Extrication challenges. 10 tips for EMS crews working at extrication scenes. EMS on scene.
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Biomedical subjects
Publications and source records attributed to J Czajkowski.
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Current opinions concerning the value of trabeculectomy performed in adults and children are presented and compared with author's own experiences. The probability of intra- and postoperative complications especially hypotonia and malignant glaucoma, are discussed.
Four hepatitis C virus transmission chains at three dialysis units were disclosed by limited sequencing; three of these were disclosed by analysis of the NS5-B region of the genome. Dialysis on the same shift as that during which infected patients were dialyzed was the common factor for seven patients in two chains. Two nurses exposed to needle sticks and their sources of infection constituted two other chains. The strains of three chains belonged to subtype 1a and formed clusters with an intrachain variability of 0 to 6 nucleotides compared to 8 to 37 nucleotides for unrelated strains within this subtype. The clusters were supported by bootstrap values ranging from 89 to 100%.
The author presents history of development of views on glaucoma diagnostics and therapy. A special attention is paid to the role of Polish ophthalmologists.
PURPOSE: The purpose of the paper is to present the possibility of treatment of periorbital capillary hemangiomas in infancy. MATERIALS AND METHODS: Doppler colour ultrasonography was used as a method of diagnosis and monitoring of the treatment. The material comprised 11 patients aged from 1 month to 3 years. In 6 cases local corticosteroid injections were applied, in 3 cases surgical treatment was performed, out of which 1 additionally received steroid. RESULTS: Results of the treatment were satisfactory in all patients. No serious complications were observed. CONCLUSIONS: Basing on these cases, the authors confirmed the opinion that intralesional corticosteroid injection is the method of choice in the treatment of periorbital infantile hemangiomas. The authors indicate the usefulness of Doppler colour ultrasonography in diagnosis, demonstrating the extent of lesions and monitoring the response to therapy.
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PURPOSE: The lesions are difficult to visualize in image diagnostics. The paper aims at describing abilities of ultrasonography in the assessment of varices of the orbit. MATERIAL AND METHODS: The results of color Doppler examinations in 12 patients with moderate proptosis, in whom the presence of varices was suspected, are presented. RESULTS: The method allowed for identification and evaluation of the flow in the orbital region. The typical appearance of orbital varices and changes of the flow during the Valsalva's manoeuvre are described. CONCLUSIONS: The authors indicate a high usefulness of the method in the assessment of the orbital varices.
PURPOSE: To analyse the etiologic factors of the congenital cataract. METHODS: The authors analyzed 49 cases of congenital cataract in patients hospitalized at Polish Mother's Memorial Hospital in Lódź. The diagnostic procedures were based on own multiprofile algorithm which included natural history, complete ophthalmologic examination, metabolic, cytogenetic and serologic investigation. RESULTS: Four groups of patients were established depending on the nature of the etiologic factors: metabolic, familial and/or genetic, environmental and unknown. CONCLUSION: Etiology of more than one half of the analyzed patients was found and specific treatment was possible in some cases.
The paper presents results concerning serum creatine kinase (CPK) activity before and at different times following the surgery of extraocular muscles at concomitant strabismus. The operation evokes statistically significant increase of CPK activity which tends to normalize during healing processes.
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The finding that active cytomegalovirus (CMV) infection is associated with an increased mortality after organ transplantation and the introduction of successful antiviral treatment render more urgent the development of rapid and accurate diagnostic methods. Rapid immunodiagnosis of active CMV infection was investigated by means of immunofluorescence staining of leucocytes by monoclonal antibodies. Monoclonals directed against the matrix protein, pp65, and ClonabR monoclonal antibody, which has been claimed to be directed against immediate early antigens, were used. All monoclonal antibodies directed against the matrix protein reacted equally well in staining of polymorphonuclear cells. Monoclonals described by Gerna et al. [1991] and by Pereira et al. [1982] also reacted more clearly with mononuclear cells. One hundred fifty heparinized blood samples were collected monthly from 82 patients within 3 months after transplantation. In addition, 132 EDTA blood samples were tested in connection with suspected CMV infection. The latter approach gave a better agreement between antigen detection and virus isolation. There was a relationship between active CMV infection and the finding of antigen-positive leucocytes (P = 0.002, Fisher's exact test) found within 1 month of one another. When the number of antigen-positive cells was taken into account, a relationship to severe CMV disease was detected (P < 0.001, Fisher's exact test). The antigen test was positive at an early stage during the development of severe CMV disease. This rapid method is useful for following the disease process of CMV and in determining when to initiate antiviral treatment.
To assess the role of maternal viraemia in vertical transmission of HIV and the extent to which viraemia occurs during the various stages of pregnancy, we have attempted to detect human immunodeficiency virus (HIV) in 44 pregnant HIV-1 infected women during 47 pregnancies (30 continued, 17 aborted) and in 30 children and 12 fetuses. Infectious HIV was detected at some time during pregnancy in 59% of women from plasma and in 83% from either peripheral blood mononuclear cells or plasma. HIV was not isolated from any of the newborn babies (0/27) at birth. The mothers had a significantly higher frequency of viraemia during pregnancy than their children had by 6 months of age (p = 0.002); by this time HIV was recovered from 5 (26%) of 19 infants. HIV was not detected by virus isolation, in-situ hybridisation, or polymerase chain reaction (PCR) in 10 fetuses; the other 2 fetuses were positive either by in-situ hybridisation or by PCR but neither result could be confirmed in a second organ or by the other methods of detection. The findings show that there is no consistent spread of HIV across the placenta during maternal viraemia, and indicate that in most cases transmission occurs close to or at delivery.
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Prospective study of workers exposed to simultaneous action of petroleum derivatives and psychic stress proved statistically remarkable differences between the first study and control study (after two years) as related to macular degeneration and opacification of the lens. So far, the results do not seem to point to these phenomena as related to the differences of age and training period between the two groups. For the ultimate assessment of the effect of simultaneous intoxication with petroleum derivatives and psychic stress, it is necessary to confront the results of the study with those obtained after examining the control group including persons of the same age.
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The antibody response in 20 homosexual men with symptomatic primary HIV infection was studied with ten different antibody assays (enzyme-linked immunosorbent assays, indirect immunofluorescence assays, radioimmunoprecipitation [RIPA], and western blot). HIV antibodies were detectable by all the assays within 2 months after onset of illness. RIPA and western blot were more sensitive than the other assays--all serum samples obtained at 2 weeks and after were reactive. In all cases, the first serum sample reactive by RIPA precipitated gp160 whereas, by western blot, antibodies to p24 were first recognised. This study shows the necessity of including gp160 and p24 in any assay to detect early antibody response in primary HIV infection. 5 patients were studied by virus isolation. During the 2 first weeks after onset of symptoms, HIV was demonstrated in cell-free plasma in all cases and, in 4 cases, also in peripheral blood mononuclear cells. Samples obtained later contained demonstrable infectious virus in only 1 of 4 cases. Thus a phase of viraemia precedes the antibody response in symptomatic primary HIV infection.