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Biomedical subjects

E Marczak

Publications and source records attributed to E Marczak.

17 recordsLinked to original sources
PubMed2002

Elective coronary angioplasty with 60 s balloon inflation does not cause peroxidative injury.

BACKGROUND: The aim of this study was to evaluate the ongoing controversial issue of whether ischemia/reperfusion during elective coronary angioplasty evokes myocardial peroxidative injury. DESIGN: We measured indicators of free radical damage to lipids (free malondialdehyde) and proteins (sulphydryl groups) in coronary sinus blood in 19 patients with stable angina who were undergoing elective angioplasty for isolated stenosis of the proximal left anterior descending coronary artery. Ischemia induced by 60 s balloon inflations was confirmed by lactate washout into coronary sinus after deflation, with immediate and 1 min samples. Peroxidative injury was assessed from washout of (a) malondialdehyde measured directly by high performance liquid chromatography and (b) reduced sulphydryl groups, inverse marker of protein oxidative stress. RESULTS: Mean lactate concentration immediately after each deflation increased by 120-150% of the initial value, confirming ischemia and showing that blood originated largely from the ischemic region. Lack of myocardial production of malondialdehyde was confirmed by (a) no arteriovenous differences in individual basal concentrations (aortic, range 0.33-12.03 nmol mL-1, mean 7.82; coronary sinus blood, range 0.52-15.82 nmol mL-1, mean 8.18), and (b) after deflations, mean concentrations were not significantly different from preocclusion value. There was no decrease in concentration of sulphydryl groups throughout angioplasty. CONCLUSION: Elective coronary angioplasty with 60 s balloon inflations is a safe procedure that does not induce peroxidative myocardial injury as assessed by methods used in the present study.

Angioplasty, Balloon, Coronary↗
PubMed2001

[Peritonitis in children treated with automated peritoneal dialysis].

The rate of peritonitis, its etiology and efficacy of treatment was compared between 28 children treated with APD for a total of 439 dialysis months and 24 children on CAPD treated for 328 dialysis months. The peritonitis rate was significantly lower in children on APD (1 episode per 27 months) than in children on CAPD (1 episode per 17 months) (p = 0.005). The etiology of peritonitis (68% v. 62% Gram + organisms), efficacy of treatment (100% v. 100%) and relapse rate did not differ between the machine operated and manual methods of peritoneal dialysis.

Adult↗
PubMed2001

[Efficacy and safety of renal biopsy in children performed with an automatic biopsy device under control of ultrasonographic imaging].

UNLABELLED: The efficacy and safety of kidney biopsy in children performed with an automatic Biopty Gun device under real time ultrasound was analysed. The procedure was performed under sedation during short hospitalisation with ultrasound assessment of complications performed after 24 hours. 98% of 131 biopsies yielded representative material with an average 16 glomeruli obtained per biopsy. Symptomatic perirenal haematomas were observed in 80%, subcapsular haematomas in 3.8% and arteriovenous fistulas in 4.6% of children on post biopsy ultrasound. They resolved spontaneously in all patients. CONCLUSIONS: Real time ultrasound guidance with the use of automatic biopsy devices should become the standard practice for kidney biopsy in children due to its efficacy and safety. The procedure should be performed during short hospitalization to enable ultrasound monitoring of early complications.

Adolescent↗
PubMed2001

[Bilateral hydrothorax in a 13-year old girl treated with continuous ambulatory peritoneal dialysis renal replacement therapy].

Bilateral hydrothorax is a very rare complication of ambulatory peritoneal dialysis in children. We present a case of a 13-year-old girl who developed bilateral acute hydrothorax during after seven months of CCPD. Peritoneal dialysis was temporarily discontinued and the child was transferred to haemodialysis. Six weeks later the patient was successfully resumed CCPD.

Adolescent↗
PubMed2000

Protein hydrolysates for oral tolerance.

To induce oral tolerance in multiple sclerosis treatment, we proposed to use the predigested protein of pig spinal cord. The most biologically active composition was obtained from the hydrolysis of an undenaturated homogenate of proteins digested with pepsin. Feeding the rats with our preparation, before or after immunization with MS antigens, strongly reduced development of the experimental autoimmune encephalomyelitis (EAE). The biological results obtained in animals suggest that the developed method of induction of the oral tolerance should be effective in human treatment, at least as a support mechanism in combination with other treatment methods.

Animals↗
PubMed2000

[Changing clinical course of hemolytic uremic syndrome in children].

An incidence of hemolytic-uraemic syndrome as a cause of the acute renal failure in childhood, its early survival rate and long-term sequela quences were compared in the 1970s, 1980s, and 1990s in the same geographical area. 196 children with HUS were treated between 1972-1999. 94% had a typical D+ HUS. The majority were of patients severely ill with 87% requiring peritoneal dialysis of an average 14 days duration. The children were grouped into three 9-year periods for comparison (1972-1980, 1981-1989, 1990-1999). 105 patients were followed for 2-27 years (mean 1 years). An incidence of HUS as a cause of ARF in childhood ranged from 58% and 50% in the 1970s and 1980s to 30% in the past decade. With time survival rate has improved dramatically over the years from 80% and 75% to 97% in the 1990s. Deo spite better short term outcome the late consequences of HUS are serious. The longer the follow-up, the greater percentage of patients with severe outcome. At last follow-up only 32% children showed full recovery. 33% are on renal replacement therapy or have impaired renal function. The severity of the initial lesions to the kidney measured by the duration of anuria is a marker of poor late prognosis. With improving early outcome the clinical significance of HUS is focusing on its severe long-term consequences.

Adolescent↗
PubMed2000

[Hypertension in children with chronic renal failure].

Hypertension is one of the main risk factors of mortality for children on renal replacement therapy. It has also been recognised as one of the major risk factors for progression of renal failure. The aim of the study was to define the prevalence of hypertension in children with chronic renal failure, treated in a single centre, and to assess the efficacy of its diagnosis and management. Hypertension was present in 27% of 40 children before the onset of chronic renal failure, increasing to 57% with the development of CRF, and reaching 86% at onset of dialysis. Reflux nephropathy, hemolytic-uraemic syndrome and glomerular disease were most frequently associated with severe hypertension. ACE inhibitors (70%), diuretics (52%), and calcium channel blockers were the most frequently used antihypertensives with 49% of the children being on monotherapy. Despite therapy 43% of children had elevated blood pressure levels and 16% had echocardiographic signs of LVH. A 24 hour ambulatory blood pressure measurements were more sensitive in diagnosing hypertension and assessing adequacy of blood pressure control. Early and intensified treatment should prevent end organ damage though optimal blood pressure values to aim obtain are still to be defined.

Adolescent↗
PubMed1997

Interstitial tissue fraction. The prognostic marker in membranoproliferative glomerulonephritis in children.

OBJECTIVE: To explain the differences in the clinical course of membranoproliferative glomerulonephritis (MPGN) in children and to find some prognostic markers at the disease onset that correlate with the disease outcome. STUDY DESIGN: We reviewed clinical histories and laboratory findings, reexamined kidney biopsies performed at the disease onset and evaluated volume relations between kidney components in children with the diagnosis of MPGN. RESULTS: Children were divided into three groups based on their final clinical status: I. children without features of active nephropathy, II. children with persistent nephropathy, and III. children who died of kidney disease and those who had chronic renal insufficiency. Reevaluation of kidney biopsies led to a change in the histopathologic diagnosis in several cases in all three groups. Morphometric analysis showed increasing interstitial tissue volume from group I through group III in MPGN and other forms of glomerulonephritis diagnosed after reevaluation. All the morphologic, clinical and laboratory features estimated by means of multivariate analysis of variance showed statistically significant individual characteristics of each group defined by clinical outcome. CONCLUSION: Increased interstitial tissue volume in the kidney biopsy at the disease onset is a negative prognostic factor in MPGN.

Biomarkers↗
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↗
PubMed1995

[Clearance, reabsorption and excretion of free and bound L-carnitine in children].

Acylcarnitines are by-products of fatty acid, pyruvate and some xenobiotics metabolism excreted in urine. We compare the renal handling of free and acylcarnitine in a group of 15 healthy children in relation to sodium and urea excretion and to sodium fractional tubular reabsorption (FTR%) and fractional excretion (FE%). Urea and sodium were determined by routine laboratory method; free and acylcarnitines by enzymatic one. FTR% and FE% were determined as a % of filtration load. Linear regression was used for calculation of correlation coefficient "r" from paired data. Low correlation (r = 0.25; p = 0.42) between urea and free carnitine excretion was observed; for excretion of acylcarnitine and urea correlation was much higher (r = 0.61; p < 0.03). Excretion of free correlation was negatively correlated with sodium FTR (r = -0.86; p < 0.001) and there was no correlation at all for acylcarnitine excretion and sodium FTR. It can be assumed:-neither excretion nor reabsorption of acylcarnitines are Na-dependent;-renal handling of free and total carnitines proceeds on different mechanisms.

Adolescent↗
PubMed1982

Mesangial proliferative glomerulonephritis in children.

Over a ten year period 105 children with a histological diagnosis of a mesangial proliferative glomerulonephritis were diagnosed. Patients were divided into two groups according to their clinical presentation at the time of diagnosis. Ninety two children presented with nephrotic syndrome (NS) of whom 82 received steroid therapy. No response was observed in 26 children and in 56 remissions were short in duration and subsequent relapses were frequent. Eighty nine children with the nephrotic syndrome were treated with cyclophosphamide (CP) of whom 26 had a steroid resistant NS, 53 were steroid dependent and 10 were previously untreated. Eighty four entered remission with a mean duration of 46 months. Only 5 children did not respond to treatment with CP. No correlation could be found between the results of therapy and the degree of morphological changes on examination of renal biopsy. The second group consisted of 13 children presenting with a persistent nephritic syndrome and or proteinuria. These children were untreated and no progression of renal disease was observed after several years follow up.

Child↗
PubMedDate not supplied

Prognostic factors in the hemolytic-uremic syndrome.

During 1972-1986, 142 children with the hemolytic-uremic syndrome were treated. Most of them were infants (73%). The total mortality rate reached 25.4%. Computer analysis revealed the following risk factors of a fatal outcome: severe gastrointestinal symptoms during the prodromal period, coma, convulsions, malignant hypertension, persistence of prodromal symptoms over 7 days, hyperkalemia over 7 mmol/l, acidosis with bicarbonate level less than 15 mmol/l, a delay of over 5 days in starting dialysis, and transport to dialysis unit of over 100 km. The greatest risk of death existed during the first 3 weeks from onset. Among 142 children, 106 survived the acute phase. They were followed up from 2 to 16 years. Nine were lost to follow-up. Twelve children developed chronic renal failure.

Discriminant Analysis↗