Biomedical subjects

K Krawczyk

Publications and source records attributed to K Krawczyk.

At least 19 recordsLinked to original sources

PubMed2001

A multicenter randomized phase II study of oral vs. intravenous vinorelbine in advanced non-small-cell lung cancer patients.

PURPOSE: A randomized phase II trial of oral vs. intravenous (i.v.) vinorelbine was designed to determine the efficacy and safety of oral vinorelbine with an intrapatient dose escalation in previously untreated patients with advanced non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: Between December 1997 and April 1999, 115 patients with stage IIIB or IV NSCLC were randomized (2 to 1) to receive either oral vinorelbine at a dose of 60 mg/m2/week for the first three administrations and then increased to 80 mg/m2/week in the absence of severe neutropenia, or i.v. vinorelbine at 30 mg/m2/week. RESULTS: One hundred and fourteen patients (76 in the oral arm and 38 in the i.v. arm) were treated. Ninety-eight patients (86%) were eligible and assessable. The two treatment arms were well-balanced for demographic and prognostic features. After external panel review, the response rates in evaluable patients were 14%, in the oral arm and 12% in the i.v. arm. The median progression-free survival with oral and i.v. vinorelbine was 3.2 months and 2.1 months, respectively, and the median survival 9.3 and 7.9 months, respectively. The most common hematological toxicity was neutropenia, which was severe (grade 3-4) in 46% of patients and for 7% of administrations in the oral arm, and in 62% of patients and for 25% of administrations in the i.v. arm. Non-hematological toxicities including nausea, vomiting, anorexia, weight loss, diarrhea .and constipation were generally mild to moderate. CONCLUSION: The activity of oral and i.v. vinorelbine in advanced NSCLC appears to be comparable. The safety profiles of both formulations look qualitatively similar. Oral vinorelbine can therefore be considered a good alternative to i.v. administration.

Administration, Oral↗

PubMed2001

Dysphagia training programmes: 'fixes that fail' or effective inter-disciplinary working?

A number of factors influencing the development of dysphagia training programmes are identified, some of which relate to cultural issues and to the way systems operate. Lessons can be learned from current theories of relevance to effecting change in professionals' working practice. These lessons can be applied beyond dysphagia to other areas in which speech and language therapists are involved.

Deglutition Disorders↗

PubMed2000

[Early detection of COPD by high risk population spirometric screening].

UNLABELLED: COPD is the most frequent chronic lung disease in Poland. The disease is however under-diagnosed, especially at the early stages. The aim of the study was to assess the efficacy of spirometric screening for COPD in middle aged smokers. Informations on causes and symptoms of COPD were disseminated in mass media in 14 large cities. Subject aged over 39 and with smoking history of > 10 packyears were invited for a free spirometry in local chest clinic. However, everyone attending had the spirometry performed. Spirometry was performed according to ATS recommendations. Airway obstruction (AO) was diagnosed when FEV1/FVC < 85% of N and categorised as mild (FEV1 > 70% of N), moderate (FEV1 50-69% of N) or severe (FEV1 < 50% of N). Spirometry was accompanied by an antismoking advice. RESULTS: 12.781 subjects were screened (mean age 52 +/- 12 years, 57% males). In 8.269 subjects who complied with inclusion criteria AO was diagnosed in 29.8% (mild in 10.9%, moderate in 12% and severe in 6.9%). In smokers < 40 years of age and a history of < 10 packyears AO was found in 8.8% (mild in 6.0%, moderate in 1.8% and severe in 1.0%). CONCLUSION: Mass spirometry is an effective and easy method for early detection of COPD.

Adolescent↗

PubMed2000

[Incidence of chronic obstructive pulmonary disease among chronic smokers inhabiting Krakow and Proszowice].

COPD is the most common chronic lung condition whose identification is delayed. This paper undertakes to identify the present COPD occurrence frequency in the urban area of Krakow and the rural area of Proszowice. It makes use of free of charge spirometry tests in > 40 year-old volunteers, with the smoking history of at least 1 pack of cigarettes per day for 10 years. One in four persons examined in Krakow and one in three persons examined in Proszowice manifested ventilation impairment mainly of the obturation type. Severe obturation was diagnosed in one in three persons with ventilation dysfunction. In the conclusion the vital influence of COPD on public health is stressed, which should prompt a serious programme of early COPD identification and treatment, on regional or national scale.

Comorbidity↗

PubMed1998

Does chemotherapy-induced leukopenia predict a response in small-cell lung cancer?

The correlation between chemotherapy-induced toxicity and treatment outcome in cancer patients has not been studied thoroughly. Our aim was to evaluate whether there is any relationship between chemotherapy-induced leukopenia and response to treatment in small-cell lung cancer (SCLC). Data derived from records of 228 patients treated within two prospective multicentre phase II studies were analysed. In the first study (101 patients) chemotherapy included vincristine, epirubicin and cyclophosphamide and, in the second (127 patients), cyclophosphamide, etoposide and epirubicin; both regimens were given every 3 weeks. In the present analysis, the correlation between treatment outcome (response rate and survival) and highest scores of leukopenia within the first two and up to the fourth chemotherapy cycle, respectively, was evaluated. The objective response rate for the entire group was 66%; 53% in patients whose white blood cells remained normal and 85% in those who developed leukopenia within the first two cycles (P = 0.000). In multifactorial analysis, also including other treatment- and patient-related factors, independent correlation with response to chemotherapy was found for leukopenia (P = 0.001), chemotherapy regimen (P = 0.002) and the combined relative dose intensity (P = 0.018), but not for patient sex, age, performance status, pre-study weight loss, extent of disease and initial white blood cell count. Leukopenia within the first two cycles of chemotherapy was not correlated with survival, whereas such correlation for leukopenia occurring up to the fourth cycle was at the borderline level (P = 0.06). These findings suggest a relationship between chemotherapy-induced leukopenia and tumour response in SCLC.

Adult↗

PubMed1997

[Foreign body imitating bronchial neoplasm].

A case of 53 year-old male admitted to the Clinic with fever and persisting cough with a muco-purulent secretion, varying in intensity for about 4 months, was presented. Prior to the admission to the Clinic the patient was treated with antibiotics, which only slightly relieved the symptoms mentioned above. The patient was admitted to the Clinic with diagnosis of chronic bronchitis, right sided bronchopneumonia with a suspicion of lung cancer. Performed chest X-ray seemed to confirm this diagnosis. Later on, tomography scans and bronchoscopy demonstrated a foreign body in the bronchus. Bronchoscopy not only allowed to exclude neoplastic change but also enabled us to "treat" the patient by extracting his molar tooth remained in the main right bronchus, which caused purulent inflammatory changes in this bronchus. After subsequent antibiotic therapy patient's general condition improved and radiological chest image returned to normal. Persistent cough and recurrent fever are often the symptoms of the lung cancer. It should be emphasised that in the observed case longterm treatment of these changes lasted for 4 months without chest radiological examination.

Bronchi↗

PubMed1997

[Neurotic disturbances, depression and anxiety disorders in the population living in the vicinity of overhead high-voltage transmission line 400 kV. Epidemiological pilot study].

Numerous reports suggest a relationship between the increased incidence of depressive and neurotic symptoms in humans and the exposure to extremely low frequency electromagnetic field (EMF) at the place of residence. Our study was conducted in one of the Cracow suburbs with low socio-economic status, adjacent to an easement containing two 400 kV high-voltage transmission lines (distance up to 50 m from the line). The population investigated comprised 70 persons (35 males and 35 females). This group was exposed to EMF from 1986. A control group (n = 37), non-exposed to EMF, was also tested. The EMF intensity was measured by special devices. The following assessments instruments were used: Anamnestic Data Questionnaire, Neurotic Symptoms Questionnaire "O" Spielberger Self-Rating Questionnaire, and Beck-Self-Rating Scale. The measurements of the electric field levels taken at the front walls of investigated buildings averaged much higher than normal values of safety exposure. Our investigation showed the increased psychopathological values in all clinical tests. The difference between the group exposed to EMF and the control population was statistically significant. The results of our study did not support a possible cause-and-effect relationship between EMF and psychopathology observed. Some other factors (noise) can be responsible for the data obtained. The hypothesis that EMF produced by external electric power lines may enhance the occurrence of neurotic symptoms and depression, requires further clinical and experimental investigations.

Adult↗

PubMed1994

[Analysis of prognostic factors for long term survival in patients with small cell lung cancer].

Prognostic factors for long term survival were analyzed in a group of 719 patients with small cell lung carcinoma treated within 4 consecutive prospective multicenter trials between 1981 and 1990. 74 patients (10.3%) survived more than 2 years; 30 of them (4.2%) with no evidence of disease. The most significant determinator of prolonged survival was extent of disease: 13.9% (59/424) of patients with limited disease vs. 5.1% (15/295) with extensive disease survived more than 2 years (p < 0.001). Of 138 female patients 24 (17.4%) were long term survivors, compared to 8.6% (50/581) of males (p < 0.01). Initial good performance status and no weight loss were also found to be correlated with long term survival. Of the group of 2-year survivors 51 patients subsequently died (median survival duration 31 months), 10 are alive with cancer or are lost to follow up and 13 are in complete remission with median follow up of 64 months. 20 patients (3.8%) survived more than 5 years. This study confirms the possibility of cure in SCLC, especially in patients with favorable prognostic factors.

Adult↗

PubMed1990

[Calcitonin in direct and indirect pulp capping].

Calcitonin, the hormone produced by C cells of the thyroid playing a great role in calcium homeostasis, was used for direct and indirect pulp capping. This procedure was done on 200 teeth. Late follow-up after 12, 18 and 24 months or even longer was obtained in 146 cases: 110 with indirect pulp capping and 36 with direct capping. In the first follow-up examination 7 cases were regarded as failures, in late follow-up 5 failures were found, thus the total failure rate was 3.8%. The usefulness of calcitonin for biological treatment of pulp is unquestionable.

Adolescent↗

PubMed1989

[Diagnostic problems in patients with superior vena cava syndrome].

Diagnostical difficulties were shown in 275 patients with the superior vena cava syndrome (SVCS) evaluated in the years 1970-1982. Men consisted 84 percent of the group. In 68 percent the symptoms preceded hospitalization by less than one month. 31 percent of the patients were treated without histopathological verification. In 83 percent the cause of the SVCS was lung cancer. Only in 10 patients (5.3%) non-malignant causes were present. Basing on analysis of their material the authors conclude that it it possible to make a diagnosis of SVCS etiology in the majority of the patients. This is mandatory because the etiology of this syndrome is variable, and the therapy may produce unwarranted and unjustified side effects in many cases.

Adult↗

PubMed1989

[Intravenous catheters (venflons) in children as a possible cause of hospital infections].

The authors made 106 cultures from the endings of intravenous catheters used in children hospitalized in the teaching hospital in the years 1987-88. In 30 cases (28%) the cultures were positive. The most common cultures were those of Staphylococcus and Micrococcus. No correlation was found between the time of keeping a catheter in the vein and the number of positive cultures from the catheter. The children not receiving antibiotics had 2.6 as many positive cultures as those receiving antibiotics.

Adolescent↗

PubMed1988