Biomedical subjects

Andrzej Stankiewicz

Publications and source records attributed to Andrzej Stankiewicz.

At least 19 recordsLinked to original sources

PubMed2006

[Early intubation of lacrimal duct in traumatic and operative lower eyelid loss and medial canthal region defects, with simultaneous reconstruction dressed by application of self constructed battlefield ophthalmic dressing].

The treatment of acquired, imperfect drainage of tears through the lacrimal duct system in the situation of medial canthal region defect (operative or traumatic), is an important part of clinical ophthalmology and reconstructive surgery. The multidisciplinary approach to the reconstruction of all soft tissues with use of early prosthetic reconstruction and lower canalicular intubation by use of silicone tube or simple nylon thread, is the theme of the paper. The lacrimal duct repair should be performed on primarily, as well as coverage or reconstruction of skin defect. The authors compared the efficiency of simple lower canalicular intubation with use of normal surgical thread or silicone tube, with immediate medial canthal region defect plastic reconstruction. Simultaneously, the original self-constructed special battlefield ocular dressing was tested in the analyzed cases, to determine whether it is the suitable or not, in the procedure. The results were estimated on the base of clinical criteria: degree of epiphora after 6/12 weeks (subjective and evaluated accordingly to Munk score), early lacrimal obstruction/stenosis, comfort/discomfort of patient, and utility of the military dressing (bad/good/very good). The proposed own method of simple use of nylon thread seems to be useful, particularly in traumatic damage of lower canaliculus associated with multilayer medial canthus soft tissues defects and facial bone structures impairment. In analyzed material, it was more comfortable for patients than silicone intubation and may be utilize in definitive reconstruction, as well as in temporary splinting of lacrimal system and creation of artificial lacrimal drainage through the lower canaliculus. It is useful at the battlefield conditions. The battlefield ocular dressing tested on was very high evaluated in traumatic cases and considered as good in neoplastic patients.

Adult↗

PubMed2006

[Multifocal intraocular lenses].

Multifocal intraocular lenses are the new option not only in cataract surgery, but either in refractive surgery. Use of multifocal lenses make patients less dependent on spectacle, than after implantation of monofocal intraocular lenses. In this article we present an actual review of multifocal intraocular lenses. Two main types of the implants: refractive and diffractive are described with their detailed characteristics. Special attention we paid on advantages and disadvantages as well as some limits to implantation of the multifocal implants.

Accommodation, Ocular↗

PubMed2005

Comparison of pioglitazone and gliclazide in sustaining glycemic control over 2 years in patients with type 2 diabetes.

OBJECTIVE: The hypothesis that pioglitazone treatment is superior to gliclazide treatment in sustaining glycemic control for up to 2 years in patients with type 2 diabetes was tested. RESEARCH DESIGN AND METHODS: This was a randomized, multicenter, double-blind, double-dummy, parallel-group, 2-year study. Approximately 600 patients from 98 centers participated. Eligible patients had completed a previous 12-month study and consented to continue treatment for a further year. To avoid selection bias, all patients from all centers were included in the primary analysis (a comparison of the time-to-failure distributions of the two groups by using a log-rank test) regardless of whether they continued treatment for a 2nd year. By using repeated-measures ANOVA, time course of least square means of HbA(1c) and homeostasis model of assessment (HOMA) indexes (HOMA-%S and HOMA-%B) were analyzed. RESULTS: A greater proportion of patients treated with pioglitazone maintained HbA(1c) <8% over the 2-year period than those treated with gliclazide. A difference between the Kaplan-Meier curves was apparent as early as week 32 and widened at each time point thereafter, becoming statistically significant from week 52 onward. At week 104, 129 (47.8%) of 270 pioglitazone-treated patients and 110 (37.0%) of 297 gliclazide-treated patients maintained HbA(1c) <8%. Compared with gliclazide treatment, pioglitazone treatment produced a larger decrease in HbA(1c), a larger increase in HOMA-%S, and a smaller increase in HOMA-%B during the 2nd year of treatment. CONCLUSIONS: Pioglitazone is superior to gliclazide in sustaining glycemic control in patients with type 2 diabetes during the 2nd year of treatment.

Blood Glucose↗

PubMed2005

[Clinical indications for enucleation in the material of Department of Ophthalmology, Medical Academy in Białystok in the years 1982-2002].

PURPOSE: To evaluate the current clinical indications for enucleation in the material of Department of Ophthalmology, Medical Academy in Białystok. MATERIAL AND METHODS: We retrospectively reviewed all enucleations performed between the years 1982 and 2002. Into analysis were included 367 patients (226 males and 141 females) at the age from 18 to 94 years. They were divided into seven groups according to the causes leading to enucleation: trauma, intraocular tumor, glaucoma, phthisis bulbi, endophthalmitis, complications of ocular surgery and corneal diseases. RESULTS: In our series trauma was the most frequent cause of enucleation (36%), followed by malignant tumor (20.7%), glaucoma (19.6%), phthisis bulbi (9%) and endophthalmitis (8.1%). The majority of intraocular tumors with histological confirmation were melanomas (92.1%). There were significantly more enucleation for trauma in males (p < 0.0001). Patients aged less than 30 years constituted 83.8% of all enucleations for trauma. The total number of eye removals decreased significantly (p < 0.005) over seven-year periods from 149 in 1982-1988, 121 in 1989-1995 to 97 in 1996-2002. CONCLUSIONS: Improved new diagnostic and therapeutic methods, widespread use of photocoagulation in vascular disorders and methods of vitreoretinal surgery in traumas, effective antimicrobial treatment have contributed to the decreasing frequency of enucleation.

Adult↗

PubMed2005

[Immediate vitrectomy as a method of choice in the treatment of endophthalmitis].

This study is evaluation of the results of surgical treatment in case of postoperative endophthalmitis. The results of 16 pars plana vitrectomies in 16 patients with clinical evidences of postoperative endophthalmitis were analyzed. Successful management of postoperative endophthalmitis depends on timely diagnosis and institution of appropriate therapy.

Aged↗

PubMed2005

[Therapy of the wet form of age-related macular disease: the present state and perspectives].

Age-related macular disease (ARMD) is affecting the central part of the retina. ARMD has two major forms: the dry type and the wet type. Although wet type comprises only 15% of ARMD, it is responsible for 90% of severe visual impairment in all ARMD cases. The problem is effective treatment of ARMD, above all its wet type. Laser therapy, retina surgery, TTT and local radiotherapy did not give expected results. The aim of this article is to present modern trends of wet type ARMD therapy, including pharmacotherapy and photodynamic therapy (PDT) in relation to pathobiology of choroidal neovascularization (CNV). The goals of pharmacotherapy were discussed in support, that choroidal neovascularization is a dynamic evolution, which includes initiation, active inflammation and non active involution. Cellular mechanisms of photodynamic therapy were presented. It is necessary to accentuate that in the future it can be a combination between PDT and pharmacotherapy, which inhibits early stage mediators of all types CNV and limits inflammation attendant CNV. These therapeutic approaches ere more likely succeed and included wide spectrum of wet ARMD pathogenesis. The clinical studies show that may be soon we will treat wet form of ARMD using angiostatic steroids, anti-VEGF monoclonal antibodies and anti-VEGF aptamers.

Choroidal Neovascularization↗

PubMed2004

[Premises and preoperative causes of posterior capsule rupture during cataract surgery].

PURPOSE: Retrospective analyze of dependence between intra-operative lens posterior capsule rupture during cataract removal surgery and local and general patient condition. MATERIALS AND METHODS: 2092 cataract operations was performed in 1998-2001. 97 patients has a posterior capsule rupture. In 1029 phacoemulsifications were 48 capsule posterior ruptures and 49 in extracapsularies cataract removals. CONCLUSIONS: Local changes, like grade of cataract maturity, PEX syndrome, inflammations and structural changes of vitreous body has a crucial influence on the operation process. Age of patient, metabolic abnormalities, diabetes, hypertension and collagen diseases are general causes of lens capsule posterior rupture.

Adult↗

PubMed2004

[Monitoring of blood pressure during phacotrabeculectomy].

PURPOSE: To evaluate systolic and diastolic blood pressure during phacotrabeculectomy performed under regional anaesthesia with retrobulbar block and intravenous analgosedation with midazolam and fentanyl. MATERIAL AND METHODS: 68 patients were involved into the study: I Group: 37 patients with chronic cardiovascular and metabolic diseases: 22 women and 15 men (45 operations), mean aged 72.02 years, mean weight 73.4 kg, II Group: 31 patients without additional diseases: 20 women and 11 men (44 operations), mean aged 70 years, mean weight 68.9 kg. Systolic and diastolic arterial blood pressure was recorded at 5-minute intervals throughout the intraoperative period and anesthetist intervened medically when necessary. RESULTS: In I Group statistically significant mean systolic BP decrease was observed in 5 and 20 minutes after injection of midazolam and fentanyl and mean diastolic BP decrease was observed in 5 and 15 minutes after analgosedation. In II Group statistically significant mean systolic BP decrease was noted in 5 minutes and mean diastolic BP decrease in 5 and 35 minutes. During phacotrabeculectomy mean systolic and diastolic BP was statistically higher in I group. In I group 12 patients and in II group 4 patients required additional antihypertensive drug. CONCLUSIONS: Regional anaesthesia with retrobulbar block and intravenous analgosedation provides hemodynamic stability. Patients with cardiovascular and metabolic diseases required acute observation during phacotrabeculectomy.

Aged↗

PubMed2004

[Diagnostic problems of unilateral exophthalmos--case report].

This paper presents a case of a 54-year-old patient with unilateral exophthalmos. During the hospitalization basic laboratory investigations, USG, skull X-ray film, NMR of orbits were carried out. The patient was treated with systemic corticosteroids with good response. Inflammatory infiltration and venous stasis are considered to be the cause of exophthalmos. Granulomatous orbital inflammation was detected. The etiology of nonspecific orbital inflammation remains still unknown.

Exophthalmos↗

PubMed2004

[Theoretical and clinical aspects of the use of prostaglandins in glaucoma therapy].

In the first part of the article the main information and recent research on the uveoscleral outflow pathway, including its morphology and physiology were presented. The structure of extracellular matrix of ciliary muscle and the changes of it, that are induced by prostaglandins, resulting in decreasing intraocular pressure were emphasized. In the second part biochemical characteristics of prostaglandin analogues, using nowadays were presented. Their efficacy in reducing intraocular pressure and safety profile were described.

Amides↗

PubMed2004

[A multicentre, observative, non-invasive study of the tolerance of NYOLOL gel 0,1% in ocular hypertensive patients].

PURPOSE: To evaluate the safety and efficacy of Nyolol Gel 0,1%/Novartis vs. regular timolol formulation (Ofterisin 0,5%) in ocular hypertensive patients. MATERIAL AND METHODS: A comparative, multicentred non-invasive, 16-weeks study. 192 glaucoma or ocular hypertensive patients were randomized into 2 groups: patients receiving regular timolol treatment (group I) and patients treated with timolol gel formulation. After 8 weeks of assigned treatment subjects from group I were switched to Nyolol gel and the subjects from group B - to regular timolol respectively. Intraocular pressure (IOP), objective and subjective tolerance of treatment were evaluated. RESULTS: There were no differences between groups as far as level of IOP was concerned. The incidence of ocular adverse events was higher when patients were switched to timolol aqueous eye drops. Subjective local tolerance of timolol gel formulation was better than conventional eye drops. CONCLUSIONS: Timolol 0,1% gel formulation with a once daily application provides an IOP reduction equivalent to timolol 0,5% solution given twice a day. Local tolerability and safety of gel formulation is better than aqueous solution, both in the patient's and physician's opinions.

Adrenergic beta-Antagonists↗

PubMed2003

[The eye as an effector of allergic reaction].

In this work the symptoms of allergic diseases of the eye were shortly described. The role of mast cells, eosinophils and lymphocytes taking part in allergic reaction was presented. The cellular mechanisms which lead to symptoms of allergic diseases of the eye were discussed. Histopathological changes in the eye tissues and their clinical importance were taken into consideration. The analysis of allergic symptoms of the eye on the basis of the knowledge of pathophysiological processes gives important information both for ophthalmologists and allergologists.

Cytokines↗

PubMed2003

[Influence of topically applied iodides on urinary iodine excretion and thyroid function].

PURPOSE: The present study was undertaken, to evaluate whether ophthalmic drug, containing iodine applied to conjunctival sac might result in a significant increase of urine iodine excretion and thus might be indirectly associated with the risk of iodine-induced hyperthyroidism. The aim of the study was to examine the occurrence of biochemically relevant changes in urine iodine excretion and in thyroid function after topical administration of ophthalmic drug containing iodine. MATERIAL AND METHODS: In the study twenty-two patients without a history of thyroid disease were examined. The Vitreolent (Ciba Vision) was applied topically to conjunctival sac four times a day for one month. The urinary iodine excretion, using "Rapid Urinary Iodine Test" (Merck KgaA) and parameters of thyroid function (TSH, FT3, FT4) were measured before starting and after therapy. RESULTS: The data showed, that was a significant increase in urinary iodine excretion at the end of therapy; as far as thyroid function was concerned, neither changes in level of TSH nor thyroid hormones were observed.

Administration, Topical↗

PubMed2003

[The influence of spontaneous posterior vitreous detachment in resolution of diabetic macular edema in NIDDM].

PURPOSE: To establish the influence of posterior vitreous detachment on development and resolution of diabetic macular edema in NIDDM. To asses the posterior vitreous detachment role in argon laser treatment of diabetic macular edema. MATERIAL AND METHODS: Retrospective study. RESULTS: 68 eyes of 36 patients were involved into the study, 52 eyes (76.5%) with macular edema and 16 eyes (23.5%) without macular edema. Posterior vitreous detachment (PVD) was present in 62.5% of cases without macular edema, and only 30.77% of cases had macular edema. Laser treatment applied in accordance to general standards cased resolution of macular edema in all cases with posterior vitreous detachment. In group with no spontaneous posterior vitreous detachment, macular edema resolved only in 19.23% of cases. CONCLUSIONS: Diabetic macular edema is less common in eyes with spontaneous posterior vitreous detachment. This observation shows, that not only vascular factor but also vitreo-macular tractions are responsible for macular pathology in diabetic macular edema. The efficacy of standard argon laser treatment depends also on vitreo-macular relation--presence of PVD, and is more sufficient in eyes with posterior vitreous detachment.

Aged↗

PubMed2003

[Genetic instability in human malignant uveal melanomas].

PURPOSE: The aim of the study was evaluation of genetic changes: loss of heterozygosity (LOH) and microsatellite instability (MSI) in the genome of cells of the uveal melanoma. MATERIAL AND METHODS: The incidence of MSI and LOH in cells of uveal melanomas was examined in tissue specimens obtained at surgical resection of the tumour in 14 patients. The results were related to respective MSI and LOH incidence in the genome of peripheral blood cells of the same patients. DNA was isolated with organic extraction. The fluorescent multiplex polymerase chain reaction (PCR) was used to amplify microsatellite loci included in commercially available human identification kits. Phenotyping was performed with the use of ABI Prism 310 Genetic Analyzer. RESULTS: MSI and LOH was found in 6 of 14 cases of uveal melanoma, manifested at one or more loci. MSI was present in chromosomes 3, 11 and 16. LOH was detected in chromosomes: 2, 3, 8, 13, 16 and 19. Genetic instability of the LOH/MSI type was detected in 3 patients with long anamnesis and large tumor infiltrating retrobulbar structures (pT4 feature). Two patients died within a year because of generalized cancer disease. CONCLUSIONS: 1 Loss of heterozygosity and microsatellite instability is present in uveal melanomas. 2. Genetic instability of LOH/MSI type associates with advanced size of tumour and progression of neoplastic disease.

Adult↗

PubMed2003

[Clinical efficacy of ciprofloxacin 0.3%9 (Ciloxan) in the treatment of bacterial infections of the external eye segment].

PURPOSE: The main subject of the study was to evaluate efficacy of ciprofloxacin 0.3% ophthalmic solution (Ciloxan) in the treatment of bacterial conjunctivitis and surgical prophylaxis. Safety and comfort of topical ciprofloxacin treatment was also examined. MATERIAL AND METHODS: Two study arms: 99 patients with bacterial conjunctivitis (A group) and 48 patients awaiting cataract surgery (B group--total 147 subjects in both groups) received ciprofloxacin 0.3% ophthalmic solution (Ciloxan) 4 doses a day for seven days. Bacteriological evaluation was established before and after treatment for each eye. RESULTS: 95 out of the 99 patients (96%) in the first arm were completely cured (all signs and symptoms of the bacterial conjunctivitis were eliminated). In the second arm complete eradication of bacterial flora was achieved in 46 out of 48 pretreated patients (96%). CONCLUSIONS: Topical ciprofloxacin 0.3% (iloxan) was found very effective and fast in reduction of typical signs and symptoms of bacterial conjunctivitis as well as in eradication of bacterial flora before surgery treatment.

Adolescent↗

PubMed2003

[Vitrectomy in diabetic macular edema].

Macular edema remains one of the important therapeutic issues. Vitero-macular tractions are said, to be the cause of persistent, non responding to laser treatment diabetic macular edema. Surgical removal of these tractions is used in treatment of non resolving macular edema. However, vitrectomy in treatment of diabetic macular edema remains the experimental, method requiring further studying.

Diabetic Retinopathy↗

PubMed2003

[Formation of congenital anomalies of the optic disc. Part II. Congenital anomalies of the optic disc with inappropriate disc size].

Embryological conditions, each of fifth congenital anomalies of the optic disc from the group of anomalies of inappropriate optic diameter was described. Few available epidemiological data were given. The influence of medications, drugs, intoxications, as well as premature birth on genesis of congenital anomalies was taken into consideration. Malformation of central nervous system was introduced together with clinical syndromes related to congenital anomalies of the optic disc indicating the genetic condition.

Coloboma↗