Publications by authors named "Janusz Sierdzinski"

41 Publications

Association between air pollution and COVID-19 mortality and morbidity.

Intern Emerg Med 2021 Oct 12. Epub 2021 Oct 12.

Department of General and Experimental Pathology, Medical University of Warsaw, Warsaw, Poland.

Coronavirus disease (COVID-19) pandemic is affecting the world unevenly. One of the highest numbers of cases were recorded in the most polluted regions worldwide. The risk factors for severe COVID-19 include diabetes, cardiovascular, and respiratory diseases. It has been known that the same disease might be worsened by chronic exposure to air pollution. The study aimed to determine whether long-term average exposure to air pollution is associated with an increased risk of COVID-19 cases and deaths in Poland. The cumulative number of COVID-19 cases and deaths for each voivodeship (the main administrative level of jurisdictions) in Poland were collected from March 4, 2020, to May 15, 2020. Based on the official data published by Chief Inspectorate of Environmental Protection voivodeship-level long-term exposure to main air pollution: PM, PM, NO, SO, O (averaged from 2013 to 2018) was established. There were statistically significant correlation between COVID-19 cases (per 100,000 population) and annual average concentration of PM (R = 0.367, p = 0.016), PM (R = 0.415, p = 0.009), SO (R = 0.489, p = 0.003), and O (R = 0.537, p = 0.0018). Moreover, COVID-19 deaths (per 100,000 population) were associated with annual average concentration of PM (R = 0.290, p = 0.038), NO (R = 0.319, p = 0.028), O (R = 0.452, p = 0.006). The long-term exposure to air pollution, especially PM, PM, SO, NO, O seems to play an essential role in COVID-19 prevalence and mortality. Long-term exposure to air pollution might increase the susceptibility to the infection, exacerbates the severity of SARS-CoV-2 infections, and worsens the patients' prognosis. The study provides generalized and possible universal trends. Detailed analyzes of the phenomenon dedicated to a given region require taking into account data on comorbidities and socioeconomic variables as well as information about the long-term exposure to air pollution and COVID-19 cases and deaths at smaller administrative level of jurisdictions (community or at least district level).
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http://dx.doi.org/10.1007/s11739-021-02834-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8505468PMC
October 2021

COVID-19 Pandemic-Related Anxiety in Pregnant Women.

Int J Environ Res Public Health 2021 Jul 6;18(14). Epub 2021 Jul 6.

Department of Obstetrics and Gynecology, Institute of Mother and Child, Kasprzaka 17a, 01-211 Warsaw, Poland.

The COVID-19 pandemic outbreak influenced general and mental health worldwide. The objective of this study was to assess the anxiety level during the COVID-19 pandemic among pregnant women and compare it between COVID-infected and non-infected groups. We prospectively assessed the daily routine and anxiety level using a bespoke questionnaire and GAD-7 scale validated for pregnant women. With logistic regression, we established possible risk factors of generalized anxiety disorder spectrum and main causes of concern. The dataset included 439 responders of our survey. Of which, 21% had COVID-19 infection during pregnancy; 38% were screened for possible generalized anxiety disorder and the proportion was higher in women who suffered from COVID-19 (48% vs. 35%, = 0.03). Pre-pregnancy anxiety or depression diagnosis and intentional social contact avoidance increased the risk of anxiety (aOR 3.4 and 3.2). Fetal wellbeing was the main concern for 66% of the responders. The COVID-19 pandemic and related restrictions substantially altered daily lives of pregnant women, exaggerating the prevalence of anxiety compared with the pre-COVID-19 studies (38% vs. 15%). COVID-19 infection during pregnancy was associated with increased levels of generalized anxiety scores. Patient-tailored psychological support should be a mainstay of comprehensive antenatal medical care in order to avoid anxiety- and stress-related complications.
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http://dx.doi.org/10.3390/ijerph18147221DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8307177PMC
July 2021

Comparison of Intranasal Steroid Application Using Nasal Saline Irrigation and a Mucosal Atomization Device to Treat Chronic Rhinosinusitis.

J Aerosol Med Pulm Drug Deliv 2021 Sep 13;34(5):311-321. Epub 2021 Apr 13.

Department of Otorhinolaryngology, Faculty of Medicine and Dentistry, Medical University of Warsaw, Warsaw, Poland.

Chronic rhinosinusitis (CRS) is a disease that can significantly reduce patients' quality of life (QoL). Intranasal steroid therapy is the most commonly used treatment for CRS. There are many evaluation tools dedicated to assessing CRS patients' QoL, but none of them evaluates QoL during local steroid therapy. Mucosal atomization devices (MADs) and nasal saline irrigation (NSI) are effective and safe methods of applying intranasal steroids for CRS patients. The sample population for this prospective study comprised 43 CRS patients. Following endoscopic sinus surgery, all participants received intranasal steroids administered via an MAD, followed by NSI for 1.5 months. Each participant completed the SNOT-22 (22-item Sino-Nasal Outcomes Test) score and a new questionnaire, the Complementary Topical Nasal Drug Delivery Questionnaire (the Complementary Questionnaire), at the end of 3 months of intranasal steroid therapy. The patients' responses in both the SNOT-22 score and the Complementary Questionnaire revealed significant differences in their adverse experiences. The patients who received intranasal steroid treatment using NSI experienced more frequently delayed nasal drainage, higher frequency of ear symptoms, and facial pain/pressure, while those whose therapy was administered using an MAD reported complaints such as nasal irritation, nasal dryness, and postnasal drip with unpleasant taste/smell. We used the Complementary Questionnaire as an effective tool for assessment of the QoL of CRS patients. The SNOT-22 score and the Complementary Questionnaire make it possible to select an intranasal applicator tailored to a CRS patient's specific complaints.
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http://dx.doi.org/10.1089/jamp.2020.1644DOI Listing
September 2021

Observation of the natural course of type 3 spinal muscular atrophy: data from the polish registry of spinal muscular atrophy.

Orphanet J Rare Dis 2021 03 24;16(1):150. Epub 2021 Mar 24.

Department of Neurology, European Reference Network EURO-NMD, Medical University of Warsaw, Warsaw, Poland.

Background: Spinal muscular atrophy (SMA) is one of the most frequent and severe genetic diseases leading to premature death or severe motor disability. New therapies have been developed in recent years that change the natural history of the disease. The aim of this study is to describe patients included in the Polish Registry of SMA, with a focus on the course of type 3 SMA (SMA3) before the availability of disease-modifying treatments.

Results: 790 patients with SMA were included in the registry (173 with type 1 [SMA1], 218 with type 2 [SMA2], 393 with SMA3, and six with type 4 SMA [SMA4]), most (52%) of whom were adults. Data on SMN2 gene copy number were available for 672 (85%) patients. The mean age of onset was 5 months for SMA1, 11.5 months for SMA2, and 4.5 years for SMA3. In patients with SMA3, the first symptoms occurred earlier in those with three copies of SMN2 than in those with four copies of SMN2 (3.2 years vs. 6.7 years). The age of onset of SMA3 was younger in girls than in boys (3.1 years vs. 5.7 years), with no new cases observed in women older than 16 years. Male patients outnumbered female patients, especially among patients with SMA3b (49 female vs. 85 male patients) and among patients with SMA3 with four copies of SMN2 (30 female vs. 69 male patients). 44% of patients with SMA3 were still able to walk; in those who were not still able to walk, the mean age of immobilization was 14.0 years. Patients with SMA3a (age of onset < 3 years) and three copies of SMN2 had significantly worse prognosis for remaining ambulant than patients with SMA3b (age of onset ≥ 3 years) and four copies of SMN2.

Conclusions: The Registry of SMA is an effective tool for assessing the disease course in the real world setting. SMN2 copy number is an important prognostic factor for the age of onset and ambulation in SMA3. Sex and age of disease onset also strongly affect the course of SMA. Data supplied by this study can aid treatment decisions.
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http://dx.doi.org/10.1186/s13023-021-01771-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7992780PMC
March 2021

Endoglin Expression and Microvessel Density as Prognostic Factors in Pediatric Rhabdomyosarcoma.

J Clin Med 2021 Feb 1;10(3). Epub 2021 Feb 1.

Department of Otorhinolaryngology, Faculty of Dental Medicine, Medical University of Warsaw, 19/25 Stepinska St., 00-739 Warsaw, Poland.

(1) Background: The study proposed to analyze microvessel density (MVD) in rhabdomyosarcoma (RMS) based on the expression of angiogenesis markers and define its prognostic role in this group of patients. (2) Methods: The study included forty-nine pediatric patients diagnosed with RMS. Tumor tissue expression of CD31, CD34, and CD105 was analyzed. MVD was calculated and correlated with clinical RMS prognostic parameters. (3) Results: CD31, CD34, and CD105 are expressed in all RMS cases. MVD/CD105 was significantly higher in the RMS group than in the control group. The mean and median values of MVD/CD105 in RMS were lower than MVD/CD31 and MVD/CD34. MVD/CD105 was significantly higher in patients with alveolar RMS and those with metastatic disease. Patients with higher levels of MVD/CD105 had a higher risk of death (HR = 1.009). (4) Conclusion: CD105 is a relevant angiogenesis marker in pediatric RMS, and MVD/CD105 is an independent risk factor of short overall survival in children with RMS.
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http://dx.doi.org/10.3390/jcm10030512DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7867094PMC
February 2021

Intraoperative Dialysis During Liver Transplantation.

Transplant Proc 2020 Oct 21;52(8):2454-2458. Epub 2020 May 21.

Department of Nephrology, Dialysis, and Internal Diseases, Medical University of Warsaw, Warsaw, Poland.

Background: Orthotopic liver transplantation (LT) is a technically complex surgical procedure associated with a major risk of hemodynamic instability and metabolic derangement, especially in patients with coexisting renal dysfunction. Some centers have applied intraoperative renal replacement therapy (ioRRT) to support patients with preoperative renal failure and prevent critical complications. Although there is a strong theoretical rationale for this treatment, there remains a paucity of definite data demonstrating its benefits.

Methods: This was a retrospective observational study of all adult patients undergoing intraoperative dialysis in our center from January 2010 till December 2016.

Results: The study group consisted of 88 patients with a mean MELD score of 31.4. Six patients underwent simultaneous liver and kidney transplantation. Forty-four (50%) recipients were admitted to the intensive care unit before transplantation, and 19 (21.6%) needed mechanical ventilation. Twenty-eight (31.8%) of the procedures were retransplantations, and 40 (45.4%) patients had been undergoing renal replacement therapy before LT. The mean preoperative serum creatinine was 2.82 ± 1.13 mg/dL. The majority of patients (54.5%) was operated on using the veno-venous bypass technique. The mean arterial blood pH and potassium levels after reperfusion were 7.2 ± 0.12 and 4.04 ± 0.95 mmol/L, respectively. Postreperfusion syndrome (PRS) occurred in 11 (13.9%) patients in whom dialysis started at least 15 minutes before reperfusion. Dialysis circuit clotting occurred in 9.1% of cases. There were no other adverse events of ioRRT.

Conclusion: Our data suggests that intraoperative dialysis in severely ill patients with a high MELD score is safe and effective. Lower than expected PRS occurrence needs to be confirmed in a study with a control group.
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http://dx.doi.org/10.1016/j.transproceed.2020.01.129DOI Listing
October 2020

Role of chromatin remodeling complex SWI/SNF and VDR in chronic rhinosinusitis.

Adv Clin Exp Med 2020 Mar;29(3):313-323

Department of Otorhinolaryngology, Faculty of Medicine and Dentistry, Medical University of Warsaw, Poland.

Background: The SWI/SNF (SWItch/sucrose non-fermentable) chromatin remodeling complex enables glucocorticoid receptor (GR) and vitamin D receptor (VDR) to function correctly and is engaged in inflammation response. The SWI/SNF may play an important role in chronic rhinosinusitis (CRS).

Objectives: The aim of this study was to assess the following: 1) the gene and protein expression of the SWI/SNF complex subunits in sinonasal mucosa; 2) relation of SWI/SNF complex and VDR expression; and 3) correlation with clinical data.

Material And Methods: The study population consisted of 52 subjects with CRS without nasal polyps, 55 with CRS with nasal polyps and 59 controls. The SWI/SNF protein expression level was analyzed in immunohistochemical (IHC) staining. Human nasal epithelial cells (HNECs) was stimulated using lipopolysaccharide (LPS), Staphylococcal enterotoxin B (SEB) and vitamin D3 (vitD3) in vitro. The transcript level of the SWI/SNF subunits was measured with polymerase chain reaction (PCR).

Results: In the control group, the intensity of the IHC staining for SWI/SNF subunits was significantly higher than in both groups of patients with CRS (p < 0.05). A positive correlation of the SWI/SNF protein expression was noticed with VDR expression level (p < 0.043). Association between SWI/SNF protein expression level and allergy, neutrophils and body mass index (BMI) has been observed (p < 0.05). The decreased transcript level of the SWI/SNF subunits genes in HNECs was observed after LPS stimulation and increased after vitD3 stimulation.

Conclusions: The SWI/SNF complex may influence CRS through steroid hormone signaling and VDR. Thus, modification in therapy may be mandatory in patients with CRS and altered SWI/SNF signaling, reflecting resistance to steroids treatment.
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http://dx.doi.org/10.17219/acem/117683DOI Listing
March 2020

Visfatin as a predictor of obstructive sleep apnea in atrial fibrillation patients.

Sleep Breath 2020 Sep 13;24(3):1215-1218. Epub 2020 Mar 13.

Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.

Background: Obstructive sleep apnea (OSA) often coexists with atrial fibrillation (AF) and makes the course of AF worse. The negative impact of OSA on AF may be due to atrial stretch, hypoxia, hypertension, obesity, fibrosis, and inflammation. Several mediators are thought to be responsible for this correlation, among them adipokines such as visfatin. This study aimed to assess the association between visfatin concentrations and OSA in patients with AF.

Aims: This study aimed to assess the association between visfatin concentrations and OSA in AF patients.

Methods: In a tertiary Cardiology Department, hospitalized patients previously diagnosed with AF were enrolled in the study. Diagnosis of OSA was made based on a respiratory polygraphy and patients had blood samples taken for assessment of plasma visfatin concentration.

Results: A total of 266 patients with AF (65% men, age 57.6 ± 10.1) were enrolled, and 121 (45%) were diagnosed with OSA. Patients with OSA had higher visfatin concentrations than those without OSA (2.13 ± 0.17 vs. 1.70 ± 0.21 ng/mL; p = 0.04). Patients with mild OSA had visfatin levels equal to 1.77 ± 0.17 ng/mL, moderate OSA 2.38 ± 0.18 ng/mL, and severe OSA 3.55 ± 0.61 ng/mL (p for trend = 0.017). Multivariate regression analysis showed that increased visfatin concentrations were associated with the risk of OSA (odds ratio 1.92; 95% confidence interval 1.09-3.40).

Conclusions: Patients with AF who were diagnosed with OSA had significantly higher plasma visfatin levels which increased according to the severity of OSA. Furthermore, multivariate regression analysis identified visfatin concentration over 1.25 ng/mL, male sex, age over 59.1 years, and permanent AF as the factors showing independent correlation with OSA.
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http://dx.doi.org/10.1007/s11325-020-02025-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7426319PMC
September 2020

Assessment of cancer stem cell marker expression in primary head and neck squamous cell carcinoma shows prognostic value for aldehyde dehydrogenase (ALDH1A1).

Eur J Pharmacol 2020 Jan 5;867:172837. Epub 2019 Dec 5.

Department of Biochemistry, First Faculty of Medicine, Medical University of Warsaw, Banacha 1 Str., 02-097, Warsaw, Poland. Electronic address:

Cancer stem cells (CSCs) play a key role in carcinogenesis and progression of head and neck squamous cell carcinomas (HNSCC). The most common markers indicating for CSCs are: CD44, CD24, CD133, ALDH1A1. Our objective was to evaluate the prognostic potential of CSC markers in HNSCC. The study included 49 patients treated for primary HNSCC, 11 patients with upper respiratory tract epithelial dysplasia and 12 subjects with the normal pharyngeal mucosa as a control group. The frequency and expression levels of the four CSC markers were assessed by immunohistochemistry. Univariate and multivariate analyses were used to correlate CSC expression levels with tumor stage, lymph node metastases or overall survival (OS). CD44, CD24, CD133, ALDH1A1 were widely expressed in tumors, whereas CD44 was found to be higher in cancer tissue (P = 0.001). ALDH1A1 expression levels were found to be significantly higher in T3-T4 tumors vs. T1-T2 tumors (P = 0.05). Lymph node metastases had significantly higher expression levels of CD24 (P = 0.01) and CD133 (P < 0.05) than primary tumors. Multifactorial analysis revealed that overall survival (OS) for patients with ALDH1A1 negative tumors was 5.25 times higher than for patients with ALDH1A1 positive (ALDH1A1+) tumors (P = 0.01). On univariate and multivariate analysis, only ALDH1A1 positivity had a significant effect on OS of HNSCC patients (HR = 2.47 for P = 0.02). Immunohistochemistry-based assessments of CSC marker expression in HNSCC has significant predictive implications for patients with HNSCC. The frequency of CSCs in the tumor, specifically of ALDH1A1+ cells correlated with five-year OS in these patients.
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http://dx.doi.org/10.1016/j.ejphar.2019.172837DOI Listing
January 2020

Usefulness of Visfatin as a Predictor of Atrial Fibrillation Recurrence After Ablation Procedure.

Am J Cardiol 2020 02 7;125(3):415-419. Epub 2019 Nov 7.

1(st) Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.

Visfatin is an adipokine produced by visceral fat tissue and takes part in fibrosis and inflammatory response. In the heart muscle, it is connected with the progression of atherosclerosis. Currently, there is no data on how visfatin affects atrial fibrillation (AF) onset. The study aimed to establish if baseline visfatin levels are connected with the risk of arrhythmia recurrence after AF ablation. In this prospective, long-term, observational study, we enrolled 290 consecutive patients admitted for AF ablation. All patients were screened for cardiovascular risk factors and had blood serum taken to measure visfatin concentrations before the ablation procedure. The end point of the study was a recurrence of the AF, defined as at least one AF episode of at any moment during the follow-up period. The screening included AF of at least 30 second duration assessed with electrocardiogram (ECG) monitoring, including 24-hour ECG Holter monitoring, implantable pacemakers, implantable defibrillators, or subcutaneous ECG monitoring devices. After excluding patients disqualified from the procedure the study population consisted of 236 patients, mean age 57.8 years (64.8% male). Mean body mass index in the population was 29.6  ±  4.8 kg/m and arterial hypertension was highly prevalent (73.3% of patients). In 129 (54.7%) cases we observed recurrence of AF during the follow-up period. Patients with AF recurrence had higher visfatin levels (1.7 ± 2.4 vs 2.1 ± 1.9 ng/ml; p <0.0001) and multivariate logistic regression analysis containing age, sex, and other independent variables showed that patients with elevated visfatin levels were almost 3-time more likely to experience AF recurrence (odds ratio 2.92; 95% confidence interval 1.60 to 5.32). In conclusion, patients with higher visfatin levels are at elevated risk of arrhythmia recurrence after ablation for AF. Visfatin can be a useful marker for risk stratification in this group of patients.
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http://dx.doi.org/10.1016/j.amjcard.2019.10.052DOI Listing
February 2020

The needle EMG findings in myotonia congenita.

J Electromyogr Kinesiol 2019 Dec 3;49:102362. Epub 2019 Oct 3.

Department of Neurology, Medical University of Warsaw, Warsaw, Poland.

Introduction: Myotonia congenita (MC) is caused by pathogenic variants in the CLCN1 gene coding the chloride channel protein.

Methods: To test the hypothesis that needle EMG could be helpful in distinguishing between the recessive and dominant MC, we performed EMG examination in 36 patients (23 men) aged 4-61 years with genetically proven MC: in 30 patients with autosomal recessive MC (Becker MC) and in 6 with autosomal dominant MC (Thomsen MC).

Results: Myotonic discharges were recorded in 95.8% of examined muscles. For the whole MC group we observed a significant positive correlation between parameters of motor unit activity potentials (MUAPs) in vastus lateralis and tibialis anterior muscles and the duration of the disease. Similar correlation for biceps brachii also was found in Becker MC subgroup only.

Discussion: EMG could still be helpful in diagnosis of MC and together with provocative tests might be useful in differentiation between recessive and autosomal MC.
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http://dx.doi.org/10.1016/j.jelekin.2019.102362DOI Listing
December 2019

Sex education in Poland - a cross-sectional study evaluating over twenty thousand polish women's knowledge of reproductive health issues and contraceptive methods.

BMC Public Health 2019 Jun 3;19(1):689. Epub 2019 Jun 3.

1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Pl. Starynkiewicza 1/3, 02-015, Warsaw, Poland.

Background: Reproductive health is a part of a comprehensive definition of complete physical, mental and social well-being. Sex education is an important aspect of public health. Ignorance, due to the lack of sex education leads to risky sexual behaviors.

Methods: Our cross-sectional study was aimed at investigating a representative group of Polish women's knowledge about the physiology of the menstrual cycle, contraceptive methods, infertility and cervical cancer prevention. The data were collected by face-to-face interviews and an anonymous electronic questionnaire.

Results: The study group involved 20,002 respondents. Most of the women were of reproductive age (mean 27.7), parous (60.8%), of higher education (71%) and living in large cities (> 500 k citizens, 36.8%). 62.2% of the women gave correct answers to at least 5 of 7 questions concerning the physiology of the menstrual cycle. Three factors had a significant influence on the number of correct answers: higher education (p = 0.0001), more frequent gynecological appointments (p = 0.0001) and living in a larger city (p = 0.002). Women of higher education level had more often used some form of contraceptive method previously (87% vs. 78.4%, p = 0.001), recommended natural family planning methods to their peers (18.4% vs. 15%, p = 0.001) and regularly attended gynecological appointments (85.7% vs. 78.8%, p = 0.001) when compared with those women with lower educational levels. The three most effective contraceptive methods identified by respondents were: oral contraceptives (71.1% answers), intrauterine devices (50.2%) and parenteral hormonal contraceptives (30.4%). The effectiveness of natural family planning was more often emphasized by women who had never used any contraceptives before (20.1% vs 6.7%). Most of the participants (80.8%) believed that in-vitro fertilization is an effective infertility treatment and should be reimbursed in Poland. Also, 95.2% of the respondents reported that they had undergone a Papanicolaou test within the past 3 years, but only 3% of these women were aware of all the risk factors for cervical cancer mentioned in our survey.

Conclusions: It is very important to improve comprehensive reproductive health education in Poland, especially among women of lower educational levels and living in small centers. In future, educational programs and gynecologists should focus on implementing and improving these aforementioned issues.
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http://dx.doi.org/10.1186/s12889-019-7046-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6547576PMC
June 2019

The impact of lifestyle upon the probability of late bacterial infection after soft-tissue filler augmentation.

Infect Drug Resist 2019 23;12:855-863. Epub 2019 Apr 23.

Department of Microbiology, Medical University of Warsaw, Warsaw, Poland.

Little is known about the influence of lifestyle-related factors upon the risk of late bacterial infection (LBI) emerging at the site of soft-tissue filler augmentation. The aim of this study was to analyze the impact of some such factors on the risk of LBI by comparing their respective prevalence between two groups of previously healthy women: a group in which infection occurred at a site of cross-linked hyaluronic acid (HA) augmentation and a second group which did not have such an infection. The infection group featured 25 women who developed LBI at a site of cross-linked HA augmentation; the control group featured 92 women who did not experience complications during a 24-month period of observation after the same procedure. Data was analyzed statistically using Chi-square tests and logistic regression. : The two groups did not differ significantly in terms of age. However, the frequency of antibiotic therapy, household pet ownership, occupation, hormone replacement therapy or contraception use, and attendance at a swimming pool, sauna, or gym attendance were found to vary with statistical significance, <0.05. Women in the control group practiced a more active lifestyle. Antibiotic therapy in the year preceding cross-linked HA augmentation was a factor which rendered a patient predisposed towards the development of LBI. Pet ownership was more prominent among women who did not suffer LBI than within the group in which soft tissue filler-related complications had occurred.
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http://dx.doi.org/10.2147/IDR.S200357DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6499440PMC
April 2019

Treatment of late bacterial infections resulting from soft-tissue filler injections.

Infect Drug Resist 2019 20;12:469-480. Epub 2019 Feb 20.

Department of Microbiology, Medical University of Warsaw, Warsaw, Poland,

Purpose: Late bacterial infections (LBIs) after esthetic facial augmentation using hyaluronic acid (HA) fillers are relatively rare yet severe complications that are difficult to treat. No adequate treatment standards have hitherto been formulated. We have bridged this gap by formulating a treatment scheme based on the principles of treating foreign-body implantation-related infections and treating bacterial growth in the form of biofilm. The objective of this study was to evaluate the efficacy of a comprehensive scheme for treating LBI complications after facial augmentation using cross-linked HA fillers.

Methods: A total of 22 patients with LBI symptoms at a site of cross-linked HA injection underwent treatment and observation. The comprehensive treatment scheme formulated by Marusza and Netsvyetayeva (M&N scheme) comprised draining the lesion, dissolution of cross-linked HA with hyaluronidase, broad-spectrum antibiotic combination therapy, and use of probiotics. While 17 patients underwent the M&N scheme, the remaining five were treated with other schemes. Statistical analysis of the data was performed using Mann-Whitney and χ nonparametric tests with SAS 9.4 software.

Results: All 17 patients who underwent the M&N scheme experienced resolution of symptoms, with no recurrence of infection at the HA-injection sites.

Conclusion: To treat LBI at a site of cross-linked HA administration, the principles applicable to infections resulting from implantation of a foreign body must be followed. The treatment period should be sufficiently long for complete resolution of symptoms. The efficacy of treatment is considered proven if 2 months have elapsed without recurrence since the symptoms resolved. The M&N scheme is recommended for use as the first therapeutic option for treating LBI related to soft-tissue fillers.
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http://dx.doi.org/10.2147/IDR.S186996DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390860PMC
February 2019

Microsatellite instability and manifestations of angiogenesis in stage IV of sporadic colorectal carcinoma.

Medicine (Baltimore) 2019 Jan;98(1):e13956

Department of General, Transplant & Liver Surgery.

Angiogenesis represents one of the critical mechanisms that facilitates carcinoma development. The study objective was to evaluate whether the microsatellite instability of colorectal carcinoma has impact on the angiogenesis activity in liver metastases.In a cohort of 80 randomly selected patients with stage IV colorectal carcinoma, 30% were recognized as microsatellite unstable (Microsatellite instability high-frequency (MSI-H)). The endothelial progenitor cell fraction (CD309+) was counted within the subpopulation of CD34+CD45+ cell and CD34+CD45- cells by flow cytometer. vascular endothelial growth factor (VEGF) factor levels were quantified in serum samples by enzyme-linked immunosorbent assay (ELISA). A control group consisted of 36 healthy volunteers. The relationship of genomic instability to angiogenesis activity was evaluated by multivariate analysis in comparison to the controls, adopting a P < .05 value as statistically significant.The expression of endothelial progenitor cells (EPCs) and VEGF was significantly higher in MSI-H compared to both microsatellite stability (MSS) patients and healthy controls (P < .008). Multi-parametric analysis showed microsatellite instability (OR=9.12, P < .01), metastases in both lobes (OR = 32.83, P < .001) and simultaneous metastases outside liver (OR = 8.32, P < .01), as independent factors associated with increased angiogenesis as assessed by measures of EPC and VEGF. A higher percentage of EPCs within the white blood cell fraction (total % EPCs / white blood cells (WBC)) and higher serum concentrations of VEGF were present in patients with MSI-H colorectal cancer, and not with MSS cancers (P < .001).MSI-H patients with colorectal cancer metastases are associated with the overexpression of circulating EPCs and VEGF, potentially driving angiogenesis. This should be considered in therapeutic decision-making.
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http://dx.doi.org/10.1097/MD.0000000000013956DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6344194PMC
January 2019

Assessment of postural stability in women with hip osteoarthritis: A case-control study.

Acta Orthop Traumatol Turc 2019 Jan 18;53(1):56-60. Epub 2018 Dec 18.

Medical Center, Medical University of Warsaw, Poland.

Objective: The aim of the study was to assessment the impact of hip osteoarthritis on postural stability.

Methods: One hundred and twenty-five randomly selected women 20-85 years old (mean age of 49 ± 24.4 years) were assigned to three groups based on age, health status and activity level. Group 1 (cases) - elderly women with diagnosed hip osteoarthritis, group 2 (control) - women without hip osteoarthritis, and group 3 (control) - healthy young women. Assessment of postural stability were measured using a WIN-POD Pel 38 electronic podometer. Statistica 10 software was used to perform t-test resulting in significance level of p < 0.05.

Results: Significant differences in pedobarographic balance measurements were observed between the study groups with eyes opened or closed (deviation length eyes open: group 1-3 and 2-3 p < 0.0001; eyes closed group 1-2 p = 0.19; 1-3 and 2-3 p < 0.0001; deviation area eyes open: group 1-3 and 2-3 p < 0.0001; eyes closed group 1-3 and 2-3 p < 0.0001; deviation velocity eyes open: group1-3 and 2-3 p < 0.0001; eyes closed group 1-2 p < 0.010, 1-3 and 2-3 p < 0.0001). The poorest postural stability was observed in patients with hip osteoarthritis (deviation length eyes open vs eyes closed 180.8/201.7 p = 0.028, deviation area 128.7/145.7 p = 0.771, deviation velocity 5.1/6.1 p < 0.0001), and the best postural stability was observed in young women (deviation length 111.3/137.5 p < 0.0001, deviation area 57/76.9 p = 0.003, deviation velocity 3.4/4.2 p < 0.0001).

Conclusion: (1) Osteoarthritic degeneration of the hip joint results in a significant disturbance in proprioception. This finding was reflected by the inferior stability parameters collected from subjects with hip osteoarthritis when asked to stand with their eyes closed. These finding were not observed in the other groups. (2) The disorder of the body stability of people with osteoarthritis may be a relative indication for the implantation of hip arthroplasty.
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http://dx.doi.org/10.1016/j.aott.2018.07.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6424653PMC
January 2019

25(OH)D serum concentration in women with menstrual disorders -risk factors for Vitamin D deficiency.

Neuro Endocrinol Lett 2018 Sep;39(3):219-225

1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland, Pl. Starynkiewicza 1-3, 02-015 Warsaw, Poland.

Introduction: Vitamin D (VD) plays a crucial role in calcium metabolism as well as immunological and endocrine homeostasis. Previous studies revealed strong inverse correlation between VD levels and insulin resistance, parathyroid dysfunctions and autoimmune thyroid disease. Insufficient evidence concerns its dependency of ovarian hormones. Malfunctioning of the ovaries results in menstrual disorders that are one of the most common endocrine impairments in young women of reproductive age.

Material And Methods: The study was aimed to evaluate the correlation between 25(OH)D serum concentration and estradiol, testosterone as well as body mass index (BMI) in women with oligomenorrhea. 134 women of reproductive age with oligomenorrhea were eligible for the study. 25-hydroxyvitamin D [25(OH)D], estradiol, testosterone and sex hormone-binding globulin (SHBG) were measured using chemiluminescence immunoassay. Free androgen index (FAI) and body mass index (BMI) were calculated.

Results: Critical 25(OH)D deficiency (<10 ng/ml) was found in 13.4% of women, the risk of deficiency (<30 mg/dl) was diagnosed in 69.4%, while sufficient level of VD (>30 mg/ml) in 17.2% of them. Significant negative correlation was detected between 25(OH)D and estradiol serum concentrations (r=-0.2; p=0.049), as well as BMI levels (r=-0.22; p=0.01). However, no significant correlation was found between 25(OH)D and testosterone (r=-017; p=0.055), SHBG (r=0.08; p=0.4) and FAI (r=-0.1; p=0.24).

Conclusions: Thorough assessment of vitamin D deficiency/insufficiency is required among patients with menstrual disorders, especially those overweighed and obese. Early screening and VD supplementation in women with estrogen-dependent disorders may become a part of routine management in order to optimize endocrine health.
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September 2018

Role of Vitamin D and Its Receptors in the Pathophysiology of Chronic Rhinosinusitis.

J Am Coll Nutr 2019 02 2;38(2):108-118. Epub 2018 Nov 2.

a Department of Otorhinolaryngology , Faculty of Medicine and Dentistry, Medical University of Warsaw , Poland.

Objectives: Chronic rhinosinusitis (CRS) is a disease that represents a challenging therapeutic problem. Vitamin D and its receptors (VDR) are involved in the regulation of the immune system and may play role in CRS. Objectives of this study were to assess the relationships between the total concentration of vitamin D (25VD3) in sera, vitamin D receptor (VDR) expression, 1α-hydroxylase expression, and clinical data, including age, gender, Sino-Nasal Outcome Test (SNOT-22), computerized tomography (CT) scan, allergy status, and vitamin D supplementation in CRS patients with (CRSwNP) and without nasal polyps (CRSsNP), and in a control group.

Methods: The studied group comprised 52 patients with CRS without nasal polyps (sNP), 55 with CRS with nasal polyps (wNP), and 59 in the control group. The endpoints were determined by appropriate methods. We conducted immunohistochemical staining of gathered tissue from the ostiomeatal complex for determination of VDR and 1α-hydroxylase. Analytical results were compared with clinical data as already noted.

Results: A decrease in VDR nuclear staining occurred in CRS patients as compared to controls. Insignificant differences were observed in 1α-hydroxylase, expression in all studied groups, while VDR and cytochrome CYP27B1 protein expression (1α-hydroxylase) correlated with clinical data.

Conclusions: The data provide evidence that indicates that vitamin D and its receptor and enzymes may play a role in CRS.
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http://dx.doi.org/10.1080/07315724.2018.1503102DOI Listing
February 2019

Long-term effects and quality of life following definitive bile duct reconstruction.

Medicine (Baltimore) 2018 Oct;97(41):e12684

Department of General, Transplant & Liver Surgery.

The study covered a cohort of 236 patients with transection of hepatic duct. It aimed to assess the long-term outcome of the reconstruction and a patient's quality of life.The literature contains many controversies over timing of biliary reconstruction and who ought to repair the injury but just few reports on the long-term outcomes and patient's quality of life.The bile duct system was reconstructed by hepaticojejunostomy in 236 patients. Of these, 139 patients were initially repaired at a public hospital and referred because of stricture (Group A, N = 59) or of an anastomosis dehiscence (Group B, N = 80); 97 were unrepaired and referred because of a surgical clip occluding the duct (Group C, N = 39) or bile leakage from an open duct (Group D, N = 58). All patients were surveyed in 2015 for quality of life using WHOQOL-BREF.The mean time of follow-up was 150 months. The time without symptoms amounted to >5 years in 78.6% of patients. The mean time before anastomosis renewal ranged from 8.9 to 4.7 years (P < .04). Multivariate analysis showed infection, failure of reconstruction in public hospital, and female sex as factors responsible for poor long-term outcome.Patients in Group C had better quality of life than the others (P < .001) with respect to physical health (median 67.85) and psychological condition (median 79.16). The overall mortality was 15.2%.The long-term result of reconstruction depends on the cause of referral which, in turn, arises from subsequent intervention taken in local hospitals.
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http://dx.doi.org/10.1097/MD.0000000000012684DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6203466PMC
October 2018

The association between serum metalloproteinase concentration, obesity, and hormone levels in reproductive-aged women.

Endokrynol Pol 2019 27;70(1):49-56. Epub 2018 Sep 27.

1st Department of Obstetrics and Gynegology, Medical University of Warsaw, Warsaw, Poland.

Introduction: Increased levels and activity of some matrix metalloproteinases (MMPs) are described in obesity-related vascular diseases. Factors that influence MMP blood concentration are still being investigated. This research aims to evaluate the concentration of most types of MMPs: collagenases (MMP-1, -3, -8, -13), matrilysin (MMP-7), gelatinase (MMP-9), and metalloelastase (MMP-12) in serum of women in reproductive age in relation with their body mass index (BMI), age, oestradiol, and progesterone concentrations.

Material And Methods: Blood samples were taken from 54 healthy reproductive-aged women with normal menstrual cycles. The weight and height of all women were measured, and body mass index (BMI) was calculated. Concentration of MMP-1, -3, -7, -8, -9, -12, and MMP-13 was evaluated using a Procarta Immunoassay Kit. Serum concentrations of oestradiol and progesterone were evaluated by immunochemiluminescence (32 in the proliferative and 20 in the secretory phase of menstrual cycle). The results of the study were statistically calculated using Pearson, Spearman, and Kruskal-Wallis tests.

Results: Positive correlation between MMP-7, -8, -9, -12, and -13 levels and BMI was demonstrated. Significantly higher concentrations of MMPs were found especially in obese women compared to women with normal BMI. In healthy, regularly menstruating premenopausal women, MMP levels did not correlate with oestradiol and progesterone concentrations.

Conclusions: The results suggest that body mass can influence MMP serum concentration in women with regular menstrual cycles.
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http://dx.doi.org/10.5603/EP.a2018.0067DOI Listing
July 2019

Microvessel density in head and neck squamous cell carcinoma.

Eur Arch Otorhinolaryngol 2018 Jul 10;275(7):1845-1851. Epub 2018 May 10.

Department of Otolaryngology, Faculty of Medicine and Dentistry, Czerniakowski Hospital, Medical University of Warsaw, 19/25 Stępińska Str., 00-739, Warsaw, Poland.

Purpose: Microvessel density (MVD) corresponds to the intensity of neo-angiogenesis. MVD assessments are based on the expression levels of the vascular endothelium markers such as, e.g., CD34 or CD105. The goal of this study was to assess MVD among patients with head and neck squamous cell carcinoma (HNSCC), and to evaluate the predictive value of MVD in head and neck cancers.

Methods: The study included 49 patients treated for HNSCC and 11 patients with dysplasia of the upper respiratory tract epithelium. Control tissues consisted of 12 normal mucous membranes of the throat. Expression levels of MVD markers were assessed by immunohistochemistry (IHC) using tissue microarrays (TMA). Clinicopathological factors and patients' survival over the 5-year follow-up period were analyzed.

Results: The MVD/CD34 values were found to be significantly elevated in the HNSCCs compared to the non-malignant control tissues (p = 0.001) and to dysplastic tissues. (p = 0.02). Significantly higher MVD/CD105 values were also seen in the tumor compared to the control tissues (p = 0.001) or the dysplastic tissues (p = 0.001). Unexpectedly, significantly lower MVD/CD34 values were seen in the tumor tissues of patients with the T3-T4 tumors compared to those with T1-T2 tumors (p = 0.01).

Conclusions: HNSCCs have statistically higher MVD values compared to dysplasia of the upper respiratory tract epithelium. However, the MVD/CD34 values did not correlate with local invasiveness (the T feature) of HNSCCs. This counterintuitive observation suggests that assessments of MVD as performed on TMA by IHC using anti-CD34 or anti-CD105 antibodies considered to be specific for endothelial cell markers might underestimate the extent of the tumor vascularity in HNSCC.
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http://dx.doi.org/10.1007/s00405-018-4996-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5992238PMC
July 2018

Short-term effect of kinesiology taping on temperature distribution at the site of application.

Res Sports Med 2018 Jul-Sep;26(3):365-380. Epub 2018 Mar 25.

g II Faculty of Medicine , Medical University of Warsaw , Poland.

The aim of the study was to assess skin temperature after short-term kinesiology tape application. Seventy-four healthy volunteers with no history of lower back pain participated in the study. Kinesiology tape was applied in the experimental group, and Matopat Classic adhesive tape was applied in the placebo group. Study participants wore the tape for four consecutive days and were then thermographically analyzed for changes in skin temperature. Examination of skin surface temperature distribution revealed a significantly lower temperature (mean decrease, 1.3°C P = .001 area1, 1.5°C P = .001 area2, 1.6 P = .008 area3) immediately after kinesiology tape the removal. One hour after removal of the tape, a statistically significant increase in temperature was observed over all three areas (mean increase, 0.9°C P = .025 area1, 1.0°C P = .0008 area2, 1.0 P = .011 area3). In group 2, there were no statistically significant temperature changes. Based on the findings, we determined that kinesiology taping may affect skin temperature at the site of application.
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http://dx.doi.org/10.1080/15438627.2018.1447468DOI Listing
September 2018

Skin bacterial flora as a potential risk factor predisposing to late bacterial infection after cross-linked hyaluronic acid gel augmentation.

Infect Drug Resist 2018 12;11:213-222. Epub 2018 Feb 12.

Department of Microbiology, Medical University of Warsaw, Poland.

Introduction: Cross-linked hyaluronic acid (HA) gel is widely used in esthetic medicine. Late bacterial infection (LBI) is a rare, but severe complication after HA augmentation. The aim of this study was to determine whether patients who underwent the HA injection procedure and developed LBI had qualitatively different bacterial flora on the skin compared to patients who underwent the procedure without any complications.

Methods: The study group comprised 10 previously healthy women with recently diagnosed, untreated LBI after HA augmentation. The control group comprised 17 healthy women who had a similar amount of HA injected with no complications. To assess the difference between the two groups, their skin flora was cultured from nasal swabs, both before and after antibiotic treatment in the study group.

Results: A significant increase in the incidence of was detected in the control group (=0.000) compared to the study group. The study group showed a significantly higher incidence of (=0.005), (=0.006), (=0.048), and (=0.048) compared to the control group.

Conclusion: The bacterial flora on the skin differed in patients with LBI from the control group. The control group's bacterial skin flora was dominated by . Patients with LBI had a bacterial skin flora dominated by potentially pathogenic bacteria.
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http://dx.doi.org/10.2147/IDR.S154328DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5813765PMC
February 2018

Electromyographic findings in sporadic inclusion body myositis.

J Electromyogr Kinesiol 2018 Apr 11;39:114-119. Epub 2018 Feb 11.

Department of Neurology, Medical University of Warsaw, Warsaw, Poland.

Introduction: Clinically oriented diagnostic criteria can be as specific for diagnosis of sporadic inclusion body myositis (sIBM) as pathological criteria, especially at the time of presentation. EMG may provide an convincing proof that a muscle biopsy should be performed.

Aims: To compare the EMG results in patients with sIBM divided into subgroups based on the newest ENMC criteria for sIBM and to obtain the utility of EMG in the diagnostic process at the time of presentation.

Methods: We retrospectively analysed 16 patients with sIBM for motor unit action potential (MUAP) morphology as well as occurrence and distribution of abnormal spontaneous activity (SA) in muscles.

Results: Abnormal SA was recorded in 62.5% of sIBM patients. We found statistically significant differences between subgroups in the incidence of polyphasic MUAPs and high amplitude outliers which were more commonly seen in the "clinico-pathologically defined sIBM". Duration of MUAP in the tibialis anterior was significantly shorter in "probable sIBM".

Discussion: "Pseudo-neurogenic" MUAPs, mainly in lower limb muscles, are more commonly seen in "clinico-pathologically defined sIBM" while myopathic MUAPs with prominent abnormal SA are recorded in patients diagnosed with "probable sIBM". Both EMG patterns may be suggestive of sIBM and be an indication for further diagnosis.
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http://dx.doi.org/10.1016/j.jelekin.2018.02.003DOI Listing
April 2018

Seasonal trends in hypertension in Poland: evidence from Google search engine query data.

Kardiol Pol 2018 3;76(3):637-641. Epub 2018 Jan 3.

1st Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland.

Background: Various conditions, including arterial hypertension, exhibit seasonal trends in their occurrence and magnitude. Those trends correspond to an interest exhibited in the number of Internet searches for the specific conditions per month.

Aim: The aim of the study was to show seasonal trends in the hypertension prevalence in Poland relate to the data from the Google Trends tool.

Methods: Internet search engine query data were retrieved from Google Trends from January 2008 to November 2017. Data were calculated as a monthly normalised search volume from the nine-year period. Data was presented for specific geographic regions, including Poland, the United States of America, Australia, and worldwide for the following search terms: "arterial hypertension (pol. nadciśnienie tętnicze)", "hypertension (pol. nadciśnienie)" and "hypertension medical condition". Seasonal effects were calculated using regression models and presented graphically.

Results: In Poland the search volume is the highest between November and May, while patients exhibit the least interest in arterial hypertension during summer holidays (p < 0.05). Seasonal variations are comparable in the United States of America representing a Northern hemisphere country, while in Australia (Southern hemisphere) they exhibit a contrary trend.

Conclusions: In conclusion, arterial hypertension is more likely to occur during winter months, which correlates with increased interest in the search phrase "hypertension" in Google.
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http://dx.doi.org/10.5603/KP.a2017.0264DOI Listing
November 2018

Comparison of 3 Times a Week 4- and 5-Hour In-Center Hemodialysis Sessions with Use of Continuous Non-Invasive Hemodynamic Monitoring.

Ann Transplant 2017 Jun 6;22:346-353. Epub 2017 Jun 6.

Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland.

BACKGROUND Very aggressive ultrafiltration rate (lasting 3.5-4 h) may result in inadequate hemodialysis (HD). Our aim was to characterize HD-induced cardiovascular adaptation and its links to fluid removal during 4- vs. 5-h HD sessions. MATERIAL AND METHODS The study involved 50 HD patients. A Cardioscreen device (Messtechnik, Ilmenau, Germany) was used to perform non-invasive hemodynamic measurements during mid-week HD sessions. Body fluids and nutritional status were assessed with a Body Composition Monitor (Fresenius Medical Care). Clinical and laboratory data were also analyzed. RESULTS It was shown that when comparing 3 times a week 4- vs. 5-h dialysis sessions, body mass index (BMI [kg/m²]), Kt/V, and ultrafiltration volume (UFV [mL]) were significantly lower in the 4-h dialysis group (23.1±3.5 vs. 27.1±4.7; 1.36±0.28 vs. 1.55±0.23; 1770±601 vs. 2831±836; P<0.05, respectively). Cardiac index (CI [L/min/m²]) and thoracic fluid content (TFC [1/kW]) were significantly reduced in 4-h dialysis sessions (3.1±0.6 to 2.7±0.7; 35.1±8.4 to 32.8±6.8; P<0.05, respectively). In patients treated with 5-h dialysis sessions, we found that heart rate (HR [bpm]) was significantly increased (69±10 to 74±15; P<0.05) and TFC was reduced (34.3±8.9 to 31.5±8.2; P<0.05). In patients treated with 4-h dialysis sessions, systemic vascular resistance index (SVRI [dyn·s·cm^-5/m²]) increased from 2369±799 before HD to 2592±735 after HD (P=0.342). CONCLUSIONS The obtained data indicate that in extended (5-h) HD sessions, hemodynamic compensation occurred with increased HR, while in short (4-h) HD sessions, compensation occurred with increased SVRI. Providing longer but less intensive HD is more physiologic than the conventional therapy, and will improve patient tolerability and clinical outcomes.
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http://dx.doi.org/10.12659/aot.902358DOI Listing
June 2017

Contribution of volume overload to the arterial stiffness of hemodialysis patients.

Ren Fail 2017 Nov;39(1):333-339

d Department of Emergency Medicine , Medical University of Warsaw , Warsaw , Poland.

Arterial stiffness is evaluated with the measurement of pulse wave velocity (PWV), while overhydration (OH) and nutritional status are evaluated with bioimpedance spectroscopy (BIS). In this study, we investigated the effect of a single dialysis session on arterial stiffness, hydration status, and laboratory parameters. The observational, cross-sectional, cohort study included 71 HD patients with mean age 64 ± 16 yrs. A Complior device was used to perform PWV measurements. The patients were examined immediately before and 15 min after a mid-week hemodialysis session. Body fluids and nutritional status were studied using a Body Composition Monitor (BCM), Fresenius Medical Care. Clinical and laboratory data were also analyzed. Multivariate regression analysis of PWV before HD showed that an OH increase of 1 L relate to a PWV parameter rise before HD of 0.523 m/s. Multivariate regression analysis of PWV after HD showed that a rise of central SBP after HD of 10 mmHg relate to a PWV increase after HD of 0.707 m/s. Our data indicate that hydration status and blood pressure may be major determinants of PWV in HD patients.
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http://dx.doi.org/10.1080/0886022X.2017.1279552DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6014471PMC
November 2017

Prospective Evaluation of the Correlation of Posturographic Data, Pain Intensity and Functional Capacity in Patients with Osteoarthritis of the Lumbosacral Spine - Pilot Study.

Ortop Traumatol Rehabil 2016 Jan-Feb;18(1):53-63

Department of Medical Informatics and Telemedicine, Medical University of Warsaw, Poland.

Background: A significant effect of osteoarthritis of the lower limbs and spine on deterioration of the stability of the human body has been demonstrated in recent years. However, no reports have investigated the correlation between indices of body stability and functional capabilities of such patients.

Aim: 1. To evaluate selected posturographic parameters in women with subacute low back pain. 2. To determine the correlation between the indices of body stability, pain intensity and functional capabilities in women with osteoarthritis of the lumbosacral spine.

Materials And Methods: The study involved a randomly selected group of 20 women (mean age 62.2 ± 8.6 years) treated on an outpatient basis for low back pain. A posturographic evaluation was performed immediately before and after rehabilitation and at three months after completion of the treatment. The study used a WIN-POD PEL 38 electronic podometer. The Statistica 10.0 statistical package was used for statistical assessment of the study data, which was based on Friedman's ANOVA, Wilcoxon test and Spearman's correlation, with the level of significance set at p<0.05.

Results: 1. The women with lumbosacral pain experienced significantly impaired postural stability in the absence of visual control. 2. After rehabilitation, there was a significant reduction in pain intensity and improved body stability and functional capability of the subjects. 3. A correlation was found between pain intensity (VAS), and the parameters of the respondents' functional capabilities (WOMAC).

Conclusions: 1. Objective posturographic assessment correlated with the results of recognized subjective clinical tests. 2. The observed abnormal postural stability in women with subacute lumbosacral pain may be a consequence of an impairment of proprioception in this group of patients. 3. The results encourage further research of larger study populations.
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http://dx.doi.org/10.5604/15093492.1198861DOI Listing
April 2017

Assessment of Arterial Stiffness, Volume, and Nutritional Status in Stable Renal Transplant Recipients.

Medicine (Baltimore) 2016 Feb;95(6):e2819

From the Department of Nephrology Nursing (LC, JW); Department of Laboratory Medicine, Medical University of Warsaw (EC); Department of Anesthesiology, Cardinal Wyszynski National Institute of Cardiology (AK); Division of Medical Informatics and Telemedicine (JS); and Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland (ZT, LS).

Reduction of cardiovascular death might have a significant effect on the long-term survival rates of renal transplant recipients (RTRs). The aim of the study was to assess the relation between arterial stiffness and graft function, adipose tissue content, and hydration status in patients after kidney transplantation (KTx).The study included 83 RTR patients (mean age: 55 ± 13 years) who had been admitted to a nephrology-transplantation outpatient clinic 0.5 to 24 years after KTx. Clinical and laboratory data were analyzed and eGFR was calculated with the CKD-EPI formula. Arterial stiffness was assessed in all RTRs with pulse wave propagation velocity (PWV) with the use of a complior device. In addition, fluid and nutritional status was assessed with a Tanita BC 418 body composition analyzer. The control group consisted of 31 hospital workers who received no medication and had no history of cardiovascular disease.Multivariable linear regression analysis, with PWV as a dependent variable, retained the following independent predictors in the final regression model: red blood cell distribution width (RDW) (B = 0.323; P = 0.004), age (B = 0.297; P = 0.005), tacrolimus therapy (B = -0.286; P = 0.004), and central DBP (B = 0.185; P = 0.041). Multivariable linear regression analysis with eGFR as a dependent variable retained the following independent predictors in the final regression model; creatinine concentration (B = -0.632; P = 0.000), hemoglobin (B = 0.280; P = 0.000), CRP (B = -0.172; P = 0.011), tacrolimus therapy (B = 0.142; P = 0.039), and triglycerides (B = -0.142; P = 0.035).Our data indicates that: kidney transplant recipients can present modifiable CVD risk factors linked to increased arterial stiffness, DBP, waist circumference, SCr, time on dialysis, CyA therapy, and visceral fat mass; RDW is a parameter associated with arterial stiffness; and parameters such as CyA therapy, time on dialysis, PWV, RDW, and triglycerides show negative associations with the allograft function assessed with eGFR.
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http://dx.doi.org/10.1097/MD.0000000000002819DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4753951PMC
February 2016

Evaluation of the Effectiveness of Preoperative Physiotherapy Using the Lysholm-Gillquist Scale in Patients Qualified for Surgical Arthroscopic Anterior Cruciate Ligament Reconstruction - Pilot Study.

Ortop Traumatol Rehabil 2015 May-Jun;17(3):249-58

Division of Medical Informatics and Telemedicine, Warsaw University of Medicine, Poland.

Background: Recent years have seen a noticeable increase in the number of people experiencing total damage to the anterior cruciate ligament in the knee joint. The causes are many, but increased sporting activity among people who generally lead a hypokinetic lifestyle is regarded as the most important factor. Researchers are seeking to optimize the surgical treatment and rehabilitation.

Aim Of The Study: To evaluate the effectiveness of preoperative physiotherapy according to the Lysholm and Gillquist scale in patients scheduled for arthroscopic anterior cruciate ligament reconstruction.

Material And Methods: The study involved a random sample of 30 patients with confirmed complete rupture of anterior cruciate ligament (ACL) qualified for surgical ACL reconstruction. Within this group, an experimental group consisted of 15 patients (mean age 41.0 ± 7 years) who attended physiotherapy before surgery based on recognized therapeutic models. A control group consisted of 15 patients (mean age 39.0 ± 9 years). The Lysholm and Gillquist 100-point scale was used for assessment. Student's t test, the Mann-Whitney U test and the Wilcoxon test were used for statistical analysis. The level of statistical significance was set at p < 0.05.

Results: The operated knee improved functionally in both the experimental and control group. In the experimental group, the difference was 20 points and was statistically significant at p = 0.000. In the control group, the difference was 6 points, which was also within the limit of statistical significance at p = 0.002.

Conclusions: 1. Patients with total ACL rupture attending a pre-operative rehabilitation program led by a physiotherapist (experimental group) achieved greater improvement in functional status compared with the control group. 2. These results indicate a need to analyze the impact ofpreoperative rehabilitation on the final outcome of patients after complete ACL rupture.
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http://dx.doi.org/10.5604/15093492.1162424DOI Listing
February 2017
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