Biomedical subjects

Marta Maskey-Warzechowska

Publications and source records attributed to Marta Maskey-Warzechowska.

10 recordsLinked to original sources

PubMed2006

[Catamenial pneumothorax].

Catamenial pneumothorax (CP) is a specific type of secondary spontaneous pneumothorax. It is characterized by a temporal relationship with menses. CP is considered to be the most frequent symptom of thoracic endometriosis. It occurs mainly in women above 30 years of age and is typically right sided. The authors reviewed the current literature on this entity. The hypotheses on its pathogenesis and the diagnostic possibilities and therapeutic options are discussed.

Diagnosis, Differential↗

PubMed2006

[Exhaled nitric oxide in patients with obstructive sleep apnea syndrome].

UNLABELLED: Exhaled nitric oxide has been extensively investigated as a non-invasive marker of airway inflammation. Some authors have suggested that morning FE(NO) in obstructive sleep apnea syndrome (OSAS) patients is elevated due to inflammation of upper airways, while others have not found any differences between patients and healthy subjects. The purpose of this study was to analyze concentration of exhaled nitric oxide (FE(NO)) in OSAS patients. METHODS: 119 (99 M, 20 F) consecutive patients of sleep laboratory participated in this study. Standard overnight sleep studies with polysomnography or portable screening device were carried out in the whole group: OSAS was diagnosed in 66 patients and 53 no-OSAS served as controls. FE(NO) was measured on-line with a flow rate kept at 0.045 - 0.055 l/s, according to the recommendations of ATS using a chemiluminescence analyzer twice: before the sleep study (8-10 p.m.) and after termination of data collection (6 - 8 a.m.). There were no differences in age between patients and controls. Respiratory disturbance index (RDI) was 40.3+/-24.9 in patients and 3.7+/-2.8 in controls (p<0.001). In OSAS patients both evening and morning FE(NO) was significantly higher compared to controls (23.1+/-14.8 ppb vs. 16.8+/-9.8 ppb and 22.4+/-13.2 ppb vs. 15.3+/-8.1 ppb respectively, p<0.05). Weak but statistically significant correlations for the whole group between morning FE(NO) and mean and minimum arterial oxygen saturation (SaO2) during sleep and number of study minutes with SaO2<90% were observed. Lower evening FE(NO) in OSAS patients with coexisting arterial hypertension when compared to normotensive OSAS patients was also noticed (19.1+/-10.8 ppb vs. 27.1+/-19.1 ppb; p<0.05). CONCLUSIONS: The increase in FE(NO) in OSAS patents may be caused by repetitive apneas and hypoxemia during sleep.

Adult↗

PubMed2006

[Influence of nasal continuous positive airway pressure on response to exercise in patients with obstructive sleep apnea syndrome].

UNLABELLED: Obstructive sleep apnea syndrome (OSAS) patients are at risk of cardiovascular complications. The aim of this study was to assess the effect of treatment with continuous positive airway pressure (CPAP) on the response to symptom limited exercise test. METHODS: twenty nine OSAS patients (1 F, 28 M), mean age 50.7+/-9.7 yrs with body mass index of 32.6+/-4.5 kg/m2 participated in the study. OSAS was diagnosed by overnight polysomnography. Incremental cardiopulmonary exercise test (CPET) on a treadmill was performed twice: before and after 2-3 weeks of regular treatment with CPAP. RESULTS: mean apnea + hypopnea index (AHI) before therapy was 57.6+/-12 h(-1). CPAP treatment did not change peak oxygen consumption (VO2max) (38.3+/-9.0 vs. 38.9+/-6.9 mlO2/kg/min, p=ns) or peak heart rate (153.4+/-21 min- vs. 155.5+/-22 min(-1), p=ns). There were no significant changes in ventilation or gas exchange variables. However, a decrease in peak systolic blood pressure from 194.5+/-24 mmHg to 186.7+/-27.9 mmHg (p<0.05) with CPAP treatment was found. During recovery a decrease in heart rate (at 1st minute and minutes 3 - 6) and mean arterial pressure (MAP) (minutes 4-7) with CPAP treatment was observed. Significant correlations between VO2max and AHI (r=-0,38, p<0,05); MAP at peak exercise and: AHI, mean oxygen saturation (SaO2) during sleep, minutes of sleep with SaO2<90% (T90); MAP at recovery (minutes 3-8) and T90 before CPAP treatment were also noted. CONCLUSIONS: OSAS patients are not limited on exercise. Treatment with nasal CPAP attenuates circulatory response to incremental exercise on a treadmill.

Blood Pressure↗

PubMed2006

[Bronchial obstruction reversibility test in the assessment of COPD severity--controversies].

UNLABELLED: The GOLD and ERS/ATS guidelines recommend the post-bronchodilator FEV1 (% predicted) to define the severity of chronic obstructive pulmonary disease (COPD). Yet in various publications authors analyze the pre-bronchodilator value or do not clearly state which value was used when the bronchial reversibility test was performed. The guidelines established by the Polish Respiratory Society (PRS) do not specify if performing the reversibility test is necessary to estimate the COPD severity and suggest a reversibility test evaluation which differs from that in the ERS/ ATS and GOLD recommendations. AIM: to assess the changes in the degree of severity of COPD in the classification based upon the pre- and post-bronchodilator FEV1 and to compare the interpretation of the reversibility test as suggested by GOLD and ATS/ ERS and the PRS. METHODS: 145 COPD patients (67F, 78M, mean age 67.5+/-8.9 yrs) with a negative bronchial obstruction reversibility test (salbutamol 400 microg) were enrolled to the study. For each patient the degree of COPD severity using the pre- and postbronchodilator FEV1 was established. The pre- and post-bronchodilator classifications were compared. Differences in the interpretation of the reversibility test according to the GOLD and ATS/ ERS and the Polish guidelines were analyzed. RESULTS: In 22 subjects (15.2%) the degree of disease severity changed after salbutamol. The changes were most frequent in the group of severe and very severe COPD (77.3% of changes). In 1 patient (0.7%) post-bronchodilator severity was greater than before salbutamol intake. In 7 patients (4.8%) the post-bronchodilator FEV1/FVC exceeded 70%, thus excluding the diagnosis of COPD. Of all the 145 negative (according to the ATS/ ERS and GOLD criteria) reversibility tests in 24 cases (16.6%) the test was positive when the criteria recommended by PRS were applied. CONCLUSIONS: the bronchial obstruction reversibility test is essential in the diagnosis and assessment of severity of COPD. Despite poor obstruction reversibility in this disease the use of pre-bronchodilator FEV1 in the assessment of COPD severity may be misleading and is an obstacle in the comparative analysis of studies in the domain of this disease. Differences in the guidelines for the management of COPD may also hinder comparative studies and influence epidemiologic data.

Aged↗

PubMed2006

[Maximal respiratory pressures and exercise tolerance in patients with COPD].

UNLABELLED: Many authors reported respiratory muscle function impairment in patients with chronic obstructive pulmonary disease (COPD). Impaired respiratory muscle function may contribute exercise intolerance which is frequently observed in this disease. AIM OF THE STUDY: was to determine the influence of respiratory muscle function on exercise capacity in patients with COPD. METHODS: 23 patients with stable COPD aged 62.7 +/- 9.3 years (6F, 17M; mean post-bronchodilator FEV1 = 47.9 +/-12.4% value predicted) participated in the study. Exercise capacity was assessed by the six-minute walk test and the incremental cardiopulmonary exercise test (CPET) on a treadmill. Maximal respiratory pressures (PImax, PEmax) were evaluated before and directly after CPET. RESULTS: The mean peak oxygen uptake (VO max) was 27.2 +/- 6.1 mlO2/min/kg and the mean distance walked during the 6MWT was 569.4 +/- 101.7 m. Both PIMax and PE max decreased significantly after maximal exercise (71.4 +/-23.0 vs 63.6 +/- 22.2 cmH2O, p = 0.001 and 124.9 +/- 46.5 vs 112.3 +/- 46.6 cm H2O, p = 0.02 respectively). No correlation between VO2max and the 6-minute walk distance and the maximal respiratory pressures was found. We observed a negative correlation between the 6-minute walk distance and the difference between the pre- and post CPET maximal inspiratory pressure. CONCLUSIONS: respiratory muscle function is impaired in patients with COPD but this does not affect exercise performance. Exercise causes a decrease of the respiratory muscle strength.

Aged↗

PubMed2006

[Macrophage phenotype in induced sputum in asthma subjects].

Macrophages represent the most predominant immune effector cells in the alveolar spaces and conducting airways and are known to express activated phenotype. The study was aimed at assessing the differences in cellular profile and the expression of selected surface markers on sputum macrophages in asthma and healthy subjects. 17 healthy subjects (never smoked) and 10 mild asthma subjects treated with glucocorticosteroids were enrolled into the study. For macrophage phenotyping a immunocytochemistry method was used with commercially available antibodies anti: CD14, CD71, CD11b and CD54. The nonparametric Mann Whitney U test was applied for data comparison, p value <0.05 being regarded as significant. The total number of cells were increased in asthma patients 4.81+/-5.27x 10(6) /ml vs healthy 2.8+/-2.15 x 10(6)/ml and it was statistically significant. Statistically significant increase in the percentage of eosinophils was observed in mild asthma subjects. No differences were found between the proportion in macrophages and lymphocytes. The macrophage phenothype in induced sputum differed in both groups. The expression of CD11b was higher in asthma group and the difference was statistically significant. The proportion of macrophages with the expression of CD 14, CD 71 and CD54 was comparable in both groups. Macrophage phenotyping during glucocorticosteroid therapy is useful in the assessment of inflammatory process in asthma subject.

Adult↗

PubMed2004

[The effect of asthma and COPD exacerbation on exhaled nitric oxide (FE(NO))].

UNLABELLED: Exhaled nitric oxide is a marker of airway inflammation and it is significantly decreased by glucocorticosteroid therapy, especially in patients with asthma. AIM OF THE STUDY: Evaluation of changes in FE(NO) in asthma and COPD exacerbation. MATERIALS AND METHODS: 17 patients with acute asthma and 19 patients with an exacerbation of COPD were enrolled to the study. FE(NO) (chemiluminescence, on-line, restricted breath technique measurement in accordance with the ATS recommendations) was performed for five consecutive days following admission to hospital. Results of the following additional blood investigations: peripheral white blood cell count, ESR, C-reactive protein level, arterial blood gases, spirometry or peak expiratory flow were also analyzed. RESULTS: The average value of FE(NO) on admission was 41.5+/-10.7 ppb (95% CI: 18.8-64.2 ppb) asthma patients and 28.6+/-5.4 ppb (95% CI: 17.4-40.0 ppb) in COPD patients. In asthma patients a significant decrease of FE(NO) on the third day of therapy was observed (41.5 vs 26.1 ppb, p < 0.05). We found a positive correlation between FE(NO) on admission and the peripheral blood eosinophil count. In COPD patients a significant decrease of FE(NO) on the 4th day was noted (28.6 vs 17.5 ppb, p < 0.05). FE(NO) in both groups was higher than that of 19 healthy volunteers previously studied in our laboratory (14.1+/-4.7 ppb; 95% CI: 11.8+/-16.4 ppb). CONCLUSIONS: Exacerbations of asthma and COPD are associated with an increased FE(NO). FE(NO) measurement is a useful tool in the assessment of treatment efficacy. Exhaled nitric oxide may indicate the intensity of allergic inflammation in patients with asthma.

Acute Disease↗

PubMed2004

[Reproducibility of exhaled nitric oxide (FENO) measurements in healthy subjects].

UNLABELLED: The aim of the study was to evaluate the short-term variability of FENO in healthy subjects. METHODS: 33 healthy volunteers (26 F, 7 M) aged 32.6 +/- 9.5 yrs with body mass index (BMI) of 23.3 +/- 3 kg/m2 participated in the study. Exhaled nitric oxide was analyzed on 5 consecutive days with a chemiluminescence analyzer (NIOX, Aerocrine, Sweden) according to the ATS recommendations. The exhalation flow was between 0.045 and 0.055 l/s. The measurements were performed at the same time of the day and the subjects were asked to refrain from eating and drinking for at least one hour before the analysis. RESULTS: The mean value of FENO for the whole group was 13.9 +/- 5.4 ppb, there were no correlations between FENO and age, BMI, sex or the concentration of ambient nitric oxide. Day-to-day coefficient of variation was 13.3 +/- 5.3% (range 4.6 - 23.9%), the value of pooled SD - 2.1 ppb and ICC (intraclass correlation coefficient) was 0.84. No relationship was observed between variability of FENO and intervals between measurement of exhaled nitric oxide and intake of food or beverages. CONCLUSION: Chemiluminescence analysis of FENO with NIOX is a highly reproducible method, however one has to take into account the possibility of about 13% variability of FENO within 5 days.

Adult↗

PubMed2003

The cellular composition and macrophage phenotype in induced sputum in smokers and ex-smokers with COPD.

STUDY OBJECTIVES: The relationship between smoking and COPD has been well-documented. We investigated the impact of cigarette smoking on airway inflammation in COPD patients. DESIGN: Changes in cell profiles in induced sputum (IS) samples from smokers with COPD and patients who ceased smoking were compared. SETTING: Department of pneumonology in a university hospital. PATIENTS: IS samples were collected from 17 smokers and 17 ex-smokers with COPD. INTERVENTIONS: We examined IS samples for differential cell counts and macrophage phenotypes determined by immunocytochemistry with monoclonal antibodies anti-CD11b, anti-CD14, anti-CD54, and anti-CD71. MEASUREMENTS AND RESULTS: The median IS volume was greater and the total cell count was higher in smokers than in ex-smokers. The difference, however, was not significant. We did not find any significant differences in the proportions of cells and in the phenotypes of macrophages between the two groups, with the proportion of eosinophils being slightly higher in the group of smokers. We found, however, a significant positive correlation between the decrease in pulmonary function parameters and the number of pack-years smoked, an inverse correlation of pulmonary function test results with the number of lymphocytes in IS, and a correlation between some changes in the expression of macrophage surface markers and smoking history. There was no correlation between the time from smoking cessation and any cellular component found in IS samples. CONCLUSIONS: The analysis of IS samples in patients with COPD revealed no significant differences in cell count and macrophage phenotypes between active smokers and ex-smokers.

Aged↗

PubMed2002

[Lung cancer in COPD--a clinical analysis].

Recently, increased lung cancer morbidity among patients with chronic obstructive pulmonary disease (COPD) has been observed. There have been efforts to determine the risk factors for lung cancer in these patients. In our study we analyzed smoking history, pulmonary function tests, arterial blood gases and selected laboratory investigations in a group of 46 patients with COPD and primary lung cancer (group I) and compared them to results obtained from 46 randomly selected patients with COPD without lung cancer (group II). The mean number of pack years was higher in group I (55.5 vs 40.0, p < 0.05) and so was the number of patients with severe COPD (55.8% vs 42.1%). We found no differences in ESR, blood count and arterial blood gases, the level of fibrinogen was significantly higher in group I. In 63.4% of the patients lung cancer at stage III and IV was diagnosed. In 15.2% of the patients pathological diagnosis was not established due to severe general condition and low FEV1. We conclude that coexistence of COPD may be a serious obstacle in the diagnosis and treatment of primary lung cancer. Patients with COPD require evaluation for coexistence of lung cancer.

Aged↗