Katarzyna Broll-Waśka

Medical University of Silesia in Katowice, Catowice, Silesian Voivodeship, Poland

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Publications (8)4.77 Total impact

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    ABSTRACT: To our knowledge anorexia nervosa (AN) adversely influences bone density, but whether qualitative characteristics of bone are also affected is not known. For this reason we investigated prospectively the changes in skeletal status in a population of 18 adolescent girls with AN aged 11.5-18.1 years (mean 15.9+/-1.9 years) using both dual-photon X-ray absorptiometry (DXA) and quantitative ultrasound (QUS) measurements, bone turnover markers (osteocalcin, bone alkaline phosphatase - bALP, carboxy-terminal cross-linked telopeptide of type I collagen - ICTP), and laboratory investigations (serum total and ionised calcium, serum phosphate, urine calcium/creatinine ratio, luteinizing hormone - LH, follicle-stimulating hormone - FSH, estradiol). Measurements of bone mineral density at the spine (s-BMD) and total body (TB-BMD) and amplitude-dependent speed of sound (Ad-SOS) of the hand phalanges were performed at baseline, 7.8+/-2.4 and 19.4+/-5.6 months of follow-up. The mean values of TB-BMD, s-BMD and Ad-SOS measurements did not change during the period of observation. The mean Z-scores for TB-BMD and Ad-SOS were significantly lower after 19.4 months of observation vs. baseline (-1.06+/-1.00 vs. -0.67+/-0.98 vs. and -0.50+/-0.88 vs. 0.26+/-1.75, respectively). Z-scores for s-BMD decreased non-significantly (p=0.08). Among bone turnover markers, we observed a significant increase in bALP and a non-significant increase in osteocalcin serum concentrations which were below normal ranges for age, sex and Tanner stage at baseline. High baseline serum ICTP concentration decreased non-significantly, reaching normal ranges during the observation. We conclude that anorexia nervosa seriously affects skeletal status in adolescent girls. Bone turnover markers analysed together with densitometric parameters suggest that AN influences both bone formation and resorption processes. QUS measurements at hand phalanges may be an appropriate method in the evaluation of skeletal status in patients with AN.
    No preview · Article · Aug 2007 · Bone
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    ABSTRACT: Since 1937, when familial precocious puberty (FPP) was described for the first time, only few reports on FPP have been published. The majority of them is concerned with the most investigated form of FPP, occurring only in male --testotoxicosis (male-limited precocious puberty -- MLPP). Recently another form of FPP -- familial hyperestrogenism (aromatase excess syndrome -- AES) has been described. The authors aimed to review the literature data concerning different forms of FPP emphasizing the diagnostic criteria, etiology, mode of inheritance and treatment.
    No preview · Article · Feb 2006 · Endokrynologia, diabetologia i choroby przemiany materii wieku rozwojowego: organ Polskiego Towarzystwa Endokrynologow Dzieciecych
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    ABSTRACT: Anorexia nervosa (AN) is thought to appear predominantly in girls and young women. Twenty years ago the incidence of AN was considered as 1 boy to 10-15 girls. Recent data suggest that the girls to boys rate is 4:1. The most frequently AN in boys begins during puberty. Boys and young men reluctantly apply for help to medical professionals trying to hide their symptoms. The diagnosis of AN is established and the treatment is being performed only when they suffer from a marked loss of weight or a severe depression with suicidal thoughts. We report seven male patients with AN and review the differences in a course of this disease between male and female patients.
    No preview · Article · Feb 2006 · Wiadomości lekarskie (Warsaw, Poland: 1960)
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    Joanna Oświecimska · Katarzyna Ziora · Gabriela Geisler · Katarzyna Broll-Waśka
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    ABSTRACT: The pathogenesis of anorexia nervosa (AN) remains still unclear. It has been reported that neuropeptides may play a role in the control of appetite and hormone release contributing to hormonal disturbances in AN. However the question if neuropeptide alterations are consequence or cause of malnutrition is still unresolved. Serum leptin, neuropeptide Y (NPY) concentrations as well as hormones (FSH, LH, estradiol, cortisol and fT4) serum levels were prospectively estimated in 19 girls aged 11.7-17.7 years (mean 15.5 years) with anorexia nervosa (AN) at the admission to the hospital (baseline) and at follow-up after 7.21+ 2.32 months of treatment. The treatment consisted of hypercaloric diet, psychotherapy and vitamins supplementation. Mean leptin concentration significantly increased from 7.99 + 2.6 to 9.98 + 2.48 microg/ml (p<0.01), whereas mean NPY concentration significantly decreased from 34.10 + 9.81 to 29.6 + 8.04 pmol/l (p<0.01). Leptin/BMI ratio was constant, while NPY/BMI ratio decreased. There were no significant differences between leptin and NPY serum concentrations at baseline and follow-up in eumenorrheic vs. amenorrheic patients. Simple linear correlation analysis showed negative correlation between leptin and NPY concentrations at baseline (r=-0.67; p<0.05) and at follow-up (r=-0.76; p<0.05) only in eumenorrheic subgroup. There were no significant correlations between leptin, NPY and BMI and body weight values. 1) Serum concentration of leptin increases and serum concentration of NPY decreases significantly during the treatment of anorectic girls. 2) These changes do not correspond with increasing body weight and BMI suggesting disregulation of appetite and body weight control mechanisms in AN. 3) Altered neuroregulation of the neuropeptides (leptin and NPY) secretion may contribute persistent amenorrhea after weight gain in anorectic patients with low initial BMI.
    Preview · Article · Sep 2005 · Neuro endocrinology letters
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    ABSTRACT: Background: Patients with AN commonly complain of symptoms suggesting primary or secondary esophageal motility disorders. Aim: The aim of our study was to analyse the prevalence and intensity of esophageal motor disturbances in adolescents meeting standard diagnostic criteria for primary AN. Material, methods: We performed stationary esophageal manometry, using 4-channel water-perfused catheter Polygraph (Medtronic). We investigated 21 children (20 girls and 1 boy), aged 15.85 ± 1.42 years (12.6-18.1 years) diagnosed as having primary AN. All of them were in the acute phase of disease. Results: Tracings described as fully within the normal range had only 8 out of 21 children (42.9%). The most common manometric abnormality was incomplete upper esophageal sphincter (UES) relaxation during swallows, which was found in 7 children (33,3%). Three patients (14,3%) had incomplete lower esophageal sphincter (LES) relaxation during wet swallows. Two children (9.5%) had low LES pressure (less than 10 mm Hg). One patient (4,8%) had decreased amplitude of the contractions in the distal esophagus (less than 40 mm Hg). Although we found many abnormalities in manometric recordings, none of them significantly correlated statistically significant with any parameters of history, clinical symptoms or severity of AN. Conclusions: Many children in acute phase of primary AN have various esophageal motility abnormalities, but these findings seem to be non-specific and are not correlated with clinical course or severity of symptoms.
    No preview · Article · Jan 2005 · Pediatria polska
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    ABSTRACT: Hypokalaemic periodic paralysis (HPP) is a rare autosomal dominantly inherited myopathy characterized by transient episodes of paralysis with concomitant hypokalaemia due to ionic channel disfunction. We report a 14-year-old boy with HPP, who was referred to the university hospital because of suspicion of hyperaldosteronism. On the basis of a typical course of the disease, a tendency to relapse and after exclusion of other causes of hypokalaemia, we established the diagnosis of HPP. Management (avoidance of physical effort, dietary limitation of carbohydrates, permanent potassium supplementation, acethazolamide) was successful. There were no relapse of paralysis for 2.5 years, the boy's general condition is excellent and serum electrolytes maintain within normal limits.
    No preview · Article · Jan 2005 · Pediatria polska
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    ABSTRACT: The problem of intracranial calcifications in children has not been widely discussed in the literature yet. The aim of this study is to emphasise different clinical aspects of intracranial calcifications found in subcortical nuclei and cerebellum in children with disturbed calcium metabolism. We report three different cases of hypoparathyroidism in children in whom similar radiological changes on computed tomography (CT) of the brain were found. An 11-year-old boy was referred to us after episode of tetany. We confirmed the diagnosis of idiopatic hypoparathyroidism (presence of Chvostek and Trousseau signs, hypocalcemia, hyperphosphatemia, low parathormone serum concentration). On brain CT small, symmetric calcifications in the subcortical nuclei and frontal lobes were imaged. A diagnosis of pseudohypoparathyroidism type Ib in 10-year-old girl was established on the basis of clinical symptoms (syncope with seizures, recurrent carpopedal spasms in the past) and laboratory investigations (hypocalcemia, hyperphosphatemia, high parathormone serum concentration). In 11-year-old girl autoimmune polyglandular syndrome type I was diagnosed (hypoparathyroidism with chronic mucocutaneous candidiasis and nail dystrophy from the age of 2). CT of the brain showed multiple irregular symmetric calcifications in cerebellar hemispheres, internal capsula and subcortical nuclei on the border of white and grey matter in both frontal lobes.
    No preview · Article · Feb 2004 · Endokrynologia, diabetologia i choroby przemiany materii wieku rozwojowego: organ Polskiego Towarzystwa Endokrynologow Dzieciecych
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    ABSTRACT: The aim of the study was to show the growing problem of poisoning with easily accessible shrub Datura stramonium among children and young people. 21 children with the symptoms of poisoning with this plant were treated in The Silesian Centre for Children's Diseases in Zabrze in the years 1999-2001. The majority of patients were boys (18 cases) at the age between 15-17 years (15). These were intentional consumptions except for one case of a 3-year-old boy. Cumulative poisoning was also present. The patients came mainly from full families with 2 children where either both parents were unemployed or only one of them worked. In most cases hospitalisation was initiated in the first 12 hours after ingesting the plant. On admission consciousness limitation (15), psychomotor agitation (11), mumbling speech (11), visual hallucinations (7) and aggression (6) were noted. The symptoms subsided quickly, however, only in one patient agitation and limited logical contact were still present for 2 days. Physical examination showed dilated pupils (20), dryness of mucous membrane (10) and skin redness. Toxicological examination confirming poisoning was carried out in 4 cases. It included one child out of 6 belonging to the group of cumulative poisoning. In the remaining children the diagnosis was based on taking a history and clinical picture. Treatment was based mainly on intravenous hydration. 8 children required hydration in the second day of hospitalisation and 2 in the next 2 days. One child was treated in the Intensive Care Unit. The average hospitalisation period was 3.8 days.
    No preview · Article · Feb 2002 · Wiadomości lekarskie (Warsaw, Poland: 1960)