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M Krasnik

Publications and source records attributed to M Krasnik.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Occurrence of lung cancer in Denmark 1943-1986. Reliability of the cancer registry].

A rise in the number of adenocarcinomas of the lung and a fall in squamous cell carcinomas are seen in Denmark since 1978; a change based on a growing number of lung cancers among women with an excess of adenocarcinomas. A fall in the frequency of autopsies in Denmark will entail the loss of an essential control of the quality of diagnosis of lung cancer, primary or secondary, and make future descriptive studies difficult to interpret. The validity of morphologic diagnosis of lung cancer as recorded by the Danish Cancer Registry during 1943-1986 was assessed. We extracted a stratified random sample of 5% of all recorded cases prior to 1978, these were then recorded according to the ICD-O classification. Cases after 1978 were originally coded in the Registry according to ICD-O, here we checked the coding against the original reports. The information on morphology prior to 1978 was too inprecise to merit evaluation of trends and proportionate distributions by morphology. After 1978 data was adequate, and after 1983 very precise.

Adenocarcinoma↗
PubMed1994

Halving the number of leg amputations: the influence of infrapopliteal bypass.

A retrospective review of amputations in patients with vascular disease during 10 years in Bispebjerg Hospital was undertaken. There were 1383 amputations leading to 1167 final level amputations. In previously independent patients there were 482 below knee amputations (BKA), 476 above knee amputations (AKA) and 43 had disarticulations in the ankle, knee or hip. During the period studied the number of final level amputations in independent patients were halved from 122 in 1981 to 58 in 1990. A similar reduction was also found in the total number of amputations: from 171 to 90, and in the number of reamputations: from 35 to 21. However, amputations in patients from long stay institutions remained at a constant level by on average 17 per year. The decrease in amputation rate took place synchronously with an increasing use of bypass to crural and pedal arteries as well as an overall increase in vascular reconstructions and angioplasties of more than 100%. However, the BKA/AKA ratio decreased from 1.12 to 0.67 (p < 0.005).

Adult↗
PubMed1993

[Tetracycline pleurodesis in the treatment of spontaneous pneumothorax].

From 1979 to 1988 483 patients were admitted with primary spontaneous pneumothorax. All patients underwent thoracoscopy to identify the cause of pneumothorax. Chemical pleurodesis with tetracycline was performed if cysts less than 2 cm in diameter were found. If larger cysts were found the patient underwent thoractomy. In 93 patients with cysts larger than 2 cm the recurrence rate after thoracotomy was 4%. In 390 patients treated with intrapleural instillation of tetracycline, the recurrence rate was 16% (61 patients). The cause of recurrence in 42 patients was cysts missed at the initial thoracoscopy. This study has demonstrated that thoracoscopy is a reliable and safe method for selection of patients for chemical pleurodesis.

Adolescent↗
PubMed1993

[Cardiac arrhythmias after transmediastinal resection of the esophagus].

A study of 45 patients who underwent blunt transmediastinal resection of the esophagus without thoracotomy is presented. Sixteen patients (38%) developed a cardiac arrhythmia. The most common arrhythmia was atrial fibrillation/flutter. Even though 14 of the arrhythmias (88%) converted to sinus rhythm, a significantly higher death-rate was seen in this group of patients (p < 0.0014). As we suspect a relation between cardiac arrhythmia and increased mortality after this type of operation, we propose that a double-blind study should be carried out in order to determine the value of an antiarrhythmic treatment.

Aged↗
PubMed1993

Treatment of primary spontaneous pneumothorax with intrapleural tetracycline instillation or thoracotomy. Follow-up of management program.

Spontaneous pneumothorax has a high incidence of recurrence if treated only with intercostal drainage. A series of 404 patients in a special treatment program is presented. Early thoracoscopy was performed in 97%. The 86 patients (21%) then found to have true cyst (> 2 cm) were subjected to thoracotomy with removal of cyst and mechanical pleurodesis, and in the others a dilute tetracycline solution was instilled intrapleurally, followed by intercostal tube drainage. There was no recurrence of pneumothorax in the group treated with thoracotomy, but 8% recurrence in the tetracycline-treated group. Repeated thoracoscopy was performed in 21 of the 25 patients with recurrent pneumothorax, and thoracotomy with resection of large cyst in four. The probable cause of recurrence was identified in 21 cases, making the true recurrence rate 1% (4 patients). The mean hospital stay was 7.6 days for the patients with thoracotomy and 4.3 days for the tetracycline-treated group.

Adult↗
PubMed1992

[Antibiotic prophylaxis in lung surgery. A review].

The most important postoperative infections in general pulmonary surgery are empyema, pneumonia and wound infection. Risk factors are underlying malignant disease and the duration of the operation. The extent of pulmonary resection also appears to be of a certain significance. Five prospective randomized, double-blind, placebo-controlled investigations are available. Together, these investigations demonstrate that prophylactic antibiotic treatment, in which the first dose is administered immediately prior to operation, reduces the frequency of pneumonia (from 27% to 17%) and the frequency of wound infection (from 18% to 4%). Despite antibiotic prophylaxis, empyema occurs with frequency of 3%. Prophylactic antibiotic treatment has also reduced the duration of hospitalization and the postoperative employment of antibiotics. The relatively few comparative investigations have not indicated unanimously that any particular antibiotic was more advantageous than other. At present, we have insufficient knowledge about the pathogenesis of the above mentioned postoperative infections. Such knowledge could increase the possibility of other prophylatic measures.

Anti-Bacterial Agents↗
PubMed1992

Treatment of pleural empyema secondary to pneumonia: thoracocentesis regimen versus tube drainage.

BACKGROUND: Pleural empyema is a well known complication of pneumonia. Attitudes differ, however, about the best treatment of this condition and the place of drainage, early operation, and local antibiotics. METHODS: In a retrospective study 94 consecutive patients with verified empyema caused by pneumonia were admitted to the department of either pulmonary medicine or thoracic surgery. Treatment was either by a lavage regimen (daily thoracocentesis, saline rinse, systemic antibiotics, and in some patients instillation of local antibiotics) in the medical ward (51 patients) or by tube drainage and systemic antibiotics in the surgical unit (43 patients). RESULTS: The stay in hospital was significantly shorter in the medically treated patients than in the surgical group--2.3 v 5.0 weeks respectively. Furthermore, pleurocutaneous and bronchopleural fistulas developed more frequently in patients treated by tube drainage than in those treated with the thoracocentesis regimen alone (13 (30%) v 5 (10%) and 6 (14%) v 2 (4%) for each complication respectively). The overall mortality was 8.5% with no differences between treatments. CONCLUSIONS: Treatment with a lavage regimen plus local and systemic antibiotics seems to be associated with a lower frequency of complications and a shorter duration of hospital stay than tube drainage and systemic antibiotics. These results should be confirmed by a prospective, randomised study.

Adult↗
PubMed1991

Antibiotic prophylaxis in non-cardiac thoracic surgery. A double-blind study of penicillin vs. cefuroxime.

Patients referred for elective pulmonary surgery were enrolled in a prospective, randomized, double-blind study comparing the prophylactic efficacy of four-dose regimens of penicillin-G 5 million IU and cefuroxime 1.5 g. the first dose given immediately preoperatively. The treatment groups were comparable preoperatively with regard to all tested demographic factors. No significant intergroup difference was found concerning postoperative empyema, wound infection, septicaemia, pneumonia or fever of unknown origin, or any other complication or parameter tested in connection with pulmonary surgery. No side effects were observed, and no effects on the patients normal bacterial flora. Penicillin is recommended as prophylaxis in this type of surgery.

Cefuroxime↗
PubMed1989

Changes in pneumonectomy-space gas tensions.

The development of a simple and reliable method for measurement of the partial pressures of the atmospheric gases offers the possibility of both basic and clinical examination of the air in natural as well as pathological or iatrogenic cavities. From measurements in nine patients a plot of the changes in pO2 and pCO2 in the pneumonectomy space from the end of the thoracotomy to the establishment of equilibrium with the blood gases was made. pCO2 equilibrated faster than pO2 (6- and 50 h respectively). The equilibrium difference between arterial pO2 and pneumonectomy space pO2 was 6.5 kPa (2.5-12.3 kPa) and we propose that measuring this difference may be a sensitive method for the diagnosis of bronchopleural fistula. During the study period one of the patients developed a bronchopleural fistula. The suspicion was based on X-ray findings and was supported by gas analysis from the pneumonectomy space, and conclusively confirmed by bronchoscopy.

Adult↗
PubMed1987

[Pneumothorax].

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Denmark↗
PubMed1987

Pleurodesis in spontaneous pneumothorax by means of tetracycline. Follow-up evaluation of a method.

The validity of previous recommendation of early thoracoscopy and tetracycline pleurodesis in the management of spontaneous pneumothorax without thoracoscopically visualized true cyst was assessed under non-trial, normal hospital conditions. Among 46 patients treated during a year, seven underwent immediate thoracotomy following finding of large cysts. Of the remaining 39 patients, 11 had recurrence of pneumothorax after a median of 11 (range 2-64) weeks. Repeat thoracoscopy then showed large cyst or bullous emphysema in seven cases. Tetracycline pleurodesis was again performed in the others. In continued observation for at least 2 years there were no further recurrences. The importance of meticulous thoracoscopy is stressed. The demonstrated diagnostic errors do not detract from the value of tetracycline pleurodesis when spontaneous pneumothorax is caused by rupture of only tiny blebs on the surface of an otherwise healthy lung. The procedure is fast, simple and efficacious.

Adolescent↗
PubMed1987

Presence of circulating endotoxins during cardiac operations.

Ten patients having coronary artery bypass grafting were intraoperatively and postoperatively analyzed for endotoxins with the Limulus amoebocyte lysate test. A new highly sensitive rocket immunoelectrophoretic assay for reading the reactions of endotoxins with Limulus amoebocyte lysate was used. Preoperatively, all blood samples from the patients had negative Limulus amoebocyte lysate tests, negative blood cultures, normal total white cell counts, and were clinically without signs of infection. Intraoperatively, a substantial amount of endotoxins were found in samples from the extracorporeal circuit, the pulmonary artery, and the cardiac suction lines, which persisted during the cardiopulmonary bypass. The endotoxin content decreased significantly (p less than 0.05) 6 hours after cardiopulmonary bypass and further decreased within the seventh postoperative day (p less than 0.01). A positive Limulus amoebocyte lysate test was also found in some of the fluids administered during the operation, that is, the cardioplegic fluids, the priming fluids for the extracorporeal circuit, the blood transfusions, and the ice for local cooling. Postoperatively, all patients had rectal temperatures below 38.5 degrees C, but no correlation was found between the magnitude of endotoxin content and the degree of fever. Only one of the patients had positive blood cultures. Despite the measured endotoxin content, no intraoperative or postoperative complications were found.

Aged↗