Roczniki Akademii Medycznej w Bialymstoku (1995)最新文献

Purpose: Evaluation of quality of life, appraisal of pain quality and intensity, assessment of treatment and care effectiveness in palliative care patients treated at the in-patient Palliative Care Department in Czestochowa Province Hospital.

Material and methods: The study was performed in 50 randomly chosen patients at the in-patient Palliative Care Department in Czestochowa Province Hospital. The studied group comprised 22 women and 28 men. The trial lasted since October 2003 till April 2004 and this was longitudinal study. At the first assessment patients filled Modified Sheet Pain Assessment, Support Team Assessment Schedule (STAS) and Rotterdam Symptom Checklist (RSCL). At the second, third and fourth appraisal patients filled RSCL and STAS.

Results: In patients surveyed by STAS at the second assessment 52% of patients achieved very high scores (poor effectiveness of treatment and care), 32% high scores - unsatisfactory treatment and care, 15% average results (average treatment and care). Results of RSCL indicate for decrease in physical activity and global quality of life of terminal patients. At the fourth assessment after 4 weeks of the treatment nearly 80% patients assessed their physical state as low.

Conclusions: The results indicate that patients have poor performance status, no effective treatment is provided, psychological state is significantly impaired, and patients were forced to resign from social life because of cancer progression.

Breast feeding is the only proper way to feed a newborn and a baby during the first several months of his life. The most professional way of preparation for natural feeding is The Childbirth School. Education ought to be continued in maternity wards. The aim of this study is to prove that women who participated in The Childbirth Courses are better motivated and prepared for breast feeding. Material and methodology. The research comprised 294 lying-in women hospitalized in maternity ward in Clinic of Obstetrics and Perinatology, Pomeranian Medical University in Szczecin from June 2001 to December 2002. The examined women were divided into two groups: Group I--"study group"--comprised 129 lying-in women who attended the childbirth school courses during at least one pregnancy, but no earlier than 2 years ago. Group II--"control group" (reference group)--included 165 lying-in women who did not participate in any organized forms of prenatal education. Every woman who agreed to participate in the research was accepted. There was applied analysis of lying-in woman's documentation and author's questionnaire which was also used for further research. As a result of the research it was found that The Childbirth School increases motivation for natural feeding and prepares women for this activity. It also showed that more emphasis should be given to childbirth education for puerperal women in maternity wards; it refers in special to those women who did not attend The Childbirth School.

Unlabelled: The aim of the study was an analysis of correlation between mycological examination results and clinical features of changed toenails in patients that visited mycological laboratory due to suspected onychomycosis.

Material and methods: Samples of changed toenails were collected from 579 patients. From all that cases a precise patient's history was taken paying a special attention on previous antimycotic treatment. In the clinical examination features of toenail changes were estimated.

Results: Onychomycosis was confirmed by the mycological examination in 23.3% of patients and exclude in 56.3% of individuals. In 20.4% of all cases the fungi growth was not obtained despite of positive results of direct microscopic examination. Among the cultured fungi species the most frequently observed were strains of Trichophyton rubrum--46.6%. 46% of all patients were previously treated with antifungals but the therapy was not efficacious in 23% of them.

Conclusions: In all the cases of toenail changes it is important to take a precise patient's history, because it has an essential influence on the results of diagnostic examinations. Diagnosing onychomycosis one cannot rely only on the clinical examination because in over 50% of patients with typical for onychomycosis toenail changes the mycological examination do not confirm fungal infection.

In the last 2 decades, major progresses have been made in the management of patients with advanced colorectal cancer (ACC). The modulation of 5-fluorouracil (5-FU) by folinic acid (LV), followed by the introduction of irinotecan and oxaliplatin have significantly improved the outcome of these patients. New strategies consist of oral fluoropyrimidines, and of targeted agents to inhibit cancer signalisation.

Purpose: Alterations in the redox state during chronic ethanol consumption are associated with the oxidation of ethanol via alcohol and aldehyde dehydrogenase. Among various antioxidants present in food, strong antioxidative effects have been attributed to polyphenols of green tea. The aim of the present study was to investigate the effect of green tea consumption during chronic ethanol intake on the activity of aldehyde dehydrogenase in the liver of rats during maturation and aging.

Materials and methods: The activity of ALDH was measured in the livers of rats aged 2 (young), 12 (adult) and 24 months (old). The rats were fed with a control liquid Lieber DeCarli diet, control liquid diet containing green tea (3 g/l), ethanol liquid diet (with increasing ethanol dose from 2.3% to 7%) and ethanol liquid diet containing green tea.

Results: Chronic ethanol consumption significantly increased the liver ALDH activity in young and adult rats but decreased this activity in old animals. The drinking of green tea did not alter ALDH activity in ethanol-consuming rats. Drinking green tea alone significantly increased ALDH activity in young and adult rats but did not alter this activity in old rats.

Conclusions: These results demonstrate that green tea administered during chronic ethanol consumption does not prevent the changes in the hepatic ALDH activity in the rats at each age.

Purpose: To assess effects of NF-kappaB activation inhibitor (pyrrolidine dithiocarbamate--PDTC) alone or with endothelins (ET-1, ET-2, ET-3) in early course of cerulein-induced acute pancreatitis (AP) in rats.

Material and methods: After 4 h of AP in Wistar rats, treated with PDTC 10 or 40 mg/kg or with PDTC 10 mg/kg and ET-1, ET-2 or ET-3, 0.5 or 1.0 nmol/kg twice i.p. in 1 h interval, free active trypsin (FAT), total potential trypsin (TPT) and lipase in 12000 x g supernatants of pancreatic homogenates, plasma alpha-amylase and histological changes were assayed. %FAT/TPT was an index of trypsinogen activation.

Results: %FAT/TPT significantly increased to 12.42 +/- 2.14%, lipase to 5.51 +/- 0.84 U/mg protein and alpha-amylase to 28.5 +/- 5.61 U/mL in AP vs 1.96 +/- 0.31%, 1.29 +/- 0.11 U/mg and 5.80 +/- 1.38 U/ml in healthy control. Higher dose PDTC attenuated trypsinogen activation to 3.01 +/- 0.53% and alpha-amylase to 15.3 +/- 1.38. PDTC and ET-1 attenuated %FAT/TPT to 2.55 +/- 0.18% with lower and 2.34 +/- 0.44% with higher dose. ET-3 was less effective than ET-1: 6.76 +/- 0.46% with lower dose. Lower doses of ET-1 and ET-2 with PDTC, diminished lipase activity to 2.60 +/- 0.36 and 2.94 +/- 0.33.

Conclusions: Cumulative attenuation of trypsinogen activation after lower dose of PDTC and ET-1 approximated the effect of higher dose of PDTC. Additional effect of ET-3 was weaker than ET-1, and ET-2 was ineffective in this respect. The combination of this NF-kappaB activation inhibitor and ET-1 could be beneficial in early course of edematous AP by attenuating of trypsinogen activation. However, it should be treated with caution because of some unfavorable effects on histological scores of pancreatic injury.

Purpose: The purpose of present study was to investigate the effect of metabolic substrate pyruvate and beta-adrenergic agonist isoproterenol and combination of these agents on the force- and relaxation-frequency relationship in human heart failure.

Material and methods: The experiments were performed on isolated human ventricle strips from patients undergoing cardiac corrective open heart surgery, using conventional method of registration of electromechanical activity. The stimulation frequency of myocardial strips was 0.2, 0.5, 1.0, 1.5, 2.0, 2.5 and 3.0 Hz.

Results: In control, i.e. at perfusion of myocardial strips by Tyrode solution and stimulation frequency 1 Hz, the contraction force (F) was 0.94 +/- 0.18 mN, half time of relaxation (tr)--178.8 +/- 9.3 ms (n= 12). Pyruvate (10 mmol/L) increased F to 176.0 +/- 13.4%, tr--104.6 +/- 3.1% (n=8, p<0.05) vs control. By the action of isoproterenol (10(-5) mol/L) F increased to 122.1 +/- 10.2%, tr decreased to 58.9 +/- 3.1% (n=4, p<0.05) vs control. The relationship of F and tr from stimulation frequency in the absence of pyruvate and isoproterenol was negative. Pyruvate and isoproterenol didn't alter the shape of force-frequency relationships but F was augmented at all stimulation frequencies. The positive inotropic effect of isoproterenol was potentiated by pyruvate.

Conclusions: Pyruvate and isoproterenol alone can improve cardiac contractility in wide-range of stimulation frequency. The combination of these inotropic agents results in even more effective increase of contractile performance and therefore may be of therapeutic value in heart failure.

Unlabelled: The purpose of our study was to evaluate the clinical usefulness of serum endostatin levels during chemotherapy of lung cancer in relation to the histopathological type of the tumor, clinical stage and response to therapy.

Materials and methods: Serum concentrations of endostatin were determined in 37 patients (24 with non-small cell lung cancer and 13 with small cell lung cancer), 10 healthy subjects constituted controls. To determine endostatin levels (ELISA), venous blood samples were collected from each patient before treatment and after 4-6 courses of chemotherapy.

Results: The serum concentrations of endostatin were found significantly higher in patients in comparison with controls (p=0.003). No statistically significant differences were established between the concentrations of endostatin with regard to such clinical features, as: performance status, clinical stage (III and IV) and histopathological type (non-small cell lung cancer and small cell lung cancer). The concentrations of endostatin did not change after chemotherapy. There was no change of endostatin concentration caused by the response to treatment.

Conclusions: The serum endostatin concentrations were elevated in lung cancer patients.

Purpose: To assess the influence of low dose rofecoxib on inflammatory mediators and prostacyclin synthesis in patients with acute coronary syndromes (ACS) in a short-term follow up.

Material and methods: Twenty nine patients with ACS without ST elevation were randomized to simvastatin alone or together with low dose rofecoxib. Serum levels of interleukin 6 (IL-6), 6-keto-PGF-1alpha--stable product of prostacyclin (PGT2) and hs-C-reactive protein (hs-CRP) were assessed on enrollment and after 30-day follow up.

Results: Combination of rofecoxib with statin significantly decreased levels of hs-CRP after one month therapy (5.21 mg/l +/- 4.12 vs 2.11 mg/l +/- 2.1; p=0.0092). This effect was not evident in a group on statin alone (3.95 mg/l +/- 3.33 vs 2.48 mg/l +/- 2.39; p=0.31). 6-keto-PGF-1alpha increased not significantly in both groups. IL-6 concentration has not changed during follow up.

Conclusions: Low dose of selective COX-2 inhibitor exerts significant anti-inflammatory effect and does not diminish PG12 synthesis in study group of patients with ACS.

Purpose: Cholecystokinin regulates gut motility and visceral sensation. The aim of the study was to determine the diagnostic value of plasma cholecystokinin octapeptide (CCK-8) concentration in children with functional abdominal pain (FAP).

Material and methods: Fifty-two children (33 girls and 19 boys) aged 6-17 years with chronic abdominal pain were included in this study. On the basis of clinical data, results of endoscopy and Criteria for Functional Disorders the patients were divided into three groups: group 1--functional dyspepsia (FD), group 2--irritable bowel syndrome (IBS), group 3--non-specific FAP. The control group consisted of children without abdominal pain in anamnesis. CCK-8 concentrations in plasma were measured with radio immunoassay technique, after plasma extraction. In study protocol we analysed CCK-8 levels in fasting state and 15, 30, 60 minutes after a standard test meal.

Results: In the fasting state plasma levels of CCK-8 were similar in each group and in controls. In the IBS patients CCK-8 levels were not increased after meal. In groups 1, 3 and controls postprandial levels were higher when compared to fasting state (p<0.05). Area under curve of CCK-8 plasma concentration was the lowest in group 2, but not significant compared to controls and other groups. No correlation was found between main symptoms of FD and IBS and CCK-8 concentration in plasma.

Conclusions: We conclude that gut dysmotility and symptoms of functional abdominal pain in children are not concerned with alteration of plasma CCK-8 levels before and after meal.