Krystyna Mitosek-Szewczyk

Publications of Krystyna Mitosek-Szewczyk

• [Processes of free radical lipid peroxidation with a particular regard to the role of paraoxonase-1 in the pathogenesis of multiple sclerosis].

  Authors: Jerzy Berbecki, Krystyna Mitosek-Szewczyk, Jacek Kurzepa, Marcin Nastaj, Katarzyna Łobejko, Zbigniew Stelmasiak

  Wiadomości lekarskie (Warsaw, Poland : 1960). 01/2011; 64(1):31-6.

  Oxidative stress is an imbalance between free radicals production and antioxidant defences. Reactive oxygen species (ROS) and reactive nitrogen species (RNS) can attact and demage a variety ofOxidative stress is an imbalance between free radicals production and antioxidant defences. Reactive oxygen species (ROS) and reactive nitrogen species (RNS) can attact and demage a variety of critical biological molecules, including lipids, essential cellular proteins and DNA and may be exert in pathogenesis of many disorders. Products of lipid peroxidation can be easily reliably detected in biological fluids and tissues, yielding sensitive and specific signals of lipid peroxidation occurred in vivo. Those products are: isoprostanes (isoP) dimalonealdehyde (MDA), 4-hydroxynonenal (4-HNE). Paraoxonase-1 (PON-1) play a key role in defence of lipid peroxidation. PON-1 is an serum enzyme bound up with high density lipoproteins (HDL). The aim of this work is to discuss the role of oxidative stress in the pathogenesis of multiple sclerosis.

• Some markers of neuronal damage in cerebrospinal fluid of multiple sclerosis patients in relapse.

  Authors: Krystyna Mitosek-Szewczyk, Wanda Gordon-Krajcer, Dorota Flis, Zbigniew Stelmasiak

  Folia neuropathologica / Association of Polish Neuropathologists and Medical Research Centre, Polish Academy of Sciences. 01/2011; 49(3):191-6.

  In this paper the performance of cerebrospinal fluid (CSF) protein biomarkers important for monitoring damage of brain astrocytes and neurons for MS is reviewed. We estimated neurofilament, tau andIn this paper the performance of cerebrospinal fluid (CSF) protein biomarkers important for monitoring damage of brain astrocytes and neurons for MS is reviewed. We estimated neurofilament, tau and phospho-tau proteins, β-APP, Aβ, S-100B and neuron-specific enolase in CSF of MS patients during relapse. We noted elevation of neurofilament, tau and phospho-tau proteins, S-100B, neuron-specific enolase and c-terminal epitopes of β-APP; concomitantly decrease of Aβ was observed. These CSF biomarkers for MS relapse should reflect the central pathogenic processes in the brain, i.e., axonal and neuronal degeneration.

• Free radical peroxidation products in cerebrospinal fluid and serum of patients with multiple sclerosis after glucocorticoid therapy.

  Authors: Krystyna Mitosek-Szewczyk, Wanda Gordon-Krajcer, Piotr Walendzik, Zbigniew Stelmasiak

  Folia neuropathologica / Association of Polish Neuropathologists and Medical Research Centre, Polish Academy of Sciences. 01/2010; 48(2):116-22.

  Multiple sclerosis (MS) patients were found to have elevated thiobarbituric acid reactive material levels, increased soluble sulfhydryl groups and reduced protein sulfhydryl groups in cerebrospinalMultiple sclerosis (MS) patients were found to have elevated thiobarbituric acid reactive material levels, increased soluble sulfhydryl groups and reduced protein sulfhydryl groups in cerebrospinal fluid and serum, and slightly reduced superoxide dismutase in serum, which suggested disease activating free radical peroxidation. Moreover, levels of these varied across methylprednisolone (MP) therapy. We observed significant differences in the levels of peroxidation products between MS patients and controls. These changes were most evident in relapse. After MP therapy, levels of these indicators approached control values, especially in the remission period. Our findings suggest that MP protects against free radical attack.

• B-type natriuretic peptide as a marker of subclinical heart injury during mitoxantrone therapy in MS patients-Preliminary study.

  Authors: Piotr Luchowski, Krystyna Mitosek-Szewczyk, Halina Bartosik-Psujek, Andrzej Rubaj, Marek Jankiewicz, Joanna Wojczal, Anna Szczepańska-Szerej, Zbigniew Stelmasiak

  Clinical neurology and neurosurgery. 07/2009;

  The aim of this study was to evaluate the plasma level changes of B-type natriuretic peptide (BNP), biochemical marker of heart failure, and echocardiographic parameters during mitoxantrone treatmentThe aim of this study was to evaluate the plasma level changes of B-type natriuretic peptide (BNP), biochemical marker of heart failure, and echocardiographic parameters during mitoxantrone treatment in 22 multiple sclerosis (MS) patients (8 males, 14 females, mean age 37.1+/-6.6). Mitoxantrone (after mean cumulative dose of 58.0+/-7.0mg/m(2)) did not alter left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), posterior wall thickness (PWT) and left ventricular end-diastolic volume (LVEDV). However, mean plasma level of BNP raised from 14.53+/-3.29pg/ml at the baseline to 16.79+/-3.05pg/ml and 18.83+/-4.90pg/ml (P<0.01) after mean mitoxantrone dose of 30.7+/-5.9mg/m(2) and 58.0+/-7.0mg/m(2), respectively. These results strongly suggest subclinical myocardial dysfunction in mitoxantrone-treated group. We assume, that low-cost, repeated BNP measurements may be a good alternative for detection of early subtle myocardial injury in MS patients during routine mitoxantrone therapy.

• [Development of binding antibodies to interferon-beta during treatment of multiple sclerosis with different types of interferon-beta]

  Authors: Halina Bartosik-Psujek, Krystyna Mitosek-Szewczyk, Ewa Belniak, Zbigniew Stelmasiak

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 08/2004; 17(97):28-32.

  Interferon beta (IFN-beta) is generally considered an effective treatment for multiple sclerosis (MS). Importance of binding antibodies (BAb), which are created during the treatment of MS by the useInterferon beta (IFN-beta) is generally considered an effective treatment for multiple sclerosis (MS). Importance of binding antibodies (BAb), which are created during the treatment of MS by the use of IFN-beta, hasn't been completely explained, however it is generally reckoned that they might be one of the factors diminishing treatment efficacy. The aim of the study was the appreciation of BAb occurrence during the treatment of MS by the use of different types of interferon beta and their impact on clinical efficacy. The study included 47 patients with relapsing-remitting MS. Within 24 months 37 patients were given two different preparations of IFN-beta 1-a and 10 patients were given IFN-beta 1-b. Every 6 months clinical parameters and BAb level in serum by EIA method were estimated. All preparations of IFN-beta induced appearance of BAb, but frequency of developing BAb to IFN-beta varied according to the IFN beta given. The high levels of BAb appeared significant frequently in patients treated with IFN-beta 1-b than in patients treated with both preparations of IFN-beta 1-a. After 2 years of treatment greater disability, measured by EDSS scale was encountered in patients with high levels of BAb but differences weren't statistically significant. As well, it wasn't stated significant correlation between exacerbation numbers during the treatment.

• Oligoclonal bands measured in unconcentrated cerebrospinal fluid and other biochemical parameters in multiple sclerosis.

  Authors: Jacek Kurzepa, Marcin Nastaj, Krystyna Mitosek-Szewczyk, Halina Bartosik-Psujek, Zbigniew Stelmasiak

  Annales Universitatis Mariae Curie-Skłodowska. Sectio D: Medicina. 02/2004; 59(2):392-6.

  Various biochemical parameters of cerebrospinal fluid (CSF) obtained from sixty-nine patients with RRMS (relapse-remitting MS) were compared in this study. Total protein level, white blood cellsVarious biochemical parameters of cerebrospinal fluid (CSF) obtained from sixty-nine patients with RRMS (relapse-remitting MS) were compared in this study. Total protein level, white blood cells (WBC) count and presence of oligoclonal bands (OB) in CSF were examined. The presence of OB in unconcentrated CSF using an isoelectrofocusing assay on agarose gels and silver staining were measured in 72 percent of patients. The average CSF total protein level measured by Lowry assay was 269 mg/l (range from 61 to 712 mg/l). The mean level of white blood cells (WBC) was higher than in general population and it was 12 cells/microl. We found an increased level of WBC count among patients with the presence of oligoclonal bands in CSF.

• Tumour of great occipital foramen.

  Authors: Krystyna Mitosek-Szewczyk, Zbigniew Stelmasiak

  Annales Universitatis Mariae Curie-Skłodowska. Sectio D: Medicina. 02/2004; 59(2):410-2.

  We present the case of tumour of the great occipital foramen in a patient who was having headaches and significant mobility restriction of the cervical spine. Attention is called to diagnostic andWe present the case of tumour of the great occipital foramen in a patient who was having headaches and significant mobility restriction of the cervical spine. Attention is called to diagnostic and surgical difficulties related to this location of neoplasm.

• [The assessment of development of binding antibodies to interferon beta during interferon beta 1a treatment of multiple sclerosis]

  Authors: Halina Bartosik-Psujek, Ewa Belniak, Krystyna Mitosek-Szewczyk, Konrad Rejdak, Beata Dobosz, Zbigniew Stelmasiak

  Neurologia i neurochirurgia polska. 02/2003; 37(4):799-809.

  The importance of binding antibodies (BAb) that develop during the treatment of multiple sclerosis with interferon beta has not been fully explained yet. However, they are generally regarded as oneThe importance of binding antibodies (BAb) that develop during the treatment of multiple sclerosis with interferon beta has not been fully explained yet. However, they are generally regarded as one of factors that may diminish treatment efficacy. The aim of the study was to evaluate firstly, BAb occurrence in interferon beta 1-a (IFN beta 1-a)-treated MS patients and secondly, BAb impact on clinical efficacy of this medication. In the 36-month study participants were 21 patients with relapsing-remitting multiple sclerosis, RR-MS, (14 women, 7 men, aged 29.6 +/- 8.5). All the patients were receiving intramuscular IFN beta-1a (Avonex) for 24 months, in the dose of 30 micrograms per week. Clinical parameters and serum BAb levels (the EIA method) were estimated every 3 months. Two control groups, examined only once, included 20 RR-MS patients without IFN-beta therapy and 20 healthy volunteers. While before treatment a high BAb level was found in 2 patients (9.5%), at 6 months of treatment it was found in 8 patients (38.1%). A similar number of patients with high BAb levels was seen throughout the study during the IFN-beta treatment. On therapy completion serum BAb levels decreased very rapidly. After 2 years of treatment, disability as measured by the EDSS scale was more pronounced in patients with serum BAb, but the differences were statistically not significant. No statistically significant relationship was found either between elevated BAb levels and the number of relapses during the IFN-beta treatment (including relapses that required steroid therapy).

• [Neurologic problems in tick-borne diseases--clinical and diagnostic aspects]

  Authors: Halina Bartosik-Psujek, Ewa Belniak, Krystyna Mitosek-Szewczyk, Zbigniew Stelmasiak

  Przegla̧d epidemiologiczny. 02/2002; 56 Suppl 1:30-7.

  Tick carried illnesses frequently lead towards neurological complications. The tick-borne encephalitis and borreliosis are the most frequently encountered illnesses having such aetiopathogenesis. InTick carried illnesses frequently lead towards neurological complications. The tick-borne encephalitis and borreliosis are the most frequently encountered illnesses having such aetiopathogenesis. In the study there are presented clinical aspects of tick-borne encephalitis and borreliosis with special consideration of various neurological symptomatology. Simultaneously there are discussed current diagnostic rules of the diseases, mainly on the basis of serologic investigation.

• Retrospective analysis of mortality rates among the patients with cerebral stroke hospitalized at the Department of Neurology of the Medical University of Lublin in 1990 and 2000.

  Authors: Krystyna Mitosek-Szewczyk, Monika Miazga, Mirosław Miazga, Marta Piecyk

  Annales Universitatis Mariae Curie-Skłodowska. Sectio D: Medicina. 02/2002; 57(2):519-25.

  The aim of the study was to assess the mortality rate among the patients with cerebral stroke treated at the Department of Neurology of the Medical University of Lublin. The retrospective analysisThe aim of the study was to assess the mortality rate among the patients with cerebral stroke treated at the Department of Neurology of the Medical University of Lublin. The retrospective analysis included 413 patients hospitalized in 1990 and 2000. The following parameters were evaluated: the type of stroke, age, sex, the length of hospitalization, kinds of complications. The patients' age ranged from 17 to 89 years. The examinations were performed only in the patients with the determined diagnosis of stroke (confirmed clinically, by CT, MRI and anatomicopathologically). These examinations were also used to determine the type of stroke (haemorrhagic, ischaemic). The statistical analysis was carried out using the chi 2 Pearson's test; p < 0.005 was assumed to be statistically significant. The findings reveal a statistically significant decrease in the mortality rate among the patients with haemorrhagic cerebral stroke in 2000 compared to 1990. The mortality rate in the ischaemic stroke patients was also reduced, however the result was not statistically significant.

• [Validation of selected aspects of psychometry of the Polish version of the Multiple Sclerosis Impact Scale 29 (MSIS-29).]

  Authors: Anna Jamroz-Wiśniewska, Ewa Papuć, Halina Bartosik-Psujek, Ewa Belniak, Krystyna Mitosek-Szewczyk, Zbigniew Stelmasiak

  Neurologia i neurochirurgia polska. 41(3):215-22.

  BACKGROUND AND PURPOSE: Because of the small number of self-reported measures of disease impact on the quality of patients' life used in Poland and specific for multiple sclerosis (MS), the aim ofBACKGROUND AND PURPOSE: Because of the small number of self-reported measures of disease impact on the quality of patients' life used in Poland and specific for multiple sclerosis (MS), the aim of the study was to validate selected aspects of psychometry of the Polish adaptation of the Multiple Sclerosis Impact Scale 29, MSIS-29. MATERIAL AND METHODS: MSIS-29 was first published by Hobart and Thompson in 2001, and consists of 29 questions, the first 20 of which address the physical impact component and 9 assess the psychological impact. The higher the score, the worse is the impact of the disease on quality of patient's life. Validation analysis consisted of translation of the original English version into Polish according to all necessary translation principles and of assessment of convergent validity and internal reliability of the Polish version of MSIS-29. 104 randomly selected patients with definite MS (according to McDonald criteria) were examined: 77 women and 27 men; mean age was 36.9+/-9.4 years, and the mean disease duration was 9.05+/-6.68 years. The disability of the patients was assessed according to the Expanded Disability Status Scale (EDSS). Apart from the examined measure (MSIS-29) subjects were also asked to complete the Functional Assessment of Multiple Sclerosis (FAMS), Beck's Depression Inventory (BDI-II) and the Fatigue Severity Scale (FSS). RESULTS: MSIS-29 correlated with EDSS, FAMS, BDI-II and FSS. Internal consistency of MSIS-29 was satisfactory. CONCLUSIONS: Psychometric-statistical analysis showed that the Polish version of MSIS-29 is a valuable measure to examine the impact of disease on patients' life. The studies should be continued taking into account other aspects of psychometry.

• Selected aspects of the epidemiology of multiple sclerosis in Poland - a multicentre pilot study.

  Authors: Alina Kułakowska, Halina Bartosik-Psujek, Roman Hożejowski, Krystyna Mitosek-Szewczyk, Wiesław Drozdowski, Zbigniew Stelmasiak

  Neurologia i neurochirurgia polska. 44(5):443-52.

  The aim was to conduct a pilot study of selected epidemiological aspects of multiple sclerosis (MS) in Poland. Cross-sectional data were collected in 21 centres providing MS treatment. TheThe aim was to conduct a pilot study of selected epidemiological aspects of multiple sclerosis (MS) in Poland. Cross-sectional data were collected in 21 centres providing MS treatment. The demographic profile of the patients, medical history of MS, disability status, comorbidity, and diagnostic and treatment modalities were analysed. Data on 3581 patients were obtained, including 2494 women (69.6%) and 1030 men (28.8%) - sex ratio 2.4 : 1. The mean age was 40.7 ± 11.9 years. Monofocal onset was reported in 80.8% of cases - the most frequently reported location of lesions was supratentorial (36.1%), followed by optic nerves (26.5%) and spinal cord (20.1%). The mean disease duration was 10.2 ± 8.8 years (range 0.04-53 years), and the mean time from the first symptoms to MS diagnosis was 2.6 years. Relapsing-remitting MS was reported in 70.5% of patients, secondary progressive in 16.8%, primary progressive in 8.4%, and 'benign MS' in 2.5%. The mean EDSS score was 3.3 ± 2.2 (range 0-9.5). The family history of MS was positive in 6.4% of cases. Comorbidity mainly applied to the musculoskeletal system (6.5%), the urinary system (5.8%) and psychiatric disturbances (5.5%). Brain magnetic resonance studies were available in 96.3% of the patients, evoked potentials in 54%, and cerebrospinal fluid testing in 63.1% - of whom only 41.2% were tested for oligoclonal bands, with 84% of samples being positive. Immunomodulatory drugs were used in 842 patients (24%), predominantly interferon beta (81%) and glatiramer (13%). Mitoxantrone was the most commonly used immunosuppressant. This project is the first countrywide large-scale MS survey, covering approximately 18% of patients, according to our estimates. The results identify the clinical condition of the patients, as well as diagnostic and treatment modalities.

• [Fatigue in multiple sclerosis.]

  Authors: Ewa Dworzańska, Krystyna Mitosek-Szewczyk, Zbigniew Stelmasiak

  Neurologia i neurochirurgia polska. 43(1):71-6.

  Fatigue is one of the most common symptoms of multiple sclerosis (MS) and is associated with reduced quality of life. The fatigue syndrome is characterized by uncontrollable apathy, exhaustion,Fatigue is one of the most common symptoms of multiple sclerosis (MS) and is associated with reduced quality of life. The fatigue syndrome is characterized by uncontrollable apathy, exhaustion, fatigability and lack of energy. The mechanisms underlying fatigue in MS are still poorly understood but studies suggest that immune and neuroendocrine factors may play a causative role in the development of fatigue. The first step in management of MS-related fatigue is identifying and eliminating any secondary causes (adverse effects of drugs, infections, sleep disorders, metabolic diseases). As the fatigue syndrome in patients with MS cannot be evaluated objectively in the routine clinical setting, a number of scales have been developed. The Fatigue Severity Scale is a general scale. Additional scales that have been tested in MS include the Fatigue Impact Scale. Therapy of fatigue syndrome consists of modafinil, amantadine, pemoline and non-pharmacological management.