Monika Kowalczyk

Publications of Monika Kowalczyk

• Adult Cyclic Vomiting Syndrome Successfully Treated with Intranasal Sumatriptan.

  Authors: Monika Kowalczyk, Henry Parkman, Lawrence Ward

  Journal of general internal medicine. 11/2009;

  Cyclic vomiting syndrome is an increasingly recognized cause of nausea and vomiting in adults. We report the case of a 47-year-old man with recurrent episodes of intractable nausea and vomiting forCyclic vomiting syndrome is an increasingly recognized cause of nausea and vomiting in adults. We report the case of a 47-year-old man with recurrent episodes of intractable nausea and vomiting for one year. His symptoms persisted for 4-7 days and then resolved spontaneously, only to return after periods of time ranging from one week up to a month. After an extensive workup, which failed to determine any causative explanation for his symptoms, he was diagnosed with cyclic vomiting syndrome. His episodes of vomiting were successfully terminated with the use of intranasal sumatriptan. In this case, we highlight that sumatriptan effectively aborted symptoms in an adult patient with cyclic vomiting syndrome. Increasing physicians' awareness of adult cyclic vomiting syndrome may improve care of patients suffering from this debilitating condition.

• Off-pump revascularization with the use of both internal thoracic arteries in a 3-year-old child with Kawasaki syndrome.

  Authors: Monika Kowalczyk, Zbigniew Juraszynski, Piotr Burczynski, Grazyna Brzezinska-Rajszys, Wanda Kawalec

  The Journal of thoracic and cardiovascular surgery. 07/2009; 137(6):1554-5.

• Work-related respiratory symptoms in bird zoo keepers--questionnaire data.

  Authors: Sylwia Swiderska-Kiełbik, Anna Krakowiak, Marta Wiszniewska, Wojciech Dudek, Monika Kowalczyk, Jolanta Walusiak-Skorupa, Konrad Sliwkiewicz, Cezary Pałczyński

  International journal of occupational medicine and environmental health. 01/2009; 22(4):393-9.

  To investigate the risk factors for the development of airway diseases from occupational exposure to birds' allergens among Polish zoo garden keepers caring for birds. Two hundred workers respondedTo investigate the risk factors for the development of airway diseases from occupational exposure to birds' allergens among Polish zoo garden keepers caring for birds. Two hundred workers responded to the questionnaire including the history of work-related symptoms, job characteristics, description of occupational exposure, information on smoking habit, contact with birds and animals at home and family history of allergic diseases. General work-related symptoms were reported by 58 subjects (29%), whereas work-related respiratory symptoms were found in 40 workers (20%). The multivariate logistic regression analysis confirmed the significant role of positive family history of atopy and occupational contact with parrots either in the development of work-related symptoms or work-related respiratory allergic symptoms. The findings may confirm that work-related respiratory symptoms are an important health problem among zoo bird keepers in Poland.

• Challenge testing in the diagnosis of occupational allergic conjunctivitis.

  Authors: Tomasz Wittczak, Anna Krakowiak, Jolanta Walusiak, Alicja Pas-Wyroslak, Monika Kowalczyk, Cezary Palczynski

  Occupational medicine (Oxford, England). 11/2007; 57(7):532-4.

  BACKGROUND: Providing evidence for the allergic aetiology of ocular symptoms developing as a result of occupational exposure is important for compensation procedures in many countries. AIM: ToBACKGROUND: Providing evidence for the allergic aetiology of ocular symptoms developing as a result of occupational exposure is important for compensation procedures in many countries. AIM: To perform cellular analysis of tear fluid before and after a specific challenge test with high-molecular weight allergens in symptomatic subjects. METHODS: The subjects were 23 bakers with a history of conjunctivitis or rhinoconjunctivitis associated with occupational exposure to wheat flour and positive skin prick test with this allergen. A specific inhalation challenge test with wheat flour and a placebo test were performed. The symptom score (SS) and cellular changes in tear fluid and nasal washings were assessed. RESULTS: Specific provocation test induced significant eosinophil influx in tear fluid in only six patients. No changes in the proportion of other cells could be observed. Cytological changes in tear fluid did not correlate with either ocular SS (Pearson r = 0.18, P = 0.40) or changes in the nasal lavage fluid or SS (Pearson r = 0.13, P = 0.56). However, an analysis of SS results obtained at 30 min and at 24 h after the challenge revealed that cellular changes in tear fluid correlated significantly both with the early and late changes in SS (Pearson r = 0.52, P < 0.05 and Pearson r = 0.81, P < 0.001, respectively). CONCLUSIONS: Analysis of cellular changes in tear fluid during specific inhalation challenge test seems to be a valuable diagnostic tool in occupational ocular allergy. However, the discrepancy between the findings of cellular analysis and SS revealed by the present study requires further research.

• Prevalence and host determinants of occupational bronchial asthma in animal shelter workers.

  Authors: Anna Krakowiak, Patrycja Krawczyk, Bogdan Szulc, Marta Wiszniewska, Monika Kowalczyk, Jolanta Walusiak, Cezary Pałczyński

  International archives of occupational and environmental health. 05/2007; 80(5):423-32.

  OBJECTIVE: We examined the risk factors for the development of airway allergy in animal shelter workers. METHODS: The study population comprised 88 animal shelter workers occupationally exposed toOBJECTIVE: We examined the risk factors for the development of airway allergy in animal shelter workers. METHODS: The study population comprised 88 animal shelter workers occupationally exposed to cats and dogs. They responded to a questionnaire concerning the history of exposure to animal allergens and job characteristics and were subjected to skin prick test (SPT) to common and occupational allergens (cat and dog), and determination of total serum IgE level and specific IgE. In addition, SPT with rat and mouse allergens were performed. Bronchial hyperreactivity and peak expiratory flow rate were measured at work and off work only in workers with work-related symptoms suggestive of occupational asthma (OA). RESULTS: The prevalence of OA was 9.1%. Sensitization to dog allergens was higher than to cats. The multivariate logistic regression analysis revealed a significant role of positive family history of atopy and having a dog as pet in the past for the development of occupational airway allergy (OR 5.9; 95% CI 1.76, 20.00; P = 0.003; OR 6.47; 95% CI 1.90, 22.02; P = 0.002, respectively). In the multivariate logistic regression analysis, the risk for developing OA was most clearly associated with growing up in the country (OR 7.59; 95% CI 1.25, 45.9; P = 0.025). CONCLUSIONS: Allergic disease is a serious occupational health concern for subjects who have occupational contact with cats and dogs.

• [Kawasaki disease in children--9 years experience]

  Authors: Monika Kowalczyk, Wanda Kawalec, Jadwiga Daszkowska-York, Anna Turska-Kmieć, Grazyna Brzezińska-Rajszys, Dorota Sobielarska, Lidia Ziółkowska, Andrzej Kościesza, Dorota Jagiełłowicz, Alicja Mirecka-Rola

  Medycyna wieku rozwojowego. 9(2):179-93.

  PURPOSE: The aim of the study was assessment of the course and treatment of Kawasaki disease on the basis of own experience. MATERIAL AND METHODS: Between November 1995 and December 2004 KawasakiPURPOSE: The aim of the study was assessment of the course and treatment of Kawasaki disease on the basis of own experience. MATERIAL AND METHODS: Between November 1995 and December 2004 Kawasaki disease (KD) was diagnosed in 30 patients, (20 boys, 10 girls). The median age in acute stage was 20 months (range 1-96 months). Patients were divided into 4 groups (gr) according to changes in coronary arteries (CA). Group 1 (N=13) without CA aneurysms (CAA), group II (N=5) with small (<5mm) CAA. Group III (N=5) with medium (5-8mm) CAA, group IV (N=7) with giant (>8mm) CAA. Echocardiographic examination was performed in all patients. In echocardiographic examination the following were observed: CAA and valvar insufficiency in 15 patients, left ventricle enlargement in 3 patients, pericardial effusion in 6 patients. The treatment was intravenous immunoglobulin and aspirin in all patients, steroid treatment in 2 patients methylprednisolone, in 2 patients prednisone, in l patient hydrocortisone. The anti-inflammatory treatment was started after 10 days of illness in 66.7% of patients. Thrombi in CAA were treated in 6 patients, the treatment was: in all tissue - type plasminogen activator iv and intracoronary in 2 patients; heparin in all; enoxaparine in 3 patients; abciximab in 2 patients; acenocumarol and aspirin in all. Coronary angiographies were performed in 2 patients in acute stage of disease for thrombolytic therapy and in 4 patients during follow-up. Myocardial perfusion was assessed in SPECT (Single Photon Emission Computed Tomography) in 6 patients. Two children with giant CAA died during the first 8 months of acute stage (6.7%), 2 patients we lost from follow-up. 26 patients are in follow-up. RESULTS: during anti-inflammatory treatment (immunoglobulin, aspirin, steroid treatment) loss of fever, normalization of inflammatory markers, and no side effect, were observed except for 1 patient treated with methylprednosolone with thrombi in CAA during treatment and no side effects during treatment. During the follow-up period CAA regressed in 5 patients (35.7%), CAA became smaller in 7 patients (50%), CAA were the same in 2 patients (14.3%). Changes in echocardiographic examination: valvar insufficiency, left ventricle enlargement, pericardial effusion, disappeared during follow-up. Perfusion defects were observed in 4 patients in SPECT. In coronary angiography changes were observed in coronary arteries in 4 patients. CONCLUSIONS: 1. Kawasaki disease was diagnosed in 66.7% children after 10 days of illness. 2. Coronary artery aneurysms were found in 56.6% treated children. 3. Regression of CAA was observed in 37.5% patients mainly with small CAA. They became smaller in 50% cases mainly with medium and giant CAA. 4. Mortality rate was 6.7% and concerned children with giant CAA; they died during the first 8 months of illness. 5. Thrombolytic treatment of thrombi in CAA (rt-PA, heparin, enoxaparine, abciximab, acenocumarol, aspirin) was safe and successful. 6. In all patients with medium and giant CAA in the acute stage, changes were observed in echocardiographic, angiographic examination and myocardial perfusion during follow-up.

• [Symptoms, diagnosis and characteristic abnormalities in the coronary arteries in Kawasaki disease in children].

  Authors: Monika Kowalczyk, Anna Turska-Kmieć, Lidia Ziółkowska, Małgorzata Raszek, Wanda Kawalec

  Medycyna wieku rozwojowego. 14(4):344-9.

  Kawasaki disease (KD) is a vasculitis of unknown etiology, the diagnosis is based upon symptoms, characteristic abnormalities in the coronary arteries are the most importantKawasaki disease (KD) is a vasculitis of unknown etiology, the diagnosis is based upon symptoms, characteristic abnormalities in the coronary arteries are the most important complications. Establishment of a data base of the patients with KD, assignation of symptoms, and frequency of abnormalities in the coronary arteries according to the clinical manifestations and time of the diagnosis. The patients'data from selected centres of paediatric cardiology were put into a questionnaire form in the Internet. The data of 120 children were placed into data base in the year 2007, of which we analyzed 112 cases. The most frequent symptoms were fever and abnormalities of oral mucosa. Complete KD was diagnosed in 73%, incomplete in 27% (median of age 28 and 19 months respectively). The disease was diagnosed before its 10th day in 60% with similar frequency of both clinical manifestations, abnormalities in the coronary arteries were observed in 59% with complete and in 44% with incomplete KD clinical sings. The disease lasting longer than 70 days was diagnosed in 40% with similar frequency in both groups of clinical manifestations, abnormalities in the coronary arteries were in 79% with complete and in 75% with incomplete KD. In all cases, abnormalities in coronary arteries were in 67% with complete and in 57% with incomplete KD. The most frequent symptoms of Kawasaki disease are fever and abnormalities in the oral mucosa. Incomplete KD is more frequent in younger children. Despite complete KD in 40% of cases diagnosis was delayed. Abnormalities in the coronary arteries were more frequent in patients in whom KD was diagnosed only after the 10th day of the illness, but with the same frequency in both clinical manifestations. Diagnosis of incomplete KD before the 10th day of the illness was associated with lower risk of incidence of abnormalities in the coronary arteries.