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Biomedical subjects

M Fijałkowski

Publications and source records attributed to M Fijałkowski.

10 recordsLinked to original sources
PubMed2002

Efficacy and toxicity of MDR versus HDR brachytherapy for primary vaginal cancer.

The retrospective analysis includes a group of 50 patients with primary, invasive vaginal cancer treated with brachytherapy in the period of 1982-1993. Over 80% cases were squamous cell carcinoma. There were 14 patients in stage I according to FIGO classification and 20%, 36%, and 16% of patients in stage II, III and IV, respectively. Twenty one patients (42%) received MDR brachytherapy using Cs137 source, the remaining 29 (58%) were treated with HDR using Co60 or Ir192 sources. Among 50 patients 31 (62%) received also external beam irradiation. An overall 5-year actuarial disease-free survival was 40%, and it was 78.6% (11/14), 40% (4/10), 27.8% (5/18), 0% (0/8) for stage I, II, III and IV, respectively. For MDR or HDR5-year disease-free survival was 38% and 41%, respectively. No influence of dose rate on survival has been found (p=0.7). Local failure occurred in 20 patients (40%). Recurrences appeared in 10 patients (20%). Late complications rate was 0% and 17% for MDR and HDR, respectively. Effectiveness of brachytherapy MDR and HDR was similar, whereas serious late complications developed more often after HDR brachytherapy.

Adult↗
PubMed2001

[Tuberculous pleurisy--still difficult diagnostic problem].

In years 1989-2000 in Lung Diseases Hospital in Łódź tuberculous pleurisy TP was diagnosed in 271 patients; in 130 (48%) cases this diagnosis was confirmed by microbiological and histopathological examinations. Presence of tubercle bacilli in pleural fluid was discovered by smear and culture only in 13 cases, only by culture in 95 and in Bactec method in 7. During this period in 135 patients with pleural effusion of unknown etiology biopsy of the pleura (with Abrams needle) was performed and specific granuloma was found in 17 (13%) persons. In 15 (12%) patients it was the only method establishing diagnosis of TP (because in 2 remaining patients tubercle bacilli in pleural fluid were also found). Assessment of clinical symptoms indicates that onset of TP was insidious and course of the disease was subacute in about 30% of patients, manifested mainly by: fatigue, general weakness, night sweats. Radiological estimation of patients with TP disclosed (besides pleural effusion) lung infiltrations in 38 (28%) cases, including 13 (10%) with cavitation. Tuberculin induration with diameter 0 mm was found in 32% of patients with TP and with greater than 10 mm in 29% of patients. Because of low sensitivity of microbiological examinations of pleural fluid for tubercle bacilli biopsy of pleura should be method of choice in the diagnosis of TP in selected cases.

Adolescent↗
PubMed2000

[Pseudomonas aerogunosa pneumonia in patients treated at the Hospital for Chest Diseases].

Retrospective analysis of pneumonia caused by Pseudomonas aeruginosa was made in 66 patients, treated in hospital. Nosocomial pneumonia was diagnosed in 11 (17%) patients. In 51 patients coexisting lung diseases were present: mainly COPD and bronchiectasis. Strains of Pseudomonas aeruginosa were susceptible mostly to imipenem, meropenem, aztreonam, ticarcillin-clavulanic acid, ceftazidime, ciprofloxacin, amikacin, piperacillin-tazobactam, netilmicin. Duration of treatment in hospital was very long--59% were treated over 30 days. Combined antibacterial therapy was applied in 35 (53%) patients and monotherapy, often with different antibiotics--in 31 (47%) patients. Treatment was successful in 45 (68%) patients. In 9 patients the results of treatment was not successful: mainly because of empyema in 7 pts. Twelve (18%) patients (with coexisting COPD--6 and lung cancer--6) died. We can support current recommendations for treatment of Pseudomonas aeruginosa infection with combination of aminoglycosides or fluoroquinolones plus one of remaining antipseudomonal antibiotics. Treatment failures occurred mainly in patients with severe coexisting diseases and/or empyema.

Adult↗
PubMed2000

Influence of previous treatment on palliative effect of HDR brachytherapy in advanced esophageal cancer.

General effectiveness and influence of previous treatment on value of palliative HDR brachytherapy were assessed in 35 patients with advanced esophageal cancer treated from 1992 till 1997 with brachytherapy HDR (BT). Twelve of them were treated only with BT, II received previously chemoradiotherapy (CHTT), 12 teleradiotherapy (TT). BT appeared to be effective method of palliation. No significant differences in effectiveness of BT in analyzed groups were observed. Sever complications were observed in 9 cases (26%), and that in patients treated previously. Brachytherapy seems to be efficient after previous treatment, however, in this case, the risk of complications increases.

Adult↗
PubMed1999

[Pleural needle biopsy in the diagnostic standards of pleural diseases in the past and today].

Pleural needle biopsy (PNB) maintained its value in spite of introduction of videothoracoscopy. Diagnostic possibilities of PNB using Abrams needle were evaluated during 1989-1998 in 114 patients aged 17-82 years. In histological examinations of the biopsy specimens were diagnosed: neoplasms--in 47 (41%) patients, tuberculosis--in 10 (9%) and chronic nonspecific pleuritis--in remaining 57 patients. Data from further course of the disease confirmed diagnosis of neoplasms and tuberculosis. Complication of PNB was encountered only in 1 patient (pneumothorax). Among 47 patients with malignant infiltration of the pleura in the biopsy specimen only in 20 (42%) neoplastic cells were demonstrated in cytologic examination of the pleural fluid. PNB remains still useful in the diagnosis of causes of pleural diseases. Specificity of this method can be enhanced by more precise localization of the pleural lesions using imaging technics (USG, CT, MRI). PNB should be more widely performed in the diagnosis of pleural diseases of unknown etiology particularly when videothoracoscopy is not feasible.

Adolescent↗
PubMed1997

[Staphylococcal pneumonia--analysis of material from patients treated at the Hospital for Lung Diseases in the years 1981-1994].

Retrospective analysis of staphylococcal pneumonia was made in 182 patients, aged 18-88 years /61% more than 60 years old/ treated in hospital in years 1981-1994. Majority of these patients had various concomitant diseases, mostly chronic bronchitis and lung cancer. Strains of Staphylococcus aureus were sensitive mainly to amoxycillin--clavulanic acid, roxitromycin, amikacin, netilmicin, clindamycin, cefamandol, chloramphenicol, rifampicin and resistant mostly to penicillin /90% of strains/, ampicillin, tetracyclines. In many cases initial antibacterial treatment was inadequate in relation to sensitivity pattern of staphylococci--hence many changes of antibiotics were observed in the course of the therapy. Newer antistaphylococcal drugs were applied only in the last years of the study. Despite these therapeutical drawback outcome of staphylococcal pneumonia was good in 85% of patients; 14% of patients died /mainly as a consequence of comorbidities/. Successful therapy of staphylococcal pneumonia requires early recognition of possibility of infection due to Staphylococcus aureus and adjustment of drugs to probable or actual sensitivity of these pathogens.

Adult↗
PubMed1996

[Pleural needle biopsy in diagnosis of pleural effusion].

Diagnostic reliability of percutaneous parietal pleural biopsy with use of the Abrams needle technique performed over a period 1989-1994 was assessed in 37 patients with pleural effusion of unknown etiology, aged 24-82 years. Adequate diagnostic specimens were obtained in 33 patients. Histopathological diagnosis established neoplasma (39,4%), tuberculosis (9.1%) and chronic nonspecific pleuritis (51,5%). No complications of the procedure were encountered. Pleural needle biopsy should be more widely applied as a basic method in the diagnosis of pleural effusions of unknown etiology.

Adult↗
PubMed1995

[Psychogenic pseudo-asthmatic syndrome].

The authors present a case of a 42-year-old patient treated for severe attacks of dyspnoea and wheezing of 12 years duration. She was hospitalized 8 times in medical or pneumonology wards and underwent treatment in a sanatorium 6 times. Since 5 years she has been periodically and recently permanently on oral glucocorticosteroids. Dyspnoea was accompanied by diffuse wheezing and prolongs expiration. It was also observed that her mode of respiration during an attack consisted in forced expiration at small air volumes in the lungs. Theatrical behaviour of the patient was striking. Bronchial challenge with acetylcholine and metacholine was negative. Bronchoscopy revealed profound intussusception of the membraneous part of the trachea and bronchi. Psychiatric diagnosis confirmed hysterical personality. The demonstrated case proves that the value of bronchial challenge is difficult to overestimate in diagnosing asthma. It concerns not only cases where symptoms are scanty but also patients with the so-called troublesome treatment-resistant asthma.

Adult↗
PubMed1995

[Logistic model in diagnosis of lung cancer].

Specificity of the diagnosis of lung cancer (l.c.) based upon clinical and radiological criteria was investigated in patients who died in Hospital of Lung Diseases in Lódź between in 1985 and 1989. Autopsy revealed diagnostic errors in 37% cases. Twenty most common disease features were taken into consideration. Logistic analysis helped to create clinical-mathematical model which allows for interpretation of disease features in two distinct categories: l.c. (non-neoplasmatic lung disease). Eight features proved to be significant (changes in RBC, weight loss, chest pain, increased sputum production, haemoptisis, hilar tumor, pleural effusion, peripheral round shadow on chest X-ray). Diagnostic usefulness of the model was checked in prospective study a group of patients who died from properly diagnosed l.c. (499 cases). Our model allowed for proper diagnosis of neoplasmatic cause of the disease with higher probability than morphological methods (including both intravital and autopsy examination).

Diagnostic Errors↗