Papers by Jerzy Konstantynowicz
Medicina & Laboratorio, 2011
Evaluación del riesgo litogénico en niños basado en una muestra de orina al azar en la mañana
1Zakład Biochemii, Radioimmunologii i Medycyny Doświadczalnej, Instytut „Pomnik – Centrum Zdrowia... more 1Zakład Biochemii, Radioimmunologii i Medycyny Doświadczalnej, Instytut „Pomnik – Centrum Zdrowia Dziecka”, Warszawa Kierownik Zakładu: prof. dr hab. med. Roman Janas 2Klinika Endokrynologii, Centrum Medyczne Kształcenia Podyplomowego, Warszawa Kierownik Kliniki: prof. dr hab. med. Wojciech Zgliczyński 3Klinika Pediatrii, Reumatologii, Immunologii i Chorób Metabolicznych Kości, Uniwersytecki Dziecięcy Szpital Kliniczny im. Ludwika Zamenhofa w Białymstoku Kierownik Kliniki: dr hab. med. Jerzy Konstatynowicz 4Zakład Biochemii i Chemii Klinicznej, Warszawski Uniwersytet Medyczny Kierownik Zakładu: prof. dr hab. med. Jacek Łukaszkiewicz 5Klinika Geriatrii, Chorób Wewnętrznych i Chorób Metabolicznych Kości, Centrum Medyczne Kształcenia Podyplomowego, Warszawa Kierownik Kliniki: prof. dr hab. med. Marek Tałałaj
International Journal of Endocrinology, 2018
The study objective was to assess the prevalence of cardiovascular disease risk factors in patien... more The study objective was to assess the prevalence of cardiovascular disease risk factors in patients treated for childhood cancer (N = 101) and to determine the involvement of clinical (cancer type and therapy) and/or genetic (FTO gene rs9939609 polymorphism) factors. Anthropometric features, laboratory findings, and standardized osteodensitometric indices (fat and lean mass) were considered. Overweight/obesity was found in 17.82% of the patients; however, central adiposity was found in as many as 42.5%. At least one abnormality in lipid metabolism was observed in 35.6%. Densitometry revealed elevated levels of fat mass in 44.55% of the patients. None of the parameters studied were associated with the FTO gene polymorphism. Standardized waist circumference was significantly higher in patients treated for leukemia than those treated for solid tumors (p = 0 04). Our findings indicate a high rate of central adiposity among childhood cancer survivors, especially leukemia patients. The prevalence of risk factors of cardiovascular disease after anticancer therapy is not FTO gene polymorphism-dependent.
Journal of Clinical Medicine, Oct 20, 2018
The aim of this study was to evaluate levels of osteocalcin (OC), osteoprotegerin (OPG) and total... more The aim of this study was to evaluate levels of osteocalcin (OC), osteoprotegerin (OPG) and total soluble receptor activator of nuclear factor-κB ligand (RANKL), and bone mineral density (BMD) in patients on long-term acenocoumarol (AC) treatment. The cross-sectional study was carried out in 42 patients treated long-term with AC and 28 control subjects. Serum concentrations of OC, OPG, and sRANKL were measured using enzyme linked immunosorbent assay (ELISA) kits, and BMD at the femoral neck and lumbar spine were assessed by dual energy X-ray absorptiometry. A significantly decreased concentration of OC was found in AC users compared to control subjects (4.94 ± 2.22 vs. 10.68 ± 4.5; p < 0.001). Levels of OPG, sRANKL logarithm (log), sRANKL/OPG log ratio, and BMD were comparable between. In female AC users, positive correlations between OC and RANKL log, and between OC and RANKL/OPG log ratio (p = 0.017; p = 0.005, respectively), and a negative correlation between OC and OPG (p = 0.027) were found. Long-term AC anticoagulation significantly decreases OC concentration, but does not affect other bone metabolism markers or BMD. Our results also suggest the possibility that long-term treatment with AC may alleviate bone resorption in postmenopausal women.
Journal of Clinical Densitometry
AIM The aim of the study was to investigate whether salivary mineral content may be associated wi... more AIM The aim of the study was to investigate whether salivary mineral content may be associated with bone status in women after menopause. MATERIAL AND METHODS The study group consisted of 125 postmenopausal women aged 64.3 ± 6.9 yr, derived from the epidemiological SilesiaOsteoActive Study. All participants underwent hip and spine bone densitometry using dual energy X-ray absorptiometry, dental examination, and saliva content analysis. Data for salivary pH, copper, calcium, phosphorus, and zinc concentrations were evaluated. RESULTS Mean femoral neck bone mineral density (BMD) was 0.739 ± 0.118 g/cm2, total hip BMD 0.891 ± 0.14 g/cm2, and spine BMD 0.868 ± 0.14 g/cm2. Salivary pH was significantly lower in women with spinal osteoporosis defined as T-score below -2.5, compared to individuals with normal BMD (pH: 6.65 ± 0.67 vs 6.96 ± 0.58, p < 0.05). There was a significant though weak inverse correlation between Ca concentration in saliva and femoral neck BMD (r = -0.23, p < 0.05). CONCLUSIONS High salivary calcium content and low salivary pH may be indicative of low hip and decreased spine BMD, respectively. These associations may reflect demineralization process (calcium redistribution) influencing bone, and a negative effect of acidity on mineral tissues, although causal pathway remains not clear.
PLOS ONE
Objectives The Sarcopenia Quality of Life (SarQoL) questionnaire, a sarcopenia-specific patientre... more Objectives The Sarcopenia Quality of Life (SarQoL) questionnaire, a sarcopenia-specific patientreported outcome measure, evaluates quality of life with 55 items. It produces 7 domain scores and 1 overall quality of life score, all between 0 and 100 points. This study aims to contribute to the interpretation of the SarQoL scores by calculating the standard error of measurement (SEM) and smallest detectable change (SDC) in a sample of subjects from 9 studies. Methods Subjects from 9 studies (conducted in Belgium,
Frontiers in Endocrinology
Objective: Both vitamin D and K2 are involved in a number of metabolic processes, including bone ... more Objective: Both vitamin D and K2 are involved in a number of metabolic processes, including bone metabolism; however, associations between the vitamins are not fully understood. The aim of the study was to evaluate serum concentrations of 25-hydroxyvitamin D [25(OH)D] in adult patients receiving long-term acenocoumarol (AC) treatment. Participants and methods: In this cross-sectional study, 58 Caucasian patients (31 women, 27 men) with a median age of 65 years receiving long-term AC therapy were evaluated and compared with 35 age-and gender-matched healthy controls. The AC treatment was used due to recurrent venous thromboembolism (34.5%), atrial fibrillation (31%), or mechanical heart valve prostheses (34.5%). Medical records and a questionnaire were used to obtain information about chronic diseases, smoking habits, and the duration of therapy and weekly dose of AC. Anthropometric measurements were performed, and serum concentration of 25(OH)D and total alkaline phosphatase (ALP) activity were measured. results: Among the 58 patients receiving long-term AC treatment, a high proportion (46.6%) demonstrated significant vitamin D deficiency with concentrations of 25(OH) D lower than 20 ng/mL. The median concentration of 25(OH)D in subjects receiving AC was significantly lower compared to the control group [20.4 (17.4; 26.1) vs. 28.2 (24; 32.7); p < 0.001]. No differences were found between women and men receiving AC therapy. In patients receiving AC, a negative correlation was found between the concentration of 25(OH)D and the weekly dose of AC (r = −0.337, p = 0.01). Patients with concentrations of 25(OH)D < 20 ng/mL were found to have a significantly higher median dose of AC, compared to those with concentrations of 25(OH)D ≥ 20 ng/mL [21 (17; 31) vs. 17 (12; 28); p = 0.045]. conclusion: In conclusion, treatment with AC is associated with low 25-hydroxyvitamin D levels, although the path leading to this phenomenon is not entirely clear. Long-term administration of AC in adults may increase the risk of chronic vitamin D deficiency, thus, effective supplementation of vitamin D in these individuals needs careful consideration.
The Journal of Steroid Biochemistry and Molecular Biology, 2017
Endokrynologia Diabetologia I Choroby Przemiany Materii Wieku Rozwojowego Organ Polskiego Towarzystwa Endokrynologow Dzieciecych, Feb 1, 2004
Advances in diagnosis and improved methods of treatment have resulted in increasing number of lon... more Advances in diagnosis and improved methods of treatment have resulted in increasing number of long-term survivors in children with Wilms tumor. Growth and puberty are important for accumulation of bone mass; chemotherapy nad radiotherapy used in treatment for Wilms tumor can influence bone structure and physical development. Leptin plays an important role in metabolism of adipose tissue and bone mineralization. Considering that neoplasm and its treatment can affect normal development in childhood, we analysed the influence of antineoplastic treatment on bone mineralization and the correlations between serum leptin levels, body composition and bone mineral density in survivors of Wilms tumor. Twenty subjects (12 boys) treated for Wilms tumor at the mean age of 10.9 (range 3-20 years) participated in this study. Mean follow up period after discontinuation of therapy was 5.6 years (range 2 months - 13.5 years). Mean age of diagnosis was 3.9 years (range 1 month - 12.6 years). 18 patients received chemotherapy, 7 - additionally radiotherapy and 2 infants had only surgery treatment. We measured fat mass - FM, fat free mass - FFM, bone mineral density - BMD total and BMD spine using dual energy x-ray absorptiometry (DXA) and compared to the results obtained for healthy references (SD score). Leptin levels were measured with RIA method. 1. No difference was found in leptin levels, body mass index, FM, FFM, BMD total and spine in relation to sex. 2. Means of SDS BMI, FM, FFM, BMD and leptin were in the normal range for the age and sex matched controls. 3. We found the correlation between leptin level and BMI, FM, FFM and BMD total and spine, no correlation was found between SDS values. 4. We observed a positive correlation between SDS BMD and SDS BMI, FM, FFM, BMD spine. 5. BMI, FM and leptin levels were higher in children treated with radiotherapy and chemotherapy than in children treated with only chemotherapy. However, the SDS values were comparable with the healthy controls. 6. SDS BMD total was decreased in 5/20 subjects (25% of all studied patients) compared with healthy controls. The results demonstrated the risk of osteopenia in the group of children treated for Wilms tumor and the necessity for long-term monitoring of bone mineralization.
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Polski Merkuriusz Lekarski Organ Polskiego Towarzystwa Lekarskiego, Oct 1, 2007
Chemotherapeutic agents such as glucocorticoids, methotrexate, antymetabolities, cranial and loca... more Chemotherapeutic agents such as glucocorticoids, methotrexate, antymetabolities, cranial and local irradiation) may severely disturb normal growth, bone mineral acquisition and skeletal development because the most individuals go through the stages of rapid growth when childhood acute lymphoblastic leukemia (ALL) is diagnosed. Aim of the study. Analysis of the bone density accretion in children and adolescents in various time after tretament for acute lymphoblastic leukemia. Materials and methods. we examined 107 patients (70 males) who had been treated for ALL according to the protocol of the Polish Pediatric Leukemia, Lymphoma Study Group. Mean age at diagnosis was 7.3 years (range 1-19 years). They received chemotherapy with different doses of methotrexate: 46 patients-5 g/m 2 ; 24-2 g/m 2 and 37 children received in doses of 0,5-1 g/m 2. Cranial irradiation was performed in 22 patients in doses of 12 Gy, in 39 patients in doses of 18 Gy, 46 children did not receive cranial irradiation. The examinations were performed three times. First: immediately after end of maintenance therapy; second: 1,5 years after therapy and third: longer than 5 years after therapy. History of fractures, bone mineral density (BMD) measurements of lumbar spine (L2-L4) and total body were performed using dual-energy x-ray absorptiometry (GE Medical Systems Lunar DPX-L), expressed as g/cm 2 and compared to reference values obtained from the 473 age-and gendermatched healthy children from the same region of Poland. Results. at all points we did not find any differences between studied group and age-and gender-matched peers: BMI Z-score 0.77 vs 1.57 vs 0.72); BMD-total Z-score (-0.11 vs 0.012 vs 0.21); BMDspine Z-score (0.03 vs 0.10 vs 0.08). BMD SDS >-2 in first study was observed in 11.5% patients, in second-in 10% and in last-in 7.1% patients. In consecutive examinations we observed accretion of bone mass, similar as in healthy populationi. Age at diagnosis, gender, cumulative doses of steroids, using CNS radtiotherapy, high doses of methotrexate did not relate to examined (after treatment) parameters. Patients with history of fractures had lower BMD-total in second assessment and lower BMD-spine in all examiantions, however, statistical significant was not reach. Conclusions. The disease itself and its complex treatment did not disturb the bone density accretion in examined patients. The patients with history of fractures (before and after tretament) tended to have lower mean values of bone density, (especially in region of spine) than patients without fractures. Small number of patients in last examination did not allowed to conclude about peak bone mass in our patients.
Maternal and Child Health Journal, 2016
The aim of this study was to determine how pediatric patients and their parents perceive health c... more The aim of this study was to determine how pediatric patients and their parents perceive health care during hospital stays, what are their expectations of doctor behaviors, and which components of care do they consider to be the most important. Methods A qualitative descriptive study was carried out using the open interview technique. Twenty-six parents and 22 children undergoing hospital treatment participated. Results Our analysis identified two major themes: (1) doctor verbal and non-verbal behaviors, which included informing and explaining, conversations on topics other than the illness, tone of voice and other behaviors; and (2) perceived strategies used by doctors. This category included claims of doctors' intentional use of medical jargon to avoid addressing parental questions directly. Parents admitted that they did not understand medical vocabulary, but they also thought they might understand more of the medical issues if the doctor spoke using terms comprehensible to them. Conlcusions Our study shows the importance of interpersonal relationship affecting patient perception of quality of pediatric care. Parents of pediatric patients perceive that doctors behave in ways that deflect parents' questions and avoid providing them with medical information. Such behaviors include doctors excusing themselves by saying they are busy and using medical jargon. Medical students and doctors should be trained to communicate effectively with patients and their parents and develop skills to convey information in a simple and comprehensible way.
Chirurgia narzadów ruchu i ortopedia polska, 2004
In years 2001-2003 six children (3 boys ond 3 girls) from 2.1 to 18.7 years old with osteogenesis... more In years 2001-2003 six children (3 boys ond 3 girls) from 2.1 to 18.7 years old with osteogenesis imperfecta (OI) were treated in our clinic. Besides clinical and radiological evaluation, densitometry and biochemical analysis of collagen were performed. Biochemical analysis was performed on cultured in vitro fibroblasts from the skin biopsies. Based on this findings 1 child was graded as type I of OI, 4 children as type III and 1 as type IV. Recognition of collagen defect helps with diagnosis and makes the decision for pharmacological treatment easier. In 1 child with the dramatic type III OI therapy with pamidronian was implemented with good result. Performed surgical treatment, intramedullar stabilisation with Rush rod, proved to be useful choice in correcting axial deformations of the lower extremities and preventing from the future fractures.
Journal of Human Hypertension, 2013
Objective. We aimed to determine the prevalence of excess body mass in juvenile idiopathic arthri... more Objective. We aimed to determine the prevalence of excess body mass in juvenile idiopathic arthritis (JIA) children and to investigate the influence of obesity into the early, subclinical changes in cardiovascular system in these patients. Methods. Fifty-eight JIA patients, aged median 13 years, were compared to 36 healthy controls. Traditional cardiovascular risk factors and inflammatory markers (hsCRP, IL-6, TNF , adiponectin) were studied together with IMT (intima-media thickness), FMD (flow mediated dilation), and LVMi (left ventricle mass index) as surrogate markers of subclinical atherosclerosis. Results. Thirteen JIA children (22%) were obese and had increased systolic blood pressure, cholesterol, triglycerides, insulin, HOMA, hsCRP, and IL-6 compared to nonobese JIA and controls. FMD was decreased compared to nonobese JIA and controls, whereas IMT and LVMi were increased. In multivariate regression analysis, TNF , SDS-BMI, and systolic blood pressure were independent predictors of early CV changes in JIA. Conclusions. Coincident obesity is common in JIA children and is associated with insulin resistance, dyslipidemia, and increased levels of inflammatory markers leading to early changes in cardiovascular system. Thus, medical care of children with JIA should include strategies preventing cardiovascular disease by maintenance of adequate body weight.
Health & Social Care in the Community, 2009
Home visits by doctors and nurses are considered an important indicator of the quality of healthc... more Home visits by doctors and nurses are considered an important indicator of the quality of healthcare. Published data are scarce regarding the role of family nurses in providing professional home care in Central and Eastern European countries that have recently introduced reforms to their primary care systems. The objective of the present study was to describe the involvement of family nurses in home visits in the context of organizational and legal changes in service provision, that is, to analyse the role of the family nurses employed by family doctors (1998) versus family nurses working in autonomous positions (2002 and 2006). The proportion of patients in the community receiving a home visit from a family nurse, the purpose of the family nurse&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s home visit and patient expectations towards the family nurse were studied. A series of cross-sectional studies were conducted in a small town in northeastern Poland, based on three consecutive surveys taken at 4-year intervals (1998, 2002, 2006, surveys I, II and III, respectively). During each survey, 1000 patients were interviewed (face to face) with structured questionnaires. In 1998, family nurses were employed by family doctors, but by 2002, nurses had established their own practices and held direct contracts with the National Health Fund. A significant increase in the percentage of patients receiving home visits from a family nurse was observed between surveys I and II (12.8% and 30.0%); however, the number of respondents reporting a home visit in survey III decreased to 23.9%. Patients over 75 years of age were the major demographic group receiving family nursing at home. This study suggests that reform of the primary healthcare system in Poland has produced changes in the family nursing system. Independence, contractual obligations and self-employment of Polish family nurses have resulted in their greater participation in home visits.
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Papers by Jerzy Konstantynowicz