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Biomedical subjects

K Gorzelak

Publications and source records attributed to K Gorzelak.

11 recordsLinked to original sources
PubMed1999

[Treatment outcome in tobacco dependence after nicotine replacement therapy and group therapy].

The deletorious health effects of smoking are generally known. In spite of that, great numbers of people still smoke tobacco in the whole world. It is primarily due to the addictive properties of nicotine. Cigarette smoking is also dependent on various social and psychologic factors making quitting very difficult. Among various treatment modalities for tobacco dependence we aimed to assess the efficacy of nicotine replacement therapy (NRT) vs group therapy. 325 subjects smoking at least 15 cigarettes/day for more than 3 years were studied. They were allocated to group therapy (neurolinguistic programming) or NRT (gum or patch) at their will. Non-smoking was validated at each of follow-up visits, at 1 and 2 weeks 1, 3, 6, 12 months by measuring CO in expired air. All groups were matched in age, smoking history and nicotine dependence. The best quit rate was observed as a result of group therapy (41% at 1 year, p. < 0.001) as compared to nicotine patch (2%) and nicotine gum (9%).

Administration, Cutaneous↗
PubMed1997

Effect of long-term oxygen therapy on survival in patients with chronic obstructive pulmonary disease with moderate hypoxaemia.

BACKGROUND: To date only two controlled studies have been published on the effects of domiciliary oxygen treatment on survival in patients with chronic obstructive pulmonary disease (COPD) with advanced respiratory failure. The survival in such patients despite oxygen treatment remains poor. The prescription of long term oxygen therapy (LTOT) in less severe disease remains controversial. The aim of this study was to evaluate the rationale for prescribing oxygen to patients with COPD with moderate hypoxaemia. METHODS: One hundred and thirty five patients with COPD, with PaO2 7.4-8.7 kPa (56-65 mmHg) and advanced airflow limitation (mean (SD) forced expiratory volume in one second (FEV1) 0.83 (0.28) 1), were randomly allocated to a control (n = 67) and LTOT (n = 68) group. The patients were followed every three months for at least three years or until death. RESULTS: The cumulative survival rate was 88% at one year, 77% at two years, and 66% at three years. No significant differences were found in survival rates between patients treated with LTOT and controls, nor did longer oxygen use (over 15 hours per day) improve survival. Younger age, better spirometric values, and higher body mass index predicted better survival. CONCLUSIONS: Domiciliary oxygen treatment does not prolong survival in patients with COPD with moderate hypoxaemia. Airway limitation seems to determine survival in this group of patients.

Female↗
PubMed1997

Causes of death in patients with COPD and chronic respiratory failure.

Although the factors associated with mortality, such as forced expiratory volume in one second (FEV1), arterial oxygen tension (Pa,O2) and pulmonary arterial pressure, have been well described, there is limited information on the circumstances of death in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to investigate the causes and circumstances of death in patients with COPD and chronic respiratory failure (Pa,O2 < 8.0 kPa (60 mmHg) breathing air), treated with long-term oxygen therapy (LTOT). Ten European centres participated in the study and data were collected from patients both during a period of clinical stability and at the time of death. Of the 215 patients evaluated (161 males and 54 females; aged 66 +/- 10 yrs), the major causes of death were: acute on chronic respiratory failure (38%); heart failure (13%); pulmonary infection (11%); pulmonary embolism (10%); cardiac arrhythmia (8%); and lung cancer (7%). Seventy five percent of patients died in hospital. There was no difference in the number of patients who died in the morning, afternoon and night hours. Twenty percent of the total died during sleep and in 26% death was unexpected. A lower arterial carbon dioxide tension (Pa,CO2), less oxygen usage per 24 h, and increased incidence of arrhythmias were seen in those patients who died suddenly. Drug therapy was not related to unexpected death. The majority of patients with chronic obstructive pulmonary disease on long-term oxygen therapy died from chronic or acute on chronic respiratory failure. Prevention and treatment of respiratory failure in patients with chronic obstructive pulmonary disease is likely to have the greatest impact in reducing mortality.

Aged↗
PubMed1996

[Reproducibility of results for overnight pulse oximetry in patients with chronic obstructive pulmonary disease].

Overnight pulse-oximetry (PO), as the only non-invasive method assessing arterial blood oxygenation during sleep, became widely used additional criterion for the long-term oxygen therapy especially in chronic obstructive pulmonary disease (COPD) patients. The aim of this study was to assess the reproductibility of pulse-oximetry in COPD patients. We studied 20 stable COPD pts mean age 64.6 +/- 7.2 years with severe airway obstruction-FEV1 = 0.87 +/- 0.33 L and hypoxaemia-PaO2 = 55.8 +/- 6.9 mmHg. Three PO were performed in each patient at one and seven nights intervals. There were no statistically significant differences in results obtained at all three PO. The mean oxygen saturation changed from one night to another only by 0.1%, the initial and final-maximally by 0.5%. High correlations for mean oxygen saturation (r = 0.94 and 0.78 respectively), initial oxygen saturation (r = 0.78 and 0.52) and final oxygen saturation (r = 0.69 and 0.77) were observed. In conclusion PO is reproducible in stable COPD patients at 1 and 7 days intervals.

Aged↗
PubMed1996

[Evolution of nocturnal pulse-oximetry results in patients with chronic obstructive pulmonary disease].

The aim of this study was to evaluate if results of overnight pulse-oximetry (PO) change with time and progression of the disease. We studied 39 COPD patients. Majority of them (33 pts) were treated with long-term oxygen therapy (LTOT). Fifty pairs of PO were performed in the whole group separated from 1 to more than 3 years. Pulmonary function tests were performed at the same time as PO. Results of these tests showed progressive deterioration in the lung function-decrease of FEV1 and PaO2. Despite of that there were no statistically significant changes in any variable of PO in any studied group. This phenomenon is difficult to explain. It may resulted from the improvement in the cardiac output observed in COPD patient undergoing LTOT. May be that studied groups were not large enough or time of observation was too short to reveal differences. Stabilization of PO results in spite of deterioration in the lung function in COPD patients needs more studies.

Female↗
PubMed1996

[Eight years of experience in Warsaw with domiciliary long term oxygen therapy].

Between August 1986-July 1994 45 1 patients with chronic hypoxaemia were referred to us for evaluation. 315 of them (70%) were qualified for LTOT according to national guidelines. There were 189 pts with COPD (60%), 40 with late sequelae of pulmonary tuberculosis (TB), 21 with interstitial pulmonary fibrosis (IPF), 15 with bronchiectasis (BE), 15 with severe kyphoscoliosis (KS) and 35 with other disease leading to chronic respiratory failure. All patients received oxygen from an oxygen concentrator and have been regularly followed-up. The best survival rate in patients followed up for at least 3 years was observed in KS (68%) and COPD pts (50%). The worst survival was seen in BE (9%) and IPF (21%). 183 pts died during the follow-up and in 3 pts (1%) LTOT was withdrawn. The most frequent cause of death were either acute (58%) or chronic (21%) cardiorespiratory failure.

Aged↗
PubMed1995

[Clinical picture and outcome of conservative treatment for obstructive sleep apnea].

The aim of the study was to assess the clinical picture of patients with obstructive sleep apnea (OSA) and to investigate the long term effectiveness of treatment with continuous positive airway pressure (CPAP). 170 subjects were investigated with Mesam 4 screening device. Full polysomnography was performed in suspected patients confirming the diagnosis (AHI > 10) in 72 cases (69M, 3F), mean age 46.7 +/- 8.4 yrs, mean weight 110 +/- 19 kg. Snoring (100%) apneas (96%), excessive daytime sleepiness (98%) and nocturia (73%) were the most common symptoms. Application of CPAP therapy resulted in elimination of apneas, improvement in sleep architecture and in arterial blood oxygen saturation. Apnea index decreased from 63 +/- 22 to 4 +/- 4. First night compliance to CPAP was about 95%. OSA symptoms rapidly regressed. Follow-up examination was performed in 45 patients who used CPAP for more than 1 year. All subjects presented with improvement in quality of life, all but one were using CPAP almost every night (mean 6.6 +/- 0.9 night per week). The most common side effects of CPAP were uncomfortable nose mask (42%), throat dryness (27%) and eye irritation (24%) We concluded that CPAP treatment in OSA occurs to be effective, long term compliance is high, side effects are benign and mostly due to poorly fitting mask.

Adult↗
PubMed1995

[Predictors of survival in patients with chronic obstructive pulmonary disease with moderate hypoxemia].

Long-term oxygen therapy (LTOT) is a well established method of treatment in patients with chronic obstructive pulmonary disease (COPD). There are two main qualification criteria for LTOT: severe hypoxaemia (PaO2 < 55 mmHg) and moderate hypoxemia (PaO2 > 55 mmHg) accompanied by signs of cor pulmonale. We were unable to find any controlled investigations on the effect of LTOT on survival in this group of patients. We studied 85 COPD patients with PaO2 between 56-65 mmHg. Fourty four patients were treated at theirs homes with LTOT, 41 formed a control group. Both groups presented with severe airway obstruction--FEV1 < 1L. All patients were followed up for at least 3 years. During this time 27 patients died from the LTOT group and 26 patients from the control group. Survivors were younger and had less severe airway obstruction than nonsurvivors. Cox's proportional hazard regression analysis showed that only age and spirometric parameters--VC, VC%N, FEV1 were good predictors of survival. LTOT did not improve prognosis in this group of patients. Results of our study suggest the need of verification of LTOT qualification criteria.

Aged↗
PubMed1995

[Prognostic value of nocturnal pulse-oximetry in patients with chronic obstructive pulmonary disease treated with oxygen at home].

UNLABELLED: The aim of this study was to investigate if results of overnight pulse-oximetry (OPO) predict survival in COPD patients undergoing long-term therapy (LTOT). 97 COPD patients (74 M and 23 F) qualified for LTOT from 1986 to 1992 were studied. When qualifying for LTOT patients were mean age 59 years old, had severe airway obstruction (mean FEV10,9L), hypoxaemia (mean PaO2 53 mmHg) and hypercapnia (mean PaCO2 48 mmHg). Two OPO were performed in each patient: the first on atmospheric air and the second while breathing oxygen. All patients were observed for at least 2 years or until death. Fifty five patients died during the observation time. All deaths were related to the primary disease. Survival analysis by Cox formula showed the prognostic value of mean, initial and minimal arterial oxygen saturation while breathing air and of initial oxygen saturation while breathing oxygen. Also classical factors, such as age or FEV1, had the prognostic value in this group of patients. IN CONCLUSION: results of overnight oxygen saturation affect prognosis in COPD patients despite long-term domiciliary oxygen treatment.

Adult↗
PubMed1994

Hand-scoring of MESAM 4 recordings is more accurate than automatic analysis in screening for obstructive sleep apnoea.

The MESAM 4 system, developed to monitor breathing sounds, heart rate, arterial oxygen saturation (Sao2) and body position, was proposed as a screening method for obstructive sleep apnoea (OSA). The aim of the study was to assess the accuracy of hand-scoring versus automatic-scoring in screening for obstructive sleep apnoea. The study population consisted of 56 patients, 51 males, and 5 females, mean age 47 +/- 10 yrs, suspected of having obstructive sleep apnoea. Full polysomnography and MESAM 4 recordings were performed simultaneously. The apnoea+hypopnoea index was hand-scored in polysomnography and in MESAM 4. The hand-scoring in MESAM 4 was based on analysis of breathing sounds, heart rate and Sao2 changes taken together. The automatic-scoring system of MESAM 4 calculated oxygen desaturation index, heart rate variation index and intermittent snoring index. The diagnosis of obstructive sleep apnoea (apnoea+hypopnoea index > or = 10) was established by polysomnography in 37 patients. Sensitivity and specificity of hand-scored MESAM 4 diagnosis were 100 and 63%, respectively. Sensitivity and specificity of MESAM 4 diagnosis with automatic-scoring were: from oxygen desaturation index 100 and 27%; from heart rate variation index 81 and 74%; and from intermittent snoring index 92 and 16%, respectively. We suggest that hand-scoring of MESAM 4 is more accurate than automatic-scoring in screening for obstructive sleep apnoea.

Female↗