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Biomedical subjects

J Michalak

Publications and source records attributed to J Michalak.

At least 19 recordsLinked to original sources
PubMed2004

Improvement in deep vein haemodynamics following surgery for varicose veins.

OBJECTIVE: o analyse the effect of superficial and perforating veins surgery on deep vein incompetence. METHODS: During a six-month period between 2000 and 2001 24 patients (32 limbs) with chronic venous insufficiency (CVI) were treated. They were selected because they had varicose veins and proximal deep vein incompetence with photoplethysmography (PPG) venous refilling time (VRT) <15 s with a below knee tourniquet, and a femoral or popliteal vein reflux time (RT) >1.5 s on duplex ultrasound. The group was divided according to aetiology into 21 legs with primary (Ep) and 11 with secondary CVI (Es). All patients underwent removal of varices with stripping of the saphenous veins, if appropriate. In 21 cases subfascial endoscopic perforating vein surgery (SEPS) was performed to ligate incompetent perforating veins. RESULTS: The average VRT for the entire group increased from 9.8 s before to 15 s after operation (p<0.001, paired t test). In the Ep group the average VRT increased from 11 to 18 s (p<0.001, paired t test), in Es group from 7.5 to 10 s (p>0.001, paired t test). Duplex ultrasonography before surgery showed femoral vein incompetence in 28 and the popliteal incompetence in 26 cases. The average femoral vein RT was 1.9 s before and 1.4 s after surgery (p<0.001, paired t test). The femoral RT in the Ep group decreased from 1.9 to 1.3 s (p<0.001, paired t test) and in the Es group from 1.9 to 1.6 s (N.S.). In the popliteal vein, RT was 1.8 s before, and 1.3 s after surgery (p<0.001, paired t test). The RT in the Ep group shortened from 1.8 to 1.1 s (p<0.001 paired t test) and in the Es group from 1.9 to 1.5 s (N.S.). CONCLUSION: Surgical treatment of varicose veins and of calf perforators results in reduced deep vein reflux. The improvement is most marked in cases of primary venous insufficiency.

Endoscopy↗
PubMed2004

Progress of local symptoms of superficial vein thrombosis vs. duplex findings.

BACKGROUND: Risk of subsequent deep vein thrombosis (DVT) following superficial vein thrombosis (SVT) is not fully appreciated. Mechanisms, time relations and risk factors for DVT arising upon earlier SVT remain unclear. The aim of this study was to analyze time relations between local symptoms of lower limb superficial vein thrombosis, duplex findings and onset of deep vein thrombosis during clinically evident course of SVT. PATIENTS AND METHODS: 46 patients with early (onset less than 72 hours prior to inclusion) clinical diagnosis of SVT, confirmed ultrasonographically were included in this prospective, multicenter study. Progress of pain, erythema and swelling in relation to subsequent ultrasound changes in size and localization of thrombus at 0, 7, 14 and 21 day of study has been recorded. RESULTS: Local symptoms subsided completely during 3 weeks. At that time thrombus disappeared completely only in 26% of cases, in remaining cases decreased in size from average 117.5 mm to 43.0 mm. Thrombus regression was similar to venous blood outflow direction--proximal to femoral area. Thrombus propagation was observed following regression of local symptoms of SVT. 4 cases of DVT (8.7%) were diagnosed at 2-11 days. CONCLUSIONS: Local, clinically detectable symptoms of SVT regress incomparably quicker than thrombus in affected veins. Risk of further thrombus propagation extends well beyond the period of intensive local symptoms of SVT. Regression of thrombus in femoral area requires significantly more time than in popliteal or calf segment. Thrombus propagation is directed with blood flow towards femoral segment.

Adult↗
PubMed2001

Good practice in health, environment and safety management in enterprise.

Good practice in health, environment and safety management in enterprise (GP HESME) is a process that aims at continuous improvement in health, environment and safety performance, involving all stakeholders within and outside the enterprise. This WHO program is supported by other international organizations, and the declaration of Ministers of Health and Ministers of Environment adopted in 1999. The basic issues of the GP HESME concept are presented as well as its prerequisites, benefits and participants. The key partners in GP HESME are employers and their organizations, representatives of employees, governmental agencies, local authorities, financial and insurance institutions, occupational health services, environmental and social services, associations of professionals, research and training institutions. The HESME system is intended to function at different levels: international, national, local community, and enterprise settings. The lists of expected benefits for each group of stakeholders are discussed. Evaluation of GP HESME is based on the criteria and indicators, the most important of them are briefly presented.

Europe↗
PubMed2001

[Results of treatment of vesicovaginal fistulas].

OBJECTIVES: The results of treatment of 74 patients with vesicovaginal fistulas are presented. MATERIALS AND METHODS: The clinical analysis have been performed in 74 women aged from 24 to 70 years (on average 53.4), who had to be treated for vesicovaginal fistulas in the Department of Urology of Lublin University School of Medicine between 1966-1999. RESULTS: The most common cause of vesicovaginal fistulas was gynaecological surgery. Patients who-underwent the operation 96, 9% were cured (after 1st operation 84, 8%). 8 cases were cured by using conservative therapy.

Adult↗
PubMed2001

[Vesico-uterine fistula].

Our observations of 14 women with vesico-uterine fistulas as a result of caesarean section complications were presented. The patients were treated between 1965-1999 in urology clinic in Lublin. The case were diagnosed on the basis of medical history, radiological investigations and cystoscopy. In 3 cases hysterectomy was performed, in the rest of cases uterus was preserved and after the first operation complete recovery was observed.

Adult↗
PubMed2001

[The relation between Chlamydia pneumoniae infection and abdominal aortic aneurysm].

The aim of our study was to evaluate the frequency of C. pneumoniae infection in abdominal aortic aneurysm (AAA) patients by measuring C. pneumoniae specific serum IgG, IgM and IgA levels and the activation of their immune system by measuring the concentrations of IL-10, IL-12, IFN-gamma and TNF-alpha in patients' serum. Microimmunofluorescence method was applied to evaluate the level of anti-C. pneumoniae IgG, IgA and IgM. The concentrations of cytokines were evaluated using ELISA method. Serologic markers of persistent C. pneumoniae infection have been detected in 25/28 (89.3%) patients and in 6/20 (30%) healthy controls. In 40% (10/25) of patients with serologic markers of persistent C. pneumoniae infection high titers of specific IgG and IgA indicated active infection--reinfection or exacerbation of chronic infection. Mean concentrations of IL-10, IL-12, IFN-gamma and TNF-alpha indicated lack of protection against intracellular pathogens. Since all patients in this group were diagnosed as having symptomatic AAA, we suggest that active infection can exacerbate inflammation in the AAA wall and accelerate progression of the disease. In our opinion patients with active C. pneumoniae infection may be candidates to the antimicrobial treatment.

Aged↗
PubMed2001

Histoclinic of the abdominal aortic aneurysms.

The aim of this study was to analyze the scientific protocol of 21 patients operated due to abdominal aortic aneurysm. Arterial hypertension was the common feature for the whole group. Typical microscopic changes for true aortic aneurysm in all histopathological findings were approved. A different in size thrombus was always present inside the aortic sac. In every case atherosclerotic lesions were recognized in the aneurysm wall. In some samples the multiple inflammatory infiltration consisting of mononuclear cells were observed. Simultaneously an intensive angiogenesis process was seen.

Aged↗
PubMed2000

[Tension-free vaginal tape operation: the new alternative method of treatment of genuine stress urinary incontinence].

Twenty patients, aged 54.4 +/- 12.6 years, suffering from genuine stress urinary incontinence underwent intravaginal slingplasty. The mechanical support for the urethra provided prolen mesh tape. The aim of the study was the assessment of clinical efficacy of newly introduced method of the treatment of genuine stress urinary incontinence. The diagnosis of urinary incontinence was based on patients' history, Gaudenz questionnaire and the results of urodynamic investigation. The mean time of surgical procedure was 20 minutes. The follow-up which was done after 1.5 to 7 months from the operation revealed that all patients remained continent. Among complications related to the procedure were 2 cases of cystotomy, 1 case of retropubic haematoma and 2 cases of urinary retention. None complication required invasive treatment and influenced the end results of the therapy.

Adult↗
PubMed1999

[The efficacy of subterranean therapy in the salt chamber of Kinga Spa in Wieliczka for patients suffering from allergic rhinitis].

42 patients (27 women and 15 men aged 14-65 years) suffering from atopic and non atopic rhinitis were submitted for 24 days to the subterraneo-therapy in salt chambers of Kinga Spa in Wieliczka during the exacerbation of their illness. 20 patients suffered from pollen or dust mites allergy and the next 22 patients from non atopic rhinitis with recurrent nasal polyposis. In the first week and at the end of the therapy rhinoscopy, peak nasal inspiratory flow and smell were evaluated as well as daily symptoms score was noted in each treated patient. The results of performed observations indicate that unrelatively to the type of the rhinitis: 1. the nasal symptoms (running nose, sneezing, block of the nose) resolved directly during the stay of the patient in the salt chamber but the more constant effect was visible with the time of the therapy. 2. an increase in the peak nasal expiratory flow was connected with the decrease of nasal mucosal edema, 3. the smell disturbances disappeared in the patients together with the decrease of mucosal edema. The observed changes seem to be connected with the influence of the salt chambers' microclimate on the cells osmolarity disturbances in the nasal mucosa provoked by the non infectious chronic inflammation.

Adolescent↗
PubMed1999

Low molecular weight heparin versus acenocoumarol in the secondary prophylaxis of deep vein thrombosis.

The aim of this study was to determine the efficacy and safety of subcutaneous weight-adjusted dose low molecular weight heparin (LMWH) compared with oral anticoagulant (OA) in the prevention of recurrent venous thromboembolism. In a prospective multicenter trial, 202 patients with symptomatic proximal deep vein thrombosis (DVT) were included. As soon as the diagnosis of DVT was confirmed by phlebography, 101 were randomly assigned to receive LMWH (nadroparin) for secondary prophylaxis and 101 to receive OA (acenocoumarol). Patients in both groups were initially treated with nadroparin in a dose of 85 anti-Xa IU/kg s.c. every 12 h. Secondary prophylaxis with either nadroparin, 85 anti-Xa IU/kg s. c. once daily, or acenocoumarol was continued for at least 3 months. Three patients in the LMWH group and 6 in the OA group were excluded from analysis for various reasons. During the one-year combined secondary prophylaxis and surveillance period, 7 of of the 98 evaluable patients (7.1%) in the LMWH group and 9 of the 95 evaluable patients (9.5%) in the OA group had a documented recurrence of venous thromboembolism (Fisher's exact test, p = 0.61). Of these, 2 patients who received LMWH and 7 patients on acenocoumarol had recurrences in the 3-month period of secondary prophylaxis. Four patients (4.1%) in the LMWH group developed bleeding complications during this study period, as compared with 7 (7.4%) in the OA group (Fisher's exact test, p = 0.37). There were two major bleedings, one in the LMWH group and one in the OA group. Eleven patients died, 5 (5.1%) in the LMWH group and 6 (6.3%) in the OA group. It is concluded that nadroparin in a dose of 85 anti-Xa IU/kg s.c. once daily provides an effective and safe alternative to oral anticoagulants in the secondary prophylaxis of DVT.

Acenocoumarol↗
PubMed1998

[The ruptured, infected femoral artery aneurysm in the patient with diabetes mellitus].

The performance of vascular operations in the patients with co-existing diabetes poses a very difficult therapeutic problem. In our thesis we present the cases in which only after multiple reconstruction operations the limb could be saved. In the case of infection of the vascular prosthesis an extra-anatomic transplant (graft) is the only solution.

Aged↗
PubMed1998

Polish approach to the quality assurance system in occupational health services.

The most important factors which influence the quality of Occupational Health Services in Poland are discussed. The legal regulations, the system of specialist education, guidelines and standards in occupational medicine, and the role of regional specialists supervision system are presented. The audit of medical documentation revealed the 'sub-populations' of doctors who are concerned about the quality and those who are not. Keeping relatively moderate prices of services by some OHS units, even at the cost of their quality, has become a side-effect of competition. The establishment of an accreditation system in OHS is postulated, basing on the existing elements of such a system.

Education, Medical↗
PubMed1997

[The effect of specialist supervision on the quality of medical documentation in occupational health services].

The effect if different factors on the quality of documentation on medical prophylactic examinations in occupational health services is presented. Following the binding legal regulations, the tools (forms and application software) for evaluating the quality of documentation by regional specialists has been developed. The medical documentation has been kept by authorized doctors using old and new forms. The results of three successive controls carried out in three voivodships during the third term of 1996 showed improved quality parameters (transparency and input of appropriate data) due to new pattern of medical documentation. Nevertheless, the key role in quality assurance of medical documentation is played by a regional specialists, equipped with suitable tools facilitating assessment of documentation kept by individual doctors.

Documentation↗
PubMed1996

[Quality assurance in occupational health services].

The general conditions influencing the quality assurance and audit in Polish occupational health services are presented. The factors promoting or hampering the implementation of quality assurance and audits are also discussed. The major influence on the transformation of Polish occupational health services in exorted by employers who are committed to cover the costs of the obligatory prophylactic examination of their employees. This is the factor which also contributes to the improvement of quality if services. The definitions of the most important terms are reviewed to highlight their accordance with the needs of occupational health services in Poland. The examples of audit are presented and the elements of selected methods of auditing are suggested to be adopted in Poland.

Humans↗
PubMed1996

The effect of iloprost on peroxidation in dog ischaemic myocardium.

The aim of this study was to investigate the effect of Iloprost (Schering AG), a stable prostacyclin analogue, on the intensity of thiobarbituric acid-reactive substances (TBARS), conjugated diene and hydroperoxide production in ischaemic dog myocardium. Adult male mongrel dogs were divided into groups as follows: A = sham/operated group, B = control animals, and C = Iloprost-supplemented group. The drug was administered as a single intravenous bolus at a dose of 10 micrograms/kg. Partial heart ischaemia was induced by occlusion of the left descending coronary artery. After 3 h ischaemia the dogs were killed, their hearts were removed and the levels of the above-mentioned peroxidation products were assayed. The concentrations of TBARS, conjugated dienes and hydroperoxides were significantly increased not only in the ischaemic region, but also in the border zone and in the "normally" perfused region of the heart. A considerable decrease of these products was observed in the Iloprost-treated group. A direct effect of Iloprost on the heart cell membranes is postulated.

Animals↗
PubMed1995

Exploratory photochemistry of 5-azido-8-alkoxy-substituted psoralens free and bound to DNA.

5-Azido-8-alkoxy psoralens were synthesized. Laser flash photolysis (LFP: XeF, 351 nm, 55 mJ, 17 ns) of the azides in acetonitrile or benzene solution produces the triplet nitrene and a small amount of ketenimine. Laser flash photolysis of the azides in methanol or aqueous solution cleanly produces the triplet nitrene. In aqueous solution containing highly polymerized calf thymus DNA, LFP produces a mixture of triplet nitrene and ketenimine corresponding to photolysis of free and bound psoralen, respectively. The two transients decay slowly but at different rates. Assignment of the transient spectra were secured by matrix EPR and UV-visible spectroscopy. The triplet nitrene lifetime is the same in buffer and in the presence and absence of calf thymus DNA. The results explain why psoralen azides are unable to efficiently nick plasmid DNA pBR322 upon UV activation.

Animals↗