-90R), interpersonal problems (Inventory of Interpersonal Problems), eating behavior (Fragebogen zum Essverhalten) and body image (Fragebogen zum Korperbild). RESULTS: During 49 days (mean) of inpatient treatment, patients lost an average of 5.6 kg (4.4%) in the behavioral (n = 130) and 5.7 kg (4.4%) in the psychodynamic setting (n = 137). In both settings, eating behavior, well-being and body image also improved significantly. One year after discharge, return rate was 73%. Forty percent had further reduced their weight (by more than 5% compared to intake), 36% had regained weight, but were still below intake level, and another 24% had increased weight above intake. CONCLUSION: Behavioral and psychodynamic treatments were equally effective reducing weight and distress over 1 year.

Adult↗

Tissue localization of Toll-like receptors in biopsy specimens of liver from children infected with hepatitis C virus.

Toll-like receptors (TLR) are important tools of innate immunity, localized mainly on cells of the immune system, but also have been shown on cells of other origin. In the current study, they have been searched in biopsy specimens of liver from children bearing chronic viral hepatitis of C type (HCV). TLR2, TLR3 and TLR4 were traced by means of polyclonal antibodies and avidin-biotin complex (ABC) immunohistochemistry. Besides, mRNA for TLR was looked for using specific primers and polymerase chain reaction. Several controls, including neutralization of primary antibody with respective blocking peptide, confirmed the specificity of the immunohistochemical reaction. All TLR tested could be visualized in a focal distribution in single hepatocytes and some cells of inflammatory infiltrates. There was no reaction whatsoever in liver samples not infected with hepatotropic virus. In molecular studies, mRNA for TLR2 and TLR4 was detected in both noninfected and hepatitis B virus-infected established cell lines of human hepatoma as well as in HCV(+) biopsy samples. These data indicate that TLR can be traced in liver cells, both at the protein and at the mRNA level. Their irregular and focal distribution in HCV(+), but not in HCV(-), liver suggests some role of TLR in the pathogenesis of chronic viral hepatitis, at least in children.

Adolescent↗

The fibre dimensions of uterine smooth muscle of the rabbit following treatment by female sex steroids.

The effects of female sex hormones on the dimensions of myometrial smooth muscle fibres were studied by using ovariectomized rabbits. After one month of treatment, the fiber dimensions of the outer myometrial layer were measured, using cryostat sections. Calculated smooth muscle fiber volume was found to be in the sequence: control < medroxyprogesterone < estradiol < estradiol + medroxyprogesterone < estradiol alone. The measurements show that medroxyprogesterone-treated uteri contain the narrowest and the longest smooth muscle fibres, while estradiol treatment have the largest cells. This study complements previous observations in showing that medroxyprogesterone alone, or in combination with other modulators, contributes to sustain pregnancy by increasing internal resistance of estradiol-primed myometrial smooth muscle fiber fascicles. Our discussion, based on recent literature, shows that this resistance is ultimately controlled by changes in the myometrium innervation, in the repression of some controlling myofibrillar components, in the expression of specific membrane receptors and ionic channels, and in favoring the switching of molecular connexins in gap junctions, making P paramount in maintaining pregnancy. Moreover, other recent observations have also shown that probably an hcG-like hormone actually control P receptors expression in myometrial smooth muscles.

Animals↗

Postoperative plasma interleukin-6 in patients with renal cancer correlates with C-reactive protein but not with total fibrinogen or with high molecular weight fibrinogen fraction.

The concentration of fibrinogen (Fb) and its fractions, the levels of interleukin-6 (I1-6), C-reactive protein (CRP), and immunoglobulin G (IgG) were determined in 38 patients operated on because of renal cancer. The increased Fb and I1-6 concentrations were found in approximately one-half of the patients with malignancy. The relations among the high molecular weight (HMW) and two low molecular weight (LMW and LMW') fibrinogen fractions in these patients before surgery did not differ from the corresponding relations in normal subjects. The levels of all (except IgG) compounds studied increased after surgery and the peak of I1-6 was observed on the first postoperative day but that of CRP on the third day. The concentrations of total Fb and of its HMW fraction were the highest also on the third postoperative day and this was in contrast with the decline of low molecular weight fractions at the same time. These variations of estimated variables can be regarded as being relevant to the acute phase response. We have noted a correlation between the maximal concentrations of I1-6 and CRP, but not between the corresponding concentrations of Il-6 and total Fb or HMW Fb; this may suggest that the concentration of Fb is also under the control of a factor other than I1-6.

Adult↗

Prevalence of high IgM anticardiolipins in patients with ischemic stroke.

Lupus anticoagulant (LA), IgG and IgM isotypes of anticardiolipins (aCL), lipoprotein (a), and the resistance to activated protein C were determined in patients with ischemic stroke. The raised concentration of the aCL-IgM isotype was noted in 42% of patients with this type of stroke, and it was in contrast with an 8% frequency of an increased level of aCL-IgG isotype in these cases. The high level of lipoprotein (a) was found with similar frequency in stroke patients and in age-matched control subjects. It is concluded that the elevated concentration of IgM isotype of anticardiolipin antibodies can be regarded as significant in the ethiological work-up in elderly stroke patients.Copyright Lippincott-Raven Publishers

Journal Article↗

Hemostatic variables in patients with intrauterine fetal death.

OBJECTIVE: To assess the occurrence of hemostatic disturbances in patients with intrauterine fetal death (IFD). METHOD: The occurrence of abnormal results of hemostatic variables and of bleeding complications was noted from the medical records of 41 patients with IFD, 6 of whom had a multiple pregnancy. RESULT: Apart from the increased platelet count, results of blood coagulation tests in all except one patient with IFD did not differ from normal values. This patient, who had a twin pregnancy with one dead fetus, had an increase in fibrin degradation products and fibrin monomers 4 weeks after IFD and fibrinogenopenia and thrombocytopenia 2 weeks later. CONCLUSION: The deterioration of systemic hemostasis in women with IFD is rare and only occurs after 4 weeks of dead fetus retention; the main signs of this deterioration are fibrinogenopenia and thrombocytopenia.

Blood Coagulation Tests↗

The nursing process: a tool for healing the environment.

Assessment, planning, implementation and evaluation can be useful in addressing environmental issues. "Eco-teams" can develop comprehensive waste management programs through implementing a "reduce, reuse, recycle, buy recycled" approach. Serious commitment to such behavior can result in significant savings while reducing dramatically the resources, energy and pollution associated with manufacture and disposal of many items commonly used in healthcare settings.

Environmental Health↗

Earth rituals.

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Environmental Pollution↗