Biomedical subjects

Zdzisław Sićko

Publications and source records attributed to Zdzisław Sićko.

6 recordsLinked to original sources

PubMed2004

[Sudden sensorineural hearing loss: a treatment protocol including glucocorticoids and hyperbaric oxygen therapy].

The aim of this study was to evaluate the efficacy of pharmacological treatment (corticosteroids, vasodilators, vitamins, Betaserc) combined with hyperbaric oxygen therapy (HBO) in the sudden sensorineural hearing loss (SSNHL). We reviewed 52 patients with SSNHL treated pharmacologically and with HBO (group A) between 1997 and 2000. All patients in this group received once daily, five days a week, 100% oxygen in a multiplace chamber under pressure of 2.5 ATA for 60 minutes (plus two 5 minutes air breaks). The other group (group B) consisted of 81 patients treated only pharmacologically between 1980 and 1997. Both groups were similar regarding age, season of the year in which deafness occurred, presence of vestibular symptoms and tinnitus, therapeutic delay from initial symptoms to start of treatment, and initial hearing loss, however there were significant differences in gender and shape of hearing loss. The improvement after treatment was measured by tonal audiometry. The retrospective analysis of audiometries performed in all patients was conducted. The improvement of hearing loss was statistically significantly better for group A (vasodilators, high-dose of corticosteroids, vitamins, Betaserc, HBO) than group B (vasodilators, lower-dose of corticosteroids, vitamins) in any single frequency (500-1000-2000-3000-4000-6000-8000 Hz) and in 4 ranges of frequencies (PTA, HTA, PMTA, OAA) both for relative and absolute values. We concluded that the combined therapy of high-dose corticosteroids and HBO improved the clinical results of treatment in the SSNHL, and therefore should be performed in such cases. We also observed that therapeutic delay and flat hearing loss are predictors of poor clinical outcome.

Adult↗

PubMed2004

Delayed treatment of bubble related illness in diving--review of standard protocol.

The basic treatment of diver with bubble related illness consists of recompression in medical hyperbaric facility. However transportation of injured diver to hyperbaric chamber can last for several hours. During that time the process induced by gas bubbles spread out and finally result in activation of many pathophysiological events. Currently approved standard of treatment before starting of recompression consists of normobaric oxygenation, intravenous or oral fluids and general stabilization of the patient condition. Usage of several pharmacological agents is promising, including corticosteroids, antiplatelet and anticoagulant therapy or lidocaine. Those drugs are most often used in some centres but still there is lack of randomized controlled studies concerning their efficacy in decompression illness of divers. The review of available bibliography presented in this paper leads to conclusion that recommendations of the Second European Consensus Conference on Hyperbaric Medicine "The Treatment of Decompression Accidents in Recreational Diving" published in 1996 in Marseille, France for fluid replacement and drug therapy for decompression accidents are still valid. This protocol includes the fluid treatment, normobaric oxygen and intensive therapy. Other drugs (aspirin, lidocaine, heparin, steroids, calcium channel blockers, antioxidants) should still be treated as an option considered by clinician, but without strong evidences from clinical studies.

Decompression Sickness↗

PubMed2003

[Surgical treatment and adjunct hyperbaric therapy to improve healing of wound infection complications after sterno-mediastinitis].

UNLABELLED: Although the incidence of wound complications after median sternotomy is less than 1%, it remains a serious complication in patients undergoing cardiac procedures. We suggest that the combination of hyperbaric oxygen therapy and aggressive surgical approach improves clinical outcomes in these patients. Between August 1997 and May 2002, 55 patients with postoperative sternal wound infection and/or mediastinitis were qualified for hyperbaric oxygen treatment in connection to surgical management. Surgical procedure included wound debridment and/or sternum rewiring, omental pedicle flap plasty or sternectomy. Hyperbaric oxygen therapy consisted of 20 to 40 expositions per patient and was carried before and after the surgery. RESULTS: There was no in-hospital death. The total time between the admission and discharge from the hospital varied from 2 to 24 weeks (average 8 weeks). The infection has been cured in all patients treated for postoperative sternal wound infection. That has been confirmed by negative bacteriological tests, stabilization of the sternum and complete wound healing. CONCLUSIONS: The combination of surgical treatment and hyperbaric oxygen therapy may improve clinical outcome in patients with sterno-mediastinis and poststernotomy wound infection after cardiac surgery.

Cardiac Surgical Procedures↗

PubMed2003

The maximum tissue half-time for nitrogen elimination from divers' body.

Both the longest tissue half-time (T1/2max) and the maximum allowable pressure gradient (deltaP) define the safe rate of decompression (DR) after saturation expositions. The mathematical relation between them (DR = -k x deltaP, where: k = ln(2)/(T1/2max)) suggests that experimentally established decompression rate can be hypothetically described by the infinite number of T1/2max and deltaP combinations. The observed number of decompression sickness after saturation decompressions forced to change those parameters subsequently and finally led to values far outside physiological range. Therefore the aim of this study was to compare values of the longest tissue half-time of nitrogen desaturation from diver's body published since 1908 in order to present the evolution of opinions concerning desaturation process. Non-physiological values of T1/2max (from 75 to 1280 minutes) have been published during historical evolution of decompression tables and systems. The currently accepted values of T1/2max (in the range of 320-480 minutes) for saturation and non-saturation air and nitrox divings and hypobaric decompressions, still need to be precised. The discrepancy between T1/2max values obtained using isobaric decompression method and decompressions after diving indicates different physiological phenomena during nitrogen elimination in both methods.

Decompression↗

PubMed2003

Oxidative stress during oxygen tolerance test.

Reactive oxygen species, including oxygen free radicals are normally generated in human cells during aerobic metabolism. Their production may increase during breathing of hyperoxic mixtures. The 'oxidative stress' has been postulated to be an important contributor to CNS oxygen toxicity. One of the highest partial pressure of oxygen used in healthy humans is 280 kPa(a) during 30 min of 'oxygen tolerance tests' (OTT). This test is conducted in order to detect some individuals with an increased sensitivity to high partial pressures of oxygen leading them to develop CNS oxygen toxicity earlier than others. The purpose of this study was to investigate whether the OTT (30 min of breathing pure oxygen at 280 kPa(a)) would significantly induce oxidative stress in healthy population. The first group consisted of 52 subjects, in whom total antioxidant status (TAS) was measured. The second group consisted of 44 subjects, in whom protein carbonyls (PC), total thiol (t-SH) and heat shock proteins (HSP70) were measured. All measurements were done just before and immediately after the OTT. There was no statistically significant change of TAS. We observed a small, however statistically significant increase of PC and decrease of t-SH. A significant decrease of HSP70 was detected, however false positives of initial measurements are suspected. In summary, in young healthy subjects 30 min of breathing oxygen under pressure of 280 kPa(a) induces oxidative stress which can be detected by increase of protein carbonyls and by decrease of total thiol. In our study this stress was not reflected in measurement of total oxidative status and heat shock proteins.

Adult↗

PubMed2003

[An application of hyperbaric oxygen therapy in otolaryngological oncology].

Postradiation changes in the tissues and delayed wound healing were presumed by all hyperbaric medicine societies including Undersea and Hyperbaric Medical Society (UHMS) and European Committee for Hyperbaric Medicine (ECHM) as one of the basic indications for hyperbaric oxygen therapy (HBO). The authors estimated the influence of hyperbaric oxygen on molecular, biochemical and cellular changes in injured tissues including that after radiotherapy. Reviewing the references the authors tried to state the actual role of HBO in oncology of head and neck tumors. The authors referred their experiences in adjuvant therapy of head and neck neoplasms with HBO: 1] postradiation changes of head and neck after adjuvant radiotherapy (7 cases) and after primary radiotherapy (1 case); 2] delayed postoperative wound healing (1 case).

Adult↗