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Biomedical subjects

M Kokot

Publications and source records attributed to M Kokot.

At least 19 recordsLinked to original sources
PubMed2000

Forensic toxicology in urban South Africa.

BACKGROUND: An analysis has been made of the pattern of deaths due to poisoning in South Africa over the period 1991-1996. METHODS: The database held by the Forensic Science Service Laboratory, covering the period 1991-1996 was analyzed. RESULTS: Agricultural chemicals are a major cause of mortality. Among drugs of abuse, combinations of methaqualone/diphenhydramine and cyclizine/dipipanone contribute a disproportionately high percentage of cases. Metal poisoning is common as are cases of poisoning attributed to remedies prescribed by traditional healers.

Agrochemicals↗
PubMed2000

Cleavage anomalies in early human embryos and survival after prolonged culture in-vitro.

This study examines the relationship between common morphological anomalies of cleaving embryos and their ability to form apparently normal blastocysts in vitro. The impact of cleavage rate, fragmentation, and multinucleation on compaction, cavitation, along with inner cell mass and trophectoderm formation has been assessed. The study population consisted of 102 patients who elected or were selected to have a day 5 embryo transfer. Clinical pregnancy and implantation rates were 66.7 and 49% respectively. Slow and fast cleavage had a significant negative association with normal blastocyst formation. Only 13.8% (67/484) of embryos with <7 cells and 27.5% (25/91) of those with >9 cells on day 3 formed blastocysts with apparently normal morphology, compared to 41.9% (252/602) with 7-9 cells on day 3 (P < 0.001). Fragmentation had a negative impact on normal blastocyst formation. Embryos with >15% fragmentation formed normal blastocysts at a significantly lower rate (46/279; 16.5%) than embryos with 0-15% fragmentation (311/935; 33.3%) (P < 0. 001). Furthermore, the pattern of fragmentation was associated with blastocyst formation. Type IV fragmentation led to a significant reduction in blastocyst formation (25/170 or 14.7%), compared to types I, II and III which performed much better (38.6, 32.9 and 32.4% respectively). Only 15.9% (22/138) of embryos with one or more multinucleate cells on day 2 and/or 3 formed normal blastocysts compared with 31.9% (335/1051) (P < 0.001) of those without multinucleation. Collectively, the data suggest that cleavage anomalies, some of which do not preclude development after short-term culture, may reduce the developmental competence of embryos after prolonged culture.

Blastocyst↗
PubMed2000

[Fluticasone propionate in the treatment of perennial allergic rhinitis: open multicenter trial].

One hundred and ten patients with perennial allergic rhinitis, currently symptomatic, were treated with fluticasone proprionate nasal spray (Flixonase) in open, multicentre efficacy and safety study. The drug studied statistically significantly decreased all symptoms of the disease conjunctivitis included, in the first week of treatment in the patient's and doctor's assessment. The full effect of treatment was revealed in the third week. There was significant protective effect observed during two weeks after the cessation of treatment. Adverse events were mild and occurred in fifteen cases, in two cases could be due to the drug (< 2%).

Administration, Intranasal↗
PubMed2000

[Selection of a personal dry powder inhaler based on peak inspiratory flow measurements in selected groups of patients with bronchial obstruction].

Peak inspiratory flow rate (PIFR) in 165 COPD patients and 119 asthmatic children was investigated. In-Check set (peak inspiratory flow meter) which can mimic the internal resistance of some dry powder inhalers, e.g. Discus, Aerolizer and Turbuhaler, was used. All children and adults subjects achieved the minimum and optimum PIFR independently to bronchial obstruction when using Discus resistance. Optimum values of PIFR adequate for Turbuhaler resistance attained 57.4% of patients in both groups together. The worst results were observed in regard to Aerolizer resistance when only 21.1% of patients were able to achieve optimum PIFR. Checking actually PIFR may be useful before prescribing dry pressure inhaler for children and elderly COPD patients, especially in cases with bronchial obstruction. Discus can be optimally used by all patients despite of age and lung function.

Administration, Inhalation↗
PubMed1999

Findings in fatal cases of poisoning attributed to traditional remedies in South Africa.

An analysis of the Johannesburg forensic database over the years 1991-1995 revealed 206 cases in which a traditional remedy was either stated to be the cause of death or was found to be present in a case of poisoning with an unknown substance. The range of toxins detected was wide, with herbal materials being found in 43% of cases, and pharmaceutical or agri-chemicals in 20% and 33% respectively. Since there are as yet no standard methods for the detection of many herbal remedies or their metabolites, careful analysis, using methods such as HPLC/MS, are mandatory for the correct identification of the true cause in cases of poisoning ascribed to traditional remedies.

Cause of Death↗
PubMed1998

Urinary excretion of Tamm-Horsfall protein in normotensive and hypertensive elderly patients.

Tamm-Horsfall protein (THP) is a glycoprotein that is exclusively produced by the kidney in the thick ascending limb of Henle's loop (TAHL). Disturbances of TAHL function are associated with decreased urinary THP excretion. It is well known that renal function declines with advancing age. Moreover, it is suggested that THP may play a role in the pathophysiology of hypertension. The aim of this study was to assess urinary excretion of THP (U-THP) in healthy and hypertensive elderly patients. Fifteen young healthy subjects (YHS), 15 young hypertensive patients (YHT), 15 older normotensive (>60 years) subjects (OHS) and 31 older (>60 years) hypertensive patients (OHT) were examined. In all subjects 24-h urinary volume (UV), U-THP and creatinine (U-Cr), specific gravity of urine (U-SG), serum creatinine (S-Cr), and mean arterial pressure (MAP) were assessed. THP urinary excretion was significantly decreased in normotensive elderly patients, but not in hypertensive ones. Higher U-THP in the elderly hypertensive as compared with the elderly normotensive patients seems to be more the consequence than the cause of arterial hypertension.

Adolescent↗
PubMed1997

[The influence of uncomplicated pregnancy on the function of particular nephron segments].

There was determined excretion albumins, beta 2-microglobulin and Tamma-Horsfall's protein with urine in 50 healthy pregnant women just before delivery and in 15 healthy non pregnant women. There was established uncreased excretion of albumin and beta 2-microglobulin with urine in healthy pregnant women, however decreased excretion Tamma-Horsfall's protein. The results of the examinations suggest the function change particular nephron's section in physiologic pregnancy. The knowledge of this changes have significant meaning for proper results interpretation of index examinations activity particular nephron's section in healthy pregnant women.

Adult↗
PubMed1997

[The activity of renal glomeruli and tubules during uncomplicated pregnancy: influence of delivery on urinary excretion of albumin, beta 2-microglobulin and Tamm-Horsfall protein].

There were examined the influence the various types of delivery (spontaneous, oxytocin induced, cesarean section) on the value of albumin's (marker of glomerular activity), beta 2-microglobulin's (beta 2-M) (marker of activity proximal renal tubule) and Tamm-Horsfall's protein (pTH) (as a marker of activity distal's renal tubule) excretion in 50 healthy pregnant women without clinical symptoms of nephropathy. There were also estimated creating concentration in plasma and value of creating excretion in urine before and after delivery in every women. There were stated a little increase of albumin and beta 2-microglobulin but proper excretion (pTH) in urine in every group of pregnant women. There were estimated increase of albumin and pTH excretion in urine after spontaneous delivery, oxytocin inducted or cesarean section, particularly in women after cesarean section. The type of delivery had not an effect on the beta 2-microglobulin's urine excretion. The results of conducted researches suggest occurrence of functional changes in both renal glomeruli and tubules in physiologic pregnancy. The type of delivery reveals differentiated in quantity's respect the influence on albumin's and pTH excretion, but it has not an effect on beta 2-microglobulin's urine excretion.

Adult↗
PubMed1997

[Effect of 12-week treatment with amlodipine on plasma renin activity and adrenal cortex function in patients with essential hypertension].

UNLABELLED: The present study aimed to assess the influence of 12-week treatment with Amlodipine (Am) on plasma renin activity (PRA), baseline and ACTH stimulated secretion of cortisol (C) and aldosterone (A). 21 patients with mild or moderately severe essential hypertension (EH) were examined. PRA was assessed under baseline and stimulatory conditions, C and A were estimated in blood samples withdrawn before (0') and 30, 60, 90, 120, 150, 180 minutes after i.v. administration of 0.25 mg of Synacthen. All parameters were performed twice: before and after 12-week treatment with 5-10 mg/d of Am. The control group (not treated with Am) consisted of 15 healthy volunteers. In EH patients PRA was significantly higher after 12 weeks of Am administration. Patients with EH before Am treatment showed a reduced response of C and A secretion to Synacthen as compared with controls, which became normalized after Am treatment. CONCLUSIONS: 1. Patients with EH are characterized by reduced response of C and A secretion to ACTH. 2. 12-week treatment with Am exerts a stimulatory effect on Synacthen induced C and A secretion and PRA in EH patients.

Adult↗
PubMed1996

[Half-time of erythropoietin in patients with chronic obstructive pulmonary diseases].

Presence of elevated plasma levels of erythropoietin (EPO) has been reported both in polycythaemic and normocythaemic patients with chronic obstructive pulmonary disease (COPD). The present study aimed to elucidate in what extent prolonged erythropoietin half-life time (T1/2EPO) is involved in the pathogenesis of elevated plasma EPO levels in patients with COPD. Seven normocythaemic patients (5 men and 2 women) with CODP and 6 healthy controls (4 males and 2 females) were examined. In all examined subjects half-life time of erythropoietin was determined after i.v. administration of EPO in a dose of 50 U/kg b.m. In COPD patients the T1/2EPO value was 5.98 +/- 0.67 hours and did not differ from that found in healthy controls (5.87 +/- 0.35 h). Results obtained in this study suggest participation of factors other than prolonged half-time of erythropoietin in the pathogenesis of polycythaemia in patients with COPD.

Erythropoietin↗
PubMed1996

Alterations of Tamm-Horsfall protein immunoreactivity after partial desialylation and deglycosylation.

The role of the carbohydrate moiety of Tamm-Horsfall protein (THP) was investigated by studying the effect of partial enzymatic desialylation and deglycosylation on its immunoreactivity. In our experiments primarily sialic acid alpha 2,6 linked to a galactose was split off, resulting in a 14% increase of immunoreactivity. It was increased up to 21% by further removal of the sugar residues. We also found that complexes composed of THP and human serum albumin, immunoglobulin G or transferrin reacted with anti-THP antibodies. When these complexes were formed with desialylated or deglycosylated THP an essential increase of this reactivity (about 25%) occurred. Our studies indicate that modifications of the carbohydrate moiety of THP (which might occur in vivo by changes in the glycosylation process e.g. in pathologic conditions) lead to increased exposure of THP to the immune system.

Animals↗
PubMed1996

[Fluticasone propionate in treatment of seasonal allergic rhinitis--open multicenter study].

Eighty five patients with seasonal allergic rhinitis, currently symptomatic, were treated with fluticasone proportionate nasal spray (Flixonase) in open, multicentre efficacy and safety study. The drug studied statistically significant decrease all but one (conjunctivitis) symptoms of the disease in the first week of treatment in the patient's and doctor's assessment. The full effect of treatment was revealed in the second week. There was significant protective effect observed during two weeks after the cessation of treatment. Adverse events were mild and occurred in two cases, due to disease itself rather, than the drug tested.

Administration, Intranasal↗
PubMed1995

-Efficacy and safety of using amlodipine in treatment of mild and moderate essential hypertension-.

UNLABELLED: The present study aimed to assess the efficacy and tolerance of amlodipine (Norvasc-Pfizer) in the treatment of 152 patients with mild and moderate essential hypertension. This study was a multicenter and open trial and lasted 24 weeks. During 7 visits arterial blood pressure, heart rate, body weight and side effects of amlodipine were registered. The dosage of amlodipine was 5 to 10 mg/day. 59 patients received also other antihypertensive drugs in doses used before starting amlodipine treatment. 57 patients needed changes in amlodipine dosing from 5 to 10 mg/day. During the study no significant changes in body weight or heart rate were noticed. Mean arterial blood pressure dropped significantly from 123.9 +/- 0.6 at the beginning of the study to 102.3 +/- 0.8 mm Hg at the end of this study. During this study a total of 26 dropouts were noticed. The reasons of these dropouts were the following: side effects--6 patients, noncompliance--7 patients, insufficient hypotensive effect--7 patients, unknown reason--5 patients, hypertensive crisis--1 patient. The following side effects were observed ocdemata of the legs in 10.5%, headaches in 2% of patients. One patient complained of increased susceptibility to weather changes, 1 patient had nausea and dizziness and 1 had headaches, pains in the legs and chest and nausea. All these side effects were mild and transient. CONCLUSION: Results obtained in this trial suggest, that amlodipine is an efficient and well tolerated antihypertensive drug in patients with mild and moderate essential

Adult↗
PubMed1994

[Erythropoietin secretion in patients with chronic obstructive lung diseases during normobaric oxygen inhalation].

BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) are characterized by compensatory polycythaemia probably induced by increased erythropoietin (EPO) secretion in the kidneys. METHODS AND RESULTS: As the regulatory mechanisms of erythropoietin secretion in chronic obstructive pulmonary disease are scarcely known we studied plasma EPO levels in 14 patients with COPD (pO2 = 61.9 +/- 1.4 mm Hg, Hct = 47.8 +/- 1.1%) under basal conditions, after two hours of isobaric oxygen breathing and two and four hours after discontinued oxygen breathing. The control group consisted of 12 healthy subjects (pO2 = 87.5 +/- 2.2 mm Hg, Hct = 43.7 +/- 1.6%). Under basal conditions patients with COPD showed significantly higher plasma erythropoietin levels as compared with healthy controls. Oxygen breathing was followed by a significant decline of plasma EPO levels both in patients with COPD as in the control group. This decline was significantly more marked and of longer duration in COPD patients than in healthy controls. CONCLUSIONS: 1. Patients with chronic obstructive pulmonary disease are characterized by significantly higher plasma EPO levels as compared with healthy subjects. 2. The renal oxygen sensor function involved in the regulation of EPO secretion seems to be altered in COPD patients.

Erythropoietin↗
PubMed1994

Renal clearance of endogenous erythropoietin in patients with proteinuria.

Recent data indicated the importance of urinary losses of erythropoietin (Epo) in the pathogenesis of anaemia in patients with nephrotic syndrome. In the present study we aimed to investigate plasma and urinary Epo levels and their renal handling in relation to beta 2-microglobulin (beta 2m), sodium metabolism and the renin-angiotensin-aldosterone system (RAAS), respectively, in patients with sub-nephrotic range proteinuria (SNP), microalbuminuric diabetics and hypertensives, and in healthy subjects studied on a standardized diet containing 120 mmol sodium and 70 g protein per day. We found that patients with SNP were characterized by lower plasma levels of Epo than healthy subjects but no differences were found in urinary excretion of Epo, endogenous Epo clearance and its fractional excretion (FEEpo). There were no differences between groups in FE beta 2m and FENa and plasma aldosterone levels but plasma renin activity was higher in patients with SNP than in the controls. No relationships were found between Epo levels and activity of the RAAS and sodium metabolism, respectively. Our data suggest that lower levels of plasma Epo in patients with SNP and normal renal excretory function are not due to urinary losses of Epo but rather to the decreased production/degradation ratio.

Adult↗
PubMed1994

Erythropoietin secretion in patients with chronic renal failure after pure oxygen breathing.

The present study aimed to assess the relationship between erythropoietin (EPO) secretion and hyperoxemia in uremic patients. In 19 patients with chronic renal failure (10 were hemodialyzed and 9 were not dialyzed) and in 13 healthy subjects plasma erythropoietin levels were assessed during 6 h of air breathing and a second time during 2 h of pure oxygen breathing and during 4 h after discontinued oxygen breathing. Under basal conditions, uremic patients showed higher plasma erythropoietin levels (39.85 +/- 5.86 mU/ml in hemodialyzed and 29.05 +/- 4.94 mU/ml in nondialyzed patients) as compared with healthy controls (21.04 +/- 1.77 mU/ml). Pure oxygen breathing was followed by a significant decline of plasma EPO levels both in patients with chronic renal failure and in the control group. However, this decline was significantly less marked and of longer duration in chronic renal failure patients than in healthy controls.

Administration, Inhalation↗
PubMed1994

Effect of isobaric hyperoxemia on erythropoietin secretion in hypertensive patients.

We assessed the influence of hyperoxemia on erythropoietin secretion in patients with various etiological forms of arterial hypertension (essential, n = 15; renoparenchymal, n = 16; renovascular, n = 15) and in 15 healthy subjects. On the first day of the study, blood was withdrawn at 1-hour intervals for the estimation of erythropoietin during a total of 6 hours and at 2-hour intervals for the assessment of PO2. Three days later the same parameters were assessed again at identical time intervals, but the subjects were breathing pure oxygen during the first 2 hours. Breathing with pure oxygen resulted in a significant increase of blood PO2 (184.85 +/- 4.47 versus 85.92 +/- 2.28 in essential, 185.21 +/- 5.52 versus 84.55 +/- 3.04 in renoparenchymal, and 181.7 +/- 3.14 versus 87.49 +/- 2.25 in renovascular hypertension groups and 189.84 +/- 5.2 versus 85.89 +/- 1.73 mm Hg in healthy subjects; P < .001 in all groups). Baseline plasma erythropoietin was not different among the groups (29.33 +/- 4.14 in essential, 24.56 +/- 3.09 in renoparenchymal, and 27.77 +/- 3.29 in renovascular hypertension groups and 24.23 +/- 2.70 mU/mL in the control group). The pattern of erythropoietin decline was different in the groups of hypertensive patients. In patients with essential hypertension, unlike in healthy subjects and patients with other etiological forms of arterial hypertension, only a very short-term suppression of erythropoietin levels was observed during hyperoxemia. No significant changes in blood pressure during breathing with pure oxygen were found in any of the studied groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗