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Biomedical subjects

L Zaborski

Publications and source records attributed to L Zaborski.

At least 19 recordsLinked to original sources
PubMed2005

The analysis of mortality from cardiovascular diseases in Pomeranian province.

PURPOSE: Descriptive epidemiology characterises frequency of appearance of given event (here decease) in dependence of many factors concerning a person, region or time of existence of given salubrious phenomena. The source of information was the official death registry that provides complete records of all deaths that took place in Pomeranian province. This description of sanitary situation of people from particular area enables doing comparison between regions, facilitates researching etiological factors, planning work of medical workers and programming preventive rules. Cardiovascular diseases during last fifty years are the main reason of death of people from developed countries which is also Poland. MATERIAL AND METHODS: The aim of this work is to find out differences in health condition between citizens of Pomeranian province and other people in Poland and countries of European Union. RESULTS: In Pomeranian province in 2002 the highest mortality from cardiovascular diseases was observed for Sztum county (587.5/100,000) and was 72.5% of all deaths in this region. Similarly, there was high mortality these reasons in Tczew county (442.1/100,000), Malbork county (406.9/ 100,000) and also in Tricity (424.8/100,000). The lowest mortality from cardiovascular diseases was observed in Gdańsk county (257.2/100,000) and was only 40% of all deaths in this region. Relatively low mortality was in Czluchow county (288.9/100,000). Frequency of death from cardiovascular diseases in Pomeranian province has become lower from year 2000 (361.0/100,000) to year 2002 (347.9/100,000). It was lower than in other parts of Poland (449.8/100,000 in year 2000) but higher than in countries of European Union (257.8/100,000 in year 2000). CONCLUSIONS: Mortality from cardiovascular diseases has decreased during last few years. Also there are distinctions in this phenomena among regions of Pomeranian province, other parts of Poland and countries of European Union. From these reasons health care should be differentiated to address the differences in spatial patterns of risk observed.

Adult↗
PubMed2000

A phase II trial of nerve growth factor for sensory neuropathy associated with HIV infection. AIDS Clinical Trials Group Team 291.

OBJECTIVE: To evaluate the safety and efficacy of recombinant human nerve growth factor (rhNGF) in HIV-associated sensory neuropathy (SN) within a multicenter, placebo-controlled, randomized trial (ACTG 291). BACKGROUND: SN affects 30% of individuals with AIDS, is worsened by neurotoxic antiretrovirals, and its treatment is often ineffective. NGF is trophic for small sensory neurons and stimulates the regeneration of damaged nerve fibers. METHODS: A total of 270 patients with HIV-associated SN were randomized to receive placebo, 0.1 microg/kg rhNGF, or 0.3 microg/kg rhNGF by double-blinded subcutaneous injection twice weekly for 18 weeks. The primary outcome was change in self-reported neuropathic pain intensity (Gracely Pain Scale). Secondary outcomes included an assessment of global improvement in neuropathy by patients and investigators, neurologic examination, use of prescription analgesics, and quantitative sensory testing. In a subset, epidermal nerve fiber densities were determined in punch skin biopsies. RESULTS: Both doses of NGF produced significant improvements in average and maximum daily pain compared with placebo. Positive treatment effects were also observed for global pain assessments (p = 0.001) and for pin sensitivity (p = 0.019). No treatment differences were found with respect to mood, analgesic use, or epidermal nerve fiber densities. Injection site pain was the most frequent adverse event, and resulted in unblinding in 39% of subjects. Severe transient myalgic pain occurred in eight patients, usually from accidental overdosing. There were no changes in HIV RNA levels or other laboratory indices. CONCLUSIONS: We found a positive effect of recombinant human nerve growth factor on neuropathic pain and pin sensitivity in HIV-associated sensory neuropathy. rhNGF was safe and well tolerated, but injection site pain was frequent.

Adult↗
PubMed2000

Does the effect of respondent characteristics on consumer assessments vary across health plans?

Responses to the Consumer Assessments of Health Plans Survey (CAHPS) are related to respondent characteristics. CAHPS procedures include casemix adjustment to remove effects of difference in respondent characteristics on comparative plan ratings, under the assumption that casemix coefficients are homogeneous across plans. The authors analyzed data from the Washington state CAHPS demonstration, fitting hierarchical models in which coefficients of casemix variables and intercepts could vary by plan. They estimated the impact of variability in casemix coefficients on plan adjustments and also assessed the implications for differential effects of individual characteristics at different plans. Estimated between-plan variability of coefficients was small, but the data are consistent with substantially larger variability. The potential impact of this variability on adjustments for plans was small relative to the magnitude of the adjustments. Comparisons between plans for individuals, however, could be affected substantially. This methodology could be useful wherever casemix adjustment is applied.

Adult↗
PubMed1999

Neurological outcomes in late HIV infection: adverse impact of neurological impairment on survival and protective effect of antiviral therapy. AIDS Clinical Trial Group and Neurological AIDS Research Consortium study team.

OBJECTIVE: In a large multi-center clinical trial of combination reverse transcriptase inhibitors (RTIs), we assessed the impact of antiretroviral therapy on neurological function, the relationship between neurological and systemic benefit, and the prognostic value of neurological performance in late HIV-1 infection. DESIGN: Neurological evaluations incorporated in a randomized, multi-center trial of combination antiretroviral therapy. SETTING: Forty-two AIDS Clinical Trials Group sites and seven National Hemophilia Foundation sites. PATIENTS: Adult HIV-infected patients (n = 1313) with CD4 counts < 50 x 10(6) cells/l. INTERVENTIONS: Four combinations of reverse transcriptase inhibitors consisting of zidovudine (ZDV), alternating monthly with didanosine (ddl), or in combination with zalcitabine (ddC), ddl or ddl and nevirapine. MAIN OUTCOME MEASURES: Mean change from baseline of a four-item quantitative neurological performance battery score, the QNPZ-4, administered to 1031 subjects. RESULTS: Triple therapy and ZDV/ddl combination preserved or improved neurological performance over time compared with the alternating ZDV/ddl and ZDV/ddC regimens (P < 0.001), paralleling their impact on survival in the same trial as previously reported. QNPZ-4 scores were predictive of survival (P < 0.001), after adjusting for CD4 counts and HIV-1 plasma RNA concentrations. CONCLUSIONS: Combination antiretroviral therapy can have a salutary effect on preserving or improving neurological function. Superior systemic treatments may likewise better preserve neurological function. The significant association of poor neurological performance with mortality, independent of CD4 counts and HIV-1 RNA levels indicates that neurological dysfunction is an important cause or a strong marker of poor prognosis in late HIV-1 infection. This study demonstrates the value of adjunctive neurological measures in large therapeutic trials of late HIV-1 infection.

AIDS Dementia Complex↗
PubMed1999

Comparison of gynecologic history and laboratory results in HIV-positive women with CD4+ lymphocyte counts between 200 and 500 cells/microl and below 100 cells/microl.

OBJECTIVE: To assess rates of sexual activity, contraceptive use, genital infections and dysplasia, and other gynecologic symptoms among well-characterized populations of HIV-seropositive women enrolled in two Adult AIDS Clinical Trials Group (AACTG) randomized studies. METHODS: Gynecologic data were collected using standardized interview and examination forms from women enrolled in two protocols: ACTG 175, an antiretroviral trial (CD4+ lymphocyte counts 200-500 cells/microl) and ACTG 196, a Mycobacterium avium complex prophylaxis trial (CD4+ counts < or =100 cells/microl). RESULTS: Women enrolled in the two studies were similar in age, race, weight, and history of illicit or injection drug use, but women in ACTG 196 (n = 67) had lower median CD4+ counts (median, 35 cells/microl; range, 0-135 cells/microl versus median, 356 cells/microl; range, 131-620 cells/microl; p < .0005), were less likely to be antiretroviral naive (6% versus 38%; p < .0005), and were more likely to have a Karnofsky score <80 (28% versus 5%; p < .0001) than women in ACTG 175 (n = 185) at baseline. Recent changes in menstrual cycle were not different between groups. Women enrolled in ACTG 196 were less likely to be sexually active (40% versus 61%; p < .005), but both groups reported high levels of contraceptive use. Papanicolaou smear results in ACTG 196 and ACTG 175 respectively, were: normal, 38% and 50%, atypia, 24% and 39%, low-grade squamous intraepithelial lesions (SIL), 27% and 10%, and high-grade SIL, 11% and 0.7% (p < .001). CONCLUSIONS: Gynecologic complications are common among HIV-seropositive women with CD4+ lymphocyte counts < 500 cells/microl and are more common and severe among those with more advanced immunosuppression.

Adult↗
PubMed1998

A phase I/II trial of nimodipine for HIV-related neurologic complications.

BACKGROUND: Few effective treatments are available for AIDS dementia complex (ADC) and HIV-associated neuropathy. However, recent in vitro studies indicate that nimodipine, a voltage-dependent calcium channel antagonist, can prevent HIV-related neuronal injury and may provide a novel form of treatment for these disorders. METHODS: To determine the safety and possible efficacy of this agent, 41 patients with mild to severe ADC, including 19 patients with neuropathy, were entered into the AIDS Clinical Trial Group multicenter, phase-I and phase-II study. Nimodipine at 60 mg p.o., five times daily; 30 mg p.o., three times daily; or placebo was administered for 16 weeks as adjuvant treatment to antiretroviral therapy. RESULTS: Neuropsychological performance at baseline, measured by the composite neuropsychological Z score (NPZ-8), correlated significantly with the ADC stage and with CSF levels of neopterin, a marker of immune activation. No significant differences in toxicity were observed among the three arms. Intent-to-treat analysis showed no significant change in the NPZ-8, although improvement was suggested in the high-dose arm. In addition, a trend toward stabilization in peripheral neuropathy was observed in both nimodipine arms compared with placebo. CONCLUSIONS: Nimodipine and other similar nonantiretroviral agents may provide a safe and promising avenue of treatment for neurologic disorders associated with HIV infection. The results of this study indicate that further clinical trials are warranted.

AIDS Dementia Complex↗
PubMed1998

State of circulatory system in equipment operators working in harbour.

A group of harbour workers was examined: 127 operators of mechanic equipment, 74 cranemen, 55 container stevedores, 36 hoistmen. The control group consisted of 49 electricians. Mean age of the subjects was: 37.1 +/- 7.7 years, working experience averaged 15.5 +/- 7.4 years. All the examined workers were subjected to ecg, phonocardiographic examinations and to the physical analysis of circulation according to Wezler-Boerger and Braemser-Ranke. Heart beat rate at rest did not show statistically significant differences (p > 0.05). In the measurements of the diastolic and systolic pressure at rest statistically significant differences between the controls and the other groups were found. Arterial hypertension (160 mmHg and over the systolic pressure, and 95 mmHg and over diastolic pressure) was found in 21% mechanic equipment operators, 15% cranemen, 11% container stevedores, 8% hoistmen. 341 Ecg recordings were evaluated with the Minnesota Code, no pathologies in Q or QS were revealed. Features of the parasympathetic system effect were noted in 24% of the people examined. Alterations within ST-T segment were observed in the people showing arterial hypertension. Features of the sympathetic system impact were registered in 9% of cases. In phonocarcdiographic examinations 3 cases of compensated heart defects were revealed. The parameters obtained from the physical analysis were evaluated in the subjects with an appropriate weight, obesity and arterial hypertension. By comparison of mean rates of the central pulse, electric resistance, stroke and minute volume and air chamber volume statistically significant differences were found (p < 0.001). Evaluating the whole of the results a risk of the heart ischemic disease was found in 1/4 of the people examined. The changes observed were associated with individual factors, not with the job performed.

Adult↗
PubMed1997

Diseases and work-related injuries in Polish seafarers and conditions of their work on foreign-flag ships.

A questionnaire survey was conducted in 1994-1996 among Polish seafarers employed on foreign-flag ships, in order to collect their opinions and experiences on work and life on these ships, and to estimate the morbidity and injuries incidence. The majority of 1103 respondents were satisfied with the conditions of work and life on these ships: their food, accommodation, the health and safety of work, standard of health care on board were good or satisfactory; they had no problems with living and working together on the same ship with seamen of other nationalities. But about 7.8% of respondents complained that the safety and health of work on their ship was unsatisfactory, or conditions of work "endangered their health and life". The self-reported morbidity (calculated rate 176.8 per 1000 men per year) and accidents (rate 114.5 per 1000 per year) was recorded.

Accidents, Occupational↗
PubMed1996

Application of regression analysis to examination of degree of loss of hearing.

The present study is an attempt to apply analysis of regression for the purposes of evaluation of loss of hearing. This method consists in calculating equations of regression for relation between the age of the examined people and the degree of elevation of the hearing threshold for various frequencies. The slope of the regression line allows to conclude about the degree of damage to hearing. Practical application of this method was shown with an example of a study on the status of hearing in workers of several manufacturing departments of a pottery plant.

Adult↗
PubMed1991

Noise in the workplace and audiometric examinations in workers of a ceramic factory.

732 workers from several loudest production departments in a pottery plant were examined. The noise level measurements were carried out at a regular course of work. Auditory sensitivity threshold was determined via air conduction, at frequencies of 250, 500, 1000, 2000, 4000 and 8000 Hz. Functioning of the organ of hearing under conditions of noise at the workplace was analysed. The influence of several noise levels--up to 85 dB/A/ and higher, and the relation between the length of service and hearing sensitivity threshold were investigated. The largest exposures were recorded in the batching and milling plant, sorting and kilns departments.

Ceramics↗
PubMed1985

The noise and functional disturbances of the cardio-vascular system in seamen.

The work presents quantitative relations between service-dependent noise dose levels and "unspecific" for the noise influence remote effects basing on the study of the cardiovascular system of 207 members of the deck and engine room crews. The seamen observed had no hearing losses due to noise (according to the ISO standard 1999). The study carried out in the pause between sea-going voyages showed that when the length of the service exceeded 10 years the noise dose increment of 1 dB corresponds to the hypertension frequency increment of 2%. The increase of the dose and the length of the service turns out as a trend towards the diminished mean arterial pulse pressure (AP) and elevated diastolic and mean dynamic AP. By resorting to the correlation-regression analysis the information value of the mean dynamic AP for the noise influence evaluation was shown as well the possibility to determine the safe noise action dose which may not be over 100 dB at the service length under 40 years.

Adult↗
PubMed1978

[Effectiveness of ear protective devices].

Efficiency of 9 types of hearing protectors was investigated. A subjective method of an absolute hearing threshold shift in free sound field in 20 well-hearing-persons was applied. The results obtained are presented in figures. It was found that the maximum efficiency of most hearing protectors usually fell toon the frequency of 4000 Hz and amounted to 20--41 dB. The minimum efficiency usually fell to the frequency of 125 Hz and amounted to 8--21 dB. Attenuation efficiency of broad-band noise was 18-40 dB and approximated the maximum efficiency of pure sounds, sometimes even surpassing it. The results of determinations differed from the values given by manufacturers, which accounts for the need of undertaking such investigations.

Ear Protective Devices↗