Biomedical subjects
Publications and source records attributed to M Wojciechowska.
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The Facing Dementia Survey included interviews with approximately 1200 members of the general public, 600 persons who served as primary caregivers for a person with Alzheimer's disease (AD) and 96 persons with AD. Members of the general public and the caregivers indicated level of agreement on a 5-point scale to a series of attitudinal statements about the disease as well as other diagnostic questions. Persons with AD underwent a qualitative interview. Results indicate that Europeans are acutely aware of the potentially devastating consequences of AD, but few are familiar with the early-stage symptoms. Most members of the general population accept that early intervention and therapy are key to slowing the effects of the disease. Caregivers often delayed consulting a physician about a loved one's behaviour, partly because of uncertainty about early signs of AD. They also expressed doubt about the ability of physicians to make the diagnosis. Caregivers experience profound effects of AD in every area of their life--emotional, physical, social and financial. Persons with AD responded to their diagnosis in one of three ways: a fatalistic attitude, a belief that their problems are linked to old age or a lack of acceptance. Survey respondents from three populations were critical of the level of government investment in and support of AD.
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Proper identification of the organism and determination of their sensitivity to antimicrobial agents, is the most important part of the management of patients with symptoms of respiratory system infections. In the case of pulmonary infections, the utility of sputum for diagnosing the cause of lower respiratory tract infections seems to be limited. In the patients receiving antibiotics, there is a high rate of colonization of the upper respiratory tract that may lead to the overgrowth of one or an other pathogen, making it more abundant in the upper than an lower respiratory tract. Also, the patients may be unable to provide adequate lower-respiratory-tract samples. For these reason, more invasive procedures have been recommended. These include bronchoscopy with bronchoalveolar lavage (BAL) sampling. The purpose of our study was to determine the value of sputum and BAL fluid on the basis of profile bacteria and their drug sensitivity isolated from the patients treated in Nat. Res. Inst. Tuber. and Lung Diseases in Warsaw during period of 3 years (1995-1997). On the basis of analysis of 5926 sputum samples and 3534 bronchoscopic materials we have found that the bacterial pathogens species and drug resistant pattern were similar in sputum samples as in materials of bronchoscopic procedures. The same bacterial species and numbers Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus were predominant in both type of clinical materials with near the same frequency.
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The action of amiloride on two different components of airway electrical potential difference, one stable (PD) and the other transiently hyperpolarizable after gentle mechanical stimulation (dPD), was studied by means of isolated tracheal wall mounted in a modified Ussing apparatus. The immediate effect of amiloride, when added to the bathing and stimulating medium, was a partial depolarization, and a diminution or elimination of dPD. After at least 60 min incubation of the tracheal wall with amiloride in the presence of the drug in the bathing and stimulating fluid, both the PD, and dPD were no different from the control. This difference between the immediate and the sustained action of amiloride on airway PD suggests that there is an efficient regulatory system in the airway walls which stabilizes the transepithelial PD. The usefulness of amiloride as a drug for cystic fibrosis patients is discussed in the light of these findings.
Among 290 BMT procedures: 74 AML, 78 ALL, 34 CML, 6 SAA, 3 MDS, 42 HD, 35 NHL, 11 MM, and 7 solid tumours (breast or testis cancer) Allogeneic BMT was performed in 76 patients and ABMT/APBCT in 214 patients. Survival, DFS and relapse curves were calculated using the Kaplan-Meier product limit method. Variables potentially affecting survival and DFS were assessed in a multivariate analysis by the Cox proportional hazard model in a stepwise regression. The promising results were obtained in high risk adult ALL in the first CR. DFS in CR1 patients transplanted after full dose induction and high dose consolidation was significantly longer if compared to those who received dose/time reduced or postponed treatment. For CR> or =2 patients and with CNS involvement at diagnosis ABMT offers a salvage therapy that needs further improvement. In relapsed and refractory HD better results are obtained in patients relapsing > 1 year after first CR and in patients with entirely nodal localisation of this relapse. In NHL bone marrow and spleen infiltration at diagnosis appear to be an unfavourable prognostic factor.
Autologous peripheral blood stem cell transplantation (APBSCT) is a method used analogically to autologous bone marrow transplantation (ABMT) to obtain hematological reconstitution following myeloablative therapy in patients with hematological malignancies. We have now applied this procedure in two patients with recurrent high risk Hodgkin's disease. Collection of circulating stem cells mobilised with cyclophosphamide/G-CSF was performed by several leukaphereses on Fenwal 3000, with access through inferior vena cava. Nucleated cells were separated by dextran sedimentation, cryopreserved, and stored at (-) 196 degrees C. Additional marrow collection was performed in one patient. Conditioning regimen consisted of BCNU, etoposide and cyclophosphamide delivered at days -3 and -2. Collected material containing on average 3.6 x 10(8)/kg nucleated cells and 8.0 x 10(6)/kg CD34(+) cells was transfused at day 0. G-CSF was administered following transplantation to one patient to hasten the recovery. Hematological recovery was relatively quick. Neither serious adverse events nor signs of relapse were observed following transplantation. Our results supported by other's reports indicate, that APBSCT enables hematological recovery similarly to ABMT in Hodgkin's disease. The advantage of APBSCT is a possibility to collect material in patients with marrow involvement, hypoplasia or fibrosis. Outcomes obtained following APBSCT are at least as good as following ABMT. High-dose chemotherapy followed by APBSCT or ABMT should be considered in all patients with recurrent Hodgkin's disease sensitive to chemotherapy.
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Hospital infections are still an important problem of to-days medicine. The most common and dangerous one is pneumonia. The purpose of this study was to determine the cause of pneumonia in patients operated on under extracorporeal circulation. It was proved that micro-organisms responsible for pneumonia in our patients were Pseudomonas sp. and Staphylococcus aureus. No correlation between the bacterial flora cultured from the air in operating theatre and post-op. ward and bacterial flora responsible for pneumonia was found. It can be infer that pulmonary infections were rather caused by hospital cross-infections or endogenic infections in colonized patients.
Autologous peripheral blood stem cell transplantation (APBSCT) is used similarly to autologous bone marrow transplantation (ABMT) to reconstitute bone marrow following myeloablative therapy in patients with proliferative diseases of the blood. Eight patients with recurrent and refractory lymphoma (3 HD, 4 NHL) and multiple myeloma aged 17-55 were included into the study. Peripheral blood stem cells following their prior mobilisation with cyclophosphamide 4-7 g/m2 and/or G-CFS or Dexa-BEAM + G-CSF were collected by subsequent leukaphereses on Fenwal CS3000. Nucleated cells were separated by sedimentation, cryopreserved in a programmed freezer and then stored at-196 degrees C. Bone marrow has been additionally collected in one patient. Conditioning treatment prior to transplantation consisted of BCNU, etoposide and cyclophosphamide (CBV) in lymphomas and melphalan in multiple myeloma. Collected material with mean cellularity 5.52 x 10(8)/kg and mean CD34+ contents 6.27 x 10(6)/kg was reinfused by central line. G-CSF was given in 5 patients to hasten the bone marrow recovery. All patients fully recovered and left hospital on average 35.5 days following transplantation. No signs of relapse were seen throughout the observation period (mean 349.5 days). Neutrophils > 0.5 G/1 were obtained on day + 20, > 1.0 G/1 on day 30, platelets > 50 G/1 on day 29, > 100 G/1 on day 53, reticulocytes > 0.015 on day 30, erythrocytes transfusions were needed up to day 39. Presented outcomes together with other reports indicate, that APBSCT is a highly efficient way to rescue repeatedly relapsing patients with proliferative diseases of the lymphatic systems, even those presenting with changes in the bone marrow (neoplasmatic infiltrate, hypoplasia or fibrosis).
Fifty six adult acute nonlymphoblastic leukemia patients were randomised in 1993 year according to Polish Acute Leukemia Group (PALG) into prospective, cooperative trial with the same prognostic factors distribution. The results of induction treatment using idarubicin on days 1, 3, 5 plus arabinoside cytosine 1-7/10 plus etoposide 1-5 (ICE7/10) vs. daunorubicin on days 1-3 plus Ara-C 1-7/10 with additional HD Ara-C in case of not sufficient cytoreduction in 6th day's bone marrow biopsy (3+7/+/-HD) and etoposide in M4-5 subtype are comparable (63 vs. 61% CR). Complete remission was achieved significantly more frequency (p < 0.02) after 1 cycle of induction treatment with ICE7/10 (93%) compared with 3+7+/-HD (55%), and 10 days shorter time to CR was observed. Side effects were comparable in both groups. The program with IDA needed more intensive supportive therapy.
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The effect of the antioxidant butylated hydroxyanisole (BHA) on benzo(a)pyrene (BP) metabolites binding to DNA, percentage of diols and phenols in the total amount of BP metabolites extracted to organic solvent, were studied in : incubation mixture of rat liver microsomes, cultured mouse embryo cells, human skin, and human lymphocytes. The amount of BP metabolites bound to DNA in mouse embryo cells and human skin decreased in the presence of BHA. No effect was found in human lymphocytes. Percent of phenols increased in mouse embryo cell cultures; percent of diols decreased in cultures of human skin and lymphocytes.
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