Iwona Brzosko

Publications of Iwona Brzosko

• [Adverse effects of cyclosporin a observed in rheumatoid arthritis and psoriatic arthritis].

  Authors: Krzysztof Prajs, Jacek Fliciński, Hanna Przepiera-Bedzak, Iwona Brzosko, Lidia Ostanek

  Annales Academiae Medicae Stetinensis. 01/2010; 56 Suppl 1:48-51.

  INTRODUCTION: Rheumatoid arthritis (RA) and psoriatic arthritis (PA) represent diseases which often demand aggressive therapy in order to control the process and inhibit lesion formation in jointsINTRODUCTION: Rheumatoid arthritis (RA) and psoriatic arthritis (PA) represent diseases which often demand aggressive therapy in order to control the process and inhibit lesion formation in joints and organs. This kind of therapy can be achieved with cyclosporin A (CsA), particularly when combined with methotrexate (MTX). This combination is far more effective than single-drug therapy and is capable of significantly reducing the number of articular lesions. Considering the fact that monotherapy is associated with many adverse effects, it is feared that both drugs in combination may produce cumulative toxicity. The aim of this work was to determine the frequency of adverse effects caused by CsA in patients treated for RA and PA at the Outpatient Rheumatology Clinic of the First Public Hospital in Szczecin. MATERIAL AND METHODS: Our study group consisted of 61 patients, including 47 with RA--35 females, mean age 51 yrs (range: 21-69 yrs), mean disease duration 9.9 yrs (range: 2-23 yrs); 12 males, mean age 51.8 yrs (range: 33-74 yrs), mean disease duration 8 yrs (range: 3-14 yrs) and 14 with PA--6 females, mean age 41.1 yrs (range: 33-55 yrs), mean disease duration 7.8 yrs (range: 2-16 yrs); 8 males, mean age 42.9 yrs (range: 35-50 yrs), mean disease duration 7.0 yrs (range: 0.5-21 yrs). All patients were on MTX. During 11 years of follow-up, CsA was withdrawn due to adverse effects in 20 patients (32.8%). The following adverse effects were observed: arterial hypertension (n=19), hand tremor (n=11), hirsutism (n=7), elevated creatinine (n=17), gingival hypertrophy (n=9), abnormal appetite (n=2), peripheral neuropathy (n=1), lymphocytosis (n=1), skin lesions (n=1), diarrhea (n=2), recurrent infections (n=1), candidiasis (n=1), zoster (n=1), and neoplasm (n=2). Adverse effects responsible for withdrawal of CsA in 14 patients (23%) appeared more frequently during the first 12 months of therapy. Our observations indicate that CsA is well tolerated. The majority of adverse effects subsided after dose reduction or temporary withdrawal of the drug.

• [Cardiovascular manifestations of seronegative inflammatory spondyloarthropathies].

  Authors: Hanna Przepiera-Bedzak, Iwona Brzosko, Małgorzata Peregud-Pogorzelska, Marek Wódecki, Marek Brzosko

  Annales Academiae Medicae Stetinensis. 01/2010; 56 Suppl 1:62-5.

  Cardiovascular manifestations of seronegative spondyloarthropathies represent an important clinical problem which has not been fully elucidated. Clinically significant cardiovascular symptoms areCardiovascular manifestations of seronegative spondyloarthropathies represent an important clinical problem which has not been fully elucidated. Clinically significant cardiovascular symptoms are present in 10% of patients with ankylosing spondylitis (AS), usually in the case of long-standing disease. The following echocardiographic abnormalities have been reported in AS: ascending aortitis, aortic insufficiency (1-34%), mitral insufficiency (1-76%), mitral valve prolapse (5.7-10%), and diastolic dysfunction (20-50%). Abnormalities of the cardiac conduction system may develop in 1% to 33% of AS patients as a consequence of postinflammatory scarring of the myocardium. Cardiovascular diseases are the leading cause of death (36.2%) of patients with psoriatic arthritis (PsA). The risk of death in PsA is 1.3 times greater than in the general population. The following echocardiographic abnormalities can be seen in PsA: fibrinous pericarditis (18.2%), myocarditis (15.9%), and valvular disease (5.7%). Diastolic dysfunction in PsA correlates with the presence of articular lesions and duration of psoriasis. The importance of a thorough investigation of the cardiovascular system in patients with seronegative spondyloarthropathies is emphasized.

• [Ear involvement in Wegener's granulomatosis]

  Authors: Marek Wódecki, Iwona Brzosko, Hanna Przepiera-Bedzak, Marek Brzosko

  Wiadomości lekarskie (Warsaw, Poland : 1960). 02/2007; 60(11-12):574-7.

  Clinical manifestation of Wegener's granulomatosis could be multiorgan. Authors present the review of literature concerning on inflammatory changes in ears that in consequence could lead to hearingClinical manifestation of Wegener's granulomatosis could be multiorgan. Authors present the review of literature concerning on inflammatory changes in ears that in consequence could lead to hearing impairment or deafness.

• [Glottis morphology in rheumatoid arthritis]

  Authors: Katarzyna Amernik, Czesława Tarnowska, Iwona Brzosko, Halina Grzelec, Mirosław Burakl

  Otolaryngologia polska. The Polish otolaryngology. 02/2007; 61(1):85-90.

  Rheumatoid arthritis (RA) is an inflammatory disease of the connective tissue, which can affect larynx and cricoarytenoid (CA) joints, as well. The AIM of this study was assessment of 1) glottisRheumatoid arthritis (RA) is an inflammatory disease of the connective tissue, which can affect larynx and cricoarytenoid (CA) joints, as well. The AIM of this study was assessment of 1) glottis morphology and frequency of laryngeal structures involvement in RA of peripheral joints and 2) evaluation of rheumatoid patients' complaints which can indicate the laryngeal involvement. MATERIAL: 77 patients were examined (71 women and 16 men) in the age from 19 to 77 (mean 56,69). RA duration was from 1 month to 29 years (mean 9,38). RA was active in 61% of patients. Method: Anamnesis, physical examination, videolaryngoscopy, computer tomography, electromyography. RESULTS: The most frequent complaints were: foreign body sensation in the throat (51%), hoarseness (47%) with accompanying weakness of voice and dysphagia. In videolaryngoscopic examination swelling and/or redness of mucosal tissue in CA area was observed in 45% of patients. In 3 women impairment of vocal folds was stated, in 1 it was limitation of right vocal fold mobility and in 2 bilateral vocal folds immobility and tracheotomy was necessary. In patients with active RA and with foreign body sensation in the throat significantly more often inflammatory changes in larynx were visible. CONCLUSIONS: 1. Rheumatoid inflammation in the larynx is demonstrated by swelling and/or redness of mucosal tissue in CA area and in some individuals by its immobilization. 2. In the periods of RA intensification complains of foreign body sensation in the throat and hoarseness may indicate on laryngeal involvement. Our study results justify a suggestion of continuation of the morphological and functional changes estimation in patients with peripheral RA.

• [SAPHO syndrome--clinical features].

  Authors: Hanna Przepiera-Bedzak, Iwona Brzosko, Jacek Fliciński, Włodzimierz Samborski, Marek Brzosko

  Polskie Archiwum Medycyny Wewnętrznej. 12/2006; 116(6):1172-7.

  Presentation of clinical features of the SAPHO syndrome. Seventeen patients (15 women and 2 men) with confirmed diagnosis of the SAPHO syndrome was presented. The culture of biopsy of pustulotic skinPresentation of clinical features of the SAPHO syndrome. Seventeen patients (15 women and 2 men) with confirmed diagnosis of the SAPHO syndrome was presented. The culture of biopsy of pustulotic skin lesions was performed in 11 patients. ESR, C-reactive protein level and Waaler-Rose test were determined in all patients, and antinuclear antibodies and bone scintigraphy were performed in 16 patients. X-ray of the sterno-clavicular joints was performed in 15 patients. The age of patients was 22-59 yr. (mean: 47.1 yr). The duration of joint symptoms was 0.1-25 yr. (mean: 4.4 years). Pustulosis was presented in 16 patients, only 1 patient had acne. All patients suffered from pain localized on the anterior chest wall. Tenderness of the peripheral joints: wrist (in 7 patients), shoulder (in 7 patients), knee (in 4 patients) was shown. In 6 patients, skin changes preceded joint symptoms, in 2 patients skin changes followed joint symptoms after 5 and 10 yr., respectively. All patients had negative the Waaler-Rose test. Active inflammatory process characterized by an increased ESR and C-reactive protein level was present in 12 patients. Abnormalities in x-ray of the sterno-clavicular joints were present in 4 patients. Characteristic alternations for the SAPHO syndrome in scintigraphic picture of the skeleton were observed in 14 patients. All patients were treated with non-steroidal anti-inflammatory drugs. In 8 patients, treatment with antibiotics, in 11 patients--with sulfasalazine, in 3 patients--with methotrexate and low doses of glucocorticosteroids, in 1 patient--with colchicines was performed. Association of typical skin changes with pain of the anterior chest wall is the key for diagnosis of the SAPHO syndrome. It seems that this syndrome is more common in Poland than it has been previously estimated.

• [Activity of the disease and selected echocardiographic abnormalities in ankylosing spondylitis]

  Authors: Hanna Przepiera-Bedzak, Małgorzata Peregud-Pogorzelska, Marek Brzosko, Iwona Brzosko, Edyta Płońska, Zdzisława Kornacewicz-Jach

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 04/2006; 20(117):296-8.

  Cardiovascular involvement in the course of ankylosing spondylitis (AS) is a very important problem. The aim was to assess the influence of the activity of the disease on echocardiographicCardiovascular involvement in the course of ankylosing spondylitis (AS) is a very important problem. The aim was to assess the influence of the activity of the disease on echocardiographic abnormalities in ankylosing spondylitis. MATERIAL AND METHODS: We studied 38 AS patients. Activity of the disease was assessed according to the ESR and following indexes: BASMI, BASFI, BASDAI, BASG-t, BASG-6. Using 2-dimensional echo Doppler (Acuson 128XP) the heart dimensions were determined according to the American Society of Echocardiography guidelines. RESULTS: Patients with mitral valve prolapse compared with the group of the AS patients without this abnormality had significant higher (p = 0.05) activity of the disease assessed by ESR. Patients with aortic incompetence compared with the group of the AS patients without this abnormality, had significant (p = 0.04) lower disease activity assessed by BASG-6. We found significant negative correlation between EF and disease duration, and significant lower disease activity assessed by BA SG-6. Patients with pericardial effusion compared with group without this had significant shorter (p = 0.05) disease duration. CONCLUSION: There was no significant influence of the following indexes: BASMI, BASFI, BASDAI, BASG-t, BASG-6 of the activity of the disease on echocardiographic abnormalities in ankylosing spondylitis.

• [Quality of life and activity of disease in patients with rheumatoid arthritis]

  Authors: Krzysztof Prajs, Jacek Fliciński, Iwona Brzosko, Hanna Przepiera-Bedzak, Lidia Ostanek, Marek Brzosko

  Annales Academiae Medicae Stetinensis. 02/2006; 52 Suppl 2:39-43.

  PURPOSE: The aim of this study was to evaluate the quality of life in patients with rheumatoid arthritis (RA) considering their age, activity of the disease, its duration and radiological stage.PURPOSE: The aim of this study was to evaluate the quality of life in patients with rheumatoid arthritis (RA) considering their age, activity of the disease, its duration and radiological stage. MATERIAL AND METHODS: The study group consisted of 151 women (mean age 55.0 years, mean duration of RA 9.4 years) and 45 men (mean age 55.0 years, mean duration of RA 9.4 years). All subjects were treated at the Department of Rheumatology and at the SPSK-1 rheumatology outpatient clinic in Szczecin. Diagnosis of RA was established according to ARA criteria of 1987. The radiological stage of the disease was established according to Steinbrocker's criteria. The patient's quality of life was evaluated with the Health Assessment Questionnaire. The activity of RA was determined with the Disease Activity Score DAS 28. RESULTS: Significant correlation between HAQ score and DAS 28 was found (correlation coefficient--R = 0.38; p < 0.001). Age (R = 0.31, p < 0.001) and radiological stage of RA (R = 0.26, p < 0.001) were also found to affect the quality of life. CONCLUSIONS: The quality of life of patients with rheumatoid arthritis is significantly influenced by their age, activity of the disease, and radiological stage of RA.

• [Adult-onset Still's disease]

  Authors: Jacek Fliciński, Marcin Milchert, Lidia Ostanek, Iwona Brzosko, Hanna Przepiera-Bedzak, Krzysztof Prajs, Marek Brzosko

  Annales Academiae Medicae Stetinensis. 02/2006; 52 Suppl 2:111-4.

  INTRODUCTION: The authors present the course and manifestations of adult-onset Still's disease on the basis of five cases diagnosed at the Department of Rheumatology, Pomeranian Medical University inINTRODUCTION: The authors present the course and manifestations of adult-onset Still's disease on the basis of five cases diagnosed at the Department of Rheumatology, Pomeranian Medical University in Szczecin. MATERIAL AND METHODS: The usefulness of two most popular sets of diagnostic criteria of adult-onset Still's disease (Yamaguchi and Cush) was analyzed. At onset of the disease, two out of five patients met both sets of the diagnostic criteria, two others met criteria of Yamaguchi and one of Cush. During follow-up, criteria of Yamaguchi were met in all cases. RESULTS: The authors suggest to use the Cushs criteria of adult-onset Still's disease when the patient does not meet the criteria of Yamaguchi and other causes of fever are excluded.

• [Churg-Strauss syndrome--report of four cases]

  Authors: Iwona Brzosko, Marek Brzosko, Lidia Ostanek, Hanna Przepiera-Bedzak, Jerzy Grabarek

  Polskie archiwum medycyny wewnȩtrznej. 05/2005; 113(4):352-8.

  Four subsequent cases of Churg-Strauss syndrome were presented. The patients fulfilled criteria of the syndrome developed by American College of Rheumatology. They were treated with combination ofFour subsequent cases of Churg-Strauss syndrome were presented. The patients fulfilled criteria of the syndrome developed by American College of Rheumatology. They were treated with combination of systemic corticosteroids and cyclophosphamide, one patient was additionally treated with plasmapheresis. In all four cases complete remission of the disease was achieved.

• Therapy with infliximab decreases the CD4+CD28- T cell compartment in peripheral blood in patients with rheumatoid arthritis.

  Authors: Andrzej Pawlik, Lidia Ostanek, Iwona Brzosko, Marek Brzosko, Marek Masiuk, Boguslaw Machalinski, Barbara Gawronska-Szklarz

  Rheumatology international. 12/2004; 24(6):351-4.

  Chronic inflammatory syndromes such as rheumatoid arthritis (RA) are associated with high frequencies of CD4+CD28- T cells. The number of these cells is genetically determined and may also be aChronic inflammatory syndromes such as rheumatoid arthritis (RA) are associated with high frequencies of CD4+CD28- T cells. The number of these cells is genetically determined and may also be a consequence of chronic exposure to tumor necrosis factor-alpha (TNFalpha). The aim of this study was to examine whether the reported efficacy of anti-TNFalpha therapy in RA involves a resurgence of T cell populations that re-express CD28. After 36-week therapy with infliximab, a significant decrease in CD4+CD28- T cells in RA patients was observed in comparison with baseline. The results suggest that TNFalpha-neutralizing therapy may restore T cell homeostasis and reduce expansion of the CD28- T cells, which are cytotoxic and may contribute to organ manifestations in RA.

• [The influence of FcgammaRIIa polymorphism on rheumatoid arthritis]

  Authors: Andrzej Pawlik, Lidia Ostanek, Iwona Brzosko, Ewa Dabrowska-Zamojcin, Marek Brzosko, Marcin Florczak, Barbara Gawrońska-Szklarz

  Polskie archiwum medycyny wewnȩtrznej. 09/2004; 112(2):907-10.

  The FcgammaRIIa receptor is most widely distributed of the Fcgamma receptors and is expressed on the most types of immunocomponent cells. Polymorphism of the FcgammaRIIa receptors may modulate immuneThe FcgammaRIIa receptor is most widely distributed of the Fcgamma receptors and is expressed on the most types of immunocomponent cells. Polymorphism of the FcgammaRIIa receptors may modulate immune complex mediated inflammation, particularly when immune complex contains IgG. The aim of the study was to evaluate the influence the FcgammaRIIa polymorphism on disease parameters activity in patients with rheumatoid arthritis (RA). The study included 75 patients with RA diagnosed according to the American College of Rheumatology criteria. In each patient the following parameters of disease activity were evaluated during one-year period: number of swollen and tender joints, morning stiffness duration, CRP, ESR as well as the disease activity in global physical assessment. There was no correlation between disease activity parameters and FcgammaRIIa polymorphism. Our results suggest, that FcgammaRIIa polymorphism does not represent an important genetic risk factor for RA activity.

• The urinary excretion of pyridinoline and deoxypyridinoline during rheumatoid arthritis therapy with infliximab.

  Authors: Lidia Ostanek, Andrzej Pawlik, Iwona Brzosko, Marek Brzosko, Rozalia Sterna, Marek Droździk, Barbara Gawrońska-Szklarz

  Clinical rheumatology. 07/2004; 23(3):214-7.

  Rheumatoid arthritis is a systemic disease that causes inflammation and joint destruction. As a result of pathological destruction in bone and cartilage, crosslinks in collagen are resorbed moreRheumatoid arthritis is a systemic disease that causes inflammation and joint destruction. As a result of pathological destruction in bone and cartilage, crosslinks in collagen are resorbed more rapidly. This causes a rise in circulating collagen crosslink levels and their urinary excretion. In RA, apart from the crosslink resorption at the site of inflamed joints, there may be increased resorption due to general bone loss associated with disease activity. The aim of this study was to evaluate the influence of therapy with infliximab on urinary excretion of pyridinoline (PYD) and deoxypyridinoline (DPYR) as a markers of collagen degradation and its correlation with clinical and biochemical parameters of disease activity. Seventeen patients with active rheumatoid arthritis treated with infliximab were recruited into the study. The therapy resulted in the reduction in the symptoms of RA and urinary excretion of PYD and DPYR. The urinary excretion of PYD correlated with a number of swollen joints, morning stiffness, CRP and ESR. The urinary excretion of DPYR correlated during infliximab therapy with the number of swollen and tender joints and morning stiffness. The measurement of urinary excretion of PYR and DPYR may give insight into bone metabolism and help us to better understand the actual changes in bone and cartilage caused by RA and its treatment.

• [SAPHO syndrome]

  Authors: Hanna Przepiera-Bedzak, Marek Brzosko, Iwona Brzosko

  Polskie archiwum medycyny wewnȩtrznej. 03/2004; 111(2):265-8.

• [Fixation of the crico-arythenoid joints in rheumatoid arthritis--preliminary report]

  Authors: Czesława Tarnowska, Katarzyna Amernik, Grzegorz Matyja, Iwona Brzosko, Halina Grzelec, Mirosław Burak

  Otolaryngologia polska. The Polish otolaryngology. 02/2004; 58(4):843-9.

  Rheumatoid arthritis (RA) is a systemic disease of connective tissue which affects joints lined with synovial membrane. Laryngeal joints also have such a structure. Among all reasons leading to theirRheumatoid arthritis (RA) is a systemic disease of connective tissue which affects joints lined with synovial membrane. Laryngeal joints also have such a structure. Among all reasons leading to their inflammation rheumatoid arthritis is mentioned on the first place. In larynx RA mostly affects cricoarythenoid joints (CA). RA of the CA joints is found in 27% to 78% suffering from RA. In the acute phase of the disease patients complain of burning and foreign body sensation in the throat, hoarseness, pain on speaking, voice fatigability, problems with swallowing. Chronic RA of the CA joints can lead to their fixation and dyspnoea, requiring emergency tracheotomy. According to the literature, this state occurs in 10% to 25% patients suffering from RA. A case of 75 years old woman is presented, who was admitted to our Clinic with severe inspiratory dyspnoea requiring tracheotomy. She was suffering from RA for 26 years. She complained of effort dyspnoea, problems with swallowing and tightness sensation in the throat for 4 years. Patient complained also about cervical spine pain, upper right extremity and knee joint periodic oedema. The patient was suffering from so severe lower extremities pain and rheumatoid changes in knee joints that she had to walk on crutches. Little hands' joints were deformed with significant ulnarisation. Videolaryngostroboscopic examination showed no movement in CA joints, paramedian position of the vocal folds and narrowing of the glottic rim to 1.5 mm. Phonatory mobility of the vocal folds was preserved. Electromiographic examination of the internal laryngeal muscles made a) during phonation--showed bilateral normal bioelectrical record from thyroarythenoid muscles, b) at rest--there was no denervation activity. In computerized tomography study no degenerative changes in CA joints were found. On the basis of clinical view and examinations results, there was considered that fixation in CA joints was due to degenerative changes, which were the result of their rheumatoid inflammation. It was emphasized that this subject has been mentioned only several times in laryngological and phoniatric handbooks and in few articles.

• The expansion of CD4+CD28- T cells in patients with rheumatoid arthritis.

  Authors: Andrzej Pawlik, Lidia Ostanek, Iwona Brzosko, Marek Brzosko, Marek Masiuk, Boguslaw Machalinski, Barbara Gawronska-Szklarz

  Arthritis research & therapy. 02/2003; 5(4):R210-3.

  Clonal expansion of CD4+CD28- T cells is a characteristic finding in patients with rheumatoid arthritis (RA). Expanded CD4+ clonotypes are present in the peripheral blood, infiltrate into the joints,Clonal expansion of CD4+CD28- T cells is a characteristic finding in patients with rheumatoid arthritis (RA). Expanded CD4+ clonotypes are present in the peripheral blood, infiltrate into the joints, and persist for years. CD4+CD28- T cells are oligoclonal lymphocytes that are rare in healthy individuals but are found in high percentages in patients with chronic inflammatory diseases. The size of the peripheral blood CD4+CD28- T-cell compartment was determined in 42 patients with RA and 24 healthy subjects by two-color FACS analysis. The frequency of CD4+CD28- T cells was significantly higher in RA patients than in healthy subjects. Additionally, the number of these cells was significantly higher in patients with extra-articular manifestations and advanced joint destruction than in patients with limited joint manifestations. The results suggest that the frequency of CD4+CD28- T cells may be a marker correlating with extra-articular manifestations and joint involvement.

• Increased genotype frequency of N-acetyltransferase 2 slow acetylation in patients with rheumatoid arthritis.

  Authors: Andrzej Pawlik, Lidia Ostanek, Iwona Brzosko, Barbara Gawroska-Szklarz, Marek Brzosko, Ewa Dabrowska-Zamojcin

  Clinical pharmacology and therapeutics. 09/2002; 72(3):319-25.

  OBJECTIVES: Acetylation polymorphism can alter therapeutic responses and toxicity to certain xenobiotics and may also be a factor that influences a patient's susceptibility to certain diseases. WeOBJECTIVES: Acetylation polymorphism can alter therapeutic responses and toxicity to certain xenobiotics and may also be a factor that influences a patient's susceptibility to certain diseases. We investigated whether patients with rheumatoid arthritis (RA) differed from healthy individuals with regard to genotype of the polymorphic enzyme N-acetyltransferase 2 (NAT2). METHODS: NAT2 polymorphism was compared in 118 healthy subjects and 82 patients with RA. NAT2 alleles (*4, *5, *6, and *7) were determined by polymerase chain reaction-restriction fragment length polymorphism methods with deoxyribonucleic acid extracted from peripheral blood. RESULTS: A statistically significant increase in the proportion of homozygous slow acetylators with 2 mutated alleles (84.1%) was found among patients with RA in comparison with healthy subjects (52.5%; P <.0001). The risk of development of RA was almost 5-fold greater in slow acetylators than in fast acetylators (odds ratio, 4.79; 95% confidence interval, 2.28-10.21). There was no correlation between NAT2 polymorphism and presence of rheumatoid factor, extra-articular manifestations, and age at first occurrence of disease symptoms. CONCLUSIONS: NAT2 slow acetylation genotype may be a risk factor of individual susceptibility to RA.

• [Skeletal changes during the course of pustulosis palmoplantaris--report of two cases]

  Authors: Hanna Przepiera-Bedzak, Iwona Brzosko, Marek Brzosko

  Polskie archiwum medycyny wewnȩtrznej. 02/2002; 107(1):59-62.

  We report two cases of coincidence palmoplantar pustulosis and joint changes. Two patients fulfilled criteria for arthroosteitis pustulosa: pustular eruptions of the palms and soles and pain ofWe report two cases of coincidence palmoplantar pustulosis and joint changes. Two patients fulfilled criteria for arthroosteitis pustulosa: pustular eruptions of the palms and soles and pain of sterno-clavicular joint. They also fulfills criteria for SAPHO syndrome: osteoarticular manifestations of palmoplantar pustulosis. Clinical examination and scintigraphy confirmed the diagnoses. Treatment was started with antibiotics and nonsteroid anti-inflammatory drugs. Oral corticosteroids therapy with methotrexate was given to one patient.

• Cardiac arrhythmias and conduction disturbances in patients with ankylosing spondylitis.

  Authors: Jaroslaw Kazmierczak, Malgorzata Peregud-Pogorzelska, Jowita Biernawska, Hanna Przepiera-Bedzak, Jaroslaw Goracy, Iwona Brzosko, Edyta Plonska, Marek Brzosko

  Angiology. 58(6):751-6.

  Conduction disturbances, aortic incompetence, and myocardial fibrosis are known complications in adult patients with ankylosing spondylitis (AS). Its incidence has been reported to be 10% to 30%;Conduction disturbances, aortic incompetence, and myocardial fibrosis are known complications in adult patients with ankylosing spondylitis (AS). Its incidence has been reported to be 10% to 30%; however, less attention has been paid to all cardiac arrhythmias. The aim of this study was to evaluate arrhythmias and conduction disturbances in patients with AS using electrocardiograms and Holter monitoring (including heart rate variability analysis) and to estimate its relationships with age, gender, clinical features, and duration of AS. Thirty-one patients with AS (20 to 69 years old, mean 50 +/- 14) and 22 healthy volunteers (26 to 69 years old, mean 49 +/- 13) underwent rheumatologic and cardiologic evaluations. Ventricular extrasystoles were present in 55% of AS patients and in 28% of controls. Supraventricular extrasystoles were present in 94% of AS patients and 100% of controls. The frequency of ventricular extrasystoles was found to be higher in the AS patients than in the control subjects. Significant differences were found in heart rate variability analyses: ultra low-frequency power and root mean square recessive difference (r-MSSD) were lower in the AS group. When the AS group was divided into subgroups (stages 3 and 4), significant differences were found between control subjects and stage 3 patients in PR interval, heart rate (HR), T-wave duration, ultra low frequency, and r-MSSD and between controls and stage 4 patients in HR, T-wave duration, and r-MSSD. QTc and QTd were not significantly different in groups and subgroups and were not correlated with any other clinical or electrocardiographic parameter. Cardiac arrhythmias were more frequent in patients with AS than in the healthy population. Simple electrocardiograms and Holter parameters do not correlate with the incidence of VESs, age, gender, clinical features, and duration of AS.

• Coronary stenosis treated by percutaneous angioplasty in a patient with dermatomyositis.

  Authors: Jaroslaw Kazmierczak, Malgorzata Peregud-Pogorzelska, Iwona Brzosko

  Angiology. 59(1):117-20.

  A female patient suffering from dermatomyositis in whom symptoms of heart failure without angina is described. An impairment of left ventricular function and significant coronary lesions wereA female patient suffering from dermatomyositis in whom symptoms of heart failure without angina is described. An impairment of left ventricular function and significant coronary lesions were diagnosed using noninvasive and invasive procedures. Coronary angioplasty with stent implantation was successfully applied to improve the quality of life and clinical symptoms.