Biomedical subjects

Z Zietkowski

Publications and source records attributed to Z Zietkowski.

15 recordsLinked to original sources

PubMed2006

Comparison of exhaled nitric oxide measurement with conventional tests in steroid-naive asthma patients.

BACKGROUND: Nitric oxide (NO) is a molecule with potent biological activity that plays an important role in the physiology of the respiratory system. Increased expression of inducible nitric oxide synthase (iNOS) and elevated fractional concentration of exhaled nitric oxide (F(ENO)) are seen in asthmatic patients. Measurement of F(ENO) has become increasingly recognized for use in the evaluation of bronchial inflammation during monitoring of antiinflammatory treatment. OBJECTIVES: The aim of this study was to evaluate F(ENO) in a group of steroid-naive asthmatics and assess the relationship of this parameter with the results of other tests used in the diagnosis of asthma and monitoring of antiinflammatory treatment in asthmatic patients. METHODS: The study was conducted in a group of 101 steroid-naive asthmatics (56 allergic and 45 nonallergic) and 39 healthy volunteers. All patients underwent measurement of F(ENO), skin prick tests with common inhaled allergens, analysis of serum eosinophil cationic protein (ECP) and blood eosinophilia, and flow-volume spirometry. When the forced expiratory volume in the first second (FEV1) was less than 80% of predicted, reversibility of airway obstruction with a beta2-agonist was assessed. A nonspecific bronchial provocation test with histamine was carried out in asthmatic patients with a baseline FEV1 of more than 70% of predicted. RESULTS: Compared to the healthy volunteers, F(ENO) was elevated in both groups of asthmatics. F(ENO) in the allergic asthma group was higher than in the group of nonallergic asthmatics. In allergic and nonallergic asthmatics, F(ENO) was significantly correlated with bronchial hyperresponsiveness to histamine, reversibility of airway obstruction, serum ECP levels, and blood eosinophilia. F(ENO) did not correlate with baseline FEV, in either group of asthmatics. In 31% of nonallergic and 9% of allergic patients, F(ENO) was less than 20 parts per billion. CONCLUSIONS: We suggest that measurement of F(ENO) could be clinically useful in steroid-naive asthmatics and should be more widely used in clinical practice. Measurement of F(ENO) is a noninvasive, simple, and reproducible procedure, the results of which correlate with other routinely used methods in the diagnosis of asthma. However, it is worth noting that some patients, especially those with nonallergic asthma, do not display elevated F(ENO).

Adult↗

PubMed2005

The influence of inhaled corticosteroids on exhaled nitric oxide in stable chronic obstructive pulmonary disease.

The aim of the study was to evaluate the exhaled nitric oxide (F(ENO)) in clinically stable chronic obstructive pulmonary disease (COPD), its relationship to the severity of the disease, pulmonary function, smoking status, reversibility of airflow limitation, and ICS therapy. The study was conducted in 47 patients with COPD and 40 healthy controls. Flow/volume spirometry and F(ENO) measurement were performed before and after 2 months of ICS therapy. F(ENO) were significantly elevated in current smokers and ex-smoking COPD patients. In both groups of COPD patients inhaled corticosteroids (ICS) therapy caused a significant decrease in F(ENO) without significant changes in FEV1. A positive correlation between initial F(ENO) and postbronchodilator FEV1 (% predicted) was observed in the group of ex-smoking COPD patients, but not in the currently smoking COPD group. In both groups of COPD patients, the initial level of F(ENO) correlated with the reversibility of airway obstruction, the increase in postbronchodilator FEV1 and the decrease in F(ENO) following ICS treatment. F(ENO) increases in patients with stable COPD. ICS therapy decreased elevated F(ENO) levels in these patients without statistically significant changes in lung function. The selection of COPD patients with increased F(ENO) level and partial reversibility of airway obstruction should be helpful in terms of proposed ICS treatment.

Administration, Inhalation↗

PubMed2005

Knowledge of risk factors and guidelines for the management of asthma. The educational role of the nurse.

PURPOSE: The aim of the study was to determine the level of knowledge concerning risk factors for the development of asthma and worsening of the course of the disease among patients, as well as achieving a better understanding of the educational role of the nurse in improving the quality of life of patients suffering from the disease. MATERIALS AND METHODS: The study was a questionnaire study involving 100 patients suffering from asthma. 59 of them were diagnosed as having an allergic and 41 a nonallergic asthma. In the main they were patients suffering from moderate to severe asthma, who had attended the outpatient allergology clinic for many years. RESULTS: Analysis of the results obtained demonstrated the significant effects of asthma for the lives and health of the patients questioned. This was reflected in the high number of people registered as unable to work and receiving invalidity benefits, and influenced the activity of the majority patients in various spheres of life. A number of respondents demonstrated poor knowledge of the risk factors for asthma and ways of eliminating the illness. The majority of patients had a good knowledge of the names, doses and ways in which they should take their prescribed medication as well as showing an understanding of the principles of taking additional medicines as necessary. Their knowledge of the principles of anti-inflammatory treatment, which is a basic factor in the treatment of patients with asthma was, however very poor. CONCLUSIONS: Among patients suffering from asthma there is a great need for health information. The majority of respondents expressed a willingness to take part in training sessions to be run by nursing staff. The focus of these educational sessions should be on improving the patients' knowledge about asthma as a chronic inflammatory disease, helping to eliminate and limit risk factors for the disease, treatment principles and avoiding the side-effects of prescribed medication.

Adult↗

PubMed2000

[The effect of local specific bronchial immunotherapy (LIT) on specific and non-specific bronchial hyperreactivity in patients with bronchial asthma sensitive to housedust mites].

The aim of the study was to evaluate the effect of LIT with mite allergens given by dry powder inhalation on bronchial hyperreactivity after histamine and allergen inhalation in patients suffering from atopic mite asthma. The study was conducted in a group of 17 asthmatics (9 patients Hypoinhal Dermatophagoides, 8 patients placebo). A decrease in specific (early asthmatic reaction during specific bronchial provocation test) and non-specific bronchial hyperreactivity has been revealed in the group treated with Hypoinhal Dermatophagoides. No changes were observed in placebo group. A slight improvement in LAR (late asthmatic reaction during specific bronchial provocation test) was observed, but the results were not statistically significant.

Administration, Inhalation↗

PubMed2000

[Usefulness of Dermatophagoides pteronyssinus allergen extract from the Allergopharma J.G. Company for bronchial provocation in patients with bronchial asthma].

The value of Dpt allergen extract, produced by Allergopharma J.G., for performance of the bronchial provocation test in asthmatics was evaluated. The studies were carried out in 40 asthmatics with positive skin prick test with Dpt. Bronchial provocation test was performed according to Ryan's method. After an allergen inhalation, an early asthmatic reaction (EAR) and late asthmatic reaction (LAR) may appear. The following results were observed: a dual asthmatic reaction (EAR and LAR)--in 19 persons, the EAR--only in 9 patients, and the LAR--only in 1 patient. The negative result of the provocation were found in 11 patients. The frequency of particular patterns of the bronchial reactions was similar to those published before by us and other authors, with different allergen extracts. The allergen extract of Dpt from Allergopharma J.G. can be used to bronchial challenge.

Adolescent↗

PubMed1999

[The effect of intrabronchial specific immunotherapy on certain immunologic parameters in asthmatic patients with allergic to house mites].

The aim of this study was to evaluate the influence of intrabronchial specific immunotherapy (SIT) on chosen immunological parameters in asthmatic patients sensitised to house dust mites. No statistically significant changes in the allergen induced basophil histamine release and in the serum levels of specific IgE and IgG4 have been shown. In contrast it has been demonstrated statistically significant increase of secretory IgA in saliva of patients who have undergone the immunotherapy. A decrease in the serum concentration of ECP has been shown after the course of SIT.

Allergens↗

PubMed1999

[Evaluation of efficacy and safety of intrabronchial specific immunotherapy with allergy medication against allergies to house mites among patients with bronchial asthma].

The purpose of this study was to evaluate efficacy and safety of local immunotherapy with inhaled allergens of house dust mites in asthmatic patients. An opened study was conducted in a group of 16 patients who have undergone 7 months course of immunotherapy. It has been shown statistically significant decrease in a score of clinical symptoms and in administered medications. On the other hand it has been demonstrated statistically significant increase of PEF in these patients. A decrease in specific and non-specific bronchial hyperreactivity has been revealed in bronchial provocation tests. Specific, local immunotherapy seems to be efficacious and well-tolerated way of hyposensitisation in house dust mite allergic patients.

Adolescent↗

PubMed1999

[The effect of sputum induction on spirometry parameters in patients with bronchial asthma].

Evaluation of differential cell count and biochemical parameters in sputum seems to be a valuable method in asthma studies. The purpose of the paper was to evaluate the effects of sputum induction alone and after fenoterol and salmeterol premedication, on spirometry in asthma patients. The another aim of the study was to observe the correlation between bronchial hyperreactivity and decreases in FEV1 and MEF50 in asthmatics during sputum induction. The studies were carried out on 20 mild to moderate asthma patients (FEV1 baseline 79 +/- 16% of the predicted values) who inhaled an increasing concentration of hypertonic saline (3%, 4% and 5%), using an ultrasonic nebuliser. The forced expiratory volume in one second and MEF50, as the good indicators of bronchial obturation, were evaluated. During the sputum induction significant decreases in FEV1 and MEF50 were observed, which were proportional to the concentration of NaCl. After inhalation of 3% of NaCl the mean of FEV1 was 87.2 +/- 12.7% of the baseline, after 4%--84.3 +/- 16.9% and 5%--77.4 +/- 19.8%. No significant correlation between bronchial hyperreactivity and the induced decreases in FEV1 and MEF50 were found. Fenoterol and salmeterol fully prevented bronchial obturation during sputum induction.

Administration, Inhalation↗

PubMed1998

[Clinical evaluation of 12 week salmeterol therapy in allergic asthma patients].

The purpose of the study was to evaluate the efficacy of salmeterol in asthma therapy. The study was performed on a group of 16 allergic asthma patients sensitive to house dust mite allergens. After a run-in period the patients were treated with salmeterol, 2 x 50 micrograms, for a period of 12 weeks. They noted an intensity of asthma symptoms, morning and evening PEF, beta 2-agonist consumption and adverse in their diary cards. On the visit to the clinic spirometry was performed. During the treatment a significant reduction in the symptom score, PEF variation, beta-agonist consumption and an increase in the value of morning and evening PEF were noted. The above results indicate the great efficacy of salmeterol in asthma therapy.

Adult↗

PubMed1998

[Evaluation of the enhaled glucocorticosteroid effect on non-specific and specific bronchial reactivity with particular reference to the late inflammatory phase in atopic asthma patients. I. The effect of a single dose of budesonide R on specific and non-specific bronchial reactivity].

The effect of a single dose of 320 micrograms of budesonide R on specific and non-specific bronchial response was evaluated. The study was carried out on a group of 12 patients suffering from mild allergic asthma, sensitive to Dermatophagoides pteronyssinus (D. pteronyssinus). On the first day the bronchial provocation test (BPT) with metacholine was performed, and the next day the effect of a single dose of the drug studied on bronchial response to metacholine was evaluated. On the third day sBPT with D. pteronyssinus allergen was performed. The allergen challenge could induce an early (EAR) and a late asthmatic reaction (LAR). After the BPT with the allergen, a 42 days' run-out period was required to eliminate the effects of the allergen provocation on the results of the next tests. Before the evaluation of the effect of budesonide on the allergen challenge, the non-specific response to metacholine was checked again. The results indicate that a single dose of budesonide R does not affect non-specific and specific bronchial response.

Adult↗

PubMed1998

[Evaluation of the inhaled glucocorticosteroid effects on non specific bronchial reactivity with particular reference to the late inflammatory phase in atopic asthma patients. II. The effect of regular administration of budesonide R on specific and non-specific bronchial reactivity].

The purpose of the study was to determine whether regular administration of budesonide R decreases inflammation, specific and non-specific bronchial hyperreactivity in allergic asthma patients. The studies were carried out on 16 patients suffering from mild to moderate allergic asthma, sensitive to D. pteronyssinus allergen. After performance of the specific and non-specific bronchial provocation tests, collection of blood samples for an ECP evaluation, the patients were regularly treated with budesonide R, 2 x 320 micrograms for a period of 8 weeks. At the end of the study the BPTs and blood collection were repeated. BPTs with methacholine and D. pteronyssinus were performed according to Ryan's method. After the allergen challenge, early (EAR) and late asthmatic reaction (LAR) were to be observed. After the therapy non-specific BHR to methacholine expressed as PC20FEV1 and specific BHR to allergen (PD20FEV1D. pteronyssinus) and serum ECP concentrations decreased significantly. Although after the treatment with budesonide R, the patients had to inhale much larger amounts of allergen, in order to induce EAR, the number of LAR did not change significantly. After treatment the LAR appeared about 1 hour later and the decrease in FEV1 was less than previously. We conclude that budesonide R decreases the intensity of the inflammation and BHR.

Adult↗

PubMed1996

[Usefulness of allergen extract Aquagen SQ-Dpt for administering bronchial provocation tests].

The value of the allergen extract, Aquagen SQ-Dpt, for performance of the bronchial provocation test in allergic asthma patients was evaluated. The studies were carried out on 117 patients suffering from allergic mite asthma. Bronchial challenge was performed according to Ryan's method. After an allergen inhalation, an early asthmatic reaction (EAR) and a late asthmatic reaction (LAR) may appear. In our studies a dual reaction (EAR and LAR) was observed in 53.8% of the patients, the EAR only in 27.4% and the LAR only in 2 patients. The subjects with the dual response demonstrated a higher sensitivity to the allergen than those with only the EAR. A positive, statistically significant correlation between specific and non-specific bronchial hyperreactivity was found. The frequency of the appearance particular patterns of the bronchial responses was similar to those published by other authors, using different allergen extracts. Aquagen SQ-Dpt can be used to perform of the sBPT.

Adult↗

PubMed1995

[Value of a specific bronchial provocation test in comparison with other methods in diagnosis of atopic bronchial asthma].

The aim of this study was to determine the relation between specific Bronchial Provocation Test (sBPT), the serum specific IgE level (sIgE) and specific basophil histamine release (Dpt HR) in asthma patients, sensitive to Dermatophagoides pteronyssinus (Dpt). The studies were carried out on 30 mild asthma patients with positive case history and strongly positive skin tests with Dpt. In all the patients were performed following tests: BPT with histamine, serum specific IgE level against Dpt (sIgE Dpt), spontaneous basophil HR (spHR), anti-IgE depended basophil HR (aIgE HR), Dpt depended basophil HR (Dpt HR), sBPT with Dpt (sBPT Dpt). The positive results of sBPT Dpt were observed in 27 patients. Twenty six of them had the early¿ asthmatic response (EAR) at least, 19--dual asthmatic response (EAR and LAR) and isolated late asthmatic response (LAR) demonstrated only one patient. The correlation coefficient (r) between sIgE and Dpt HR was 0.4 p < 0.04, between sIgE and sBPT Dpt r = -0.4, p < 0.03, and between sBPT Dpt and Dpt HR r = -0.37, p < 0.05. The results showed a significant correlation between sIgE and Dpt HR, sIgE and sBPT Dpt, sBPT Dpt and Dpt HR and these tests appear to be of value in casual diagnosis of allergic bronchial asthma, but only sBPT makes possible to observe LAR.

Adult↗

PubMed1995

[Behavior of various spirometry parameters during bronchial provocation tests with D. pteronyssinus in patients with asthma, sensitized to housedust mites].

Changes in particular spirometry parameters during specific bronchial provocation test (BPT) with an allergen in asthmatics sensitized to house dust mites were evaluated. Studies were carried out on 130 patients. Specific BPT with D. pteronyssinus was performed according to the Ryan's method using a jet De Villbiss 646 nebuliser powered by compressed air and connected to the French Rosenthal dosimeter. The spirometry was measured using Pneumoscreen II (Jaeger - Germany). The provocation was terminated when a value of FEV1 fell at least 20% from baseline and then the spirometry parameters were measured hourly for a period 8 hours. Early and late asthmatic responses were founded. Results were expressed as a percentage of the maximum decrease from the baseline in particular parameters. To the statistical calculations only positive sBPT results founded in 96 patients were selected. The mean values of the decreases during of the EAR were as follow: FEV1 = 30.6 +/- 9.9%, FVC = 18.9 +/- 9.9%, FEV/FVC = 14.6 +/- 9.2%, FEV25-27 = 41.5 +/- 15.7%, PEF = 30.8 +/- 15.7%. The correlation coefficients were between FEV1 and FVC -0.57, FEV1 and FEV1/FVC -0.56, FEV1 and FEF25.75 -0.65, FEV1 and PEF -0.6. The results were statistically significant. Decreases in FEV1 and PEF were very similar each other. The greatest changes were observed in FEF25.75. The curves of the FEV1 and PEF averages observed during LAR were quite close to each other and almost parallel. The usefulness of the both parameters seems to be equal.

Animals↗

PubMed1995

[Effect of flunisolide on exacerbation of clinical symptoms, spirometric parameters, consumption of B2-adrenergic drugs and levels of cortisol and ECP in serum of patients with bronchial asthma].

The effects of flunisolide on a symptoms, spirometry, beta 2-agonist consumption, serum cortisol and ECP levels in 30 asthmatics were assessed. The patients qualified for the study after a two week run--in period, inhaled flunisolide from MDI--1000 micrograms daily (2 x 2 puffs) for a period of 4 weeks. Patients noted daily asthma symptoms, morning and evening PEF, the beta 2-agonists consumption and side effects in their diary cards. Each patient had 3 visits to the clinic, before and after the run-in period and at the end of the study. During the visits spirometry were performed. After the flunisolide therapy, statistically significant decreases in the daily and nightly asthma symptoms, diurnal variations of PEF, beta 2-agonist consumption, serum ECP levels and increases in morning and evening PEF and in serum cortisol levels. The patients tolerated the drug well. No serious side effects were observed during the study.

Adrenergic beta-Agonists↗