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Mosiewicz J, Brożyna-Tkaczyk K, Reichert E, Myśliński W, Panasiuk L, Jaroszyński A, Mosiewicz-Madejska B. Selected routine laboratory tests in the clinical assessment of patients with obstructive sleep apnea. Ann Agric Environ Med 2023; 30:737-742. [PMID: 38153079 DOI: 10.26444/aaem/177205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
INTRODUCTION Obstructive sleep apnea (OSA) is a chronic disease characterized by repetitive complete or partial occlusion of the upper airways during sleep with respiratory muscle effort, which leads to consecutive apneas and hypopneas. Obstruction of the upper airways during sleep leads to repetitive episodes of disrupted airflow and consequent changes in blood oxygenation, resulting in hypoxaemia and hypercapnia. Intermittent hypoxaemia induces the production of pro-inflammatory factors and promotes metabolic dysregulation and platelet aggregation. OBJECTIVE The main aim of this study was to determine differences, if any, in selected standard parameters in routine laboratory tests often used in GP practice between patients with obstructive sleep apnea, without comorbidities, and a well-defined control group with the absence of this syndrome proven in polygraphic examination. MATERIAL AND METHODS Of the 192 clinically assessed persons with suspected OSA and admitted to the Internal Medicine Department in Lublin, 85 were qualified for the study after application of exclusion criteria. Demographic and health behaviour-related data, medical history regarding sleep habits and cardiovascular disease, were collected from each patient. RESULTS Apart from significantly higher MCV and MCH among the cpontrol group, no significant differences were found between patients with obstructive sleep apnea and the control group. CONCLUSIONS The results can be useful for the holistic assessment of the health status of patients with newly-diagnosed OSA.
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Affiliation(s)
- Jerzy Mosiewicz
- Chair and Department of Internal Medicine, Medical University, Lublin, Poland
| | | | | | - Wojciech Myśliński
- Chair and Department of Internal Medicine, Medical University, Lublin, Poland
| | | | | | - Barbara Mosiewicz-Madejska
- I Chair and Department of Oncological Gynaecology and Gynaecology, Independent Public Hospital No 1, Lublin, Poland
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Myśliński W, Szwed M, Szwed J, Panasiuk L, Mosiewicz J. Comparison of health care systems in Poland and Great Britain by Poles staying temporarily in Great Britain prior to the COVID pandemic. Ann Agric Environ Med 2022; 29:588-591. [PMID: 36583328 DOI: 10.26444/aaem/157461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Poland's accession to the European Union intensified migration for work purposes. One of the most popular destinations for emigration was Great Britain, which allocates more money to health protection than Poland, where there is a widespread belief that the quality of public health care is poor. However, more negative opinions were expressed by migrants about health care in Great Britain. OBJECTIVE The aim of the study was to compare and assess the quality of health services in Poland and Great Britain prior to the SARS COVID-19 pandemic. MATERIAL AND METHODS The study was conducted in the form of a questionnaire addressed to Poles who stay or stayed in the territory of Great Britain and used services provided by both Polish and British medical entities. 1,625 people took part in the study: 1,402 women (86.28%) and 223 men (13.72%). The survey contained 30 questions, of which statistically significant results were obtained in 5 of them. RESULTS There was a statistically significant difference in the average assessments of health services in Poland and Great Britain. The availability of primary health care services and specialist services, other than gynaecology, in Poland was rated higher. In addition, the quality and costs of treatment received a much higher average score in the evaluation of Polish health care compared to the British system. CONCLUSIONS Although the amount of financial outlays and statistical data should suggest the advantage of the British health care system, the respondents assessed the services provided in Poland being better.
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Affiliation(s)
| | - Monika Szwed
- Students Scientific Circle, Department of Internal Diseases, Medical University, Lublin Poland
| | - Jakub Szwed
- Independent Public Health Care Cenrtre, Lublin, Poland
| | | | - Jerzy Mosiewicz
- Department of Internal Diseases, Medical University, Lublin, Poland
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Kowalik M, Myśliński W, Mosiewicz J. Cutaneous microcirculation reactivity in patients with arterial hypertension, taking into account intake of anti-hypertensive drugs. Ann Agric Environ Med 2022; 29:582-587. [PMID: 36583327 DOI: 10.26444/aaem/157146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
OBJECTIVE The aim of the study was to assess the reactivity of the cutaneous microcirculation in patients with arterial hypertension (AH), taking into account the intake of anti-hypertensive drugs, using laser doppler flowometry (LDF) and the post-occlusive reactive hyperaemia (PORH) test. MATERIAL AND METHODS The analysis included 44 patients with well-controlled AH, and 22 subjectively healthy volunteers aged 23 - 74 years, matched with the study group. During the study period, 22 patients in the study group were taking ACEI drugs, also in combination with other drug groups in terms of gender and age. 19 patients were taking other groups of drugs, including: ARB, beta-blockers, alpha-blockers, CCB, diuretics, also in combination, while 3 patients were not taking medication for AH; they were recommended non-pharmacological treatment. Blood biochemical tests, ambulatory blood pressure monitoring (ABPM) and PORH test using LDF were performed. RESULTS The study showed that the PORH flow parameters were not differ statistically significantly between the study and control groups (p> 0.05). Statistically significant differences were shown in the PORH maximum level (ML) on the skin forearm between the study group not taking ACEI drugs and the control group. No statistically significant differences were shown between the study group taking ACEI and the control group. CONCLUSIONS The pathogenesis of AH is multifactorial and depends, inter alia, on disturbances at the level of microcirculation. Proper treatment, especially with the use of ACEI, can improve the microcirculation in AH patients.
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Affiliation(s)
- Marcin Kowalik
- Department of Internal Medicine, Medical University, Lublin, Poland
| | | | - Jerzy Mosiewicz
- Department of Internal Medicine, Medical University, Lublin, Poland
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Myśliński W, Szwed M, Szwed J, Panasiuk L, Brożyna-Tkaczyk K, Borysowicz M, Mosiewicz J. Prevalence of target organ damage in hypertensive patients with coexisting obstructive sleep apnea. Ann Agric Environ Med 2022; 29:294-299. [PMID: 35767766 DOI: 10.26444/aaem/149469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION AND OBJECTIVE Obstructive sleep apnea (OSA) is associated with cardiovascular risk and higher mortality. Assessment of subclinical organ lesions is significant for prevention of clinically manifested complications which might result in death. The aim of the study was to assess the prevalence of subclinical target organ damage in hypertensive patients with OSA, and to establish whether these lesions are dependent on the intensity of sleep-disordered breathing. MATERIAL AND METHODS The study covered 67 patients with OSA diagnosed on the basis of polygraphy. Depending on the apnea/hypopnea index (AHI), the patients were divided into two groups: G1 (n=32; AHI=5-30) and G2 (n=35; AHI>30). The control group C consisted of 31 hypertensive subjects with OSA risk estimated as low based on the Berlin Questionnaire (BQ). Each patient had the following parameters measured: intima-media thickness (IMT), ankle-brachial index (ABI), left ventricular mass index (LVMI), and estimated glomerular filtration rate (eGFR). RESULTS The patients with severe OSA had significantly higher LVMI compared to the control group (130.99±44.6 g/m2 versus 106.61±27.86 g/m2; p=0.0332). The G2 group had higher eGFR than C (104.7±17.96 ml/min/1.73m2, 88.85±17.68 ml/min/1.73m2; p=0.0058). Similar results of eGFR were observed between G1 and C (104.35±21.06 ml/min/1.73m2, 88.85±17.68 ml/min/1.73m2; p=0.0081). G1 and G2 did not differ significantly in terms of eGFR. The other measured parameters, such as IMT and ABI, did not differ significantly between OSA and controls. CONCLUSIONS Patients with severe OSA demonstrate signs of left ventricular hypertrophy, while early atherosclerotic lesions (ABI and IMT) were not more intense than in the control group. High eGFR levels may indicate hyperfiltration, which does not correlate with OSA intensity level.
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Affiliation(s)
| | - Monika Szwed
- Students Scientific Association, Medical University, Lublin, Poland
| | - Jakub Szwed
- Students Scientific Association, Medical University, Lublin, Poland
| | | | | | - Magdalena Borysowicz
- Department of Anaestesiology, Mazowieckie Provincial Specialistic Hospital, Warsaw, Poland
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Reichert E, Mosiewicz J, Myśliński W, Jaroszyński A, Stanek A, Brożyna-Tkaczyk K, Madejska-Mosiewicz B. Level of Serum Fetuin-A Correlates with Heart Rate in Obstructive Sleep Apnea Patients without Metabolic and Cardiovascular Comorbidities. IJERPH 2022; 19:ijerph19116422. [PMID: 35682006 PMCID: PMC9180227 DOI: 10.3390/ijerph19116422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 05/22/2022] [Accepted: 05/23/2022] [Indexed: 11/16/2022]
Abstract
Obstructive sleep apnea (OSA) is the most common type of sleep-induced breathing disorder in the adult population and significantly affects the condition of the cardiovascular system. Fetuin-A (Fet-A) is a hepato- and adipokine, which prevents vessel calcification, and its level correlates with atherogenesis and metabolic disorders. The associations of cardiovascular diseases (CVD) both with OSA, which increases CVD risk, and Fet-A, which prevents CVD, justify the question of their mutual interactions in patients with OSA. Therefore, we sought to analyze Fet-A as an early biomarker of CVD risk in OSA patients without metabolic and cardiovascular comorbidities except for properly controlled arterial hypertension. We have found that in these patients, OSA does not appear to directly affect Fet-A levels. However, high Fet-A levels were more common in the group of patients with OSA, and the hypopnea index was significantly higher among subjects with the highest Fet-A levels. The level of Fet-A in OSA patients positively correlates with pulse rate, and it does not correlate with pulse pressure in this group unlike in the control group, where such a relationship exists. To our best knowledge, this is the first study to analyze this relationship in OSA patients without any significant cardiovascular comorbidities.
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Affiliation(s)
- Elżbieta Reichert
- Individual Specialist Medical Practice, Włostowicka 293 C St., 24-100 Puławy, Poland;
| | - Jerzy Mosiewicz
- Department of Internal Diseases, Medical University of Lublin, Staszica 16 St., 20-081 Lublin, Poland; (J.M.); (W.M.)
| | - Wojciech Myśliński
- Department of Internal Diseases, Medical University of Lublin, Staszica 16 St., 20-081 Lublin, Poland; (J.M.); (W.M.)
| | - Andrzej Jaroszyński
- Collegium Medicum, Jan Kochanowski University in Kielce, 23-517 Kielce, Poland;
| | - Agata Stanek
- Department and Clinic of Internal Medicine, Angiology and Physical Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Batorego 15 St., 41-902 Bytom, Poland
- Correspondence:
| | - Klaudia Brożyna-Tkaczyk
- Department of Internal Diseases, 1st Public University Hospital No. 1 in Lublin, Staszica 16 St., 20-081 Lublin, Poland; (K.B.-T.); (B.M.-M.)
| | - Barbara Madejska-Mosiewicz
- Department of Internal Diseases, 1st Public University Hospital No. 1 in Lublin, Staszica 16 St., 20-081 Lublin, Poland; (K.B.-T.); (B.M.-M.)
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Rymkiewicz E, Dzida G, Myśliński W, Prystupa A, Trojnar M, Zakrzewski M, Mosiewicz-Madejska B, Mosiewicz J, Mosiewicz J. Depression in the elderly with type 2 diabetes mellitus. Clinical Diabetology 2022. [DOI: 10.5603/dk.a2021.0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Brożyna-Tkaczyk K, Myśliński W, Mosiewicz J. The Assessment of Endothelial Dysfunction among OSA Patients after CPAP Treatment. Medicina (B Aires) 2021; 57:medicina57040310. [PMID: 33806108 PMCID: PMC8064446 DOI: 10.3390/medicina57040310] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/22/2021] [Accepted: 03/24/2021] [Indexed: 11/21/2022] Open
Abstract
Background and Objectives: Microcirculation dysfunction is present in patients with obstructive sleep apnea (OSA). Intermittent hypoxia generates “oxidative stress”, which contributes to chronic inflammation. The secretion of nitric oxide (NO), which is responsible for adequate regulation of the endothelium, is impaired due to a decrease in endothelial nitric oxide synthetase (eNOS) expression and an increase in endogenous eNOS inhibitors. Furthermore, nocturnal awakenings lead to the dysregulation of cortisol release and increased stimulation of the sympathetic nervous system. The non-invasive method of choice in OSA treatment is continuous positive airway pressure (CPAP). Materials and Methods: PubMed, Scopus, and Google Scholar databases were searched, and only papers published in the last 15 years were subsequently analyzed. For this purpose, we searched for keywords in article titles or contents such as “obstructive sleep apnea”, “microcirculation”, and “CPAP”. In our review, we only studied English articles that reported systemic reviews and meta-analyses, clinical studies, and case reports. Results: Endothelial dysfunction can be assessed by methods based on reactive hyperemia, such as flow-mediated dilation (FMD) measured by ultrasonography, laser-Doppler flowmetry (LDF), or capillaroscopy. In invasive techniques, intravenous administration of vasodilator substances takes place. Some surveys detected impaired microcirculation in OSA patients compared with healthy individuals. The level of dysfunction depended on the severity of OSA. CPAP treatment significantly improved endothelial function and microvascular blood flow and lowered the inflammatory mediator level. Conclusions: The first-choice treatment—CPAP—reduces the number of apneas and hypopneas during the night, induces the reversal of hypopnea and the chronic inflammatory state, and enhances activation of the sympathetic nervous system. Changes are visible as improved blood flow in both macro- and microcirculation, increased arterial elasticity, and decreased stiffness. Thus, early implementation of adequate treatment could be essential to reduce high cardiovascular risk in patients with OSA.
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Prystupa A, Kiciński P, Luchowska-Kocot D, Nowicki G, Dzida G, Myśliński W, Zakrzewski M, Mosiewicz J, Panasiuk L. Analysis of novel serum markers of fibrosis and angiogenesis in patients with alcoholic liver cirrhosis. Ann Agric Environ Med 2020; 27:568-573. [PMID: 33356062 DOI: 10.26444/aaem/127621] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Alcohol consumption causes acute and chronic liver injury. The clinical forms of alcohol liver disease (ALD) include steatosis, hepatitis, cirrhosis, and hepatocellular carcinoma (HCC) associated with liver cirrhosis. OBJECTIVE The aim of the study was to determine the levels of novel markers of fibrogenesis and angiogenesis in patients with alcoholic liver cirrhosis. Serum levels of angiopoietin-like peptide 4 (ANGPTL-4), asialoglycoprotein receptor 1 (ASGP-R1), and S100 calcium-binding protein A8 (S100A8) were assessed. Levels of hyaluronic acid (Hyal) and collagen IV (Coll IV) werealso determined at various stages of alcoholic liver cirrhosis. MATERIAL AND METHODS The study group consisted of 72 patients with alcoholic liver cirrhosis, while the control group included 22 healthy subjects without a history of alcohol abuse. The degree of liver cirrhosis was evaluated according to the Pugh-Child criteria (Pugh-Child score). Based on thse scores, patients were assigned to one of three groups: Pugh-Child (P-Ch) A - 21 with stage A, P-Ch B - 23 with stage B and P-Ch C - 28 with stage C liver cirrhosis. Serum levels of markers were determined using ELISA. RESULTS The study findings demonstrated higher levels of ANGPTL-4, ASGP-R1, S100A, hyaluronic acid and serum collagen IV in the group of patients with alcoholic liver cirrhosis, compared to the control group. Furthermore, their levels increased with the progression of alcoholic liver cirrhosis. CONCLUSIONS The biomarkers analysed in the study may be useful for diagnosis and prognosis in patients with alcoholic liver cirrhosis.
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Affiliation(s)
- Andrzej Prystupa
- Department of Internal Medicine, Medical University, Lublin, Poland
| | - Paweł Kiciński
- Department of Experimental Haematooncology, Medical University, Lublin, Poland
| | | | - Grzegorz Nowicki
- Department of Family Medicine and Community Nursing, Medical University, Lublin, Poland
| | - Grzegorz Dzida
- Department of Internal Medicine, Medical University, Lublin, Poland
| | | | | | - Jerzy Mosiewicz
- Department of Internal Medicine, Medical University, Lublin, Poland
| | - Lech Panasiuk
- Department of Internal Diseases and Hypertension, Institute of Rural Health, Lublin, Poland
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Dec-Gilowska M, Trojnar M, Makaruk B, Mosiewicz-Madejska B, Dzida G, Mosiewicz J. Local elasticity of the aorta in patients with type 2 diabetes mellitus. J Int Med Res 2020; 48:300060520952643. [PMID: 32909478 PMCID: PMC7488900 DOI: 10.1177/0300060520952643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective Arterial elasticity is important for assessing the state of an artery. This cross-sectional study aimed to non-invasively examine stiffness parameters of the ascending aorta in patients with type 2 diabetes mellitus (T2DM). Methods We studied 58 patients, including 38 with T2DM and 20 controls. The stiffness of the aorta was evaluated during transthoracic echocardiography. Aortic parameters of stiffness, such as the stiffness index, elasticity index, and compliance index, were calculated using the aortic maximal diameter, aortic minimal diameter, and blood pressure. Results Pulse pressure values were significantly higher patients with T2DM than in controls. The β index was significantly higher in patients with T2DM lasting for >7 years compared with those with T2DM lasting for <7 years. Mean aortic compliance was significantly lower in patients with a longer duration of diabetes than in those with a shorter duration of diabetes. Aortic elasticity was significantly lower in patients with diabetes and arterial hypertension compared with patients without diabetes with concomitant arterial hypertension. Conclusions Patients with T2DM, especially when T2DM is long-term, have increased stiffness and decreased compliance of the ascending aorta. Pulse pressure, which is a cardiovascular risk factor, is also significantly increased in patients with T2DM.
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Affiliation(s)
- Małgorzata Dec-Gilowska
- Department of Internal Diseases, Medical University of Lublin, Lublin, Poland.,Department of Internal Diseases, Diabetology and Endocrinology, Medical University of Warsaw, Warsaw, Poland
| | - Marcin Trojnar
- Department of Internal Diseases, Medical University of Lublin, Lublin, Poland
| | - Bogusław Makaruk
- Department of Internal Diseases, Medical University of Lublin, Lublin, Poland
| | | | - Grzegorz Dzida
- Department of Internal Diseases, Medical University of Lublin, Lublin, Poland
| | - Jerzy Mosiewicz
- Department of Internal Diseases, Medical University of Lublin, Lublin, Poland
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Dworzańska A, Tudrujek-Zdunek M, Mosiewicz J, Panasiuk L, Tomasiewicz K. A 56-year-old man with RT-PCR negative nasopharyngeal swabs with Coronavirus Disease 2019 (COVID-19) Pneumonia. Ann Agric Environ Med 2020; 27:317-318. [PMID: 32588614 DOI: 10.26444/aaem/123543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Diagnostic procedure in Coronavirus Disease 2019 (COVID-19) is based mainly on performing real-time-reverse transcription-polymerase chain-reaction (RT-PCR), which has been accepted as the gold standard method. In some cases, such as mutations of the SARS-CoV-2 genome, variable viral load kinetics or laboratory errors, it can be false-negative. CASE REPORT The case is presented of a 56-year-old man with respiratory tract symptoms, with twice negative results of real-time-reverse transcription-polymerase chain-reaction of nasopharyngeal swabs and positive chest computed tomography, with typical findings for COVID-19 pneumonia. CONCLUSIONS Patients with negative RT-PCR results, but with positive computed tomography findings characteristic for COVID-19, should be treated as well as those infected.
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Affiliation(s)
- Anna Dworzańska
- Chair and Department of Infectious Diseases, Medical University, Lublin, Poland
| | | | - Jerzy Mosiewicz
- Chair and Department of Internal Diseases, Medical University, Lublin, Poland
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Dec-Gilowska M, Trojnar M, Makaruk B, Czop M, Przybylska-Kuc S, Mosiewicz-Madejska B, Dzida G, Mosiewicz J. Circulating Endothelial Microparticles and Aortic Stiffness in Patients with Type 2 Diabetes Mellitus. ACTA ACUST UNITED AC 2019; 55:medicina55090596. [PMID: 31527473 PMCID: PMC6780956 DOI: 10.3390/medicina55090596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 08/30/2019] [Accepted: 09/09/2019] [Indexed: 01/14/2023]
Abstract
Diabetes mellitus represents a metabolic disorder the incidence of which has been on the increase in recent years. The well-known long-term complications of this disease encompass a wide spectrum of renal, neurological and cardiovascular conditions. The aim of the study was to investigate the serum concentration of endothelial microparticles (EMPs) as well as selected noninvasive parameters of the ascending aorta stiffness calculated with echocardiography. In this study, 58 patients were enrolled-38 subjects diagnosed with type 2 diabetes mellitus (T2DM) and 20 healthy controls. The analyzed populations did not differ significantly with respect to age, renal function, systolic and diastolic blood pressure. The patients with diabetes and concomitant hypertension presented higher levels of EMPs in comparison with diabetic normotensive subjects. Among patients with diabetes and hypertension, aortic stiffness assessed with the elasticity index (Ep) was higher and the aortic compliance index (D) lower than in the diabetic normotensive group. No correlation between the amount of EMPs and lipid profile, C-reactive protein (CRP) level and glycemia, was observed in the studied group. There was, however, a statistically significant positive correlation between the creatinine level and amount of EMPs, while the negative relationship was documented for EMPs level and the estimated glomerular filtration rate (eGFR).
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Affiliation(s)
- Malgorzata Dec-Gilowska
- Chair and Department of Internal Diseases, Medical University of Lublin, 20-059 Lublin, Poland.
- Chair and Department of Internal Diseases and Diabetology, Medical University of Warsaw, 02-091 Warsaw, Poland.
| | - Marcin Trojnar
- Chair and Department of Internal Diseases, Medical University of Lublin, 20-059 Lublin, Poland.
| | - Boguslaw Makaruk
- Chair and Department of Internal Diseases, Medical University of Lublin, 20-059 Lublin, Poland.
| | - Marcin Czop
- Department of Clinical Genetics, Medical University of Lublin, 20-059 Lublin, Poland.
| | - Sylwia Przybylska-Kuc
- Chair and Department of Internal Diseases, Medical University of Lublin, 20-059 Lublin, Poland.
| | - Barbara Mosiewicz-Madejska
- Chair and Department of Internal Diseases, Medical University of Lublin, Students Medical Association, 20-059 Lublin, Poland.
| | - Grzegorz Dzida
- Chair and Department of Internal Diseases, Medical University of Lublin, 20-059 Lublin, Poland.
| | - Jerzy Mosiewicz
- Chair and Department of Internal Diseases, Medical University of Lublin, 20-059 Lublin, Poland.
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Przybylska-Kuć S, Zakrzewski M, Dybała A, Kiciński P, Dzida G, Myśliński W, Prystupa A, Mosiewicz-Madejska B, Mosiewicz J. Obstructive sleep apnea may increase the risk of Alzheimer's disease. PLoS One 2019; 14:e0221255. [PMID: 31487291 PMCID: PMC6728035 DOI: 10.1371/journal.pone.0221255] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 08/04/2019] [Indexed: 12/27/2022] Open
Abstract
Objectives Amyloid-β 1–40 (Aβ 1–40) and amyloid-β 1–42 (Aβ 1–42) are the proteins known to be involved in the pathogenesis of Alzheimer’s disease (AD)–the most common cause of dementia in the elderly. Hypoxia is suspected to be one of conditions associated with Aβ plasma level increase. A common reason of hypoxia is obstructive sleep apnea (OSA), characterized by recurrent episodes of apnea. Aim The aim of the study was to evaluate plasma Aβ 1–40 and Aβ 1–42 concentrations in patients with OSA. Methods Patients with suspected OSA (n = 112) underwent polygraphic examinations Patients with confirmed OSA (n = 81) showed apnea/hypopnea index greater than or equal to 5. Mild and moderate form of the disease was defined when AHI was 5–30 (n = 38, OSA+), severe–when AHI was >30 (n = 43, OSA++). Individuals with AHI<5 (n = 31) served as control group (OSA-). Results Aβ 1–40 concentrations in OSA++ (191.1 pg/ml) group was significantly (p<0.05) higher compared with OSA- (76.9 pg/ml) and OSA+ (159.4 pg/ml) and correlated with selected parameters of hypoxemia severity. There were no differences in Aβ 1–42 concentration between the groups. Conclusion In patients with severe OSA Aβ 1–40 plasma concentrations are significantly higher compared with OSA- and OSA+ and seem to be related to hypoxia severity, which may indicate increased risk of AD development in this group of patients.
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Affiliation(s)
- Sylwia Przybylska-Kuć
- Chair and Department of Internal Diseases, Medical University of Lublin, Lublin, Poland
| | - Maciej Zakrzewski
- Chair and Department of Internal Diseases, Medical University of Lublin, Lublin, Poland
- * E-mail:
| | - Andrzej Dybała
- 1st Military Hospital in Lublin, Department of Internal Medicine, Lublin, Poland
| | - Paweł Kiciński
- Department of Experimental Hematooncology, Medical University of Lublin, Lublin, Poland
| | - Grzegorz Dzida
- Chair and Department of Internal Diseases, Medical University of Lublin, Lublin, Poland
| | - Wojciech Myśliński
- Chair and Department of Internal Diseases, Medical University of Lublin, Lublin, Poland
| | - Andrzej Prystupa
- Chair and Department of Internal Diseases, Medical University of Lublin, Lublin, Poland
| | - Barbara Mosiewicz-Madejska
- Chair and Department of Internal Diseases, Students Scientific Association, Medical University of Lublin, Lublin, Poland
| | - Jerzy Mosiewicz
- Chair and Department of Internal Diseases, Medical University of Lublin, Lublin, Poland
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Trojnar M, Patro-Małysza J, Kimber-Trojnar Ż, Czuba M, Mosiewicz J, Leszczyńska-Gorzelak B. Vaspin in Serum and Urine of Post-Partum Women with Excessive Gestational Weight Gain. ACTA ACUST UNITED AC 2019; 55:medicina55030076. [PMID: 30909620 PMCID: PMC6473861 DOI: 10.3390/medicina55030076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 03/14/2019] [Accepted: 03/20/2019] [Indexed: 12/30/2022]
Abstract
Background and objectives: Data concerning vaspin in obstetric aspects are limited and conflicting. The aim of the study was to evaluate vaspin concentrations in the serum and urine of women with excessive gestational weight gain (EGWG) in the early post-partum period (i.e., 48 h after delivery), when placental function no longer influences the results. Materials and Methods: The study subjects were divided into two groups of 28 healthy controls and 38 mothers with EGWG. Maternal body composition and hydration status were evaluated by the bioelectrical impedance analysis (BIA) method. Concentrations of vaspin, fatty acid-binding protein 4 (FABP4), leptin, and ghrelin were determined via enzyme-linked immunosorbent assay (ELISA). Results: Serum vaspin levels were lower in the EGWG group, whereas no significant differences were noted between the groups, with regard to the urine vaspin concentrations. In both studied groups, the serum vaspin concentrations correlated positively with the urine FABP4 levels and negatively with gestational weight gain, body mass index gain in the period from pre-pregnancy to 48 h after delivery (ΔBMI), and fat tissue index (FTI). In the multiple linear regression models, the serum vaspin concentrations were positively dependent on the serum FABP4 levels, as well as negatively dependent on triglycerides, FTI, and ΔBMI. Conclusions: Our study revealed that the EGWG mothers were characterized by significantly lower serum vaspin concentrations in the early post-partum period compared with the subjects that had appropriate gestational weight gain. Our observation supports previous hypotheses that vaspin might be used as a marker of lipid metabolism in pregnancy and maternal adipose tissue. Considering the fact that FABP4 is widely referred to as a pro-inflammatory adipokine, further research on the protective role of vaspin seems crucial, especially in the context of its relationship to FABP4.
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Affiliation(s)
- Marcin Trojnar
- Chair and Department of Internal Medicine, Medical University of Lublin, 20-081 Lublin, Poland.
| | - Jolanta Patro-Małysza
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, 20-090 Lublin, Poland.
| | - Żaneta Kimber-Trojnar
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, 20-090 Lublin, Poland.
| | - Monika Czuba
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, 20-090 Lublin, Poland.
| | - Jerzy Mosiewicz
- Chair and Department of Internal Medicine, Medical University of Lublin, 20-081 Lublin, Poland.
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Trojnar M, Patro-Małysza J, Kimber-Trojnar Ż, Leszczyńska-Gorzelak B, Mosiewicz J. Associations between Fatty Acid-Binding Protein 4⁻A Proinflammatory Adipokine and Insulin Resistance, Gestational and Type 2 Diabetes Mellitus. Cells 2019; 8:cells8030227. [PMID: 30857223 PMCID: PMC6468522 DOI: 10.3390/cells8030227] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 03/03/2019] [Accepted: 03/03/2019] [Indexed: 12/12/2022] Open
Abstract
There is ample scientific evidence to suggest a link between the fatty acid-binding protein 4 (FABP4) and insulin resistance, gestational (GDM), and type 2 (T2DM) diabetes mellitus. This novel proinflammatory adipokine is engaged in the regulation of lipid metabolism at the cellular level. The molecule takes part in lipid oxidation, the regulation of transcription as well as the synthesis of membranes. An involvement of FABP4 in the pathogenesis of obesity and insulin resistance seems to be mediated via FABP4-dependent peroxisome proliferator-activated receptor γ (PPARγ) inhibition. A considerable number of studies have shown that plasma concentrations of FABP4 is increased in obesity and T2DM, and that circulating FABP4 levels are correlated with certain clinical parameters, such as body mass index, insulin resistance, and dyslipidemia. Since plasma-circulating FABP4 has the potential to modulate the function of several types of cells, it appears to be of extreme interest to try to develop potential therapeutic strategies targeting the pathogenesis of metabolic diseases in this respect. In this manuscript, representing a detailed review of the literature on FABP4 and the abovementioned metabolic disorders, various mechanisms of the interaction of FABP4 with insulin signaling pathways are thoroughly discussed. Clinical aspects of insulin resistance in diabetic patients, including women diagnosed with GDM, are analyzed as well.
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Affiliation(s)
- Marcin Trojnar
- Chair and Department of Internal Medicine, Medical University of Lublin, 20-081 Lublin, Poland.
| | - Jolanta Patro-Małysza
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, 20-090 Lublin, Poland.
| | - Żaneta Kimber-Trojnar
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, 20-090 Lublin, Poland.
| | | | - Jerzy Mosiewicz
- Chair and Department of Internal Medicine, Medical University of Lublin, 20-081 Lublin, Poland.
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15
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Kowalik M, Guz A, Prystupa A, Mieczkowska J, Sołdaj-Bukszyńska K, Ignatowicz A, Szczuka B, Rola S, Mosiewicz J. Anaemia and neurologic complications- the dominating manifestations of infective endocarditis -case report. J Pre Clin Clin Res 2018. [DOI: 10.26444/jpccr/83727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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16
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Kiciński P, Schlegel T, Dybała A, Zakrzewski M, Przybylska-Kuć S, Myśliński W, Mosiewicz J, Głuszek S, Jaroszyński A. Spatial QRS-T angle in patients with newly diagnosed obstructive sleep apnea syndrome. Adv Med Sci 2017; 62:240-245. [PMID: 28501722 DOI: 10.1016/j.advms.2016.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Revised: 09/21/2016] [Accepted: 11/29/2016] [Indexed: 01/19/2023]
Abstract
PURPOSE The aim of the study was to assess the spatial QRS-T angle (QRS-TA) in a group of newly diagnosed and untreated adult patients with obstructive sleep apnea syndrome (OSAS) and to identify potential factors affecting this parameter. PATIENTS AND METHODS The study group (PSG-confirmed OSAS) included 62 individuals, aged 51.7±10.3 years. The control group consisted of 25 individuals, aged 46.6±16.6 years with no sleep-disordered breathing. The diagnosis of OSAS and assessment of its severity was based on unattended all-night screening polysomnography. The spatial QRS-TA was reconstructed from 12-lead ECG using Kors' regression method. RESULTS Significant differences of spatial QRS-TA values were found between patients with severe OSAS (36.9±18.9°) and the controls (20.3±13.4°; p<0.01) and between patients with mild or moderate OSAS (32.3±20.1°) and the controls (p=0.01). Statistically significant correlations were found between spatial QRS-TA and polysomnographic indices (i.e. AHI, AI, RDT and RDTI). CONLUSIONS Spatial QRS-TA values are significantly higher in patients with OSAS than in controls, thus indicating increased heterogeneity of myocardial action potential. Further long-term prospective studies evaluating the prognostic value of spatial QRS-TA in OSAS patients are needed.
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Affiliation(s)
- Paweł Kiciński
- Department of Family Medicine, Medical University of Lublin, Lublin, Poland.
| | - Todd Schlegel
- Department of Clinical Physiology, Karolinska Institutet, Stockholm, Sweden; Nicollier-Schlegel SARL, Trélex, Switzerland
| | - Andrzej Dybała
- Department of Internal Diseases, 1st Military Hospital, Lublin, Poland
| | - Maciej Zakrzewski
- Department of Internal Diseases, Medical University of Lublin, Lublin, Poland
| | | | - Wojciech Myśliński
- Department of Internal Diseases, Medical University of Lublin, Lublin, Poland
| | - Jerzy Mosiewicz
- Department of Internal Diseases, Medical University of Lublin, Lublin, Poland
| | - Stanisław Głuszek
- Faculty of Medicine and Health Science, The Jan Kochanowski University, Kielce, Poland
| | - Andrzej Jaroszyński
- Department of Family Medicine, Medical University of Lublin, Lublin, Poland; Faculty of Medicine and Health Science, The Jan Kochanowski University, Kielce, Poland
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17
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Kuzemko D, Rymarz E, Prystupa A, Dzida G, Mosiewicz J. Diabetic autonomic neuropathy of the gastrointestinal tract – etiopathogenesis ,
diagnosis, treatment and complications. J Pre Clin Clin Res 2017. [DOI: 10.26444/jpccr/75140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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18
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Wawrzycki B, Chodorowska G, Pietrzak A, Prystupa A, Krupski W, Majdan M, Mosiewicz J, Krasowska D. Ulcerative colitis accompanied by aseptic abscesses syndrome and small-vessel vasculitis. J Pre Clin Clin Res 2016. [DOI: 10.5604/18982395.1227574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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19
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Kiciński P, Przybylska-Kuć SM, Tatara K, Dybała A, Zakrzewski M, Mysliński W, Mosiewicz J, Jaroszyński AJ. Reliability of the Epworth Sleepiness Scale and the Berlin Questionnaire for screening obstructive sleep apnea syndrome in the context of the examination of candidates for drivers. Med Pr 2016; 67:721-728. [PMID: 28005081 DOI: 10.13075/mp.5893.00494] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND The aim of the study has been to assess the usefulness of the Epworth Sleepiness Scale (ESS) and the Berlin Questionnaire (BQ) for obstructive sleep apnea syndrome (OSAS) screening. The capacity of both tests to discriminate between healthy individuals or with mild OSAS (apnea-hypopnea index (AHI) < 15/h) vs. patients with moderate or severe OSAS (AHI ≥ 15/h) was evaluated. MATERIAL AND METHODS The study encompassed 223 patients with a suspicion of the OSAS. The ESS and BQ were completed by patients unassisted. Screening polysomnography was performed using the Porti SleepDoc. The OSAS was diagnosed when AHI ≥ 15/h or AHI ≥ 5/h with simultaneous occurrence of clinical symptoms. RESULTS The ESS score was found to be significantly higher in the study group compared to the control group (8.9±5.9 vs. 11.6±5.2 pt, p < 0.0001). Otherwise, there were no significant inter-group differences in the percentage of high-risk individuals according to the BQ (83.7% vs. 92.3%, p > 0.05). Sensitivity of the ESS and BQ was 53.2% and 93.1%, respectively while specificity was 58.8% and 16.2%, respectively. Poor correlation between the ESS score and AHI and apnea index were noticed (r = 0.22, p = 0.001 and r = 0.24, p < 0.001, respectively). CONCLUSIONS Considering its low sensitivity, the ESS should not be used as a screening test for the OSAS diagnosis amongst candidates for drivers. The BQ is characterised by high sensitivity for the OSAS diagnosis with AHI ≥ 15/h, however, due to low specificity, the questionnaire may increase the number of healthy individuals referred for needless diagnostic procedures. Med Pr 2016;67(6):721-728.
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Affiliation(s)
- Paweł Kiciński
- Medical University of Lublin / Uniwersytet Medyczny w Lublinie, Lublin, Poland (Department of Family Medicine / Katedra i Zakład Medycyny Rodzinnej).
| | - Sylwia Magdalena Przybylska-Kuć
- Medical University of Lublin / Uniwersytet Medyczny w Lublinie, Lublin, Poland (Department of Internal Diseases / Katedra i Klinika Chorób Wewnętrznych)
| | - Kalina Tatara
- Medical Center SANITAS / Centrum Medyczne SANITAS, Lublin, Poland (Occupational Medicine Outpatient Clinic / Poradnia Medycyny Pracy)
| | - Andrzej Dybała
- Medical University of Lublin / Uniwersytet Medyczny w Lublinie, Lublin, Poland (Department of Internal Diseases / Katedra i Klinika Chorób Wewnętrznych)
| | - Maciej Zakrzewski
- Medical University of Lublin / Uniwersytet Medyczny w Lublinie, Lublin, Poland (Department of Internal Diseases / Katedra i Klinika Chorób Wewnętrznych)
| | - Wojciech Mysliński
- Medical University of Lublin / Uniwersytet Medyczny w Lublinie, Lublin, Poland (Department of Internal Diseases / Katedra i Klinika Chorób Wewnętrznych)
| | - Jerzy Mosiewicz
- Medical University of Lublin / Uniwersytet Medyczny w Lublinie, Lublin, Poland (Department of Internal Diseases / Katedra i Klinika Chorób Wewnętrznych)
| | - Andrzej J Jaroszyński
- Medical University of Lublin / Uniwersytet Medyczny w Lublinie, Lublin, Poland (Department of Family Medicine / Katedra i Zakład Medycyny Rodzinnej)
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20
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Urbańczuk M, Kiciński P, Dybała A, Myśliński W, Mosiewicz J, Jaroszyński A. Factors influencing troponin T concentration in patients with obstructive sleep apnea syndrome. Folia Cardiologica 2016. [DOI: 10.5603/fc.a2016.0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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21
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Lewandowski T, Baginski A, Malecha-Jedraszek A, Mosiewicz J, Donica H. The evaluation of 25(OH)D concentration in blood serum of chronic heart failure patients. Current Issues in Pharmacy and Medical Sciences 2016. [DOI: 10.1515/cipms-2016-0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
This current study examined patients with severe chronic heart failure (CHF) in order to ascertain the held vitamin D, based on an assessment of calcidiol [25(OH)D] concentration. It also identified and evaluated possible correlations between 25(OH)D level and the concentration of total calcium, inorganic phosphates and creatinine concentration in their serum. Herein, venous blood samples were taken from 36 patients with CHF. Diagnosis was confirmed by echocardiographic, as well as by electrocardiographic examinations. In this work, the control group consisted of 41 randomly selected healthy individuals. The results of our study showed that CHF patients had significantly lower concentration of 25(OH)D, as well as total calcium and inorganic phosphates. Moreover, mean creatinine concentration was higher, in comparison to the control group, but did not exhibit statistical significance. As calcium-phosphate homeostasis is regulated by numerous factors, including PTH, neurohormonal factors and calcitriol (1,25(OH)2D), it is possible that vitamin D deficiency may play a significant role in the pathomechanism of CHF, and a lowered 25(OH)D level may be related to progression of the disease.
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Affiliation(s)
- Tomasz Lewandowski
- Department of Biochemistry Diagnostics, Medical University of Lublin, 11 Staszica, 20-081 Lublin, Poland
| | - Andrzej Baginski
- Department of Biochemistry Diagnostics, Medical University of Lublin, 11 Staszica, 20-081 Lublin, Poland
| | - Arleta Malecha-Jedraszek
- Department of Biochemistry Diagnostics, Medical University of Lublin, 11 Staszica, 20-081 Lublin, Poland
| | - Jerzy Mosiewicz
- Department of Internal Diseases, Medical University of Lublin, 16 Staszica, 20-081 Lublin, Poland
| | - Helena Donica
- Department of Biochemistry Diagnostics, Medical University of Lublin, 11 Staszica, 20-081 Lublin, Poland
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22
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Dyczko M, Grzywa-Celińska A, Barud W, Celiński R, Dworzański W, Szmygin-Milanowska K, Mosiewicz J. [Late diagnosis of Gaucher's disease - care reports]. Pol Merkur Lekarski 2016; 41:32-34. [PMID: 27734818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
UNLABELLED Gaucher's disease if one of the most frequent, among extremely rare, lysosomal storage diseases. It is the autosomal recessive inherited metabolic disorder, which can present in three main clinical forms. Type 1 - the most benign, in a not-neuropathic form, and types 2 and 3, both in neuropathic form, which manifest serious neurological symptoms. AIM The aim of the study was to draw attention to the late diagnosing of Gaucher's disease in the Polish population and to popularize the knowledge about this ultra-rare disease. CASE REPORTS Having analyzed the cases of our patients, we have concluded that the diagnosis of Gaucher's disease type 1 is often made with a time delay of up to several years. The lack of deeper knowledge about the disease and its symptoms among the physicians was found a main reason for this time lag. The disease is usually not taken into consideration in difference diagnosis due to its "ultra-rare" character. Furthermore, the course of the disease is usually occult with no spectacular symptoms, whereas the frequently occurring chronic weakness and bone pains are not treated as serious pathology. CONCLUSIONS Early diagnosis of the Gaucher's disease gives patients the chance of an appropriate, effective substitutive therapy, as well as recovery of organ disturbances.
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Affiliation(s)
- Monika Dyczko
- Medical University of Lublin, Poland: Chair and Department of Internal Diseases
| | - Anna Grzywa-Celińska
- Medical University of Lublin, Poland: Chair and Department of Pneumonology, Oncology and Allergology
| | - Wojciech Barud
- Medical University of Lublin, Poland: Chair and Department of Internal Diseases
| | - Rafał Celiński
- Medical University of Lublin, Poland: Cardiology Unit with Cardiac Intensive Care Unit, Regional Specialist Hospital in Lublin, Poland
| | - Wojciech Dworzański
- Medical University of Lublin, Poland: Cardiology Unit with Cardiac Intensive Care Unit, Regional Specialist Hospital in Lublin, Poland
| | | | - Jerzy Mosiewicz
- Medical University of Lublin, Poland: Chair and Department of Internal Diseases
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23
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Gorczyca-Siudak D, Siudak Ł, Mosiewicz J. Knowledge of vitamin K antagonists’ use in atrial fibrillation patients. Med Og Nauk Zdr 2016. [DOI: 10.5604/20834543.1198721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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24
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Kosior-Jarecka E, Łukasik U, Wróbel-Dudzińska D, Kocki J, Bartosińska J, Witczak A, Chodorowska G, Mosiewicz J, Żarnowski T. Risk Factors for Normal and High-Tension Glaucoma in Poland in Connection with Polymorphisms of the Endothelial Nitric Oxide Synthase Gene. PLoS One 2016; 11:e0147540. [PMID: 26807726 PMCID: PMC4726562 DOI: 10.1371/journal.pone.0147540] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 01/04/2016] [Indexed: 11/19/2022] Open
Abstract
Aim The purpose of this study was to evaluate the influence of polymorphisms of the eNOS gene on the clinical status of patients with normal and high tension glaucoma. Methods 266 Polish Caucasian patients with primary open angle glaucoma were studied. Of the 266, 156 had normal tension glaucoma (NTG) and 110 high tension glaucoma (HTG). DNA material was isolated from peripheral venous blood using commercial kits. Real-time PCR reaction was used to amplify the promoter site of the endothelial nitric oxide synthase (eNOS) gene, including the single nucleotide polymorphism (SNP) site T-786C and part of the 7th exon of eNOS, including G894T SNP. Genotypes were determined with TaqMan SNP Genotyping Assays. Results There were no significant differences in frequencies of the allelic variants of both polymorphisms. In G894T SNP, however, the wild GG form was more common in the HTG group. The SNP of the eNOS gene did not significantly influence the progression rate in either of the groups studied. There were no differences in variants of the eNOS gene regarding the necessity for and success of surgery and the progression of the disease. In the NTG group, no statistical correlation was observed between G894T, T786C polymorphism variants, and risk factors such as optic disc haemorrhages, optic disc notches, and peripapillary atrophy. Mean diastolic and systolic pressure during the day and night were lowest in NTG patients with the CC variant of the T786C polymorphism. No statistical correlation was observed between the G894T and T786C polymorphisms and capillaroscopic examination results. Conclusions Genotype frequencies are similar for both the eNOS G894T and T-786C polymorphisms in NTG and HTG patients. These polymorphisms do not correlate with risk factors and do not influence the state of the capillary system in NTG patients. Systolic blood pressure is lower in NTG patients with mutated alleles of both polymorphisms.
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Affiliation(s)
- Ewa Kosior-Jarecka
- Department of Diagnostics and Microsurgery of Glaucoma, Medical University, Lublin, Poland
- * E-mail:
| | - Urszula Łukasik
- Department of Diagnostics and Microsurgery of Glaucoma, Medical University, Lublin, Poland
| | | | - Janusz Kocki
- Department of Clinical Genetics, Medical University, Lublin, Poland
| | - Joanna Bartosińska
- Department of Dermatology, Venerology and Paediatric Dermatology, Medical University, Lublin, Poland
| | | | - Grażyna Chodorowska
- Department of Dermatology, Venerology and Paediatric Dermatology, Medical University, Lublin, Poland
| | - Jerzy Mosiewicz
- Department of Internal Diseases, Medical University, Lublin, Poland
| | - Tomasz Żarnowski
- Department of Diagnostics and Microsurgery of Glaucoma, Medical University, Lublin, Poland
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25
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Dyczko M, Sawa M, Grzywa-Celińska A, Szmygin-Milanowska K, Kuczyńska M, Mosiewicz J. Three interesting cases of syndrome of inappropriate antidiuretic hormone secretion. J Pre Clin Clin Res 2015. [DOI: 10.5604/18982395.1186502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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26
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Myslinski W, Barud W, Feldo M, Chrapko M, Chrapko B, Mosiewicz J, Pietura R, Piekarski P, Dybala A, Zubilewicz T. Buerger’s disease-like arteritis associated with Crohn’s disease. A case of ‘vas-colitis’? Acta Angiologica 2015. [DOI: 10.5603/aa.2015.0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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27
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Grzywa-Celińska A, Dyczko M, Rękas-Wójcik A, Szmygin-Milanowska K, Witczak A, Ostrowski S, Barud W, Mosiewicz J. [Ventilatory disorders in patients with chronic heart failure]. Pol Merkur Lekarski 2015; 39:248-250. [PMID: 26608495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Chronic heart failure (CHF) is a condition in which both structure and functional capacity of cardiac muscle are impaired, resulting in ineffective peripheral tissue perfusion. Affecting numerous organs and systems, it is currently considered to be a systemic illness. Among significant, however until now, hardly recognized consequences of CHF there are ventilatory disorders. Their presence may be explained by proximity of heart and lungs inside rib cage or by close functional cooperation between these two organs. Ventilatory disorders clinically manifest as exacerbations of the underlying disease, i.e. intense dyspnea--primarily exertional in nature, over time, present even at rest. On the basis of functional pulmonary tests, ventilatory disorders may be classified into three categories: restrictive, obstructive and most commonly--mixed. The restrictive model is represented in bodypletysmography as reduction in the total lung capacity to values less than 5th percentile of the predicted values for normals, while Tiffeneau index remains intact. Such condition may probably result from the chronic inflammatory process affecting lung tissue, for which the reaction of macrophage cells to both pulmonary stasis, as well as increased volume of interstitial and alveolar fluid remains the underlying cause. The increased formation of connective tissue fibers engenders thickening of alveolar-capillary membrane, occurrence of disturbed oxygen diffusion and emergence of hypoxemic respiratory failure. Ventilatory disorders of obstructive nature are characterised by reduction of Tiffeneau index--the calculated ratio between forced expiratory volume in 1. second and forced vital capacity--to values below 5th percentile of the predicted range. The research results indicate for the presence of bronchiolar narrowing--dominant in small-diameter bronchi and bronchioles, with larger structures being unaffected--clearly depicted in spirometry as reduced levels of forced expiratory flow after exhaling 50% and 75% of forced vital capacity. Due to a considerable epidemiological problem, as well as significance of the clinical symptoms manifesting ventilatory disorders in course of chronic heart failure, there should be put emphasis on cardiac injury prevention in individuals from risk groups and the proper treatment of patients already suffering from chronic heart failure.
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Affiliation(s)
- Anna Grzywa-Celińska
- Medical University of Lublin, Poland: 1Chair and Department of Pneumonology, Oncology and Allergology; 2Chair and Department of Internal Medicine
| | - Monika Dyczko
- Medical University of Lublin, Poland: Chair and Department of Internal Medicine
| | - Agata Rękas-Wójcik
- Medical University of Lublin, Poland: Chair and Department of Internal Medicine
| | | | - Agnieszka Witczak
- Medical University of Lublin, Poland: Chair and Department of Internal Medicine
| | - Stanisław Ostrowski
- Medical University of Lublin, Poland: Chair and Department of Internal Medicine
| | - Wojciech Barud
- Medical University of Lublin, Poland: Chair and Department of Internal Medicine
| | - Jerzy Mosiewicz
- Medical University of Lublin, Poland: Chair and Department of Internal Medicine
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28
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Kałan M, Witczak A, Mosiewicz J, Donica H. [The involvement of galectin-3 in heart failure]. POSTEP HIG MED DOSW 2015; 69:1107-1113. [PMID: 26400896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
Hart failure (HF) accounts for numerous serious problems: medical, social and financial. HF affects 2-3% adult population and its frequency increases with age. Despite advances in laboratory diagnostics of HR the use of biochemical markers remains limited. Currently, only natriuretic peptides, especially type B natriuretic peptides (BNP) and N-terminal fragment of pro-BNP (NT-proBNP) have been fully approved biomarkers employed in diagnosing HF. The concentration of those peptides fluctuates and largely depends on age, gender, renal function, day/night rhythm and volemia which reflects hemodynamic state rather than hart abnormal structure. As the application of natriuretic peptides is limited in certain groups of patients, it is necessary to search for other more stable biomarkers. Recent investigations have suggested galectin-3 (gal-3) to be a new promising cardiological marker. Gal-3 belongs to a family of lectins that demonstrate binding specificity for β-galactoside which are produced by activated macrophages. Its operative path involves stimulation of cardiac fibroblasts and collagen production which can result in pathological remodeling of the myocardium structure. Numerous research found substantially increased gal-3 level in patients with chronic HF disregarding the etiology of disease. Moreover, some clinical studies have proved that increased gal-3 concentration is a factor of poor prognosis and predicative of death due to any reason in patients with HF. Contrary to natriuretic peptides, gal-3 is hemodynamically stable which is an additional asset of gal-3 as a marker of myocardial fibrosis.The article presents current state of research into gal-3 involvement in HF pathogenesis and possible use of gal-3 as a diagnostic marker of HF.
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Milaniuk S, Pietrzak A, Mosiewicz B, Mosiewicz J, Reich K. Influence of psoriasis on circulatory system function assessed in echocardiography. Arch Dermatol Res 2015; 307:855-61. [PMID: 26121943 PMCID: PMC4643101 DOI: 10.1007/s00403-015-1586-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Revised: 04/27/2015] [Accepted: 06/05/2015] [Indexed: 01/08/2023]
Abstract
Psoriasis vulgaris is a chronic disease with a multifactorial pathogenesis. It affects about 2–4 % of the population all over the world. In course of psoriatic arthritis, joints’ damages are observed. In patients with psoriasis vulgaris and psoriatic arthritis, there is increased morbidity and mortality caused by cardiovascular diseases observed. The aim of the study is to analyze the echocardiography of patients with psoriasis vulgaris and psoriatic arthritis on the basis of the literature available in PubMed database. Abnormalities found in echocardiography of patients with psoriasis include valvular defects (40.7 % of the patients), left ventricle diastolic dysfunction (27.8 %), and left ventricle hypertrophy (11.1 %). Left ventricle’s systolic disorders, increased aorta stiffness index and increased pulmonary artery blood pressure were also observed in this group of patients.
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Affiliation(s)
- Sylwia Milaniuk
- Department of Internal Medicine, Medical University, Staszica St 16, Lublin, Poland
| | - Aldona Pietrzak
- Department of Dermatology, Venereology and Paediatric Dermatology, Medical University, Radziwillowska St 13, Lublin, Poland
| | - Barbara Mosiewicz
- Students Medical Association, Medical University, Staszica St 16, Lublin, Poland
| | - Jerzy Mosiewicz
- Department of Internal Medicine, Medical University, Staszica St 16, Lublin, Poland.
| | - Kristian Reich
- Dermatologikum Hamburg, Stephansplatz 5, Hamburg, Germany
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Dec M, Bartoszek E, Mosiewicz J. Circulating endothelial cells as biomarker of vascular damage. Med Og Nauk Zdr 2015. [DOI: 10.5604/20834543.1152904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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31
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Filipczak A, Michalska-Jakubus M, Górska-Kosicka M, Woźniak K, Kowalewski C, Krupski W, Pietrzak A, Wallner G, Mosiewicz J, Lotti T, Krasowska D. Coexistence of pemphigus foliaceus and acquired hemophilia A: A case report. J Dermatol 2015; 42:638-41. [PMID: 25855134 DOI: 10.1111/1346-8138.12853] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 02/07/2015] [Indexed: 11/25/2022]
Abstract
Pemphigus foliaceus (PF) is an autoimmune bullous dermatosis with anti-desmoglein-1 autoantibodies. Acquired hemophilia A (AHA) is a rare coagulation disorder with a high mortality rate, caused by anti-factor VIII immunoglobulin G antibodies leading to spontaneous severe hemorrhages into skin, muscles or soft tissues. This coagulopathy may be associated with malignancies, drug reactions and autoimmune disorders including bullous dermatoses. Herein, we demonstrate a first report of AHA in the course of pemphigus foliaceus. A 55-year-old woman presenting with extensive, erosive, crusted, scaly skin lesions was diagnosed with PF based on histopathological and immunofluorescent examination, confirmed by the presence of anti-desmoglein-1 antibodies on enzyme-linked immunoassay. She developed extensive internal hemorrhages and prolonged external bleeding after laparotomy. Based on coagulation tests, AHA was diagnosed. Simultaneous remission of pemphigus and coagulopathy occurred with immunosuppressants and recombinant activated factor VII.
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Affiliation(s)
- Aleksandra Filipczak
- Department of Dermatology, Venerology and Paediatric Dermatology, Lublin, Poland
| | | | - Magdalena Górska-Kosicka
- Department of Haemotooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland.,Department of Haemostatic Disorders and Internal Diseases, Institute of Haematology and Transfusion Medicine in Warsaw, Warsaw, Poland
| | - Katarzyna Woźniak
- Department of Dermatology and Immunodermatology, Medical University of Warsaw, Warsaw, Poland
| | - Cezary Kowalewski
- Department of Dermatology and Immunodermatology, Medical University of Warsaw, Warsaw, Poland
| | - Witold Krupski
- Department of Medical Radiology, University Hospital No.1 in Lublin, Lublin, Poland
| | - Aldona Pietrzak
- Department of Dermatology, Venerology and Paediatric Dermatology, Lublin, Poland
| | - Grzegorz Wallner
- 2nd Department of General, Gastroenterological and Alimentary Oncological Surgery, Medical University of Lublin, Lublin, Poland
| | - Jerzy Mosiewicz
- Department of Internal Diseases, University Hospital No.1, Medical University of Lublin, Lublin, Poland
| | - Torello Lotti
- Dermatology Division, University of Rome G. Marconi, Rome, Italy
| | - Dorota Krasowska
- Department of Dermatology, Venerology and Paediatric Dermatology, Lublin, Poland
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Kancik E, Mitrut T, Pańko T, Prystupa A, Sompor J, Lubek T, Mosiewicz J, Nogalski A. Effect of hyperbaric oxygen therapy in a patient with
Wegener’s granulomatosis – case report. Med Og Nauk Zdr 2015. [DOI: 10.5604/20834543.1142350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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33
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Witczak A, Prystupa A, Zamecka M, Biłan A, Krupski W, Mosiewicz J. Pulmonary lymphangitic carcinomatosis in the course of gastric cancer – Case report. J Pre Clin Clin Res 2015. [DOI: 10.26444/jpccr/71481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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34
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Witczak A, Mosiewicz J, Prystupa A. Pulmonary embolism associated with oral contraceptive use – Case report. J Pre Clin Clin Res 2015. [DOI: 10.26444/jpccr/71482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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35
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Kancik E, Milaniuk S, Prystupa A, Mosiewicz J. Complications after chemotherapy in the practice of a specialist in internal medicine. Med Og Nauk Zdr 2014. [DOI: 10.5604/20834543.1132053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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36
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Prystupa A, Makaruk B, Milaniuk S, Baraniak J, Kurys-Denis E, Chan TY, Prystupa T, Krupski W, Mosiewicz J. Ultrasonography of abdominal cavity in the diagnostics of tumours of the large intestine – Case report. Med Og Nauk Zdr 2014. [DOI: 10.5604/20834543.1132050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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37
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Dyczko M, Dybała A, Barud W, Chrapko B, Mysliński W, Mosiewicz J. [Difficulty in diagnosis of primary hyperaldosteronism as the cause of resistant hypertension and severe hypokalemia--case report]. Pol Merkur Lekarski 2014; 37:289-291. [PMID: 25546991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The most common endocrinological cause of secondary hypertension is primary hyperaldosteronism. Despite great progress in laboratory and imaging techniques, its identification is often difficult. We report the case of the 52-year-old man with resistant hypertension and severe hypokalemia. Renovascular hypertension, Cushing syndrome and pheochromocytoma were excluded as potential causes of drug-resistant hypertension in the presented case. Renal potassium excretion was significantly high. The results of plasma aldosterone concentration measured in supine position as well as in standing position were ambiguous. Computed tomography revealed abnormal round solid mass with a maximum diameter of 11 mm in the left adrenal. As there were not diagnostic results of laboratory research and ambiguous character of pathological structure in research computed tomography we have decided to carry adrenal cortex scintigraphy with iodomethyl-norcholesterol 131I. The result of this research was consistent with left adrenal scan of computed tomography and left adrenal adenoma has been confirmed. Normal blood pressure and normokalemia were restored after surgical treatment.
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Barud W, Ryczak E, Bilan A, Chrapko B, Wasyl Roman A, Mosiewicz J. Beneficial Effects of Lithium and Radioiodine Therapy in the Treatment of Hyperthyroidism. tjem 2014. [DOI: 10.4274/tjem.2305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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39
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Pietrzak A, Czuczwar P, Mosiewicz J, Paszkowski T, Chodorowska G, Bartosinska J, Gerkowicz A, Paluszkiewicz P, Freud T, Cohen AD. Cardiovascular disease in psoriatic post-menopausal women. J Eur Acad Dermatol Venereol 2014; 29:1231-4. [PMID: 25073722 DOI: 10.1111/jdv.12620] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 05/26/2014] [Accepted: 06/06/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND It is generally accepted that the risk of cardiovascular disease (CVD) in women is significantly increased after the menopause. Hormonal changes associated with the menopausal transition may also alter the course of autoimmune diseases. It has been reported that menopause may exacerbate the symptoms of rheumatoid arthritis, systemic sclerosis and giant cell arteritis, but attenuate the course of systemic lupus erythemathosus. There is a growing body of literature indicating that the course of psoriasis may be altered by menopausal hormone changes. Considering the fact that both psoriasis and menopause are independent risk factors for CVD, and that menopause may exacerbate the course of psoriasis, a possible additive effect between these two conditions may be crucial for proper monitoring and treatment of peri- and post-menopausal psoriatic patients. OBJECTIVE The aim of this study is to analyse potential relationship between psoriasis, menopausal status and risk of CVD. MATERIALS AND METHODS A retrospective analysis of the Clalit Health Services database was performed in an attempt to provide new data and the available literature concerning these issues was reviewed. Data on cardiovascular events in 10 872 female psoriatic patients and 19 471 controls were extracted and compared. RESULTS In both psoriatic and control patients the association of CVD increased with age. The association of CVD was significantly greater in psoriatic patients, but no significant differences were found between any of age groups. CONCLUSIONS The association of psoriasis and CVD in women increases with age but there is insufficient evidence to confirm that menopause increases the risk of psoriasis. Further studies directly addressing this issue are needed.
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Affiliation(s)
- A Pietrzak
- Chair and Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, Lublin, Poland
| | - P Czuczwar
- 3rd Chair and Department of Gynecology, Medical University of Lublin, Lublin, Poland
| | - J Mosiewicz
- Chair and Department of Internal Medicine, Medical University of Lublin, Lublin, Poland
| | - T Paszkowski
- 3rd Chair and Department of Gynecology, Medical University of Lublin, Lublin, Poland
| | - G Chodorowska
- 3rd Chair and Department of Gynecology, Medical University of Lublin, Lublin, Poland
| | - J Bartosinska
- 3rd Chair and Department of Gynecology, Medical University of Lublin, Lublin, Poland
| | - A Gerkowicz
- 3rd Chair and Department of Gynecology, Medical University of Lublin, Lublin, Poland
| | - P Paluszkiewicz
- Department of Surgery and Surgical Nursing, Medical University of Lublin, Lublin, Poland
| | - T Freud
- Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel
| | - A D Cohen
- Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel.,Chief Physician Office, Central Headquarters, Clalit Health Services, Tel Aviv, Israel
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Kuczyńska M, Dziaduch E, Grzywa-Celińska A, Lachowska-Kotowska P, Mosiewicz J. Lethal acute liver failure in a 60 y/o female patient with AILD III (Ann Arbor) T-cell
lymphoma in remission state – Case report. J Pre Clin Clin Res 2014. [DOI: 10.26444/jpccr/71464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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41
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Prystupa A, Dec M, Baraniak J, Mosiewicz J. Gastrointestinal tract changes in the course of Henoch-Schönlein purpura – Case report. Med Og Nauk Zdr 2014. [DOI: 10.5604/20834543.1112234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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42
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Grzywa-Celińska A, Szmygin-Milanowska K, Dyczko M, Kwaśniewska K, Celiński R, Mosiewicz J. [Comorbidity of chronic heart failure and chronic obstructive pulmonary disease]. Pol Merkur Lekarski 2013; 35:251-253. [PMID: 24575642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Cardiovascular diseases most frequently coexist with the chronic obstructive pulmonary disease (COPD). The studies report on over 10 million patients of population suffering both chronic heart failure (CHF) and COPD. Similarity of the clinical symptoms and risk factors found in the medical history of patients with chronic heart failure and chronic obstructive pulmonary disease often causes diagnostic mistakes. At present, medicine has the wide range of diagnostic methods. Among them: well taken medical history, chest radiogram, determination of the serum concentration of natriuretic peptides, spirometry with bronchial reversibility test and many others should be mentioned. The skillfull interpretation of their results guarantee the possibility of more effective treatment. Pulmonary hypertension constitutes the link between the chronic obstructive pulmonary disease and CHF. Although its clinical manifestations are not specific and can be partially masked by the symptoms of COPD, the possibility of its existance should be taken under consideration in every patient with worsening effort toleration or intensification of dysponoea and stable spirometric values with the lack of other causes. It should be emphasized that, apart from the diagnostic leading to diagnosis of those two conditions in one patient, there are also the possible interactions of their concurrent treatment.
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Kurys-Denis E, Prystupa A, Wójtowicz M, Mosiewicz J, Krupski W. Rare cause of recurrent fainting – multiple kinking and brachiocephalic origin of the left common carotid artery. J Pre Clin Clin Res 2013. [DOI: 10.26444/jpccr/71439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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44
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Mosiewicz J, Pietrzak A, Chodorowska G, Trojnar M, Szepietowski J, Reich K, Rizzo M. Rational for statin use in psoriatic patients. Arch Dermatol Res 2013; 305:467-72. [DOI: 10.1007/s00403-013-1374-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 05/03/2013] [Accepted: 05/28/2013] [Indexed: 12/27/2022]
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45
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Mieczkowska J, Mosiewicz J, Rutkowska E, Jedrych M, Prystupa A, Lachowska-Kotowska P. Selected problems of medical qualification for physical fitness in postmenopausal women. J Sports Med Phys Fitness 2013; 53:295-303. [PMID: 23715255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
AIM The aim of this study was to assess the relationship between sex hormones in blood and the occurrence of chest pain and degree of exercise capacity in postmenopausal women. METHODS Fifty-two postmenopausal women with chest pain in retrosternal area in history (group A) and 52 asymptomatic (group B) were examined. Estradiol (E2), total testosterone (T), dehydroepiandrosterone sulphate (DHEA-S), sex hormone binding globulin (SHBG) concentrations in blood were measured. The free testosterone (FT), bioavailable testosterone (BT), index of free testosterone (FTI) and the index of free estradiol (FE2I) were calculated. ECG exercise stress tests were performed by the treadmill stress test track. RESULTS In group A compared with B there were higher: systolic blood pressure (SBP), (129.3±13.5 vs. 121.8±17.1 mmHg, P=0.04), diastolic blood pressure (DBP) (80.8±11.8 vs. 78.6±12.1, P=0.04) at rest, maximum SBP post exercise (172.2±15.9 vs. 157.8±14.2 mmHg, P=0.0003) and lower DHEA-S (122.7±62.8 vs. 150.8±72.9 µg/100 mL, P=0.05) and T (1.5±0.6 vs. 1.7±0.6 nmol/l, P=0.04). T correlated with exercise duration (ED) (R=-0.251, P<0.05), FT with SBP increase during exercise (R=0.286, P<0.05) and ED (R=0.280, P<0.05), BT positively correlated with heart rate (HR) increase during exercise (R=0.285, P<0.05) and with ED (R=0.297, P<0.05). CONCLUSION In postmenopausal women chest pain in history occurs regardless of exercise capacity and may be connected with arterial hypertension, deficiency of DHEA-S and androgenicity. Exercise capacity of postmenopausal women may be influenced by sex hormones, which levels in blood could be useful in the qualification for physical recreation plan.
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Affiliation(s)
- J Mieczkowska
- Department of Internal Medicine Medical University of Lublin, Lublin, Poland.
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46
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Grzywa-Celińska A, Celiński R, Kwaśniewska K, Dyczko M, Prystupa A, Mosiewicz J. [The usefulness of natriuretic peptides measurements in the diagnostics of chosen cardiovascular diseases]. Pol Merkur Lekarski 2013; 34:232-234. [PMID: 23745332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Natriuretic peptides compose the group of neurohormones produced by the myocardium in response to its walls stretching caused by the volume or pressure overload. They restrain the sodium kidney reabsorbtion, thus increasing the diuresis and natriuresis. They also participate in blood pressure, initial load as well as the water-mineral balance regulation. The main representatives of this group are ANP (atrial natriuretic peptide) and BNP (brain netriuretic peptide). With regard to slow dynamics of the serum levels changes, the measurements of BNP play an important role in cardiological diagnotics. Its serum concentration raises in these cardiovascular diseases that are connected with the left ventricle overload. So it can be treated as a specific left ventricle dysfunction marker, whereas its high concentrations correlate with the functional class according to NYHA. It also can be used in risk stratification in patients with the acute coronary syndrome and pulmonary embolism, as well as helping to differentiate the pulmonary and cardiac causes of acute dyspnoea. The serum level of NT-proBNP (N-terminal propeptide of brain natriuretic peptide) is also the independent predictive factor of the recurrence of atrial fibrillation after the restoring the sinus rhythm.
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Pietrzak A, Brzozowska A, Lotti T, Mosiewicz J, Wysokiński A, Mieczkowska J, Hercogova J, Bartosińska J, Juszkiewicz-Borowiec M, Chodorowska G. Future diagnosis, today's treatment - cardiomyopathy in the course of psoriasis: a case report. Dermatol Ther 2013; 26:489-92. [PMID: 24552414 DOI: 10.1111/dth.12021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Psoriasis is a relatively common, chronic skin disease of inflammatory origin. In recent years, public attention has been drawn to a more and more frequently observed relationship between psoriasis and cardiovascular disease. Nowadays, psoriasis is independently held responsible for increased cardiovascular mortality. It seems that the actual significance of the problem, together with a heart-related death risk for these patients is often underestimated. This study presents clinical evidence collected during a long-term observation and treatment of an 80-year-old psoriatic patient with concomitant diabetes, hypertension, and ischemic heart disease, whose overall clinical picture also suggested a congestive, inflammation-related cardiomyopathy with conduction disorders and severe heart failure. Despite the patient's advanced age and associated serious, long-established psoriasis-related problems, he was successfully treated with the use of interventional cardiology methods, as well as cardiac resynchronization therapy.
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Affiliation(s)
- Aldona Pietrzak
- Department of Dermatology, Venereology and Paediatric Dermatology, Medical University, Lublin, Poland
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Witczak A, Prystupa A, Kurys-Denis E, Borys M, Czuczwar M, Niemcewicz M, Kocik J, Michalak A, Pietrzak A, Chodorowska G, Krupski W, Mosiewicz J, Tomasiewicz K. Acute respiratory distress syndrome (ARDS) complicating influenza A/H1N1v infection--a clinical approach. Ann Agric Environ Med 2013; 20:820-822. [PMID: 24364461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
ARDS is defined as an acute inflammatory syndrome characterized with bilateral parenchymal lung infiltrates on chest radiograph and PaO2/FiO2 ratio<200 resulting from causes other than acute left ventricular dysfunction. Inflammatory lung lesions may be induced by different disorders, with sepsis being the leading cause of ARDS. Other causes include infectious pneumonia, aspiration of gastric contents, drugs, severe trauma, fat embolism, surface burn, massive blood transfusion. Influenza A/H1N1 infection seems to be responsible for the development of extremely severe type of ARDS with poor response to routine treatment. Despite great progress in the management of ARDS with novel agents and sophisticated techniques, including antimicrobial drugs, extracorporeal membrane oxygenation, prostaglandins, nitric oxide, prostacyclin, exogenous surfactant administration and activated protein C, supportive treatment based mostly on advanced mechanical ventilation in the intensive care units seems to be the most important for the prognosis.
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Affiliation(s)
| | - Andrzej Prystupa
- Department of Internal Diseases, Medical University, Lublin, Poland
| | - Ewa Kurys-Denis
- II Department of Radiology, Medical University, Lublin, Poland
| | - Michał Borys
- II Department of Anaesthesiology and Intensive Care, Medical University, Lublin, Poland
| | - Mirosław Czuczwar
- II Department of Anaesthesiology and Intensive Care, Medical University, Lublin, Poland
| | - Marcin Niemcewicz
- Military Institute of Hygiene and Epidemiology, Biological Threat Identification and Countermeasures Centre, Pulawy, Poland
| | - Janusz Kocik
- Military Institute of Hygiene and Epidemiology, Biological Threat Identification and Countermeasures Centre, Pulawy, Poland
| | - Anna Michalak
- Department of Dermatology, Venerology and Pediatric Dermatology, Medical University, Lublin, Poland
| | - Aldona Pietrzak
- Department of Dermatology, Venerology and Pediatric Dermatology, Medical University, Lublin, Poland
| | - Grażyna Chodorowska
- Department of Dermatology, Venerology and Pediatric Dermatology, Medical University, Lublin, Poland
| | - Witold Krupski
- II Department of Radiology, Medical University, Lublin, Poland
| | - Jerzy Mosiewicz
- Department of Internal Diseases, Medical University, Lublin, Poland
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Mieczkowska J, Mosiewicz J, Sak J, Grzybowski A, Terlecki P, Barud W, Kwaśniewski W, Tutka P. Effects of cigarette smoking, metabolic syndrome and dehydroepiandrosterone deficiency on intima-media thickness and endothelial function in hypertensive postmenopausal women. Med Sci Monit 2012; 18:CR225-34. [PMID: 22460094 PMCID: PMC3560833 DOI: 10.12659/msm.882622] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Cigarette smoking is a major risk factor of atherosclerosis. The aim of this study was to assess the relationship between smoking and arterial hypertension as well as endothelial dysfunction in postmenopausal women without clinically manifested symptoms of atherosclerosis. Material/Methods The study groups consisted of 35 current smokers and 45 nonsmokers. The thickness of intima-media complex (IMT), a marker of atherosclerosis, was measured in carotid arteries. Plasma concentrations of fasting glucose, insulin, lipoproteins, inflammatory markers (tumor necrosis factor-alpha, intercellular adhesion molecule-1), matrix metalloproteinases (metalloproteinase-9, tissue inhibitor of metalloproteinase-1), insulin, and dehydroepiandrosterone sulfate (DHEA-S) were measured. Results Smokers compared with nonsmokers showed lower fasting glucose levels in blood (87.0±10.9 and 93.2±13.6 mg/dl, p<0.05), higher mean systolic (131.1±15.9 vs. 123.0±10.9 mm Hg, p<0.05) and diastolic (81.7±11.4 vs. 75.2±9.2 mm Hg, p<0.05) blood pressure during daytime, and higher average heart rate during the daytime (78.2±9.3/min vs. 71.5±9.5/min, p<0.01) and at night (67.2±10.6/min vs. 61.7±7.7/min, p<0.05), respectively. The IMT in the right carotid artery was significantly higher in smokers than in nonsmokers (0.96±0.16 mm vs. 0.82±0.21, p<0.05) and was positively correlated with smoking intensity (R=0.36) and habit duration (R=0.35). The comparison of inflammatory markers, metalloproteinases, and DHEA-S concentrations in plasma did not reveal significant differences between the 2 groups. A significant negative correlation between DHEA-S concentration in plasma and IMT in right carotid artery was found in smokers. Conclusions Smoking in hypertensive postmenopausal women is associated with lower fasting blood glucose and BMI values, but higher arterial pressure and heart rate, and increases in IMT in right carotid artery.
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Affiliation(s)
- Jolanta Mieczkowska
- Department of Internal Medicine, Medical University of Lublin, Lublin, Poland
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Kucharska K, Popczak G, Prystupa A, Mosiewicz J. [Factors influencing the variable response to treatment with oral anticoagulants]. Wiad Lek 2012; 65:38-43. [PMID: 22827114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
During therapy with oral anticoagulants, which are the main drugs used for treatment and prevention of thromboembolic diseases, there is significant variability in individual doses required to achieve the therapeutic effect. Oral anticoagulant therapy requires regular monitoring of INR, which should be within the range of 2-3. Currently there is no reliable test predicting which patient will require an extremely high or low dose of these drugs. The variability of responses to oral anticoagulants is regulated by demographic factors such as age, sex, body mass; environmental factors and genetic factors. The personal factors include medication, diet, coexisting systemic diseases. Among genetic factors the most important are polymorphisms of two genes which take part in metabolism of vitamin K and oral anticoagulants. These are: a gene encoding CYP2C9, an enzyme which is involved in hepatic metabolism ofcoumarin derivatives and vitamin K epoxide reductase complex subunit 1 (VOKRC1), the target enzyme of action of oral anticoagulants. Less important are mutations in genes encoding other subunits of cytochrome P450, vitamin K dependent clotting factors, calumenin, gamma-glutamyl carboxylase, apolipoprotein E and microsomal epoxide hydrolase. All these factors can affect both the pharmacokinetics and pharmacodynamics of coumarin derivatives. Considering the main genetic and environmental factors we can predict the dose of oral anticoagulants required in about two-thirds of cases.
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