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Biomedical subjects

S Dabrowiecki

Publications and source records attributed to S Dabrowiecki.

13 recordsLinked to original sources
PubMed2006

A modified technique of delayed basilic transposition - initial results.

The radiocephalic wrist fistula remains the "gold standard" for primary vascular access placement according to NKF -DOQI guidelines. However, liberal inclusion criteria for dialysis therapy, as well as increasing longevity and prevalence of diabetes, have led to an increased number of patients with distal vessels unsuitable for vascular access creation. Another available location, and one used with increasing frequency, is the anterior cubital fossa. Arteriovenous anastomoses in this location leads to the development of two possible vascular accesses: cephalic and basilic. The basilic vein needs to be transposed to the anterior aspect of the arm. However, this procedure is technically difficult and carries a high risk of complications, often associated with axial torsion or kinking of the transposed vein during placement in the subcutaneous tunnel. The authors propose a simple technical modification which minimizes the risk of these complications. The main advantage is the prevention of axial torsion and kinking, as well as avoiding venous stenosis by transecting the vein at its widest point.

Aged↗
PubMed2006

Etiology of inguinal hernia: ultrastructure of rectus sheath revisited.

In the last decade, in the search for abdominal-wall hernia etiology, attention has been brought to alterations in the connective tissue ultrastructure as the probable etiological factor. These may cause weakening of connective tissue, which in turn may form ground for hernia formation. To investigate this hypothesis in depth, we compared the ultrastructure of the connective tissue in hernia patients and the control group. The study group consisted of five patients with primary inguinal hernia (Nyhus II = 4, Nyhus IIIa = 1). Another five patients posted for emergency appendectomy created the control group. Tissue specimens, harvested intraoperatively from the rectus muscle sheath (RAMS) and fixed in 4% glutaraldehyde, underwent staining by the Masson, H-E and methylene blue techniques and were assessed by microscopy (light and scanning electron). The examinations showed significant differences in the rectus sheath ultrastructure. They included altered architecture, placement and quantity of collagen and elastic fibers, differences in the caliber of individual fibers and disrupted ground matter-to-fiber ratio. In patients with hernias, chaotic arrangement of collagen fibers was seen, as well as their thinning and a decrease in the general amount of elastic fibers, replaced by ground matter. Our research has shown significant differences in the structure of the RAMS between patients with hernias and healthy individuals. This supports the theory linking connective tissue alterations with the etiology of hernia, and stating that these alterations include connective tissue at locations distant from the hernia site as well, as the rectus sheath itself does not form a hernial defect.

Adolescent↗
PubMed1998

Microcirculation in lower limbs during laparoscopic cholecystectomy.

To study the influence of venous hypertension, which develops in lower limbs under pneumoperitoneal pressure, on microcirculation, plethysmographic measurements were performed in patients before and during laparoscopic and traditional (open) cholecystectomy. During laparoscopy, isovolumetric venous pressure (estimate of capillary pressure), and filtration coefficient (estimate of patent capillary surface) decreased, which was not the case during open surgery. These results indicates that venous hypertension during laparoscopic surgery does not extend to the microcirculation; vasoconstriction is a result of protective mechanisms, which disable excessive fluid filtration in microcirculation. Parameters of macrocirculation (ambient venous pressure, compliance of calf tissue) changed intraoperatively in both groups similarly, irrespectively of the surgical technique.

Blood Pressure↗
PubMed1997

The influence of laparoscopic cholecystectomy on perioperative blood clotting and fibrinolysis.

In order to investigate changes in coagulation and fibrinolysis arising during and after laparoscopic surgery we studied 24 patients, who were operated on because of biliary lithiasis [21 females, three males, aged 36-69 (mean 50) years]. The reference group consisted of 17 patients, who were operated on traditionally [15 females, two males, aged 25-72 (mean 55) years]. Blood samples were taken from cubital vein 24 h prior to the operation, during the cholecystectomy, on the 1st and 3rd postoperative days. Additionally, before and during operation blood was sampled simultaneously from femoral vein. Both groups had similar perioperative values of platelet count, fibrinogen and t-PA Ag. Patients operated on laparoscopically had generally lower values of F1 + 2 and plasmin-alpha 2-antiplasmin complexes, and intra-operative PAI-1 activity than those operated on traditionally. Test values in blood sampled simultaneously from femoral and cubital veins were not statistically different. The data obtained show that generation of thrombin and plasmin is lower in patients operated on laparoscopically compared with those having traditional surgery. Venous stasis during laparoscopic cholecystectomy in lower extremities does not cause local alterations in hemostasis.

Adult↗
PubMed1997

[Microcirculatory hemodynamics in the lower limbs during laparoscopic cholecystectomy].

To study the influence of venous hypertension, which develops in lower-limbs under pneumoperitoneal pressure, on microcirculation-plethysmographic measurements were performed in patients before and during laparoscopic and traditional (open) cholecystectomy. During laparoscopy isovolumetric venous pressure (estimate of capillary pressure), and filtration coefficient (estimate of patent capillary surface) decreased, which was not the case during open surgery. Results indicates that venous hypertension during laparoscopic surgery does not extend to microcirculation; vasoconstriction is due to protective mechanisms, which disable excessive fluid filtration in microcirculation. Parameters of macrocirculation (ambient venous pressure, compliance of calf tissue) changed peroperatively in both groups similarly, irrespectively of the surgical technique.

Adult↗
PubMed1995

[Structured abstracting of scientific medical publications].

Abstracts play an important role in medical literature as the carriers of synthetic information. Their significance grows as computerized data bases are in use in which whole information should comprise no more than 250 words. Critical appraisal the abstracts' standard resulted in a proposal for data presentation divided into significant parts (structured abstracts). The abstract of an original clinical trial should contain description of the objective, design, setting, patients, intervention, main outcome measures, results and conclusions. The abstract of the review article should provide information about the purpose, data identification, study selection, data extraction, results of data synthesis and conclusions. This form obliges the authors to precise, logical formulation draws out the essential aspects of the work, facilitates literature review, and critical appraisal.

Abstracting and Indexing↗
PubMed1995

[Effectiveness of endoscope disinfection process].

The effectiveness of flexible endoscopes disinfection was evaluated. Since 1991 to 1994--157 inoculations were taken from endoscopic equipment--right after the examination and after their disinfection. Following the endoscopes examinations were contaminated by microorganisms normally resident in the throat, respiratory and digestive tracts, but also with bacteria (Acinetobacter, Pseudomonas, Proteus) which could be source of severe nosocomial infections. Three times there was Ps. aeruginosa on an endoscope after its disinfection, which demonstrates ineffectiveness of the whole sanitary process. Constant surveillance demands sterility of the fluids employed during the disinfection process. The improvement in sanitary level is achieved when endoscope exposition to glutaraldehyde has been elongated, to each endoscope a new solution of detergent has been applied, and sterile water handling (its production, storage, and use) has been polished up.

Acinetobacter↗
PubMed1995

[Interpretation of diagnostic data exemplified by tests for identification of Helicobacter pylori in gastric mucosa].

Seven diagnostic tests were employed to detect the infection of gastric mucosa with the H. pylori bacteria, among patients with epigastric pain and dyspeptic complains. The tests' results were compared to the bacteriologic culture. For each test the following criteria were taken into consideration: sensitivity, specificity, positive and negative predictive values. The tests' accuracy was compared with the agreement expected by chance and beyond chance (kappa). For each test the likelihood ratio was calculated for its positive and negative results. The construction of so called diagnostic decision tree was presented, which allows on the evaluation of the diagnostic test and its utility. The best result were obtained from the test, in which the identification of bacteria took place in the histopathologic specimen after its Gram staining. The interpretation of clinical significance of diagnostic data is simplified with the use of likelihood ratio calculated for a positive test result.

Adult↗
PubMed1991

Tissue reaction to polypropylene mesh: a study of oedema, blood flow, and inflammation in the abdominal wall.

The purpose of the present work was to study the tissue reaction to polypropylene mesh (Marlex) implanted in three different layers of the abdominal wall, comparable to common clinical practices. The reaction to mesh was compared in terms of tissue oedema, blood flow, and histological appearance in rats. When mesh was placed between muscle layers, blood flow in the abdominal wall was high during the first 4 days after implantation but similar to flow in nonoperated rats 14 and 140 days after implantation. When mesh was placed under skin or on the peritoneum, there was no hyperaemia early after implantation, and flow rate was clearly lower than in non-operated controls 140 days after implantation. The operative procedure produced increased tissue water content, declining from the 1st to the 14th day after operation. Mesh induced additional oedema in adjacent muscle tissue irrespective of localization of the implant (p less than 0.01, vs. sham). Except when separated by peritoneum, mesh caused hyperaemia in muscle tissue in direct contact with mesh the 1st and the 4th day after implantation. After 14 and 140 days no mesh-induced hyperaemia was present. The inflammatory response to mesh was similar in the peritoneum and between muscles, less pronounced in the subcutis. It was characterized by the accumulation of macrophages and the formation of inflammatory granulation tissue in the subacute phase, later followed by the formation of fibrous tissue around mesh fibres. This study suggests that mesh implants should be placed in apposition to muscles in order to obtain well-vascularized healing.

Abdominal Muscles↗