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Biomedical subjects

J Lipiński

Publications and source records attributed to J Lipiński.

At least 19 recordsLinked to original sources
PubMed2000

Correlation between plasma carnitine, muscle carnitine and glycogen levels in maintenance hemodialysis patients.

Chronic hemodialysis (HD) may lead to losses of carnitine from plasma and muscle. Plasma carnitine does not reflect the body content of carnitine. The purpose of this study was the evaluation of total and free plasma and muscle carnitine concentrations (TPC, FPC, TMC, FMC), muscle glycogen and the relationship between plasma and tissue carnitine content and the basic indices of lipid metabolism in HD patients. The studies were conducted in two groups: the first one consisted of 37 HD patients (19 F, 18 M), the second one served as the control and was composed of 29 (10 F, 19 M) patients with healthy kidneys. Tissue specimens in HD patients were taken during surgery on arterio-venous fistula from brachioradial muscle. Carnitine and glycogen measurements were performed using enzymatic methods according to Cederblad and Huijng respectively. Total cholesterol (CH), HDL-CH, and triglycerides were assayed by enzymatic commercial test system (Boehringer-Mannheim, Germany). To summarise, we found the following phenomena in our HD patients in comparison with the controls: 1) In plasma: similar TPC but decreased FPC levels and FPC/TPC ratio which may suggest free carnitine deficiency. 2) In muscle: significantly lower TMC and FMC levels but normal FMC/ITMC ratio. 3) Negative correlation between TMC and FMC levels and duration of dialysis treatment. 4) No correlation between plasma and muscle camitine concentration. 5) Significantly higher concentration of muscle glycogen which could be explained by the changes in the structure of muscle fibres in HD patients and/or lower physical activity. 6) A positive correlation between FPC/APC or FPC/TPC ratio and HDL-CH in HD patients which may suggest that an appropriate proportion between free and acylcarnitines may influence HDL-CH levels in that population.

Adult↗
PubMed2000

Modern approach to management of patients following major trauma.

Trauma remains one of the three main causes of death all over the world. In Poland severe trauma is also an important public health problem which should be fully recognised in the changing system of our health service. There is a growing understanding and interest in the integration of pre-hospital, in-hospital and rehabilitation services taking part in the management of trauma patients. The importance of emergency medicine departments has been found valuable in Western countries and should be promoted by all means in our country. Certain recommendations of treatment of patients following severe trauma have been discussed concerning anti-shock therapy, diagnostic and operative management in polytraumatized patients with major head trauma, thoracic and abdominal trauma and also operative stabilization of fractures of bones. It has been concluded that in our country, especially in bigger cities, patients following major trauma should be treated in specially designed units (centers) integrated with emergency medicine departments providing competent intensive therapy and surgical interventions of well trained trauma teams introducing optimal modern trauma algorithms.

Craniocerebral Trauma↗
PubMed1997

[Selected injury severity scales for practical use in traumatology].

Measurement of severity of injuries is by all means needed in contemporary traumatology. Objective assessment of several different injuries is helpful in different comparisons concerning different groups of trauma patients. The authors have chosen 4 number scales: Trauma Scale (TS), Abbreviated Injury Scale (AIS), Injury Severity Score (ISS) and APACHE (Acute Physiology and Chronic Health Evaluation) in order to assess their application in traumatological practice. Advantages and disadvantages of number scaling describing of severity of injuries in trauma patients have been discussed.

Humans↗
PubMed1997

[Preventable deaths after severe trauma].

A detailed analysis of 234 trauma patients who died after being admitted to the Department of Trauma Surgery in 1990-1996 has been performed in prospective studies. Among all fatalities multiple injuries have been diagnosed in 86 persons (36.7%) while single injuries have been found in 148 persons (63.3%). The mean Injury Severity Score (ISS) was 18. Consequences of severe head injuries, cardio-pulmonary complications, shock and pulmonary artery embolism have been identified as the main causes of death. All fatal cases have been reviewed by a multidisciplinary panel of physicians and judged as nonpreventable or preventable. In 28 cases errors and deficiencies leading to death have been identified and thus the overall preventable death rate (PDR) was 11.9%. PDR has been much higher among multiply injured patients than in patients with single injuries. Preventable diagnostic errors and deficiencies in management of multiply injured patients have been committed mainly in the early resuscitative phase. A decrease of PDR in fatalities treated lately in our Department has been recorded. Other aspects concerning studies on preventability in trauma patients have been discussed.

Adolescent↗
PubMed1997

[Enzymatic markers in peritoneal lavage fluid for diagnosis of blunt abdominal trauma].

Value of Diagnostic Peritoneal Lavage (DPL) in blunt abdominal trauma has been analysed in the studies. The material included 84 patients who were subjected to DPL since 1990 till 1994, and who were treated in the Department of Trauma Surgery Medical University of Gdańsk. The enzymatic examination of the lavage perfusate performed in this study revealed that the level of the activity of the aspartic transaminase and the alanine transaminase over 10 IU/L indicate hepatic injury, and the level of the alkaline phosphatase over 3 IU/L point at the injury of the large intestine, small intestine and mesentery.

Alanine Transaminase↗
PubMed1997

[Thrombotic complications of arterio-venous fistulas in chronically hemodialysed patients].

Treatment by means of repeated haemodialysis has been accepted as the basic method of renal substitution treatment in our country. Thrombosis has been found as the most frequent local complication in arterio-venous (A-V) fistulas. The purpose of this study has been to analyse the frequency of thrombosis in relation to the type of A-V fistula and occurrence of early thrombosis (within 24 postoperative hours). Studies have been based in 186 patients (31 children) in whom 545 A-V surgical procedures have been performed to create and maintain permanent vascular access for haemodialysis. The mean age of the patients was 37 years. Thrombosis has been detected in 41.5% of fistulas and has been found as the main cause of 49.4% secondary procedures. Most frequently they have been observed in A-V fistulas using PTFE prosthesis. Rare complications have been found in brachio-basilic and brachio-cephalic fistulas. Early thrombosis has been observed in 4.5% of A-V fistulas. The causes of early thrombosis and within 30 postoperative days have been discussed in detail. In these complications thrombectomy (60.5%) and thrombectomy combined with creating new anastomosis (31.9%) have been performed most frequently. It has concluded that the condition of anastomosed vessels is the most important factor influencing early thrombosis.

Adolescent↗
PubMed1994

[A case of large bowel injury with a safety belt in a pregnant woman].

The authors present the case of a 24-year-old pregnant woman (9th week of pregnancy) who, due to a traffic accident, suffered transverse colon rupture through a sudden compression of the intestine with a "traditional" safety belt. The authors analyse the mechanism of injury, method of treatment, and on the basis of literature data discuss various body injuries developing as a result of action of safety belts.

Accidents, Traffic↗