Biomedical subjects

Stanisław Sierakowski

Publications and source records attributed to Stanisław Sierakowski.

At least 19 recordsLinked to original sources

PubMed2006

[Matrix metalloproteinases and tissue inhibitors of metalloproteinases in the pathogenesis of rheumatoid arthritis].

Rheumatoid arthritis (RA) is a chronic inflammatory disorder of joints characterized by the accumulation of mononuclear cells and the proliferation of the synovium-lining layer. The role of lymphocytes, macrophages and fibroblasts infiltrating the synovium is not fully understood. These cells are supposed to be involved in the tissue destruction by several mechanisms, including the production of proinflammatory cytokines and matrix metalloproteinases. Matrix metalloproteinases (MMPs) are the enzymes that participate in the proteolytic degradation and remodelling of the extracellular matrix. Their action is controlled by tissue inhibitors of metalloproteinases (TIMPs). In this review we describe the role of metalloproteinases and their tissue inhibitors in the pathogenesis of rheumatoid arthritis.

Arthritis, Rheumatoid↗

PubMed2006

[Cyclophosphamide treatment in patients with systemic sclerosis].

Systemic sclerosis (SSc) is a chronic, multisystemic, connective tissue disease characterized by fibrosis of the skin and visceral organs and the impairment of blood vessels. The etiology of SSc is unknown and its pathogenesis unclear. Effective treatment of SSc is also unavailable. Cyclophosphamide (CFX) has been reported to exert some beneficial actions in SSc patients, in particular in those with interstitial lung disease. However, it should be kept in mind that CFX treatment is related to multiple side effects. The aim of this study was to review available literature concerning the use of CFX in SSc patients.

Cyclophosphamide↗

PubMed2006

[Secondary lethal catastrophic antiphospholipid syndrome in 24-years old female patient with overlap syndrome (systemic sclerosis and systemic lupus erythematosus)].

In our article we describe the case of 24 years old woman with overlap syndrome under form of systemic sclerosis and systemic lupus erythematosus complicated by secondary antiphospholipid syndrome (APS). The first manifestation of antiphospholipid syndrome was intrauterine fetal death. Afterwards pulmonary embolism occurred. After several weeks in result of catastrophic course of antiphospholipid syndrome coronary artery thrombosis and myocardial infarction occurred with following prominent left ventricle systolic failure and multi organ failure. The patient died about one month after discharge from the hospital.

Adult↗

PubMed2006

[Diagnosis and treatment of Lyme arthritis].

Lyme disease is a multisystem disease that affects primarily skin, nervous system, heart and joins. Lyme disease is caused by Borrelia burgdorferi and spread by Ixodes ticks. Arthritis is a well-known manifestation of Lyme disease (LD). Joint symptoms associated with B. burgdorferi infection range from arthralgias, to brief attacks of arthritis, to chronic erosive synovitis. Arthritis may present as oligo- or monoarthritis and typically causes intermittent attacks of oligoarticular arthritis in a few large joints, especially the knee. A small percentage of patients may develop chronic arthritis. The diagnosis is usually based on the clinical picture, exposure in an endemic area, and detection of IgG antibody against B. burgdorferi by ELISA and Western blotting. Spirochetal DNA may be detected in joint fluid by PCR. Antibiotic treatment during early stages normally prevents development of late manifestations. Joint involvement is treated successfully with a 1-month course of doxycycline or ceftriaxone. However, about 10% of Lyme arthritis patients do not respond sufficiently to antibiotic treatment. If patients have persistent arthritis despite a second course of antibiotics with negative results of PCR testing, treatment with anti-inflammatory agents or arthroscopic synovectomy is possible. In this article, we discuss clinical features, diagnosis and treatment.

Adult↗

PubMed2006

[Causes of death of patients with systemic sclerosis].

UNLABELLED: Systemic sclerosis (SSc) is a chronic, systemic connective tissue disease, characterized by progressive skin fibrosis, internal organs and disfunction blood vessels. THE AIM: of the study was o analyze death causes in patients with SSc and the assessment of relationship between clinical status, immunologic test results and survival/mortality of patients with SSc. MATERIAL AND METHODS: Case histories of all patients with SSc, hospitalized for six years (since 1'" October 1999 to 1It October 2005) in Department of Rheumatology and Internal Diseases, Medical University of Bialystok, were retrospectively analyzed. Current patients status at the end-point of study was estimated during control examination and phone contact in selected cases. The time and cause of death was based on autopsy results. RESULTS: In study group of 76 patients with SSc, 13 deaths were found (17,1%). Death cause analyses revealed that: interstitial lung disease was the main cause of death (4/13 - 30%). As a secondary cause of death in these patients neoplasms were recognized (3/13 - 23,1%). In all patients with neoplasms exudation in pleura was diagnosed. CONCLUSIONS: Pulmonary complications and neoplasms are predominant causes of death in patients with SSc. Risk factors of death are: pulmonary hypertension and myositis. The presence of exudation in pleura in patients with SSc is a bad prognostic symptom and a possible sign of neoplastic disease.

Adolescent↗

PubMed2005

A study on vascular endothelial growth factor and endothelin-1 in patients with extra-articular involvement of rheumatoid arthritis.

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease associated with a wide range of extra-articular manifestations. Recent studies emphasise a key inflammatory role of the endothelial cells, either by overexpression of inflammatory mediators or by the proliferation of new blood vessels, in the disease process leading to the systemic organ involvement. To evaluate the relationship between internal organ manifestations and immunological markers of endothelial activation, serum levels of vascular endothelial growth factor (VEGF) and endothelin-1 (ET-1) were determined by an enzyme-linked immunosorbent assay in 64 RA patients and in 32 healthy controls. In comparison with a control group, higher serum concentrations of VEGF and ET-1 (p<0.001) in RA patients were demonstrated. A comparison between both RA groups with (20 patients) and without systemic involvement (44 patients) showed significantly higher concentrations of VEGF (p<0.05) and ET-1 (p<0.01) in the sera of patients with systemic manifestation. Moreover, a significant positive correlation between VEGF and ET-1 (r=0.475, p<0.001) in RA patients was found. A positive correlation between VEGF and Disease Activity Score (DAS) 28 index (r=0.39, p<0.005) as well as erythrocyte sedimentation rate (ESR) (r=0.564, p<0.0001) and C-reactive protein was found. ET-1 serum level correlated significantly with ESR (r=0.326, p<0.05) and DAS 28 index (r=0.307, p<0.05). These results suggest that the elevated serum levels of VEGF and ET-1 are associated with systemic organ involvement in RA patients and may play a key role in the pathogenesis of extra-articular manifestation of the disease.

Amyloidosis↗

PubMed2005

[Capillaroscopy in the diagnosis of systemic sclerosis].

Capillaroscopy is a safe, simple, non-invasive, low-cost analysis of the nailfold circulation. Vascular lesions play a significant role in the pathogenesis of systemic sclerosis. It has been shown that a characteristic microangiopathy, so-called "scleroderma pattern capillary abnormalities", --are present in the majority of patients with systemic sclerosis and already appear in the early stage of the disease. Due to this fact, capillarosopy is considered a practical tool for diagnosing and monitoring patients with systemic sclerosis. Capillaroscopy can help in the selection of patients that need more aggressive therapeutic interventions. Recently, the presence of typical capillaroscopic abnormalities has been suggested as one of the minor criteria for the early diagnosis and classification of systemic sclerosis. The present study presents the role of capillaroscopy in the management of patients with systemic sclerosis.

Diagnosis, Differential↗

PubMed2005

[Progressive physical disability, pain and quality of life of patients with rheumatoid inflammation of the joints].

WHO pronounced years 2000-2010 the Decade of Bones and Joints--the main purpose of which is the improvement of the quality of life of patients suffering from inflammatory movement organ condition. A chronic disease leading to disability, handicap and even premature death is progressive rheumatoid arthritis (RA). Irreversible changes in the joints develop during the first years of RA. For the patient it results in certain ailments, physical disorders, lowering of the level of health and the quality of life. The purpose of the thesis was: specifying health problems of patients suffering from RA; evaluation of the level of physical disability along with patient's quality of life; defining both educational and caring tasks contributing to the improvement of the quality of life of the patient and preparation of the patient and their family to self-care. Patient suffering from RA demands professional manifold care and complex therapeutic actions. It is the patient themselves, however, who decides to what extent they allow the disease to control their lives or how much they control the disease themselves. Patient and their family need advice and support in the first stage of illness but also throughout the disease, in order to adapt to patient's changing health conditions--disorganizing and disordering physical, psychological and social functioning of the patient. Ascertaining the factors determining attitudes and aspirations of the patient may lead to achieving conditions influencing the improvement of the quality of their lives.

Activities of Daily Living↗

PubMed2005

[Quality of life in medicine--origins, main concepts and directions of change].

Assessment of the quality of life depends not only health, but also on many other factors, which together make up the everyday life of the individual, including: independence, relationship to the environment, personal beliefs, attitudes and religion. The illness process, irrespective of its stage or magnitude, influences the life of the patient, very often leading to a break down in organisation and limiting his/her ability to fulfill his/her roles and social functions. In consequence, a lowering of living standards results. For many years, health was measured in very narrow terms and in a negative sense. Deviations from normal health were measured, with no attempt to find indicators of good health. The aim of this paper is to present the origins and main concepts underlying the notion of quality of life, which developed first within the social sciences, and since the 1970s has been recognised within medicine. The approach demonstrates a different perspective for understanding a sick person, not merely from the biological point of view, but also taking into account aspects of psychological social and spiritual functioning. Introduction of the concept of quality of life is determined by the fact that the aim of therapeutic interventions ought to be not only reducing the symptoms of an illness, but also providing an improvement in the sick person's functioning, thus leading to an improvement in his/her quality of life.

Clinical Medicine↗

PubMed2005

[Quality of life in rheumatoid arthritis. Methods of measurement].

Interest in quality of life in the medical sciences arises out of a holistic conception of the medical model. Taking into account the whole patient, concentrating efforts not only on extending his/her life in a biological sense, but also on increasing activities whose aim it is to create an active life, similar to the lives of healthy people. A chronic condition, which reduces the quality of life in illness is rheumatoid arthritis (RA). The illness leads to impairment in motor function, changes in excess of those caused by joint damage, and systemic complications, leading in consequence to a lowering in levels of health and living standards for the patient. The quality of life for a patient with RA depends on the individual patient's own skills in overcoming difficulties, on his/her ability to adapt and on psychological and social health resources. The aim of this paper is to present instruments for the measurement of quality of life and health problems of a psychological and social nature in those suffering from chronic and damaging RA. A multidimensional therapeutic approach should aim not only to reduce the difficulties associated with the illness, but also to improve the patient's functioning, and consequently his/her quality of life.

Adaptation, Psychological↗

PubMed2005

[Defect of glycosylation of immunoglobulin G in rheumatoid arthritis patients].

Rheumatoid arthritis (RA) is a multisystem disorder in which immunological abnormalities result in symmetrical joint inflammation, articular erosion, and extra-articular involvement. The etiology of RA is still unknown, but a defect in the glycosylation of IgG may be involved in its immunopathogenesis. Several studies have shown a correlation between the amount of IgG lacking galactose and the activity of RA. IgG galactosylation has been shown to be a useful marker of early RA and an indicator of poor prognosis. Analysis of IgG galactosylation may offer an insight into disease pathogenesis and may also be useful in RA diagnosis.

Arthritis, Rheumatoid↗

PubMed2005

[Immunopathological disturbances in systemic sclerosis].

Systemic sclerosis (SSc) is a disorder of the connective tissue characterized by the vascular dysfunction and progressive fibrosis of the skin, and various internal organs, which results in their dysfunction and failure. Activation of the immune system seems to play an important role in the pathogenesis of the disease. Contribution of the immune mechanisms to the development of the disease is indicated by the presence of the typical auto-antibodies, inflammatory cells infiltration in the skin and internal organs, and activation of cells participating in the immune response. Activation of the immune cells leads to release of proinflammatory/profibrotic cytokines and growth factors which in turn stimulate extensive proliferation of fibroblasts and collagen production. Activation of the immune system may also lead to impairment of endothelial function and development of angiopathy typical for systemic sclerosis, and subsequently chronic ischaemia of the affected tissues. In this review we describe the abnormalities of endothelial cells, T and B cells, and fibroblasts in patients with systemic sclerosis.

Autoantibodies↗

PubMed2005

[An up date on pulmonary hypertension related to systemic sclerosis].

Systemic sclerosis (scleroderma) is a chronic, progressive connective tissue disease characterized by typical skin changes and internal organ involvement. Arterial pulmonary hypertension is found in approximately 10-15% of patients with systemic sclerosis, and is considered as one of the most fatal complications of the disease. When pulmonary hypertension secondary to scleroderma related interstitial lung disease, left-sided cardiac insufficiency and thrombo-embolic disease is also taken into account, the frequency of pulmonary hypertension in systemic sclerosis may be as high as.50%. Recent investigations brought new information considering the pathogenesis of pulmoanry hypertension and allowed new therapeutic approches to be introduced. Early diagnosis of pulmonary hypertension is a key issue in clinical practice, but it is a challange in patients with systemic disease such as systemic sclerosis. Current review presents up to date information on the pathogenesis, early diagnosis and treatment of pulmonary hypertension related to systemic sclerosis.

Humans↗

PubMed2005

[Correlations between serum matrix metalloproteinase (MMP-1, MMP-3, MMP-9, MMP-13) concentrations and markers of disease activity in early rheumatoid arthritis].

The purpose of this study was to analyse the correlations between serum concentrations of the matrix metalloproteinases (MMP-1, MMP-3, MMP-9, MMP-13) and clinical markers of disease activity in patients with early rheumatoid arthritis (RA). The study group consisted of 30 RA patients, untreated with disease modifying antirheumatic drugs (DMARDs) or corticosteroids, with disease duration less than 3 years. The analysis of serum concentrations of MMPs was based on a quantitative sandwich ELISA. We observed the positive significant correlations between studied MMPs and clinical markers of disease activity, such as number of swollen joints or erythrocyte sedimentation rate (ESR). Furthermore, we revealed significant correlations between serum MMP-1, MMP-3, MMP-9, MMP-13 concentrations and disease activity score (DAS) (p < 0.01; p < 0.001; p < 0.001; p < 0.05 respectively). We conclude that studied matrix metallo-proteinases might be useful clinical markers of disease activity in early rheumatoid arthritis.

Adult↗

PubMed2005

[Interstitial lung disease related to systemic connective tissue diseases].

Interstitial lung disease (ILD) is one of the most frequent and most serious complications of connective tissue diseases such as systemic sclerosis, systemic lupus erythematosus, dermato- and polymyositis, Sjogren's syndrome, or mixed connective tissue disease. Diagnosis of ILD is often delayed in patients with connective tissue diseases because of the systemic character of the primary condition, restricted physical activity of the patient and insufficient awareness of the physycian. The aim of the current review is to present the up-to-date information on ethiopathology, classification, diagnosis and treatment of ILD in patients with connective tissue diseases.

Collagen Diseases↗

PubMed2004

[Kidneys in rheumatoid arthritis].

Kidney pathology is a common phenomenon which is revealed in patients with rheumatoid arthritis (RA). Its incidence is estimated at 50-60% of all patients. It is an important clinical problem because it directly affects the outcomes of RA. Changes in the kidneys may result directly from either the underlying illness or complications due to various, including iatrogenic causes. In the following paper we present actual views on the subject of the known up-to-date causes of renal impairment in the course of RA.

Arthritis, Rheumatoid↗

PubMed2004

[Serum tumor necrosis factor alpha (TNF-alpha) concentration correlates with soluble adhesion molecules and vascular endothelial growth factor (VEGF) in rheumatoid arthritis].

In present study we investigated whether the serum concentration of tumour necrosis factor alpha (TNF-alpha) is associated with soluble adhesion molecules and vascular endothelial growth factor (VEGF) in rheumatoid arthritis (RA) patients. Serum levels of TNF-alpha, soluble intercellular adhesion molecule 1 (sICAM-1), soluble vascular cell adhesion molecule 1 (sVCAM-1), soluble E-selectin (sE-selectin) and VEGF were assessed by ELISA in 38 patients with RA. We demonstrated the TNF-alpha to correlate with sICAM-1 (p < 0.001), sVCAM-1 (p < 0.01) and VEGF (p < 0.01). No association was noticed between TNF-alpha and sE-selectin serum concentrations. Moreover, serum TNF-alpha, sICAM-1, sVCAM-1 and VEGF levels correlated with markers of RA activity such as the erythrocyte sedimentation rate, C reactive protein level and the number of swollen joints. Data presented in this report support the concept of the VEGF synthesis stimulation by TNF-alpha. Analysis of the serum TNF-alpha, sICAM-1, sVCAM-1 and VEGF levels may be useful in the prediction of the RA activity.

Adult↗

PubMed2004

The influence of doxycycline on articular cartilage in experimental osteoarthrosis induced by iodoacetate.

The experiment was performed on 36 Wistar rats. On the first day of the experiment iodoacetate was administered to the left posterior knee joint of the 18 rats which composed Group I. The second group of 18 rats received additionally doxycycline (doxy) through the gastric tube in doses comparable with those of doxycycline used in humans. The experiment lasted 21 days. The animals were sacrificed after 7, 14 and 21 days in groups of 6 rats each. In sections stained with Safranin 0 semiquantitative histochemical intensity tests were performed on articular cartilage glycosaminoglycans (GAG) using a four-point scale (0-3). In the first group examined destructive lesions in the articular cartilage and weak reactivity on GAG were noted at all stages of the experiment. The intensity of GAG staining was higher in the second group after 14 and especially after 21 days, which may suggest a protective action of doxy on articular cartilage.

Animals↗