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Biomedical subjects

A Samet

Publications and source records attributed to A Samet.

At least 19 recordsLinked to original sources
PubMed2005

[Postobstructif pulmonary oedema after endotracheal extubation at the recovery of general anaesthesia].

We report two cases of postobstructif pulmonary oedema occurring after extubation at the recovery of general anaesthesia and presenting some similarities. The young age of the patient and the occurrence of upper airway obstruction after extubation, as well as the radiologic nondependent distribution of alveolar pattern are typical. The underlying pathophysiology seems to be the mechanical disruption of the alveolar-capillary membrane.

Adult↗
PubMed2001

Life-threatening pneumothorax of the ventilated lung during thoracoscopic pleurectomy.

PURPOSE: To report the case of a patient who underwent right thoracoscopic pleurectomy with lung exclusion and developed contralateral (left) pneumothorax with resulting life-threatening alteration of the respiratory and cardiovascular functions. CLINICAL FEATURES: A 28-yr-old male was admitted to the intensive care unit for a well tolerated, second episode of spontaneous right pneumothorax and scheduled for right thoracoscopic pleurectomy. Anesthesia was induced and maintained with sufentanil and propofol. A double lumen endotracheal tube (ETT) was inserted, its correct positioning checked clinically and by fiberoptic bronchoscopy and the patient was placed in the left decubitus position. Approximately one hour into the procedure, during the second period of right pulmonary exclusion, SpO2 values decreased within two minutes to 78%. End tidal capnography (EtCO2) values decreased to 6-8 mmHg within seconds and peak airway pressure increased to values between 50 and 60 cm H2O. Severe cyanosis, sinus bradycardia and arterial hypotension developed. The surgical procedure was stopped, propofol administration discontinued, bipulmonary ventilation reinstituted and the patient placed in the supine position which restored hemodynamic and respiratory function. Inspection and auscultation were consistent with tension left pneumothorax which was evacuated. CONCLUSION: Pneumothorax of the ventilated lung during one lung ventilation for thoracoscopic procedures must be diagnosed quickly. Reinstitution of bipulmonary ventilation should probably be the first therapeutic attitude.

Adult↗
PubMed2001

Vascular transformation of lymph node sinuses.

Vascular transformation of lymph node sinuses is an uncommon condition and only isolated cases have been reported. It is characterized by conversion of nodal sinuses into capillary-like channels, often accompanied by fibrosis. Venous or lymphatic obstruction is thought to be the underlying mechanism, and in most cases factors that may contribute to lymphovascular obstruction can be identified such as tumour in the vicinity, vascular thrombosis, heart failure, previous surgery or radiotherapy. Most cases involve abdominal lymph nodes, and head and neck involvement is rare. We present two cases of vascular transformation of lymph node sinuses presenting only as cervical lymphadenopathy, without an obvious cause of lymphovascular obstruction.

Adult↗
PubMed2001

Medium-term middle ear ventilation with self-manufactured polyethylene T-tubes for the treatment of children with middle ear effusion.

We present the results of the insertion of self-made polyethylene T-tubes for a period of 15-24 months for the treatment of chronic middle-ear effusion. We compare the outcome of our patients to the reported outcome of patients treated with other commonly used ventilation tubes for either shorter or longer periods of time. In a retrospective review of 603 T-tubes inserted in 306 children up to the age of 12 years, charts were reviewed for age, sex, surgical procedure performed, duration of ventilation and complications. In all cases the indication for surgery was chronic middle-ear effusion. The tubes were electively removed by the authors after 15-24 months of ventilation. Spontaneous extrusion was considered a complication. The mean period of ventilation was 20 months. Post-operative otorrhoea was experienced in 6.6 per cent of ears; 4.8 per cent of tubes extruded spontaneously, whereas 3.15 per cent had to be removed earlier than originally planned; 4.9 per cent of ears were re-ventilated at a later date, and 1.49 per cent of ears developed a persistent perforation. We demonstrate that the outcome of patients treated with our self-manufactured tubes for a period of 15-24 months is, in many respects, better or at least comparable to the reported outcome of patients treated with other commonly used ventilation tubes for either shorter or longer periods of time, and that the many complications associated with the conventional T-tube can be reduced. We suggest that our favourable outcome may be due to the duration of ventilation, which was controlled to be shorter than the conventional long-term T-tubes and longer than that of grommets.

Child↗
PubMed2001

[Verrucous carcinoma of the nose and maxillary sinus].

Verrucous carcinoma is a rare type of squamous cell carcinoma that is most commonly seen in the oral cavity, and seldom in the larynx. It should be distinguished from benign papilloma, verrucous hyperplasia and well-differentiated non verrucous squamous cell carcinoma. Verrucous carcinoma is a rare tumor of the sinonasal tract. Only 28 such cases have been described in the medical literature reviewed until this time. We describe the first case in Israel of a patient with such a tumor in the nasal cavity. We reviewed the existing literature dealing with Verrucous Carcinoma of paranasal sinuses.

Aged↗
PubMed2000

[Acute pulmonary edema associated with the use of beta2-mimetic tocolytic agents].

A case of severe pulmonary oedema during beta2-adrenergic agonist tocolytic therapy (salbutamol) in a pregnant woman admitted for preterm labor at 32 weeks of amenorrhoea is reported. Echocardiography and haemodynamic investigations did not show any left ventricular systolic or diastolic dysfunction. Pulmonary oedema is an exceptional complication of beta2-adrenergic agonist tocolytic therapy. The diagnosis is considered in pregnant patients presenting with respiratory distress, associated with or following tocolytic therapy. Anaesthetic management of patients treated with a beta2-adrenergic agonist should take into consideration the delay between discontinuation of tocolytic therapy and anaesthetic induction, as well as volume expansion.

Acute Disease↗
PubMed2000

Total inferior turbinectomy: operative results and technique.

The internal nasal structures, including the turbinates, regulate the nasal airflow. The surgical treatment of turbinate hypertrophy remains controversial. A wide variety of surgical procedures is performed, with universally unsatisfactory results. Interference with nasal physiology and possible postoperative complications have been the main reasons for the objection to total inferior turbinectomy. Over a 6-year period, 357 total inferior bilateral turbinectomies were performed at our institution. We present the results of these procedures and describe our surgical technique. We conclude that even in a hot and dusty climate, total inferior turbinectomy is an effective and relatively safe procedure.

Adolescent↗
PubMed2000

[Bacteriologic evaluation of otitis externa and chronic otitis media].

The authors present results of bacteriological examinations in 187 patients with chronic otitis media (OMC) and otitis externa treated in ENT Department, Medical University of Gdańsk in the years 1997-1998. Ear swabs and aspirates were investigated for aerobes and anaerobes 254 bacterial isolates were obtained. Among 150 patients with OMC aerobes were isolated in 130 (86.7%) in 13 (8.5%) mixed aero-anaerobes flore and in 20 (19.3%) no bacterial growth was observed. From patients with COM there were 199 bacterial isolates among them 177 aerobes cultures, 13 anaerobes and 9 fungal. From the external ear canal there were 55 cultures, among them 45 (81.8%) aerobes, 6 (10.9%) mixed aero-anerobes and 4 (7.3%) fungal. The most frequent observed bacteria were Staphylococcus aureus, Pseudomonas aeruginosa and Proteus mirabilis which showed the best susceptibility on ciprofloxacine and amikacine.

Adolescent↗
PubMed2000

[Microorganisms in clinical material collected from patients at the Public Clinical Hospital Nr 1 in Gdansk from 1997-1999].

Occurrence of microorganisms isolated from clinical specimens collected from patients in Clinical Hospital no. 1 in Gdańsk in years 1997-1999 was analyzed. In this period there was no change in occurrence of Gram-negative bacteria, that accounted for 44-46% isolates. The number of isolations of Gram-positive bacteria dropped from 45% to 40%, and yeast risen from 5% to 10%. The analysis of blood cultures shows decrease in occurrence of bacteremia caused by Gram-negative bacteria and increase in occurrence bacteremia caused by Gram-positive bacteria and yeast. We observed also that the number of multi-resistant Gram-positive isolates (MRSA, VRE) decreased but there was rise in occurrence of multiresistant Gram-negative isolates (ESBL+, CRPA).

Bacteremia↗
PubMed1999

Isolation and epidemiological study of vancomycin-resistant Enterococcus faecium from patients of a haematological unit in Poland.

Enterococcus faecium has recently emerged as a serious nosocomial pathogen. Vancomycin resistant enterococci (VRE) have been isolated in Europe and the USA since 1988. This is the first report on isolation of vancomycin resistant E. faecium (VREM) strains in Poland, from Haematological Unit patients in the Clinical Hospital in Gdańsk. In total, 6412 samples were examined between December 1996 and October 1997. Five hundred and five isolates of Enterococcus spp. were collected. One hundred and one were classified as Enterococcus faecium of which 49 were resistant to vancomycin (MIC > 256 mg/L) and teicoplanin (MIC > 256 mg/L), characteristic of the VanA phenotype. Twenty-nine patients were infected or colonized. A PCR-based specific diagnostic assay confirmed the phenotype. The multiplex PCR-restriction fragment length polymorphism patterns were consistent with VanA-type of vancomycin-resistant E. faecium for all isolates examined. These isolates were epidemiologically-related as shown by PCR-fingerprinting.

Adult↗
PubMed1998

[A Polish multicenter survey of antimicrobial susceptibility and prevalence of beta-lactamase production among bacterial pathogens isolated from hospitalized and ambulatory patients].

The aim of the study was to establish the frequency of occurrence of bacterial pathogens with beta-lactamase activity, and pattern of resistance among aerobic and anaerobic strains isolated from: respiratory tract, urinary tract, skin and soft tissues (hospitalized patients) and throat swabs (ambulatory patients). The study was conducted in 1994 year in 6 bacteriological laboratories in four Polish towns (Warszawa, Kraków, Katowice, Gdańsk) according to the protocol. Sensitivity of bacteria was tested by the disc method on the Müeller-Hinton agar or chocolate agar according to NCCLS, activity of beta-lactamase was tested with nitrocephin. A total 2038 clinical strains--1869 aerobic and 169 anaerobic was well-defined and tested for susceptibility to ten antibiotics--amoxicilin, augmentin, ofloxacin, gentamycin, cefradin, erythromycin, cefuroxim, kotrimoxazol, cefalexin and cefaclor. Among the isolated aerobes Staphylococcus aureus (25.1%), E. coli (23.2%) and Haemophilus influenzae (14.0%) were most frequent, and in the group of anaerobes the most frequent were Bacteroides spp (40.8%) We have found 45.8% of all tested aerobic strains with beta-lactamase production, the highest proportion in pathogens isolated from respiratory tract--51.4%, 46.6% from urinary tract, and 48.4% from skin and soft tissues. Among the isolated anaerobic--68.8% of Bacteroides and 28.6% others produced beta-lactamase. Forty percentage of all strains were sensitive to amoxicilin, 70-90% of aerobic bacteria were sensitive to augmentin. Augmentin had a high activity against anaerobic bacteria too. Only a small proportion of the tested aerobic bacteria (12.2%) were resistant to ofloxacin, gentamycin showed a sufficient activity against tested strains (24.4% were resistant). The most frequent pathogen--Staphylococcus aureus was resistant to amoxicilin in 83.1% hospitalized patients, and in 73.9% in ambulatory patients.

Anti-Bacterial Agents↗
PubMed1996

[The clinical course of fungal urinary tract infection in neonates].

The authors present the clinical course of 8 cases of fungal infection of the urinary tract in newborns. Three of the investigated children were premature or with intrauterine hypotrophy, a congenital defect of the urinary tract was detected in one child. In 5 cases the fungal infection followed bacterial septicaemia. Two of the 8 children required peritoneal dialysis, another two required insertion of intravenous catheters for parenteral feeding, and four required bladder catheterisation. The diagnosis of fungal urinary tract infection was established on the basis of urine culture, the presence of specific serum anti-candida antibodies and results of ultrasonographic examination (vs). In 7 of 8 cases the possibility of fungal infection was suggested by US examination. Seven children were treated with fluconazole combined with 5-fluorocytosine, one was treated with fluconazole. Pyelostomy was performed, in two of the patients all of them received supportive treatment. Our clinical observations point to the necessity of prophylaxis in case of predisposing factors to fungal infection and the use of abdominal ultrasonography for detection of early stages of fungal urinary tract infection.

Antifungal Agents↗
PubMed1995

Identification of Serratia marcescens on the basis of polymerase chain reaction-amplified ribosomal DNA spacer polymorphisms.

The aim of the present study was to develop a method for identification of strains of Serratia marcescens that is also suitable for use in the epidemiologic studies. 40 clinical strains of Serratia marcescens were investigated by using the polymerase chain reaction (PCR). We used primers to amplify spacer regions between the 16S and 23S genes in the prokaryotic rDNA genetic loci. When the spacer amplification products were resolved by electrophoresis, the resulting patterns could be used to distinguish all of the strains tested into 3 groups (group A-35, group B-3 and group C-2 isolates). Digestion of PCR fragments of the group A strains with HinfI enzyme enabled separation of organisms into 3 distinct groups (A1-A3).

Base Sequence↗