Biomedical subjects

J Pawlik

Publications and source records attributed to J Pawlik.

At least 19 recordsLinked to original sources

PubMed2004

Nonattendance at outpatient endoscopy.

BACKGROUND AND STUDY AIMS: Nonattendance at outpatient endoscopy leads to inefficiency and delay in diagnosis. We aimed to identify factors associated with failure to attend outpatient gastroscopy and colonoscopy. PATIENTS AND METHODS: We carried out a retrospective audit of nonattendance at outpatient endoscopy over a 12-month period at our tertiary hospital endoscopy unit. Attending patients on the same endoscopy list were used as controls. Patient charts and referral letters were reviewed. The information collected included referral source, time between referral and procedure, indication and type of procedure, reason for nonattendance and history of previous endoscopy. Following the audit a trial of telephone reminders was implemented over a 3-month period. RESULTS: From 2157 outpatient procedures that were scheduled, 263 nonattendees (12.2 %) were identified with 261 controls. Of the nonattendees, 109 (41 %) did not attend for colonoscopy, 121 (46 %) did not attend for gastroscopy and 33 (13 %) failed to turn up for combined procedures. Monday was the most common day of the week for nonattendance (40 % of nonattenders). Nonattendees were younger (46 +/- 14 vs. 55 +/- 16, P < 0.001), less likely to be referred from a gastroenterologist ( P < 0.001) or private practice ( P = 0.02) and more likely to be referred from the emergency department ( P = 0.007). Subsequent to this, a 3-month period of telephone reminder reduced nonattendance rates from 12.2 % to 9 % ( P = 0.03). CONCLUSIONS: Younger patients scheduled for outpatient endoscopy on Mondays who are not referred by a gastroenterologist or private physician are more likely not to attend. These patients should be targeted for interventions designed to increase attendance. Telephone reminders have a modest effect on reducing nonattendance rates.

Adult↗

PubMed2000

Partial CFTR genotyping and characterisation of cystic fibrosis patients with myocardial fibrosis and necrosis.

Myocardial necrosis and fibrosis is a rare complication of cystic fibrosis (CF) causing sudden and unexpected death in infancy due to cardiac arrest. Characteristic morphological lesions are recognisable postmortem. The 18 CF patients with this complication had varied clinical features including mild pulmonary involvement, early onset severe pancreatic insufficiency, and profound electrocardiogram (ECG) changes. In this group of patients, 5 were deltaF508 homozygotes, 1 was deltaF508/ N1303K and 1 was a deltaF508/M compound heterozygote. A pair of affected siblings (deltaF508 homozygotes) were fully concordant for myocardial involvement and for the general course of the disease. The co-existence of a genetic predisposition to myocardial lesions resulting most probably from severe cystic fibrosis transmembrane (CFTR) genotypes (such as deltaF508/deltaF508, deltaF508/N1303K) and deficiency of certain trophic factors necessary for metabolism of the myocardium, are postulated to cause myocardial complications in CF leading to circulatory failure and early death.

Cardiomyopathies↗

PubMed1999

Alveolar macrophages of children suffering from recurrent infections of respiratory tract are less efficient in eliminating apoptotic neutrophils.

During bacterial infections of the respiratory tract, neutrophils (PMN) are recruited to the lung by various mechanisms, including production of interleukin-8 (IL-8) by alveolar macrophages (AM). After fulfilling their defense function, PMN become apoptotic and have to be disposed of by AM to prevent local damage to the lung tissue by oxygen species and proteolytic enzymes. We measured the levels of IL-8 in the bronchoalveolar lavage (BAL) and the ability of AM to engulf senescent PMN in a groups of children with and without recurrent infections of the respiratory tract. The IL-8 level was measured by enzyme-linked immunosorbent assay (ELISA). The phagocytosis of apoptotic neutrophils was evaluated microscopically by the presence of myeloperoxidase positive material in AM before and after 1 h of incubation with senescent PMN. The data show that children suffering from recurrent infections have increased IL-8 in BAL and that their AM have a lower ability to engulf apoptotic PMN in vitro. Furthermore, the proportion of annexin V-binding cells was higher in BAL of children with recurrent infections of the respiratory tract than in normal controls.

Adolescent↗

PubMed1999

Bronchoalveolar lavage in children with chronic diffuse parenchymal lung disease.

The aim of the present study was to compare cellular and noncellular components of bronchoalveolar lavage fluid (BAL) in a group of children with a diagnosis of chronic diffuse parenchymal lung disease (cDPLD) and a group of children without parenchymal lung disease undergoing BAL for various clinical indications (control group). We evaluated cellular and non-cellular components (total proteins, albumin, hyaluronic acid, and fibronectin) in BAL fluid from 14 children (7 boys and 7 girls; mean age 9.2 years, range 5 months to 18.4 years) fulfilling the clinical and radiological diagnosis of chronic cDPLD, and in 19 controls without evidence of lung disease. The 14 patients were assigned to two study groups: early-stage cDPLD (6 patients; age range 5 months to 5.2 years; duration of illness, 5-7 months) and long-standing cDPLD (8 patients; age range 9.6-18.4 years; duration of illness, 1.2-17.6 years). Ninety-three percent of the patients with cDPLD had at least two BAL constituents outside normal limits, with high numbers of cells, including all types of alveolar cells, but especially lymphocytes and foamy macrophages. These findings indicate a mixed, predominantly lymphocytic alveolitis. Our patients also had a significant increase in two noncellular BAL components, namely fibronectin and hyaluronic acid. BAL samples from children with long-standing cDPLD contained increased numbers of lymphocytes, whereas samples from children with early-stage cDPLD contained increased percentages and numbers of foamy macrophages and increased concentrations of fibronectin, hyaluronic acid, and albumin. In conclusion, we clearly identified an abnormal BAL profile in our group of cDPLD patients. Moreover, BAL findings differentiated younger cDPLD patients in the early stages of their illness from old patients with long-standing disease.

Adolescent↗

PubMed1999

Exclusion of chromosome 7 for Kartagener syndrome but suggestion of linkage in families with other forms of primary ciliary dyskinesia.

Explore the source record for details and available documents.

Chromosomes, Human, Pair 14↗

PubMed1997

The Kartagener syndrome--an electron microscopic studies of biopsied mucosa.

We studied 43 tissue samples taken from patients (16 male and 27 women) with clinical diagnosis of Kartagener's syndrome. The specimens were fixed and prepared for transmission electron microscopy. After preliminary light microscopic examination 23 cases were qualified for ultrastructural studies. We found abnormal number of cilia on the bronchial mucosa cells. The ciliary structure was abnormal. In several cases we observed lack of inner and/or outer dynein arms, abnormal location of central microtubules, and abnormal number of microtubular doublets. Other findings were as follows: replacement of ciliated cells by goblet ones, mucosal edema and inflammatory infiltrate.

Adolescent↗

PubMed1995

[Broncho-pulmonary complications due to aspiration of foreign bodies by children].

The paper describes 239 children with bronchopulmonary disease due to foreign body (f.b.) aspiration treated in our center during between 1980-1992. Twenty-eight percent of the cases had been referred to hospital without any suspicion of f.b. aspiration. Almost half of the children (49.7%) were below the age of 2 years. Boys were affected more often (61.5%) than girls. In 61.1% the cases the f.b. had been aspirated into the right bronchial tree. Pieces of nuts were the most common f.b. - 35.1%. The most common chest X-ray symptoms were disturbances of bronchial patency (74.1%). Non-metalic, but potential shadowing f.b. like bones and teeth gave the clear signs only in 17.6% of the cases. After f.b. aspiration chronic irreversible lesions such as bronchiectasis and lung fibrosis were observed in 18.8% of the children. The prevalence of bronchiectasis was proportional to the duration of deposition. If the f.b. had been removed within the first month after aspiration we observed no complications. After aspiration of ears of grain, bronchiectasis was present in 80% of cases. Aspiration of f.b. into the left bronchial tree very often caused ventilation disturbations. Such cases were diagnosed and treated earlier than cases of right side f.b. aspirations. As a consequence bronchiectasis in the left lung was observed 2.7 less frequently.

Bronchi↗

PubMed1994

Genetically determined sparteine oxidation polymorphism in a Polish population.

The genetic oxidation polymorphism was determined in 160 healthy Polish volunteers from the south-west of Poland (Wrocław region), using sparteine as a model drug. The results of a Polish population study revealed a bimodal distribution of the sparteine metabolic ratio and showed the existence of two oxidation phenotypes designated as extensive and poor metabolizers. The frequency of poor metabolizers in our study (8.8%) compares well with most results of poor oxidation metabolizers in Caucasian populations.

Adolescent↗

PubMed1990