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Biomedical subjects

J Dzieniszewski

Publications and source records attributed to J Dzieniszewski.

At least 19 recordsLinked to original sources
PubMed2006

Guidelines in the medical treatment of Helicobacter pylori infection.

Scientific evidence based on controlled clinical research confirm substantial benefits resulting from the eradication of H. pylori infection in such pathologies of the alimentary tract as: gastric peptic and duodenal ulcer (active or confirmed in the future and ulcer disease complications), MALT (Mucosa Associated Limphoid Tissue) lymphoma, atrophic gastritis, past stomach resection, gastric cancer in the family. The above group of indications is strongly recommended for eradicative treatment. During the last several years there have been many guidelines made by international and national specialist groups. "Test and treat" strategy of undiagnosed dyspepsia treatment is based on possibility to carry out non-invasive tests confirming H. pylori infection. First symptoms of dyspepsia in people over 45 years of age constitute recommendation for endoscopy, as well as symptoms assumed to be "alarming" (loss of weight, anaemia, bloody vomiting, tarry stool, dysphagia) regardless of patient age. An individual approach to eradication is proposed in gastroesophageal reflux disease, and use of non-steroid anti-inflammatory drugs. Antibacterial activity towards H. pylori is shown by many antibiotics (amoxicillin, macrolides, tetracyclines) and some other chemotherapeutic agents (nitroimidazoles) and bismuth. PPIs are recommended, because through increase of pH in stomach they create conditions to act for antibiotics. During the stage of first line triple therapy, it is advised to apply PPI and two antibacterial medicines at the same time (PPI + amoxicillin+metronidazole or clarithromycin). Such therapeutic action ensures achievement of eradication of H. pylori infection in 80-90% of cases. In case of lack of treatment efficiency in the first-line therapy, 7-14 day treatment may be repeated using triple therapies (PPI + 2 antibiotics) substituting the antibiotic with the metronidazole or tetracycline, or quadruple therapies (PPI + bismuth citrate + 2 antibiotics). Side effects during eradicative treatments occur quite rarely (from 15 to 30%).

Amoxicillin↗
PubMed2005

Nutritional status of patients hospitalised in Poland.

AIM: Screening and extended assessment of the nutritional status of patients on admission and on discharge from hospital were carried out. DESCRIPTION: The studies were carried out in four teaching hospitals, four provincial hospitals and four county hospitals in Poland. SUBJECTS: Screening examinations were carried out for 3310 randomly selected patients (every 10th patient admitted to hospital, including 1916 female cases aged from 16 to 92 y and 1394 male patients aged from 16 to 100 y). Extended examinations were carried out on 210 patients aged from 16 to 87 y (including 122 female and 88 male). MAIN ASSESSMENT PARAMETERS: Anthropometric (height, weight, body mass index (BMI), waist-to-hip ratio (WHR), arm circumference) and biochemical indices (erythrocyte count, haemoglobin concentration, white blood cell count, blood lymphocyte count and serum albumin serum concentration). The extended examinations included determination of antioxidant vitamins (A, C, E), vitamin B(12) and folic acid. RESULTS: On admission to hospital, 10.43% of the patients surveyed had a BMI below 20 kg/m(2), in 20.74% of patients serum albumin concentration was below 3.5 g/dl, indicating possible protein energy malnutrition. In addition, 21.02% had lymphocyte count below 1.5 x 10(3)/mm(3). During hospitalisation, deterioration in the nutritional status of the patient population occurred. On discharge from hospital, the percentage of patients with BMI < 20 kg/m(2) increased to 11.21% and the percentage with low blood albumin (<3.5 g/dl) increased to 28.57%. On admission, vitamin C deficiency was present in 51.8% of patients, folic acid deficiency in 32%, vitamin E deficiency in 10%, vitamin B(12) deficiency in 6.8% and vitamin A deficiency in 1.4%. Vitamin deficiencies were present equally in malnourished, overweight and obese patients. CONCLUSIONS: In patients admitted to hospitals in Poland, malnutrition risk demonstrated by BMI was observed in 10.43% of patients. On the basis of biochemical indices, increased nutritional risk was demonstrated in 21% of patients. Vitamin malnutrition was seen in the majority of patients. A significant correlation between weight, BMI, arm circumference, blood lymphocyte count and the number of days spent in hospital was observed. SPONSORSHIP: The Committee of Scientific Research and the Ministry of Health-PBZ 012-14.

Adolescent↗
PubMed2004

Glycemic and insulinemic responses to six cereal products in healthy adults.

Glycemic index (GI) and insulin index (II) scores of six cereal-based foods (biscuits and shortbreads) were determined and the relationship between the glycemic and insulin responses of the foods was examined. The study was conducted using recommended by FAO/WHO methodology using glucose as a standard food. We obtained a range of GI scores from 49 to 68% and II scores from 51 to 75%. The test foods' blood insulin responses were in parallel to their glycemic responses although in every case the level of II was higher than the level of GI. The foods' II scores were closely related to their GI scores (r=0.80).

Adolescent↗
PubMed2003

Pancreas; pancreatitis--Polish accomplishments.

Polish accomplishments in clinical and experimental pancreatology concern acute (AP) and chronic (CP) pancreatitis. Special notice was drawn in Polish studies on hemostasis disorders in acute experimental pancreatitis (AEP), and resulting clinical implications (possibility of thrombotic-embolic complications leading to hemorrhagic defects associated with coagulation factors consumption). Studies on lysosomal hydrolases role in AEP pathogenesis were discussed. In those studies notice was drawn to initiating role of zymogen activation by lysosomal hydrolases, especially beta-glucuronidase, with smaller activity of acid phosphatase and cathepsin in this process. It was stated, that also lysosomal enzymes are released from macrophages obtained from bronchoalveolar lavage fluid in AEP. It was revealed that prostacyclin (PGI(2)) shows stabilizing effect on lysosomes in liver and kidneys in AEP. Platelets activating factor antagonist inhibits pulmonary lysosomal hydrolases activity in such conditions. Polish studies concerning reactive forms of oxygen role in AEP pathogenesis are one of the first in Europe. Oxidative-antioxidative balance was disturbed in acute pancreatitis course and associated multiorgan changes both under experimental conditions and in humans. Oxidative stress as an early prognostic symptom in AP in humans was also emphasized, showing correlation of oxidative stress indicators with phospholipase A serum activity and polymorphonuclear elastase in plasma of patients with different degree of this disease. In a range of clinical studies special attention should be given to studies concerning lipid disorders as an AP etiological factor in humans. Clear decrease in lipoprotein lipase activity in AP in humans was determined. Polish studies concerning importance of sphincterectomy in acute gallstone derivative pancreatitis (AGP) were presented. Polish researchers accomplishments in chronic alcoholic pancreatitis (CAP) etiopathogenesis were discussed.

Animals↗
PubMed2001

[Non-pharmacological treatment of hypertension in practice of primary care physicians].

The role of non-pharmacological methods in prevention and treatment of hypertension is well documented. Weight in patients with overweight and obesity, sodium intake restriction and alcohol drinking limitation are especially effective in arterial pressure reduction. The aim of this questionnaire study was to evaluate the knowledge and skills in that field of physicians working in primary health care. The study was done with 91 physicians working in Warsaw District. All of them declared that they give instructions about life style to their patients with hypertension. In majority it was oral consultation (36 persons, 39%) or oral consultation with distribution of booklets or brochures (48 persons, 52%). Six physicians (7%) sent patients to specialist. Pharmacological treatment was started most often from the systolic pressure 160 mmHg (59 persons, 64%) and diastolic pressure 100 mmHg (39 persons, 42%). Non-pharmacological advice was given most often at systolic pressure above 140 mmHg (44 persons, 48%) and diastolic pressure above 90 mmHg (67 persons, 73%). Salt intake reduction was advised always or usually by 82 physicians (90%), alcohol drinking reduction by 77 persons (85%) and tobacco smoking cessation by 86 persons (95%). Regular physical activity was advised always or usually by 75 persons (82%). Evaluation of nutrition was done predominantly by asking a few not-formal questions (62 persons, 67%). Only 1 physical used daily diary of nutrition. Similarly in evaluation of physical activity 62 persons (67%) used only not-formal questions. It is worthily to note that 36 persons (40%) considered that they need more skills to give advices of healthy life style, 49 persons (53%) did not enough time to do that and 30 persons (33%) thought that it is hard to give advices they can't keep themselves. All questionnaire physicians declared to use non-pharmacological treatment in patients with hypertension. Quite good knowledge of essential recommendations in that field was stated. The results of this questionnaire indicate that many physicians estimate their knowledge and skills as low in that sphere.

Adult↗
PubMed2000

Tobacco smoking and vitamin C concentration in gastric juice in healthy subjects and patients with Helicobacter pylori infection.

Low gastric juice total vitamin C concentration in the presence of Helicobacter pylori infection probably plays a role in gastric carcinogenesis. Vitamin C plays a role in the neutralization of various pathogenic factors connected with H. pylori infection, including the destruction of free radicals, which damage tissues and cell DNA, and inhibition of the formation of N-nitroso compounds, which have a strong carcinogenic activity. The aim of the study was to determine whether tobacco smoking had any effect on gastric juice vitamin C concentration in healthy subjects and in patients infected with H. pylori. Eighty-six patients with dyspeptic symptoms undergoing routine endoscopy entered the study after giving informed consent. In all patients plasma and gastric juice total vitamin C levels were measured by a spectrophotometric method. They were entered into four groups: group I (controls) - H. pylori-negative non-smokers (n = 17), group II - H. pylori-negative smokers (n = 16), group III - non-smokers with H. pylori infection (n = 21), and group IV - H. pylori-infected smokers (n = 32). In the control group (I) the mean gastric juice total vitamin C concentration was 17.1 microg/ml (range 5.3-40.0 microg/ml), which was significantly higher (P < 0.05) than in group II (12.6 microg/ml, range 5.1-21.0 microg/ml), group III (5.8 microg/ml range 2.1-13.7 microg/ml) and group IV (3.9 microg/ml, range 1.1-10.6 microg/ml) (P < 0.001). Statistically significant differences also were noted between groups II and III (P < 0.01) and groups II and IV (P < 0.001) and between groups III and IV (P < 0.05). These results demonstrate that the concentration of vitamin C in gastric juice is significantly lower in smokers than in non-smokers. This was observed in healthy subjects as well as H. pylori-infected patients. This phenomenon may be one of the mechanisms whereby smoking contributes to the production of gastric lesions, impairs healing of peptic ulcers and also increases the recurrence rate of peptic ulcers in cases with H. pylori infection.

Adult↗
PubMed2000

[Interactions between food and drugs. 1. Malabsorption].

The paper overviews food-drug interactions. The part 1 reviews the interactions of foods with the many different agents which occur at the level of absorption, considering the mechanisms involved. The food-drug interactions can cause an increase, decrease, or delay in the bioavailability of the drugs. There is an aspect of therapy which may have an important clinical repercussion, which it must not be forgotten.

Biological Availability↗
PubMed2000

[Interactions between food and drugs. 2. Disturbances of drug metabolism and synergistic mode of action].

The paper overviews food-drug interactions. The part 2 reviews the interactions of foods with the drugs which occur at the level of metabolism. Concomitant intake with food increases or decreases the concentrations of many agents in humans. The effect seems to be mediated mainly by suppression of the cytochrome P450 in the liver and in the small intestine wall. This results in a diminished first pass metabolism with higher bioavailability and increased maximal concentrations of substrates of this enzyme. To avoid the interactions many drugs should not be taken with the meal and citrus juices, particularly grapefruit juice.

Biological Availability↗
PubMed1999

[A review of methods for organizing nutritional education for hospitalized patients].

Diet-related diseases are diagnosed very frequently among inpatients and result in high mortality rate. Most commonly, the severity of illness or poor prognosis can be reduced or diminish by change of the lifestyle or simply-eating behavior. Across many countries there is conducted research of nutrition education potentials. It is usually applied to patients during their staying in hospital and after. A review of methods of nutrition education for hospitalised patients was done. The methods can be classified into three categories: instructional, motivational and behavioral. The effectiveness of the methods was the main concern. There were two major ways to evaluate this effectiveness: direct approach (laboratory or anthropometry tests) and indirect approach (questionnaires, food diary). An advantage of nutrition education providers' employment was discussed. Many studies show that nutrition education is an effective method in secondary prevention of diet-related diseases. It is promising to disseminate these kind of efforts in Poland.

Feeding Behavior↗
PubMed1998

Effects of high dose vitamin C treatment on Helicobacter pylori infection and total vitamin C concentration in gastric juice.

Low gastric juice total vitamin C concentration in the presence of Helicobacter pylori (H. pylori) infection probably plays a role in gastric carcinogenesis. In vitro vitamin C has been shown to inhibit the growth of H. pylori. The aims of this study were to determine the effect of high dose vitamin C administration on H. pylori infection and on gastric juice total vitamin C concentration in patients with H. pylori related chronic gastritis. Sixty patients with dyspeptic symptoms and proven chronic gastritis and H. pylori infection, who were undergoing routine endoscopy, entered the study after giving informed consent. They were randomly coded into two treatment groups. Group 1 (controls, n = 28) were treated with antacids for 4 weeks and Group 2 (n = 32) received vitamin C 5g daily also for 4 weeks. Nine patients did not complete the study and were excluded. Plasma and gastric juice total vitamin C levels were measured at baseline, at the end of 4 weeks treatment and again 4 weeks after treatment cessation. In the control group H. pylori infection remained unchanged in all 24 patients throughout as did the mean gastric juice total vitamin C concentration. However, in the vitamin C treated group eight of 27 patients (30%) who completed the treatment course the H. pylori infection was eradicated (P = 0.01). In these patients the mean gastric juice total vitamin C concentration rose significantly from 7.2 +/- 1.6 micrograms/ml after 4 weeks treatment (P < M 0.001) and 19.8 micrograms/ml 4 weeks after treatment was discontinued (P < 0.001). In the remaining 19 patients with persistent H. pylori infection, the mean gastric juice total vitamin C concentration rose less than in those with successful H. pylori eradication; 6.3 +/- 1.7 micrograms/ml before treatment, 10.8 +/- 1.5 micrograms/ml after 4 weeks treatment (P < 0.05) and a return to pre-treatment levels (7.1 +/- 2.7 micrograms/ml) 4 weeks after vitamin C intake stopped. There were no side effects of vitamin C treatment. This study has shown that 4 weeks daily high dose vitamin C treatment in H. pylori infected patients with chronic gastritis resulted in apparent H. pylori eradication in 30% of those treated. In those patients there was also a highly significant rise in gastric juice total vitamin C concentration which persisted for at least 4 weeks after the treatment ceased. A significant, though less marked, gastric juice total vitamin C concentration increase was observed during vitamin C treatment even in subjects with persistent H. pylori infection, though this was not maintained after treatment ended. The mechanism whereby vitamin C treatment appeared to result in H. pylori eradication is unclear. Further confirmatory studies are indicated.

Adolescent↗
PubMed1997

[A case of ascites in the course of acute pancreatitis].

The case of acute alcoholic pancreatitis, complicated by internal pancreatic fistula is being reported. The general patients symptom in initial illness period was ascites in peritoneal cavity. Biochemical investigation of ascites has shown elevated activity of amylase and protein which is typical for pancreatic ascites. The late diagnosis of ascites cause (in 3rd week of the illness) and complications decreased efficacy of the treatment used (parenteral nutrition and somatostatin). Thus worse the course of the illness.

Acute Disease↗
PubMed1997

Multicenter evaluation of dual-therapy (omeprazol and amoxycillin) for Helicobacter pylori-associated duodenal and gastric ulcer (two years of the observation).

Treatment with the proton pump inhibitor (omeprazole) and single antibiotic (amoxycillin), two synergistic compounds, can cure Helicobacter pylori (H. pylori) infection, but this therapy is not as effective as had been expected. However, some studies show promising results. The aim of our study was to evaluate the effect of two weeks dual-therapy with omeprazole (O) and amoxycillin (A) on gastric (GU) and duodenal ulcer (DU) patients: ulcer healing, eradication of the H. pylori and recurrence rate of the ulcer. We studied 216 patients (aged 18-70) endoscopically proven GU (58 patients) and DU (158 patients). Rapid urease test from the two antrum biopses and two antral and two corporeal biopses using Giemsa stain method for confirmation of the H. pylori infection were used. The patients were treated with omeprazole 20 mg BID and amoxycillin 1.0 g BID for 2 weeks and investigated every 4 months during 2 years. Clearance effect of Hp infection was achieved in 65.1% GU and 66.4% DU patients. Eradication ("check point" after 4 months) in 43% DU and 56.6% GU patients was confirmed. Reinfection rate was found in 16% during 2 years. We conclude--dual-therapy (O and A) is not sufficiently effective to be recommended as an anti-H. pylori treatment. H. pylori eradication prevents recurrence of peptic ulcer and is an important issue in attempts to achieve permanent ulcer healing.

Adolescent↗
PubMed1997

Helicobacter pylori eradication and antral intestinal metaplasia--two years follow-up study.

Intestinal metaplasia (IM) appears to be an important stage in the pathogenesis of intestinal type of gastric cancer. The purpose of the study was to evaluate how H. pylori eradication modifies IM in gastric antrum. 35 patients (19 M + 16 F) with peptic ulcer (28 duodenal ulcer +7 gastric ulcer) and antral IM with accompanying H. pylori infection proven by urease test and histological examination were followed-up after healing an ulcer achieved by 14 days treatment with 40 mg/d omeprazole and 2 g/d amoxicillin. Endoscopy examination was done every 4 months during 2 years after eradication. At least two antral biopsies were taken during each endoscopy. H. pylori eradication was achieved in 23 patients (66%). No reinfection was observed during the time of observation. The medium grade of intestinal metaplasia after eradication of H. pylori declined from 1.76 to 0.57 over the period of follow-up (p < 0.01). The difference became statistically significant from the 12 months after eradication. No significant change was seen in the group of non-eradicators (1.83 at the beginning of observation and 1.91 at the end point). Statistical difference between eradicators and non-eradicators was stated from the 12th month after eradication. Total regression of intestinal metaplasia was observed in 30% cases after one year and 61% cases after two years after H. pylori eradication. The cure of H. pylori infection significantly reduces the presence of antral IM. Regression of IM appears to be a long-term process taking many months after H. pylori eradication.

Adult↗