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Biomedical subjects

M Adámková

Publications and source records attributed to M Adámková.

At least 19 recordsLinked to original sources
PubMed2006

Our experience in the nutritional support of a burned child treated with integra.

Integra artificial skin was applied on 16% of TBSA after necrectomy on a 7-month-old girl who was scalded on 26% of TBSA by her mother when she was cooking goulash. Nutritional parameters were monitored during the period of 25 days from the 1st necrectomy and application of Integra up to the first autotransplantation--in the period when the other burnt surfaces were almost healed. The average intake of proteins and energy to achieve normal levels of monitored nutritional parameters was lower than that recommended by calculations for similarly burnt children. Our observation is similar to that of King.

Burns↗
PubMed2005

Our first experience with Integra.

The advantages of Integra have lead to an increase in its use after extensive burn injuries, in reconstructive surgery after burns, and abroad in general reconstructive surgery as well. At the Burn Center of FNsP Hospital in Ostrava Integra was used for the first time in March 2003. Since then, seven patients have undergone operations, involving the use of Integra in 14 body areas. In four of the patients scars after burns were corrected--on the neck, axilla, two on the trunk, two in the popliteal area and one between the toes. In three patients the artificial skin was applied after necronectomy. In a 7-month-old baby and in a 2-year-old child with burn injuries exceeding 25% of the body surface it was applied twice on the trunk, once on the upper extremity and once on the lower extremity. In an adult female Integra was applied on her neck and axilla after burns to a lesser extent. We have evaluated the scars one year after surgery in two patients. Cosmetic appearance was good in both of them. We have noted good functional result after the reconstruction of axilla. After reconstruction in the neck area and reconstruction of the necrectomy in the neck area and axilla, the functional results were average. The average functional results in both patients are probably due to poor compliance with the immobilization and following rehabilitation program.

Adult↗
PubMed2005

Surgical treatment of electrical burns by local flap plastic surgery.

Electrical burns are a serious problem within burn medicine even though they are relatively uncommon. The size of the burn is small, but the wound is often deep, and frequently the patient has systemic complications as well. In the majority of patients with such injuries immediate surgical intervention is essential, consisting of escharotomy, fasciotomy, and debridement of the devitalized tissues, necrectomy of the burn area, and closure of the defect by a direct suture, a dermo-epidermal graft, or local flap. Our report consists of three case studies. The patients underwent local flap plastic surgery after a full thickness soft tissue loss. All three patients healed primarily and did not require further correction of flaps. Final functional and aesthetic results are very good if the local flap is used appropriately.

Adolescent↗
PubMed2005

Burn injury in senior citizens over 75 years of age.

This is a retrospective analysis of a group of 67 senior citizens over 75 years of age who had been hospitalized at the Burn Center of the FNsP Hospital in Ostrava--Poruba in the years 1999 - 2003. We have studied a group of males and females, noting their average age, most common causes of burn injuries, mechanisms of burn injuries, average extent of burn injuries, and most commonly burned body parts. We have also reviewed the seriousness of burn injury in senior citizens, factors that complicated the course of treatment as well as its impact on the final therapeutic effect. The importance of specific approach and individual therapeutic strategy is emphasized. We would also like to emphasize the need for complex therapy approach due to secondary diseases that are very common in this age group. The treatment of burn patients in this age group is very challenging from a personal and economic point of view. The goals of therapy are a full recovery and the return of the patient to normal life. However, goals and therapeutic results are determined and limited by the above-mentioned factors. Nevertheless, every therapeutic success, although partial, should be perceived as positive. For the patient, every success from the point of view of the ability to take care of himself or herself and the overall quality of life is fundamental.

Accidents, Home↗
PubMed2005

First experience with the use of vacuum assisted closure in the treatment of skin defects at the burn center.

Morykwas and Argenta developed Vacuum Assisted Closure (VAC) in the early 90s for the treatment of tissue defects. In 2004, for the first time at our workplace, we used this method in the treatment of six patients between 54 and 91 years of age. Two of the patients were treated for a varicose ulcer on a lower extremity, two patients for loss of skin after an inflammation secondary to infection, one high-risk patient for deep burns, and one patient for a deep defect caused by an inappropriate medical care. We observed blood circulation improvement in all patients, which permitted an early dermo-epidermal graft.

Aged↗
PubMed2003

Endocrine changes after burns: the bone involvement.

Any major burn is followed by a pronounced endocrine and metabolic response, by an acute phase response. In 30 burn subjects whose bone status was studied after burn trauma with the densitometer HOLOGIC 2000, bone involvement was found 6 and 12 months postburn: the Bone Mineral Density (BMD) of their lumbar vertebrae L1-4 and of their left hip dropped significantly in most of them. Elevated levels of cortisol both in blood and in urine (free cortisol) were found, accompanied by very low testosterone, dihydrotestosterone (DHT) and free testosterone levels in blood of the burned males, but not of the females. Elevated 17beta-estradiol levels were found in many burned males; they were generally not low in the burned females. DHEA-S levels were generally low. Very low levels of the triiodothyronine (T3) and of the free thyroxine (FT4) were found. Increased, even very high, PTH values were occasionally present. hGH and IGF-1 were generally normal, with a few exceptions (low or increased levels). Total and ionized calcium levels were low after burn, 250H vitamin D (calcidiol) was usually low or low normal too. Prolonged and very high levels of CTX and of NTX (both are indicators of bone resorpcion, of collagen catabolism) were found, as well as of the ACP (acid phosphatases), but the latter were less manifest, if compared with the CTX and NTX. ALP (alkaline phosphatases) were elevated too, but their elevated levels were much less pronounced than the levels of CTX and NTX. Osteocalcin levels were initially low to low normal, to increase later to the normal levels. As for the cytokines that had been investigated, mostly the elevated levels of TNFalpha were found, as well as those of IL-2, IL-6 and IL-8. Finally, a few suggestions have been given regarding the additional possibilities how to treat the burned patients: the use of anabolics, of vitamin D, of calcium, eventually of calcitonin.

Acute-Phase Reaction↗
PubMed2001

Treatment by continuous renal replacement therapy in patients with burn injuries.

Continuous renal replacement therapy (CRRT) is a relatively new therapeutic procedure which helps in the treatment of critically ill patients with renal failure as well as those without renal failure. CRRT effectively removes urea and creatinine and maintains a balanced milieu interleur and water balance. A role in the elimination of pro-inflammatory cytokines is also ascribed to this method. Most frequently venovenous haemofiltration and venovenous haemodiafiltration are used. The authors present their experience with the CRRT treatment of 40 patients in the Burn Centre Ostrava and with the results attained.

Adolescent↗
PubMed1992

The effect of partial hepatectomy on the genotoxicity of aflatoxin B1. II.

The influence of partial hepatectomy (PH) on the genotoxic effect of aflatoxin B1 (AFB1) mycotoxin in male Chinese hamsters (Cricetulus griseus) in vivo was studied after a repeated i.p. application of small doses of AFB1 during 8 weeks. The frequency of aberrant cells did not increase after repeated application and persisted throughout the whole period on a relatively stable level. No cumulative genotoxic effect of repeated doses of AFB1 was observed. PH decreased the genotoxic effect of AFB1 only in week 4, while in weeks 6 and 8 no significant differences between hepatectomized and nonhepatectomized animals were recorded.

Aflatoxin B1↗
PubMed1991

The effect of partial hepatectomy on the genotoxicity of aflatoxin B1.

The influence of partial hepatectomy on the genotoxic effect of aflatoxin B1 (AFB1) mycotoxin in male Chinese hamsters (Cricetulus griseus) was studied after application of a single i.p. dose of 1.0 mg AFB1/kg. Changes in the fractions of proliferating bone marrow cells, values of the mitotic index of liver cells and morphologic changes in liver tissue were also monitored. Partial hepatectomy reduced significantly the mutagenic activity of AFB1 measured by the frequency of chromosome aberrations in bone marrow cells during 5 days. In hepatectomized animals AFB1 cytotoxicity was significantly reduced as evaluated by changes in the values of proliferating bone marrow cell fractions. There were no important morphologic changes in the liver. In hepatectomized AFB1 treated animals mitotic activity in liver tissue was substantially lower than in hepatectomized but AFB1 untreated animals.

Aflatoxin B1↗
PubMed1990

Dose and time dependence of chromosomal aberration yields of bone marrow cells in male Chinese hamsters after a single i.p. injection of aflatoxin B1.

The frequency of chromosomal aberrations in bone marrow cells, after a single i.p. aflatoxin B1 (AFB1) dose, was examined in male Chinese hamsters (Cricetulus griseus). There was a significant increase in aberrant cells within 5 days of administration of a dose of 0.1 micrograms-5 mg AFB1/kg, and on the 36th day. After a single dose of 5 mg AFB1/kg the enhanced frequency of aberrant cells was monitored up to day 104 with no sign of a decrease to control level. The results indicate that the minimum mutagenic effect of an AFB1 dose in this system is 0.1 micrograms/kg. Attention is drawn to the long-term presence of chromosomal aberrations even after a single i.p. exposure to AFB1.

Aflatoxin B1↗
PubMed1984

The mutagenic activity of aflatoxin B1 in the Cricetulus griseus hamster and Macaca mulatta monkey.

Chromosome aberrations were scored in bone marrow cells of Cricetulus griseus hamsters and Macaca mulatta monkeys given a single i.p. injection of aflatoxin B1 (AFB1). The mutagenic activity of AFB1 was assessed by the percentage of cells bearing aberrations and by the total frequency of chromosome and chromatid breaks. Chinese hamsters were treated with five different doses of AFB1 ranging from 1 microgram to 5 mg/kg (LD50/30 = 12.2 mg/kg) and the aberration yields at each AFB1 dose level tested were determined at 24 h intervals for 5 consecutive days. Compared to controls the increase in the two types of chromosome abnormalities was significant in all tests. At 5 mg/kg of AFB1 the tests were carried out over a period of 92 days to assure the analysis of aberration yields with time. All chromosome aberration assays conducted during this period showed significant increases in the frequencies of aberrant cells and chromosome and chromatid breaks in comparison to controls. Macaque monkeys were treated in the same fashion using 0.1 and 1.0 mg/kg of AFB1 and the dynamics of chromosome aberration yields was analyzed for a period of 730 days. Similarly as in the case of Chinese hamsters the percentage of cells with aberrations and the frequency of chromosome and chromatid breaks were always higher in this period than the control value. Long-term aberration yield data obtained experimentally were expressed in the form of analytical curves which allowed to establish the time when the yields of aberrant cells reached their maxima and when they returned to the control level. In both animal species tested the courses of analytical curves had a similar dynamics. Factors that might be responsible for a long-term persistence and relatively great fluctuations of the chromosome aberration yields encountered after a single injection of AFB1 are discussed in detail.

Aflatoxin B1↗
PubMed1983

Endorphin releasers: a new possible approach to the treatment of pain after burns--a preliminary report.

Decapeptide ceruletide (CRL), chemically related to cholecystokinin and gastrin, proved to have remarkable analgesic properties when administered to a group of 22 burned patients, 15 patients with acute myocardial infarction, and 8 patients suffering from pain caused by malignant tumours with metastases. Its effect was such, that many of the patients required no other analgesics (opiates) even after a prolonged administration (up to 10 days) of CRL. In some of the patients a marked euphoria developed. There were no substantial changes in EEG records during CRL administration in 15 controls, among them 4 epileptics. It is probable that CRL helps to activate the internal analgesic system. In the burned patients cortisol, testosterone, renin, prolactin and tri-iodothyronine (T3) levels in serum (plasma) were measured (radio-immunoassays). CRL did not block the stress response (no drop of increased cortisol levels, no increase in low T3 levels), but it modified (influenced) it (drop of the high renin levels, and a tendency to increase the very low testosterone levels). CRL appears to act as an endorphin releaser, as evidenced by the plasma levels of beta-endorphins (quotations). CRL and similar drugs may represent a new, more physiological and probably safer approach to the management of pain.

Burns↗
PubMed1979

Endocrine response after burn.

The use of radioimmunoassays has made new advances in post-burn endocrine studies possible. The mean fasting IRI plasma (pl.) levels were elevated for 7 weeks, sometimes reaching very high values. During OGTT, an impaired glucose tolerance and insulin resistance could be found. Pl. HGH levels were normal or slightly increased, and their hypoglycemia-caused rise in the first two postburn weeks was blocked. Renin and Angiotensin II pl. levels were high or very high in almost all burned patients. They were very sensitive indicators of burn stress. ACTH pl. levels were in some respects unpredictable: sometimes very high, sometimes only moderately elevated, or normal. There was mostly no correlation between them and the respective 17-OHCS. Serum FSH was uniformly low or very low, while LH was high (25%), normal (31%) or low (44%). Pl. testosterone levels were uniformly very low, except for the first 1-2 postburn days, even in minor burns, their levels returning to normal during convalescence. The response after chorionic gonadotropin was similar. This severe peripheric endocrine gland involvement (burn toxins? impaired circulation?) could be found to some extent when T4 (thyroxine) levels in serum were measured, especially during TSH tests. There was no correlation between TSH and T4 values. The pituitary response (LH, TSH, less FSH) to TRF and LHRH was normal in all patients tested. All the above can have far reaching endocrine and metabolic consequences (catabolism, fuel supply, endocrine priorities), with many new research and therapeutic possibilities.

Adrenocorticotropic Hormone↗