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Biomedical subjects

P Nowakowski

Publications and source records attributed to P Nowakowski.

18 recordsLinked to original sources

High mineral and vitamin E intake by pregnant ewes lowers colostral immunoglobulin G absorption by the lamb.

A 2 x 2 factorial arrangement of treatments with 78 mature ewes was used to evaluate the effects of supplementing the pregnant ewe's diet with high levels of minerals and vitamin E on immunoglobulin G (IgG) absorption by the lamb and whether any altered efficacy of IgG absorption was due to the colostrum or to the lamb. The ewes were estrus-synchronized in October and housed in wk 10 of gestation. In the final 7 wk of gestation, a grass silage-based diet, offered ad libitum, was supplemented with 500 g of a 19% CP concentrate, and from 1 wk later until lambing, half the ewes was offered 48 g of a mineral/vitamin supplement containing 6.5 g of Ca, 4.9 g of P, 5.9 g of Mg, 4.0 g of Na, 790 mg of Zn, 3.5 mg of Se, 40 mg of I, 200 mg of Mn, 20 mg of Co, and 40 IU of vitamin E. At birth, the lambs were allocated to one of four treatments in a 2 x 2 factorial arrangement, with lamb origin and colostrum origin as the two factors. The lambs born to ewes not offered the mineral supplement were fed colostrum obtained from their own dams or from ewes in the mineral-supplemented treatment, whereas lambs born to ewes given supplemental minerals were fed colostrum obtained either from their dams or from ewes in the control treatment. The ewes were milked at 1, 10, and 18 h postpartum and the lambs were fed using a stomach tube. A 5-mL blood sample was taken from each lamb at 24 h postpartum for IgG analysis. The level of fecal adhesion to the upper tail/rump area of the lamb was subjectively scored at 72 h postpartum. There was no difference in gestation length, lamb birth weight, colostrum yield, or IgG production (P = 0.16 to 0.82). When ewes were fed supplemental minerals, the serum IgG content of the progeny was lower than in their control counterparts (6.8 vs. 16.1 g/L; P < 0.001), regardless of whether the lamb received colostrum from ewes with or without access to supplementary minerals. The difference in serum IgG concentrations at 24 h postpartum was a direct reflection of a compromised efficiency in IgG absorption. The progeny of ewes with access to minerals had higher (P < 0.05) levels of fecal adhesion, which was not related to the origin of the colostrum, indicating altered digestive function in these lambs. We conclude, using the sheep as a model, that high mineral intakes in late pregnancy not only lower serum IgG concentrations in the lamb, but also that high mineral intakes result in the neonate being preprogrammed at birth so that it is born with a compromised ability to absorb colostral IgG.

Absorption↗

40-year experience in surgical treatment of congenital chest deformations--ethiopathogenesis, operative techniques and clinical results.

PURPOSE OF THE STUDY: The aim of this study was to assess the results of surgical treatment of 58 patients with pectus excavatum and 11 with pectus carinatum and discuss the problems connected with ethiopathogenesis and operative techniques. MATERIAL: 69 chest deformations treated between 1961-2001. METHODS: The clinical results were analyzed with 1) Kopera-Król Rtg-index, 2) Gizycka's Rtg-index of chest flattening, 3) Haller and Nakahara CT-index, 4) Heart position after operation, 5) Frequency of upper respiratory infections, 6) Appearance of postoperative scar, 7) Patient's opinion. Histopathological investigations were used to assess ethiopathogenesis of chest deformations. RESULTS: 90% permanent correction achieved in group of patients operated in the age from 12 to 17. Otherwise we noted between the patients who were operated in the age from 6 to 10-37% recurrence of deformity. Generally we had 70% excellent and good results. The opinion of patients (including cosmetics effects, psychical state and exercise tolerance) was much better-86.6%. Particularly correction of pectus carinatum gives good cosmetics effects as well as improvement of exercise tolerance. DISCUSSION: Nuss modified correction employing a substernal stabilizing plate is an alternative for transsternal traction in the classical Ravitsch' procedure. Authors present advantages and disadvantages of both methods. The optimal age for surgical correction and inter and post operative procedure are discussed. CONCLUSIONS: Ethipathogenesis of pectus excavatum and carinatum remains unsettled. Disturbances in endochondral ossification and growth of costal cartilage seem to be more probable cause of the deformities than diaphragm underdevelopment. Mild and severe forms of the two deformities result in circulatory-respiratory malfunctions, cosmetic defects and psychical problems. Due to possible circulatory-respiratory disorder, appropriate premedication as well as intra- and postoperative monitoring of RR, ECG, O2, CO2 are very important on the first day after the surgery. Ravistch-Garnier procedure for pectus excavatum and Chen procedure for pectus carinatum remain operations of choice. Transsternal traction can be replaced with internal stabilisation with a bar placed under the sternum what considerably reduces the time of hospitalisation but requires one more hospitalisation to remove the bar. Correction of pectus carinatum is permanent, correction of pectus excavatum turned out to be permanent in 90% cases providing that they were performed in patients aged 12-16. When patients were at the age 6-10, recurrence of the deformity occurred in 37% of cases. According to the clinical assessment, in both age groups, the proportion of very good or good scores equalled 70% and according to patient's evaluation--86.6%.

Adolescent↗

[The value of electroneurography in recognition of peripheral ischaemic polyneuropathy in patients suffering from critical leg ischaemia].

Peripheral arteries disorders cause not only leg ischaemia, but also peripheral polyneuropathy. Polyneuropathy increases ischaemic pain. The aim of this study was to estimate how many patients suffering from critical leg ischaemia have symptoms of peripheral polyneuropathy. 40 patients were investigated: 37 men and 3 women; mean age was 57 years. All patients underwent electroneurographic examination. It consisted of measurements of motor conduction in tibial and peroneal nerves, wave F, sensory conduction in sural nerve. Polyneuropathy was observed in 95% of patients. The frequency of polyneuropathy was also significantly enlarged in leg with non critical ischaemia. We did not observe the greater risk of polyneuropathy in diabetic patients. The work is an introduction to the following clinical studies.

Adult↗

[Repeated excision of abdominal aortic aneurysm--case report].

A case of 69-year-old male patient with recurrent abdominal aortic aneurysm is described. The patient had been successfully operated on for infrarenal abdominal aortic aneurysm 4 years before, and 2 months postoperatively dilatation of juxtarenal part of abdominal aorta was diagnosed in ultrasonic examination. Due to progressive enlargement of juxtarenal aneurysm the patient was admitted to hospital again and operated on. Excision of aneurysm with implantation of both renal arteries to the prosthesis was done. The perioperative course was uneventful. Authors emphasize the importance of evaluation of abdominal aorta after operative treatment of aneurysm (ultrasonic, CT, MRI) to diagnose recurrent aneurysms.

Aged↗

[Is a post-cholecystectomy syndrome the result of inappropriate preoperative diagnosis?].

The occurrence of the postcholecystectomy syndrome is very often connected with inappropriate preoperative diagnostics. One of the reasons might be the presence of gastric or duodenal ulcer, what can be connected with peri- and late postoperative complications. The prospective analysis of 250 patients admitted to the Department because of cholelithiasis was performed. In 28.8% of cases endoscopical changes in the upper alimentary tract were recognized. That is why, in patients qualified for cholecystectomy the upper alimentary tract endoscopy should be performed.

Adult↗

Lumbar spinal stenosis.

Symptoms for spinal stenosis apparently result from an incongruity between the capacity and contents of the spinal nerve passages. These symptoms are most frequently seen in men in their fifth or sixth decade of life. Spinal extension generally exacerbates the claudication-type symptoms (lower-extremity pain and paresthesia), whereas spinal flexion diminishes these symptoms. Differential diagnosis is needed to rule out vascular claudication due to atherosclerosis. Decisions regarding surgery should be made based not only on diagnostic imaging but also on a thorough history and clinical examination.

Diagnostic Imaging↗

Seasonal variation in testes size in Polish Merino rams and its relationship to reproductive performance in spring.

Observations relating testes size to body weight in growing and adult Polish Merino rams were performed during 3 consecutive years in a flock of 1700 pedigree ewes. October-born ram lambs were measured for testis diameter (TD), scrotal circumference (SC), and body weight (BW) at 100 (January), 150 (March), 180 (April), 240 (June), 365 (October), and 480 d (February) of age. In adult rams (n = 63 to 73 per year) BW and SC were measured in March, May (prior to breeding), August and October. Semen quality was evaluated before each breeding season, and the results of controlled reproductive performance (2 natural services to designated rams) were analyzed. Indices were applied to relate testis size to body weight: TD BW , SC BW and TW BW . Heritability estimates of testes indices in ram lambs at 100 to 240 d and at 480 d of age ranged from 0.21 to 0.36 (SE = 0.067 to 0.090). In adult rams SC measurements within months in consecutive years were repeatable (r = 0.55 to 0.68; P< or =0.01). Single measurements of adult ram gonads were not related to other reproductive traits, but significant relations were found when dynamic changes in testes size were examined as the percentage of testes weight change from March to May. Consistent correlations (positive or negative r = 0.2 to 0.5; P < or = 0.01) between seasonal changes in adult ram testes, semen quality, reproductive performance and in testes size in growing ram lambs were observed. The data suggest that the best time for selecting Polish Merino rams for a seasonality in reproduction is in March at 150 d of age.

Journal Article↗

[Treatment of ureter injuries after obstetric-gynecologic surgery].

The article presents an analysis of 21 patients with ureter injuries originated during obstetric-gynaecological operations treated in Urology Clinic in Medical Academy Poznań. Attention was particularly focused on prevention and fast diagnosis of injuries based on intra-operation examination usg, urography, and ascending pyelography. This fast diagnosis is of crucial importance for the cure.

Adnexal Diseases↗

Iliocaval compression syndrome.

Iliocaval compression syndrome is a significant disorder in a number of patients who have lower extremity venous complaints. The diagnosis may be suspected by positive findings on exercise strain gauge venous plethysmography and unilaterally increased ambulatory venous pressures. The diagnosis is confirmed by ascending and, in some instances, descending venography which demonstrates the iliocaval compression with or without intraluminal web formation. Transstenosis pressure gradients may be measured to confirm the hemodynamic significance of the lesion. We advocate direct operative repair of the iliocaval junction with rerouting of the iliac artery and excision of the iliocaval webs with cephalic vein patch angioplasty. It provided good results in the present study when coupled with an adjunctive regimen of perioperative subcutaneous heparin and warfarin. Further investigation into the exact prevalence and significance of the iliocaval compression syndrome is needed. Only an aggressive approach to patients with lower extremity venous complaints will help clarify the exact prevalence and natural history of this disorder.

Adult↗

[The integrated health service in Poland].

In 1973 was started in Poland the integration of medical care units which until than had performed the functions of medical (hospital and out-patient) care, social welfare and first aid. Thus, integrated medical care districts were set up for: the whole population (383); industrial enterprises (40) and higher education institutes (8). The present work is aimed at characterizing the integrated medical care districts and at defining the tasks which devolve upon those who fulfill the function of general director of these units.

Health Services↗