Effect of mycophenolate mofetil on hematological side effects incidence in renal transplant recipients.

Mycophenolate mofetil (MMF), an immunosuppressant administered after solid organ transplantation, is generally well tolerated; however, it frequently causes hematological toxicity. In this study, we aimed to assess the relation between the pharmacokinetic parameters of MMF metabolites (mycophenolic acid [MPA] and 7-O-MPA glucuronide [MPAG]) and the adverse effects on the hematopoietic system in renal transplant recipients. The four-h pharmacokinetic profiles of MPA and MPAG were determined using the HPLC method for MMF-treated patients (n = 61) among 106 renal transplant recipients (during the late post-transplant period) participating in the study. Anemia was more frequently observed in the study group compared with the control group (30.7% vs. 20.0%) and although the difference was insignificant, plasma iron concentrations were significantly higher in patients treated with MMF (32.9 ± 9.4 µmol/L vs. 28.7 ± 9.4 µmol/L; p = 0.032). Iron supplementation was more frequently applied to patients with anemia (48.2%) compared with patients with hemoglobin within the norm (20.3%; p = 0.005). As all MPAG pharmacokinetic parameters correlated negatively with hemoglobin and hematocrit, and MPAG pharmacokinetic parameters were higher in patients with anemia, MPAG may be the predicting factor of MMF side effects. In renal transplant recipients, especially with deteriorated renal function, extensive iron supplementation may be ineffective as anemia was associated with declined renal function and was not caused by low iron concentration.

An assessment of dietary intake and state of nutritional in hypertensive patients from rural and urban areas of Greater Poland.

The aim of this study was to determine the nutritional factors connected with the prevalence of hypertension in rural and urban areas of Greater Poland. The study consisted of 308 people aged 35-62, with essential hypertension but without any other coexisting disorders. The studied group consisted of 154 residents of Poznan (79 women and 75 men) and 152 inhabitants of rural areas in Greater Poland (78 women and 74 men). Participants were randomly assigned to the study. Nutritional state assessment was based on Body Mass Index (BMI) and body fat percentage. Dietary intake were assessed with a 24-hour nutritional survey from 3 consecutive days. Analysis of anthropometric examination results showed a large prevalence of obesity in the studied group. Moreover people living in rural areas had a significantly higher BMI and body fat percentage than those living in a city. It has been proved that the patients with hypertension consume food with an excess of fat and a shortage of fibre, antioxidant vitamins, potassium, calcium and magnesium. The total food rations of rural dwellers consisted of larger amounts of fat, cholesterol and vitamin A compared to those of city dwellers. Present studies have shown incorrect dietary intake among patients with hypertension, often related to the coexistence of overweight and obesity. Obtained results indicate significantly worse eating habits and state of nutrition among rural inhabitants.

Effect of clinical condition and mycophenolate mofetil on plasma retinol, α-tocopherol and ß-carotene in renal transplant recipients.

INTRODUCTION: Plasma antioxidant vitamins (retinol, α-tocopherol, ß-carotene) were measured to establish the influence of clinical condition and mycophenolate mofetil (MMF) treatment on the nutritional status of renal transplant recipients. MATERIAL AND METHODS: In 106 adult patients plasma vitamins were measured and 24-h diet history questionnaires were conducted. The MMF influence on plasma vitamins was verified in 61 patients. RESULTS: The current dietary intakes of vitamins in daily food rations were lower than recommended. Plasma retinol was lower in patients suffering from gastrointestinal disorders (1.25 ±0.48 mg/l vs. 1.55 ±0.70 mg/l) and inversely associated with aminotransferases activity (p = 0.019) and creatinine clearance (p = 0.021). Retinol concentrations were positively associated with plasma creatinine (p = 0.027) and pharmacokinetic parameters of MMF phenyl glucuronide. ß-Carotene concentrations were higher in women (0.39 ±0.46 mg/l vs. 0.28 ±0.23 mg/l; p = 0.041) and when MMF was co-administered with cyclosporine vs. tacrolimus (0.45 ±0.62 mg/l vs. 0.25 ±0.19 mg/l). Plasma α-tocopherol correlated negatively with the mycophenolic acid pre-dose concentration (p = 0.027) and was significantly lower in patients treated with calcineurin inhibitors (8.90 ±5.23 mg/l vs. 12.25 ±5.62 mg/l). A positive correlation was observed between α-tocopherol levels and aspartate aminotransferase (p = 0.006). In multivariate regression aspartate aminotransferase and MMF treatment significantly influenced retinol (p < 0.001). CONCLUSIONS: The MMF treatment was associated with significantly lower retinol concentrations. The gastrointestinal disorders occurrence in MMF-treated patients may cause a decrease in retinol absorption. Diet adjustment and/or vitamin A supplementation should be considered.

The influence of hypotensive drugs on the taste sensitivity in patients with primary hypertension.

Numerous hypotensive drugs result in decreasing the taste sensitivity or total loss of taste perception. The aim of this study was to evaluate the influence of selected groups of hypotensive drugs used in combined treatment of the taste sensitivity in patients suffering from primary arterial hypertension. The study was conducted in a group of 84 patients aged 30-60, including 43 women and 41 men. The patients were divided into four groups depending on the applied combined treatment including the following treatment regimes: diuretic + beta-blocker, diuretic + beta-blocker + ACE-I, ACE-I + diuretic, ACE-I + diuretic + calcium channel blocker. The study involved also control group of 20 healthy people (without medications) aged 30-60, including 10 women and 10 men. Taste sensitivity was evaluated by two methods: chemosensory and electrogustometric. Chemosensory method was used to asses the sensitivity to salt and sweet tastes with the use of increasing concentrations of saccharose water solutions (0.012-0.041 mmol/L) and water solutions of sodium chloride (0.008-0.068 mmol/L). Electrogustometric thresholds of taste sensitivity were established with electrogustometer. The minimal intensity of the current, which stimulates nerve endings of the taste stimuli-transmitting nerves was determined in two areas of the tongue: at the apex and at the sides. By two different methods of evaluation it was shown that the analyzed groups of hypotensive drugs affect the taste sensitivity of the patients. It was observed that healthy people had higher taste sensitivity than patients. Introducing ACE-I into combined therapy significantly reduced the electrogustometric sensitivity in patients.

Effect of mycophenolate mofetil on plasma bioelements in renal transplant recipients.

The proper concentrations of plasma bioelements may favorably reduce the incidence of metabolic disorders, which often occur during immunosuppressive therapy. Mycophenolate mofetil (MMF) is currently one of the most frequently administered immunosuppressive agents; however, MMF treatment is often related to gastrointestinal side effects. The aim of this study was thus to verify whether the MMF treatment itself, or its metabolite pharmacokinetics, has an effect on the concentrations of plasma bioelements. To determine this, the effect of MMF on the levels of both major (sodium [Na], potassium [K], calcium [Ca], magnesium [Mg]), and trace (iron [Fe], zinc [Zn], copper [Cu]) plasma bioelements in 61 renal transplant recipients was assessed in comparison to a control group (n = 45). The pharmacokinetic parameters of mycophenolic acid were determined by the high-performance liquid chromatography method. All patients filled out a 24-h diet history questionnaire. The results showed high plasma concentrations of Fe and low plasma concentrations of Mg and Zn as compared with diagnostic norms. The patients treated with MMF had significantly lower plasma Na (P < 0.001) and significantly higher plasma Zn (P = 0.030) and Cu concentrations (P < 0.001). In conclusion, MMF treatment was found to affect plasma Fe, Zn, and Cu levels by increasing their concentrations while decreasing the plasma Na concentration. Mg and Zn deficiencies, as well as excessive Fe levels, are frequently observed irrespective of the immunosuppressive regimen applied, which suggests that monitoring of these bioelements may be favorable.

[Selected risk factors of metabolic syndrome and disorders of taste perception]. / Wybrane czynniki ryzyka zespolu metabolicznego a zaburzenia zmyslu smaku.

The sense of taste, apart from the sense of smell and sight, is one of the most important senses that play crucial role in the transmission of information regarding the food and its usefulness for consumption. Alarming is an increasing number of people with the taste dysfunction. This kind of dysfunction is serious problem especially among the elderly that arise not only from unavoidable and natural processes of ageing but also from health problems and taken medications. Disturbances of taste perception influence on food preferences and may increase to a large extent the development of the metabolic-civilization diseases or even intensify them. Considering the increasing amount of people with metabolic syndrome and rising prevalence of taste disturbances, the current essay include the literature review regarding this subject. It must be underline that metabolic syndrome and taste perception disorders may decrease not only the quality of life but also have unbeneficial influence of health status.

[The influence of selected factors on smell sensitivity of adult people]. / Wplyw wybranych czynników na wrazliwosc wechowa osób doroslych.

The smell sensitivity was assessed in the group of young adults with seven models of herbal spices' available on domestic market and the attempt was made to estimate the factors influencing that sensitivity. The conducted study revealed that the smell sensitivity with an applying of herbal spices' models is better in male group than female. There was no influence of current stimulants (alcohol and cigarettes) on smell sensitivity in the study group, what may be caused by short exposure time to these factors, considering the age of study group.

Effects of short-term garlic supplementation on lipid metabolism and antioxidant status in hypertensive adults.

This prospective and uncontrolled clinical study attempted to evaluate the effects of short-term supplementation with oily garlic formulation on lipid metabolism, glucose level and antioxidant status in patients suffering from primary arterial hypertension. Seventy subjects aged 30 to 60 years with primary arterial hypertension, including 38 females (mean age: 52.0 +/- 8.3 years) and 32 males (mean age: 48.6 +/- 8.2 years), took part in the study. In addition to receiving a standard antihypertensive pharmacotherapy they took 6 capsules of garlic preparation daily for 30 days. Before and after phytotherapy blood samples were collected to assay total cholesterol, HDL, LDL, triglycerides, lipid peroxidation products (TBARS) and vitamin A, C and E, beta-carotene, glutathione and glutathione peroxidase activity, and arterial blood pressure was measured. The analyzed garlic preparation was found to significantly lower lipid level and the level of lipid peroxidation products in the blood. It markedly increased vitamin E concentration in the serum, whereas the increases in the levels of other antioxidant vitamins and glutathione peroxidase activity proved insignificant. The product did not affect arterial blood pressure in the study subjects. The results of this study suggest that the investigated garlic preparation may be tentatively used as an adjunct agent in treatment of arterial hypertension because of its hypolipemic and antioxidant properties.

[The tobacco smoking and basic coefficients of nutritional status of youth in secondary schools]. / Palenie tytoniu i podstawowe wskazniki stanu odzywienia mlodziezy szkól ponadpodstawowych.

The aim of the study was the assessment of cigarette smoking by youth from secondary schools. The study was conducted among 700 pupils of secondary schools from Poznan in the year 2004 and it was based on questionaire survey regarding frequency and the period of smoking, as well as the basic anthropometric measurements including body mass and height. The study revealed notable proportion of girls with underweight, however the boys were mostly overweight. Smoking habits concerned often girls than boys. However higher proportion of boys started earlier smoking comparing to girls. Both girls and boys have smoked cigarettes not earlier than during last five years. It was proved that most pupils were not pharmacologically addicted to nicotine. Notable number of smokers tended to quit smoking.

[Tobacco smoking and frequency of arterial hypertension in students of Poznan universities]. / Palenie tytoniu i wystepowanie nadcisnienia tetniczego wsród studentów poznanskich uczelni.

The aim of the study was to assess the tobacco smoking among students of three Poznan universities and its effect on the students' blood pressure. Into the consideration were taken the frequency and duration of tobacco smoking, and the number of cigarettes smoked daily. The study involved 700 students. An appropriate questionnaire was used to collect the data, and blood pressure measurements were taken. The results were statistically analyzed using t-Student and chi2 tests. The results show that the gender and type of the university attended influence the prevalence of tobacco smoking. The percentage of smoking men was significantly higher than the percentage of smoking women. The lowest percentage of smokers was found among the students of the Medical Sciences University as compared with other universities. In addition, some positive correlation between tobacco smoking and the occurrence of arterial hypertension was observed.

[Analysis of dietary habits and dietary intake in hypertensive smokers]. / Ocena zwyczajów zywieniowych i sposobu zywienia osób palacych papierosy z nadcisnieniem tetniczym.

The aim of this study was to compare dietary habits and nutrient intake of hypertensive smokers with hypertensive non-smokers. The study population comprised 30 hypertensive smokers and 35 non-smokers, aged 30-60y. The participants were subjected to a triple 24-h diet recall and to a dietary habits questionnaire. The results showed that smokers had unhealthy patterns of nutrient intake. Smokers declared consuming too much fat, cholesterol and too low antioxidant vitamins, calcium and fibre. It was found that concentration of vitamin E in smokers' daily diet is significant lower than in non-smokers. Smokers consumed significantly higher saturated fatty acids comparing to non-smokers. In conclusion, smokers have unhealthy diet and it may intensify harmful effects of smoking in their organism.

[Influence of smoking on selected microelements in serum and hair of adults]. / Wplyw palenia papierosów na stezenie wybranych mikroelementów w surowicy krwi i wlosach osób doroslych.

The aim of this study was to assess the concentrations of iron, zinc and copper in serum and hair of smokers and nonsmokers. The study population comprised 162 subjects aged 30-60 years, in this 47 smokers and 115 non smokers. All subjects had their blood and hair samples collected for analysis. Content of the analysed microelements was assayed with atomic spectrophotometry using Zeiss AAS-3 spectrophotometer. Statistical analysis was done with Statistica 6.0. The results showed that smokers had significantly lower concentration of copper in serum than non smokers. The analysis of molar ratio of minerals in serum showed significantly lower ratio of zinc to copper in smokers as compared to non smokers. The content of minerals in hair of both groups was insignificant. Based on the obtained results it is justified to conclude that smoking can influence on copper metabolism in organism.

[Tobacco smoking and the frequency of arterial hypertension in adults]. / Palenie papierosów a wystepowanie nadcisnienia tetniczego u osób doroslych.

This study aimed to evaluate the influence of the tobacco smoking on the frequency of arterial hypertension in adults. This study involved 160 sub. jects, aged 30 to 60 years. Study group included hypertensive subjects and control group-healthy adults. The arterial blood pressure was measured and tobacco smoking was evaluated based on the questionnaire. The obtained results were found the same percent of smokers in both groups. In study and control group, it was shown comparable values of blood pressure in smokers and nonsmokers. A farther study including more number of subjects and influence nutrition and nonnutrition factors on blood pressure in adults are necessary.

[Effect of tobacco smoking on taste sensitivity in adults]. / Wplyw palenia papierosów na wrazliwosc smakowa osób doroslych.

This study aimed to evaluate the influence of the tobacco smoking on taste sensitivity in healthy adults. The study involved healthy subjects, aged 30 to 60 years. The experimental group consisted of 28 smoking subjects; the control group consisted of 33 non smokers. The ability to recognize four basic types of taste and thresholds for detection of sweet and salty taste were determined in this study. The measurement of taste thresholds were carried out by electrogustometry. The obtained results have been found higher thresholds for detection of salty taste in smokers compared with control subjects (p<0.05). We estimated that such tastes as: sweet, salty, sour have been recognized by smokers weaker and their sensitivity of tongue receptors to electric stimulus was slightly lowered than nonsmokers.