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Górska K, Maskey-Warzęchowska M, Barnaś M, Białas A, Barczyk A, Jagielska-Len H, Jassem E, Kania A, Lewandowska K, Majewski S, Martusewicz-Boros MM, Piotrowski WJ, Siemińska A, Sładek K, Sobiecka M, Trzaska-Sobczak M, Tomkowski W, Żołnowska B, Krenke R. Therapeutic decisions in a cohort of patients with idiopathic pulmonary fibrosis: a multicenter, prospective survey from Poland. Ther Adv Chronic Dis 2022; 13:20406223221117982. [PMID: 36052286 PMCID: PMC9425901 DOI: 10.1177/20406223221117982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/19/2022] [Indexed: 11/16/2022] Open
Abstract
Background Pirfenidone and nintedanib are considered as the standard of care in idiopathic pulmonary fibrosis (IPF), but there is no consensus as to which of these two agents should be regarded as first-line treatment. Objective To provide real-world data on therapeutic decisions of pulmonary specialists, particularly the choice of the antifibrotic drug in patients with IPF. Methods This was a multicenter, prospective survey collecting clinical data of patients with IPF considered as candidates for antifibrotic treatment between September 2019 and December 2020. Clinical characteristics and information on the therapeutic approach were retrieved. Statistical evaluation included multiple logistic regression analysis with stepwise model selection. Results Data on 188 patients [74.5% male, median age 73 (interquartile range, 68-78) years] considered for antifibrotic therapy were collected. Treatment was initiated in 138 patients, while 50 patients did not receive an antifibrotic, mainly due to the lack of consent for treatment and IPF severity. Seventy-two patients received pirfenidone and 66 received nintedanib. Dosing protocol (p < 0.01) and patient preference (p = 0.049) were more frequently associated with the choice of nintedanib, while comorbidity profile (p = 0.0003) and concomitant medication use (p = 0.03) were more frequently associated with the choice of pirfenidone. Age (p = 0.002), lung transfer factor for carbon monoxide (TLCO) (p = 0.001), and gastrointestinal bleeding (p = 0.03) were significantly associated with the qualification for the antifibrotic treatment. Conclusion This real-world prospective study showed that dose protocol and patient preference were more frequently associated with the choice of nintedanib, while the comorbidity profile and concomitant medication use were more frequently associated with the choice of pirfenidone. Age, TLCO, and history of gastrointestinal bleeding were significant factors influencing the decision to initiate antifibrotic therapy.
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Affiliation(s)
- Katarzyna Górska
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Marta Maskey-Warzęchowska
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Małgorzata Barnaś
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Adam Białas
- Department of Pathobiology of Respiratory Diseases, Medical University of Lodz, Lodz, Poland
| | - Adam Barczyk
- Department of Pneumonology, Medical University of Silesia, Katowice, Poland
| | - Hanna Jagielska-Len
- Clinical Department of Lung Diseases, K. Marcinkowski University Hospital, Zielona Gora, Poland
| | - Ewa Jassem
- Department of Pneumonology, Medical University of Gdańsk, Gdańsk, Poland
| | - Aleksander Kania
- Department of Pulmonology, Jagiellonian University Medical College, Kraków, Poland
| | - Katarzyna Lewandowska
- 1st Lung Diseases Department, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
| | | | - Magdalena M Martusewicz-Boros
- 3rd Lung Diseases and Oncology Department, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
| | | | - Alicja Siemińska
- Department of Allergology, Medical University of Gdańsk, Gdańsk, Poland
| | - Krzysztof Sładek
- Department of Pulmonology, Jagiellonian University Medical College, Kraków, Poland
| | - Małgorzata Sobiecka
- 1st Lung Diseases Department, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
| | | | - Witold Tomkowski
- 1st Lung Diseases Department, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
| | - Beata Żołnowska
- 1st Lung Diseases Department, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
| | - Rafał Krenke
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
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Kuczyński W, Wibowo E, Hoshino T, Kudrycka A, Małolepsza A, Karwowska U, Pruszkowska M, Wasiak J, Kuczyńska A, Spałka J, Pruszkowska-Przybylska P, Mokros Ł, Białas A, Białasiewicz P, Sasanabe R, Blagrove M, Manning J. Understanding the Associations of Prenatal Androgen Exposure on Sleep Physiology, Circadian Proteins, Anthropometric Parameters, Hormonal Factors, Quality of Life, and Sex Among Healthy Young Adults: Protocol for an International, Multicenter Study. JMIR Res Protoc 2021; 10:e29199. [PMID: 34612837 PMCID: PMC8529469 DOI: 10.2196/29199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/13/2021] [Accepted: 04/14/2021] [Indexed: 11/29/2022] Open
Abstract
Background The ratio of the second finger length to the fourth finger length (2D:4D ratio) is considered to be negatively correlated with prenatal androgen exposure (PAE) and positively correlated with prenatal estrogen. Coincidentally, various brain regions are sensitive to PAE, and their functions in adults may be influenced by the prenatal actions of sex hormones. Objective This study aims to assess the relationship between PAE (indicated by the 2D:4D ratio) and various physiological (sex hormone levels and sleep-wake parameters), psychological (mental health), and sexual parameters in healthy young adults. Methods This study consists of two phases. In phase 1, we will conduct a survey-based study and anthropometric assessments (including 2D:4D ratio and BMI) in healthy young adults. Using validated questionnaires, we will collect self-reported data on sleep quality, sexual function, sleep chronotype, anxiety, and depressive symptoms. In phase 2, a subsample of phase 1 will undergo polysomnography and physiological and genetic assessments. Sleep architecture data will be obtained using portable polysomnography. The levels of testosterone, estradiol, progesterone, luteinizing hormone, follicle-stimulating hormone, prolactin, melatonin, and circadian regulatory proteins (circadian locomotor output cycles kaput [CLOCK], timeless [TIM], and period [PER]) and the expression levels of some miRNAs will be measured using blood samples. The rest and activity cycle will be monitored using actigraphy for a 7-day period. Results In Poland, 720 participants were recruited for phase 1. Among these, 140 completed anthropometric measurements. In addition, 25 participants joined and completed phase 2 data collection. Recruitment from other sites will follow. Conclusions Findings from our study may help to better understand the plausible role of PAE in sleep physiology, mental health, and sexual quality of life in young adults. International Registered Report Identifier (IRRID) DERR1-10.2196/29199
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Affiliation(s)
- Wojciech Kuczyński
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Lodz, Poland
| | - Erik Wibowo
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Tetsuro Hoshino
- Department of Sleep Medicine and Sleep Disorder Center, Aichi Medical University, Aichi, Japan
| | - Aleksandra Kudrycka
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Lodz, Poland
| | - Aleksandra Małolepsza
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Lodz, Poland
| | - Urszula Karwowska
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Lodz, Poland
| | - Milena Pruszkowska
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Lodz, Poland
| | - Jakub Wasiak
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Lodz, Poland
| | - Aleksandra Kuczyńska
- Department of Microbiology and Laboratory Medical Immunology, Medical University of Lodz, Lodz, Poland
| | - Jakub Spałka
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Lodz, Poland
| | | | - Łukasz Mokros
- Department of Clinical Pharmacology, Medical University of Lodz, Lodz, Poland
| | - Adam Białas
- Department of Pathobiology of Respiratory Diseases, Medical University of Lodz, Lodz, Poland
| | - Piotr Białasiewicz
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Lodz, Poland
| | - Ryujiro Sasanabe
- Department of Sleep Medicine and Sleep Disorder Center, Aichi Medical University, Aichi, Japan
| | - Mark Blagrove
- Department of Psychology, Swansea University, Swansea, United Kingdom
| | - John Manning
- Applied Sports, Technology, Exercise, and Medicine Research Centre, Swansea University, Swansea, United Kingdom
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Małolepsza A, Kudrycka A, Karwowska U, Hoshino T, Wibowo E, Pál Böjti P, Białas A, Kuczyński W. The role of screening questionnaires in the assessment of risk and severity of obstructive sleep apnea - polysomnography versus polygraphy. Adv Respir Med 2021; 89:188-196. [PMID: 33966264 DOI: 10.5603/arm.a2021.0038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/01/2021] [Accepted: 02/04/2021] [Indexed: 11/25/2022]
Abstract
Obstructive sleep apnea (OSA) is a disease of significant importance, which may lead to numerous severe clinical consequences. The gold standard in the diagnosis of this sleep-related breathing disorder (SRBD) is polysomnography (PSG). However, due to the need for high expertise of staff who perform this procedure, its complexity, and relatively low availability, some simpler substitutes have been developed; among them is polygraphy (PG), which is most widely used. Also, there is a variety of questionnaires suitable to assess the pre-test probability and severity of OSA. The most frequently used ones are the STOP-BANG questionnaire (SBQ), NoSAS questionnaire, and Berlin questionnaire (BQ). However, they have different sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) when being used in various populations. The aim of this study is to provide a concise and clinically-oriented review of the most frequently used questionnaires, with special attention to its strengths and limitations. Moreover, we discuss whether PSG or PG would be more preferred for confirming OSA diagnosis with the highest likelihood.
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Affiliation(s)
- Aleksandra Małolepsza
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Lodz, Poland
| | - Aleksandra Kudrycka
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Lodz, Poland.
| | - Urszula Karwowska
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Lodz, Poland
| | - Tetsuro Hoshino
- Department of Sleep Medicine and Sleep Disorder Center, Aichi Medical University, Aichi, Japan
| | - Erik Wibowo
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Péter Pál Böjti
- Department of Neurointervention, National Institute of Clinical Neurosciences, Budapest, Hungary
| | - Adam Białas
- Department of Pathobiology of Respiratory Diseases, Medical University of Lodz, Lodz, Poland
| | - Wojciech Kuczyński
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Lodz, Poland
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Kuczyński W, Kudrycka A, Małolepsza A, Karwowska U, Białasiewicz P, Białas A. The Epidemiology of Obstructive Sleep Apnea in Poland-Polysomnography and Positive Airway Pressure Therapy. Int J Environ Res Public Health 2021; 18:ijerph18042109. [PMID: 33671515 PMCID: PMC7927121 DOI: 10.3390/ijerph18042109] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/15/2021] [Accepted: 02/18/2021] [Indexed: 01/27/2023]
Abstract
The aim of this study is to provide a brief summary of the epidemiological data on obstructive sleep apnea syndrome (OSAS) diagnosis and therapy in different regions of Poland from 2010 to 2019. We performed a retrospective study in the sleep center of the Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Poland. We requested data from the National Health Service concerning the number of new diagnoses of OSAS, the polysomnographies (PSGs) that were performed, and reimbursements of positive airway pressure (PAP) therapy in each region of Poland in the period 2010–2019. The constant increase in the number of polysomnographies performed and PAP reimbursements suggests the need to create a national network between regional sleep centers to provide proper care for patients with OSAS, and PAP therapy.
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Affiliation(s)
- Wojciech Kuczyński
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 92-215 Lodz, Poland; (A.K.); (A.M.); (U.K.); (P.B.)
- Correspondence: ; Tel./Fax: +48-42-2725656
| | - Aleksandra Kudrycka
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 92-215 Lodz, Poland; (A.K.); (A.M.); (U.K.); (P.B.)
| | - Aleksandra Małolepsza
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 92-215 Lodz, Poland; (A.K.); (A.M.); (U.K.); (P.B.)
| | - Urszula Karwowska
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 92-215 Lodz, Poland; (A.K.); (A.M.); (U.K.); (P.B.)
| | - Piotr Białasiewicz
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 92-215 Lodz, Poland; (A.K.); (A.M.); (U.K.); (P.B.)
| | - Adam Białas
- Department of Pathobiology of Respiratory Diseases, Medical University of Lodz, 90-153 Lodz, Poland;
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Torbiarczyk J, Sobczak P, Torbiarczyk K, Miłkowska-Dymanowska J, Antczak A, Górski P, Białas A, Piotrowski W. Czy bronchoskopia jest zawsze niezbędna w diagnostyce krwioplucia? Adv Respir Med 2018. [DOI: 10.5603/arm.58533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Wstęp: Bronchofiberoskopia jest często wykonywanym badaniem we wstępnej diagnostyce krwioplucia. Wiele danych wskazuje jednak na to, że badanie to nie zawsze dostarcza dodatkowych istotnych informacji, ponad te uzyskane z badań obrazowych. Z tego powodu przeprowadzono analizę, której celem było określenie przydatności bronchofiberoskopii w pierwszoplanowej diagnostyce krwioplucia. Materiał i metody: Przedmiotem retrospektywnej analizy były wyniki badań bronchoskopowych wykonanych u pacjentów kierowanych do pracowni bronchoskopowej. Zawarto w niej jedynie te badania, w których wyłącznym wskazaniem było krwioplucie, wyłączając inne przyczyny z zakresu układu oddechowego. Wyniki: Do ostatecznej analizy włączono 114 pacjentów. Mediana wieku wynosiła 59 lat (IQR: 46–64.75). Aktywne krwawienie stwierdzono w badaniu u 13 pacjentów (11.4%). Nie różnili się oni od pozostałych pod względem wieku: 59 (54–69) v. 59 (45–64) lat; W = 532.5, p = 0.27, oraz płci: c2 = 1.68, p = 0.2. Natomiast u 29 pacjentów (25.44%) w bronchofiberoskopii nie ujawniono żadnych nieprawidłowości. Pacjenci należący do tej grupy byli istotnie młodsi—46 (34–62) v. 60 (53–67) lat; W = 782, p = 0.003. Wnioski: Mały odsetek wyników wskazujących na aktywne krwawienie sugeruje nadużywanie bronchofiberoskopii w diagnostyce krwioplucia. Wskazania do tego badania powinny być zrewidowane, w szczególności w grupie młodych pacjentów z niemasywnym krwiopluciem.
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Miłkowska-Dymanowska J, Białas A, Górski P. Wybrane Aspekty Opieki Medycznej nad Chorymi na Astmę lub Przewlekłą Obturacyjną Chorobę Płuc (POCHP) w Polsce. Adv Respir Med 2018. [DOI: 10.5603/arm.57070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Wstęp: Istotnym problemem jest brak jednolitych standardów dotyczących zróżnicowanej roli lekarza podstawowej opieki zdrowotnej (POZ) i specjalistów prowadzących chorych na przewlekłą obturacyjną chorobę płuc (POChP). Celem niniejszej pracy było oszacowanie jakości postępowania medycznego z uwzględnieniem dwustopniowego systemu opieki zdrowotnej. Materiał i metody: Badanie wykonano w okresie 9.2016–12.2016 roku. Zastosowano metodę ankietową. W badaniu uczestniczyli lekarze POZ oraz alergolodzy i pulmonolodzy z Polski. Moduł podstawowy kwestionariusza zawierał dane o liczbie leczonych na astmę i POChP, przebieg wizyt, zalecane leczenie, przestrzeganie zaleceń przez pacjentów. Z kolei, moduł kwestionariusza dla specjalistów dotyczył szczegółów wizyt specjalistycznych, ich częstości, charakteru, oceny terapii farmakologicznej i niefarmakologicznej oraz oceny leczenia w POZ. Wyniki: Kwestionariusz podstawowy wypełniło 807 lekarzy ze stażem pracy wynoszącym średnio 21 lat (± 9.85). Większość ankietowanych stanowili lekarze POZ (56%), następnie specjaliści chorób płuc (28%) i alergolodzy (16%). Lekarze POZ leczyli 47 osób/miesiąc z chorobami obturacyjnymi, 48.94% chorujących na astmę oraz 51.06% na POChP. Raportowali 3 nowe rozpoznania/ miesiąc astmy lub POCHP. Alergolodzy leczyli głównie chorych na astmę (105 osób/miesiąc), w tym 19 nowo zdiagnozowanych osób). Pulmonolodzy przyjmowali miesięcznie mniej chorych na astmę niż chorych na POChP—odpowiednio 71 i 98 pacjentów i raportowali 14 osób/miesiąc nowych rozpoznań POChP. Większość chorych przyjmowała leki w osobnych inhalatorach w tym: wziewne glikokortykosteroidy (wGKS), długodziałający agoniści receptora b-adrenergicznego (LABA). Najczęściej stosowanym typem inhalatora we wszystkich 3 grupach był dysk. Według specjalistów ponad połowa chorych z nowo rozpoznaną chorobą lub leczonych przez POZ wymagała modyfikacji leczenia. Wnioski: Istnieje ilościowa dysproporcja w zakresie opieki medycznej nad chorym na POCHP lub na astmę pomiędzy stanem rzeczywistym, a faktycznymi i zgodnymi ze światowymi standardami, potrzebami pacjentów.
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Piotrowski W, Martusewicz-Boros M, Białas A, Lewandowska K. Idiopatyczne włóknienie płuc (IPF)—Powszechna praktyka kliniczna w Polsce przed erą leków antyfibrotycznych. Adv Respir Med 2017. [DOI: 10.5603/arm.54807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Wstęp: Idiopatyczne włóknienie płuc (IPF, Idiopathic pulmonary fibrosis) jest przewlekłym, postępującym i destrukcyjnym schorzeniem układu oddechowego, z medianą przeżycia wynoszącą 3–5 lat. Pirfenidon (PIR) i nintedanib (NTB) to jedyne leki, które skutecznie spowalniają progresję choroby. Choć są zarejestrowane w Polsce, nie były w naszym kraju powszechnie dostępne do końca 2016 roku z powodu braku zasad finansowania. Celem badania była ocena powszechnej praktyki klinicznej w Polsce w odniesieniu do rozpoznawania i leczenia IPF w okresie przed wprowadzeniem leków przeciwzwłóknieniowych. Materiał i metody: Przeprowadzono badanie ankietowe wśród lekarzy uczestniczących w dwóch ogólnopolskich kongresach pulmonologicznych w 2016 roku. Wyniki: W badaniu wzięło udział 150 lekarzy. Tylko 55% respondentów deklarowało, że ostateczne rozpoznanie jest stawiane we współpracy z radiologiem. Tylko 40% lekarzy kierujących chorych na chirurgiczną biopsję płuca omawia jej wyniki bezpośrednio z patologiem. Nigdy nie kieruje chorych z podejrzeniem IPF na chirurgiczną biopsję płuca 22%. Wśród respondentów 85% uważa, że płukanie oskrzelowo-pęcherzykowe (BAL, bronchoalveolar lavage) może być przydatne dla rozpoznania. Niestosowanie żadnych leków u chorych na IPF deklarowało 41% respondentów, a 23% lekarzy deklarowało stosowanie kortykosteroidów w większych dawkach w monoterapii lub w skojarzeniu z innymi lekami. Tylko 43% respondentów zastosowałoby leki obniżające kwasowość soku żołądkowego u chorego z objawami refluksu żołądkowo-przełykowego (GERD, gastro-esophageal reflux disease), a tylko 11% niezależnie od rozpoznania GERD. Wnioski: Większość polskich pulmonologów nie jest wspierana przez radiologów w procesie diagnostycznym. Standardy leczenia były niesatysfakcjonujące, głównie z powodu braku regulacji dotyczących finansowania leczenia. Dalsza edukacja jest wskazana w celu poprawy standardów leczenia chorych na IPF w Polsce.
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Piotrowski W, Kupczyk M, Białas A. Editors Note. Adv Respir Med 2017. [DOI: 10.5603/arm.54106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The Editors of Advances in Respiratory Medicine would like to warmly welcome new members of the Scientific Advisory Board. Our invitation to join the Board was kindly accepted by Professor Christer Janson and Professor Raffaele Antonelli Incalzi [...]
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Miłkowska-Dymanowska J, Białas A, Laskowska P, Górski P, Piotrowski W. Zaburzenia funkcji tarczycy w przewlekłej obturacyjnej chorobie płuc. Adv Respir Med 2017. [DOI: 10.5603/arm.50850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Ryzyko zachorowania na przewlekłą obturacyjną chorobę płuc (POChP), podobnie jak ryzyko chorób tarczycy, wzrasta z wiekiem. POChP jest częstą chorobą systemową, związaną z przewlekłym stanem zapalnym. Wiele chorób gruczołów dokrewnych, w tym chorób tarczycy, przebiega z cechami zapalenia systemowego. Wyniki badań epidemiologicznych wskazują na większe ryzyko zachorowania na choroby tarczycy u chorych na POChP. Te związki nie zostały dotychczas dobrze zbadane, a choroby tarczycy nie są powszechnie uznawane za częste współchorobowości POChP. Choroby tarczycy mogą negatywnie wpływać na jakość życia chorych na POChP. Ich rozpoznanie może być trudne, ponieważ kluczowe objawy są maskowane przez symptomy choroby podstawowej. Lepsze poznanie związków pomiędzy chorobami tarczycy a POChP może się przyczynić do poprawy efektów leczenia chorych na POChP. W niniejszej pracy dokonano przeglądu literatury poświęconej związkom pomiędzy POChP i chorobami tarczycy.
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Białas A, Synder M, Dyhdalewicz A, Walenczak K. Analysis of Upper Limb Movement Range and Global Grip Strength After Surgical Treatment of AO Type C Distal Radius Fractures Using LCP Plates and K-wires. Ortop Traumatol Rehabil 2016; 18:223-229. [PMID: 28157078 DOI: 10.5604/15093492.1212866] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND This paper presents the outcomes of treatment of AO Type C distal radius fractures using LCP plates and K-wires. The analysis focused on comparison of movement range and global grip strength between the operated limb and the healthy one. MATERIAL AND METHOD The study involved 60 patients treated in the Regional Specialist Hospital in Zgierz in the period 2008-2013. LCP plates were used in 31 cases and fixation with K-wires was employed in 29 patients. The movement range and grip strength were evaluated in line with the standards of orthopaedic examination, using a goniometer and a dynamometer. X-ray imaging was used to assess the bony anatomy. The results were subsequently compared with those for the healthy limb. RESULTS The analyses showed that neither approach produced a grip strength equal to that of the healthy limb. In two cases of Type C1 fractures treated using LCP plates, the movement range was the same as that of the other upper limb; these results were not obtained in any of the patients with K-wires. Superior outcomes were recorded for LCP plates; however, the differences were not significant. Radiographs revealed a significant difference in the degree of restoration of the articular surface, with LCP plates producing superior outcomes. CONCLUSIONS 1. The use of LCP plates enables more accurate restoration of the bone anatomy in the distal radius. 2. The mobility and grip strength of the limb were similar for both therapeutic procedures provided appropriate radiographic outcomes had been achieved. 3. The functional deficit in both groups was strongest for rotational movements of the forearm and grip strength of the limb.
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Affiliation(s)
- Adam Białas
- Orthopedic and Trauma Surgery Department, M. Curie-Skłodowska Regional Specialist Hospital in Zgierz, Poland
| | - Marek Synder
- Orthopedic and Trauma Surgery Department, Teaching Hospital of the Military Medical University in Łódź, Poland
| | - Artur Dyhdalewicz
- Orthopedic and Trauma Surgery Department, M. Curie-Skłodowska Regional Specialist Hospital in Zgierz, Poland
| | - Krzysztof Walenczak
- Orthopedic and Trauma Surgery Department, M. Curie-Skłodowska Regional Specialist Hospital in Zgierz, Poland
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Białas A, Krauze P, Walenczak K. Distal humeral AO type C fracture--analysis of LCP fixation. Ortop Traumatol Rehabil 2014; 15:297-304. [PMID: 24431267 DOI: 10.5604/15093492.1073828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Distal humeral fractures of type C by AO are serious musculoskeletal injuries, affecting the function of the elbow and upper limb. The authors present the results of treatment of these injuries with the use of two LCP plates. MATERIAL AND METHODS We report on 25 patients aged 26-75 years who were operated on between 2008 and 2010. We examined 20 patients. Treatment results were evaluated basing on patient histories (Oxford Elbow Score), clinical examination (Mayo Elbow Score) and radiographs. We rated the percentage loss of movement in relation to the healthy limb. RESULTS Bony union was achieved in all patients. A scoring system based on the Oxford Elbow Scale rated the outcomes as excellent and good in 13 (65%) patients, fair in 5 (25%) and poor in 2 (10%). The Mayo Elbow Scale revealed 12 (60%) excellent and good results, 6 (30%) fair results and 2 (10%) poor results. CONCLUSION Restoration of elbow anatomy with stable fixation of bone fragments allows early resumption of movements, predicting a good clinical outcome.
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Affiliation(s)
- Adam Białas
- Department of Trauma and Orthopaedic Surgery, Regional Specialist Hospital, Zgierz
| | - Paweł Krauze
- Department of Trauma and Orthopaedic Surgery, Regional Specialist Hospital, Zgierz
| | - Krzysztof Walenczak
- Department of Trauma and Orthopaedic Surgery, Regional Specialist Hospital, Zgierz
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Białas A, Borzęcka-Prokop B, Wesełucha-Birczyńska A, Camra J, Najbar M. Evolution of surface vanadia-like species on unsupported V–O–W catalyst for NO decomposition in the course of redox-treatment. Catal Today 2007. [DOI: 10.1016/j.cattod.2006.08.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Camra J, Bielańska E, Bernasik A, Kowalski K, Zimowska M, Białas A, Najbar M. Role of Al segregation and high affinity to oxygen in formation of adhesive alumina layers on FeCr alloy support. Catal Today 2005. [DOI: 10.1016/j.cattod.2005.06.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kornelak P, Mizukami F, Weselucha-Birczyńska A, Proniewicz L, Djega-Mariadassou G, Białas A, Najbar M. Evolution of active species of nanostructured anatase-supported V–O–Mo catalyst in the course of reduction and oxidation. Catal Today 2004. [DOI: 10.1016/j.cattod.2004.04.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Najbar M, Mizukami F, Kornelak P, Wesełucha-Birczyńska A, Borzęcka-Prokop B, Bielańska E, Białas A, Banaś J, Su D. Studies of processes occurring during alkoxide derived V–O–W unsupported catalyst formation. Catal Today 2004. [DOI: 10.1016/j.cattod.2004.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Back BB, Baker MD, Barton DS, Basilev S, Bates BD, Baum R, Betts RR, Białas A, Bindel R, Bogucki W, Budzanowski A, Busza W, Carroll A, Ceglia M, Chang YH, Chen AE, Coghen T, Conner C, Czyz W, Dabrowski B, Decowski MP, Despet M, Fita P, Fitch J, Friedl M, Gałuszka K, Ganz R, Garcia E, George N, Godlewski J, Gomes C, Griesmayer E, Gulbrandsen K, Gushue S, Halik J, Halliwell C, Haridas P, Hayes A, Heintzelman GA, Henderson C, Hollis R, Hołyński R, Holzman B, Johnson E, Kane J, Katzy J, Kita W, Kotuła J, Kraner H, Kucewicz W, Kulinich P, LawV C, Lemler M, Ligocki J, Lin WT, Manly S, McLeod D, Michałowski J, Mignerey A, Mülmenstädt J, Neal M, Nouicer R, Olszewski A, Pak R, Park IC, Patel M, Pernegger H, Plesko M, Reed C, Remsberg LP, Reuter M, Roland C, Roland G, Ross D, Rosenberg L, Ryan J, Sanzgiri A, Sarin P, Sawicki P, Scaduto J, Shea J, Sinacore J, Skulski W, Steadman SG, Stephans GS, Steinberg P, Straczek A, Stodulski M, Strek M, Stopa Z, Sukhanov A, Surowiecka K, Tang JL, Teng R, Trzupek A, Vale C, van Nieuwenhuizen GJ, Verdier R, Wadsworth B, Wolfs FL, Wosiek B, Woźniak K, Wuosmaa AH, Wysłouch B, Zalewski K, Zychowski P. Charged-particle multiplicity near midrapidity in central Au+Au collisions at sqrt[SNN]=56 and 130 GeV. Phys Rev Lett 2000; 85:3100-3104. [PMID: 11019276 DOI: 10.1103/physrevlett.85.3100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2000] [Indexed: 05/23/2023]
Abstract
We present the first measurement of pseudorapidity densities of primary charged particles near midrapidity in Au+Au collisions at sqrt[s(NN)] = 56 and 130 GeV. For the most central collisions, we find the charged-particle pseudorapidity density to be dN/deta|(|eta|<1) = 408+/-12(stat)+/-30(syst) at 56 GeV and 555+/-12(stat)+/-35(syst) at 130 GeV, values that are higher than any previously observed in nuclear collisions. Compared to proton-antiproton collisions, our data show an increase in the pseudorapidity density per participant by more than 40% at the higher energy.
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Affiliation(s)
- B B Back
- Physics Division, Argonne National Laboratory, Argonne, Illinois 60439-4843, USA
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