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Biomedical subjects

Tomasz Zieliński

Publications and source records attributed to Tomasz Zieliński.

12 recordsLinked to original sources
PubMed2005

[The frequency of risk factors of thromboembolic and hemorrhagic complications in patients treated with oral anticoagulants after heart valve replacement].

UNLABELLED: Thromboembolic (TE) and hemorrhagic (H) complications are the most significant problems in patients treated with oral anticoagulants (OA) after implantation of artificial valvular prostheses of heart. This problem was discussed in worlds scientific literature, but was not comprehensive investigated in Polish population of patients. The aim of the study was to assess the frequency of TE and H complications and their influence on mortality and morbidity and to determine the risk factors related to clinical and hemodynamical patients status. MATERIAL AND METHODS: Between December 1997 and December 1998, 358 patients hospitalized in our Department were qualified for cardiac surgery. There were 177 women and 181 men with a mean age 56.9+/-10.3 (range 21-80 years), who underwent 144 mitral, 172 aortic, 42 both artificial heart valve replacement. All patients were followed prospectively. RESULTS: Follow up was 100% complete and averaged 36.7+/-12.1 months. The total follow-up was 1109.8 pty. Linearized incidents of death was 2.1%/pty (30 patients). TE events were in 30 patients (2.7%/pty). H events occurred in 46 patients (4.15%/pty). The TE and H complications were the most important causes of morbidity and mortality in observed population of patients after mechanical heart valve replacement. Frequency of complications was inside the broad spectrum of values presented in the literature. CONCLUSIONS: The independent risk factors of death were: lower EF (RR: 1.06; CI 95%: 1.02-1.08), advanced functional NYHA class in presurgery period (RR: 3.5; CI 95%: 1.1-8.2) and advanced functional NYHA class in postsurgery period (RR: 7.5; CI 95%: 3.6-15.5). The independent risk factor of TE as well H complications was an advanced functional NYHA class in perioperative period (respectively for TE and H complications RR: 4.2; CI 95%: 1.9-8.9 and RR: 3.2; CI 95%: 1.5-6.7). In the group with artificial heart valve in reference to the severe (class III) complications of postoperative period-independent risk factors were atherosclerosis risk factors (hypertension, hypercholesterolemia, diabetes and smoking) (RR: 2.4; CI 95%: 1.3-5.6).

Adult↗
PubMed2005

[Thromboembolic and haemorrhagic complications in patients treated with anticoagulants after artificial heart valve replacement. Risk factors dependent on quality of anticoagulant treatment].

UNLABELLED: Thromboembolic (TE) and hemorrhagic (H) complications are the most significant causes of morbidity and mortality in patients treated with oral anticoagulants (OA) after implantation of artificial valvular prostheses. The risk of complications is dependent on recommended target INR ranges and quality of anticoagulation treatment. We studied 358 patients with a mean age 56.9 +/- 10.3 (who underwent 144 mitral, 172 aortic, 42 both artificial heart valve replacement). The follow up was averaged 36.7 +/- 12.1 month. Linearized incidents of TE events was 2.7%/pty, H events--4.15%/pty. The quality of anticoagulant treatment based on following parameters: averaged INR +/- SD, percentage measurements of INR within the target range 2.5-3.5, within the broad range 2-4 and under 2 and over 5. Average frequency of tests, SD/averaged INR X 100%--was similar in patients with TE and H complications and event free patients. Significant differences were found when a shorter period of time-3 months preceding the TE or H incident was analized compared with the average results of measurements of event free patients. The patients with TE and H complications have statistically significant higher fluctuation ratio than event free patients (respectively: 1.09 -/+ 0.71 and 1.71 -/+ 1.06 vs 0.5 -/+ 0.32, p = 0.04 and 0.02 ) CONCLUSIONS: 1. The risk of TE and H complications was dependent on high fluctuation of INR values in the period of 3 months before the event. 2. The worse control of measurements of INR in the period of 3 months before the event in comparison with yearly values within the recommended target ranges show, that TE and H complications are directly dependent on period of poor INR control.

Adult↗
PubMed2004

The coexistence of acute aortic dissection with autosomal dominant polycystic kidney disease--description of two hypertensive patients.

BACKGROUND: Acute aortic dissection is a rare but potentially lethal disease characterized by high early mortality when left untreated. However, survival may be significantly improved by the timely institution of appropriate medical and/or surgical therapy. Autosomal dominant polycystic kidney disease (ADPKD) is one of the most common hereditary disorders, accounting for 8-10% of the cases of end-stage renal disease. Hypertension occurs frequently and is an early manifestation of ADPKD in approximately 50-70% of non-azotemic patients. ADPKD, often caused by mutations in the PKD1 gene, is associated with life-threatening vascular abnormalities that are commonly attributed to the frequent occurrence of hypertension. METHODS: We present two cases of hypertensive patients with acute aortic dissection (type A Stanford) coexisting with ADPKD. RESULTS: A 54-year-old male hypertensive patient and a 47-year-old male hypertensive patient, both with known ADPKD were diagnosed and operated with acute dissection of ascending aorta. Both patients were characterized by severe hypertension; therefore, in both cases, degree of hypertension is likely to be causative for this vascular complication. However, since ADPKD is associated with the vascular complications mentioned above, abnormality of the structure of the arterial wall of the thoracic aorta cannot be ruled out. CONCLUSION: Aortic dissection is a rare but potentially disastrous complication, and clinicians should always consider this when dealing with patients with ADPKD who present with chest pain or collapse.

Aortic Dissection↗
PubMed2004

[Significance of the DNA-HPV research in cervical cancer prevention].

The purpose of our research was to assess DNA-HPV frequention observation and evaluation of the diagnostic value mRNA E6 and E7 HPV16 and HPV18 profile concentration in prognostic risk of intraepithelial lesions and cervical cancer progression in women with cytological screening. Human papilloma virus (HPV) infection were detected in 13.8% normal samples, presence HPV16 and 18 in 7.5% samples were detected. HPV 16, 18 or HPV16 and 18 infection were detected in 85% HSIL (high-grade squamous intraepithelial lesion) samples. HPV16 or HPV18 infection in 100% cancer samples were detected. In samples from control group expression of E6 and E7 genes were not detected. In LSIL (low-grade squamous intraepithelial lesion) group HPV16 E7 gene in 2.6% samples, in HSIL group E7 gene in 9.5% samples were detected. In all cancer samples E7 or E6 HPV16 and/or HPV18 were detected.

Adult↗
PubMed2004

Latrogenic complications due to the nasogastric and rectal cannula in neonates.

BACKGROUND: An abnormal position of nasogastric and rectal tubes can be the cause of iatrogenic injuries Most often it can happen in neonates and premature infants. MATERIAL/METHODS: From 1982 through 2003, we observed 9 neonates (8 premature infants) with perforation of the alimentary tract. RESULTS: In most of these patients the only radiological sign was displacement of the nasogastric tube. In 5 children the tube was outside the esophagus, in 3 outside the stomach, and in 1 case perforation was caused by the rectal cannula. Neonates with esophageal perforation were treated conservatively with good effects. Surgical treatment was performed in four children with gastric and rectal perforation - two of whom died. CONCLUSIONS: Evaluation of the position of nasogastric tube on the plain chest and abdominal x-ray is a very important diagnostic Consideration. Any deviation from the normal course of the tube should be suggestive of alimentary tract injury, even in the absence of any other signs of perforation.

Catheterization↗
PubMed2003

[Pregnancy in a patient with Turner syndrome].

Fertility in patients with a diagnosis of Turner's syndrome confirmed by karyotype examination is a very rare phenomenon. Only in 2% of all cases the pregnancy is a result of a spontaneous ovulation and intrauterine fertilization. Due to high proportion of complications occurring in pregnancy, in labour and in puerperium, only minority of patients can expect delivering a healthy infant. Literature data indicate that 40% of patients with Turner's syndrome give birth to a healthy child. Other pregnancies are terminated either by delivering a child with congenital defect or by a spontaneous abortion. We report a case of a 26-year-old patient with Turner's syndrome (46XX/45XO) who menstruated regularly after hormonal replacement therapy. She had regular menstrual bleeding through period of two years, after withdrawal of hormones administration. In march diagnosis of pregnancy was made, as a result of a spontaneous ovulation. The healthy, full-term fetus was born in 40th week of pregnancy.

Adult↗
PubMed2003

[Correlation between transcriptional activity of vascular endothelial growth factor (VEFG) and transcriptional activity of its receptors (FLT-1 and FLK-1) in low-grade squamous intraepithelial lesions (LSIL) of uterine cervix].

OBJECTIVES: In this report we focus on angiogenesis, as one component of a complex molecular relations in the process of neovascularisation in the low-grade intraepithelial changes (LSIL). Increasing number of publications indicates that the interrelation between isoforms of VEGF (VEGF121, VEGF145, VEGF165, VEGF183, VEGF189, VEGF206) but not total VEGF is responsible for angiogenesis, both in physiological and pathological processes. The molecular co-operation of the said isoforms and their receptors results in morphological presentation of "de novo" created vascular network that dynamically involves the entire connective tissue stroma of the uterine cervix. METHOD: The selection of intraepithelial pathology 38 cases to assess molecular activity of the given genes was based on colposcopy examination. Tissue specimens were taken for pathological investigation and to analyse transcriptional activity and mRNA alternative splicing of the angiogenesis genes. VEGF, Flt-1, Flk-1. To analyse quantitative gene expression RT-PCR TaqMan was performed. To estimate the dependence transcriptional activity of Flt-1 and Flk-1 on VEGF gene expression Spearman's correlation rank was performed. Differences with p < 0.05 were considered significant. RESULTS: The comparison of transcriptional activity of VEGF and its receptors revealed significant correlation between increase in the number of Flt-1 mRNA copies and enhanced mRNA expression of VEGF121 (p < 0.05), VEGF145 (p < 0.05), VEGF165 (p < 0.05), VEGF183 (p < 0.05), VEGF189 (p < 0.05), and VEGF206 (p < 0.05). Significant increase in the number of Flk-1 mRNA copies was observed in case of enhanced mRNA expression of VEGF121 (p < 0.05), VEGF145 (p < 0.05), VEGF183 (p < 0.05), VEGF189 (p < 0.05) and VEGF206 (p < 0.05). The number of sFlt-1 mRNA copies significantly correlated only with enhanced VEGF145 mRNA expression (p < 0.05). CONCLUSION: Changing intensification of transcriptional activity of VEGF gene and its receptors indicates on autocrine mechanism regulation of angiogenic genes activity in the first steep of carcinogenesis--LSIL.

Carcinoma, Squamous Cell↗
PubMed2003

[Generalized choreic involuntary movements in the course of stroke: case report].

Involuntary movements are rare ischemic stroke complication. Hemichorea, hemibalism and dystonia cases were described, especially during haemorrhage into basal ganglia and thalamus. The case of 73 years old woman is presented who was admitted to our Clinic cause of sudden choreatic involuntary movements occurrence within axial muscles and limbs. Computed Tomography showed ischemic focus in basal ganglia (head of caudate nucleus and lentiformis nucleus) and anterior branch of internal capsule. Cerebral angio--CT confirmed partial occlusion both medial arteries and atherosclerotical changes within the rest of cerebral arteries.

Aged↗
PubMed2002

Effect of resveratrol, a natural polyphenolic compound, on platelet activation induced by endotoxin or thrombin.

Resveratrol (3, 4', 5-trihydroxystilbene), a natural polyphenol, is found in some plants that are used in human nutrition. Grapes are a major source for resveratrol, and a significant amount can also be found in red wine. Several experimental studies have demonstrated biological properties of resveratrol, especially its anti-inflammatory, antioxidant, anti-platelet and antitumor effects. In the present study, we investigated the first step of platelet activation-platelet adhesion stimulated by lipopolysaccharide (LPS) from Proteus mirabilis (weak stimulator) and thrombin (strong activator) in the presence of resveratrol. Our studies show that endotoxin (0.3 microg/10(8) platelets), like thrombin (0.2 U/10(8) platelets), induced the adhesion of platelets (expressed as absorbance of cell attached proteins) to collagen and fibrinogen. Preincubation of washed platelets with resveratrol at physiological plasma concentrations (25-100 microg/ml, 30 min, 37 degrees C) had an inhibitory effect on adhesion of platelets to collagen after activation by LPS alone or LPS with thrombin. The strongest effect on this process was caused by resveratrol at the concentration of 100 microg/ml. Pretreatment of platelets with resveratrol (25-100 microg/ml, 30 min, 37 degrees C) had also inhibitory effects on adhesion of platelets to fibrinogen after stimulation of these cells by LPS alone or by LPS with thrombin at the same concentration. In conclusion, we suggest that resveratrol present in human diet may be an important compound responsible for the reduction of platelet adhesion and changed reactivity of blood platelets in inflammatory process.

Animals↗
PubMed2002

[Usefulness of selected ultrasonographic methods for evaluation of fetal weight in twins].

Evaluation of three mathematical methods, based on ultrasound examination, in order to estimate foetal weight in twins and compare them with actual birth weight. Retrospective analysis of ultrasonicly assessed 27 pairs of twin babies, who were born within 10 day of ultrasound examination and then outcome's comparison with newborn weight, measured just after the delivery. The ultrasonic measurements were performed to calculate estimated foetal weight using mathematical models of Shepard, McCallum and Hadlock. All outcomes were compared to birth weight. Statistical analysis, employed in our research, was percentage error according to formula: % = (EFW - BW) x 100/EFW (EFW - estimated foetal weight, BW - birth weight). The mean foetal weight calculated according to Shepard's method was 2605.9 g and 2651.6 g, relatively for the first (I) and second (II) twin baby. By using McCallum's method outcomes were as follows: (I) -2558.4 g (II) -2655.4 g and for Hadlock's method: (I) -2480.9 g and (II) -2540.3 g. Actual birth weight came to 2664.1 g for (I) and 2639.6 g for (II). Percentage error was found -2.23, using Shepard's method, -4.13, using McCallum's method and -7.38, using Hadlock's method, for the first twin-baby. Relatively, for the second twin-baby, values were found as follows: 0.45, 0.59, -3.91. Shepard's method is the most helpful in prediction of birth weight in twin pregnancy. Separate evaluation of each of twin babies can be more significant indicator in prognosis of appearance in intrauterine growth retardation (IUGR), comparatively to evaluation of weight's discordance between both twin-foetuses.

Female↗