Publications by authors named "Barbara Lisowska"

14 Publications

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Which idea is better with regard to immune response? Opioid anesthesia or opioid free anesthesia.

J Inflamm Res 2020 5;13:859-869. Epub 2020 Nov 5.

Department of Anaesthesiology and Intensive Care, Division of Teaching, Medical University of Warsaw, Warsaw 02-005, Poland.

The stress of surgery is characterized by an inflammatory response with immune suppression resulting from many factors, including the type of surgery and the kind of anesthesia, linked with the drugs that are used and the underlying disease of the patient. The trauma of surgery triggers a cascade of reactions involving the immune response and nociception. As strong analgesics, opioids provide the analgesic component of general anesthesia with bi-directional effect on the immune system. Opioids influence almost all aspects of the immune response in regards to leukocytes, macrophages, mast cells, lymphocytes, and NK cells. The suppressive effect of opioids on the immune system is limiting their use, especially in patients with impaired immune response, so the possibility of using multimodal anesthesia without opioids, known as opioid-free anesthesia (OFA), is gaining more and more sympathizers. The idea of OFA is to eliminate opioid analgesia in the treatment of acute pain and to replace it with drugs from other groups that are assumed to have a comparable analgesic effect without affecting the immune system. Here, we present a review on the impact of anesthesia, with and without the use of opioids, on the immune response to surgical stress.
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http://dx.doi.org/10.2147/JIR.S275986DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7652233PMC
November 2020

The Effect of the Treatment at a Pain Clinic on the Patients' Assessment of Their Pain Intensity and the Incidence of Mental Disorders in the form of Anxiety, Depression, and Aggression.

Int J Environ Res Public Health 2019 02 18;16(4). Epub 2019 Feb 18.

Department of Anesthesiology and Intensive Care, John Paul II Western Hospital in Grodzisk Mazowiecki, 11 Daleka St., 05-825 Grodzisk Mazowiecki, Poland.

The aim of the study was to analyze the effect of the treatment given to patients in a pain clinic on their assessment of pain intensity and the incidence of emotional disturbances in the form of anxiety, depression, and aggression. The study was conducted from January 2014 to April 2018 among patients under the care of two Warsaw pain clinics. The study tools were the Hospital Anxiety and Depression Scale-Modified Version (HADS-M) and the Numerical Rating Scale (NRS). The project enrolled 325 patients, with women comprising 60.62% of patients, and the age bracked of 65⁻79 years comprising 39.38% of patient. The major reasons for attending the pain clinic were osteoarticular pain (44.92%) and neuropathic pain (42.77%). The therapy applied lowered the patients' pain intensity (4.98 vs. 3.83), anxiety (8.71 vs. 8.12), aggression (3.30 vs. 3.08), and the overall HADS-M score (18.93 vs. 17.90), which shows that the treatment of both the pain symptoms and the associated emotional disturbances in the form of anxiety and aggression was effective. Sex is a factor affecting pain intensity. The level of mental disorders was influenced by the sex and age of the patients and how long they had been treated in the pain clinics.
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http://dx.doi.org/10.3390/ijerph16040586DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406293PMC
February 2019

Positives and negatives of nonsteroidal anti-inflammatory drugs in bone healing: the effects of these drugs on bone repair.

Drug Des Devel Ther 2018 21;12:1809-1814. Epub 2018 Jun 21.

Department of Anaesthesiology and Intensive Care, Medical University of Warsaw, Warsaw, Poland.

Tissue damage following injury triggers the processes of coagulation, inflammation and healing. In tissues surrounding the bone, the result of the healing process is a scar, while bone tissue has a unique ability to achieve shape, strength and pre-injury function. Bone healing is a process of regeneration rather than classic recovery. The result of this process is the formation of new, healthy bone tissue instead of a scar. Many factors can inhibit or impair the bone healing process, and their influence is critical during the stages of inflammation and angiogenesis and finally on the clinical outcome. Nonsteroidal anti-inflammatory drugs (NSAIDs) play an essential role associated with their analgesic potency and anti-inflammatory effects. NSAIDs are also the most often used drugs in patients who require pain control and inflammation reduction due to musculoskeletal diseases or injures. Although their analgesic effect is well documented, NSAIDs also interfere with bone healing; therefore, the relative benefits and disadvantages connected with their administration should be taken into consideration. Despite the negative effect, NSAIDs have beneficial properties, but their clinical benefits in relation to dose and time of use are still unclear. Therefore, in this review, we focus on bone healing with relation to the impact of NSAIDs.
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http://dx.doi.org/10.2147/DDDT.S164565DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6016595PMC
November 2018

Lights and shadows of NSAIDs in bone healing: the role of prostaglandins in bone metabolism.

Drug Des Devel Ther 2018 18;12:1753-1758. Epub 2018 Jun 18.

Department of Anaesthesiology and Intensive Care, Medical University of Warsaw, Warsaw, Poland.

In this review, we discuss the current data about the anatomy and function of bone tissue with particular regard to influence of prostaglandins. Bone tissue dynamics are characterized by a constant remodeling process that involves all bone tissue cells. The communication between bone component cells and other organs is necessary for bone remodeling equilibrium and confirms the dynamic character of bone tissue. Remodeling is also a vital element of healing processes and in adapting bone tissue to stress responses. Therefore, in our review we present the role and significance of bone cells and signaling pathways enabling maintenance of bone homeostasis and remodeling process stability. Cyclooxygenase (COX) is a crucial enzyme in the production of prostaglandins and thromboxane. We focus on the role of COX isoenzymes with highlighting their connection with bone formation, resorption and repair. Prostaglandins are known as arachidonic acid metabolites acting through specific membrane receptors and play an important role in the regulation of osteoblast and osteoclast functions. Prostaglandin PGE2 with its four defined receptors (EP1R, EP2R, EP3R and EP4R) is crucial to maintain balanced bone turnover. Their stimulatory or inhibitory effects appear to depend on different structure-activity relations and signaling pathways. We have described the role of these receptors in bone metabolism and healing. We conclude that the activity of prostaglandins in bone tissue is defined by maintaining bone remodeling balance and its reactions to humoral mediators and mechanical stress. Most data confirm that among prostaglandins, PGE2 takes part in all processes of trauma response, including homeostasis, inflammation and healing, and plays a key role in bone physiology.
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http://dx.doi.org/10.2147/DDDT.S164562DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6014392PMC
November 2018

Application of titration methods for measuring the contents of ammonium nitrogen and volatile fatty acids in agricultural biogas plants.

J Biotechnol 2017 Dec 14;264:38-42. Epub 2017 Oct 14.

Department of Anaesthesiology, Medical Centre for Postgraduate Education Clinical Hospital Adam Gruca, CMKP,Konarskiego Street 13, 05-400 Otwock, Poland.

The aim of our research was to assess a relatively new method of estimating ammonium nitrogen concentration in anaerobic digestion of plant substrates. We analysed our own data, received from the anaerobic digestion of maize silage (PM), as well as data published by Purser et al. (2014) who measured energy crops and slurry (ECS), and food waste (FW). In our study, the process was monitored for VFA content that was determined by gas chromatography, and for the content of ammonium nitrogen determined using the HACH LANGE LCK 303 cuvette test. We created polynomial regression models that bind the content of ammonium nitrogen with the volume of HSO used to titrate the sample from initial pH to pH 5. To estimate parameters of model, the PM dataset was used. The obtained models were positively validated using ECS and FW datasets. Our results confirmed the effectiveness of the Purser et al. method with an average absolute error of less than 223mgl of the VFA concentration, which was approximately 20-times less than the level that caused inhibition. In conclusion, we can affirm the suitability of using titration methods to assess the ammonium nitrogen content of bioreactors with a stable composition.
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http://dx.doi.org/10.1016/j.jbiotec.2017.10.008DOI Listing
December 2017

The dynamics of an anaerobic digestion of crop substrates with an unfavourable carbon to nitrogen ratio.

Bioresour Technol 2016 Sep 31;216:607-12. Epub 2016 May 31.

Department of Anaesthesiology, Medical Centre for Postgraduate Education, Clinical Hospital Adam Gruca, CMKP, Konarskiego Street 13, 05-400 Otwock, Poland.

The purpose of this study was to investigate the effects of the characteristics of basic crop substrates, such as the carbon, nitrogen, ash and volatile fatty acids contents, on the dynamics of the anaerobic digestion process. For this purpose, the stepwise anaerobic digestion of silage from six different plant species was carried out. Scaled probability distributions (log-normal, log-logistic, logistic, Weibull and Gompertz) were used to approximate the cumulative methane production curves obtained. The results indicated that the Gompertz distribution best fit the process. The hazard function of the Gompertz distribution was used to describe the process change dynamics. Ridge regression models were made and tested to clarify the impact of the crop properties on the distribution parameters. The analysis results indicated that the initial rate of the process depended on the reactor acidity and that the nitrogen content of the substrate was a key factor that affected the process dynamics.
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http://dx.doi.org/10.1016/j.biortech.2016.05.122DOI Listing
September 2016

Substance P and Acute Pain in Patients Undergoing Orthopedic Surgery.

PLoS One 2016 5;11(1):e0146400. Epub 2016 Jan 5.

Faculty of Production Engineering, Warsaw University of Life Sciences, Warsaw, Poland.

Objective: There is a limited information about the role of Substance P (SP) in acute pain nociception following surgical stimulation in patients with a chronic inflammatory state not to mention the link between this neuropeptide level changes and intensity of pain. The goal of the research was to find the correlation between SP level changes and acute pain intensity in patients with rheumatoid arthritis undergoing elective orthopedic surgery.

Material And Methods: Patients with rheumatoid arthritis (RA) were enrolled in the study. The correlation between acute pain intensity and concentration of SP in serum as well as in drainage fluid from postoperative wound was assessed in patients with RA who underwent Total Knee Replacement (TKA) under spinal anesthesia.

Results: In patients with RA a correlation between intensity of acute pain and serum SP was found postoperatively, whereas there was no correlation between intensity of acute pain and concentration of SP in drainage fluid.

Conclusions: 1. The correlation between acute pain intensity and SP serum concentration was found postoperatively in patients with RA. 2. The correlation between acute pain intensity and SP concentration in drainage fluid was not found postoperatively in patients with RA.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0146400PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4701134PMC
June 2016

Substance P and Chronic Pain in Patients with Chronic Inflammation of Connective Tissue.

PLoS One 2015 7;10(10):e0139206. Epub 2015 Oct 7.

Faculty of Veterinary Medicine, Warsaw University of Life Sciences, Warsaw, Poland.

Objective: Evidence suggests that substance P (SP) is involved in chronic joint inflammation, such as the pathogenesis of rheumatoid arthritis and osteoarthritis. The goal of the research was to evaluate the correlation between chronic pain and changes in the SP level in patients with chronic inflammation of the connective tissue.

Methods: Patients with osteoarthritis and rheumatoid arthritis were enrolled in this study. The relationship between chronic pain intensity and the serum SP concentration was evaluated in these groups of patients with osteoarthritis and rheumatoid arthritis.

Results: The results showed a positive correlation between the serum SP concentrations and chronic pain intensity.

Conclusions: 1. The SP serum concentration was significantly different between the groups of patients with OA and RA. 2. There was a positive correlation between the serum SP concentration and chronic pain intensity in OA and RA patients.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0139206PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4622041PMC
June 2016

Anesthesiology and the cytokine network.

Postepy Hig Med Dosw (Online) 2013 Aug 5;67:761-9. Epub 2013 Aug 5.

Department of Anesthesiology and Intensive Care, Medical Centre for Postgraduate Education Warsaw, Prof. Adam Gruca Teaching Hospital.

The immune response is a highly specific reaction carried out by means of specialized cells that belong to the immune system. There are two types of immune response mechanisms aimed towards pathogens: non-specific, innate reactions, and specific, acquired reactions. Acquired immunity, characterized by its specificity, is comprised of lymphocytes, including both T cell and B cell populations. The role of B lymphocytes is not limited to the humoral response, though the cellular immune response is carried out mainly by various T lymphocyte subpopulations. The reactions of the humoral and cellular responses complement and stimulate one another mutually - cytokines are their common linking element. The attachment of cytokines to their specific receptors activates a sequence of signals - either intracellular or between the cells of various systems. This organization of respective connections and reactions, including the functional relations between cells of the immune response, in its complexity, is best described as a cytokine network. The response of the immune system to surgical trauma can be looked at from both a local and a general perspective. Not only surgical trauma caused by tissue damage, however, influences the functioning of the immune system, but also the drugs and techniques used during anesthesia. Our article is a presentation of the effects of medications used in anesthesia with respect to their influence on the cytokine network.
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http://dx.doi.org/10.5604/17322693.1061412DOI Listing
August 2013

Comparison of rheumatoid articular adipose and synovial tissue reactivity to proinflammatory stimuli: contribution to adipocytokine network.

Ann Rheum Dis 2012 Feb 11;71(2):262-7. Epub 2011 Oct 11.

Department of Pathophysiology and Immunology, Institute of Rheumatology, Warsaw, Poland.

Objectives: (1) To compare spontaneous and stimuli-induced adipocytokine secretion by articular adipose tissue (AAT) and synovial membrane (SM) explants obtained from patients with rheumatoid arthritis (RA). (2) To investigate the biological activity of AAT and SM released factors.

Methods: Tissues were obtained from patients undergoing joint replacement surgery. Tissue explants were treated with proinflammatory cytokines relevant to RA pathogenesis (interleukin 1β (IL-1β), tumour necrosis factor (TNF), interferon γ, IL-15, IL-17, IL-23). Selected adipocytokine (TNF, IL-6, IL-8, IL-1β, IL-1Ra, adiponectin, leptin) concentrations were measured in culture supernatants using ELISA. The biological activity of tissue-conditioned media was evaluated by measuring production of selected factors (IL-6, IL-8, Dickkopf-1, osteoprotegerin) by fibroblast-like synoviocytes (FLS).

Results: Spontaneous cytokine release from AAT was ≤12% of that produced by SM, while leptin was secreted in similar amounts. AAT was highly reactive to proinflammatory cytokines (IL-1β>TNF). AAT treated with IL-1β released four times more leptin, similar amounts of IL-6 and IL-8 and about 20% of TNF, as compared with SM. Upon activation, the IL-1 receptor antagonist (IL-1Ra)/IL-1β ratio was higher in AAT than in SM cultures. Irrespective of activation status, SM produced twice as much adiponectin as AAT. Conditioned media from AAT and SM cultures similarly upregulated IL-6, IL-8, Dickkopf-1 and osteoprotegerin production by rheumatoid FLS.

Conclusion: Rheumatoid AAT is highly reactive tissue which upon stimulation secretes considerable amounts of proinflammatory (IL-6, IL-8, TNF) and anti-inflammatory (IL-1Ra) cytokines and classical adipokines. This tissue releases biologically active factors that intensify pathogenic activities of rheumatoid FLS. Thus, AAT should be considered an important contributor to the pathological processes taking place in the RA joint.
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http://dx.doi.org/10.1136/annrheumdis-2011-200123DOI Listing
February 2012

[The role of strong opioids in the treatment of the chronic musculoskeletal pain].

Pol Merkur Lekarski 2008 Jun;24(144):552-5

Instytut Reumatologii w Warszawie, Poradnia Leczenia Bólu.

This article concentrates on recent evidence about opioid analgesics for persistent musculoskeletal pain. Chronic musculoskeletal pain is a major health problem for which opioids provide one treatment option. Pain is an experience that affects all aspects of a patient's life and effective pain management with strong opioids may help the patient to focus on the positive aspects of life, decreasing the focus on pain. This therapy should be reserved for patients who fail to respond to other lower-risk options and only after proper consideration is given to the long-term consequences of strong opioid use according to the WHO three-step ladder. Several reviews and our experience have shown that opioids are typically reserved for moderate to severe musculoskeletal pain that cannot be relieved by other drugs. In this article are presented the strong opioid drugs, routes of administration, dosage guidelines and potential adverse effects. The management of patients with chronic musculoskeletal pain is a common clinical challenge.
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June 2008

Anaesthesiological problems in patients with rheumatoid arthritis undergoing orthopaedic surgeries.

Clin Rheumatol 2008 May 18;27(5):553-6. Epub 2008 Jan 18.

Department of Anesthesiology, Institute of Rheumatology, Spartańska 1, 02 637 Warsaw, Poland.

The article presents anaesthesiological problems in patients with rheumatoid arthritis (RA) scheduled for orthopaedic surgeries. Organ changes due to RA and related treatment were taken into account. The anaesthetic techniques used for patients with RA underwent orthopaedic procedures were presented.
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http://dx.doi.org/10.1007/s10067-008-0839-7DOI Listing
May 2008

[Spinal anesthesia and postoperative analgesia with intrathecal morphine for orthopedic surgery].

Chir Narzadow Ruchu Ortop Pol 2007 Jan-Feb;72(1):55-60

Klinika Reumoortopedii, Instytut Reumatologii im. prof dr hab. med. Eleonory Reicher.

The aim of this study was to evaluate the analgesic efficacy and side effects of intrathecal morphine in the dose range 0.2-0.5 mg. One-hundred patients scheduled for elective lower limb orthopedic operation under spinal anesthesia using hyperbaric or isobaric bupivacaine 0.5% with morphine in dose from 0.2 to 0.5 mg. Pain score, duration of analgesia and the incidence of adverse effects like nausea, vomiting, pruritus, urinary retention and respiratory depression were assessed for 48 hr postoperatively. There were significant differences in the duration and efficacy analgesia and the incidence of pruritus the morphine dose-related. We did not observe the increased frequency of nausea and vomiting with increased dose. The respiratory depression not observed in connection with intrathecal morphine. The evidence from this current study suggests that spinal anesthesia with combination of local anesthetic and morphine can be employed to provide safe and efficacious analgesia in patients undergoing orthopedic operations. The adverse effects which developed due to intrathecal morphine were able to treat with success.
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August 2007

Postoperative evaluation of plasma interleukin-6 concentration in patients after total hip arthroplasty.

Ortop Traumatol Rehabil 2006 Oct;8(5):547-54

Klinika Reumoortopedii, Instytut Reumatologii im. prof. dr hab. med. Eleonory.

Background. The aim of this study was to examine the circulating IL-6 in patients after orthopedic surgery, and the correlation between IL-6, body temperature and the level of postoperative pain. Material and methods. We studied 27 patients undergoing orthopedic hip arthroplasty, including 14 with osteoarthritis and 13 with rheumatoid arthritis. The local medical ethics committee approved the study, and all patients signed informed consent upon being enrolled. All patients received spinal anesthesia. Samples were collected just before and at 24, 48, and 72 hours after surgery; at the same time, body temperature and reported pain were monitored. Results. Plasma IL-6 levels showed a decrease after surgery. This suggests some influence of plasma cytokines on the possible beneficial effects of regional anesthesia on the clinical course after surgery. The level of IL-6 was associated with body temperature and pain in patients after operation. Conclusions. The plasma concentration of IL-6 is a significant factor affecting body temperature and pain after surgery in patients who have undergone hip arthroplasty.
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October 2006