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Biomedical subjects

M Wierzbicka

Publications and source records attributed to M Wierzbicka.

At least 55 records · Page 3Linked to original sources

[Therapeutic effectiveness of Cedax in the treatment of selected acute upper respiratory diseases].

A group of 66 patients with acute inflammatory upper respiratory tract diseases were examined in the ENT Department of Poznań Medical Academy between November 1996 and November 1997. Specimens for bacteriological cultures were collected from the ear, nose and throat. The subjects were treated with ceftibuten. Clinical improvement was reported in all cases. In 44 patients, ceftibuten treatment eliminated pathogenic bacteria (as evidenced by microbiological analysis).

Acute Disease↗

[Squamous cell carcinoma of the nose and sinuses in a 18-year-old patient: a case report].

A case of squamous cell carcinoma of the nose and paranasal sinuses in an 18-year-old male is presented. Carcinoma of the nose and sinuses is not common and accounts for 3-5% of an all malignancies in the head and neck. Peak incidence of the disease seems to occur in the 6th and 7th decade of life. No cases of nasal carcinoma were observed under the age of thirty. The authors discuss the difficulties in setting the diagnosis--nonspecific symptoms mimic those of chronic sinusitis.

Adolescent↗

[Microflora of periodontal pockets in advanced periodontitis].

The aim of study was the evaluation of periodontal pockets microflora in patients with advanced periodontitis. From each subject 16-20 samples were taken using paper points. Pooled sample after 60 s. mixing was serially diluted in reduced BHI. For total cell counts and for the isolation of black pigmented anaerobes Brucella agar supplemented with 5% sheep blood, hemin, menadione, with and without Kanamycin-Vancomycin mixture and BM agar plates were used. For isolation of A. actinomycetemcomitans TSBV agar plates were used. Cultures were incubated in anaerobic chamber at 37 degrees C for 7 days and TSBV agar plates in an atmosphere of 95% air-5% CO2 at 37 degrees C for 5 days. Microorganisms were identified by Gram staining, colony morphology, fluorescence in UV-light, haemagglutination of 3% sheep erythrocytes, fermentation of sugars, production of indole, urease (API 20A), specific enzymes (Rapid ID 32A). Twenty seven subjects with clinically recognized periodontitis were examined. Microorganisms important in periodontitis were isolated from periodontal pockets of almost all examined subjects. The number of bacteria obtained from the sample of one patient ranged from 1 x 10(4) CFU/ml to 3,6 x 10(6) CFU/ml. Porphyromonas gingivalis was identified in the samples taken from 17 patients, Prevotella intermedia-19, Actinobacillus actinomycetemcomitans -11, Fusobacterium nucleatum-9, Peptostreptococcus spp.-22.

Adult↗

[The evaluation of ceftibuten (Cedax) effectiveness in the prevention of perioperative infections].

Cedax is the antibiotic drug of the third generation cephalosporin type. In the Department of Otolaryngology of the University Medical School in Poznań tests were carried out on the effectiveness of this drug in the prevention of perioperative infections (tonsillectomy, adenotomy, septoplastics, nasal polypectomy, mucotomy). The experiment comprised 50 patients who were administered Cedax once a day of the period of five consecutive days, beginning on the day of the surgery. Control group compare 50 patients who did not receive the antibiotic cover. For the comparison of both groups the following symptoms were taken into account: general condition of the patient, body temperature in the first few days after the surgery, the healing of the operative wound (the condition of mucosa, healing "per primam" or "per secundam"), the presence and type of nasal discharge. A high degree of efficiency of ceftibuten has observed.

Adult↗

[Cystic fibrosis in adults--clinical aspects].

Nineteen patients with cystic fibrosis were seen in the I Department of Tuberculosis and Lung Diseases during 3.5 years. There were 12 (63%) female, and 7 male, aged from 16 to 35 years (mean 23.2). Most patients were diagnosed in childhood, but 4 were diagnosed in their early adulthood. The diagnosis was confirmed by positive chloride sweat test in all cases. Molecular DNA analyses were performed in 16 cases. In 9 (56%) cases two mutations in the CFTR gene were identified. In 5 cases one mutation was identified. All patients had bronchiectases confirmed by CT. Spirometry showed lung function impairment with predominantly obstructive pattern. Mean VC was 2.57l, mean FEVI was 1.66l. In 7 (37%) cases FEVI was lower then 30% of predictive value. Hypoxemia was found in 11 (58%) cases and hypercapnia in 3 (16%) cases. Sputum cultures were positive for mucoid P. aeruginosa in 12 (63%) cases, for Staph. aureus in 16 (84%) cases. Persistent colonisation with nontuberculous mycobacteria was found in 2 (10.5%) cases. Aspergillus fumigatus was identified in sputum cultures in 2 subjects who had also positive precipitation test. Diabetes mellitus was diagnosed in 2 cases. Meconium ileus equivalent was seen in 1 case. Pneumothorax was seen in 1 case. One patient died in the endstage of the illness.

Adolescent↗

[Invasive pulmonary aspergillosis caused by Aspergillus ochraceus].

Invasive pulmonary aspergillosis (IPA) is a frequent complication in patients with severe neutropenia resulting from cytotoxic chemotherapy. In Europe, Aspergillus fumigatus is most common pathogen of IPA. In our case, IPA was recognised in 54 year old female suffering from acute lymphoblastic leukemia with pancytopenia. The patient developed severe granulocytopenia during chemotherapy. Chest radiograph revealed progressive bilateral infiltrations with cavitation. In sputum culture Aspergillus ochraceus was found. The results of precipitating tests were positive for A. ochraceus and A. fumigatus. Treatment with amphotericin B was used successfully leading soon to clinical improvement, yet radiological lesions remained largely unchanged. The patient received itraconazole, which was very effective and caused almost complete regression. Two episodes of IPA recurrence were treated with antifungal therapy with good results.

Antifungal Agents↗

[Ultrasonographic characteristics of neck lesions and the value of ultrasound examination in postoperative monitoring of patients with laryngeal cancer].

The purpose of this study was to evaluate the superiority of ultrasound examination of the neck in comparison with palpation in patients operated on and irradiated because of the larynx cancer. Close follow up by means of ultrasonography all patients after initial operation is essential to detect recurrence early, while surgical salvage is still feasible. Scars, oedema and anatomical changes due to prior surgery and radiotherapy make the clinical examination very difficult. Apart from demonstrating non palpable nodes, ultrasound may also depict nodal size, multiplicity, relation to the surrounding vessels, invasion of the carotid artery and malignant extension in the salivary glands or thyroid. 12 pictures of ultrasound were presented.

Carotid Arteries↗

[Dysphagia due to diffuse degenerative changes in the cervical spine].

Degenerative changes in the cervical spine can produce osteophytes of the anterior margins of the cervical vertebrae. Although cervical osteophytes have been reported to cause many complications, most remain clinically silent. Very few cases of pharyngeal dysphagia and pseudotumoral bulging of pharyngeal wall resulting from cervical osteophytes have been described. Dysphagia in these cases is caused either by mechanical obstruction or by paraoesophageal inflammation due to irritation at the osteophytes processes. We present a case of 63 year-old patient suffering dysphagia secondary to cervical osteophytes. ENT examination reveal bulged wall of the hypopharynx resemble the tumor. The diagnosis was established by conventional X-ray of the spine and CT. We investigated this case fully to rule out an alternative pathology.

Cervical Vertebrae↗

[Results of surgical treatment of laryngeal cancer in elderly patients in 1946-95].

In the years 1946-1995 in Karol Marcinkowski University School of Medical Sciences, Department of Otolaryngology, Head and Neck Surgery the long term results on 2223 patients with laryngeal cancer treated surgically according to the age were evaluated. Five year survival rates after total laryngectomy in elderly persons was 44.2%. Five year survival rates (67.7%) after partial laryngectomy justify their application in suitably chosen cases of cancer of the larynx.

Adult↗

[Treatment of patients with pulmonary aspergilloma with itraconazole].

The study aimed to assess effectiveness of itraconazole in treating pulmonary aspergilloma. Treatment with this triazole derivative was employed in 11 patients with pulmonary aspergilloma. Nine patients underwent a complete 6 month treatment at 200-400 mg dose. The treatment was discontinued in lesions 2 patients who demonstrated progression of lesions. Haemoptysis withdrew in 5 patients, the same number of patients displayed negative fungus culture. Only in 1 patient radiological appearances improved and negative sputum culture as well as cessation of haemoptysis were observed. No significant adverse reactions were reported for any patients. Six months after completion of the treatment haemoptysis recurred in 2 patients, renewed growth of A. Fumigatus was quoted for 3 patients and intensified precipitating test results for 2 patients. Only 1 patient improved within all the required parameters. The results of the conducted study indicate that itraconazole by infiltrating lung cavity inhibits fungus growth on the surface of aspergilloma, which, in isolated cases can lead to aspergilloma necrosis. The results of itraconazole treatment are not sufficiently satisfactory to justify application of itraconazole in routine treatment of pulmonary aspergilloma.

Adult↗

[On classification of changes in necrotizing lesions of the midface].

Lethal midline granuloma syndrome (LMG) describes lesions of the midface and is characterized by a progressive and often fatal ulceration and destruction of the upper air way involving the nose, the paranasal sinuses, the palate and the soft tissues of the face. Under the term LMG we distinguish four entities: idiopathic midline destructive disease (IMDD), polymorphic reticulosis (PR), non Hodkin's lymphoma and Wegener's granulomatosis (WG). Review of the literature allows to present the differential diagnosis making use of latest technological achievements in clinical immunology and immunohistochemistry. First of all the LMG must be discriminated from localized WG occurring in the midface. The clinical, serological and histopathological findings in WG are described. Literature review is carried out and recent concepts of it's etiology and pathogenesis are presented. Autoantibodies directed against cytoplasmic antigens of neutrophils (ANCA) with specificity for proteinase 3 (PR 3) are valuable marker for differential diagnosis and specificity are discussed. We make a comparison between the "limited" or "non renal" WG and "classical" or "renal" form of the disease.

Adolescent↗

[Metastasis of colon cancer to the larynx: a case report].

A 52 years-old male was accepted to the ENT Department because of hoarseness lasting for three month. According to the case history, in 1990 he underwent the anterior resection sigmorecti due to carcinoma. Preliminary histopathological specimen examinations performed in our department twice, suggested chronic, fibrotic laryngitis. Another histopathological examination carried out during surgical procedure of the prelaryngeal region opening, showed pictures characteristic for metastatic tumor.

Adenocarcinoma, Mucinous↗

[Swallowing disorders in patients after the laryngeal cancer surgery].

Anatomical and functional changes of the oral cavity, pharynx and larynx due to malignant tumor surgery and irradiation, cause breathing, swallowing, phonation and lung protection disorders. Deglutition disorders and choking are observed in all patients who have undergone supracricoid laryngectomy. We presented 33 patients after supracricoid laryngectomy with simultaneous CHEP (6) or CHP (27) reconstructions. 18 patients had one arytenoid cartilage removed, in 1 patient both of them were removed. Removal of the stomach tube took place between 29-36th day after the surgery. 4 patients showed symptoms of the aspiration pneumonia. Difficulties in swallowing liquids persist in some cases even a few years after the surgery. Re-education and rehabilitation of swallowing is the predominant problem and the most important goal after the CHP and CHEP surgery.

Deglutition Disorders↗

[Juvenile angiofibroma presented in the clinical materials of the Otolaryngological Department of the Academy of Medicine in Poznan in the years 1977-1993].

16 patients suffering from angiofibroma were treated in the Otolaryngological Clinic, Academy of Medicine in Poznań, in the years 1977--1993. The patients were aged from 10--36, the mean age 15. All patients were treated surgically, and the method choice was Denker's surgery. 3 patients were reoperated because of local relapse. On the bases of the described cases good results of full recovery of patients with angiofibroma treated surgically are presented.

Adolescent↗

[Incidence of second primary malignant neoplasms in patients treated for laryngeal cancer].

Although the survival rates reported for patients with laryngeal cancer are quite good, there is a risk of developing second malignant tumors in this population. From a total analyzed of 1268 patients with laryngeal cancer, the second malignant tumors in 30 persons group were identified. The prognosis for second malignant tumors is poor, especially with tumors of the lung and oesophagus. Vitamin A and carotenoids are promising for second malignancies prevention.

Adult↗