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Biomedical subjects

D Górecka

Publications and source records attributed to D Górecka.

At least 37 records · Page 2Linked to original sources
PubMed1997

Cardiac arrhythmias in chronic obstructive pulmonary disease.

Supraventricular and ventricular dysrhythmias, as well as conduction disturbances of varying severity are frequently observed in chronic obstructive pulmonary disease (COPD). The type of arrhythmia that occurs in patients with COPD is influenced by their clinical state. Co-existing coronary heart disease, severe blood gas abnormalities and medication may precipitate the rhythm disturbances. Particularly in patients with acute respiratory failure, the presence of arrhythmias is associated with poor prognosis. However, more studies are needed to assess the importance of cardiac arrhythmias in stable COPD patients and their value in predicting survival.

Arrhythmias, Cardiac↗
PubMed1996

Psychological status of COPD patients before and after one year of long-term oxygen therapy.

Cognitive function, psychological status, and attitudes were investigated in 90 patients with chronic obstructive pulmonary disease before the initiation of long-term oxygen therapy and after one year of treatment. Assessment included clinical interview, Wechsler Intelligence Scale I.Q., Bourdon-Wiersma Test, Benton Verbal Retention Test, Rey's Test of Remembering 15 Words, Beck's Depression Scale, Taylor's Manifest Anxiety Scale, and Tylka's Psychological Evaluation Scale of the Effectiveness of Rehabilitation. The mean I.Q. of the patients studied was slightly above average at 107 points. Tests of cognitive function showed reduced performance. These included tests of repeating numbers, pictorial anecdotes and numerical symbols. Rey's Test of Word Memory was also below average but increased following treatment. In the Bourdon Test, there were 58 correct deletions and 7 omissions initially, improving to 67 and 8, respectively, after treatment. Poor visual and spatial memory did not improve after treatment. Before treatment, patients demonstrated depressed mood, low self-esteem with narrow interests, signs of anxiety, mental stress and depression. After a year of long-term oxygen therapy significant improvements in mood and attitudes were demonstrated. We conclude that long-term oxygen therapy may be capable of producing a significant improvement in emotional status. However, the effects of oxygen treatment are difficult to separate from effects of other aspects of care in producing a sense of increased security and well-being.

Adult↗
PubMed1996

[Evaluation of prognostic factors and progress of disease in patients with COPD treated with long-term oxygen].

Long-term sequential evolution of pulmonary function, blood gas, body mass index (BMI) and oxygen breathing time was observed in 266 COPD patients with advanced airway obstruction (FEV1 = 0.80 L), and severe respiratory failure (PaO2 = 52 mmHg, PaCO2 = 49 mmHg) undergoing LTOT. There were significant differences between survivors and non-survivors at entry and during the treatment. Patients dying during LTOT had at entry lower BMI and more advanced airway limitation than survivors. They did not differ in blood gas values. During the follow-up (between 1-4 years) different trends in evolution of studied variables were observed in survivors (over 4 years on LTOT) and patients dying during LTOT (up to 4 years). Long term stabilization of spirometric and blood gas values as well as in mean oxygen breathing time (14 hours) were observed in survivors. In non-survivors a significant progression in airway limitation and respiratory failure coupled with better compliance with LTOT (oxygen use increased from 15 to 17 hours/ day) was observed especially in the last year before death. In survivors BMI increased significantly during the treatment, whereas in non-survivors no change was observed.

Blood Gas Analysis↗
PubMed1996

[Eight years of experience in Warsaw with domiciliary long term oxygen therapy].

Between August 1986-July 1994 45 1 patients with chronic hypoxaemia were referred to us for evaluation. 315 of them (70%) were qualified for LTOT according to national guidelines. There were 189 pts with COPD (60%), 40 with late sequelae of pulmonary tuberculosis (TB), 21 with interstitial pulmonary fibrosis (IPF), 15 with bronchiectasis (BE), 15 with severe kyphoscoliosis (KS) and 35 with other disease leading to chronic respiratory failure. All patients received oxygen from an oxygen concentrator and have been regularly followed-up. The best survival rate in patients followed up for at least 3 years was observed in KS (68%) and COPD pts (50%). The worst survival was seen in BE (9%) and IPF (21%). 183 pts died during the follow-up and in 3 pts (1%) LTOT was withdrawn. The most frequent cause of death were either acute (58%) or chronic (21%) cardiorespiratory failure.

Aged↗
PubMed1995

[Predictors of survival in patients with chronic obstructive pulmonary disease with moderate hypoxemia].

Long-term oxygen therapy (LTOT) is a well established method of treatment in patients with chronic obstructive pulmonary disease (COPD). There are two main qualification criteria for LTOT: severe hypoxaemia (PaO2 < 55 mmHg) and moderate hypoxemia (PaO2 > 55 mmHg) accompanied by signs of cor pulmonale. We were unable to find any controlled investigations on the effect of LTOT on survival in this group of patients. We studied 85 COPD patients with PaO2 between 56-65 mmHg. Fourty four patients were treated at theirs homes with LTOT, 41 formed a control group. Both groups presented with severe airway obstruction--FEV1 < 1L. All patients were followed up for at least 3 years. During this time 27 patients died from the LTOT group and 26 patients from the control group. Survivors were younger and had less severe airway obstruction than nonsurvivors. Cox's proportional hazard regression analysis showed that only age and spirometric parameters--VC, VC%N, FEV1 were good predictors of survival. LTOT did not improve prognosis in this group of patients. Results of our study suggest the need of verification of LTOT qualification criteria.

Aged↗
PubMed1995

[Effects of smoking tobacco on exercise tolerance in healthy subjects].

The aim of the study was to investigate the effects of smoking on exercise tolerance in middle aged smokers. Sixty two healthy subjects 55 males and 7 females with mean age 35 +/- 7 years were studied. There were 47 smokers (smoking 21.5 cigarettes per day for a mean of 16 years) and 15 non-smokers (control group). Resting pulmonary function was normal in both groups, however smokers had significantly lower VC as well as MEF 50 and MEF 75. A maximal incremental exercise on cycloergometer using ramp protocol was performed. Ventilatory parameters (breath by breath method) together with transcutaneous oxygen saturation (every minute), heart rate (continuously) and blood pressure (every minute) were recorded. Significant differences in exercise tolerance in studied groups were observed. Smokers tolerated a lower maximal workload for a shorter time and deferred significantly in both maximal oxygen consumption and oxygen consumption at anaerobic threshold. Five persons, all smokers did not reach the anaerobic threshold. In five smokers a decrease in ECG ST segment was observed. No differences were found in breathing reserve, heart reserve or maximal oxygen pulse. It seems that a decreases exercise performance is due to cardiac limitation.

Adult↗
PubMed1994

The adequacy of oxygenation in COPD patients undergoing long-term oxygen therapy assessed by pulse oximetry at home.

It is probable that some daily activities may cause marked falls in arterial oxygen saturation (SaO2) in patients undergoing long-term oxygen therapy (LTOT), despite good oxygenation at rest. We estimated the adequacy of LTOT in 34 randomly selected chronic obstructive pulmonary disease (COPD) patients at home by monitoring SaO2 continuously over 24 h. The subjects were also asked to complete a questionnaire listing frequent daily activities. Despite almost normal mean SaO2 (94%) at the beginning of recording (O2 2 l.min-1, at rest) the subjects studied spent 6.9 h below an SaO2 of 90%, with minimum SaO2 of 61%. On average we observed 10 episodes of desaturation in each patient over 24 h, both while breathing air and oxygen. The comparison of SaO2 recordings and questionnaires revealed the highest number of desaturations during sleep, followed by naps, watching the television, eating, washing and talking. The oxygen flow rate prescribed, based on blood gas measurements at rest, did not protect 85% of the patients studied from deep falls in SaO2 during daily life. An increase oxygen flow during some activities and during sleep is suggested.

Activities of Daily Living↗
PubMed1993

The influence of cigarette smoking on sister chromatid exchange frequencies in peripheral lymphocytes among nurses handling cytostatic drugs.

Genotoxic compounds and various cancer chemotherapeutic agents can interact with tobacco smoke synergistically, especially among cigarette smoking nurses handling cytostatic drugs. The aim of the study was to examine the hypothesis that tobacco smoking has a greater influence on sister chromatid exchange (SCE) frequencies among nurses than the influence of cytostatics in working conditions. The frequencies of SCE in lymphocytes investigated among hospital staff who handle anti-cancer drugs were higher than in a control group which did not handle them (smokers and non-smokers). The increase of SCE frequencies was observed more often among cigarette smoking nurses and less among non-smoking nurses who handle cytostatics 3 times a week.

Antineoplastic Agents↗
PubMed1992

Acute effect of oxygen on pulmonary arterial pressure does not predict survival on long-term oxygen therapy in patients with chronic obstructive pulmonary disease.

The growing number of patients treated with long-term oxygen therapy (LTOT) poses the question which physiologic variables could predict the patients who may benefit the most from this cumbersome and expensive treatment. We wanted to verify if the acute effect of oxygen on pulmonary arterial pressure (PAP) is related to survival on LTOT as was suggested recently in the literature. We studied 46 chronic obstructive pulmonary disease (COPD) patients qualified for LTOT. The acute effects of O2 on pulmonary hemodynamics were assessed by pressure and flow measurements before and after 30 min of O2 breathing via 28% Ventimask. Thirty-nine patients reacted with a fall of the mean PAP of less than 0.7 kPa 5 (mm Hg). These were termed nonresponders (NR). In seven patients, mean PAP fell greater than or equal to 0.7 kPa 5 (mm Hg). They were called responders (R). After the initial investigations, patients were followed up on LTOT for 2 yr or until death. During the first year, four patients died; three from the NR and one from the R group. After 2 yr of LTOT, 15 patients died (12 from NR and 3 from R groups). The 2-yr survival rate was 69% in NR and 57% in R groups, respectively. We conclude that survival on LTOT is not related to the acute effect of oxygen on the PAP in COPD patients investigated in the steady-state period of the disease.

Female↗
PubMed1992

[Natural history of pulmonary hypertension in chronic obstructive lung diseases and the usefulness of the simple noninvasive methods of its diagnosis].

In 47 patients with chronic obstructive pulmonary disease and 19 patients with idiopathic pulmonary fibrosis pulmonary haemodynamics were studied. Pulmonary arterial pressure was compared with non-invasive lung function tests, ecg and the chest X-ray. Correlations between pulmonary arterial pressure and some of those parameters were found. Investigations were repeated after 3 or 5 years depending on severity of pulmonary hypertension initially found. The progression of pulmonary hypertension was found. It was accompanied by intensification of non-invasive indices of pulmonary hypertension. More than half of patients with initially severe pulmonary hypertension (> or = 30 mmg Hg) did not survive 3 years.

Adult↗
PubMed1992

[Quality and results of year-long home oxygen therapy in Poland].

Accuracy of qualification to LTOT and the results of one year of treatment were assessed in 12 regional centres in Poland. 390 patients with advances respiratory failure entered the study. There were 305 patients with COPD and 85 patients with other chronic lung diseases. The accuracy of qualification to LTOT in Poland is satisfactory--2/3 of patients were accepted to treatment with severe hypoxaemia (PaO2 55 mm Hg), the remainder with moderate hypoxaemia (PaO2 = 56-65 mm Hg) and signs of tissue hypoxia. After one year of treatment 6.5% of patients did not need LTOT and 13% stopped to fulfill the single entry criterion still needing treatment.

Adult↗
PubMed1992

[Effect of short-term home oxygen therapy on pulmonary artery pressure does not predict the survival of patients with chronic obstructive lung disease].

We wanted to verify if the acute effect of oxygen on pulmonary arterial pressure (PPA) is related to survival on LTOT as was suggested recently in the literature. We studied 46 COPD patients qualified for LTOT. The acute effects of O2 on pulmonary haemodynamics were assessed by pressure and flow measurements before and after 30 mins of O2 breathing via 28% Ventimask. Thirty nine patients reacted with a fall of the mean PPA of less than 5 mm Hg. These were termed nonresponders (NR). In seven patients mean PPA fell > 5 mm Hg. They were called responders (R). After the initial investigations patients were followed up on LTOT for 2 years or until death. During two years of LTOT 15 patients died (12 from NR and 3 from R groups). The first two years survival rate was 69% in NR and 57% in R groups respectively. We conclude that survival on LTOT is not related to the acute effect of oxygen on the pulmonary arterial pressure in COPD patients investigated in the steady-state period of the disease.

Adult↗
PubMed1992

[Effect of tobacco smoking on pulmonary function in employees of the Institute of Tuberculosis and Lung diseases in Warsaw].

The effects of smoking habit on pulmonary function was studied prospectively (from 1987 to 1991) in a group of the staff in the Institute of Tuberculosis and Lung Diseases in Warsaw. The prevalence of smoking was the lowest among physicians (42% in 1987 and 24% in 1991). Nurses smoked more--51% in 1987 and 41% in 1991. A positive trend in quiting smoking was noted especially among physicians, nurses and technicians. Pulmonary function test were normal in all studied groups. The most pronounced decreases in lung function were noted in smokers.

Adult↗
PubMed1992

[Cough-syncope syndrome in tracheobronchomalacia].

A 40-year-old man, referred for treatment of syncope due to cough, was found to have generalized tracheobronchomalacia. The diagnosis was based on an abnormal collapsibility of the trachea and bronchi on bronchoscopic examination. The detailed investigations confirmed the diagnosis of cough-syncope syndrome due to tracheobronchomalacia. Based on this case the causes, symptoms and possible treatment of those clinical entities are discussed.

Adult↗
PubMed1992

Adherence to entry criteria and one year experience of long-term oxygen therapy in Poland.

The adherence to entry criteria and results of one year long-term oxygen therapy (LTOT) in Poland were analysed. Four hundred and seven patients with advanced respiratory failure due to chronic lung diseases qualified for LTOT were observed for one year in 12 regional LTOT centres. There were 315 patients with chronic obstructive pulmonary disease (COPD) and 92 with other chronic lung diseases. In 270 patients the prescription of oxygen was based on the single criterion of stable arterial oxygen tension (PaO2) less than or equal to 55 mmHg (7.3 kPa); and in the remaining 137 with less severe stable hypoxaemia (PaO2 56-65 mmHg) (7.4-8.6 kPa), on concomitant signs of cor pulmonale and/or of tissue hypoxia. Of 407 patients who started LTOT, 95 (23%) died during the first year of treatment. The mortality rate was 21% for COPD patients and 33% for patients with other lung diseases. After one year of LTOT 312 patients survived: 250 COPD patients and 62 with other lung diseases. Of these, 19 COPD patients (8%) and 9 with other chronic lung disease (15%) who had PaO2 less than or equal to 55 mmHg (7.3 kPa) when oxygen was prescribed, presented with PaO2 greater than 55 mmHg (7.3 kPa). From the 137 patients (106 with COPD and 31 with other lung diseases) who qualified with less severe hypoxaemia, 10 COPD patients (10%) and 5 (16%) with other lung disease had PaO2 greater than 65 mmHg (8.6 kPa).(ABSTRACT TRUNCATED AT 250 WORDS)

Eligibility Determination↗
PubMed1991

[Smoking habits, knowledge and attitude of pulmonologists concerning problems of smoking in Poland].

An analysis was carried out on 850 self-report questionnaires sent to Polish pulmonologists on their knowledge and attitude toward smoking. In the sampled population 38% of the males and 29% of females smoked. Smoking was dated as first among various noxious factors in human pathology. The knowledge of harmful effect of smoking was restricted to the cardio-respiratory system. Part of the responders, mainly smokers believe that smoking less than 15 cigarettes is harmless. ++Ex-smokers were most active in smoking cessation programs. Knowledge of harmful effect of smoking and cessation programs by physicians is unsatisfactory and teaching programs concerning this problem is mandatory.

Adult↗