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Biomedical subjects

J Szmidt

Publications and source records attributed to J Szmidt.

At least 37 records · Page 2Linked to original sources
PubMed2000

[Thrombectomy in a patient with a mobile clot in the inferior vena cava--case report].

Switching from heparin to acenocoumarol was complicated by severe retroperitoneal bleeding in a 50-years old patient with massive pulmonary embolism and deep venous thrombosis. The haematomas were evacuated by surgical procedure. Planned insertion of a vena cava filter was abandoned because of a mobile clot in inferior vena cava (IVC) reaching above renal veins as evidenced by spiral computed tomography (SCT). Patient was transferred to the Surgical Department of Medical Academy in Warsaw where thrombectomy was performed. In spite of mechanical and pharmacological methods of venous thrombosis prophylactic, thrombectomy was complicated by massive proximal deep venous thrombosis of right leg and distal part of IVC. Patient was successfully treated with UFH i.v. followed by low molecular weight heparins. No bleeding complications were observed. Screening for thrombophilia and cancer were negative. This case report is an example of difficulties in clinical management in a patient who has both life-threatening thromboembolic disease and bleeding.

Heparin, Low-Molecular-Weight↗
PubMed1999

Effects of the correction of renal artery stenosis on blood pressure, renal function and left ventricular morphology.

The aim of this study was to evaluate the effect of renal artery stenosis (RAS) correction in hypertensive patients on 24 h SBP, 24 h DBP, creatinine clearance (GFR), urinary albumin excretion (UAE) and LV morphology and mass (LVMI). A total of 61 hypertensive patients with RAS undergoing PTRA and/or surgical treatment entered the prospective study. The final analysis was done in 44 patients (age range 45.8 +/- 16.2 years) with RAS (atherosclerosis (ASC) 31 patients, fibromuscular dysplasia (FMD) 12 patients, arteritis 1 patient) who underwent PTRA (34 patients) or surgical treatment (10 patients) and presented no Doppler signs of restenosis (or a new stenosis) during 1-year observation. The pre-interventional assessment repeated after 6 and 12 months included ABPM, GFR, UAE and echocardiography. The results were analysed in the combined group (CG) and in according aetiology. 24 h SBP and 24 h DBP decreased in all groups 6 months post-intervention and did not change further. Cure of HT was observed in 35% and 29% of ASC patients at 6 and 12 months respectively; and in 58% of FMD patients. Failure rate at 12 months was 48% in ASC against 25% in FMD. The mean GFR in CG was higher 12 months after intervention. The increase in GFR was noted in 45% of patients, the decrease in 25% of patients at 12 months. Normal values of UAE were found in 71% of patients, pre- and post-intervention alike. Mean LVMI and number of patients with LVH in CG decreased already during the initial 6 months post-intervention and did not change further. In conclusion, correction of RAS leads to cure of or improved control of hypertension in the majority of the patients with FMD, but in the ASC group in about half of cases no BP cure or improvement was seen. The renal function was improved or stable in two-thirds of patients after revascularization. Successful renal revascularization was followed by regression of LVH, which was evident within 6 months post-intervention.

Adolescent↗
PubMed1999

Kidney transplantation in recipients with atherosclerotic iliac vessels.

The influence of atherosclerotic lesions of hypogastric and iliac arteries of kidney recipients on intraoperative surgical technique and one-year graft and patient survival was investigated. Among 1553 transplanted kidneys atherosclerotic lesions which required surgical intervention were found in 201 (12.9%) recipients. Thrombendarterectomy (TEA) of hypogastric artery was performed in 142 cases with subsequent anastomosis with the renal artery. Occlusion of hypogastric artery was an indication for renal graft artery to external iliac artery anastomosis in 32 patients. Atherosclerotic changes in external and common iliac artery required TEA in 25 patients and anastomosis between renal artery and external artery was performed. Ilio-iliac bypass or Y-graft simultaneously with kidney transplantation were performed in two cases. One-year survival rate of allografts and patients was 88% and 93%, respectively. No grafts were removed due to kidney artery thrombosis. We conclude that hypogastric artery after TEA provides adequate blood supply to kidney graft.

Adult↗
PubMed1998

The effect of cyclosporine on regulators of fibrinolysis in plasma from renal allograft recipients.

Fibrinolytic disturbances are thought to play an important role in processes leading to deterioration of renal allograft function. We investigated the effect of CsA therapy on the regulation of fibrinolysis in kidney graft recipients by measuring plasma concentration and activity of plasminogen activators (tPA, uPA) and their inhibitors (PAI-1, 2). We found an increase in tPA activity and in PAI-1 concentration as well as a decrease in PAI-1 activity in renal allograft recipients as compared to healthy controls, but did not confirm a correlation between these observations and CsA administration. tPA and PAI-2 concentrations as well as uPA activity did not significantly differ between the studied groups. We showed a significant decrease in uPA plasma concentration in patients treated with azathioprine. The significance of this finding is unknown.

Adult↗
PubMed1996

Renal transplantation in Warsaw: a registry report.

In a country undergoing socioeconomic transformation, with all the attendant financial difficulties, it is rather difficult to obtain very good results in this expensive and advanced method of therapy. However, in spite of such difficulties, the results obtained are equal to the European standards, with 85% and 65% one- and five-year graft survival, respectively.

Adolescent↗