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Lubinski W.,Military Institute of Medicine | Golczewski T.,Polish Academy of Sciences
Journal of Applied Physiology | Year: 2010

The need for ethnic-specific reference values of lung function variables (LFs) is acknowledged. Their estimation requires expensive and laborious examinations, and therefore additional use of results in physiology and epidemiology would be profitable. To this end, we proposed a form of prediction equations with physiologically interpretable coefficients: a baseline, the onset age (AO) and rate (S) of LF decline, and a height coefficient. The form was tested with data from healthy, nonsmoking Poles aged 18-85 yr (1,120 men, 1,625 women) who performed spirometry maneuvers according to American Thoracic Society criteria. The values of all the coefficients (also AO) for several LFs were determined with regression of LF on patient's age and deviation of patient's height from the mean height in the year group of this patient. S values for forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), peak expiratory flow, and maximal expiratory flow at 75% of FVC (MEF75) were very similar in both sexes (1.03 ± 0.07%/yr). FEV1/FVC declines four to five times slower. S for MEF25 appeared age dependent. AO was smallest (28-32 yr) for MEF25 and FEV1. About 50% of each age subgroup (18-40, 41-60, 61-85 yr) exhibited LFs below the mean, and 4-6% were below the 5th percentile lower limits of normal, and thus the form of equations proposed in the paper appeared appropriate for spirometry. Additionally, if this form is accepted, epidemiological and physiological comparison of different LFs and populations will be possible by means of direct comparison of the equation coefficients. Copyright © 2010 the American Physiological Society.


Choromanska A.,Military Institute of Medicine | Macura K.J.,Johns Hopkins University
Polish Journal of Radiology | Year: 2012

The solitary pulmonary nodule (SPN) has always been a diagnostic challenge for the radiologists. Currently, with increased utilization of computed tomography (CT) greater number of nodules is being discovered, with numerous indeterminate lesions, which frequently cannot be immediately classified into benign or malignant category. In this article we review the imaging features of benign and malignant round opacities; we demonstrate currently used standards and also more advanced techniques that are helpful in evaluating SPNs such as contrast-enhanced CT, PET/CT imaging and also pathologic sampling with biopsy or surgical resection. We also summarize the methods of evaluating and managing SPNs based on the latest guidelines from the Fleischner Society and American College of Chest Physicians. © Pol J Radiol, 2012.


Jahnz-Rozyk K.,Military Institute of Medicine | Szepiel P.,Boehringer Ingelheim
International Journal of COPD | Year: 2015

Background: Long-acting inhaled bronchodilators, including anticholinergic tiotropium, are recommended for the maintenance therapy of chronic obstructive pulmonary disease (COPD). It has been shown in a number of studies that treatment with tiotropium alleviates symptoms, improves exercise tolerance, health status, and reduces exacerbations in patients with moderate to very severe stage COPD. Aim: The aim of this noninterventional study was to observe the early effects of the maintenance treatment with tiotropium in patients with COPD of different severities, who had been previously treated on a regular basis, or as required, with at least one short-acting bronchodilator, in a real-life setting in Poland. The effect of the treatment was assessed through the collection of COPD Assessment Test (CAT) data. Patients and methods: The MATHS clinical study was an observational, noninterventional, open-label, prospective, uncontrolled, single-arm, postmarketing, surveillance, real-life study conducted with the involvement of 236 pulmonology clinics based in Poland. The tiotropium observational period was 3 months. The health and COPD status was measured with the CAT questionnaire. The primary efficacy endpoint was the mean change from the baseline in the total CAT score at the end of the 3-month observational period. Results: Patients treated with 18 μg of tiotropium once daily for 3 months showed a statistically significant result, with a clinically meaningful mean reduction (improvement) of 7.0 points in the total CAT score. The improvement was slightly greater in patients with more severe COPD; the mean change in the total CAT score was 7.6 in the subgroup of patients with more severe COPD and 6.7 points in the subgroup of patients with moderate COPD. Conclusion: Results of this real-life study provide further support for the use of tiotropium as a first-line maintenance treatment for patients with COPD of different severities in Poland. © 2015 Jahnz-Różyk and Szepiel.


Markiewicz T.,Warsaw University of Technology | Markiewicz T.,Military Institute of Medicine
Diagnostic Pathology | Year: 2011

Background: The Matlab software is a one of the most advanced development tool for application in engineering practice. From our point of view the most important is the image processing toolbox, offering many built-in functions, including mathematical morphology, and implementation of a many artificial neural networks as AI. It is very popular platform for creation of the specialized program for image analysis, also in pathology. Based on the latest version of Matlab Builder Java toolbox, it is possible to create the software, serving as a remote system for image analysis in pathology via internet communication. The internet platform can be realized based on Java Servlet Pages with Tomcat server as servlet container.Methods: In presented software implementation we propose remote image analysis realized by Matlab algorithms. These algorithms can be compiled to executable jar file with the help of Matlab Builder Java toolbox. The Matlab function must be declared with the set of input data, output structure with numerical results and Matlab web figure. Any function prepared in that manner can be used as a Java function in Java Servlet Pages (JSP). The graphical user interface providing the input data and displaying the results (also in graphical form) must be implemented in JSP. Additionally the data storage to database can be implemented within algorithm written in Matlab with the help of Matlab Database Toolbox directly with the image processing. The complete JSP page can be run by Tomcat server.Results: The proposed tool for remote image analysis was tested on the Computerized Analysis of Medical Images (CAMI) software developed by author. The user provides image and case information (diagnosis, staining, image parameter etc.). When analysis is initialized, input data with image are sent to servlet on Tomcat. When analysis is done, client obtains the graphical results as an image with marked recognized cells and also the quantitative output. Additionally, the results are stored in a server database. The internet platform was tested on PC Intel Core2 Duo T9600 2.8GHz 4GB RAM server with 768x576 pixel size, 1.28Mb tiff format images reffering to meningioma tumour (x400, Ki-67/MIB-1). The time consumption was as following: at analysis by CAMI, locally on a server - 3.5 seconds, at remote analysis - 26 seconds, from which 22 seconds were used for data transfer via internet connection. At jpg format image (102 Kb) the consumption time was reduced to 14 seconds.Conclusions: The results have confirmed that designed remote platform can be useful for pathology image analysis. The time consumption is depended mainly on the image size and speed of the internet connections. The presented implementation can be used for many types of analysis at different staining, tissue, morphometry approaches, etc. The significant problem is the implementation of the JSP page in the multithread form, that can be used parallelly by many users. The presented platform for image analysis in pathology can be especially useful for small laboratory without its own image analysis system. © 2011 Markiewicz; licensee BioMed Central Ltd.


Grabysa R.,Medica Healthcare Center | Wankowicz Z.,Military Institute of Medicine
Medical Science Monitor | Year: 2013

Background: Current guidelines for the management of arterial hypertension (AH) emphasize the importance of diagnosing subclinical organ damage, which determines cardiovascular prognosis. The aim of our study was to evaluate the prevalence of left ventricular hypertrophy (LVH), LV geometry patterns, and LV systolic/diastolic dysfunction among men with uncontrolled AH and chronic kidney disease (CKD) stages 3A and 3B. Material/Methods: The study group included 256 men with essential AH. Glomerular filtration rate (eGFR) was calculated by the simplified MDRD equation. Left ventricular structure and function were assessed using echocardiography. Results: Target blood pressure values were observed in 44 (17.2%) patients. In the studied group, eGFR <60 ml/min/1.73 m2 was found in 67 (26.2%) subjects. Forty-nine (19.14%) patients were in stage 3A and 18 patients (7.03%) in stage 3B of CKD. We demonstrated that LVEDD, LA, RWT, and LVMI ECHO parameters were distinctly higher (p<0.05) in poorly controlled hypertensive patients in CKD stage 3B when compared with patients in CKD stage 3A. A significantly higher prevalence of LVH, including LV eccentric hypertrophy, was observed in stage 3B when compared to stage 3A of CKD (p<0.05). LVEF and E/A ratio decreased along with the decline of renal function (p<0.05). Conclusions: Relationships between eGFR values and echocardiographic abnormalities of LV structure and function observed by us support the division of CKD stage 3 into 2 substages, 3A and 3B, as proposed by recently published guidelines. Intensification of therapeutic regimen in the CKD 3B substage is therefore crucial from both cardiological and nephrological perspectives. © Med Sci Monit, 2013.

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