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Biomedical subjects

Dariusz Jurkiewicz

Publications and source records attributed to Dariusz Jurkiewicz.

At least 19 recordsLinked to original sources
PubMed2006

Functional evaluation of the vestibular organ in infants with risk factors for hearing loss occurring in the perinatal period.

BACKGROUND: Asphyxia at birth, low birth weight and low birth age constitute risk factors for inner ear damage in the perinatal period. Caloric stimulation is one of the most reliable diagnostic tools for vestibular testing in infants. Recording of vestibular-evoked myogenic potentials (VEMPs) evaluates the otolith organ and its pathways. Potentials reflecting the integrity of sacculo-collic reflex pathways are recorded on the surface of the neck muscles. The purpose of our study was to evaluate vestibular function in the discussed group of infants. MATERIAL/METHODS: 72 infants aged 3 months were examined: 40 healthy controls and 32 infants (17 girls, 15 boys) with risk factors for hearing loss occurring in the perinatal period. RESULTS: No reaction to caloric stimulation was elicited from 6 examined ears, no VEMPs were recorded from 6 ears, profound sensorineural hearing loss was diagnosed in 4 ears. The VEMP measurements did not differ between the groups. Profound sensorineural hearing loss occurred most frequently in infants with very low Apgar scores, responses to caloric stimulation were weakened in subjects with low Apgar scores. The response of the horizontal semicircular canals was more frequently abnormal than that of the otolith organs. CONCLUSIONS: The vestibular organ functions were frequently impaired in this group of infants, but the damage was rarely complete. Infants' vestibular organs should be routinely diagnosed.

Caloric Tests↗
PubMed2006

[Assessment of betahistine dihydrochloride effectiveness in the treatment of vertigo of a different aetiology based on videonystagmography test results].

UNLABELLED: Comprehensive medical history and videonystagmography (VNG) testing play very important role in balance assessment especially when dealing with balance disorders occurring occasionally. VNG in many clinical situations is performed as an initial test before complete otoneurological examination is carried out. Betahistine dihydrochloride (betahistine) a synthetic histamine analogue is one of many drugs used in the treatment of balance disorders of central or peripheral etiology. The aim of our work was to analyze, using the VNG test, effectiveness of betahistine treatment and to compare it with the control group treated with different drugs. MATERIAL AND METHODS: 42 patients suffering from vertigo were evaluated before and after the treatment with betahistine. Treatment results were compared with the results of 20 vertigo sufferers treated during the same period of time with different drugs. In effort to standardize asked questions, interviews with patients were completed with specially structured questionnaire. In 54% of patients, decreased intensity and severity of vegetative symptoms was observed after the treatment with betahistine, in 45.2% of patients (30% of the control group) decreased frequency of attacks was noted. RESULTS: In 69.1% of patients treated with betahistine and in 50% of the control group improved results of the VNG test were noted. In 9.5% of patients (4 patients) treated with betahistine and in 20% of patients from the control group, the VNG test results were worse. Quantitative and qualitative features of the VNG test were best improved in parts of the test showing features of its central origin. In 50% of patients improvement of the symmetry in Optokinetic testing, decrease or stop of vertical component of positional nystagmus was noted. In 38.1% of patients decrease of directional predominance of nystagmus in Caloric Testing was noted. None of all examined patients exhibited features of worsening of VNG test results and no new symptoms were noted. Radiological investigations showed no new pathologies. CONCLUSION: Betahistine dichloride is one of the basic drugs used in the treatment of vertigo of different etiology.

Betahistine↗
PubMed2006

[A case report of fibrous dysplasia in right temporal bone].

The authors describe the rare case of fibrous dysplasia in temporal bone. Dysplasia fibrosa is a benign osseous condition that may involve one or more bones in the cranial and extracranial skeleton. Temporal bone involvement occurs in 18 per cent of craniofacial diseases. Clinical, radiographic and histologic examinations are essential to confirm the diagnosis of fibrous dysplasia. Treatment of illness depends on the associated symptoms.

Adult↗
PubMed2006

[Application of microsurgery in diagnosis and treatment of larynx diseases].

THE AIM OF THE STUDY: was analyzing cases of laryngeal diseases and their location that required treatment by surgical procedure as well as analyzing complications resulting from microsurgery of the larynx and their location during surgical procedures and treatment performed in the Otolaryngology Clinic at Military Institute of the Health Services Central Military Hospital in Warsaw (years 1994-2003). MATERIAL AND METHODS: We analyzed 713 patients, of which 248 were women (34.8%) and 465 were men (65.2%) aged between 12 and 80 (the average age was 49.4 +/- 11.8), who were diagnosed as requiring microsurgery of the larynx using the Kleinsasser's set together with operating microscope and CO2 laser in selected cases. RESULTS: The total of 713 microsurgical operations was performed in the larynx area. The largest group were the patients who were diagnosed as having polyps (33.0%), chronic laryngitis (19.6%) and an established diagnosis of laryngeal carcinoma. Complications were observed in 416 patients (58.3%). CONCLUSIONS: Microsurgery of the larynx was the most often applied form of treatment of vocal fold polyps, chronic laryngitis and laryngeal carcinoma; pathological changes that require microsurgical treatment are mostly located in the epiglottis and the central part of the glottis whilst the major complications resulting from the microsurgery of the larynx are limited to superficial damage of the mucous membrane, mostly on the lips.

Adolescent↗
PubMed2006

[Present opinions on treatment of nasal polyps].

Nasal polyps concern about 1-4% population however the cause of disease does not be well-known. With this reason there have not causal treatment of the disease. The aim of nasal polyps treatment is as follows: removal or decrease the polyps' mass, improvement of patency of the nose, improvement of smell, opening the passage of paranasal sinuses, decrease the inflammatory discharge from the paranasal sinuses, prevention the recurrences the disease as well as improvement of quality of life. In the treatment of nasal polyps surgery, pharmacological treatment and combined both these methods were performed. The surgical treatment is not only removal of nasal polyps, but also to try to correct anatomical abnormalities. The introduction of endoscopic surgery, computer assisted navigation and microdebriders made possible to very precise surgical management of the nose and paranasal sinuses and decrease the number of complications. Surgery treatment of the nasal polyps is necessary in every suspicious about neoplasmic change case because material lets us to histopathologic examination. Pharmacological treatment of nasal polyps contains many groups of medicines. These medicines show anti-inflammatory and anti-swelling effects. Pharmacological treatment of nasal polyps can be conducted as a primary procedure and more often as a post surgery treatment. The following groups of medicines are used in pharmacological treatment of nasal polyps: glucocorticosteroids, antibiotics, antifungal, anti-leukotrienes, capsaicin, antihistaminic, lysine of acetylsalicylic acid, furosemid and antibody against IL-5. The use of glucorticosteroids in long treatment after surgical operation increased the time of remission of disease. Also in well-chosen cases use of another medicines permits on extension the time of remission and decrease a dose of used glucocorticosteroids.

Endoscopy↗
PubMed2006

[Laryngeal cancer risk factors].

Laryngeal cancer is the most common of head and neck cancers. Neoplasm used to develop basing on DNA mutation which leads to uncontrolled growth and cells' division. It is due to spontaneous mutations or influence of chemical, biological and physical factors. Laryngeal cancer generation is conditioned by many synergic factors. Some of them certainly participate in cancer genesis and this thesis is accepted by medical environment and other of them have been discussed giving different information. Definition of the risk factors role in laryngeal cancer etiology is very difficult especially regarding their contemporary occurrence in one person. Most common risk factors are environmental factors, gastroesophageal reflux, viral infections, diet, radiation, individual predisposition. Some of them, such as cigarette smoking and abuse alcohol are significantly oftener confirmed in patients with neoplasm diagnosis and others' role in developing of illness has been still researched. Thus the purpose of the study was to present so far achievements in laryngeal cancer etiology and to emphasize controversies relating to some factors' role in cancer genesis.

Alcohol Drinking↗
PubMed2006

[Hemorrhage from stomach ulceration in chronically hemodialysed patient after planned tonsillectomy].

We present a chronically hemodialysed patient who developed an acute throat hemorrhage after standard tonsillectomy, planned as a standard surgery for purulent tonsillitis being contraindication to kidney transplantation in this case. Hemorrhage diagnosed firstly as a local post tonsillectomy complication proved to be caused by in the acute stomach ulcer. In the discussion we present the differentiate diagnosis as well as procedures which should be undertaken in hemodialysed patients who develop acute hemorrhage episodes from upper respiratory tract after tonsillectomy.

Diagnosis, Differential↗
PubMed2005

[Malignant tumours of the pharynx in the years 1992-2001].

All cases of malignant tumours of the pharynx (excluding tumours of the tongue) were analyzed based on the retrospective data from the 5 clinical centers in Poland from the years 1992-2001. A considerable--over 50% increase in morbidity was found out regarding particularly tumours of the oropharynx. In the analyzed material there is a predominance of males (3:1) and the peak of morbidity significantly falls. The subjects with advanced tumours of the pharynx made 26% of the studied group. The most common histopathological diagnosis was squamous cell carcinoma and the most common site--the oropharynx, in particularly the tonsil. The data the center in Katowice, where tumours of the hypopharynx have been predominant in the last few years, may point a similar tendency in the other centers in the future.

Adolescent↗
PubMed2005

[The evolution of epidemiology and clinical characteristics of laryngeal and hypopharyngeal carcinoma in Poland from 1991 to 2001].

On the base of retrospective analysis of 12,888 cases of carcinoma of larynx and hypopharynx, diagnosed in 19 ENT Departments in Poland from 1991 to 2001, the assessment of basic epidemiological data, including the localization of tumor and stage of local and clinical advancement of the disease at the time of diagnosis has been conducted. In analyzed period of 11 years the trends to change of the mentioned above parameters has been examined. The significant increase of female patients in this period was observed, with average proportion M:F = 8:1. The glottis localization of carcinoma dominated (47.6%), followed by supraglottis (40.8%) and pyriform fossa (7.8%), with significant increase of pyriform fossa tumors in the analyzed period of 11 years. In the majority of cases the carcinoma of larynx and hypopharynx was diagnosed in the advanced stage (T3 + T4) of local disease, with the highest percentage in localization within the pyriform fossa (81.0%), and the lowest percentage in glottis tumors (45.6%). The regional lymph nodes metastases has been diagnosed in 46.7% of the analyzed group, with the highest percentage in tumors localized in pyriform fossa (82.9%), and the lowest percentage in tumors of glottis localization (33.1%). In the 11 years time the significant drop down of N0 cases and tendency to increase of N2 and N3 in the supraglottis localization of tumor. The distant metastases in the analyzed group at the time of diagnosis has been registered in 2.0%, with the highest percentage in posterior pharyngeal wall (7.6%) and pyriform fossa (7.4%). The authors postulate the renewal of prospective study on epidemiology, clinical characteristics and treatment results of larynx and hypopharynx carcinoma in Poland.

Adenocarcinoma↗
PubMed2005

[The use of superselective embolization of the maxillary artery in treatment of bleedings in the Rendu-Osler-Weber syndrome].

Rendu-Osler-Weber syndrome is a rare genetically determined disorder that affects blood vessels throughout the body and results in a tendency for bleeding. Authors describe the case of superselective embolization of the left maxillary artery with polyvinyl alcohol particles in a patient with the Rendu-Osler-Weber syndrome hospitalized and treated in the Department of Otolaryngology and the Department of Radiology of the Military Institute in Warszawa, Poland due to persistent, severe and difficult to manage nasal bleeding. After the procedure had been performed patient condition improved and frequency and severity of nasal bleeding significantly diminished. Authors conclude that superselective embolization of the maxillary artery in a patient with Rendu-Osler-Weber syndrome is safe and effective and can be a valuable alternative to the maxillary artery or the carotis externa artery ligation. Authors also describe other methods of nasal bleeding management: laser photocoagulation, argon plasma coagulation, nasal dermoplasty and pharmacological treatment. Authors indicate that treating patients with Rendu-Osler-Weber syndrome is a diagnostic and therapeutic challenge for a physician and surgeon that require special approach to a patient due to difficult to manage symptoms. Patients with Rendu-Osler-Weber syndrome should be treated in a hospital setting due to access to diagnostic imaging techniques that can be helpful in revealing possible life threatening conditions.

Aged↗
PubMed2005

[The usefulness of computer-aided navigation in endoscopic sinus and nasal surgery].

The usefulness of computer-aided navigation in endoscopic sinus and nasal surgery. Endoscopic surgeries of the sinuses are among the most difficult procedures in otolaryngology. The progress of endoscopic techniques led to reduction of invasiveness enabling the surgeon to perform precise procedures with minimal tissue traumatization. The systems for computer-aided endoscopic surgery combine preprocedural MRI or CT data with information regarding current location of the surgical tools. The aim of this study was to assess the usefulness of electromagnetic navigation system ENTrak 3500 in endoscopic nasal and sinus surgery. The study group consisted of 18 consecutive patients with maxillary or ethmoid sinusitis with concomitant nasal polyps, who were surgically treated in ENT Clinic Military Medical Institute in October 2003. In all patients the endoscopic nasal and sinus surgery with the use of computer-aided navigation was successful with complete removal of pathologic lesions within the cavities of the nose, maxillary and/or ethmoid sinuses.

Adult↗
PubMed2005

[Usefulness of fenspiride in the treatment of acute otitis media in children].

UNLABELLED: Acute otitis media is very general disease and concerns every child practically. The shortening the time of treatment as well as quick decrease of symptoms, and mainly the pain have large meaning in treatment of this disease. Combined treatment of fenspiride and typical treatment of otitis media permits as our investigations show on quicker and observed at children's larger number decrease of symptoms in children with acute otitis media. The aim of the study was to observe effectiveness of combined treatment with antibiotic and fenspiride in children with acute otitis media. MATERIAL AND METHODS: The study comprised 40 children (mean age 8.2 years). The diagnosis of acute otitis media based on medical history data, otolaryngological examination and audiometry (tone and impedance). Children with GERD, hypersensitivity to amoxicillin and fenspiride as well as hypertrophy of adenoid were excluded from the study. Children were divided in two equal groups randomly. All children received amoxicillin in dose 80 mg/kg/day in three partite doses (Amotaks, Polfa Tarchomin Poland) as well as oxymethazolin 0.05% nasal drops 3 x day 1-2 drops (0.05% Nasivin, Merck Germany). In children from second group fenspiride was applied in dose 2 ml/kg/day in three divided doses (Eurespal, Servier Francja) additionally. Treatment was provided by 10 days. During the treatment parents made record of recession in 10 point scale, estimating following parameters: the pain of ear, bother, raised the temperature of body, loss of appetite, vomiting, diarrhea, otorrhea and crying. After end of treatment control otolaryngological and audiological examinations were performed. RESULTS: In studied children symptoms were similar, and the pain of ear was in both groups main suffering. Vomiting and diarrhea the most seldom were observed. In children with acute otitis media treated additionally with fenspiride statistically significant (p<0.01) quicker recession of clinical symptoms was observed. Statistically significant (p<0.01) reduction was observed of such symptoms as the pain of ear, bother, raised of body temperature as well as crying in children treated additionally with fenspiride in comparison to children treated only with antibiotic. Earlier return of hearing and state of middle ear was observed in children from group II than in children from group I (p<0.01). We observed also statistically significant (p<0.01) improvement of hearing estimated in tonal audiometry and impedance in this group. The undesirable symptoms during the treatment were not mentioned. CONCLUSION: Our study show that combined treatment with fenspiride and antibiotic in the treatment of acute otitis media in children causes quicker reduction of symptoms as well as improvement in audiological parameters (tone and impedance).

Acute Disease↗
PubMed2005

[Computer-navigated surgery].

Computer-navigated surgery Computer-navigated surgery has become very popular in the recent years. It provides "the third dimension" to CT scans and endoscopic images. This technique enables the surgeon to reach given structures in the operation field using instruments and to visualise their location on CT scans acquired earlier by the computer and presented on the screen. Computer-navigated surgery facilitates the visualisation of instruments position in relation to anatomical structures in three projections. Because of the simultaneous presentation of the scans and the endoscopic picture on one screen, enormous comfort is granted to both the surgeon and the patient who can feel safe. The analysis of images reveals further information, which enhance the safety and lead to more effective procedures with diminished complications. The surgeon's assurance that the instruments are in the desired position, even in the anatomically complex structures, is the most impressive advantage of this technique. Computer-navigated surgery can be of great benefit in endoscopic surgery teaching programs. However, it cannot become a substitute of an adequate knowledge or replace proper education about anatomy of operated organs. The authors present the review of systems for computer-navigated surgery. They also describe their own experience based on endoscopic surgery of ethmoid and maxillary sinuses carried out with the use of computer navigation.

Endoscopy↗
PubMed2005

[Assessment of nasal obstruction treatment with the rhinomanometric examination].

The aim of the present study was to assess of nasal obstruction treatment by means of rhinomanometry at patients with deviation of the nasal septum and with rhinitis allergic or vasomotor. The research encompassed 171 patients with nasal obstruction, medicated in Department ENT, who were assigned to 6 different groups according to nasal obstruction reason: group I--42 patients with deviation of the nasal septum, group II--32 patients and group III--34 patients deviation of the nasal septum and with allergic rhinitis, group IV--33 patients and group V--30 patients with deviation of the nasal septum and vasomotor rhinitis and 30 healthy subject forming control group. In groups I, II and IV patients performed plastic surgery of nasal septum and group II and IV performed inferior nasal concha surgery. Laboratory norms for rhinomanometry were fixed on the basis of healthy control group results analysis. After the surgical treatment normal results in rhinomanometry were found: in group I 81%, in group II 53%, in group III 62%, in group IV 51% and in group V 63% patients.

Adult↗
PubMed2005

[The rare case of nasal glioma].

The authors presented a case of nasal glioma in an adult man which had performed as nasal polyp. Histopathologic studies confirmed neuroglial tissue--Astrocytoma fibrillare. These tumor cells were immunohistochemically positive for glial fibrillary acidic protein as well as for S-100 protein and vimentin. There was no communication between the tumor and the cranial cavity on radiological examination (TC, MRI). Treatment is usually surgical. In this article authors describe a case of a nasal glioma that was removed via a lateral rhinotomy.

Biomarkers, Tumor↗
PubMed2005

[Noise in military service--the current problem].

Although new norms and regulations are constantly being introduced, noise problem in the Armed Forces still exists. Excessive noise exposure is an inherent danger of the military training. To achieve combat readiness of the unit, training in a real battlefield conditions is essential. It is difficult to plan military training to avoid excessive noise exposure. It is worth noting that 95.8% recruits during selection process referred to the otolaryngology consultants were rejected due to problems with hearing. Norms and regulations of the Polish Armed Forces limiting exposure to noise with comparison to NATO regulations are discussed. Noise exposure on the target range was evaluated. Infra noise hazards were also pointed out. Disability ruling with regard to service connected hearing impairment was described.

Hearing Loss, Noise-Induced↗