PubMed Health⌕ Search

Biomedical subjects

J M Ziemski

Publications and source records attributed to J M Ziemski.

At least 19 recordsLinked to original sources
PubMed2000

ESWL in hemophiliac patients.

OBJECTIVE: To assess ESWL treatment of urolithiasis in patients with hemophilia, the frequency of hemorrhagic complications, and to determine the treatment outline. PATIENTS AND METHODS: From 1991 to 1997, eleven patients with hemophilia were treated by ESWL for urolithiasis. Substitution of deficient coagulation factors was started on the day of treatment. Ultrasound examination was performed in all cases on the 1st day after the procedure in order to discover any potential hemorrhagic complications. Substitution withdrawal depended on the patients' general status, lack of hematuria and the absence of signs of hemorrhage. Preliminary results were evaluated after 7-10 days on the basis of plain abdominal X-ray of the kidney, ureter and bladder and ultrasonography. RESULTS: In total, 25 ESWL sessions were performed, 1-6/patient. Nine patients (81.8%) discharged stones, and 2 patients are being followed up. No hemorrhagic complications were observed. CONCLUSIONS: Substitution of deficient coagulation factors makes ESWL a safe method of urinary stone management in hemophiliacs. No hemorrhagic complications were seen in our patients. Substitution withdrawal may be based on the patients' good general status, lack of hematuria and absence of signs of hemorrhage.

Adult↗
PubMed2000

[Analysis of general and hemorrhagic complications after treatment of acute proximal deep venous thrombosis of the legs treated with anticoagulants, streptokinase and thrombectomy].

The aim of the study was to present general and haemorrhagic complications in 164 patients with acute DVT in ilio-femoral segment treated with different methods of pharmacological (heparins, streptokinase) and surgical (venous thrombectomy with temporary arterio-venous fistulae) therapy. There were no fatal complications in 48 UH or LMWH treated patients. One patient bled from stress stomach, one developed intramuscular haematoma, one mild pulmonary embolism and one rise of body. Among 84 patients treated with SK five fatal bleeding complications were recorded. From other non fatal complications we recorded one GI bleeding, one splenic rupture and three massive intramuscular haematoma. Three patients died in the early post thrombectomy period. Non fatal complications included one wound haematoma, two wound infection and one with marginal necrosis. The use of LMWH or UH treatment in acute ilio-femoral venous thrombosis is save as the frequency of massive bleeding and serious general complications is rather low. Fatal haemorrhagic episodes are the major hazards of thrombolytic therapy. Venous thrombectomy with temporary arterio-venous fistula may provide a good chance for treatment of acute proximal DVT associated with complete occlusion of the lumen of affected veins in patients with severe ischemic venous thrombosis or with contraindications to heparin treatment.

Anticoagulants↗
PubMed1997

[Factor VIII inhibitor appearing in women during delivery].

Factor VIII inhibitor is rare, but very serious postpartum complication. Bleeding diathesis caused by this inhibitor is called acquired haemophilia. Three women with postpartum inhibitor to factor VIII and life threatening bleeding were described. In two patients bleeding was controlled by treatment with high doses of human and porcine factor VIII concentrates. One patient died presenting uncontrolled haemorrhagic diathesis. This work presents the problems of the diagnosis, treatment and also the elimination of the factor VIII inhibitor.

Adult↗
PubMed1990

Synoviorthesis with 198Au colloid gold in haemophilia patients. A preliminary report.

In 1988-1989 fifteen patients with severe haemophilia A and recurrent bleedings into the knee joint, aged from 19 to 44 years were treated by an intraarticular injection of 198Au colloid gold. So far 10 of them were assessed after 6 months follow-up. In 6 cases cesseation and in 2 cases reduction in number and volume of bleedings were observed. Only in 2 patients the frequency of haemarthroses remained unchanged. No significant difference in tracer uptake was observed between pretreatment 99mTc-pertechnate gamma scans of the knee joints and controls completed 6 months after the radiogold injections. It is worthy to stress the lower costs of the 198Au synoviorthesis as compared with surgical synovectomy of the knee joint. The radioisotope method is also much less traumatic to the patient than the surgical one.

Adult↗
PubMed1987

Hazards of thrombolytic therapy in deep vein thrombosis.

From 1965 to 1985, 64 deep vein thrombosis (DVT) patients were treated with streptokinase (SK). In 26 cases 'high-dose SK' (IV 100,000 units/h for 4 days) was used and in 38 patients a 'low-dose SK' regime (IV 250,000 units every 12 h for 4 days) was employed. The clinical signs of DVT subsided in 78 per cent of treated patients within 30 days of completing SK treatment. A repeat phlebography was performed immediately after SK therapy in 29 patients (45 per cent) and a total recanalization or partial thrombolysis was achieved in 80 per cent of the studied cases. In 15 patients minor and major haemorrhagic complications occurred. There were five fatalities, all in the high-dose SK group (three intracranial haemorrhages and two major bleeds). Three patients developed pulmonary embolism and none of them died. The post-treatment clinical and phlebographic evaluation did not reveal any significant difference between the two methods of SK administration, but more haemorrhagic complications (P less than 0.02, chi=5.50825) occurred in the high-dose SK patients. This report emphasizes the risk of bleeding complications during thrombolytic therapy. If SK is to be used, therefore, careful selection of patients and meticulous monitoring are mandatory.

Adolescent↗
PubMed1987

Evaluation of early postsplenectomy complications.

This study was done to define the incidence of early postsplenectomy complications and is based upon 688 splenectomies--mainly in malignant and nonmalignant hematologic conditions--performed during the period 1952 to 1986. In 354 patients, early postoperative complications were observed, among whom wound and pulmonary infections were most common. A fatal outcome was noted in 32 patients for a mortality rate of 4.7 per cent. The incidence of early complications after splenectomy is higher than after most other surgical procedures within the abdominal cavity and depends upon the underlying diseases which lead to splenectomy. Deficient immunologic defense mechanisms may be a significant factor in the development of early complications in patients after splenectomy.

Adolescent↗