Biomedical subjects

P Guzik

Publications and source records attributed to P Guzik.

8 recordsLinked to original sources

PubMed2006

Difference in estimated GFR with two different formulas in elderly individuals.

The aim of this study was to characterize the differences between the prediction of GFR with Cockcroft-Gault formula (CG=(140-age)/(72 x PCr (mg/ml), for females multiplied by 0.85) and the new formula based on the multicenter trial of the Modification of Diet in Renal Diseases (MDRD=186 x P (Cr) (-1.154) x age(-0.203); 0.742 if patient is female) in elderly subjects. The study involved 100 individuals aged 65-111 years (mean age 88.3+/-14.7; 79 females and 21 males). In all subjects GFR was estimated according to both formulas mentioned above and expressed in ml/min/1.73 m2. Thereafter we calculated the difference between MDRD and CG (MDRD-CG) and analyzed its determinants in every subject. Mean GFR, obtained with MDRD was 76.0+/-24.0, whereas according to CG 67.9+/-18.6 (p < 0.0001). However, the mean MDRD-CG was up to 30.0+/-26.6 which means that MDRD results were much higher in comparison with CG. Using the multiple linear regression analysis we showed that MDRD-CG strongly depend on age (p < 0.0001), BMI (p < 0.0001) and serum creatinine concentration (p<0.0001). However, the gender has not effect on MDRD-CG value. The values of MDRD-CG strongly and positively correlated with age (r=0.7027, p < 0.0001) and negatively both with body mass index (r=-0.7171, p < 0.0001) and serum creatinine (r=-0.5590, p < 0.0001). In summary, our results show that the difference between MDRD and CG strongly depends on age, BMI and Scr. Investigators should be aware of these differences and take it into account in elderly.

Age Factors↗

PubMed2005

Augmentation index, pulse pressure amplification and superoxide anion production in patients with coronary artery disease.

BACKGROUND: Free oxygen radicals appear to be involved in several processes that contribute to atherogenesis and increased arterial stiffness. METHODS: The aim of our study was to evaluate arterial stiffness and the production of superoxide anions by activated polymorphonuclear neutrophils (PMN) obtained from patients with stable coronary artery disease (CAD). Thirty four consecutive patients were studied (21 men, 13 women, mean age 58 years) who underwent coronary angiography. Arterial stiffness was assessed by pulse wave analysis using a validated system (Sphygmocor Mx, AtCor Medical). Superoxide anion production by activated neutrophils was determined by a spectrophotometric method involving the measurement of cytochrome C reduction. The extent of coronary narrowing was estimated by calculation of the Gensini score. RESULTS: Superoxide anion production by stimulated PMN showed a significant positive correlation with the augmentation index (AIx) and a significant negative correlation with pulse pressure amplification (PPA), (r=0.4, p=0.02; r=-0.5 and p=0.0026 respectively). In multivariable analyses, after adjustment for age, gender and Gensini score, superoxide anions and BMI were significant predictors of AIx (R2=57.37%, p=0.001) and PPA (R2=49.04%, p=0.008). Superoxide anion production was significantly higher in the middle (52.0+/-5.8 nmol O2-/2.5x10(6) PMN/30 min) and upper teriles (62.7+/-5.6) of AIx in comparison with the first tertile 31.8+/-4.1 (p< or =0.05, p< or =0.001). Moreover, superoxide anion production in the highest tertile of PPA was significantly lower (35.6+/-4.3 nmol O2-/2.5x10(6) PMN/30 min) than that in the tertile (60.8+/-6.2, p< or =0.05). Neither the augmentation index nor pulse pressure amplification correlate with the severity of coronary atherosclerosis as indicated by the Gensini score. CONCLUSIONS: markers of arterial stiffness, AIx and pulse pressure amplification correlate with superoxide anion production but not with the severity of atherosclerosis in coronary arteries.

Biomarkers↗

PubMed2005

[Heart rate variability in patients with chronic renal failure treated by hemodialysis].

Heart rate variability (HRV) is a non-invasive method used for the assessement of autonomic modulation of heart rate. Decreased HRV is an indicator of increased cardiovascular risk. The aim of this study was to evaluate the relationship between the heart rate variability and left ventricular hypertrophy and native parathormone (iPTH) serum concentration in patients with chronic renal failure (crf) treated by hemodialysis. 24-hours ECG recording with time domain HRV evaluation, resting, transthoracic echocardiography (ECHO), were measured in 59 crf patients and in 30 healthy volunteers. Creatinine, urea, total protein, albumin, electrolytes, hemoglobin, hematocrite and iPTH serum concentration as well as body mass index (BMI) were assessed in all patients. All crf patients had decreased lower values of HRV. The correlations between SDNN, pNN50, rMSSD and parameters of LVH and with PTH serum level indicated the disturbances of the autonomic function in chronic renal patients. Left ventricular hypertrophy (LVH) in all crf patients was observed. The correlations between iPTH serum level and parameters of LVH suggest the role of PTH in the development of uremic cardiomyopathy.

Arrhythmias, Cardiac↗

PubMed2004

Kidney function estimated with different formulas in centenarians.

PURPOSE: There are growing doubts about the accuracy of Cockcroft-Gault formula (CG) used for the estimation of creatinine clearance, especially in elderly. Recently, the authors of the multicenter trial of the Modification of Diet in Renal Diseases (MDRD) have proposed a new equation. Moreover, Baracskay et al. (B), proposed the special formula for the estimation of kidney function (KF) in elderly. The aim of our study was to compare the results of KF calculated with these three formulas in centenarians. MATERIAL AND METHODS: The study involved 50 centenarian subjects aged 100-111 years (41 females and 9 males) who participated in Polish Centenarians Program. In all of them KF was estimated with the CG, B and MDRD formulas. RESULTS: In the whole population examined, the mean KF according to CG was lower in comparison to both others (p < 0.001 vs both B and MDRD). Also, in females CG results were the lowest (p < 0.001 vs both B and MDRD). In contrast, KF calculated according to CG and B did not differ in males. The results of the MDRD formula significantly exceeded the two others also in males (p < 0.001 vs CG and B). No impact of gender on the obtained results could be found when CG and MDRD were used. However, according to B, the mean values for females were higher (p < 0.01). CONCLUSIONS: KF calculated with the CG, B and MDRD formulas significantly differed in the centenarians examined. Thus, further studies, which include a reference standard, are necessary to answer the question which of these mathematical formulas is the most reliable for the calculation of KF in the elderly.

Aged↗

PubMed2003

Prospective evaluation of hydroperoxide plasma levels and stable nitric oxide end products in patients subjected to angioplasty for coronary artery disease.

BACKGROUND: Oxidative stress appears to be involved in several processes that contribute to atherogenesis and restenosis following vascular intervention. METHODS: The aim of our study was to evaluate prospectively the plasma concentrations of a hydroperoxide (ROOH) and nitric oxide end product (NO(x)) in patients subjected to coronary angioplasty (PTCA) and routine control angiography 6 months after the initial procedure. We prospectively studied 48 consecutive patients (39 men, nine women, mean age 52 years) with stable angina who underwent successful elective angioplasty. A vascular segment was considered successfully treated when the residual luminal narrowing in the dilated segment immediately after angioplasty was <50%. Angiographic follow-up was obtained in all of the patients. Plasma samples were drawn at baseline (before angioplasty) and serially after angioplasty (1, 3 and 6 months afterwards). Hydroperoxides were determined by the FOX II assay (ferrous oxidation in xylenol orange, Pierce Rockford, IL). Nitrate was converted in the presence of NO3 reductase. The Griess reagent was used for the measurement of NO2. RESULTS: The overall angiographic restenosis rate was 35%. There were no significant differences in clinical variables between the patients with or without restenosis. The baseline levels (0.8+/-0.09 vs. 0.6+/-0.2 micromol/l) as well as the concentrations of authentic lipid hydroperoxide in plasma after 1 month (0.7+/-0.09 vs. 1.0+/-0.2 micromol/l) and 6 months (0.8+/-0.1 vs. 1.0+/-0.2 micromol/l) were similar in both groups. Three months after the angioplasty a significant increase in the ROOH level was noticed in the patients with restenosis (0.9+/-0.1 vs. 1.4+/-0.2, P=0.04). Plasma levels of NO(x) were similar in both groups at baseline (23.6+/-2.1 vs. 22.7+/-2.6 micromol/l) and 1 month after procedure (24.4+/-2.2 vs. 23.4+/-3.3 micromol/l). However, in patients with restenosis significant decreases in stable NO end products were observed 3 and 6 months after PTCA (18.1+/-1.5 vs. 13.3+/-1.7, P=0.04; 14.2+/-1.0 vs. 8.7+/-1.3, P=0.02, respectively). CONCLUSIONS: In patients with angiographic restenosis a significant increase in lipid peroxidation accompanied by a reduction in the stable end products of nitric oxide in plasma is observed several months after PTCA.

Angioplasty, Balloon, Coronary↗

PubMed2001

[Leukocytosis in the first day of acute ischemic stroke as a prognostic factor of disease progression].

It has been reported that white blood cells (WBC) may contribute to the initiation and further development of stroke. WBC count could have influence on hemorheology, thrombosis and induction of vasoconstriction in cerebral arteries. The aim of this work was to determine whether WBC count assessed in patients with acute stroke in the first day of the disease have a predictive value for the late clinical outcomes. Peripheral WBC count was measured at the admission to the hospital in 100 consecutive patients with acute stroke. Ischemic stroke was confirmed in all patients by head CT. Neurological status was evaluated with the use of modified Rankin's Scale. We assessed the following clinical outcomes: in-hospital mortality, the lack of neurological improvement on the 21st day of disease, and the need for hospital stay longer than 21 days. Odds ratio (OR) with 95% confidence interval (95% CI) adjusted for patient's age, gender, cardiovascular diseases, diabetes mellitus and previous stroke was calculated with the use of logistic regression. OR was evaluated both for the presence of WBC count > 10.000 cells/microliter and for each 1000 leukocytes/microliter increase. WBC count greater than 10.000 cells/microliter was associated with a more than seventy-fold greater risk for death (OR--75.18; 95% CI: 8.89-635.84; p = 0.0001), nearly eight times increased risk for the no-improvement status (OR--7.78; 95% CI: 2.51-24.17; p = 0.0004) and approximately four times increased risk for the prolonged hospital stay (OR--4.20; 95% CI: 1.50-11.72; p = 0.0062). Each 1000 cell/microliter increase in WBC count at the admission was associated with increased risk for in-hospital mortality (OR--2.24; 95% CI: 1.39-3.57; p = 0.0008), no neurological improvement (OR--1.43; 95% CI: 1.15-1.76; p = 0.0009) and the need for prolonged hospitalization (OR--1.26; 95% CI: 1.07-1.49; p = 0.0066). Increased WBC count within the first 12 hours of stroke is an independent and strong risk factor for mortality, no neurological improvement, and the need for prolonged hospitalization in the course of acute ischemic stroke.

Aged↗

PubMed2000

Comparison of fentanyl and droperidol mixture (neuroleptanalgesia II) with morphine on clinical outcomes in unstable angina patients.

The objective of the study was to compare the influence of a fentanyl and droperidol mixture (neuroleptanalgesia) with morphine on the in-hospital instability, development of acute myocardial infarction (AMI), and mortality during a 30-day and 12-month follow-up in unstable angina patients. The study was performed in 112 unstable angina patients. In addition to standard therapy for unstable angina (aspirin, heparin, nitroglycerin, and oxygen), 53 patients (63.2 +/- 9.7 years; 32 males) were randomized to receive neuroleptanalgesia (0.025 mg fentanyl and 1.25 mg droperidol in a volume of 1 mL) and 59 patients (58.6 +/- 11.5 years; 41 males) to receive morphine. Neuroleptanalgesia was started i.v. with 2 mL and could be followed by 1 mL every 4 hours. Morphine was started i.v. with 10 mg and could be followed by 5 mg every 4 hours up to angina resolution during 24 hours of hospitalization. Another 1 mL of neuroleptanalgesia or 5 mg of morphine could be administered on demand if angina lasted or reappeared earlier than the next scheduled dose. Odds ratios with 95% confidence intervals (95% CI) adjusted for the age, sex, smoking, previous myocardial infarction, and hypertension were evaluated for all study outcomes. The odds ratios for clinical in-hospital instability (5.93, 95% CI: 2.49-14.15; P = 0.0001), 12-month AMI development (3.57, 95% CI: 1.51-8.45; P = 0.0038), and 12-month mortality (6.00, 95% CI: 1.63-22.09; P = 0.0070) were significantly increased in the neuroleptanalgesia group compared with the patients on morphine. It is concluded that neuroleptanalgesia negatively influences disease course, AMI development, and total mortality in unstable angina patients.

Analgesics, Opioid↗

PubMed2000

Effects of trimetazidine on clinical symptoms and tolerance of exercise of patients with syndrome X: a preliminary study.

BACKGROUND: Trimetazidine diminishes angina and improves tolerance of exercise of patients with ischemic heart disease, and has no influence on blood pressure and heart rate. OBJECTIVE: To determine the effect of trimetazidine on angina symptoms and exercise tolerance in patients with syndrome X. METHODS: We investigated the effect of trimetazidine on the clinical symptoms and tolerance of exercise of 34 patients (20 women and 14 men, aged 32-60 years) with syndrome X (angina pectoris, positive result of exercise test, and normal coronary angiogram). The exercise test was performed before initiation of oral administration of trimetazidine therapy (20 mg three times a day) and 1 and 6 months thereafter. RESULTS: We obtained negative results of exercise treadmill tests for four patients (11.76%) after 1 month and five patients (14.71%) after 6 months of trimetazidine treatment. There was also a decrease in the incidence of effort angina after 6 months of treatment (26 patients or 76.47% before treatment versus 13 patients or 38.23% after 6 months of treatment). The drug had no significant influence on the heart rate and blood pressure. The duration for which patients could exercise was significantly prolonged by 1 month (652.9 +/- 206.2 versus 563.4 +/- 190.4 s, P = 0.0047) and 6 months (650.3 +/- 207.8 s, P = 0.0094) of treatment with trimetazidine. CONCLUSION: Treatment with trimetazidine decreases signs of angina during exercise and improves tolerance of exercise of patients with syndrome X.

Adult↗