Biomedical subjects
Publications and source records attributed to A Niemiec.
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Authors indicate the usefulness of surgical procedures in treatment of Graves-Basedow disease to obtain the best and permanent therapeutic effects and suggest its important place in modern methods of treatment. They pay attention to difficulties in deciding about the range of thyroid gland tissue resection for preserving the state of hormonal balance in postoperative period. Importance of right surgery techniques, for minimizing the number of postoperative complications is also emphasized.
Authors presents two cases of low obturation ileus caused by gallstone which had obstructed sigmoid colon. They pay attention to diagnostic problems and usefulness of sonography and X-ray techniques also in case of biliary ileus. Authors shows difficulties in surgical procedures, prefering enterotomy and evacuation of concrement, without simultaneous internal biliary fistula liquidation, especially in cases of increased risk and in old age patients.
The authors present a retrospective evaluation of the safety of anaesthetizing patients who are above 80 years of age. The level of safety is raised by canal anaesthesia, complex treatment, proper monitoring and intensified perioperative care. In patients operated in emergency routine the coexistence of heart diseases and diabetes is a disadvantage. The risk is not rising parallel to the age, but is difficult to define and demands individual evaluation.
The authors present a patient at old age with acute superior caval vein syndrome caused by a large benign goitre. Surgical treatment gave a very good early result and a very good late one, inspite of numerous additional burdens subsequent to biological condition of the operated patient.
Diagnostic difficulties have been described together with the course of hospital treatment of a 48-year old female patient who suffered from Wegener's granulomatosis. A first, the patient was treated by various specialists because of otolaryngological, ophthalmic, rheumatic and respiratory symptoms. Despite numerous symptoms suggesting Wegener's granulomatosis, ineffective treatment had been instituted for two months. Appropriate diagnosis was made on the basis of clinical symptoms and histological examination od lung biopsy. In the course of hospital diagnostic procedures, symptoms of kidney failure occurred. Treatment with cyclophosphamide and prednisone was instituted which resulted in remission of both radiological and clinical symptoms, however, the prognosis is still poor. The patient will requires long-term therapy with cyclophosphamide and a number of complications related to the therapy can be expected.
A case of a 38-year old male with respiratory failure in the course of infection by Chlamydia pneumoniae has been described. Inflammation of bronchioles and alveoli was diagnosed on the basis of clinical examination and analysis of cellular components of bronchoalveolar lavage fluid (BALF). The diagnosis was confirmed by bacteriological examination of the culture infected by the material collected from the patient. Therapy with doxycycline was instituted which resulted in remission of symptoms. The case described confirms the findings of other authors that infection by Chlamydia pneumoniae may be the cause of serious respiratory distress.
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In this study, the biochemical and clinical profile of primary hyperparathyroidism, diagnosed in 155 patients (106 females and 49 males) in the Department of Nephrology of the Silesian University School of Medicine in the years 1972-1998 was analyzed. The mean age of patients was 48.5 +/- 12.8 years. In all cases the diagnosis was confirmed by the pathomorphological examination. In the majority of cases PNP was diagnosed in a phase of advanced organic injuries. The leading clinical finding in these patients was nephrolithiasis. Asymptomatic hypercalcemia was diagnosed only in 9% of cases. In the years 1972-1992 elevated serum total calcium concentration was found in 92.6% while after introduction of routine estimation of ionized calcium concentration in 1993, hypercalcemia was found in all patients. The incidence of hypercalciuria increased significantly in patients diagnosed in the period 1993-1998 while in this same period the incidence of impaired renal function declined significantly. The elevated serum PTH was found in 86% of patients regardless whether C-terminal fragments of PTH or intact PTH-1-84 were assessed. Elevated levels of ionized serum calcium with normal or increased plasma iPTH-1-84 level are the most constant symptoms of primary hyperparathyroidism.