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Biomedical subjects

S Nitecki

Publications and source records attributed to S Nitecki.

At least 19 recordsLinked to original sources
PubMed2006

Cerebral hemodynamics in symptomatic and asymptomatic patients with severe unilateral carotid stenosis before and after carotid endarterectomy.

BACKGROUND: Data concerning hemodynamic status prior to and after carotid endarterectomy (CEA) in symptomatic and asymptomatic patients is insufficient. Transcranial Doppler (TCD) provides information regarding compensatory collateral flow as well as mechanisms of cerebral autoregulation in patients with carotid stenosis. PATIENTS AND METHODS: Forty eight symptomatic and 81 asymptomatic patients with unilateral severe carotid stenosis were examined by TCD before and in early postoperative period after CEA. RESULTS: Cigarette smoking was the only risk factor significantly more frequent in symptomatic patients. Preoperative anterior cerebral artery (ACA) and middle cerebral artery (MCA) asymmetry, basilar artery velocity and number of ophthalmic arteries with reversed flow, were not significantly different between the two groups. Pulsatility index, cerebrovascular reactivity and flow acceleration on the side of stenosis were significantly lower in symptomatic patients. After surgery there was a significant improvement of all TCD parameters in symptomatic as well as asymptomatic patients. CONCLUSIONS: The exhausted ability of cerebral autoregulation is an important factor differentiating between symptomatic and asymptomatic patients with severe carotid stenosis. Successful surgery provides good recovery of cerebral hemodynamics in both symptomatic and asymptomatic patients.

Aged↗
PubMed2003

Cognitive performance following endarterectomy in asymptomatic severe carotid stenosis.

Cognition and the effects of carotid endarterectomy (CEA) were evaluated in 22 non-demented subjects with vascular risk factors (VRF) and asymptomatic severe carotid artery stenosis (ASCAS), 14 volunteers with VRF but without stenosis, and 24 healthy controls (HC) without VRF. Non-demented subjects with VRF, with or without carotid stenosis scored inferior to HC. It is concluded that carotid stenosis is not a primary cause of cognitive deterioration and CEA does not improve cognition in patients with ASCAS.

Aged↗
PubMed2002

Pomegranate juice flavonoids inhibit low-density lipoprotein oxidation and cardiovascular diseases: studies in atherosclerotic mice and in humans.

The beneficial health effects attributed to the consumption of fruit and vegetables are related, at least in part, to their antioxidant activity. Of special interest is the inverse relationship between the intake of dietary nutrients rich in polyphenols and cardiovascular diseases. This effect is attributed to polyphenols' ability to inhibit low-density lipoprotein (LDL) oxidation, macrophage foam cell formation and atherosclerosis. Pomegranate polyphenols can protect LDL against cell-mediated oxidation via two pathways, including either direct interaction of the polyphenols with the lipoprotein and/or an indirect effect through accumulation of polyphenols in arterial macrophages. Pomegranate polyphenols were shown to reduce the capacity of macrophages to oxidatively modify LDL, due to their interaction with LDL to inhibit its oxidation by scavenging reactive oxygen species and reactive nitrogen species and also due to accumulation of polyphenols in arterial macrophages; hence, the inhibition of macrophage lipid peroxidation and the formation of lipid peroxide-rich macrophages. Furthermore, pomegranate polyphenols increase serum paraoxonase activity, resulting in the hydrolysis of lipid peroxides in oxidized lipoproteins and in atherosclerotic lesions. These antioxidative and antiatherogenic effects of pomegranate polyphenols were demonstrated in vitro, as well as in vivo in humans and in atherosclerotic apolipoprotein E deficient mice. Dietary supplementation of polyphenol-rich pomegranate juice to atherosclerotic mice significantly inhibited the development of atherosclerotic lesions and this may be attributed to the protection of LDL against oxidation.

Animals↗
PubMed1998

The effect of flufenamic acid on gastrointestinal myoelectrical activity and transit time in dogs.

BACKGROUND: Flufenamic acid, a fenamate, has been shown to alter markedly the membrane potential of small intestinal smooth muscle and increase intracellular calcium in single cells. AIMS: To determine the effects of flufenamic acid on myoelectrical motor activity and gastrointestinal transit in the intact animal. METHODS: Myoelectrical motor activity was recorded via seromuscular platinum electrodes sutured at regular intervals in the stomach and throughout the small intestine. Fasted and fed gastrointestinal transit was assessed using technetium-99m (99mTc) as the radioactive marker linked to 1 mm amberlite pellets or added to the meal. RESULTS: Flufenamic acid (600 mg, intravenously) induced intense spike activity in the small intestine. The mean duration of irregular spike activity was 250 (7) minutes. Spike activity was more pronounced in the lower small intestine. Flufenamic acid also accelerated initial gastric emptying and markedly shortened transit time in the small intestine. In the fasted state the 50% transit time in the small intestine was 54 (8) minutes with infusion of flufenamic acid compared with 105 (10) minutes in the control group; in the fed state 99mTc first reached the colon at 220 (10) minutes compared with 270 (12) minutes in the control group. CONCLUSIONS: Flufenamic acid had marked effects on both myoelectrical motor complex activity and small intestinal transit in the dog. The observed effects suggest that flufenamic acid may be of potential use as a prokinetic agent.

Animals↗
PubMed1994

Predictive factors of the outcome of traumatic cervical spine fracture in children.

The uncommon traumatic cervical spine fractures and dislocations were studied in 227 consecutively treated children (1 to 17 years of age). Lower cervical spine injuries (C-3 to C-7) affected 73% of our patients. However, among the 38 patients younger than 8 years of age, 87% had an injury at the C-3 level or higher (P < .0001). There were 19 fatalities (8.4%), all of which were associated with injuries at the C-4 level or higher. Of the 11 patients with atlanto-axial fracture or dislocation, all died soon after the injury. All had an unstable fracture and cord transection that resulted in cardiorespiratory collapse. Injuries at the vertebral levels C-1, C-2, C-3, and C-4 were associated with fatality rates of 17%, 9%, 4.3%, and 3.7%, respectively. No fatalities were encountered among patients with lesions lower than C-4. The authors conclude that the younger the age, the higher the cervical spine injury, and that the fatality rate correlates directly with the level of cervical spine fracture.

Adolescent↗
PubMed1994

Long-term perfusion of the cerebroventricular system of dogs without leakage to the peripheral circulation.

Methods developed previously for studying the effect of cerebroventricular injection or ventriculocisternal perfusion of test substances are unsatisfactory because the test substance is not confined to the central compartment. Most likely the test substance enters the peripheral circulation via the arachnoid villi. The purpose of this paper is to describe a method for perfusing the cerebroventricular system of conscious dogs without passage of test substances to the peripheral circulation. With the method described, the mean (+/- SE) cerebroventricular pressure in conscious dogs was 7.4 +/- 0.8 cmH2O (n = 16), and the mean (+/- SE) production of cerebrospinal fluid (CSF) was 25 +/- 0.3 microliter/min (n = 16). Endogenously occurring migrating myoelectric complexes (MMCs) of the small intestine were recorded in dogs before catheters were implanted in the left and right lateral ventricles and the fourth ventricle and after catheter implantation during cerebroventricular perfusion with artificial CSF alone or with CSF containing sulfated (S-CCK-OP) or nonsulfated cholecystokinin octapeptide (NS-CCK-OP). Only cerebroventricular perfusion with S-CCK-OP (1.2 pmol.kg-1.min-1; n = 20) replaced spontaneously occurring MMCs with a fed-like pattern of myoelectric activity. The results suggest that replacement of the fasting pattern of myoelectric activity with a fed-like pattern in the fasted dog was mediated by CCK-A receptors located in one or more brain nuclei surrounding the third ventricle.

Animals↗
PubMed1993

[Posttraumatic superficial temporal artery pseudoaneurysm].

The etiology of superficial temporal artery aneurysm (STAA) is usually blunt trauma. This type of aneurysm is more prevalent in young men and is also probably more common than estimated from the literature. We present 3 males and 1 female with STAA, ranging in age from 8 to 30 years, who were successfully treated. 3 were operated on under local anesthesia, while the aneurysm of the fourth was obliterated by continuous local pressure. Application of local pressure is the best measure for preventing the development of pseudoaneurysm following blunt temporal trauma. We consider surgery the treatment of choice for STAA.

Adolescent↗
PubMed1993

[Temporal artery biopsy--required or superfluous?].

Temporal arteritis is a systemic disease affecting large and medium-sized arteries in the elderly. The incidence of the disease increases with age and its major complications are blindness, cerebrovascular accidents and aortic dissection. Diagnosis is mainly based on clinical signs and symptoms. Temporal artery biopsy is a popular and simple diagnostic procedure and if positive confirms the diagnosis. However, a negative biopsy cannot exclude temporal arteritis due to its segmental nature, and the specific signs and symptoms still require treatment with corticosteroids. During the years 1982-1991 we performed 206 temporal artery biopsies, of which only 21 (10.2%) confirmed the presence of temporal arteritis. Our experience is presented with regard to the usefulness of temporal artery biopsy in particular. In view of the low biopsy yield we recommend more selective referral for this purpose.

Adult↗
PubMed1993

[Isolated iliac aneurysm].

The incidence of isolated iliac artery aneurysm is 1-2% of that of abdominal aortic aneurysms. The natural history is of gradual enlargement, with rupture the most common clinical presentation. The signs and symptoms of such an aneurysm are influenced by its concealed location within the bony pelvis. Awareness of these special characteristics improves the chances of early diagnosis and proper surgical treatment before possible rupture. We report 2 cases which demonstrate the spectrum of the clinical presentation.

Aged↗
PubMed1993

[Total colectomy and mucosal proctectomy with J-pouch anal anastomosis for ulcerative colitis and familial colonic polyposis].

Total colectomy and mucosal proctectomy with ileal pouch-anal anastomosis is the accepted surgical procedure for ulcerative colitis and familial polyposis of the colon. During 1981-1990, 25 patients with ulcerative colitis or familial polyposis underwent this operation in our department. In the majority a J-pouch was performed. In the early years, an 8 cm rectal muscular sleeve was left. In later cases, in accordance with opinions expressed in the medical literature, the length of the sleeve was shortened to about 3 cm. We present the functional results and the early and late complications on follow-up of up to 10 years (mean 3.5 years). Although this operation is not the ideal solution, it is better than the alternatives and is the surgical procedure of choice.

Adolescent↗
PubMed1993

[Update of experience with prostatic cancer].

A retrospective analysis of 302 patients with prostatic cancer, referred between 1977-1982, was updated. 15 patients (5%) with Stage A1 disease did not receive any specific treatment, and their 10-year actuarial survival was 77%. 22 (7%) had Stage A2 disease at diagnosis, 82 (27%) Stage B, 88 (29%) Stage C, and 95 (32%) Stage D. Their 10-year actuarial survival rates were 75%, 56%, 38%, and 2%, respectively. The 10-year actuarial survival of patients with well- and moderately well-differentiated adenocarcinoma was 61%, but only 13% in those with poorly differentiated adenocarcinoma (p < 0.001). A total of 116 patients with Stages A2, B and C were treated by irradiation and 71 of them also received prophylactic hormone therapy. The 10-year actuarial survival of those treated by combined irradiation and hormone therapy was 59%, compared to 19% for those treated by irradiation alone (p < 0.02). Our results emphasize the need for early diagnosis of prostatic cancer, using modern diagnostic tools such as transrectal ultrasonography and determination of prostatic specific antigen. They also prove that radiotherapy is effective and curative in a high percentage of patients with disease confined to the pelvis.

Adenocarcinoma↗
PubMed1993

[Subtotal cholecystectomy: an emergency procedure for the difficult gallbladder and high-risk patient].

Emergency cholecystectomy in high-risk patients is still associated with significant morbidity and mortality. Occasionally technical difficulties and bleeding diathesis are complicating factors. Our prospective experience with subtotal cholecystectomy in 23 consecutive patients is presented. All presented as increased surgical risks (APACHE II above 10) and suffered from acute cholecystitis with empyema or perforation. 1 patient died (4.4%), but overall, surgical complications were minimal. We conclude that subtotal cholecystectomy combines the advantages of cholecystectomy and cholecystostomy. We believe that this short, simple and safe procedure is a logical choice for emergency situations in critically ill patients.

Adult↗
PubMed1993

Contemporary management of the appendiceal mass.

An appendiceal mass is the end result of a walled-off appendiceal perforation and represents a pathological spectrum ranging from phlegmon to abscess. Over the past decade, improved imaging and interventional radiological techniques have allowed a more accurate definition of pathology and thus a more specific and less invasive management than was previously possible. A management policy should be possible that allows over 80 per cent of patients presenting with an appendiceal mass to be safely spared an open operation.

Appendectomy↗
PubMed1993

Management of the leaking rectal stump after Hartmann's procedure.

Hartmann's procedure is often selected in situations in which the construction of a colorectal anastomosis is considered unsafe. Paradoxically, the creation of the rectal stump involves placement of an intestinal suture line that is prone to leakage. We report our experience with 11 patients with a clinically significant leakage from the rectal stump after Hartmann's procedure, which was manifested as persistent postoperative intra-abdominal infection. A method for the treatment and prevention of this potentially lethal complication is presented.

Adult↗