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Biomedical subjects

K Mitosek-Szewczyk

Publications and source records attributed to K Mitosek-Szewczyk.

At least 19 recordsLinked to original sources
PubMed2004

Escalating immunotherapy of multiple sclerosis--new aspects and practical application.

Recent clinical studies in multiple sclerosis (MS) provide new data on the treatment of clinically isolated syndromes, on secondary progression, on direct comparison of immunomodulatory treatments and on dosing issues. All these studies have important implications for the optimized care of MS patients. The multiple sclerosis therapy consensus group (MSTCG) critically evaluated the available data and provides recommendations for the application of immunoprophylactic therapies. Initiation of treatment after the first relapse may be indicated if there is clear evidence on MRI for subclinical dissemination of disease. Recent trials show that the efficacy of interferon beta treatment is more likely if patients in the secondary progressive phase of the disease still have superimposed bouts or other indicators of inflammatory disease activity than without having them. There are now data available, which suggest a possible dose-effect relation for recombinant beta-interferons. These studies have to be interpreted with caution, as some potentially important issues in the design of these studies (e. g. maintenance of blinding in the clinical part of the study) were not adequately addressed. A meta-analysis of selected interferon trials has been published challenging the value of recombinant IFN beta in MS. The pitfalls of that report are discussed in the present review as are other issues relevant to treatment including the new definition of MS, the problem of treatment failure and the impact of cost-effectiveness analyses. The MSTCG panel recommends that the new diagnostic criteria proposed by McDonald et al. should be applied if immunoprophylactic treatment is being considered. The use of standardized clinical documentation is now generally proposed to facilitate the systematic evaluation of individual patients over time and to allow retrospective evaluations in different patient cohorts. This in turn may help in formulating recommendations for the application of innovative products to patients and to health care providers. Moreover, in long-term treated patients, secondary treatment failure should be identified by pre-planned follow-up examinations, and other treatment options should then be considered.

Clinical Trials as Topic↗
PubMed2004

Interleukin-8 and RANTES levels in patients with relapsing-remitting multiple sclerosis (RR-MS) treated with cladribine.

OBJECTIVE: Chemokines are involved in the pathogenesis of multiple sclerosis. The aim of the study was to evaluate the effects of immunosuppressive therapy on production of two proinflammatory chemokines--interleukin-8 (IL-8) and RANTES (regulated on activation, normal T cell expressed and secreted). MATERIALS AND METHODS: Twenty-five patients with relapsing-remitting multiple sclerosis were treated with 2-chlorodeoxyadenosine (Cladribine), administered subcutaneously in 6 cycles repeated every 5 weeks. IL-8 and RANTES levels were measured by the enzyme-linked immunoassay (ELISA) method in serum and cerebrospinal fluid (CSF) before and after treatment. RESULTS: After Cladribine treatment the levels of IL-8 decreased significantly in CSF only, whereas the RANTES levels decreased significantly both in CSF and serum. CONCLUSION: Our results suggest that Cladribine therapy might modify the circulating level of RANTES.

Adult↗
PubMed2003

Problems in diagnosing cranial base meningioma in patients with multiple sclerosis.

A 49-year-old patient had been suffering from the relapsing-remitting form of multiple sclerosis since the age of 23. Attacks of the disease appeared every 2 years in the form of right-sided hemiparesis, vertigo, and problems in maintaining balance. The symptoms disappeared after treatment. At the age 32 retrobulbar inflammation of the second cranial nerve appeared with visual acuity weakness. The symptoms disappeared after treatment. At the age of 42, bilateral weakness of visual acuity appeared and then epileptic attacks occurred. After surgical treatment of meningioma the symptoms disappeared. Only the features of a psycho-organic syndrome remained. The following attack of MS appeared 2 years after surgical intervention. MRI of the head disclosed numerous demyelinating foci.

Disease Progression↗
PubMed2003

The use of instrumental examinations in the diagnosis of headaches.

Headaches are the most common complaint reported by patients to their physician. They can be divided into spontaneous and symptomatic. The findings of the history and examination may suggest the need for diagnostic testing. The ancillary investigation and management of headache is discussed.

Angiography↗
PubMed2001

APOE genotype is a major predictor of long-term progression of disability in MS.

BACKGROUND AND OBJECTIVE: The authors recently reported that the APOE epsilon4 allele is associated with significantly greater progression of disability in a 2-year follow-up of patients with MS. In this study, these findings are substantiated and extended in a much larger group of patients followed for up to 40 years. METHODS: Two hundred five patients with clinically definite MS who were genotyped for the APOE epsilon4 carrier state were included. Groups of patients with (n = 41) and without (n = 164) APOE epsilon4 alleles were compared for latency to expanded disability status scale (EDSS) scores of 4.0 and 6.0 by Kaplan-Meier analysis with the log rank test. The results were adjusted for age at onset and sex by Cox regression analysis. RESULTS: The APOE epsilon4 allele frequency in patients with MS (0.10) was similar to that in the general Israeli population. There was a significant effect of APOE genotype on the latency to reach EDSS 4.0 and 6.0 (p = 0.0002 and p = 0.0006 by two-tailed log rank test). Median latencies were shorter by 12 and 11 years in the APOE epsilon4 group for these outcomes. These results were significant after adjustment for age at onset and sex. CONCLUSIONS: The APOE epsilon4 allele is associated with significantly faster progression of disability in MS. This is the first genetic factor to be identified with a major impact on the progression of disability in this disease.

Adult↗
PubMed2001

[Tick-borne encephalitis versus multiple sclerosis: clinical and immunological aspects].

The condition of making the diagnosis of tick-borne encephalitis is the performance of serological investigation, quite apart from careful evaluation of medical history and clinical status of patient. Contemporary diagnostics of tick-borne encephalitis uses immuno-enzymatic test (ELISA), which enables detection of specific IgM antibodies (in initial phase of disease) or IgM and IgG antibodies (in the phase of the disease with neurological symptoms). The highest diagnostic value in the infection phase of disease has the demonstration of at least fourfold increase of viral antibodies level, measured in acute phase and 2 to 6 weeks after that. In case of multiple sclerosis, a laboratory test, specific for the illness, has not been established as yet. The basis for establishing the diagnosis is the clinical picture. Results of auxiliary examinations are used for the completion of clinical evaluation and for differential diagnosis. Seroepidemiological investigations were carried out in multiple sclerosis patients to estimate the level of antibodies against tick-borne encephalitis. The investigations indicated low level of IgG antibodies in patients' serum.

Diagnosis, Differential↗
PubMed2000

[Differential diagnosis in multiple sclerosis: description of selected cases].

Multiple sclerosis (MS) should be differentiated with diseases causing disseminated lesions of central nervous system or imitating clinical course of MS. Clinical course and results of laboratory investigations also immunological tests should be taken into account in differential diagnosis of MS. We present four patients whose proper diagnoses were based on the immunological investigations.

Adolescent↗
PubMed1996

[The effect of intravenous glucose load on levels of glucose and fructose and activity of glucose-6-phosphate isomerase in serum of patients with subarachnoid hemorrhage].

The purpose of the study was to evaluate the effect of glucose load on changes of glucose and fructose concentrations in the blood and phosphohexose isomerase activity (PHI) in the serum of patients with subarachnoid haemorrhage. The investigation was applied to 20 patients with subarachnoid haemorrhage. The control group included 20 individuals. In patients with subarachnoid haemorrhage the intravenous load of hypertonic glucose solution resulted in the extended blood hyperglycaemia and the decrease of fructose concentration in final moments of test in the III, VII and XIV day of illness. The activity of phosphohexose isomerase remained normal both before and after the glucose load.

Blood Glucose↗
PubMed1996

Cerebral strokes immunopathology.

The central nervous system considering its structure, metabolism and function is one of the most complex bodily organs. It is the main system controlling and coordinating all vital functions of the organism. As a result of cerebral strokes disorders of the entire metabolic system occur. They are characterized by disregulation of carbohydrate, lardaceous, proteinaceous and water-electrolytic economy (7, 11). Immunological disorders occurring in cerebral stroke process are a secondary phenomenon, but they do influence in an essential way the course of the disease (15).

Acute-Phase Proteins↗
PubMed1996

Uraemic autonomic neuropathy.

Uraemia leads to the damage of autonomic nervous system and the emergence of uraemic autonomic neuropathy. Consequences of uraemia may be dangerous for life, therefore its early diagnosis and prevention is essential.

Autonomic Nervous System↗
PubMedDate not supplied

[Intervertebral discitis caused by staphylococcal sepsis].

The aim of the study was to present the intervertebral discitis of L5-S1 region and adjoining vertebrae in the course of staphylococcal sepsis. A 51-year-old man was treated in hospital because of sudden very strong pain in a lumbar-sacral region of spine with irradiation towards both legs. The patient had general symptoms of infection. The diagnosis of intervertebral discitis of L5-S1 region was made on the basis of magnetic resonance imaging and computed tomography. In case of radicular symptoms accompanied by very strong back pain, intervertebral discitis should be considered during diagnostic investigation.

Discitis↗
PubMedDate not supplied

Idiopathic hypoparathyroidism with intracranial calcifications and dominant skin manifestations.

Presented here is an unusual case of a 41-year-old man with idiopathic hypoparathyroidism strongly connected with dermatological, ophthalmological and neurological disorders. Since the age of 4 he had been treated ineffectively for mycosis resulting in complete baldness and atrophic nail plate changes. At the age of 35 he was diagnosed with idiopathic hypoparathyroidism. He underwent surgery twice due to bilateral cataract. CT scans of the head demonstrated numerous symmetrically located calcifications in both frontal lobes, subcortical nuclei, the paraventricular region, brain fornix, and both cerebellar hemispheres. The neuropsychological examination demonstrated the occurrence of psychosensory disorders under the form of hallucinations accompanied by a sense of fear and anxiety. It seems essential to investigate the parathyroid gland for any sign of pathology, especially amongst patients with severe dermatological and/or neuropsychological symptoms. Early diagnosis and treatment of patients with hypoparathyroidism may prevent the development of many serious complications or at least result in marked improvement of neurological manifestations.

Adult↗