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Biomedical subjects

A Pajak

Publications and source records attributed to A Pajak.

At least 55 records · Page 3Linked to original sources
PubMed1995

Treatment of steroid-dependent bronchial asthma with cyclosporin.

The treatment of chronic severe asthma is unsatisfactory for many patients. The aim of the study was to determine the effects of treatment of steroid-dependent asthma with cyclosporin. We performed a double-blind, placebo-controlled, randomized, parallel group trial on the effect of cyclosporin on pulmonary function, asthma severity and tapering of prednisone in 34 steroid-dependent asthmatics (mean oral prednisone dose: 16 mg.day-1). The study consisted of: 1) baseline period (12 weeks); 2) experimental period divided into two parts: Part I (12 weeks) cyclosporin or placebo treatment; Part II (22 weeks) cyclosporin or placebo treatment and oral prednisone reduction; and 3) follow-up observation (8 weeks). Asthma symptoms score, pulmonary function tests (daily peak expiratory flow (PEF) and bi-weekly forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and maximal mid-expiratory flow (MEF50), biochemical profile and blood cyclosporin levels were monitored throughout the study. Following cyclosporin administration, a slight beneficial effect on some subjective parameters of asthma severity was observed. At the same time, no beneficial effect on pulmonary function was noted. The time trends analysis of mean daily prednisone doses between the treatment groups revealed a statistically significant difference indicating that, during prednisone reduction, cyclosporin seemed to be slightly more efficient than placebo in reducing the requirement for systemic corticosteroid, even though the steroid reduction was accompanied by slight impairment of some pulmonary function. However, there was no significant difference in the final dose reduction between the treatment groups. These data and the known toxicity of the drug suggest a limited place for cyclosporin treatment in steroid-dependent bronchial asthma.

Adult↗
PubMed1994

Natural menopause and cardiovascular disease risk factors. The Poland and US Collaborative Study on Cardiovascular Disease Epidemiology.

Changes in risk factor levels associated with menopause have been reported in many studies in the United States and western Europe, where estrogen replacement therapy and surgical menopause are common. We studied risk factor associations in Polish women, for whom estrogen replacement therapy and surgical menopause are uncommon. The 357 postmenopausal women had higher total cholesterol levels (0.43 mmol/L) and low-density-lipoprotein cholesterol levels (0.36 mmol/L than did the 372 premenopausal women of similar ages. Triglycerides, high-density-lipoprotein cholesterol, body mass index, and blood pressure did not differ by menopausal status. We conclude that natural menopause is associated with higher levels of total and low-density-lipoprotein cholesterol levels. Natural menopause is not associated with large changes in other risk factors in this sample.

Blood Pressure↗
PubMed1994

Myocardial infarction and coronary deaths in the World Health Organization MONICA Project. Registration procedures, event rates, and case-fatality rates in 38 populations from 21 countries in four continents.

BACKGROUND: The WHO MONICA Project is a 10-year study that monitors deaths due to coronary heart disease (CHD), acute myocardial infarction, coronary care, and risk factors in men and women aged 35 to 64 years in defined communities. This analysis of methods and results of coronary event registration in 1985 through 1987 provides data on the relation between CHD morbidity and mortality. METHODS AND RESULTS: Fatal and nonfatal coronary events were monitored through population-based registers. Hospital cases were found by pursuing admissions ("hot pursuit") or by retrospective analysis of discharges ("cold pursuit"). Availability of diagnostic data on identified nonfatal myocardial infarction was good. Information on fatal events (deaths occurring within 28 days) was limited and constrained in some populations by problems with access to sources such as death certificates. Age-standardized annual event rates for the main diagnostic group in men aged 35 to 64 covered a 12-fold range from 915 per 100,000 for North Karelia, Finland, to 76 per 100,000 for Beijing, China. For women, rates covered an 8.5-fold range from 256 per 100,000 for Glasgow, UK, to 30 per 100,000 for Catalonia, Spain. Twenty-eight-day case-fatality rates ranged from 37% to 81% for men (average, 48% to 49%), and from 31% to 91% for women (average, 54%). There was no significant correlation across populations for men between coronary event and case-fatality rates (r = -.04), the percentages of coronary deaths known to have occurred within 1 hour of onset (r = .08), or the percentages of known first events (r = -.23). Event and case-fatality rates for women correlated strongly with those for men in the same populations (r = .85, r = .80). Case-fatality rates for women were not consistently higher than those for men. For women, there was a significant inverse correlation between event and case-fatality rates (r = -.33, P < .05), suggesting that nonfatal events were being missed where event rates were low. Rankings based on MONICA categories of fatal events placed some middle- and low-mortality populations, such as the French, systematically higher than they would be based on official CHD mortality rates. However, rates for nonfatal myocardial infarction correlated quite well with the official mortality rates for CHD for the same populations. For men (age 35 to 64 years), approximately 1.5 (at low event rates) to 1 (at high event rates) episode of hospitalized, nonfatal, definite myocardial infarction was registered for every death due to CHD. The problem in categorizing deaths due to CHD was the large proportion of deaths with no relevant clinical or autopsy information. Unclassifiable deaths averaged 22% across the 38 populations but represented half of all registered deaths in 2 populations and a third or more of all deaths in 15 populations. CONCLUSIONS: The WHO MONICA Project, although designed to study longitudinal trends within populations, provides the opportunity for relating rates of validated CHD deaths to nonfatal myocardial infarction across populations. There are major differences between populations in nonfatal as well as fatal coronary event rates. They refute suggestions that high CHD mortality rates are associated with high case-fatality rates or a relative excess of sudden deaths. The high proportion of CHD deaths for which no diagnostic information is available is a cause for concern.

Adult↗
PubMed1992

Poland-US collaborative study on cardiovascular epidemiology: classification agreement between US National Cholesterol Education Program and European Atherosclerosis Society hyperlipidemia guidelines in selected Polish and US populations.

Data from two epidemiological studies are used to measure the degree to which two well-known guidelines agree in measuring hyperlipidemia in population samples in the US and Poland. The epidemiological studies are the US Lipid Research Clinics Program Prevalence Study and the Pol-MONICA project in Poland and the guidelines are those adopted by the US National Cholesterol Program (USNCEP) and by the European Atherosclerosis Society (EAS). EAS guidelines were analyzed in two ways: Method 1 used triglycerides and total cholesterol only in classifying persons as hyperlipidemics or non-hyperlipidemics; Method 2 used triglycerides, total cholesterol and nine additional risk factors in the classification process. USNCEP guidelines used total cholesterol, low density lipoprotein cholesterol and the same additional nine risk factors used in EAS Method 2 in classifying hyperlipidemics. Classification differences between the two sets of guidelines were high when EAS Method 1 guidelines were compared with USNCEP guidelines. However, EAS Method 2 which included risk factors, compared favorably with USNCEP guidelines in all three populations under study.

Adult↗
PubMed1990

[Regional differences in drug use in relation to the causes].

The purpose of the study was in comparison of drug use in the treatment of coronary disease or hypertension in the random selected representative population sample of Warsaw and Tarnobrzeg province . In the study women and men aged 35 to 64 years were included according to POL-MONICA studies. Among 2646 subjects studied in Warsaw 23% used drugs whereas among 2722 subjects from the Tarnobrzeg province the drug users represented 12.1%. The most frequently used drugs in the treatment of coronary disease were nitrates, curantyl and beta-blockers. The drug use in subjects with coronary disease (DDD/1000 inhabitants/day) was 4.5-fold higher in Warsaw than in the Tarnobrzeg province . The most frequently drug used in treatment of hypertension in Warsaw were beta-blockers and diuretics, whereas in the Tarnobrzeg province among men diuretic and composed drug preparations; women in the last region used frequently composed drug preparations and smooth muscle relaxants. The relationship between the use of particular drug groups and the region was significant in women. The hypotensic drug use in Warsaw was twice as high as in the Tarnobrzeg voivodship despite similar frequency of hypertension in both regions.

Adrenergic beta-Antagonists↗
PubMed1990

Methods of total cholesterol measurement in the baseline survey of the WHO MONICA Project.

In the WHO MONICA Project (Monitoring of Trends and Determinants of Cardiovascular Disease) total cholesterol was measured in representative samples from 51 study populations in 26 countries. The biochemical measurements were done locally by the collaborating centres' laboratories. Differences in measurement procedures among the populations were found in the following factors: fasting status, posture of the subject, tourniquet use, use of serum or plasma, storage conditions, and the analytical method itself. This paper gives an overview of the methods used, and discusses the possible effects of the differences on the comparability of the results. The use of a posture other than that recommended and the use of EDTA (ethylene diaminetetraacetate) plasma are considered to be the most important factors, and were found in 9 out of the 51 populations.

Adult↗
PubMed1990

[12-year trends in cardiovascular disease mortality].

The coefficients and trends of mortality in years 1976-1987, based on data of Central Statistical Office, has been estimated in population of men and women aged 25 to 64 years, inhabitants of the Warsaw city region or the county region of Tarnobrzeg province . The trend of decrease of general mortality due to diseases of circulatory system has been statistically significant one similarly as that of mortality due to other heart diseases or ischaemic heart disease in men (group aged 25-34 or 35-44 years) in the Tarnobrzeg province . The analogously significant trend of mortality due to diseases of circulatory system or ischemic heart diseases in men aged 35-44 years has been stated in the Warsaw inhabitants. In the group of women an increase of general mortality has been noted in the youngest age group in Warsaw. In Warsaw and the Tarnobrzeg province in 1987 deaths due to diseases of circulatory system represented 33.2% and 39.9%, respectively, of total death pool among subjects aged 25 to 64 years. The respective percentages in the group of women were 29.1% and 39.4%.

Adult↗
PubMed1990

[Characteristics of the main risk factors of coronary disease among the population of Warsaw and rural agricultural population of the Tarnobrzeg province].

Basing on results of first screening of the Pol-MONICA Project in 1984 in two centres that is the Tarnobrzeg province and two districts of Polish capital Warsaw (Praga South and Praga North) the level of 11 main coronary disease risk factors was compared in 2469 men and 2729 women. The following 5 risk factors were statistically significant for both men and women: the Durnin index of body fat content, the total cholesterol concentration in the plasma, triglyceride level, numbers of daily meals. The mean level of two factors that is the HDL-cholesterol concentration and the HDL-cholesterol/total cholesterol ratio was lower in the Warsaw sample what speaks in favor of concept that the ischemic heart disease threat is greater in that population. Among men the Warsaw population exhibited moreover the significantly higher value of diastolic blood pressure as well as of Quetelet body mass index; age and numbers of cigarettes smoked daily has also been higher in that population. In women from the Tarnobrzeg province ++ the diastolic blood pressure was higher than that in the Warsaw population. The two populations studied showed also highly significant differences so far as the complex of all 11 features is concerned what enabled the qualification of 72.3% of men, and 68.4% of women as belonging to the big city population or to the agricultural-industrial population using the discriminant Fisher function.

Adult↗
PubMed1990

[Effect of inter-population differences in the levels of selected factors on the differences in arterial blood pressure].

According to the Pol-MONICA program the random selected population samples were studied in inhabitants of Warsaw or the Tarnobrzeg province . After excluding from analysis the subjects treated with the hypotensive++ or hypolipemic drugs the differences between populations studies with regard to range of mean pressure value, except systolic pressure (RRs) in women, appeared significant ones. In populations studied the arterial blood pressure (CTK) was influenced by: age, sex, education, family history with regard to the circulatory system, the alcohol intake, smoking, heart action frequency the Quetelet coefficient value, triglyceride concentration and daily sodium intake. After analysis of inter-population differences in values of above factors the mean RRs values in populations studied did not differed significantly whereas differences in mean values of diastolic pressure (RRr) were highly statistically significant.

Adult↗
PubMed1990

[Plasma lipid and lipoprotein levels among rural and urban populations in Poland in relation to risk factors of coronary disease].

There are significant differences in plasma total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides and blood pressure, prevalence of cigarette smoking, obesity, education level and alcohol consumption found between the rural and industrial populations in Poland. It was found that the differences in plasma lipids and lipoproteins concentration are related to the differences in age, sex, education level, alcohol consumption, obesity, cigarette smoking and blood pressure. Increase of education level was related to increase in plasma concentration of total cholesterol. LDL-cholesterol and triglycerides but it was related to decrease of HDL-cholesterol. After the adjustment to all above factors the differences in total cholesterol and LDL-cholesterol between the studied populations appeared insignificant. The differences in HDL-cholesterol and triglycerides remained significant.

Coronary Disease↗
PubMed1990

[Comparison of parameters and factors affecting the differences in obesity among urban population of Warsaw and the rural agricultural-industrial population of the Tarnobrzeg province].

Comparison of the parameters of obesity between two populations, urban from Warsaw and agricultural-industrial from Tarnobrzeg province revealed that skinfolds thickness, Quetelet index and body fat index, and per cent of overweight were statistically significantly higher in men from urban population. In the group of women these parameters were also statistically higher in Warsaw population with the exception of triceps skinfold and Quetelet index--differences of no statistical significance. There were also differences in the set of variables which correlate with the parameters of obesity between these two tested populations.

Adipose Tissue↗
PubMed1990

[Regional conditions of the smoking habit-- the POL-MONICA 1984 studies].

The POL-MONICA Project screened in 1984 1309 men and 1337 women aged 35 to 64 years, inhabitants of Warsaw (the Warsaw centre) and 1250 men and 1472 women aged 35 to 64 years, inhabitants of the Tarnobrzeg province (the Cracow centre). In both environments the percentage of smoking men was similar (about 57%). Women from big city environment smoked three times more frequently (33.1%) than in the agricultural areas (10.7%). The smoking intensity was higher in the agricultural areas both among men and women. It has been stated that smoking habit depends on such social or demographic patterns as age, sex, civil state, education, physical activity related to work. Smoking influenced significantly the level of such risk factors as systolic arterial blood pressure, the fat body content in both men and women, and the HDL-cholesterol in women from both environments.

Adult↗
PubMed1990

[Hypertension--diagnosis, treatment and the effectiveness of the treatment of Polish population participating in the POL-MONICA program].

According to the POL-MONICA program basing on screening studies of random population samples of two Warsaw districts and the Tarnobrzeg provinceip the detectability of arterial hypertension (AH), the AH treatment fact, the effectiveness+ of AH treatment and the populational control of AH has been evaluated. The AH control was better in Warsaw (men 55%, women 73%) than in the Tarnobrzeg province (men 44%, women 65%). In both populations the control was better among women than among men and increased with the age of subjects investigated. In both populations the treatment was introduced only in half of detected AH and increased also with the age of subjects studied. Only 20% men and 25% of women in Warsaw and 35% of men and 42% of women in the Tarnobrzeg province was effectively treated. The AH control in the Warsaw population was twice a lower than in the Tarnobrzeg province (Warsaw: men 5%, women 10%, Tarnobrzeg: men 7%, women 16%). Exceptionally bad control of HT has been stated in the youngest and the middle age men group in Warsaw (2.9%). The patterns studied with the use of MLF functions in both population studied have significant influence on the detectability and the AH treatment fact and remain without the influence of effectivity of treatment.

Adult↗
PubMed1989

Poland and US collaborative study on cardiovascular epidemiology. I. Introduction and baseline findings.

The Poland-US Agreement for Health Cooperation has as its goal the sharing of scientific information in cardiovascular disease epidemiology between the two countries. Patterns of cardiovascular disease and identification of risk factors were investigated through two large epidemiologic studies, the Pol-Monica Study in Poland and the US Lipid Research Clinics Program Prevalence Study in the United States. These two studies are described with regard to methodological issues, comparability of data collection procedures, and demographic and behavioral characteristics of the two populations involved. Mean blood pressure, lipids, and body mass indices of participants in these studies are also compared.

Adult↗
PubMed1989

Poland and US collaborative study on cardiovascular epidemiology. II. Correlates of lipids and lipoproteins in men and women aged 35-64 years from selected Polish rural, Polish urban, and US samples.

Three diverse samples of men and women aged 35-64 years living in urban Poland, rural Poland, and the United States, are described and subsequently analyzed by multiple regression methods. Total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, and the natural logarithm (ln) of triglycerides are treated separately as dependent variables, with several demographic, behavioral, and biologic factors as independent variables. In the analyses of total cholesterol, systolic blood pressure was statistically significant in men and women in all three samples, while Quetelet index, cigarette smoking, age, ethanol consumption, and education were significant in at least one of the samples. In the LDL cholesterol analyses, Quetelet index and cigarette smoking were the predominant variables; in the HDL cholesterol analyses, Quetelet index, cigarette smoking, ethanol consumption, and age were key variables; and in the ln triglycerides analyses, Quetelet index, cigarette smoking, education, and systolic blood pressure were significant.

Adult↗
PubMed1989

Poland and US collaborative study on cardiovascular epidemiology. III. Correlates of systolic and diastolic blood pressure in men and women aged 35-64 years from selected Polish rural, Polish urban, and US samples.

Three diverse samples of men and women aged 35-64 years living in urban Poland, rural Poland, and the United States are described and subsequently analyzed using systolic blood pressure and diastolic blood pressure separately as dependent variables in multiple regression. Several demographic, behavioral, and biologic factors are included in the models as independent variables. Heart rate, Quetelet index, high density lipoprotein cholesterol, and the natural logarithm of triglycerides were statistically significant in accounting for variation in systolic pressure in men in all three samples, whereas only heart rate and Quetelet index were significant in women in all samples. In the analysis of diastolic pressure, Quetelet index, heart rate, and ethanol consumption were statistically significant in men in all three samples, while only Quetelet index and heart rate were significant in women in all samples.

Adult↗
PubMed1988

Pol-MONICA Cracow on-going study: initial findings.

The findings after the first year of the study are presented. The study population is 282,052 men and women aged 25-64 years, current residents of rural Tarnobrzeg Voivodeship. The population is characterized by a declining linear trend in ischemic heart disease (IHD) mortality in men aged 35-44 years. The myocardial infarction (MI) incidence (per 100,000 residents) is 233 in men and 68 in women. The MI death rates (per 100,000 residents) are 128 for men and 29 for women. The MI 28-day case fatality is 44% for men and 41% for women. The most frequent risk factors are: smoking in men (58%) and obesity in women (40%). Around one-quarter of the men and of the women are hypertensive. The rates for hypercholesterolemia are 9% in men and 13% in women.

Adult↗