A Jedryka-Góral

Instytut Reumatologii w Warszawie, Warszawa, Masovian Voivodeship, Poland

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Publications (37)115.25 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: The principle of treating-to-target has been successfully applied to many diseases outside rheumatology and more recently to rheumatoid arthritis. Identifying appropriate therapeutic targets and pursuing these systematically has led to improved care for patients with these diseases and useful guidance for healthcare providers and administrators. Thus, an initiative to evaluate possible therapeutic targets and develop treat-to-target guidance was believed to be highly appropriate in the management of systemic lupus erythematosus (SLE) patients as well. Specialists in rheumatology, nephrology, dermatology, internal medicine and clinical immunology, and a patient representative, contributed to this initiative. The majority convened on three occasions in 2012-2013. Twelve topics of critical importance were identified and a systematic literature review was performed. The results were condensed and reformulated as recommendations, discussed, modified and voted upon. The finalised bullet points were analysed for degree of agreement among the task force. The Oxford Centre level of evidence (LoE, corresponding to the research questions) and grade of recommendation (GoR) were determined for each recommendation. The 12 systematic literature searches and their summaries led to 11 recommendations. Prominent features of these recommendations are targeting remission, preventing damage and improving quality of life. LoE and GoR of the recommendations were variable but agreement was >0.9 in each case. An extensive research agenda was identified, and four overarching principles were also agreed upon. Treat-to-target-in-SLE (T2T/SLE) recommendations were developed by a large task force of multispecialty experts and a patient representative. It is anticipated that 'treating-to-target' can and will be applicable to the care of patients with SLE.
    Annals of the rheumatic diseases 04/2014; 73(6). DOI:10.1136/annrheumdis-2013-205139 · 10.38 Impact Factor
  • Joanna Bugajska · Anna Jedryka-Góral · Robert Gasik · Dorota Zołnierczyk-Zreda ·
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    ABSTRACT: Acquired musculoskeletal dysfunction syndromes (overload syndromes) that cause limitation of the system efficiency belong nowadays to the most serious problems in the medical care of workers. The etiology of overload syndromes is multifactorial, which means that occupational factors constitute only one of many causes fostering the development of those disorders. Occupational factors which increase the risk of musculoskeletal disorders include physical factors related to the work environment or the way the work is performed, such as body posture, value of exerted forces, movement repetitiveness, load handling, mechanical vibration or microclimate as well as psychosocial factors, such as quantitative and qualitative overload, lack of control, lack of social support or work insecurity. The consequence of musculoskeletal overload syndromes is the progressing reduction of its efficiency causing limitation or even loss of work ability, which results in premature exclusion from social and occupational activities. This article presents etiological factors of musculoskeletal complains and overload syndromes and their prevalence in workers.
    Medycyna pracy 05/2011; 62(2):153-61. · 0.40 Impact Factor
  • Joanna Bugajska · Dorota Zołnierczyk-Zreda · Anna Jedryka-Góral ·
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    ABSTRACT: The aim of the study was to determine the role of psychosocial work factors in the development of musculoskeletal disorders in workers. It should be stressed that over a decade these disorders have been the subject of studies because of complaints reported not only by workers performing heavy physical work or working in awkward, forced body posture. It has also been acknowledged that stress at work caused by various psychosocial work factors can significantly influence their development. One of the models, most popular nowadays, was used in the study. It takes into account various risk factors in the etiology of cervical spine disorders. Based on this model it was shown that certain psychosocial and cultural variables (e.g., work demands and control, individual variables, individual values, work group's culture) may constitute occupational stressors and, when combined with physical load factors, may lead to stress and musculoskeletal disorders. It was also indicated that such psychosocial work factors as excessive work demands (quantitative or qualitative), inadequate control at work or lack of social support are the most frequent sources of work-related stress. The article presents the results of some prospective studies in which the role of these factors in the development of musculoskeletal disorders has been considered. Apart from work properties (factors), the role of other psychological variables was shown; these include: work involvement, perfectionism, negative affectivity or work style, which in numerous studies turned out to be important risk factors in the development of musculoskeletal disorders. Finally, potential mechanisms underlying the relationships between psychosocial factors and musculoskeletal disorders were indicated. However, it was stressed that the majority of them still require to be confirmed in future descriptive or experimental studies.
    Medycyna pracy 01/2011; 62(6):653-8. · 0.40 Impact Factor
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    ABSTRACT: Cultural differences in experiencing individual stress in rheumatoid arthritis (RA) patients might be observed. The aim of the study was to assess quality of life and psychological stress (distress) in RA patients, and to evaluate socio-demographic and disease specific variables predicting stress of patients. The study covered 300 Polish and 137 German RA patients. SF-36v2 scale was used to evaluate the patients' health. Psychological stress was defined as the feeling of "social isolation" and "being a burden" as demanding help in everyday activities. In both countries, the mental and physical health of patients deteriorated and about 50% of patients required support in everyday activities. 95% of Polish and 62% of German patients felt rejected from social activities. For the psychological stress perceived, functional capacity class 3 and male gender were shown to be predictive in Polish patients and living in a small town - in German patients. In the Polish group, the tertiary/bachelor level of education was linked with lower distress level. RA has a serious impact on the mental health owing to a great disease burden. Awareness of impact of the disease on quality of life and psychological stress of patients should be considered in routine clinical practice.
    Autoimmunity reviews 09/2009; 9(4):211-5. DOI:10.1016/j.autrev.2009.08.005 · 7.93 Impact Factor
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    ABSTRACT: This study aimed to assess the incidence of coronary heart disease (CHD) risk factors and cardiovascular risk in physical workers and managers in Poland. There were 232 male subjects: 123 managers (48.9 +/- 11.2 years old) and 109 physical workers (37.5 +/- 11.1 years old). The family history of CHD was recorded and anthropometric and biochemical indices, i.e., body mass index, visceral obesity index, blood pressure, glucose, total cholesterol, fibrinogen, HDL (high density lipoprotein), LDL (low density lipoprotein) and triglycerides were measured. Cardiovascular risk was assessed with the Systematic Coronary Risk Evaluation (SCORE) table system. The factors that turned out to be the most common in the managers were obesity, hypertension, and elevated levels of blood glucose and LDL, whereas cigarette smoking, premature CHD in the family and a high level of fibrinogen were more common in physical workers. Very high cardiovascular risk was found in 35% of managers and in 16% of physical workers.
    International journal of occupational safety and ergonomics: JOSE 02/2009; 15(1):35-43. DOI:10.1080/10803548.2009.11076786 · 0.35 Impact Factor
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    ABSTRACT: This study was conducted to investigate the relationship between perceived work-related stress and preclinical atherosclerosis. A total of 100 managers and 50 office workers aged 35-65 participated in a questionnaire study. Individual, family and work-related stress risk factors and coping were evaluated in all the studied individuals. Serum levels of biochemical (total cholesterol, LDL, HDL, TG, glucose) and serological risk factors of atherosclerosis (anticardiolipin, anti-beta(2) GPI, anti-oxLDL, anti-HSP and anti-hsCRP antibodies) were evaluated. A computer analysis of B-mode ultrasound images was used to assess carotid artery intima-media thickness (IMT) and atherosclerotic plaque in carotid arteries. Statistical analysis was conducted with SPSS v. 11.5. The studied individuals showed average ranges of both the global stress level and of coping results. In 71% no changes were found in the ultrasound image and in 29% of individuals (43) the presence of plaque was shown. The mean value of the IMT measure was 0.0618 +/- 0.013 mm. IMT and plaque correlated negatively with the level of global work-related stress (r = -0.26; P < 0.01; and r = -0.28; P < 0.01; respectively). No correlation was found either between work-related stress and coping, or between coping and IMT (P > 0.05), or between work-related stress and healthy lifestyle (no smoking, no excessive use of alcohol, high physical activity), or between healthy lifestyle and IMT (P > 0.05). Positive correlation between IMT and LDL and smoking did not result from higher stress reaction in the studied individuals. The explanation of the negative correlation between perceived work-related stress and preclinical atherosclerosis was not confirmed either by the subjects under high stress undertaking healthy protective activities or by their escaping into unhealthy behaviour. The most probable interpretation of the results is that in individuals with a low level of perceived work-related stress, somatization of stress takes place.
    International Archives of Occupational and Environmental Health 08/2008; 81(8):1037-43. DOI:10.1007/s00420-007-0297-6 · 2.20 Impact Factor
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    ABSTRACT: Work-related overload syndromes are chiefly associated with the upper limbs, where carpal tunnel syndrome (CTS) plays a leading role. This article analyses methods of diagnosing CTS, with special emphasis on those that can be used by physicians in early diagnosis of CTS in workers doing monotonous work. It also discusses occupational (e.g., assembly work, typing, playing instruments, packaging and work associated with the use of a hammer or pruning scissors) and extra-occupational factors (e.g., post-traumatic deformation of bone elements of the carpal tunnel, degenerative and inflammatory changes in tendon sheaths, connective tissue hypertrophy or formation of crystal deposits) leading to CTS; diagnostic methods (subjective symptoms, physical examination and manual provocative tests, vibration perception threshold, electrophysiological examination and imaging methods); and therapeutic and preventive management tools accessible in occupational medicine practice.
    International journal of occupational safety and ergonomics: JOSE 02/2007; 13(1):29-38. DOI:10.1080/10803548.2007.11076706 · 0.35 Impact Factor
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    ABSTRACT: The ageing European population suffers from chronic diseases, including osteoarthritis (OA). The aim of this study was to investigate the work activity/ability, the quality of life and reciprocal interaction between both in OA patients. A total of 750 OA outpatients were evaluated by a questionnaire study. Work Ability Index (WAI) and General Health Questionnaire 28 (GHQ 28) were used as tools for work ability and quality of life assessment, respectively. Statistical analysis was performed by means of ANOVA tests. A total of 22.2% OA patients were still active professionally. They had decreased work ability and decreased quality of life. A worse work ability and a worse quality of life were related with a blue-collar work, multi-joint localization of OA and co-existence of other diseases. A negative correlation was found between general scores of GHQ 28 and that of WAI and five WAI components. Findings indicate a need for work ability promotion among OA working patients to maintain both, better quality of life and higher level of satisfaction with job.
    Rheumatology International 01/2007; 27(2):131-9. DOI:10.1007/s00296-006-0177-5 · 1.52 Impact Factor
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    ABSTRACT: The aim of the study was to investigate the prevalence of early atherosclerosis in healthy workers and the relationship between classical, psychological, and immunological risk factors and atherosclerosis, as well as their predictive value. One hundred healthy managers and 50 office workers aged 35-65 were studied. In all subjects, individual, family, and occupational stress/coping risk factors were evaluated, including plasma levels of biochemical (total cholesterol, LDL, HDL, TG, glucose) and inflammatory-immunological (aCL, anti-beta(2) GPI, oxLDL, HSP, HSCRP) parameters. Carotid artery intima-media thickness (IMT) and atherosclerotic plaques in carotid arteries were assessed with computer analysis of B-mode ultrasound images. In 107 persons (71%) no changes were found in ultrasound images and in 43 individuals (29%) the presence of plaque was shown. The mean IMT value was 0.0618+/-0.013 mm. Cross-domain analysis showed that core predictors for IMT were age, LDL level, smoking, and occupation (being a manager) (beta=0.33, 0.30, 0.23, and 0.20, respectively); the core predictors for plaque were age, total cholesterol level, and an occupational stressor home-work balance (Wald=7, 6.7, and 5.6, respectively). Immunological factors were not independent predictors. In atherosclerosis, not only traditional risk factors (age, lipid disorders, and lifestyle) but also occupational stress factors may play a role. Immunological factors do not seem to play a role in the development of atherosclerosis in a population of healthy workers. The interplay between occupational stress and atherosclerotic changes requires further investigation.
    European Journal of Internal Medicine 08/2006; 17(4):247-53. DOI:10.1016/j.ejim.2005.12.005 · 2.89 Impact Factor
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    ABSTRACT: The "Euro-Lupus Cohort" is composed by 1000 patients with systemic lupus erythematosus (SLE) that have been followed prospectively since 1991. These patients have been gathered by a European consortium--the "Euro-Lupus Project Group". This consortium was originated as part of the network promoted by the "European Working Party on SLE", a working group created in 1990 in order to promote research in Europe on the different problems related to this disease. The "Euro-Lupus Cohort" provides an updated information on the SLE morbidity and mortality characteristics in the present decade as well as defines several clinical and immunological prognostic factors.
    Autoimmunity Reviews 04/2006; 5(3):180-6. DOI:10.1016/j.autrev.2005.06.004 · 7.93 Impact Factor
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    ABSTRACT: The aim of this study was to investigate the work ability in ageing workers suffering from osteoarthritis (OA), coronary heart disease (CHD) or hypertension (H). One hundred and sixty-six OA and 355 CHD/H outpatients were evaluated. The Work Ability Index (WAI) served for work ability assessment. Patients' results were compared with the results of a control group of 225 healthy young workers. Statistical analysis was performed with ANOVA tests. WAI in female and male CHD/H patients was higher than in OA patients (p < .01), better work ability was related to better education (p < .01), white-collar work (p < .01) and better recreation (p < .01); subjective work ability was determined mostly by the objective health status. The promotion of work ability among workers suffering from advanced age-related diseases should be closely related to the promotion of health. It is indicative to improve occupational education and skills, already at an early stage of a disease.
    International journal of occupational safety and ergonomics: JOSE 01/2006; 12(1):17-30. DOI:10.1080/10803548.2006.11076665 · 0.35 Impact Factor
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    ABSTRACT: The "Euro-Lupus Cohort" is composed by 1,000 patients with systemic lupus erythematosus (SLE) that have been followed prospectively since 1991. These patients have been gathered by a European consortium - the "Euro-Lupus Project Group". This consortium was originated as part of the network promoted by the "European Working Party on SLE", a working group created in 1990 in order to promote research in Europe on the different problems related to this disease. The "Euro-Lupus Cohort" provides an updated information on the SLE morbidity and mortality characteristics in the present decade as well as defines several clinical and immunological prognostic factors.
    Annales de medecine interne 01/2003; 153(8):530-6.
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    ABSTRACT: The whole world experiences progress and development, however it is the human being who pays the price in stress--an inevitable part of modern life. When encountering stress, an individual reacts at the level of both the micro- and macroenvironment. Nowadays, stress is defined as a real or interpreted threat to the physiological or psychological integrity of an individual, which results in a physiological and/or behavioral response. In the article a review of the stress conceptualization, health consequences of stress (its neurophysiology and relation to autoimmune disease) as well as ways of management (exercises and psychotherapeutic intervention) is given.
    Autoimmunity 12/2002; 35(7):421-6. DOI:10.1080/0891693021000038703 · 2.71 Impact Factor
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    ABSTRACT: An abstract is unavailable. This article is available as HTML full text and PDF.
    Medicine 06/2002; 81(3):169-78. · 5.72 Impact Factor

  • Medicine 05/2002; 81(3):169-178. DOI:10.1097/00005792-200205000-00001 · 5.72 Impact Factor

  • Medicine 12/2001; 80(6):355-77. · 5.72 Impact Factor

  • Medicine 11/2001; 80(6):355-377. DOI:10.1097/00005792-200111000-00002 · 5.72 Impact Factor
  • A Kuczyńska-Zardzewiały · W Palasik · A Jedryka-Góral · A Członkowska ·
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    ABSTRACT: Sixty patients (51 women/9 men) with diagnosis of SLE were studied for finding out the frequency of nervous system involvement in SLE, the time of of appearance of neurological involvement after diagnosis establishing, the coexistence of the antiphospholipid syndrome, and the character of changes in MR, CT and CSF. Nervous system involvement was found in 40 cases (67%), with 34 cases (56%) had involvement of the CNS, 6 patients (10%) had symptoms of peripheral nervous system dysfunction, and 3 (5%) had involvement of both systems. In 4 cases polineuropathy and transverse spinal cord lesion, and in 3 cases psychiatric symptoms were the first manifestations of SLE. Changes due to involvement of cerebral vessels (TIA, stroke) were observed in 20 patients (33%), and psychiatric symptoms in 16 cases (26.6%). No difference was found in the occurrence of stroke or TIA between SLE patients with and without antiphospholipid syndrome, and no correlations were noted between the presence of neurological or psychiatric symptoms and other SLE symptoms. CT scans demonstrated corticosubcortical atrophy in 28.3% of cases, while in MRI in T2 images small hyperintense lesions were situated mainly in the white matter (33.9%). In 5 cases oligoclonal band was found in the CSF, but without any correlation with specific neurological symptoms.
    Neurologia i neurochirurgia polska 01/2001; 35(5):781-92. · 0.64 Impact Factor
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    ABSTRACT: Many neurological or psychiatric manifestations of SLE (NP-SLE) are related to the presence of anticardiolipin antibodies (aCL) in the patient's sera. The aim of this study was to evaluate the presence of aCL in cerebrospinal fluid (CSF) in SLE patients with NP features. Fifteen SLE patients were studied, all with NP features. CSF was evaluated for intrathecal IgG synthesis, oligoclonal IgG, and blood-brain barrier impairment. Sera and CSF were tested by ELISA for the presence of aCL-IgG and aCL-IgM with and without beta2 glycoprotein (beta2 GPI) cofactor. CSF and sera of 50 low back pain patients served as controls. Six patients were aCL(+) and nine aCL(-). In all patients the general CSF examination was normal. In all patients the value of indices of intrathecal IgG synthesis were normal but oligoclonal protein was present in the CSF of three patients. In none of the patients was the blood-brain barrier impaired. Neither aCL-IgG nor aCL-IgM was detected in the CSF of any NP-SLE patient. Mean levels of aCL in patients without cofactor beta2 GPI and with cofactor were as follows: for IgG class 0.005 and 0.057 OD (negative); for IgM class 0.004 and 0.024 OD (negative). We could not detect aCL in the CSF of patients with NP-SLE, even if sera were positive for aCL.
    Clinical Rheumatology 02/2000; 19(4):306-10. DOI:10.1007/s100670070051 · 1.70 Impact Factor
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    ABSTRACT: The objective of this study was to determine the HLA class II associations of the anticardiolipin (aCL) and anti-beta2GPI (abeta2GPI) antibodies in a large series of European patients with systemic lupus erythematosus (SLE). A cohort of 577 European SLE patients was enrolled. aCL and abeta2GPI were measured by ELISA methods. Molecular typing of HLA-DRB1, DRB3, DRB4, DRB5, DQA1 and DQB1 loci was performed by the polymerase chain reaction-sequence specific oligonucleotide probes (PCR-SSOP) method. aCL of IgG, IgM and IgA isotypes were detected in 22.8%, 14% and 13.9% of patients, respectively. IgG and IgM abeta2GPI were detected in 20% of patients. aCL showed positive association with HLA DRB1*04, DRB1*0402, DRB1*0403, DRB1*07, DRB3*0301, DQA1*0201, DQA1*0301, DQB1*0302, and negative association with DQA1*0501, DRB3*0202. abeta2GPI showed positive association with DRB1*0402, DRB1*0403, DQB1*0302. DRB1*0402 carried the highest relative risk for the presence of both aCL (RR=8. 1) and abeta2GPI (RR=4.6). Our results confirm the already described associations of aCL with HLA DR4 and DR7, but also demonstrate that, among the alleles at the DRB1*04 locus, the *0402 was most represented both in aCL and in abeta2GPI positive patients. In addition, HLA class II associations of abeta2GPI are for the first time extensively examined in a large cohort of European SLE patients.
    Lupus 02/2000; 9(1):47-55. DOI:10.1177/096120330000900109 · 2.20 Impact Factor

Publication Stats

1k Citations
115.25 Total Impact Points


  • 2000-2014
    • Instytut Reumatologii w Warszawie
      Warszawa, Masovian Voivodeship, Poland
    • Università degli Studi di Siena
      Siena, Tuscany, Italy
  • 2002-2009
    • Central Institute for Labour Protection-National Research Institute
      Warszawa, Masovian Voivodeship, Poland
  • 2006
    • Hospital Clínic de Barcelona
      • Servicio de Enfermedades Autoinmunes y Sistémicas
      Barcino, Catalonia, Spain
  • 1999
    • University of Barcelona
      • Departament de Medicina
      Barcelona, Catalonia, Spain
  • 1992
    • Arthritis Research UK
      Chesterfield, England, United Kingdom