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Biomedical subjects

S Filipecki

Publications and source records attributed to S Filipecki.

121 records · Page 7Linked to original sources

Neuron-specific enolase in non-neoplastic lung diseases, a marker of hypoxemia?

Neuron-specific enolase (NSE) is a glycolytic enzyme localized within neuronal and neuroendocrine tissues. Serum NSE is widely used as a marker of neuroendocrine tumors. Moderate serum NSE elevation has been reported in some patients with benign lung diseases. We decided to investigate whether the elevation of serum NSE in non-neoplastic lung diseases is connected with hypoxemia and to what extent the recovery of sufficient ventilation with a respirator may influence NSE concentrations. Serum NSE was estimated by means of radioimmunoassay in 83 patients with various non-neoplastic lung diseases. Serum NSE exceeding 12.5 micrograms/L was significantly more frequent in patients with marked hypoxemia (PaO2 < 6.67 kPa; p = 0.03) than in others. The median NSE value in the group of patients without respiratory failure (Ro) was 7.2 micrograms/L (10% > 12.5 micrograms/L), in the group of patients with respiratory failure not requiring mechanical ventilation (Rf) it was 8.5 micrograms/L (24% > 12.5 micrograms/L), and in the group of patients with respiratory failure requiring mechanical ventilation (Rfv) 13.1 micrograms/L (60% > 12.5 micrograms/L). The differences between the Rfv group and the other two groups (Rf and Ro) were significant (P = 0.049 and p = 0.0004, respectively). During successful mechanical ventilation elevated serum NSE decreased to values below the cutoff in 8/10 patients. We conclude that serum NSE elevation is a frequent event in patients with terminal hypoxemia in the course of benign lung diseases. Normalization of serum NSE is observed in the majority of patients during the first week of mechanical ventilation.

Adult↗

[Plasma antithrombin III activity in patients with pulmonary thromboembolism].

A decreased plasma antithrombin III activity has been noted in 12 out of 20 patients. In 2 patients it was most probably congenital defect, whereas in the remaining 10 patients--acquired. The observed disorders in the activity of antithrombin III with particular reference to anticoagulant therapy have been discussed.

Adult↗

[Conservative and surgical treatment of pericarditis--our experience].

Methods and results of both conservative and invasive therapy of pericarditis were analysed in the group of 30 patients. An emphasis was on successful treatment of mild (idiopathic) pericarditis and efficiency of the early started, combined pharmacotherapy (tuberculostatics + corticosteroids) of pericarditis of tuberculous etiology. A stress is on marked immediate efficacy of surgery in case of cardiac tamponade, independent on its etiology, with simultaneous recommendation of ultrasound-guided pericardial sac paracentesis. Survival rate in patients with malignant pericarditis is relatively low.

Adult↗

[Pericarditis at the Internal Disease Clinic of the Institute of Tuberculosis and Lung Diseases (1981-1987)].

Causes, symptoms, clinical forms, and methods of diagnosis of pericarditis were analysed in a group of 30 patients. Chest pain, dyspnea, and tachycardia were prevailing clinical symptoms of the disease. Particularly useful diagnostic technique is ultrasound, being a method of choice in the diagnosis of the most frequent exudative pericarditis. The most frequent cause of cardiac tamponade was malignant pericarditis. Diagnostic problems with particular reference to tuberculous etiology of pericarditis have also been discussed.

Adult↗

[Intensive treatment of respiratory failure--personal experiences].

Controlled oxygen-therapy was used in 30 out of 49 patients (61%) with the acute respiratory failure or exacerbations of the chronic respiratory failure treated at ICU (Group Y), while artificial ventilation in the remaining 19 patients (39%; Group B). An improvement was achieved in 70% of patients of Group A and 42% in Group B. Overall improvement was achieved in 59% of the treated patients. There were 69% of treated patients with infections. Totally 41% of the treated patients died (30% of Group A and 58% of Group B). An analysis of the results has been carried out in various subgroups of the treated patients, i.e. the acute and exacerbated respiratory failure as well as partial and complete respiratory insufficiency. The result of high risk patients have also been analysed. This subgroup included sudden cardiac arrest, shock and non-compensated acidosis. Favourable effects of the intensive care of patients with infections have been discussed with particular reference to the life hazard in case of septic complications. Emphasis is on the unfavorable effects of therapy in patients with respiratory failure complicated with pulmonary embolism. Indications to the use of respirator and complications of the artificial ventilation have been discussed.

Bicarbonates↗

[Respiratory failure treated at the intensive care unit "R" of the Internal Disease Clinic of the Institute of Tuberculosis and Pulmonary Diseases (1986-1987)].

A picture and clinical course of the acute and exacerbated chronic respiratory failure have been analysed. An analysis embraced a group of 49 patients, i.e. 16 percent of all patients treated at the Intensive Care Unit. Four subgroups were distinguished depending on the etiology of the disease in which infectious, thrombo-embolic, circulatory or toxic factors caused respiratory failure. An emphasis is on the prevalence of the infectious etiology of disease being noted in 65% of patients. Acute respiratory failure was observed in 37% of patients whereas exacerbation of the chronic respiratory failure in 63%. Complete respiration distress was noted in 55% of cases and partial respiratory failure in the remaining 45%. Gasometric differences characteristic for each subgroup of the patients have also been analysed. 41% of the patients died. The highest mortality rate was seen in pulmonary embolism complicating various pulmonary diseases. Sudden cardiac arrest, shock and not compensated acidosis have been most unfavourable factors in the prognosis.

Adolescent↗

[CEFOBID in the treatment of respiratory tract infection (preliminary report)].

The therapeutical efficacy of CEFOBID (Pfizer) a third generation cephalosporine (natrium cephaperasone salt) was studied in 10 patients with acute respiratory infections including 6 with pneumonias. The therapeutical effect was arbitrarily judged according to the applied three point scale--"good", "satisfactory", "lack of effect". A "good" effects was seen in 6 patients, in 2 "satisfactory", in further two "lack" of effect was observed. Thus CEFOBID proved to be of beneficial effect in eight out of ten patients. One should stress that in the group that responded to treatment were all cases of pneumonia. CEFOBID was well tolerated. In this preliminary study the beneficial therapeutical effect in Gram negative opportunistic infections is stressed.

Acute Disease↗

[Prazosin in the preoperative management of patients with phaeochromocytoma].

The use of prazosin--a drug selectively blocking alpha-adrenergic receptors--was considered for the preoperative management of patients with phaeochromocytoma. Prazosin was administered to 8 patients in whom the diagnosis was established basing on the clinical symptoms and daily excretion of catecholamines and their metabolites with the urine. Preliminary diagnosis was subsequently confirmed operationally. Prazosin could be considered effective only in the part of treated patients. This was manifested by the drop in blood pressure to nearly normal values and diminished attacks. However, prazosin did not prevent blood pressure increase during anaesthesia and surgery. The use of prazosin in patients with phaeochromocytoma for preoperative management may be an alternative pharmacological therapy producing appropriate drop in blood pressure in some patients.

Adrenal Gland Neoplasms↗