PubMed Health⌕ Search

Biomedical subjects

Z Sledzinski

Publications and source records attributed to Z Sledzinski.

12 recordsLinked to original sources

Does the septic shock interfere experimental acute pancreatitis in rats?

INTRODUCTION: Acute pancreatitis is a disease involving pro-inflammatory mediators. Two complex and multifactorial pathogenetic ways lead to edematous or necrotizing pancreatitis. The course of the disease is thought to be the consequence of an acute inflammatory response. AIM: The authors examined the impact of Escherichia coli LPS on the acute cerulein pancreatitis in rats. METHODS: The study was performed on rats using the ceruleine pancreatitis model. The activation status of polymorphonuclear cells, blood IL-6 concentration, oxidative stress parameters, pancreatic enzymes concentration and microscopic alterations were determined at 5th and 9th h observations. RESULTS: In acute pancreatitis and acute pancreatitis with LPS groups, the peripheral polymorphonuclear cells activity was lower than in control one. Authors noticed the same neutrophil activation in acute pancreatitis after lipopolysaccharide administration although the peripheral blood polymorphonuclear cells count was significantly higher at the 9th h observation. LPS neither changed the oxidative stress within pancreatic gland, nor amylase or serum lipase activity. LPS given to acute pancreatitis animals resulted in significant increase of serum IL-6 concentration at 5th observation turning normal after 9th h. CONCLUSIONS: Collected data supports thesis of early polymorphonuclear cells involvement in acute pancreatitis and oxidative stress evidence in pancreatic parenchyma. However, results did not reveal that administration of LPS amplified inflammatory response during the course of acute pancreatitis.

Acute Disease↗

A comparison of two invasive techniques in the management of intractable pain due to inoperable pancreatic cancer: neurolytic celiac plexus block and videothoracoscopic splanchnicectomy.

BACKGROUND AND AIMS: Pancreatic cancer is characterized by a constant deterioration in quality of life, excruciating pain and progressive cachexia. The aim of this study was to compare the effectiveness of two invasive methods of pain treatment in these patients: neurolytic coeliac plexus block (NCPB) and videothoracoscopic splanchnicectomy (VSPL) to a conservatively treated control group concerning pain, quality of life and opiates' consumption. PATIENTS AND METHODS: Fifty nine patients suffering from pain due to inoperable pancreatic cancer were treated invasively with NCPB (N=35) or VSPL (N=24) in two non-randomised, prospective, case-controlled protocols. Intensity of pain (VAS-pain), quality of life (FACIT and QLQ C30) and opioid intake were compared between the groups and to a control group of patients treated conservatively before the procedure and after 2 and 8 weeks of follow-up. The analysis was performed retrospectively using meta-analysis statistics. RESULTS: Both methods of invasive pain treatment resulted in significant reduction of pain (VSPL effect size=11.27, NCPB effect size=7.29) and fatigue (effect sizes, respectively, 1.23 and 3.37). NCPB improved also significantly physical, emotional and social well-being (effect sizes, respectively, 2.37, 4.13 and 7.51) which was not observed after VSPL. No influence on ailments characteristic for the disease was demonstrated. Mean daily opioid consumption was significantly decreased after both procedures. There was no perioperative mortality and no major morbidity. CONCLUSION: Both NCPB and VSPL provide significant reduction of pain and improvement of quality of life in inoperable pancreatic cancer patients. They present rather similar efficacy, but lower invasiveness of NCPB, in combination with its more positive effect on quality of life, pre-disposes it as being the preferred method.

Adult↗

Factors influencing surgeons' choice of method for hernia repair technique.

Tension-free hernioplasty is performed using prosthetic material in one-half of hernia repair procedures in Poland but in 85% of those in the region of Pomerania. This questionnaire study of surgeons in Pomerania examined their sources of knowledge about and the factors influencing their choice of groin hernia surgery. The questionnaire was sent to surgeons from 19 hospitals and was answered by 109 (83% of hernia surgeons in the region). We analyzed their reported knowledge of particular operative techniques, factors important in selecting the technique (personal experience, trends in surgical center), and the available sources of information (e.g., medical literature, internet, information from teachers, sales representatives). All respondents reported being familiar with and able to perform tension-free techniques, but only 44% are influenced by their individual professional skills in selecting the technique. Another 44% base their decision on trends in their hospital, and only 22% consider the patient's preferences. The most frequently quoted sources of scientific information are articles in the medical literature and conference reports (90%). Only 8% of the respondents are governed in their professional work by information from pharmaceutical company representatives. Most surgeons (70%) would prefer to make a decision about using a new surgical technique after practical training sessions or workshops led by experienced colleagues. In contrast to common opinion, the information from sales representatives are of only minor importance compared to that of evidence-based data and attendance at workshops and courses.

Attitude of Health Personnel↗

Psychological factors influencing results of cholecystectomy.

BACKGROUND: Cholecystectomy is a surgical gold-standard procedure for gallbladder diseases, among which gallstones are the most frequent. Despite the introduction of minimally invasive surgery and broad access to ultrasound examination there is a group of patients in whom the surgery ailments persist. Those vague ailments can be perceived from a psychological point of view as somatization or even somatoform disorders. METHODS: The aim of the study, designed as a case-control study, was to evaluate psychological characteristics that may accompany the incidence of so-called post-cholecystectomy pain syndrome (PCPS). The study focused on 367 patients treated for gallstones in the Dept. of General, Gastroenterological and Endocrinological Surgery, Medical University of Gdańsk, Poland. At about a year after the operation, the patients received a questionnaire that included a structured interview and psychological assessment of social support and rumination. Those who revealed symptoms of PCPS were invited to the department for further medical and psychological evaluations. Psychosocial scores of PCPS and non-PCPS patients were compared. RESULTS: The PCPS patients did not present any dysfunction at the physical examination or in gastroduodenoscopy or sonography. However, they differed from the remaining. asymptomatic group in terms of lacking social support, as well as increased rumination. CONCLUSION: It is concluded that psychological variables may play an important role in the onset of subjective symptoms in at least a subgroup of the PCPS patients as a form of somatization. Psychological supportive and explanatory activities (cognitive and behavioural approach) may provide sufficient help.

Adult↗

Comparative study of the lipogenic potential of human and rat adipose tissue.

The reported low activity of lipogenic enzymes (especially adenosine triphosphate [ATP]-citrate lyase) in human adipose tissue led to the general conclusion that in humans lipogenesis occurs primarily in the liver. However, recent studies indicate that the liver plays a minor role in de novo lipogenesis and suggest that adipose tissue may be the principal lipogenic human tissue. In an attempt to resolve these contradictions we reinvestigated the lipogenic potential of human adipose tissue and compared with adipose tissue of rats fed a high-fat diet for 2 weeks and fasted overnight before death. These conditions mimic the nutritional state of patients at the moment of tissue sampling. We found that overnight fasting of the rats maintained previously for 12 days on a high-fat diet caused a decrease of ATP-citrate lyase of about 7-fold. Thus, in human adipose tissue, the mean activity of ATP-citrate lyase was approximately 8 times lower than in rats fed a high-fat diet and fasted overnight, and about 50 times lower than in rats maintained on normal laboratory diet. Unlike ATP-citrate lyase, fatty acid synthase (FAS) activity was only slightly lower in human adipose tissue than in rats maintained on a normal laboratory diet. Comparable FAS activity was found when rats were fed a high-fat diet and fasted overnight. The average activities of human adipose tissue acetyl-coenzyme A carboxylase, malic enzyme, and glucose-6-phosphate dehydrogenase were approximately 3-, 4-, and 6-fold lower than in adipose tissue from rats fed a high-fat diet and fasted overnight before tissue sampling, while the activity of 6-phosphogluconate dehydrogenase in humans was higher than in rat adipose tissue. No significant differences in lipogenic enzyme activities were found between male and female and between lean and obese patients. The rate of fatty acid synthesis in intact pieces of human adipose tissue was approximately 5 times lower than in adipose tissue pieces of rats fed a high-fat diet and fasted overnight before tissue samples were taken. The comparison of the lipogenic potential of humans and rats (maintained on the diet to mimic the nutritional state of patients at the time of tissue sampling) suggests that human adipose tissue is an important site of fatty acid synthesis.

ATP Citrate (pro-S)-Lyase↗

Small intestine perforation because of capacitive coupling as a cause of abdominal wall gas gangrene and clostridial sepsis after laparoscopic cholecystectomy.

The authors present a case report regarding abdominal wall gas gangrene and clostridial sepsis after laparoscopic cholecystectomy. Capacitive coupling was considered to be the most probable cause of small intestine perforation and further complications. Despite intensive treatment, the 69-year-old patient died.

Abdominal Abscess↗

Beneficial effect of therapeutic infusion of nafamostat mesilate (FUT-175) on hemodynamics in experimental acute pancreatitis.

Acute pancreatitis was induced in 13 anesthetized dogs by retrograde injection of bile mixed with trypsin into the pancreatic duct. Six animals were treated with intravenous infusion of new synthetic antiprotease. Nafamostat Mesilate, at a dose of 1 mg/kg/h. Four out of seven untreated animals died during the experiment. All the treated dogs survived. Hemodynamic data were regularly monitored during a ten-hour observation period. Cardiac output, mean arterial pressure and left ventricular stroke volume decreased rapidly in the untreated animals. An increase in systemic vascular resistance and pulmonary vascular resistance was observed in dogs without treatment. Nafamostat Mesilate given as therapy significantly improved the hemodynamic parameters, and prevented the animals from developing shock. The study demonstrates an advantageous influence of synthetic antiprotease Nafamostat Mesilate on the course of acute experimental pancreatitis.

Acute Disease↗