Szczepan Cofta

Analysis of serum copper and zinc concentrations in cancer patients

Several studies have shown that plasma copper concentrations are increased in various carcinomas. Zinc acts as a cellular growth protector, including growth of neoplastic cells, and its deficiency was demonstrated to be involved in several stages of malignant transformation. However, the usefulness of the serum zinc and copper determinations in cancer prevention, detection, monitoring treatment, and prognosis requires further investigations. The aim of the present study was to compare the serum copper and zinc levels in patients with cancer of the lung (PC), breast (BC), gastrointestinal tract (GIC), and gynecological (GYNC) malignancy with progress of the disease. The results of the study have shown a significant increase in the mean total serum Cu levels and the serum Cu/Zn ratio in all patient groups with cancer compared to a control group. Increased mean serum concentrations and Cu/Zn ratios were found in the whole group (ALLC), and for the GIC and GYNC groups with local as well as metastasized (Meta) disease in comparison with the control group. The mean serum concentrations of Zn were decreased only in metastasized ALLC and GYNC groups.

Oral antibiotic therapy improves fat absorption in cystic fibrosis patients with small intestine bacterial overgrowth.

BACKGROUND The aim of the present study was to assess the influence of antibiotic therapy on fat assimilation in cystic fibrosis (CF) patients with small intestine bacterial overgrowth (SIBO). MATERIALS AND METHODS Twenty six pancreatic insufficient CF patients with bronchopulmonary exacerbation and diagnosed SIBO (positive hydrogen-methane breath test) entered the study. (13)C mixed triglyceride breath test was performed before and after antibiotic therapy. Sixteen subjects were treated intravenously (ceftazidime and amikacin), ten patients orally (ciprofloxacin). RESULTS Cumulative percentage dose recovery changed significantly in the subgroup receiving antibiotics orally [median (mean±SEM): 3.6% (4.5±1.3%) vs. 7.2 (6.9±1.6%); p=0.019]. In the subgroup with intravenous drug administration, the tendency towards improvement was noted [2.7 (4.3±1.5%) vs. 5.2 (5.7±0.8%); p=0.109]. CONCLUSIONS Antibiotic therapy applied in CF patients with SIBO in the course of pulmonary exacerbation results in a significant improvement of fat digestion and absorption.

Plasma Selectins in Patients with Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is an independent risk factor in the pathogenesis of -cardiovascular diseases. The aim of the study was to analyze three specific adhesion molecules involved in the development of an atherosclerotic plaque: E-selectin (endothelium), L-selectin (leukocyte surface), and P-selectin (from platelet), circulating in plasma in patients at different OSA severity. Eighty non-smoking male Caucasians aged 30-64 were enrolled into the study after clinical, biochemical, and polysomnographic examinations. The patients were divided into four groups based on the results of apnea/hypopnea index (AHI): OSA-0 with AHI 0-4.9 (n = 20), OSA-1 with AHI 5-15 (n = 21), OSA-2 with AHI 16-30 (n = 18), OSA-3 with AHI ≥ 31 (n = 21). Complete blood count, oral glucose tolerance test, fasting lipid profile, C-reactive protein and insulin, and plasma concentrations of soluble E-selectin, P-selectin and L-selectin were measured. We found a progressive increase in the concentrations of all three selectins with the severity of OSA. In conclusion, the level of plasma adhesion molecules may be indicative of OSA severity and may contribute to cardiovascular sequelae.

Adipocytokines in sleep apnea syndrome

ObjectiveBiomarkers of adipose tissue may affect glucose and lipid metabolism and present pro-inflammatory properties, thus could be involved in the pathobiochemistry of cardiovascular disease (CVD). The coexistence of sleep apnea syndrome (OSA) and metabolic risk factors of CVD is worth explaining. The aim of the study was to compare the serum adipocytokines in subjects with and without OSA, who had all elevated body mass index (BMI).MethodsOverweight (BMI: 25.0-29.9 kg/m2) and obese (BMI: 30.0-39.9 kg/m2) OSA-suspected Caucasian males, aged 30-63, with no acute disease or chronic disorder underwent polysomnographic evaluation to select OSA-positive (AHI ≥ 5) and OSA-negative (AHI < 5) subjects. Four subgroups were created of 18 persons each: Over(weight)-OSA-Neg, Over-OSA-Pos, Obese-OSA-Neg, Obese-OSA-Pos. In all subjects, plasma carbohydrate and lipid metabolism parameters, and serum uric acid, resistin and leptin concentrations were determined.ResultsA decreased resistin level was observed in Over-OSA-Pos vs. Over-OSA-Neg subjects (P = 0.037) as well as in Obese-OSA-Pos vs. Obese-OSA-Neg (P = 0.045). No differences in leptin concentrations were observed. A positive correlation between leptin and BMI was in both overweight subgroups and a negative one between resistin and fasting glucose was in both obese subgroups.ConclusionsOSA may decrease the serum resistin level in subjects with excess body mass and also may contribute to glucose metabolism, but has no influence on the leptin level.

Blood Antioxidant Status, Dysglycemia and Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) patients present increased cardiovascular morbidity and mortality. Oxidative stress is involved in OSA and cardiovascular pathology. The aim of the study was to assess oxidative stress markers in the blood of OSA males during oral glucose tolerance test (OGTT). The study involved OSA-suspected obese males (BMI ≥ 25 kg/m(2)) aged 35-64, with no acute or chronic disorders, appointed for polysomnography to diagnose OSA (AHI ≥ 5). The results of OGTT allowed to select prediabetic (Pre) subjects and normal glucose tolerance (N), excluding newly diagnosed diabetes. Blood was collected at 0 min (fasting) and 120 min of the test. Plasma glucose, total antioxidant status (TAS), thiobarbituric acid-reacting substances (TBARS), and activity of superoxide dismutase-1 (SOD) in erythrocytes, were determined at the two time points and the difference (D) between the 120 and 0 min time points was calculated for either oxidative stress variable (D-TAS, D-SOD and D-TBARS). Fasting serum insulin and lipids also were measured fasting. There were four groups of subjects, each consisting of 22 individuals N-OSA-neg(ative), N-OSA-pos(itive), Pre-OSA-neg and Pre-OSA-pos. The N-OSA-pos and Pre-OSA-pos subjects demonstrated decreased SOD-0 compared with OSA-negative groups. In N-OSA-neg and N-OSA-pos groups, the positive differences D-SOD and D-TAS were observed, while Pre-OSA subjects presented negative differences. In conclusion, prediabetic OSA patients may consume blood antioxidant factors to counter the effects of oxidative stress, more than individuals with normal glucose tolerance.

ENDOTHELIUM-DERIVED MARKERS AND ANTIOXIDANT STATUS IN THE BLOOD OF OBSTRUCTIVE SLEEP APNEA MALES

ObjectiveThe relationship between obstructive sleep apnea (OSA) and cardiovascular disease is intensively discussed. Endothelial leukocyte adhesion molecule (E-selectin) is one of factors facilitating leukocyte migration to the subendothelial layer which could be considered proatherogenic. The aim of the study was to determine E-selectin levels and total plasma antioxidant status (TAS) in the blood of different stage OSA patients.MethodsNon-smoking, OSA-suspected males, aged 30-63, were selected for the study. An EMBLA polysomnographic system was used to establish the severity of apneic episodes. The results of apnea/hypopnea index (AHI) allowed dividing patients into the following groups: OSA-0 with AHI 0-4.9 (n = 14), OSA-1 with AHI 5-15 (n = 14), OSA-2 with AHI 16-30 (n = 13), OSA-3 with AHI ≥ 30 (n = 13). Complete blood count (CBC), glycemia during oral glucose tolerance test, fasting plasma lipid profile, uric acid, and high sensitivity C-reactive protein (hsCRP) were estimated among routine parameters. We determined plasma concentrations of E-selectin and total antioxidant status.ResultsWe found progressively decreasing concentrations of TAS (P = 0.03) and increased concentrations of E-selectin (P = 0.0001) from OSA-0 to OSA-3 subjects. No correlation between E-selectin and metabolic parameters was noted.ConclusionIn the studied OSA groups, E-selectin appeared an independent proatherogenic factor.

Impulse oscillometry in the diagnosis of airway resistance in chronic obstructive pulmonary disease.

Spirometry is a standard lung function test for diagnosis and staging of chronic obstructive pulmonary disease (COPD). Impulse oscillometry (IOS) can be complementary to spirometry, especially in patients at advanced age and with physical or mental disorders who cannot be diagnosed through spirometry. The aim of this study was to compare IOS and spirometry in the assessment of airway obstruction in COPD. The study was conducted in 112 stable COPD patients, including 29 females and 83 males of the mean age of 69±11 years. The oscillometric evaluation included total (R5), peripheral (R5-R20), and negative reactance (X5), which were compared with the predicted forced expiratory volume in 1 s (FEV1%pred). The findings show a significantly negative correlation between FEV1%pred and the R5, R5-R20, and X5. COPD patients had increased R5, R5-R20, and X5. The severity of bronchial obstruction found by impulse oscillometry correlated well the spirometric assessment. IOS is a simple to perform test that may be helpful for functional examination of COPD patients.

Treatment of advanced lung cancer by external beam radiotherapy and high dose rate (HDR) brachytherapy

Abstract Purpose Brachytherapy is a highly valued and effective palliative treatment for lung cancer, especially as it reduces intensity of dyspnoea and other symptoms arising from tumours inside the respiratory tract. In some cases, due to the location of the lesion brachytherapy is a treatment of choice. However, its curative role is unclear. A combination treatment of brachytherapy and an external beam irradiaton may play a significant role when the mediastinal lymph nodes are involved. The paper presents the results of treatment of advanced lung cancer patients by external beam irradiation and brachytherapy, and the role of this palliative treatment is discussed. Material and methods Between May 1999 and March 2000 at the Greatpoland Cancer Centre fifteen patients with advanced lung cancer were treated by HDR brachytherapy and palliative external beam irradiation using the method of hypofractionation. The patients’ age ranged between 39 to 80 years, mean: 54.3 years. The treatment consisted of external beam irradiation (total dose of 20–30 Gy), and a weekly high dose rate (HDR) brachytherapy (three fractions of 7.5 or 10 Gy, at 1 cm from the source). In three cases the treatment was started with external irradiation, whereas in 12 cases the first stage was brachytherapy. During the patients’ clinical and endobronchial follow-up of 1, 3 and 6 months, local remission and regression of difficulties in breathing, cough, pain and haemoptysis were assessed. Results In all our patients subjective improvement (regression of all symptoms) was found on the first check-up following treatment. In one case complete remission of the tumour lasted for over 6 months, in 9 cases partial remission and in two cases progression were found. Severe complications due to the high total local dose were not observed. Conclusions Combined palliative treatment (intraluminal brachytherapy and external beam irradiation) in advanced lung cancer was an efficient method that led to regression of symptoms and improvement of well-being in many patients.

The repeated use of high dose rate brachytherapy for locally recurrent lung cancer

Summary Purpose To assess the effect of repeated palliative treatment with high dose rate brachytherapy in patients with advanced lung cancer. Material and Methods Fifty-six patients, 25.3% of a total of 221 patients treated for lung cancer with HDR brachytherapy were treated twice, using High Dose Rate Brachytherapy. All patients were qualified for repeated brachytherapy due to the recurrence of intrabronchial tumour and acceptable remissions after the first treatment. The survival times were compared with selected clinical data. Correlations between survival times and subjective breathing difficulties were analyzed separately. Results The median survival time in the whole group of patients was 8.9 months. The period of obtaining a positive clinical response was correlated with a longer survival time (log-rank test, p=0.0009, F Cox test, p=0.007). In the multivariate analysis other statistically important prognostic factors were also included: the clinical stage of the primary tumour (F Cox test, p=0.04), and the interval between the first and second treatment (F Cox, p=0.004). None of the analyzed factors (dyspnoea, cough, haemoptysis and pain) had any influence on survival. Conclusion Repeated HDR brachytherapy in advanced lung cancer was an efficient method that in many patients led to regression of symptoms and improvement in life quality.

Carotid Artery Intima-Media Thickness in Hypertensive Patients with Obstructive Sleep Apnea

In this study we determined the relationship between the severity of obstructive sleep apnea (OSA) and body mass index (BMI), systolic and diastolic blood pressure (SBP, DBP), and carotid intima-media thickness (cIMT) in 30 hypertensive male patients, aged 30-70, with newly diagnosed OSA (15 with moderate OSA - Group A, and 15 with severe OSA - Group B) and 20 non-OSA hypertensive individuals (Group C). We revealed significant differences in cIMT between Groups B and C (0.9 ± 0.3 vs. 0.6 ± 0.1 mm and 1.0 ± 0.4 vs. 0.6 ± 0.2 mm in the right and left common carotid arteries, respectively; p <0.05). Increased carotid intima-media thickness in severe OSA was accompanied by higher systolic and diastolic blood pressures compared with both moderate OSA and control subjects. We conclude that in severe OSA increased blood pressure goes in tandem with the thickness of carotid intima-media, which helps explain increased cardiovascular risk in these patients.