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ABSTRACT: Background: Cytisine (CYT), the most commonly used drug for smoking cessation in Poland, was experimentally found to induce convulsions. There is a lack of studies on the influence of CYT on the anticonvulsant activity of antiepileptic drugs (AEDs). Methods: The effects of CYT on the anticonvulsant activity of six AEDs were examined in maximal electroshock (MES)-induced seizures in mice. Results: Single intraperitoneal (ip) administration of CYT in a subthreshold dose of 2 mg/kg antagonized the protective activity of ip phenytoin and lamotrigine against MES-induced seizures in mice. A dose of 1 mg/kg did not reverse the protective activity of phenytoin and lamotrigine. CYT in a dose of 2 mg/kg had no effect on the anticonvulsive activity of carbamazepine, oxcarbazepine, phenobarbital, and valproate magnesium. Conclusion: CYT ability to antagonize the anticonvulsive activity of phenytoin and lamotrigine can be of serious concern for epileptic smokers, who might demonstrate therapeutic failure to these drugs resulting in possible breakthrough seizure attacks.
Pharmacological reports: PR 01/2013; 65(1):195-200. · 2.44 Impact Factor
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ABSTRACT: 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.
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.
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.
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.
Medical science monitor: international medical journal of experimental and clinical research 04/2012; 18(4):CR225-34. · 1.70 Impact Factor
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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.
Wiadomości lekarskie (Warsaw, Poland: 1960) 01/2012; 65(1):38-43.
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Aldona Pietrzak,
Grażyna Chodorowska,
Iwona Jazienicka,
Paweł Osemlak,
Bartłomiej Wawrzycki,
Piotr Terlecki,
Jolanta Mieczkowska, Jerzy Mosiewicz,
Tomasz Zubilewicz,
Franciszek Szubstarski,
Witold Krupski,
Jana Hercogova,
Jacek C Szepietowski,
Torello Lotti
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ABSTRACT: Psoriasis is currently considered a multifactorial disease, which can coexist with many somatic and psychological disorders. We present the case of a 50-year-old woman referred to our department due to erythroderma with concomitant peculiar violaceous, polycyclic lesions most likely induced by medications. Past medical history revealed numerous systemic disorders, including metabolic syndrome, hypertension, cardiac insufficiency, obesity, and depression. Additional examinations and consultations demonstrated dyslipidemia, xanthelasma, incomplete block of the right branch of His bundle, thyreocardiac syndrome, benign adrenal tumor, and delusions. Recently, psoriasis has been intensively studied. We present the case in which erythroderma was most likely triggered by acitretin combined with ceftriaxone. Treatment of many diseases and psychiatric disturbances coexisting with psoriasis is extremely difficult and requires cooperation of various specialists.
Dermatologic Therapy 11/2011; 24(6):587-90. · 1.69 Impact Factor
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ABSTRACT: The role of statins in the primary and secondary prevention of cardiovascular events is well known. An important adverse event associated with statin treatment is myopathy; intensive physical effort in patients treated with statins increases the risk of muscle injury/myopathy. In this article we discuss the benefits and risks associated with statin treatment in patients undergoing cardiac rehabilitation after acute coronary syndromes and/or coronary revascularization procedures. In our opinion, the benefits of the secondary prevention of coronary heart disease achieved with statins seem to outweigh the hazards associated with statin therapy. The careful selection of patients for both treatment with statins and the gradual intensification of physical training in the course of cardiac rehabilitation appears to constitute an important element of the therapeutic approach.
Archives of medical science : AMS. 10/2011; 7(5):756-9.
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ABSTRACT: Early atherosclerotic changes in the endothelium associated with metabolic syndrome are generated with the participation of inflammatory cells, cytokines and enzymes of the extracellular matrix. The study is aimed at a comparison between the activity of inflammatory agents, tumour necrosis factor α (TNF-α) and the enzymes of the connective tissue matrix in the blood of healthy female patients as well as those suffering from the metabolic syndrome.
The examination included 35 women with metabolic syndrome (MS). The control group (C) comprised 35 healthy women. Lipidogram, C-reactive protein level (CRP), fasting glucose level (FGL), matrix metalloproteinase (MMP)-8 and -9 activity, tissue inhibitor of metalloproteinase-1 (TIMP-1) and TNF-α levels in blood were determined.
As compared with the control group, the level of inflammatory factors and the activity of extracellular matrix enzymes in the metabolic syndrome were statistically higher (p < 0.05) and concerned the following parameters: TNF-α (pg/ml): MS 6.59 ±3.18, C 4.78 ±2.91; CRP (mg/dl): MS 2.18 ±2.04, C 1,26 ±1.35; TIMP-1 (ng/ml): MS 265.5 ±2.9, C 205.4 ±72.6; MMP-9 (ng/ml): MS 198.2 ±138.6, C 138.6 ±116.1. Statistically significant correlations were also found between TIMP-1 and the following factors: BMI (R = 0.400, p < 0.001), waist/hip ratio (WHR) (R = 0.278, p < 0.05), waistline (R = 0.417, p < 0.001), FGL (R = 0.290, p < 0.05), HDL cholesterol (R = -0.253, p < 0.05) and triglycerides (R = 0.269, p < 0.05).There were positive correlations of MMP-9 with FGL (R = 0.446, p < 0.001) and waistline (R = 0.260, p < 0.05); MMP-8 with FGL (R = 0.308, p < 0.05); and CRP with BMI (R = 0.370, p < 0.01), WHR (R = 0.325, p < 0.01) and waistline (R = 0.368, p < 0.01).
Metabolic syndrome is connected with higher activity of cytokines (TNF-α), inflammatory markers (CRP) and matrix enzymes (MMP-9, MMP-8, TIMP-1).
Archives of medical science : AMS. 08/2011; 7(4):634-41.
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ABSTRACT: Inflammation plays a key role in the development of atherosclerosis. Studies in women receiving estrogens show their proinflammatory effects. This study sought to determine relation between sex hormones and 2 inflammation markers: C-reactive protein and fibrinogen.
One hundred men of at least age 50 years were enrolled in the study. Plasma levels of total testosterone, estradiol, sex hormone binding globulin, high-sensitivity C-reactive protein, and fibrinogen were measured. Free estradiol and free testosterone were calculated.
Estradiol and free estradiol levels were positively correlated with C-reactive protein and fibrinogen. In a subgroup analysis, this association persisted only in patients with stable coronary artery disease. No significant correlations were found between testosterone, free testosterone, sex hormone binding globulin, and markers of inflammation.
This study suggests that estradiol may have proinflammatory effects in older men with coronary artery disease.
Medical science monitor: international medical journal of experimental and clinical research 11/2010; 16(12):CR593-7. · 1.70 Impact Factor
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ABSTRACT: The Morgagni hernia is a rare condition caused by the disturbances in the embryonal development of the diaphragm. The high pressure in the abdominal cavity during the persistent constipations or in pregnant women seems to be important predisposing factor apart from advanced age, obesity, vertebral column deformities and the connective tissue diseases. That is why the Morgagni hernia is very rarely diagnosed in children but usually in women in their fifties. We present the case report of our patent who was admitted to the Department of Internal Diseases for the diagnostics of lasting for 3-4 months weakness, chest pains and the episodes of palpitations. During her stay in our Department the routine chest X-ray examination was performed, that showed the unexpected result. The diagnosis of Morgagni hernia was afterwards confirmed in the computed tomography. Even though the risk of the acute abdominal conditions in the dislocated parts of gastro-intestinal tract our patient did not agree to proposed operation.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 10/2010; 29(172):255-8.
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Journal of Pre-Clinical and Clinical Research. 01/2010;
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ABSTRACT: The chronic kidney disease (CKD) is a polysymptomatic syndrome resulting from the reduction of active nephrons. It is estimated that the disease affects from 4.7-20% of adults. According to the actual knowledge, glomerular filtration rate (GFR) less than 60 ml/min/1.73 m2 is a significant risk factor for the cardiovascular diseases. The aim of our study was to assess the frequency of using the serum creatinine level and the estimated GFR (eGFR) as the indices of renal function in clinical practice. The study was performed amongst physicians working in non-academic departments of internal disease in the region of lubelskie voivodeships in 2008. An anonymous questionnaire of own composition consisting of 18 open and closed questions was used. The questions concerned the use of eGFR and serum creatinine level in everyday practice. 162 physicians were asked to fill the questionnaire, the percent of positive answers was 27.78% which is 45 questionnaires. The best parameter in evaluation of renal function, according to the asked physicians, was serum creatinine level (49% of all answers), eGFR (47%) and serum urea level or microalbuminuria (4%). Despite the actual recommendations, the serum creatinine level still remains the most popular routine parameter used to evaluate renal function. It seems that the knowledge concerning the diagnosing of CKD and the prophylaxis of its progression among physicians is insufficient. It concerns mainly physicians with no special training, working rather in profiled than in general medicine departments. Therefore, current educational programs concerning preventing and early diagnosis of CKD should be destinated mainly to these groups of physicians.
Przegla̧d lekarski 01/2010; 67(7):491-5.
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Acta Derm. Venereol. 11/2009; 89:646-648.
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J. Pre-Clin. Clin. Res. 2009 vol. 3 nr 1,. 11/2009; 3:67-69.
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Medycyna Ogolna. 11/2009; Med. Og. 2009 t. 15 nr 2, s. 268-275:268-275.
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Acta Dermato-Venereologica 11/2009; 89(6):646-8.
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ABSTRACT: Klinefelter's syndrome is the most common genetically determined cause of male infertility. It is also connected with higher risk of many diseases such as cardiovascular disorders and malignant tumors as breast cancer and germinal tumors. As a consequence of phenotypic variability, still the majority of cases remains undiagnosed. CASE REPORT: 24 years old male who was admitted to the department because of an episode of sudden resting dyspnoea with the coexisting pain in the retrosternal region and a state of anxiety. Performed examinations did not confirm the diagnosis of heart muscle dysfunction and pulmonary embolism either. However, we noticed the constellation of the specific phenotype features of this patient: high stature, gynecomastia, abdominal obesity, poor hair growth in genital regions. The hormonal tests were performed that allowed to diagnose the hypergonadotropic hypogonadism. Cytogenetic examination revealed the abnormal karyotype of 47,XXY. CONCLUSIONS: There are no clear references as to diagnosing the Klinefelter's syndrome. Probably, like in this case report, in the majority of cases the diagnosis is accidental.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 10/2009; 27(160):331-3.
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ABSTRACT: The role of statins in primary and secondary prevention of cardiovascular incidents cannot be questioned. However, it is commonly known, that their use, especially in high doses, can cause side effects. Our study reports the case of female patient who because of an episode of unstable angina underwent the percutaneous coronary intervention (PCI) of right coronary artery (RCA), and afterwards received the hypolipemic treatment of simvastatin in the dose of 80 mg/day. After the PCI she participated in the programme of early sanatory cardiac rehabilitation. After some days of her stay she started to notice the generalized muscle pain, that she initially linked with the intensification of exercise. Two days after finishing the rehabilitation programme she was admitted to our Department with the symptoms of generalized muscle injury. Laboratory test revealed very high serum level of creatine kinase, myoglobin and transaminases. Data obtained from anamnesis and results of laboratory testing enabled to diagnose myopathy being the result of hypolipemic treatment with high dose of simvastatin. After the treatment we observed gradual regression of muscle pain, and in 12th day of the stay in our clinic the normalization of biochemical parameters was stated. Our patient reported she was not informed about the possible complications of undertaken treatment. This case report emphasizes the necessity to precisely inform the patients about the possible drugs side effects.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 09/2009; 27(159):226-8.
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ABSTRACT: This paper discusses the case of a female patient treated for chronic obstructive pulmonary disease and hyperthyroidism, who also had takotsubo cardiomyopathy with dyspnea at rest as a dominant clinical manifestation.
Polskie archiwum medycyny wewnȩtrznej 05/2009; 119(4):265-8. · 1.37 Impact Factor
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ABSTRACT: The use of methotrexate is associated with the risk of numerous, sometimes life-threatening, side effects. We describe a 76-year-old female patient treated with methotrexate (MTX) due to vertebral joint disease of unknown etiology. During the outpatient therapy, which was not conformed to doctor's recommendations, acute liver failure and symptoms of bone marrow damage developed. Despite intensive hospital treatment, the patient died.
Wiadomości lekarskie (Warsaw, Poland: 1960) 01/2009; 62(2):115-8.
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ABSTRACT: This study was performed to investigate whether postnatal administration with aged garlic extract (AGE) and allicin influences performance and systemic development of piglets exposed to early weaning. Twenty-four male piglets were weaned from sows at the age of two days of life, divided into 4 weight-matched groups and kept under conditions of artificial sow for 6 days. The first group consisted of control animals, while piglets that were given AGE daily per os at the dosages of 1 ml and 2 ml/kg body weight, respectively belonged to the second and third group. The fourth group consisted of piglets administered orally with allicin at the dosage of 1.0 mg/kg body weight/day. At the age of 8 days of life all animals were sacrificed. Next to body weight gain and morphological properties of the gastrointestinal tract, the haematological examination was performed, and activity of lysozyme and ceruloplasmin as well as level of gamma-globulins were determined. The obtained results showed that AGE and allicin improved final body weight, morphological properties of intestine villi and non-specific defence mechanisms of pigs. All these results indicate that AGE and allicin induced beneficial effects on health status, performance and systemic development of piglets.
Annals of agricultural and environmental medicine: AAEM 02/2008; 15(1):63-9. · 2.31 Impact Factor
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ABSTRACT: The examination of cognitive function is not the part of the basic set of tests which is carried out in patients with chronic obstructive pulmonary disease (COPD). However there are some theoretical reports and sparse publications indicating the impairment of these functions among patients with COPD. These impairments are related to the patients with hypoxemia. In non-hypoxemic patients with COPD cognitive performance should be studied because of controversial reports. The influence of COPD on cognitive performance is partially reversible using oxygen therapy and/or physical activity which, in our opinion, is not appreciated enough. It seems that evaluation of cognitive performance with selected tests can be helpful in the assessment of severity of the disease. Moreover, it can be useful in estimation and prognostication of the self-dependence degree as well as the patients life span. The use of such methodological tools as corresponding tests analyzing cognitive performance in patients with COPD could lead to better care. It could also minimize the risk of transition of mild cognitive impairment into dementia which results in significant quality of life deterioration. It appears that patients with present impaired cognitive performance with or without recognized dementia should remain under special care providing adequate treatment. We assumed that due to properly managed treatment it may be possible to retain the process of increasing cognitive impairment what would effect in long-term self-reliance.
Wiadomości lekarskie (Warsaw, Poland: 1960) 02/2007; 60(3-4):143-7.
