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Biomedical subjects

P Remiszewski

Publications and source records attributed to P Remiszewski.

13 recordsLinked to original sources
PubMed1998

[Pneumocystis carinii infections in patients with neoplasms and AIDS--clinical-pathologic changes in the lungs].

Pneumocystis carinii (PC) has been documented as a cause of pneumonia in a broad range of immunocompromised patients. The presentation of disease will very based on the underlying predisposing condition but a confirmation depends upon the identification of organisms in a bronchial aspiration or lung biopsy specimen. This retrospective study based on autopsies of 15 patients (pts) with AIDS and 12 non AIDS pts with neoplastic diseases. Pneumocystis carinii pneumonia (PCP) was confirmed by histologic examination. The clinico-pathological analysis emphasizes a spectrum of morphologic variation of the disease in relation to the clinical course of a principal disease. A distinction was made between the microscopical diagnosis of PC infection in AIDS and non AIDS pts; the burden of organisms in infected AIDS pts appeared greater than that of neoplastic diseases (mostly with small cell lung carcinoma). Nonspecific features of diffuse alveolar damage associated with PC organisms were identified in 67% of non AIDS pts and 13% of AIDS pts. Various degree of interstitial fibrosis was more prominent in AIDS pts (67%) than in non AIDS pts. The high frequency of atypical changes in lung might be the result of various chemotherapeutic agents used in managing these pts or repeated pulmonary infections.

AIDS-Related Opportunistic Infections↗
PubMed1997

[Hepatic tuberculosis].

Tuberculosis of the liver can be the only manifestation of the disease or it may be a part of disseminated process. Three cases of liver tuberculosis were presented. In one of them the process was restricted to the liver and the diagnosis was made only at autopsy. In two other cases, tuberculosis of the liver was a part of disseminated process. In one of them the impairment of liver function improved after therapy and in another one, in spite of therapy, the patient died with signs of cardio-respiratory and hepatic insufficiency.

Adult↗
PubMed1997

[Behcet's disease with pulmonary vessel involvement].

The case of systemic vasculitis with involvement of pulmonary vessels was described. 36-years white woman with cerebral vasculitis and recurrent uveitis 5 and 3 years ago, now was admitted to hospital because of the mouth ulceration and lesions in the chest x-ray. After lung cancer exclusion, aneurysm of pulmonary artery branch was confirmed by dynamic tomocomputer examination All mentioned above manifestations were diagnosed as Behcet disease. Patient was treated with prednison, cyclophosphamide and cyclosporine. Clinical effect was observed after corticotherapy, but no improvement in chest X-ray picture was obtained also after immunosuppression. Patient died because of pulmonary haemorrhage 7 years after first symptoms of vasculitis and 2 years after first massive haemorrhage.

Adult↗
PubMed1996

[The value of determining neuron specific enolase for diagnosis of complete remission during treatment of small cell lung cancer].

The aim of this study was to assess whether the lowest serum NSE obtained during treatment of small cell lung cancer patients can be helpful in the diagnosis of complete remission (CR). The material consisted of 68 patients with small cell lung cancer, treated in the Institute o Tuberculosis and Lung Diseases from 1.III.1993 to 15.II.1995. In the course of treatment CR was obtained in 13 patients, partial remission (PR) in 37 and no remission (NR) in 18. The distribution and median of the lowest NSE serum levels were the same in CR and RP patients. NSE serum levels remained above normal, that is above 12.5 ng/ml, in two CR patients and in 4 PR patients. 3 patients (2 with CR and I with PR) are still living for 26, 27 and 41 months in spite of NSE serum levels 14.3, 15.6 and 13.6 ng/ml respectively. In those patients in whom NR was obtained the lowest NSE level above 20 ng/l was connected with bad prognosis. We conclude that the estimation of the lowest NSE serum level in the course of treatment can not help to differentiate CR from PR.

Adult↗
PubMed1996

[Spinal tuberculosis].

The cases of 32-year-old man and 42-year-old women are presented. Their history illustrates difficulties in the diagnosis of tuberculosis of the vertebral column. The patients suffered significant pains in the lumbar region lasting one year. Despite the presence of some abnormalities in lumbar vertebrae on x-rays no examinations were ever performed to establish the diagnosis. Lumbago and osteoporosis were considered as the cause of complaints. Aetiology was confirmed only when patients developed disseminated tuberculosis of the lungs. Antituberculous chemotherapy was successful and brought a fast improvement in general status of the patients.

Adult↗
PubMed1995

Tuberculosis in the autopsy material: analysis of 1500 autopsies performed between 1972 and 1991 in the Institute of Tuberculosis and Chest Diseases, Warsaw, Poland.

SETTING: The present study is based on 1500 autopsies done in the Institute of Tuberculosis and Chest Diseases Warsaw, Poland during the years 1972-81 and 1982-91. OBJECTIVE: To assess the correctness of tuberculosis diagnosis before death in the above mentioned time periods. DESIGN: The autopsy reports were examined for the diagnosis of active tuberculosis proved by microscopy. The form and localisation of tuberculosis was assessed. The postmortem diagnosis was compared with clinical diagnosis. In those cases in which tuberculosis was not recognised before death the possible causes of this failure were analyzed. RESULTS: Active tuberculosis was found in 119 cases, 7.9% of all autopsies. It was localised in the lungs exclusively in 72 cases, in lungs and in extrapulmonary sites in 45 and in extrapulmonary sites only in 2. The frequency of active tuberculosis was the same for the two periods under evaluation. Tuberculosis was however not recognised before death in a much higher proportion of cases in 1982-92 (54%) than in 1972-81 (24%). The main cause of diagnostic failure was connected with atypical localisation of lesions on chest X-ray and with dissemination outside the lungs. Previous tuberculosis was a factor which facilitated the diagnosis of tuberculosis. CONCLUSIONS: In parallel with the decline of tuberculosis incidence in Poland, many doctors lack experience in diagnosing this disease, especially in cases with atypical X-ray presentation and with extrapulmonary localisation. This may lead to late or even very late diagnosis and have a significant impact on the epidemiological situation.

Adolescent↗
PubMed1995

[Lung carcinoids diagnosed as small cell lung cancers--important diagnostic problem].

The four cases of bronchial carcinoids were presented. Based on bronchoscopic biopsies the initial diagnosis of small cell lung cancer was established in them. The analysis of medical history was strongly suggested for carcinoid but not for small cell carcinoma. In each of them thoracotomy was performed and correct diagnosis of carcinoid was estimated based on resected tumour. The diagnostic criteria for bronchial carcinoid were discussed.

Adult↗
PubMed1994

[Tuberculosis of the tongue--case report].

The case of 56-year-old male with disseminated lesions in the lungs and ulcerations of the tongue is presented. Pathomorphological examination of the tongue ulcerations showed changes typical for tuberculosis. Cultures of 4 specimens of the sputum revealed the presence of Mycobacterium tuberculosis. Antituberculotic drugs (INH, RMP, EMB, PZA) were administered. Complete remission of the tongue ulcerations and partial remission of the lesions in the lungs were observed after 6 weeks of the treatment.

Humans↗
PubMed1993

[Tuberculosis as a cause of death in patients treated in the institute of tuberculosis in 1976-1991].

This study aimed at assessing the reasons why tuberculosis-which can be successfully treated today-is still the cause of death in some patients treated at the Institute of Tuberculosis in the last 15 years. The material consisted of clinical documentation and the results of autopsy of 30 patients who died of tuberculosis between 1976-1991. It was found that 19 out of 30 patients were not treated with antituberculous drugs or were treated only during few days because tuberculosis was diagnosed too late (in 15 patients after death). In 6 patients the treatment failed due to side effects of drugs and in 5 immunosuppressed patients, disease progressed despite the treatment. Difficulties in tuberculosis diagnosis were caused by atypical appearance of the disease in the chest X-ray (localization in the middle and lower lobes in 15 cases, absence of cavities in 22 cases) and in the extrapulmonary regions (11 cases). The main obstacle was the failure to cultivate tubercle bacilli from numerous specimens of the sputum in 10 out of 23 patients in whom the cultures were done.

Adult↗
PubMed1993

[Tuberculosis found in autopsies done in the Institute of Tuberculosis and Lung Diseases 1972-1991].

Between years 1972 and 1991 1500 autopsies were done in the Institute of Tuberculosis and Lung Diseases in Warsaw. Active tuberculosis was found in 119 cases (7.9%). 56 patients died of tuberculosis. Tuberculosis was not diagnosed during life in 37% of all cases and in 39% of that in whom it was the cause of death. Tuberculosis was undiagnosed significantly more often in the years 1982-1991 than in years 1972-1981. Tuberculosis was restricted to the lungs in 60.5% of cases, was found in the lungs and in the extrapulmonary sites in 37.8% and only outside lungs in 1.7%. This is in contrast with official polish statistics. The extrapulmonary tuberculosis was registered in only 4% of cases.

Adolescent↗
PubMedDate not supplied

[Disseminated lung tuberculosis in a patient with undiagnosed chronic hip joint tuberculosis].

A case of a 69-year male patient is reported. His history is an illustration of difficulties in the diagnosis of hip joint tbc. Patient suffered from severe pain in the right hip and thigh while walking for 25 years. Despite abnormal bone structure confirmed by several X-rays, no other examinations were ever performed to establish possible diagnosis. The patient was told to have "an inflammation" or "degeneration" of the bone. Anti-inflammatory and analgesic agents were given him to enable walking for years. Untreated tuberculosis resulted in the complete destruction of the proximal end of thigh bone and unilateral hip joint. Etiology was confirmed when the patient developed disseminated lung tuberculosis. Antitubercular drugs proved effective and brought about fast improvement of patient's health. On completion of chemotherapy, surgical treatment of the affected bones was performed.

Aged↗