PubMed Health⌕ Search

Biomedical subjects

A Sadowski

Publications and source records attributed to A Sadowski.

At least 19 recordsLinked to original sources
PubMed1993

[Effect of improper pulmonary venous compliance on clinical results of mitral valve replacement].

The pulmonary venous vascular volume and its compliance (PVcomp) are important factors influencing filling of the left ventricle. It seems that a poor PVcomp effects the value and reversibility of secondary pulmonary hypertension. Basing on Hirakawa's method PVcomp (= 0.4'' x SV/V-d) was calculated in 34 patients with isolated mitral stenosis (SM). Basing on the mean value of PVcomp the group was divided into those with poor (< = 4.3 ml/mmHg) and good (4.4 and more ml/mmHg) PVcomp. Prior mitral valve replacement (MVR) the groups did not differ in values of PAP, PWP, SVI, PVR assessed at rest. During exercise (25 Watt) in the supine position significant higher values of PAP and PWP were observed in patients with poor compliance. Six months after MVR the PAP and PWP values normalized in all patients. In the patients with the initial good PVcomp values significantly higher values of SVI and a decrease in PVR was found. During exercise (25 Watts) significantly higher values of PAP and PVR were registered in patients with initial poor PVcomp values. Pulmonary venous compliance may be an independent factors influencing the clinical outcome of mitral valve replacement 6 months after the procedure.

Compliance↗
PubMed1993

[Value of exercise test for assessment of hemodynamic efficiency of the heart].

The purpose of the work was an attempt at determination of the value of exercise test for the assessment of haemodynamic heart effectiveness. The reaction of blood pressure and heart rate to exercise was accepted as the basis for analysis. The analysis was based on a material of 40 men aged 33-66 years (mean = 51 years) with a history of myocardial infarction in whom exercise tests were carried out one year after aortocoronary bypass graft implantation. The studied men were divided into two groups A abd B depending on the reaction of blood pressure and heart rate occurring during exercise. Group A consisted of persons who responded to exercise with blood pressure and heart rate in a physiological way. The patients in group B terminated the exercise test due to pathological response. The subject of the analysis were: ischaemic changes during exercise; duration of the exercise test; attained workload in Watts; heart rhythm disturbances in group A and B; segmental left ventricular contractility disturbances evaluated on the basis of echocardiography findings. Among the patients in group B a higher percent of positive tests was found as well as shorter duration of the test and lower mean workload in relation to the patients in group A. Contractility disturbances occurred significantly more frequently - 80% among the patients in group B with greater prevalence of more sever forms of akinesis and dyskinesis (p < 0.05). Hypokinesis was observed in 7 patients (35%), akinesis in 5 cases (25%), and dyskinesis in 4 cases (20%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Surgical treatment for mitral valve defects with preponderance of mitral stenosis and high pulmonary vascular resistance. Clinical and hemodynamic observations 6 months after valve replacement].

10 patients with isolated or predominant mitral stenosis (mean mitral valve area 0.9 cm) and high preoperative values of pulmonary vascular resistance (mean 7.2 Wood units) were chosen for further hemodynamic postoperation evaluation. The patients had normal function of the aortic valve and no significant stenosis of coronary arteries. Hemodynamic evaluation was done by floating Swan-Ganz catheter preoperatively at rest and 6 months after mitral valve replacement at rest and during bicycle cycloergometer test in the supine position. Significant improvement in NYHA class was noted. Preoperatively 6 patients were in NYHA III class, 4 in NYHA IV class. After mitral valve replacement 4 patients were in class III and 6 in class II. Before mitral valve replacement only 3 patients were able to perform 25 Watt test. After surgery all except one performed at least 25 W. There was a significant decrease of pulmonary vascular resistance from 7.2 +/- 2.2 preoperatively to 3.1 +/- 1.9 Wood units at rest after the operation. Post operation during exercise pulmonary vascular resistance attained 4.2 +/- 1.9 Wood units. These changes were due to a fall in mean pulmonary artery pressure 49 +/- 13 at rest preoperatively to 25 +/- 6 mm Hg (rest) and 43 +/- 14 mm Hg (23 W) postoperatively and a rise in stroke volume index from 24 +/- 7 ml (m2) beat preoperatively to 32 +/- 9 at rest and 33 +/- 6 (25 W) postoperatively. Despite clinical and hemodynamic improvement there was no full recovery of pulmonary hemodynamics.

Adult↗
PubMed1993

[Factors influencing survival in patients with coronary disease. I. Characteristics of examined patients and survival curves].

The group of 683 patients with the significant narrowing (> 70%) of at least one coronary vessel diagnosed by coronarography performed between 1976-1988 in the Institute of Cardiology in Warsaw was followed during one to seven years. The number of patients with a poor left ventricular function was high in the group treated surgically and non surgically. Ejection fraction < 50% was found in 27% and 43% respectively, LVEDP > 12 mmHg (66% and 69%), EDVI > 100 ml/m2 (58% and 70%). Survival curves were calculated in the two different subsets of patients treated surgically and non surgically. Despite some favorite trend toward a better outcome for patients treated surgically the differences were not statistically significant for a whole group. However we showed a significantly higher probability of survival in the subgroup of the three vessel disease treated surgically compared to other treatment. There were no significant differences in survival in patients with one, two, or three vessel disease treated surgically (survival probability of 0.82; 0.78; 0.84 respectively after 7 years). In patients treated non surgically the growing number of diseased vessels worsened the prognosis (survival probability of 0.84; 0.78; 056 respectively). In our observation the differences for better outcome in patients with poor left ventricular function treated surgically did not reach a statistical significance.

Coronary Angiography↗
PubMed1993

[Factors influencing survival in patients with coronary heart disease. II. Multivariate logistic function analysis].

A group of 683 patients with the significant narrowing (> 70%) of at least one coronary vessel diagnosed by coronarography performed between 1976-1988 in the Institute of Cardiology in Warsaw was followed during one to seven years. Two hundred ninety of them were treated surgically, 393 non surgically. A multivariate logistic function (MLF) analysis of 10 variables is presented obtained from anamnesis and hemodynamic data and their significance upon survival after 2, 4 and 6 years. In the group treated non surgically the number of narrowed vessels was a factor independently significant after 2, 4 and 6 years. After 4 and 6 years the ejection fraction and the left ventricle end diastolic volume index were also significant. In the group treated surgically none of those were significant after 2 years. After 4 and 6 years anamnesis of arterial hypertonia was significant after 6 years also left ventricle end diastolic volume index. Coefficients calculated from multivariate logistic function analysis allow the calculation of probability of survival for an individual patient.

Adult↗
PubMed1989

[Early and delayed repair of gynecological ureteral injuries].

The report is based on a material of 45 patients with 54 ureteral damages after obstetric-gynaecological operations. In 30 cases nephrostomy was done and the operation on the ureter was delayed, while 24 ureters were operated on immediately after establishing of the diagnosis. The authors are proponents of early operations. The results of these operations are better, the patients recover earlier regaining fitness, and additional procedure, nephrostomy, is avoided.

Female↗
PubMed1987

Distribution of iron in pig placenta (Sus scrofa dom. L.).

Iron distribution was studied in pig placentae between 21 day till the end of pregnancy (113) with the use of histochemical and cytochemical methods and X-ray microanalysis. Iron content was measured in fetal and maternal part of the placenta with chemical methods. Iron presence was confirmed in maternal and fetal erythrocytes, cells and secretion of uterine glands and trace amount in trophoblast lining regular areolae. No significant differences were found in iron content in fetal and maternal part of the placenta throughout the entire studied period. With the applied histochemical method of iron determination according to Perls, potassium ferrocyanide also adsorbs in sites where mucopolysaccharides are present, in which iron presence has not been detected with the use of X-ray microanalysis.

Animals↗
PubMed1975

Behavioral disorders in the elderly.

Based on the study of 40 patients in a unit of a large geriatric center, as well as on long overall experience, the problems of aged men and women with various emotional disorders are discussed. Case abstracts are presented to illustrate chronic organic brain syndrome, delirium, hallucinatory behavior, paranoid ideation, depression, and reactions triggered by physical illness. The geriatrician should be fully aware of all the interlocking factors in the patient's adjustment to his condition. Only in this way can the geriatrician and staff choose the best relevant therapy.

Adjustment Disorders↗
PubMedDate not supplied

Do-not-resuscitate practices in the chronically critically ill.

OBJECTIVES: To determine the frequency of do-not-resuscitate (DNR) orders in the chronically critically ill; to identify the differences in clinical and demographic characteristics of chronically critically ill patients who have DNR orders and those who do not; to identify the differences in the cost of care between patients with and without DNR orders; and to identify the differences in DNR practices between an experimental special care unit and the traditional intensive care unit (ICU). DESIGN: Randomized, prospective design with a block randomization scheme. SUBJECTS: Two hundred twenty patients who met the following eligibility criteria for enrollment in a parent study of the special care unit: an ICU stay of at least 5 days, an absence of pulmonary artery monitoring, an absence of frequent titration of intravenous vasopressors, an Acute Physiology and Chronic Health Evaluation II score of less than 18, and a Therapeutic Intervention Scoring System score of less than 39. SETTING: A large, urban academic medical center. MEASURES: Clinical and demographic variables describing the study populations, mental status, and timing of DNR orders, mortality rates, and cost of hospitalization. RESULTS: There was no difference in the frequency of DNR orders between the special care unit versus the intensive care unit--although patients in the special care unit had a longer interval between hospital admission and initiation of the DNR order. DNR patients differed from non-DNR in that they were older, less likely to be married, and had a higher Acute Physiology and Chronic Health Evaluation II score on admission to the study. The mortality rate in the DNR group was 71% versus 6% in the non-DNR group. There was no difference in total costs. DNR patients were also more likely to have an impaired mental status on admission, and more likely to have deterioration in mental status by the time of discharge than the non-DNR patients.

Aged↗
PubMedDate not supplied

[On alleged radicular pain in patients with lumbar intervertebral disc hernias].

A review is presented of opinions on the sources and mechanisms of pain in patients with hernias of the lumbar intervertebral discs in particular, on the pathogenesis and clinical characteristics of the so called pseudoradicular syndromes in discopathies. The diagnosis of pseudoradicular syndromes reflecting the degree of involvement by the disease process of the osteoarticular and ligamentous spinal structures and the condition of spinal muscles is of importance for the therapeutic management, providing information on the necessity of avoiding rehabilitation procedures contributing to destabilization of the segmental system of the spine (certain types of exercises, exercises in suspension with large amplitude of movements, certain manual procedures) and on the use of procedures reducing the stress on the spine and strengthening it (special positions in bed, isometric exercises, balneotherapy in later stage).

Hernia↗
PubMedDate not supplied

[The attempt to define reciprocal relations between radicular and pseudoradicular syndrome in patients with lumbar disc herniation (1dh)].

Based on history and clinical examination in 100 patients with Idh we selected four clinical features characteristic of radicular and pseudoradicular (spondylogenic) syndrome. The choice was based on data from review of literature. We confirmed that pseudoradicular syndrome features appeared in most of Idh patients. Of the 100 patients in 20% pseudoradicular syndrome features prevailed, 14% experienced mainly radicular syndrome features and 66% patients presented mixed clinical picture. We suggest that above relationships should be considered in clinical practice.

Adolescent↗