Relationship between Serum Levels of Metalloproteinase-8 and Tissue Inhibitor of Metalloproteinases-1 and Exercise Test Results in Postmenopausal Women.

Physical activity as a part of the lifestyle is a significant factor influencing health condition. Exercises that require stamina are of particular importance. Oxygen metabolism, which is a significant part of all longer training processes, has an influence on cardiovascular and respiratory system functioning as well as all the processes taking part in maintenance of efficient homeostasis. Presentation of the correlation between exercise test results and MMP-8 (metalloproteinase-8) and TIMP-1 (tissue inhibitor of metalloproteinases-1) levels was attempted in this work. MMP-8 is a proteolytic enzyme taking part in progression of diseases related to process of ageing. 62 healthy women in postmenopausal period were qualified for the study (mean age: 54 ± 3.6). There was exercise test on the treadmill according to Bruce's protocol performed. MMP-8 and TIMP-1 serum levels were measured. There was statistically important correlation between increased level of MMP-8 and increased level of TIMP-1 with lower results of exercise test observed. The conducted study provides further biochemical arguments for prophylactic role of physical activity, which lowers the risk of noninfectious diseases, typical for middle adulthood, by influencing physical capacity.

Cardiovascular disease in psoriatic post-menopausal women.

BACKGROUND: It is generally accepted that the risk of cardiovascular disease (CVD) in women is significantly increased after the menopause. Hormonal changes associated with the menopausal transition may also alter the course of autoimmune diseases. It has been reported that menopause may exacerbate the symptoms of rheumatoid arthritis, systemic sclerosis and giant cell arteritis, but attenuate the course of systemic lupus erythemathosus. There is a growing body of literature indicating that the course of psoriasis may be altered by menopausal hormone changes. Considering the fact that both psoriasis and menopause are independent risk factors for CVD, and that menopause may exacerbate the course of psoriasis, a possible additive effect between these two conditions may be crucial for proper monitoring and treatment of peri- and post-menopausal psoriatic patients. OBJECTIVE: The aim of this study is to analyse potential relationship between psoriasis, menopausal status and risk of CVD. MATERIALS AND METHODS: A retrospective analysis of the Clalit Health Services database was performed in an attempt to provide new data and the available literature concerning these issues was reviewed. Data on cardiovascular events in 10 872 female psoriatic patients and 19 471 controls were extracted and compared. RESULTS: In both psoriatic and control patients the association of CVD increased with age. The association of CVD was significantly greater in psoriatic patients, but no significant differences were found between any of age groups. CONCLUSIONS: The association of psoriasis and CVD in women increases with age but there is insufficient evidence to confirm that menopause increases the risk of psoriasis. Further studies directly addressing this issue are needed.

Selected problems of medical qualification for physical fitness in postmenopausal women.

AIM: The aim of this study was to assess the relationship between sex hormones in blood and the occurrence of chest pain and degree of exercise capacity in postmenopausal women. METHODS: Fifty-two postmenopausal women with chest pain in retrosternal area in history (group A) and 52 asymptomatic (group B) were examined. Estradiol (E2), total testosterone (T), dehydroepiandrosterone sulphate (DHEA-S), sex hormone binding globulin (SHBG) concentrations in blood were measured. The free testosterone (FT), bioavailable testosterone (BT), index of free testosterone (FTI) and the index of free estradiol (FE2I) were calculated. ECG exercise stress tests were performed by the treadmill stress test track. RESULTS: In group A compared with B there were higher: systolic blood pressure (SBP), (129.3±13.5 vs. 121.8±17.1 mmHg, P=0.04), diastolic blood pressure (DBP) (80.8±11.8 vs. 78.6±12.1, P=0.04) at rest, maximum SBP post exercise (172.2±15.9 vs. 157.8±14.2 mmHg, P=0.0003) and lower DHEA-S (122.7±62.8 vs. 150.8±72.9 µg/100 mL, P=0.05) and T (1.5±0.6 vs. 1.7±0.6 nmol/l, P=0.04). T correlated with exercise duration (ED) (R=-0.251, P<0.05), FT with SBP increase during exercise (R=0.286, P<0.05) and ED (R=0.280, P<0.05), BT positively correlated with heart rate (HR) increase during exercise (R=0.285, P<0.05) and with ED (R=0.297, P<0.05). CONCLUSION: In postmenopausal women chest pain in history occurs regardless of exercise capacity and may be connected with arterial hypertension, deficiency of DHEA-S and androgenicity. Exercise capacity of postmenopausal women may be influenced by sex hormones, which levels in blood could be useful in the qualification for physical recreation plan.

Association of stromal-derived factor-1 alpha and endogenous sex hormones in men aged over 50 years with stable coronary artery disease.

PURPOSE: Many studies indicate an inverse relationship between stromal-derived factor-1 alpha (SDF-1 alpha), a chemokine, and coronary risk factors. Moreover, SDF-1 alpha is crucial in neoangiogenesis and in the mobilization and homing of endothelial progenitor cells to the ischemic coronary vessels. Numerous studies indicate that circulating sex hormones are associated with atherogenesis during male aging. The aim of this study was therefore to determine whether there exists a relationship between SDF-1 alpha and endogenous sex hormones in aging men with stable coronary artery disease (CAD). MATERIAL AND METHODS: Plasma concentrations of SDF-1 alpha, testosterone (T), estradiol (E2), and sex hormone binding globulin (SHBG) were measured and the E2/T ratio was calculated in a cross-sectional study of 82 men over 50 years of age with stable CAD. RESULTS: SDF-1 alpha was positively and significantly correlated with T (r = 0.233; p = 0.036) and with SHBG (r = 0.312; p = 0.004). There was a significant inverse correlation between SDF-1 alpha and the E2/T ratio (r = -0.463; p < 0.001). After adjustment for age, body mass index and smoking status, SHBG and E2/T ratio were the only factors associated with SDF-1 alpha. CONCLUSIONS: T and SHBG (directly) and the E2/T ratio (inversely) may be involved in the etiopathogenesis of CAD through their relationships to SDF-1 alpha.

Psoriasis and unreported excessive alcohol intake--a simple screening approach.

Psoriasis is a chronic immune-mediated skin disease of complex aetiology. Alcohol overuse has long been suspected to contribute to psoriasis pathology, and the knowledge of individual's drinking pattern may be of substantial importance for managing the disease. Unfortunately, a number of patients fail to admit to their true alcohol consumption and there is no single sign, symptom or laboratory parameter adequate for alcohol abuse diagnosis. However, there are some laboratory findings that, when present, should raise physician's suspicion that alcohol may be a problem. The aim of this article was to present simple, widely available and relatively reliable laboratory markers that might effectively assist physicians in establishing patient's drinking status. A possible screening approach is illustrated by two distinct reports of psoriatic patients who initially concealed having the problem with alcohol.

Polymorphisms of angiotensin-converting enzyme and angiotensin II receptor type 1 genes in essential hypertension in a Polish population.

BACKGROUND: The angiotensin-converting enzyme gene and the angiotensin II type 1 receptor gene meet the criteria for candidate genes in the pathogenesis of essential hypertension. The aim of this study was to assess the possible association between polymorphisms of these genes and essential hypertension in a Polish population, to evaluate them as possible genetic markers of susceptibility to hypertension, and to search for interaction between the two polymorphisms. MATERIAL AND METHODS: The insertion/deletion polymorphism at the angiotensin-converting enzyme gene locus and the A1166C polymorphism at the angiotensin II type 1 receptor gene locus were detected using the polymerase chain reaction and restriction fragment length methods. 250 patients with stable essential hypertension lasting at least 1 year were compared to 150 individuals without signs and symptoms of cardiovascular disease or family history of hypertension. RESULTS: No association was found between the insertion/deletion polymorphism at the angiotensin-converting enzyme locus and essential hypertension in the study population, although the DD genotype occurred more often (p<0.01) among patients with hypertension and a negative family history of hypertension than among hypertensives with a positive family history. There was an association in our study population between hypertension and the A1166C polymorphism at the angiotensinogen II type 1 receptor gene locus. The frequency of occurrence of the C1166 variant was higher among patients with hypertension (0.29) than in control subjects (0.20). The CC genotype occurred more frequently among hypertensives (0.10) than in the control group (0.04). Both these differences were statistically significant. This association was stronger in males, patients with a negative family history of hypertension, and non-obese patients with a body mass index less than 26 kg/m2. To test the interaction between the polymorphisms in question, the distribution of the A1166 and C1166 variants among ACE genotypes was assessed. The A1166 variant occurs more often among DD genotype normotensives. CONCLUSIONS: There was no association in our study population between essential hypertension and the I/D polymorphism at the angiotensin-converting enzyme gene locus. The C1166 variant of the angiotensin II type 1 receptor gene was associated with hypertension in our study population, while the A1166 variant seems to be protective as regards susceptibility to hypertension.

[Methylenetetrahydrofolate reductase gene polymorphism in patients with type 2 diabetes]. / Polimorfizm genu reduktazy metylenotetrahydrofolianu u pacjentów z cukrzyca typu 2.

Hyperhomocysteinemia is recognised as a risk factor of ischaemic heart disease and vascular complications of arterial hypertension. Methylenetetrahydrofolate reductase (MTHFR) gene C677T polymorphism is associated with hyperhomocysteinaemia. The aim of the study was the assessment of an association of the above polymorphism with type 2 diabetes with special attention to myocardial infarction and arterial hypertension accompanying diabetes. The study group consisted of 172 type 2 diabetics. 172 control subjects with normal glucose tolerance were age and sex matched to patients with diabetes. C677T polymorphism in MTHFR gene locus was detected using polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) method. CT and TT genotypes were found more often among diabetics (OR 1.83, 95% CI 1.16-2.89; p < 0.01). This finding may be secondary to the excess of T allele bearers among diabetics with myocardial infarction when compared to diabetics without infarction and to control group. Upon obtained results the potential role of genotypes CT and TT as risk factors of myocardial infarction among patients with type 2 diabetes could not be excluded (OR 2.33, 95% CI 0.93-5.8; p = 0.07). Genotypes containing T allele are not associated with diabetes type 2 and concomitant arterial hypertension (OR 1.45, 95% CI 0.89-2.57; p = 0.14). A confirmation in further studies is needed for the presented findings.

The influence of glucose-insulin-kalium mixture (GIK) on the selected parameters of acid-base balance in acute myocardial infarction.

The aim of the paper was assessing the influence of polarizing GIK mixture on the selected indicators of acid-base equilibrium in patients with acute myocardial infarction treated fibrinolytically. The patients had arterial blood taken in order to check pH, partial pressure of oxygen and carbon dioxide, and the content of bicarbonates. Changes in the examined parameters in the group obtaining GIK and in the one obtaining placebo were subject to critical analysis. Changes in gasometric parameters taking place under the influence of GIK administered to patients were also analysed according to the site of infarction. It was observed that after 24 hours from the beginning of infusion pH increased and pCO2 decreased in comparison to the initial examination. These changes did not depend on the kind of applied infusion (GIK or physiological saline infusion), no significant changes in bicarbonates being observed. However, after applying GIK infusion, an increase in oxygen pressure in comparison with the control group was observed, and differences between the groups were within the boundaries of significance. Neither was there observed any influence of infarction site on changes in the assessed parameters of acid-base equilibrium in the group treated with GIK nor in the one receiving placebo.

HRCT examinations in the course of silicosis.

Evaluation of diagnostic possibilities of high definition computerized tomography was performed on the material of 38 patients with recognized silicosis of small opacities on the bases of long lasting exposition, clinical and radiographic picture. Special usefulness of HRCT was shown in revealing early, scanty, radiographically imperceptible nodular changes. The presence of the so-called air traps was shown on expiratory sections.

Cardiopulmonary manifestations of subarachnoid hemorrhage--a case report.

The study presents a case of a 48-year-old female patient, in whom first symptoms of subarachnoid hemorrhage were suggestive of acute pulmonary oedema, caused by acute left ventricular insufficiency, evoked by myocardial infarction. The authors discuss the course of illness, diagnostic difficulties and changes in circulatory system, which can appear as a result of subarachnoid hemorrhage.

[Bronchial hyperreactivity as a factors of chronic obstructive pulmonary disease development in the population of the Bogdanka coal miners]. / Nadreaktywnosc oskrzeli jako czynnik ryzyka rozwoju przewleklej obturacyjnej choroby pluc w populacji górników kopalni wegla kamiennego w Bogdance.

The aim of the study was to assess the role of bronchial hyperreactivity in the development of chronic airflow obstruction in the population of the Bogdanka (Lublin Basin) coal miners. The population examined consisted of 1456 coal miners working underground in the Bogdanka colliery. The methods of the study included plethysmographic measurements of total airway resistance (Raw), spirometric measurements of forced expiratory volume in one second (FEV1), and determination of forced expiratory flowa at 75, 50 and 25 per cent of vital capacity (FEF75, FEF50 and FEF25%VC). The measurements were repeated twice--before and after administration of 0.2% solution of methacholine (1 min inhalation). Pulmonary function tests were also performed 8 years after initial measurements. The increase in the Raw value above 0.6 kPa/l/s was observed in 5.5% of the population examined. In this group of subjects the skin prick tests with common allergens, measurements of total immunoglobulin E (IgE) levels and determination of blood eosinophils count were performed. Only 12% of all hyperreactives (Raw increase > 0.6 kPa/l/s) showed features of atopy--positive skin prick tests, raised IgE levels, and increase in blood eosinophils count. Using a survival analysis as a statistical tool we evaluated for how long the pulmonary function tests remained within normal ranges in two groups: hyperreactives and controls. All hyperreactives (atopic and non-atopic) showed significantly higher risk of lung function decrease below the normal values as compared with the control group.

[M235T polymorphism of human angiotensinogen gene in essential hypertension in Polish population]. / Polimorfizm M235T ludzkiego genu angiotensynogenu w pierwotnym nadcisnieniu tetniczym w populacji polskiej.

Genetic factors play very important role in the pathogenesis of essential hypertension. Angiotensinogen gene is one of the candidate genes in the research concerning genetic background of elevated blood pressure. The aim of this work was to assess an association of M235T polymorphism in human angiotensinogen gene with essential hypertension in Polish population. 250 patients with essential hypertension and 150 normotensives were involved in the study. M235T polymorphism was detected using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) methods. Polymorphic allele and genotypes frequencies did not differ between hypertensive and normotensive groups. However T allele and TT genotype frequency among hypertensive men was higher than in normotensive men. The difference is statistically significant. T allele and TT genotype occurred more frequently in hypertensives with positive family history of essential hypertension. The difference between hypertensive men with positive family history and normotensive men was even more significant. This results are similar to those already published by other authors concerning Caucasian populations and indicate that angiotensinogen gene is involved in the determination of at least some cases of essential hypertension.

Right ventricular function in systemic hypertension.

The aim of the study was the assessment of right ventricular (RV) structure and diastolic function in hypertensive subjects. The study group consisted of 44 patients with untreated, mild to moderate essential systemic hypertension. All the patients were in sinus rhythm, no symptoms of congestive heart failure, ischaemic or valvular heart disease and lung disorders were found. Twenty-six healthy subjects were the control group. M-mode echocardiographic measurements of the right ventricular wall (RVW) diastolic thickness, right ventricular outflow tract diameter (RVOTD), left ventricular (LV) structure and LV systolic function were performed. Pulsed Doppler echocardiography was used to measure peak early (TE) and peak atrial (TA) right ventricular diastolic filling velocities as well as velocity-time integrals (VTI-TE and VTI-TA). TE:TA and VTI-TE:VTI-TA ratios were calculated. Similar parameters of the left ventricular diastolic filling were recorded at the level of mitral annulus. Mean pulmonary artery pressure (MPAP) was measured non-invasively by the estimation of pulmonary artery systolic flows. We demonstrated in hypertensive patients significantly thicker RVW (3.94 vs 2.8 mm, P < 0.001) and increased LV mass. In the hypertensive, increased TA and VTI-TA and diminished TE:TA and VTI-TE:VTI-TA ratios were recorded, indicating the abnormalities of RV diastolic function. RV diastolic filling parameters correlated positively with corresponding parameters of LV filling. The results of our study demonstrate that impairment of LV diastolic function, the common finding in systemic hypertension, is associated with diastolic disturbances of the right ventricle. RVW thickening and hypertrophy of interventricular septum seem to be major factors influencing RV diastolic function.

[Echocardiographic evaluation of pulmonary artery flow parameters in patients with chronic pulmonary disease]. / Echokardiograficzna ocena parametrów przeplywu krwi w tetnicy plucnej u chorych na przewlekla obturacyjna chorobe pluc.

This study aimed at comparing the Doppler echocardiographic artery blood flow parameters in patients with and without chronic obstructive pulmonary disease (COPD), and estimating an effect of the present degree of airway obstruction on systolic functioning of the right ventricle. The study included 28 patients with COPD, and 22 patients without COPD constituting a control group. Pulmonary functional tests have been performed with the use of body plethysmography. Doppler echocardiographic assessment of the pulmonary artery flow included a measurements the acceleration time (AcT), and right ventricular ejection time (RVET). Both AcT and RVET have been corrected for the heart rate. Corrected AcT shorter than 100 ms has been considered specific for the pulmonary hypertension (PH). AcT in the studied group of patients ranged from 67 ms to 143 ms (mean 106 +/- 21), and has been significantly shorter than that in the control group. However, no correlation between body plethysmographic findings and echocardiographic measurements has been found in COPD patients. Echocardiography is a sensitive technique detecting PH. As spirometric findings do not predict development of the cor pulmonale, Doppler echocardiographic evaluation of the blood flow in pulmonary artery may serve as a screening test.