Biomedical subjects

Barbara Burakowska

Publications and source records attributed to Barbara Burakowska.

7 recordsLinked to original sources

PubMed2004

[Value of spiral computed tomography in pulmonary hypertension].

UNLABELLED: Pulmonary hypertension (PH) represents an important diagnostic problem, because of its non-specific clinical presentation. AIMS OF THE STUDY: Estimation of sensitivity and specificity of spiral computed tomography (SCT) in diagnosis of PH. Estimation of the influence of the cause and character of PH on morphology of pulmonary arteries and right ventricle-pulmonary artery coupling. MATERIAL AND METHODS: 102 patients with clinical suspicion of acute pulmonary embolism (APE) or chronic PH (54F, av. age 51.3 +/- 17.3). Diameters of pulmonary arteries obtained in SCT, systolic pulmonary pressure calculated from the tricuspid gradient pressure, and indices of the right ventricle-pulmonary artery dynamical coupling (AcT) obtained from the echo-Doppler method were compared. RESULTS: Increased diameter (> 18 mm) of interlobar arteries was the most specific sign of PH (specificity 92%, sensitivity 45%). Diameter of proximal pulmonary arteries and pulmonary pressure was correlated in patients with APE (r = 0.487, p < 0.003), but not in those with chronic PH (r = 0.223). In a group of patients with pulmonary arterial hypertension (PAH), enlargement of proximal pulmonary arteries seemed to result in less disturbed right ventricle-pulmonary artery dynamic coupling. CONCLUSIONS: 1. SCT measurements of diameters of pulmonary arteries have relatively low sensitivity for PH, precluding its reliable exclusion. 2. The relationship between the pulmonary pressure and the diameters of pulmonary arteries was found in acute but not in chronic PH, in which right ventricle-pulmonary artery dynamical coupling seemed less disturbed when pulmonary arteries were markedly dilated.

Adolescent↗

PubMed2004

[Scimitar syndrome--case report].

Scimitar syndrome is a rare congenital anomaly. This syndrome is characterized by partial or complete anomalous pulmonary venous drainage of the right lung to the inferior vena cava. There is a characteristic abnormal radiographic shadow which descends along the right cardiac border (scimitar sign). We examined 71-year old woman with severe pulmonary hypertension due to a large shunt between pulmonary veins and right atrium. Other cause of pulmonary hypertension is atrial septum defect. Our patient required permanent pacemaker implantation for tachy-brady syndrome.

Aged↗

PubMed2004

[Diagnostic difficulties in primary mesothelioma].

A 54-year-old woman with a history of fatigue and shortness of breath was found to have a pericardial effusion and mild mediastinal lymphadenopathy. Video-assisted pericardioscopy revealed thickened pericardium studded with multiple nodules. Histologically the tumor was diagnosed as papillary adenocarcinoma. The site of the primary tumor could not be identified. As lung cancer is one of the most frequent causes of pericardial metastases the patient was treated with cisplatin and vinblastin. Following 5 courses of chemotherapy--given over a 4 month period--the amount of pericardial effusion and pericardial thickness did not change. The material from pericardial biopsy was reexamined and positive immunostaining for calretinine was found. The final diagnosis was primary pericardial mesothelioma of epithelioid type. Palliative radiotherapy of mediastinum was planned but the patient deteriorated and died due to disease progression with venous thrombosis and superior vena cava syndrome. The case illustrates the difficulties in establishing diagnosis of primary pericardial mesothelioma which is a rare tumor with poor prognosis.

Antineoplastic Agents↗

PubMed2003

[Purulent lung diseases necessitating surgical treatment--case reports].

Majority of purulent lung diseases are treated with antibiotics. But sometimes this therapy is not successful and surgical treatment is necessary. Two patients are described in this paper. 68 years old woman in whom infiltration in left lung enlarged during antibiotics therapy. CT examination did not allow to differentiate between abscessus and tumor. Results of bacteriologic and cytologic examination of transthoracic biopsy were negative. During thoracothomy abscessus was resected and diagnosis was confirmed by patomorphologic examination. The second case: 16-years old girl was addmitted to hospital because of high temperature and abnormal chest X-ray picture (infiltration and liquid level in lower right lobe). During puncture the pus was evacuated but bacteria were not cultured. Antibiotics were not effective. Thoracothomy was done and large cysta bronchogenes was resected. In both cases surgical treatment was effective.

Adolescent↗

PubMed2002

Disturbed right ventricular ejection pattern as a new Doppler echocardiographic sign of acute pulmonary embolism.

Transthoracic echocardiography (TTE) is frequently performed in patients with suspected acute pulmonary embolism (APE) to search for right ventricular (RV) pressure overload. We prospectively assessed the diagnostic value of a new Doppler echocardiographic sign of APE based on the disturbed RV ejection pattern ("60/60 sign") and compared its diagnostic performances with that of the presence of RV pressure overload, as well as with "McConnell sign" based on RV regional wall motion abnormalities. We assessed 100 consecutive patients with clinical suspicion of APE, including those with previous cardiorespiratory diseases. After TTE, all of the patients underwent reference diagnostic tests for APE. The 60/60 sign required RV acceleration time of <or=60 ms in presence of tricuspid insufficiency pressure gradient <or=60 mm Hg. APE was ultimately confirmed in 67 of 100 patients. In 17 of 67 patients, 60/60 sign correctly suggested APE, whereas 2 false-positive results were noted: in pulmonary fibrosis and in acute respiratory distress syndrome following lung resection. McConnell sign was fully specific but was noted in only 13 of 67 patients. Sensitivity and specificity were 81% and 45% for "RV-pressure overload" signs, 25% and 94% for 60/60 sign, and 19% and 100% for McConnell sign. When combined, the 2 latter signs were 94% specific and 36% sensitive in diagnosing APE. Thus, RV overload at echocardiography is not specific for APE. The 60/60 and McConnell signs are insensitive, but are reliable and helpful in bedside diagnosis of APE when direct visualization of the pulmonary arteries is impossible. Combining these 2 signs may increase the sensitivity without compromising the specificity of echocardiographic diagnosis of APE.

Acute Disease↗

PubMed2002

[Pulmonary embolism in course of deep vein thrombosis of lower extremities in patient wit bilateral femoral bone fracture after car accident injuries].

The incidence of deep vein thrombosis in Western World is estimated at about 1 case/1000/year and of pulmonary embolism at 0.5 case/1000/year. Mortality in untreated pulmonary embolism is 30%. With adequate treatment (anticoagulation) it can be decreased to 2-8%. Deep vein thrombosis and pulmonary embolism are frequent complications of various surgical procedures, especially of orthopedic interventions on hip joint. When surgery has to be performed in patient with high risk of pulmonary embolism, anticoagulant prophylaxis should be performed. Venous thromboembolic disease is the most important cause of mortality in trauma patients. We present a case of 46 years old man with bilateral fracture of femoral bone after car accident injury in whom signs of deep venous thrombosis and pulmonary embolism were observed despite the use of anticoagulant prophylaxis.

Accidents, Traffic↗

PubMed2002

[Organizing pneumonia--diagnostic and therapeutic problems].

Organizing pneumonia (OP) is a well histopathologically defined disease, which can be induced by many factors--infections, drugs, connective tissue diseases etc. In many cases a rapidly progressive course is observed with clinical picture of pneumonia. We report a case of organizing pneumonia with an acute onset and rapid deterioration in 58-year-old women. After unsuccessful treatment with antibiotics, prompt biopsy of the lung (videothoracoscopy) helped to establish the diagnosis. A rapid improvement after corticoid therapy was observed. Low dose corticoid treatment is continued. Patients remains well 20 months after onset of symptoms.

Anti-Inflammatory Agents↗