PubMed Health⌕ Search

Biomedical subjects

S Filipecki

Publications and source records attributed to S Filipecki.

At least 55 records · Page 3Linked to original sources
PubMed1994

[Outcome of patients with clinically acute massive pulmonary embolism].

Acute massive pulmonary embolism (AMPE) is an event that places the recipient at an unusually high risk of sudden death. Among 183 patients with thromboembolic disease, AMPE has been diagnosed clinically in 58 cases (32%). Diagnostic criteria: cardiac arrest (24 cases--41%), shock (12--21%) acute cor pulmonale (ACP 15--26%) and ACP with shock (7 cases--12%). There were 33 women and 25 men aged 22-88 years in this group. In 25 patients heparin (H), in 7 streptokinase (S), in 1 tPA, in 7 S after H have been used, 26 patients (45%) survived, 32 (55%) died: there were 20 sudden deaths. Advanced underlying cardiopulmonary diseases or/and recurrent pulmonary embolism seem to be the most important predictors of fatal outcome of AMPE.

Acute Disease↗
PubMed1994

[Pulmonary embolism as a serious complication of chronic obstructive pulmonary disease from material from Ward "R"].

Pulmonary embolism (PE) is a serious complication of the chronic obstructive pulmonary disease (COPD). Retrospective studies on patients with COPD treated intensive care unit (ICU) were performed to determine: 1. frequency of PE, 2. clinical course of PE in ICU-COPD-cases, 3. frequency of PE as a cause of death in the studied group. There was 10.9% of PE in COPD patients. In the analyzed group clinical presentation of PE was characterized by acute, severe, life threatening complications leading to death in 86.7%. PE was the most frequent cause of death (40.6%) in ICU-COPD patients. The results of treatment of PE in COPD are poor and the mortality in that group of patients is very high. We believe, that the improvement of management can be achieved by antithromboembolic prophylaxis, which should be instituted as soon as possible in all ICU-COPD-patients.

Adult↗
PubMed1994

[Effect of large doses of nifedipine on pulmonary hypertension in patients with recurrent pulmonary thromboembolism].

Thromboembolic pulmonary hypertension is an uncommon condition with poor prognosis. Vasodilators may be effective in some patients with that disease. The effect of nifedipine on hemodynamics was investigated in two patients with thromboembolic pulmonary hypertension treated with acenocoumarol. Nifedipine was administered in 20 mg doses hourly during right cardiac catheterization and was repeated after 1 hour until a decrease in systemic pressure occurred. Patients received 80 mg and 120 mg of nifedipine. Pulmonary artery pressures decreased in both cases. An increase of cardiac output and decrease of pulmonary vascular resistance were observed after 60-80 mg of nifedipine and continued to the end of the investigation. No effect on heart rate was observed. We suggest that high doses of nifedipine may be--in some patients--effective in reducing thromboembolic pulmonary hypertension.

Adult↗
PubMed1994

[Secondary prevention by using oral anticoagulants in patients with clinically acute massive pulmonary embolism].

Oral anticoagulants are generally accepted as secondary prophylaxis in patients with thromboembolic disease. Long term oral anticoagulant treatment of 24 survivors of clinically acute massive pulmonary embolism (AMPE) was assessed. There were following indications for such a treatment: recurrent PE/DVT in history and/or continuous risk factors. In the group of survivors of AMPE with continuing risk factors or the recurrence of that disaster the long-term oral anticoagulant therapy is effective, relatively safe and therefore justified.

Acute Disease↗
PubMed1994

[Evaluation of agreement between clinical and pathomorphologic diagnosis of pulmonary embolism].

The rate of both: false-positive and false-negative diagnoses of pulmonary embolism (PE) is high. To determine the accuracy of the ante-mortem diagnosis of PE we reviewed 78 autopsies and compared the clinical and pathological diagnoses in that group. In 64 cases PE was diagnosed clinically: in 43 it was confirmed by autopsy (67%). In 21 cases (33%) the clinical diagnoses were false-positive. There were 57 pathological diagnoses altogether: in 14 cases (25%) the clinical diagnoses were false-negative. Among falsely diagnosed patients, the diagnoses of myocardial infarction, pneumonia and malignancy were most frequent. We tried to find some distinctive features separating the cases in the subgroups. Among them venous diseases were more frequent in PE than in falsely diagnosed patients.

Adult↗
PubMed1994

[Pericarditis during the course of pulmonary embolism].

Among 121 patients with pulmonary embolism (PE) five (4%) developed pericardial syndrome, connected with PE. Other known causes of pericarditis were ruled out. In 3 cases corticosteroids were administered with anticoagulants and/or fibrinolytic agents without complications. We believe that the clinician considering in similar situations the risk-benefit ratio of anticoagulant or/and fibrinolytic therapy should certainly use corticosteroids and not abstain from the use of anticoagulants and/or fibrinolytic agents in presence of pericardial syndrome after PE. In cases with huge pericardial effusion catheter should be inserted into pericardial space, because of high probability of cardiac tamponade.

Adult↗
PubMed1994

[Pulmonary hypertension during the course of chronic pulmonary thromboembolism--case report].

Chronic thromboembolic pulmonary hypertension is a rare condition. There are two forms of that disease: major vessel thromboembolic pulmonary hypertension (CTEPH) and a "silent form": recurrent microembolism leading to extensive obstruction of the peripheral pulmonary vasculature and resulting also in severe pulmonary hypertension. On the base of case report the new approaches to the management of patients with two mentioned subgroups of thromboembolic pulmonary hypertension are discussed.

Chronic Disease↗
PubMed1994

[Multi-organ failure syndrome. Clinical picture: report of 2 cases].

Two cases of MOFS (multi-organ-failure-syndrome) are presented. Pulmonary embolism was an initial presentation in one case, acute pneumonia in the other. In both cases intensive supportive treatment including mechanical ventilation was instituted because of acute respiratory failure. Sequential dysfunction and/or failure of other organs were observed. Both patients died despite 3 and 7 weeks of intensive treatment, respectively. In both cases MOFS was confirmed by autopsy.

Fatal Outcome↗
PubMed1994

[Multi-organ failure syndrome. Pathophysiology, prevention, treatment].

MOFS Multi-Organ-Failure-Syndrome has not been recognized until past 10 to 20 years. There are many different causes that may lead to MOFS. Recently it has become clear that MOFS is the clinical endstage of the systemic hypermetabolic response to injury that is heralded by acute lung injury and followed by hepatic and renal failure and often by death. The lung injury may range from relatively slight increase of pulmonary small vessels leakage to the adult respiratory distress syndrome (ARDS). In the first part of the following paper there are presented two clinical cases resulted in MOFS. Pathophysiology, current therapy and prophylaxis of MOFS are reviewed in the second part.

Humans↗
PubMed1993

[Level of carcinoembryonic antigen, neuron-specific enolase and ferritin in serum of small cell lung cancer patients: correlation with performance status, disease extent and prognosis].

Carcinoembryonic antigen (CEA), neuron-specific enolase (NSE) and ferritin serum levels were assessed before treatment in 109 small cell lung cancer patients. CEA and ferritin serum levels were estimated by immunoenzymatic method: Abbott kits were used. NSE serum level was assessed by radioimmunoassay Pharmacia kits. In 38 patients the disease was localized, in 27 metastases were found in one organ and in 48-in two or more organs. CEA levels above 5 ng/ml were found in 41%, NSE above 12.5 micrograms/l in 86% and ferritin above 250 ng/ml in 41% of patients. The levels of CEA and NSE, but not of ferritin were correlated with the disease extent. The levels of CEA and ferritin, but not of NSE were correlated with performance status of the patients. In the patients with NSE serum levels above 50 micrograms/l and ferritin serum levels above 600 ng/ml the prognosis was significantly worse than in remaining patients.

Carcinoembryonic Antigen↗
PubMed1993

[Usefulness of monitoring levels of carcinoembryonic antigen, neuron-specific enolase and ferritin in serum of patients with small cell lung cancer for evaluating treatment outcome].

Serum levels of CEA, NSE and ferritin were monitored during cytostatic chemotherapy in 53 small cell lung cancer patients. Complete remission of cancer was correlated with normalization of CEA and NSE but not of ferritin levels. The lack of normalization of CEA and NSE levels, but not of ferritin level were connected with bad prognosis.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

Subcutaneous low molecular weight heparin versus subcutaneous unfractionated heparin in the treatment of deep vein thrombosis: a Polish multicenter trial.

In a prospective multicenter trial, 149 consecutive patients with phlebographically proven proximal and/or distal deep vein thrombosis of the leg were randomly allocated to receive subcutaneously for 10 days either low molecular weight heparin CY 216 (Fraxiparine) in a fixed dose or unfractionated heparin (UFH) in doses adjusted according to the activated partial thromboplastin time. Pre- and post-treatment phlebograms were assessed blindly using the Arnesen's score system in 134 patients available for analysis of the treatment efficacy. The mean phlebographic score after 10 days of treatment was significantly decreased in both groups (p less than 0.001) in comparison with the baseline score but the difference in score changes between the two groups was not statistically significant. There was an improvement in 45/68 patients (66%) in the Fraxiparine group and in 32/66 patients (48%) in the UFH group, and an increase in the thrombus size in 10/68 (15%) and 12/66 (18%), respectively. One symptomatic non-fatal pulmonary embolism and one major bleeding episode were observed in the UFH group. During a follow-up period of 3 months, two rethromboses had occurred in the UFH group and none in the Fraxiparine group. It is concluded that subcutaneous fixed dose Fraxiparine is safe and at least as effective as subcutaneous adjusted UFH in the treatment of deep vein thrombosis.

Adult↗