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Biomedical subjects

B Rutkowski

Publications and source records attributed to B Rutkowski.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Platinum-based chemotherapy in renal transplant recipients with malignancies: a case report and review of literature].

Authors present a case of renal transplant recipient treated with a carboplatin-based chemotherapy for testicular embryonal carcinoma. The patient experienced severe treatment-related toxicity and died due to bone marrow aplasia 3 months after the diagnosis of cancer. The safety of platinum-based chemotherapy in renal transplant recipients is discussed with reference to the literature data.

Antineoplastic Agents↗
PubMed1998

[The effect of nasal and skin colonization on the development of exit site and peritoneal catheter tunnel infections in patients on peritoneal dialysis].

ESI remain a major problem in patients undergoing peritoneal dialysis and are frequently the reason for catheter removal. The treatment is often costly and not effective and the need for routine prophylactics has to be clarified. In this study 38 peritoneal dialysis patients (15 F & 23 M, age: 18-73) were analysed prospectively for ESI and TI in respect to skin (exit site and inguinal area) and nostrils colonisation. There were 14 diabetics and 24 non-diabetics. All had standard double-cuff Tenckhoff catheter and none presented with ESI prior to the study. No treatment was applied on the basis of positive culture only. In 27 patients swab were repeated after 6-11 months. Eight episodes of ESI and three TI were recorded. Following pathogens were cultured: S.aureus in 4 Klebsiella pneumoniae in 2, Corynebacterium sp. in 1, negative in 1 and with TI S.aureus in 3. Positive nasal cultures (S.aureus, Klebs.pn.) were observed in 5 patients subsequently developing ESI (p < 0.01) and in 2 with TI. In 2 cases exit site was also colonized by pathogens responsible for ESI (p = NS). Inguinal area was colonized by various pathogens in 7 patients, but only one of these developed ESI (p = NS) and no one TI. There was no difference between diabetic and non-diabetics neither in the frequency of ESI, TI nor in nasal carriage of pathogens. In the majority of patients nostrils and inguinal area were colonized by S.epidermidis. When the second culture was analyzed it appeared that significantly more patients had exit site colonized by S.epidermidis (2 and 11 patients in 2 consecutive cultures respectively (p < 0.01). In conclusion, it appears that nasal carriers of pathogens like S.aureus and Klebsiella pneumoniae are more prone to ESI. Inguinal area and exit site colonization does not seem to precede ESI or TI. We would suggest that nasal carriage status should be routinely identified in all patients entering peritoneal dialysis programme and the carriers properly treated.

Adult↗
PubMed1998

[Treatment with erythropoietin in Central and Eastern Europe].

Human recombinant erythropoietin (r-HuEpo) was introduced widely to the clinical practice more than ten years ago. In many countries belonging to Central and Eastern Europe (CEE) use of this drug was very delayed mainly due to the high costs of treatment. The aim of the presented study was to estimate actual possibilities of r-HuEpo administration in thirteen CEE countries. Survey was performed using especially prepared questionnaires including questions connected with r-HuEpo and filled out by the members of the Central and Eastern Advisory Board in Chronic Renal Failure. Below mentioned numbers of patients were under the control of the responders during performing the survey: on hemodialysis (HD) 1119, on peritoneal dialysis (PD) 205 and 1556 after renal transplantation (RT). Respectively in subsequent groups 53.5% (HD), 41.5% (PD) and 16.2 (RT) of patients were treated using r-HuEpo. Possibilities of treatment differs significantly between two groups of countries. In those with better developed economy (Croatia, Czech, Hungary, Macedonia, Poland, Slovakia, Slovenia, Yugoslavia) 60-70% of dialysed patients were given r-HuEpo and in the rest of countries (Bulgaria, Latvia, Lithuania, Romania, Russia) this drug was administered in 10-35% of patients. The most popular way of the r-HuEpo administration were subcutaneous injections (89.3%) comparing with only 10.7% of patients getting this important hormone intravenously. Average weekly dose of r-HuEpo was 71-90 IU/kg/week in so treated patients and 91-100 IU/kg/week in whom drug was administered i.v., in majority of patients two or three times weekly. Major part of responders tried to achieve as the optimal level of Hb 10-12 g/dl but simultaneously in 1/3 of centres only achieving of the Hb level 9-10 g/dl was possible. The general majority of responders were not satisfied with the obtained results and recognised economical constrains as the main reason of such a situation. These problems were more widely observed in predialysis patients, because only few of them were on r-HuEpo treatment. Side effects of this drug expressed rarely and main of them were development or acceleration of hypertension (16%) and thrombotic complications in the vascular access (8%). The main cause of hyporesponsiveness to drug was iron deficit despite of the adequate monitoring of responders were convinced that further avoiding of economical constrains would be benefit dialysis and predialysis patients. It is especially important looking on the literature finding supported by personal experience showing that r-HuEpo was positive impact on the quality of life, status of the cardiovascular system, endocrine, metabolic and immunological disorders observed in uremic patients.

Drug Administration Schedule↗
PubMed1997

The effect of dietary enrichment with fish-oil on urinary excretion of N-acetyl-beta-D-glucosaminidase and renal function in proteinuric patients with primary glomerulopathies.

The rate of progression of renal disease depends on many factors including serum lipids and tubulo-interstitial injury. Aim of the study was to see whether fish-oil therapy may affect serum lipids and NAG excretion with urine (a marker of tubular cell damage) in humans with renal disease. The effects of dietary fish-oil fatty acids on the serum lipids, NAG urinary excretion and serum arachidonic acid concentration were examined in thirteen primary glomerulonephritic patients with proteinuria and normal renal function. The regular diet enriched with 1650 mg n-3 polyunsaturated fatty acids (18%: 20:5; n-3 EPA and 12%: 22:5; n-3 DHA) was ingested for three months. At the end of fish-oil enriched diet neither creatinine clearance nor urinary protein excretion changed significantly. But serum concentration of HDL and arachidonic acid increased (48.0 +/- 15 vs. 52.0 +/- 14; p < 0.05), (0.47 +/- 0.13 vs. 0.72 +/- 0.29; p < 0.01), respectively. Simultaneously urine NAG excretion and serum LDL decreased (11.2 +/- 7.1 vs. 10.3 +/- 7.3; p < 0.05), (163.0 +/- 57 vs. 149.0 +/- 51, p < 0.01), respectively. We presume that fish-oil supplementation may have a beneficial effect on renal tubular cells in humans and it could be linked with arachidonic acid metabolism.

Acetylglucosaminidase↗
PubMed1997

[Hypercoagulation in patients with nephrotic syndrome].

Hypercoagulation and thrombotic complications associated with nephrotic syndrome (NS) are known from many years. However pathomechanism of those disturbances is not very clear. The aim of the presented study was to determine the role of platelets in hypercoagulation phenomenon in NS patients. Studies were carried out in 15 patients with NS in the course of chronic glomerulonephritis and 15 healthy volunteers. Following parameters were estimated: prothrombin, time APTT, fibrinogen, FDP, plasminogen, antithrombin III, alpha 2-antiplasmin and using Technicon H1 autoanalyser: platelet count (PLT), mean platelet volume (MPV) and PLT Mode. Additionally platelets aggregation (spontaneous and after collagen, epinephrine, ADP) was measured using Apact (Labor) aggregometer. We observed in patients with NS: a) decrease of AT III, b) slight increase (not significant) of fibrinogen, c) decrease of MPV and Mode PLT, d) increased spontaneous aggregation and sensitivity to aggregating agents. Our results suggest that: 1. Pathomechanism of hypercoagulation in NS is multifactorial. 2. Changes in morphology and function of platelets could be one of the factor playing important role in this mechanism.

Adult↗
PubMed1997

[The levels of adenine nucleotides and hypoxanthine in blood of patients on long-term hemodialysis using dialysis fluid containing acetate or bicarbonate].

Intraerythrocyte adenine nucleotides concentration reflects energy balance of red cells and plays pivotal role in their function. In hemodialysed patients both ATP and ADP concentration in red cells was higher than in controls, p < 0.001 and p < 0.005 respectively. But AMP and hypoxanthine did not differ from control. No change of ATP, ADP and AMP was observed after hemodialysis, but hypoxanthine fall significantly, p < 0.001. The pattern of nucleotides concentration and its changes during hemodialysis was the same regardless of the mode of the therapy; e.g. acetate or bicarbonate.

Acetates↗
PubMed1997

[Evaluation of prophylaxis and actual prevalence of HBV infection in twelve hemodialysis centers of Northern Poland].

The aim of the study was to estimate the HBV infection preventive measures used in the twelve dialysis centres in north Poland. In all of the centres hepatitis B vaccination and segregation of HBV infected patients (dedicated machines or separate rooms), which are the two basic HBV infection control methods, were introduced. Our results point out that in some of the centres certain modification of these methods would be possible, including universal predialysis vaccination programme, changes in hepatitis B vaccination schedules with most effective routes of vaccination only and dedication for HBV infected patients not only separate rooms but separate dialysis staff as well.

Adolescent↗
PubMed1996

Erythrocyte nucleotides and blood hypoxanthine in patients with uremia evaluated immediately and 24 hours after hemodialysis.

Using high-performance liquid chromatography, concentrations of erythrocyte adenine nucleotides and hypoxanthine were evaluated in patients undergoing regular acetate hemodialysis before dialysis, immediately following dialysis, and 24 hr after. It was shown that adenosine triphosphate concentration was maintained consistently high, not only just after hemodialysis but also 24 hr later. There was also no difference in concentration of mono- and diphosphates of adenosine. Hypoxanthine concentration decreased twofold after hemodialysis. However, it was still markedly higher than normal values. The level of hypoxanthine was maintained at the postdialysis level, 24 hr later. This suggests that hypoxanthine production could be stimulated during acetate dialysis.

Adult↗
PubMed1996

Classification of lipid disorders in chronic hemodialyzed patients.

The aim of our study was to introduce the classification given by the European Atherosclerosis Society (A B C D E groups) for monitoring lipid disorders in chronic renal failure patients during the first year of dialysis therapy (DT). Studies were carried out in 41 chronically uremic patients (19 F, 22 M). Before the start of DT, and then every 2 months, following parameters were determined in the serum: total cholesterol, HDL-cholesterol and triglycerides. Moreover, electrophoresis of serum lipoproteins were also performed. At the start of the DT 63% of chronically uremic patients had normal values of basic lipid parameters, but this number decreased to only 29% after the first year of DT. We conclude that the modified A B C D E classification of lipid disorders in hemodialyzed patients is more convenient than the classic Fredrickson one used before.

Adolescent↗
PubMed1996

[Oral calcitriol pulse therapy in treatment of secondary hyperparathyroidism in patients with long term hemodialysis].

Oral calcitriol pulse therapy slowly becomes a method of choice in the treatment of secondary hyperparathyroidism in hemodialysis patients. It appears to be equally effective and simultaneously significantly cheaper than an intravenous therapy. In last year we have applied such a treatment to 12 hemodialysis patients with severe secondary hyperparathyroidism (iPTH range: 447-1228 pg/ml). All of them were hemodialysed 3 times a week with dialysate Ca+2 level 1.25-1.75 mM/l. Calcium carbonate was administered to maintain serum Ca level between 9.0-11.0 mg/dl and phosphate below 6.0 mg/dl. The patients were given calcitriol at dose 0.1 microgram/kg once a week, but it was obligatory to take a drug at bedtime, at least two hours after the last meal, a day before hemodialysis. During the treatment we divided the patients into two groups: I-patients who responded to our treatment (7/12); II-treatment was unsuccessful (5/12). In this group we decided to increase the dose of calcitriol to 0.075 micrograms/kg twice a week after 6 months use of a previous one. We have achieved statistically significant decrease of parathormone (p < 0.001) and alkaline phosphatase (p < 0.02) in group I and after the increase the dose of calcitriol there occurred the decrease of parathormone (p < 0.05) and alkaline phosphatase (p < 0.002) in group II. Simultaneously we have observed a great clinical improvement. Our results confirm the fact that even severe secondary hyperparathyroidism can be successfully treated with oral calcitriol pulse therapy. Administering of high doses of calcitriol at bedtime increases safety of this procedure-we have not observed any case of hypercalcemia.

Adult↗
PubMed1996

[Evaluation of platelet membrane structure in patients with chronic glomerulonephritis (CGN)].

The structure of platelet membrane determines platelet surface glycoprotein receptors and correct cell function. Meanwhile different diseases and drugs may induce changes in this structure. The aim of this study was to determine structure of platelet lipid bilayer in patients with chronic glomerulonephritis (CGN) in comparison to control group. Studies were carried out in 30 patients with nephrotic syndrome (NS) and 30 patients without this syndrome and 15 controls. Electron spin resonance phenomenon with spin labelling, was used for estimation of platelet membrane structure. CGN patient platelets showed lower order parameter A/C and increased rotation correlation time tau in comparison with healthy subjects. It indicated abnormal platelet membrane structure in these patients. The negative significant correlation between parameter A/C and plasma fibrinogen concentration of NS patients has been found (r = -0.5; p < 0.05). Additionally the value of an order parameter (A/C) has significantly positively correlated with serum triglycerides concentration in patients with NS and spontaneous platelet aggregation (r = 0.52, p < 0.05). Conclusion. 1. CGN patient platelets have revealed disorders of lipid bilayer structure. 2. These disorders could be responsible for decreased platelet aggregation observed in CGN patients in comparison to healthy controls.

Adult↗
PubMed1996

[Evaluation of factors influencing platelet aggregation in patients with chronic glomerulonephritis (CGN)].

Platelets (PLT) play an important role in hemostasis, modulation of immunological and inflammatory processes. There is also evidence that PLT takes part in the development of atherosclerosis and glomerulosclerosis. The aim of presented study was to determine morphological and functional changes of platelets and their relation to the lipid, protein and coagulation factors disturbances in patients with chronic glomerulonephritis (CGN). The studies were carried out in 60 patients with CGN diagnosed by renal biopsy: 30 patients without nephrotic syndrome (NS)-CGN and 30 patients with NS-CGN+NS. Protein and lipid disturbances, coagulation factors were estimated using routine laboratory methods. Platelet count (PLT), mean platelet volume (MPV) and modal platelet volume (PLT-Mode) were measured using Technicon H1 hematological autoanalyser. Platelet function was assessed by aggregometry using turbidimetric method (inductors: ADP 1-3 microM, collagen 50g/ml, epinephrine 0.25-5 microM). Spontaneous platelet aggregation (SPA) was measured in platelet rich plasma (PRP) without inductors for 15 min, in 1-2 hours after venesection. SPA was observed in 9 of 30 patients with CGN and in 19 of 30 patients with CGN+NS. MPV and PLT Mode were significantly higher in patient showing SPA compared with those without. Significant correlations between SPA and the concentration of plasma albumin (r = -0,70; p < 0.02) TG and CH-LDL (r = 0,61; p < 0.05) were found in CGN+NS patients. APTT was significantly shorter in patients showing SPA compared with those without and negative significant correlation between SPA and APTT was found. Platelet aggregation to inductors in CGN and CGN+NS patients was diminished compared with control group. Lack of second phase aggregation in response to aggregation inducers was observed in patients with SPA. Conclusions. 1. Platelet hyperaggregation play an important role in hypercoagulation state in CGN patients. 2. SPA in vitro was observed in majority of CGN+NS patients and in some without NS. 3. Pathomechanism of SPA is probably multifactorial (hypoalbuminemia, dyslipidemia, changes in concentration of coagulation parameters).

Adult↗