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Biomedical subjects

S Zieliński

Publications and source records attributed to S Zieliński.

At least 19 recordsLinked to original sources
PubMed2000

Pharmacokinetics of intravenously administered digoxin and histopathological picture in rabbits with experimental bile duct obstruction.

This study aimed to examine the effect of obstructive cholestasis on the pharmacokinetics of digoxin. Eighteen male rabbits were randomly ascribed to the two study groups: the sham-operated control group and the examined group - with common and cystic bile duct ligations. Digoxin was administered intravenously as a single dose of 0.02 mg/kg, and blood samples were withdrawn for up to 24 h. Digoxin concentrations were determined by the FPIA method. The pharmacokinetic parameters were calculated using a noncompartmental analysis. During the whole observation period the blood serum concentrations of digoxin were statistically higher in animals with obstructive cholestasis versus the controls. A significant increase in the area under the plasma concentration-time curve, decrease in the total body clearance and in the volume of distribution on the 6th day after the bile ducts ligation as compared to the sham-operated controls, were observed. The obtained results suggest an impaired elimination of digoxin in obstructive cholestasis in rabbits.

Animals↗
PubMed1999

Video-assisted gastrostomy: a modification.

Surgical centers that treat esophageal cancer need to create a simple and easy method to feed patients who suffer from complete occlusion of the upper alimentary tract. The purpose of this work is to present our own modification of a laparoscopic feeding gastrostomy, which is based on our own experience and previously published methods. Our system requires only two trocars and can be done under general or local anesthesia. It consists of exteriorizing a stomach fragment through a 12-mm opening in the skin under video control. The newly created gastrostomy forms a channel in the abdominal wall that is long narrow and enough to allow a 24-F catheter to be inserted without serious leakage. The method was applied satisfactorily to 11 patients, with a mean observation time of 3.5 months. It offers the patient an ongoing nutrition gastrostomy for early use. After 3 weeks, the gastrostomy can be used on a temporary basis by inserting the catheter during the feeding time and afterward withdrawing it with the gauze pad still attached. We have found this procedure to be a simple, easy, and cost-effective alternative to supplying nutrition to patients with complete upper alimentary tract stenosis. Moreover, it is superior to previously described methods.

Enteral Nutrition↗
PubMed1998

[Organization of services for treatment of postoperative pain--3-year experience].

We report organisation principles and three year experience of Acute Pain Service in general surgery clinic. 481 patients were treated after abdominal and vascular interventions, hemorrhoidal varices and mammectomies. Continuous epidural, combined spinal-epidural, intrapleural anaesthesia and continuous brachial plexus block were used for pain control. Time of analgesia varied from 1 to 4 days. The level of analgesia was assessed as good (VAS 3) in 94.8% of cases. Complications were mainly technical due to catheter or antibacterial filter failure. In 2% of cases cardiovascular complications were observed. Respiratory depression occurred in 1 patient. The work of APS team was assessed as very good by both surgeons and patients.

Acute Disease↗
PubMed1997

[Diagnostic and therapeutic value of laparoscopy in acute abdomen].

The purpose of this work is to evaluate the degree of applicability of the diagnostic laparoscopy (DL) and therapeutic laparoscopy in the acute abdomen and trauma patients. The material of 109 cases of DL performed since 1983 has been evaluated retrospectively. 22 patients were operated by laparoscopy. The patients were assessed in the following groups: I-suspected acute appendicitis, II-acute abdomen of uncertain ethology, III-abdominal trauma. In the first group 60 patients were diagnosed, 13 of them were operated by laparoscopy, 28 by open access, 15 avoided the unnecessary laparotomy. In the second group 30 patients were diagnosed, 6 of them were operated by laparoscopy, 8 open interventions were noted, 16 avoided the non-therapeutic laparotomy. In the third group 19 patients were diagnosed, 13 underwent laparotomy, 6 avoided the unnecessary intervention. There has been one death, not associated with DL (acute bowel ischemia), morbidity was 1% (one case of bleeding from the mesenterial artery, treated by conversion to laparotomy), one DL was considered as falsely negative, one not sufficient to establish the diagnosis. Basing on our experience in DL as a diagnostic tool we can confirm the accuracy of the method in 99.08% with only 1% of morbidity. 20.1% of patients were operated by laparoscopy, without complications. In conclusions the authors consider the DL allows to establish a prompt and accurate diagnosis in the acute abdomen and trauma without a therapeutic delay and unnecessary hospital observation. The fault of the method and morbidity rate is acceptable. The treatment by the same laparoscopic access offers to these patients another benefit, the more the experience is increasing.

Abdomen, Acute↗
PubMed1997

[Complications after esophageal resection due to cancer].

The aim of the study was to evaluate complications searching for ways of decreasing their incidence. 225 patients with the diagnosis of thoracic esophageal cancer had been treated in the Department of General and Transplantation Surgery, Medicala Academy, Szczecin, within the period of 1984-1995, esophageal resection was done in 90 of them and 75 were submitted to the analysis. The majority of patients i.e. 65 of them had esophagogastric anastomosis performed within the thorax while in 10 patients the anastomosis was accomplished in the neck. Complications concerning cardiovascular and respiratory system wound healing, anastomotic leakage and gastric blood supply have been analysed. Cardiovascular and respiratory complications occurred in 24 and 66 per cent of patients with mortality rate of 28.6 and 12 per cent, respectively. Wound healing disturbances were found in 3.7 per cent of patients. Anastomotic fistulas and necrosis of the stomach were observed in 4 and 5.3 per cent of patients with mortality rate of 75 and 100 per cent, respectively. A statistically significant correlation between the incidence of cardiovascular complications and disease stage was found. Only in patients operated on in I and II disease stage can we expect the serious complications to be less frequent.

Anastomosis, Surgical↗