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Arendts G, Chenoweth L, Hayes BJ, Campbell E, Agar M, Etherton-Beer C, Spilsbury K, Howard K, Braitberg G, Cubitt M, Sheehan C, Magann L, Sudharshan T, Schnitker LM, Pearce J, Gilmore I, Cerra N, duPreez J, Jaworski R, Soh SC, Celenza A. CELPI: trial protocol for a randomised controlled trial of a Carer End of Life Planning Intervention in people dying with dementia. BMC Geriatr 2022; 22:869. [PMID: 36384478 PMCID: PMC9670369 DOI: 10.1186/s12877-022-03534-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/16/2022] [Indexed: 11/17/2022] Open
Abstract
Background Dementia is a leading cause of death in developed nations. Despite an often distressing and symptom laden end of life, there are systematic barriers to accessing palliative care in older people dying of dementia. Evidence exists that 70% of people living with severe dementia attend an emergency department (ED) in their last year of life. The aim of this trial is to test whether a Carer End of Life Planning Intervention (CELPI), co-designed by consumers, clinicians and content specialists, improves access to end of life care for older people with severe dementia, using an ED visit as a catalyst for recognising unmet needs and specialist palliative care referral where indicated. Methods A randomised controlled trial (RCT) enrolling at six EDs across three states in Australia will be conducted, enrolling four hundred and forty dyads comprising a person with severe dementia aged ≥ 65 years, and their primary carer. Participants will be randomly allocated to CELPI or the control group. CELPI incorporates a structured carer needs assessment and referral to specialist palliative care services where indicated by patient symptom burden and needs assessment. The primary outcome measure is death of the person with dementia in the carer-nominated preferred location. Secondary outcomes include carer reported quality of life of the person dying of dementia, hospital bed day occupancy in the last 12 months of life, and carer stress. An economic evaluation from the perspective of a health funder will be conducted. Discussion CELPI seeks to support carers and provide optimal end of life care for the person dying of dementia. This trial will provide high level evidence as to the clinical and cost effectiveness of this intervention. Trial registration ACTRN12622000611729 registered 22/04/2022. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03534-1.
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Pomorska A, Świętoń D, Lieberman SM, Bryl E, Kosiak W, Pęksa R, Chorążewicz J, Kochańska B, Kowalska-Skabara J, Szumera M, Brzoznowski W, Jaworski R, Irga-Jaworska N. Recurrent or persistent salivary gland enlargement in children: When is it Sjögren's? Semin Arthritis Rheum 2021; 52:151945. [PMID: 35000785 DOI: 10.1016/j.semarthrit.2021.11.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/23/2021] [Accepted: 11/17/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To describe characteristic features in children with recurrent or persistent salivary gland enlargement and to propose a diagnostic algorithm with specific consideration for Sjögren's disease (SD). METHODS In this single-center, prospective study, 45 patients < 18 years, with recurrent or persistent salivary gland enlargement of unknown etiology were enrolled from 2006 to 2019. We collected detailed clinical information to characterize this group of patients including specific details of their major salivary gland signs and symptoms. We compared clinical, laboratory and radiological parameters between 4 groups based on the results of labial salivary gland biopsy (LSGB) and between patients who met existing SD criteria or not. RESULTS 44 patients, with a mean age of 6.8 years and female to male ratio 21:23 were observed over a mean of 3.8 years. Characteristics of salivary gland swelling episodes varied considerably between individuals, but the majority experienced ≤5 episodes per year, lasting ≤ 1 week, with swelling affecting either or both glands. Ocular and oral dryness symptoms were observed only in 25% and 59% patients, respectively. The majority were positive for ANA, but negative for SD-specific antibodies. A total of 75% patients fulfilled at least one of the existing SD criteria. CONCLUSION SD is a major cause of recurrent salivary gland enlargement in children. For children meeting adult criteria, the diagnosis of SD is clear. However, for the many children without dryness symptoms, objective dryness, or SD-specific antibodies, further workup including a combination of salivary gland imaging and histopathological examination can help establish the diagnosis of SD.
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Affiliation(s)
- Anna Pomorska
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdańsk, Dębinki 7, Gdańsk 80-952, Poland.
| | - Dominik Świętoń
- 2nd Department of Radiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Scott M Lieberman
- Division of Rheumatology, Allergy, and Immunology, Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa, IA, United States
| | - Ewa Bryl
- Department of Pathology and Experimental Rheumatology, Medical University of Gdańsk, Gdańsk, Poland
| | - Wojciech Kosiak
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdańsk, Dębinki 7, Gdańsk 80-952, Poland
| | - Rafał Pęksa
- Pathology Department, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Barbara Kochańska
- Department of Conservative Dentistry, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Małgorzata Szumera
- Department of Pediatrics, Gastroenterology, Hepatology and Nutrition, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Radosław Jaworski
- Department of Pediatric Cardiothoracic Surgery, Children's Memorial Health Institute, Warsaw, Poland
| | - Ninela Irga-Jaworska
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdańsk, Dębinki 7, Gdańsk 80-952, Poland
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Haponiuk I, Jaworski R, Paczkowski K, Chojnicki M, Steffens M, Szofer-Sendrowska A, Gierat-Haponiuk K, Kwaśniak E, Paśko-Majewska M, Leszczyńska K, Zieliński J, Szymanowicz W. Postoperative kinetics of common inflammatory biomarkers after congenital heart defect procedures with extracorporeal circulation in children. Kardiol Pol 2018; 76:968-973. [DOI: 10.5603/kp.a2018.0038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 11/25/2017] [Accepted: 11/27/2017] [Indexed: 11/25/2022]
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Haponiuk I, Chojnicki M, Paczkowski K, Jaworski R, Romanowicz A, Gierat-Haponiuk K. Symptomatic cardiac hemangioma resected on the first day of life. J Card Surg 2017; 32:833-836. [DOI: 10.1111/jocs.13255] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Ireneusz Haponiuk
- Department of Pediatric Cardiac Surgery; St. Adalbertus Hospital, Copernicus Ltd.; Gdańsk Poland
- Chair of Physiotherapy; Faculty of Rehabilitation and Kinesiology; Gdańsk Academy of Physical Education and Sport; Gdańsk Poland
| | - Maciej Chojnicki
- Department of Pediatric Cardiac Surgery; St. Adalbertus Hospital, Copernicus Ltd.; Gdańsk Poland
| | - Konrad Paczkowski
- Department of Pediatric Cardiac Surgery; St. Adalbertus Hospital, Copernicus Ltd.; Gdańsk Poland
| | - Radosław Jaworski
- Department of Pediatric Cardiac Surgery; St. Adalbertus Hospital, Copernicus Ltd.; Gdańsk Poland
| | - Anna Romanowicz
- Department of Pediatric Cardiac Surgery; St. Adalbertus Hospital, Copernicus Ltd.; Gdańsk Poland
| | - Katarzyna Gierat-Haponiuk
- Chair of Physiotherapy; Faculty of Rehabilitation and Kinesiology; Gdańsk Academy of Physical Education and Sport; Gdańsk Poland
- Department of Rehabilitation; Gdańsk Medical University; Gdańsk Poland
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Haponiuk I, Chojnicki M, Jaworski R, Steffens M, Paczkowski K, Szofer-Sendrowska A, Paśko-Majewska M, Gierat-Haponiuk K, Romanowicz A, Szymanowicz W. Paediatric Melody® mitral valve replacement in acute endocarditis — alternative surgical-hybrid technique. Kardiol Pol 2017; 75:845-849. [DOI: 10.5603/kp.a2017.0092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 02/26/2017] [Accepted: 03/21/2017] [Indexed: 11/25/2022]
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Jaworski R, Haponiuk I, Chojnicki M, Olszewski H, Lulewicz P. Three-dimensional printing technology supports surgery planning in patients with complex congenital heart defects. Kardiol Pol 2017; 75:185. [PMID: 28205200 DOI: 10.5603/kp.2017.0029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 09/20/2016] [Indexed: 11/25/2022]
Affiliation(s)
- Radosław Jaworski
- Department of Paediatric Cardiac Surgery, Mikolaj Kopernik Hospital, Gdansk, Poland.
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Jaworski R, Naumiuk Ł, Paczkowski K, Haponiuk I. Heater-cooler unit contamination with Mycobacterium chimaera - potential harmful risks for cardiac surgery patients. Kardiol Pol 2017; 75:412-413. [PMID: 28421583 DOI: 10.5603/kp.2017.0067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 03/08/2017] [Indexed: 11/25/2022]
Affiliation(s)
- Radosław Jaworski
- Department of Paediatric Cardiac Surgery, Copernicus Hospital, Gdansk, Poland.
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Haponiuk I, Chojnicki M, Jaworski R, Steffens M, Paczkowski K, Szofer-Sendrowska A, Paśko-Majewska M, Gierat-Haponiuk K, Romanowicz A, Szymanowicz W. Implantacja zastawki Melody w pozycję mitralną — u dziecka z nienaprawialnym uszkodzeniem zastawki w przebiegu infekcyjnego zapalenia wsierdzia. Folia Cardiologica 2017. [DOI: 10.5603/fc.2017.0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Oo T, Viswanathan S, Achan A, Huang M, Jaworski R, Russel P, Sharma R. Case discussion on an early minimal deviation adenocarcinoma of the uterine cervix. Pathology 2017. [DOI: 10.1016/j.pathol.2016.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Haponiuk J, Kwaśniak E, Andrzejczyk K, Szofer - Sendrowska A, Chojnicki M, Steffens M, Paczkowski K, Jaworski R, Gierat-Haponiuk K, Romanowicz A, Paśko-Majewska M, Haponiuk I. Objawy pooperacyjnego zespołu Hornera po korekcji wrodzonej wady serca prowadzące ostatecznie do rozpoznania zespołu Axenfelda-Riegera. Folia Cardiologica 2016. [DOI: 10.5603/fc.a2017.0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Zielinski J, Jaworski R, Irga-Jaworska N, Jaskiewicz J. 234. Quality of life during fiberoductoscopy in patients with pathological nipple discharge: A ten-year Polish experience. Eur J Surg Oncol 2016. [DOI: 10.1016/j.ejso.2016.06.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Paczkowski K, Haponiuk I, Chojnicki M, Jaworski R. Damus-Kaye-Stansel Procedure with Extracardiac Fontan: Successful Recruitment of Previously Ligated Pulmonary Valve. Heart Surg Forum 2016; 19:E206-7. [PMID: 27585204 DOI: 10.1532/hsf.1580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 05/25/2016] [Indexed: 11/20/2022]
Abstract
We present a case of a 2.5-year-old-girl with complex congenital heart disease: tricuspid atresia (TA), bulboventricular septal defect (VSD), hypoplastic right ventricle, d-transposition of the great arteries (d-TGA) with aortic outflow from redundant RV. Due to II/III degree atrioventricular block induced after diagnostic cardiac catheterization, an epicardial pacemaker was implanted during the Glenn procedure. Because of severe left ventricle outflow tract obstruction, she was finally referred for extracardiac TCPC (extracardiac Fontan type) with recruitment of PV and Damus-Kaye-Stansel anastomosis. Intraoperatively, the pulmonary trunk stump was opened and a competent pulmonary valve with flaccid leaflets was found. Simple ligation of the pulmonary trunk with a preserved pulmonary valve enabled an effective aorto-pulmonary bridging of systemic outflow tract with the use of natural fully competent ventricle-arterial valves. The relief of single ventricle outflow tract obstruction led to final stabilization of spontaneous sinus rhythm recovery after 2 years of pacemaker stimulation.
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Affiliation(s)
- Konrad Paczkowski
- Department of Pediatric Cardiac Surgery, Mikolaj Kopernik Hospital in Gdańsk, Poland
| | - Ireneusz Haponiuk
- Department of Physiotherapy, Faculty of Rehabilitation and Kinesiology, Gdańsk University of Physical Education and Sport, Gdańsk, Poland
| | - Maciej Chojnicki
- Department of Pediatric Cardiac Surgery, Mikolaj Kopernik Hospital in Gdańsk, Poland
| | - Radosław Jaworski
- Department of Pediatric Cardiac Surgery, Mikolaj Kopernik Hospital in Gdańsk, Poland
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Haponiuk I, Chojnicki M, Paczkowski K, Kosiak W, Jaworski R, Steffens M, Szofer-Sendrowska A, Gierat-Haponiuk K, Tomaszewski M. Right Ventricle Mass Removal from Tricuspid Valve Apparatus: An Unusual Thromboembolic Complication of Severe Ketoacidosis. Heart Surg Forum 2016; 19:E077-9. [PMID: 27146235 DOI: 10.1532/hsf.1378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 02/15/2016] [Accepted: 03/02/2016] [Indexed: 11/20/2022]
Abstract
The presence of a pathologic mass in the right ventricle (RV) may lead to hemodynamic consequences and to a life-threatening incident of pulmonary embolism. The diagnosis of an unstable thrombus in the right heart chamber usually necessitates intensive treatment to dissolve or remove the pathology. We present a report of an unusual complication of severe ketoacidosis: thrombus in the right ventricle, removed from the tricuspid valve (TV) apparatus. A four-year-old boy was diagnosed with diabetes mellitus (DM) type I de novo. During hospitalization, a 13.9 × 8.4 mm tumor in the RV was found in a routine cardiac ultrasound. The patient was referred for surgical removal of the floating lesion from the RV. The procedure was performed via midline sternotomy with extracorporeal circulation (ECC) and mild hypothermia. Control echocardiography showed complete tumor excision with normal atrioventricular valves and heart function. Surgical removal of the thrombus from the tricuspid valve apparatus was effective, safe, and a definitive therapy for thromboembolic complication of pediatric severe ketoacidosis.
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Affiliation(s)
- Ireneusz Haponiuk
- 1. Department of Pediatric Cardiac Surgery, Mikolaj Kopernik Hospital in Gdansk 2. Physiotherapy, Gdansk Academy of Physical Education and Sport, Gdansk.
| | - Maciej Chojnicki
- Department of Pediatric Cardiac Surgery, Mikolaj Kopernik Hospital in Gdansk.
| | - Konrad Paczkowski
- Department of Pediatric Cardiac Surgery, Mikolaj Kopernik Hospital in Gdansk.
| | - Wojciech Kosiak
- Departments of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk.
| | - Radosław Jaworski
- Department of Pediatric Cardiac Surgery, Mikolaj Kopernik Hospital in Gdansk.
| | - Mariusz Steffens
- Department of Pediatric Cardiac Surgery, Mikolaj Kopernik Hospital in Gdansk.
| | | | | | - Marek Tomaszewski
- Departments of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk.
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Gierat-Haponiuk K, Haponiuk I, Szalewska D, Chojnicki M, Jaworski R, Niedoszytko P, Leszczyńska K, Bakuła S. Effect of complex cardiac rehabilitation on physical activity and quality of life during long-term follow-up after surgical correction of congenital heart disease. Kardiol Pol 2014; 73:267-73. [PMID: 25371303 DOI: 10.5603/kp.a2014.0206] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 07/11/2014] [Accepted: 09/18/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Comprehensive cardiac rehabilitation (CCR) is an important element of the comprehensive management of grown-up congenital heart disease (GUCH) patients after surgical correction of congenital heart disease (CHD) but access to this treatment is still limited. We still lack Polish guidelines on CCR, including controlled training in young adults several years after surgical correction of CHD. AIM To assess the effect of a CCR program on physical capacity, exercise tolerance, quality of life, and severity of depressive symptoms in GUCH patients long-term after surgical correction of CHD. METHODS We studied 57 CHD patients (30 females, 27 males, mean age 23 ± 3.4 years) at least 12 months after surgical correction of a ventricular septal defect (VSD) or ostium secundum atrial septal defect (ASD II). All patients were offered a CCR program, and 31 of them participated (rehabilitation group [Reh]) and 26 refused (non-rehabilitated group [NReh]). All patients underwent baseline cardiopulmonary exercise testing (CPET) using a cycloergometer and a ramp protocol with an initial load of 20 W followed by 10 W load increments per minute. Psychological evaluation included the Beck Depression Inventory (BDI) and the Euro QoL 5D questionnaire to evaluate quality of life. Patients were reassessed 30 days after the initial evaluation using the same investigations. RESULTS During CPET, all patients reached peak exercise intensity at the level of 15-17 in the Borg scale without complications. Resting HR was lower in the Reh group (74 ± 8 bpm) compared to the NReh group (81 ± 14 bpm). During CPET, patients in the Reh group reached significantly higher peak HR and percent maximum HR. Workload increased nonsignificantly (144 W vs. 124 W, p = 0.121), while duration of exercise and peak oxygen consumption was significantly longer in the Reh group compared to the NReh group (14 min vs. 11 min, p = 0.001; and 27.5 mL/kg/min vs. 23 mL/kg/min, p = 0.003, respectively). Patients in the NReh group showed non significantly higher severity of depressive symptoms compared to the Reh group, as evaluated using BDI at 30 days (mean score 4.8 vs. 2.2, respectively, p = 0.59). In contrast, subjectively and objectively rated quality of life was significantly higher in the Reh group compared to the NReh (score 89 vs. 74.4, p < 0.01; and 94 vs. 83, p < 0.01, respectively). CONCLUSIONS Implementation of a CCR program improves physical capacity, exercise tolerance, and quality of life and reduces depressive symptoms in patients late after surgical correction of CHD. Introduction of such programs seems reasonable as a supplement to the holistic care for GUCH patients.
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Zielinski J, Jaworski R, Sadowski A, Ptach A, Maliszewski D, Jaskiewicz J. 63. The significance of fiberoptic ductoscopy in patients with pathological nipple discharge in one single centre material. Eur J Surg Oncol 2014. [DOI: 10.1016/j.ejso.2014.08.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Haponiuk I, Chojnicki M, Jaworski R, Steffens M, Szofer-Sendrowska A, Paczkowski K, Juściński J, Kwaśniak E, Szymanowicz W, Gierat-Haponiuk K, Leszczyńska K, Romanowicz A, Zieliński J. Inflammatory marker levels after hybrid treatment of selected congenital heart disease in children. Kardiol Pol 2014; 72:798-805. [PMID: 24846359 DOI: 10.5603/kp.a2014.0091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 03/24/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Hybrid treatment of congenital heart disease is indicated in a selected group of borderline patients who do not have clear indications for either surgery or interventional treatment. Hybrid procedures take the best from cardiac surgery and interventional cardiology to reduce patient risk and trauma. Hybrid closure of ventricular septal defect (VSD) and atrial septal defect (ASD) without the use of extracorporeal circulation (ECC) might be less traumatic for patient. AIM To compare levels of inflammatory markers and clinical symptoms of systemic inflammatory response syndrome during early postoperative care after conventional cardiac surgery and hybrid treatment. METHODS Our study group of 36 paediatric cardiac surgical patients in Gdansk included 22 children with perimembraneous VSD and/or ASD who underwent cardiac surgery using with ECC and 12 children with muscular VSD and 2 children with ASD who underwent hybrid treatment. We retrospectively evaluated inflammatory markers including C-reactive protein (CRP) level, white blood cell (WBC) count and mean platelet volume (MPV), and clinical variables including total duration of stay in the ward, blood transfusions, prolonged respiratory support, fever, arrhythmias, catecholamine support and wound infections. The Mann-Whitney U test was used to compare CRP levels, WBC count and MPV between the study groups. RESULTS Surgical outcomes were good in all children, with no residual leakage. A similar, predictable increase in inflammatory markers (CRP, WBS, MPV) was found in all groups: conventional cardiac surgery with ECC, hybrid treatment without ECC, and hybrid treatment with ECC. Comparison of these groups showed no statistically significant differences between levels of inflammatory markers as well as other clinical variables. CONCLUSIONS Hybrid septal defect closure induces systemic inflammatory response syndrome activation as measured by CRP level, WBC count, and MPV, which is similar to that observed after cardiac surgery using ECC. Elevations of CRP level, WBC count, and MPV were similar after hybrid treatment with or without ECC. No significant differences were noted between trends of postoperative changes in the levels of inflammatory markers after treatment.
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Affiliation(s)
| | | | | | | | | | - Konrad Paczkowski
- Oddział Kardiochirurgii Dziecięcej Szpital im.Mikołaja Kopernika w Gdańsku.
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Haponiuk I, Chojnicki M, Jaworski R, Steffens M, Szofer-Sendrowska A, Juściński J, Kwaśniak E, Szymanowicz W, Gierat-Haponiuk K, Leszczyńska K. Hybrid cardiovascular procedures in the treatment of selected congenital heart disease in children: a single-centre experience. Kardiol Pol 2013; 72:324-30. [PMID: 24293147 DOI: 10.5603/kp.a2013.0345] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Revised: 10/29/2013] [Accepted: 11/19/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND Paediatric hybrid cardiovascular procedures are becoming increasingly popular due to the wide spectrum of cardiovascular abnormalities and a large population of patients who could benefit from hybrid therapy. Contemporary hybrid procedures are introduced in the settings where routine cardiac surgery or cardiac interventions would not allow satisfactory results. Combining cardiac surgery and interventional cardiology techniques appears more beneficial and less invasive for the patient. AIM To present results of hybrid procedures performed in the treatment of selected congenital heart disease in our centre in 2008-2013. METHODS We retrospectively analysed consecutive 80 patients referred for hybrid procedures. RESULTS Overall, 73 patients survived, with 4 early and 3 late deaths. CONCLUSIONS Hybrid procedures in children with congenital heart disease combine the experience of cardiac surgery and interventional cardiology. Hybrid treatment is an alternative option for selected borderline patients. Initial results of hybrid treatment encourage further development of these methods and strategies to provide optimal benefits for the patients.
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Affiliation(s)
- Ireneusz Haponiuk
- Department of Paediatric Cardiac Surgery, Pomeranian Centre of Traumatology, Gdansk, Poland.
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Zieliński J, Jaworski R, Irga N, Kruszewski JW, Jaskiewicz J. Analysis of selected factors influencing seroma formation in breast cancer patients undergoing mastectomy. Arch Med Sci 2013; 9:86-92. [PMID: 23515419 PMCID: PMC3598126 DOI: 10.5114/aoms.2012.29219] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Revised: 03/21/2011] [Accepted: 04/11/2011] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The aim of the work was to analyze the impact of selected factors on the incidence of seroma formation in breast cancer patients undergoing mastectomy. MATERIAL AND METHODS One hundred and fifty breast cancer patients were prospectively enrolled in the study. All patients had mastectomy performed using the same operative technique with electrocoagulation. The amount of seroma formed after surgery and its duration were correlated with selected demographic, clinical and pathological parameters. RESULTS The cumulative total seroma volume collected by the end of treatment was higher and the overall time of seroma treatment was longer in patients over the age of 60 years (p = 0.001 and p = 0.001 respectively). Duration of seroma was significantly longer in obese patients (p = 0.036). The cumulative total seroma volume collected by the end of treatment was higher and the overall time of seroma treatment was longer in patients who had over 130 ml of lymph drained during the first 24 postoperative hours (p < 0.001 and p = 0.001 respectively). Additionally, longer duration of seroma was observed in patients with pathological stage I and II according to TNM-UICC (p = 0.042) and in patients with ≥ 1200 g weight resected of mammary gland (p = 0.05). CONCLUSIONS Age and obesity are important prognostic factors influencing seroma formation in breast cancer patients undergoing mastectomy. The amount of lymph formed during first postoperative day may have predictive value in assessing cumulative total seroma volume collected during treatment and its overall duration.
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Affiliation(s)
- Jacek Zieliński
- Department of Surgical Oncology, Medical University of Gdansk,
Poland
| | - Radosław Jaworski
- Department of Pediatric Cardiac Surgery, Mikolaj Kopernik Pomeranian
Centre of Traumatology, Gdansk, Poland
| | - Ninela Irga
- Department of Pediatrics, Hematology, Oncology and Endocrinology,
Medical University of Gdansk, Poland
| | | | - Janusz Jaskiewicz
- Department of Surgical Oncology, Medical University of Gdansk,
Poland
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Zielinski J, Kruszewski W, Jaworski R, Haponiuk I, Irga N, Zygon J, Kopacz A, Jaskiewicz J. Rare oesophageal tumours: experience of one centre. Eur Surg 2012; 44:361-365. [PMID: 23440953 PMCID: PMC3573716 DOI: 10.1007/s10353-012-0165-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Accepted: 10/16/2012] [Indexed: 11/26/2022]
Abstract
Aim of study The aim of this study is to compare demographic and clinical data as well as applied treatment methods in patients with rare benign and malignant tumours of the oesophagus. Methods Eight hundred and thirty patients with oesophageal cancer were treated in the Department of Surgical Oncology in 1960–2005. In 15 cases (1.8 %), rare benign (n = 11) or malignant (n = 4) types of tumours were diagnosed. Patients with rare oesophageal tumours were included in the study, excluding those with squamous cell carcinoma or adenocarcinoma of the oesophagus. Demographic and clinical data were analysed from each patient qualified for the study. Oesophageal X-rays with contrast medium, gastroscopies and, as of 1991, computed tomographies (CTs) were performed as preoperative diagnostic procedures. Results In the postoperative histopathological examinations, all benign tumours proved to be oesophageal leiomyomas. Four different malignant tumours—a sarcoma, a neuroendocrine carcinoma, a lymphoma, and a squamous cell carcinoma in a patient with Crohn’s disease, were diagnosed in the other four patients. In a group of 15 patients with rare oesophageal tumours there were ten (66.7 %) males and five (33.3 %) females. In patients with benign and malignant tumours, the mean age for the benign group reached 44 years (range: 26–75 years old) and 54.7 years (range: 47–59 years old) for the malignant group. In the preoperative period, symptoms such as swallowing disturbances, retrosternal pains, and epigastric pains were observed. Dysphagia was the leading symptom in patients with benign and malignant oesophageal tumours. Out of 15 patients, surgical procedure was carried out in 13 cases with rare oesophageal tumours. In the group of 11 patients, with benign tumours, ten (90.2 %) warranted surgical treatment. Three patients (75 %) with malignant oesophageal tumours underwent an extensive Akiyama procedure of oesophageal resection. Chemo- and radiotherapy alone were performed on one (25 %) patient with oesophageal lymphoma. Postoperative complications were observed in only four (26.6 %) patients; pneumonia in the postoperative period was diagnosed in two patients who underwent surgery; infections of the postoperative wounds were diagnosed in the other two patients. Conclusions Benign oesophageal tumours are characterised by similar clinical symptoms to malignant tumours of this organ. It is more complicated to obtain biopsy specimens for a histopathological examination in cases of benign tumours in comparison to malignant tumours. Treatment methods should be adjusted individually for each patient with a rare oesophageal tumour. For rare benign oesophageal tumours, the results of treatment are very good; however, for malignant tumours the prognosis depends on their histopathological type.
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Affiliation(s)
- J. Zielinski
- />Department of Surgical Oncology, Medical University of Gdansk, 80-214 Gdansk, Smoluchowskiego 17 Poland
| | - W.J. Kruszewski
- />Division of Oncology Propaedeutics, Medical University of Gdansk, Gdansk, Poland
| | - R. Jaworski
- />Department of Pediatric Cardiac Surgery, Pomeranian Centre of Traumatology of Gdansk, Gdansk, Poland
| | - I. Haponiuk
- />Department of Pediatric Cardiac Surgery, Pomeranian Centre of Traumatology of Gdansk, Gdansk, Poland
| | - N. Irga
- />Department of Paediatrics, Haematology, Oncology and Endocrinology, Medical University of Gdansk, Gdansk, Poland
| | - J. Zygon
- />Department of Surgical Oncology, Medical University of Gdansk, 80-214 Gdansk, Smoluchowskiego 17 Poland
| | - A. Kopacz
- />Department of Surgical Oncology, Medical University of Gdansk, 80-214 Gdansk, Smoluchowskiego 17 Poland
| | - J. Jaskiewicz
- />Department of Surgical Oncology, Medical University of Gdansk, 80-214 Gdansk, Smoluchowskiego 17 Poland
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Andreou A, Wyche M, Papadimos D, Jaworski R. 8. Myometrial osteosarcoma. Pathology 2012. [DOI: 10.1016/s0031-3025(16)32900-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Haponiuk I, Chojnicki M, Jaworski R, Juściński J, Steffek M, Pałkowska L. Delayed closure of multiple muscular ventricular septal defects in an infant after coarctation repair and a hybrid procedure--a case report. Heart Surg Forum 2011; 14:E67-9. [PMID: 21345780 DOI: 10.1532/hsf98.20101081] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
There are several strategies of surgical approach for the repair of multiple muscular ventricular septal defects (mVSDs), but none leads to a fully predictable, satisfactory therapeutic outcome in infants. We followed a concept of treating multiple mVSDs consisting of a hybrid approach based on intraoperative perventricular implantation of occluding devices. In this report, we describe a 2-step procedure consisting of a final hybrid approach for multiple mVSDs in the infant following initial coarctation repair with pulmonary artery banding in the newborn. At 7 months, sternotomy and debanding were performed, the right ventricle was punctured under transesophageal echocardiographic guidance, and the 8-mm device was implanted into the septal defect. Color Doppler echocardiography results showed complete closure of all VSDs by 11 months after surgery, probably via a mechanism of a localized inflammatory response reaction, ventricular septum growth, and implant endothelization.
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Affiliation(s)
- Ireneusz Haponiuk
- Department of Pediatric Cardiac Surgery, Mikołaj Kopernik Pomeranian Centre of Traumatology, Gdańsk, Poland
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22
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Gierat-Haponiuk K, Haponiuk I, Chojnicki M, Jaworski R, Bakuła S. Exercise capacity and the quality of life late after surgical correction of congenital heart defects. Kardiol Pol 2011; 69:810-815. [PMID: 21850625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND The long-term impact of surgical correction of congenital heart defects (CHD) on exercise capacity and quality of life (QoL) has not been well established. AIM To evaluate exercise capacity, QoL, physical activity and depression in young adult patients with a history of congenital heart defect surgery (GUCH) for simple left-to-right shunts, and to compare these parameters with those obtained in healthy volunteers. METHODS The study group consisted of 30 young adults with congenital heart defects (14 males, 16 females), aged 18-36 (mean 24.6) years who underwent corrective cardiac surgery at least 10 years earlier. The control group comprised 30 healthy students (15 males, 15 females), aged 21-28 (mean 24.4) years. We performed cardiopulmonary exercise testing on bicycle ergometer, QoL and physical activity tests, and depression inventory. RESULTS In young adult GUCH patients the exercise parameters were lower when compared to healthy peers. The Stanford questionnaire showed that physical activity was diminished as well as QoL in EuroQoL5 test. The Beck inventory showed more expressed depression in GUCH group. CONCLUSIONS The exercise capacity, physical activity and QoL of young adults with a history of surgical treatment of CHD are worse than observed in healthy peers, and the health status does not fulfil the definition of complete recovery.
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24
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Chojnicki M, Haponiuk I, Jaworski R, Juściński J, Steffek M, Sroka M, Pałkowska L. [Intraoperative imaging of hybrid procedure for muscular ventricular septal defects closure with Amplatzer Duct Occluder II]. Kardiol Pol 2011; 69:1280-1281. [PMID: 22219108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Hybrid approach becomes a promising conception of an alternative treatment for muscular ventricular septal defects (VSD) closure in infants. In this paper we report epicardial echocardiography imaging that enabled successful hybrid procedure performed in premature infant referred for surgical correction of a large perimembraneous VSD with simultaneous perventricular approach for concomitant muscular VSD.
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Affiliation(s)
- Maciej Chojnicki
- Oddział Kardiochirurgii Dziecięcej, Pomorskie Centrum Traumatologii im. M. Kopernika, Gdańsk.
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Abstract
BACKGROUND Mesodermal (müllerian) adenosarcoma arising from the peritoneum is rare and is thought to arise from pluripotent mesothelial and mesenchymal cells of the pelvic cavity or from endometriotic deposits. CASE A case of primary peritoneal mesodermal adenosarcoma arising from the omentum is described. A 50-year-old woman presented with sudden abdominal distension. Initial laparotomy revealed a 13-kg mass arising from the omentum, which was determined from frozen and paraffin sections to be serous cystadenofibroma. The tumor recurred within 10 months and weighed 18 kg at a second laparotomy. Histopathology and review of the original tumor established the correct diagnosis of mesodermal adenosarcoma. The patient died from disseminated disease 6 months later. CONCLUSION Adenosarcomas are difficult to differentiate from adenofibromas or endometriosis histologically because of the presence of large areas of low cellularity and infrequent mitotic figures. In such cases, stromal nuclear atypia and periglandular stromal cuffing are features that are diagnostic of adenosarcoma.
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Affiliation(s)
- S Visvalingam
- Obstetrics and Gynaecology, Royal North Shore Hospital, Sydney, New South Wales 2117
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27
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Samojłow R, Chrapko M, Jaworski R, Molas G, Wnuk W, Zaorska-Rajca J. [The applicability of phleboscintigraphy in diagnosis and treatment result evaluation of patients with disorders of leg venous circulation]. Ann Univ Mariae Curie Sklodowska Med 2000; 53:213-20. [PMID: 10761247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
The aim of the paper was the applicability of phleboscintigraphy in the diagnosis and monitoring of the treatment in patients with various disorders of venous circulation in lower extremities. The study comprised eighty-eight patients with the suspicion of deep veins impatience. The examination was performed using DTPA 99mTc by means of a gamma camera connected with a computer. The radioisotope was injected into the foot dorsal veins. The dose was 185 MBq. Its activity was monitoring continuously for 1 min. The estimation of the results was performed by scintigraphy imaging and curves of activity changes of chosen regions over deep veins. Phleboscintigraphy was found out to be of a great value in the diagnostics and assessment of treatment results in thrombotic-embolic disease, extra-thrombotic syndromes and in qualification of patients with lower legs varices for surgical procedures. Because of easy performance, possibility of repeating, small invasiveness and rather low cost, the method can be recommended as an introductory examination in patients with above mentioned diseases.
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Affiliation(s)
- R Samojłow
- Pracownia Medycyny Nuklearnej Wojewódzkiego Szpitala Specjalistycznego w Lublinie
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28
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Abstract
Hidradenitis suppurativa is a chronic inflammatory disease of the sweat glands and hair follicles which is rarely associated with squamous cell carcinoma (SCC). A case of vulval SCC complicating hidradenitis suppurativa is presented. In addition to being the first case to report the association of vulval SCC and hidradenitis suppurativa in the English language literature, it also illustrates the difficulty inherent in distinguishing between invasive SCC and pseudoepitheliomatous hyperplasia on histological examination. The success of wide local excision of the vulval lesion and primary closure without recourse to skin grafts, rotational flaps, or healing by secondary intention is demonstrated.
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Affiliation(s)
- T Manolitsas
- Department of Gynecologic Oncology, Westmead Hospital, Westmead, New South Wales, 2145, Australia
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29
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Jaworski R, Syska M, Piecuch T. [Analysis of iatrogenic injuries in 1988-1996]. Wiad Lek 1998; 50 Suppl 1 Pt 2:228-33. [PMID: 9424878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The analysis of 77 iatrogenic injuries observed in the authors department in the group of 75 patients was conducted. Immediate repair was performed in 71 cases. Serious complications were noticed in 11 cases. 7 patients died in the consequence of the injury.
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Affiliation(s)
- R Jaworski
- Kliniki Chirurgicznej Wojskowego Szpitala Klinicznego we Wrocławiu
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30
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Vanderbeek J, Ulrich D, Jaworski R, Werner L, Hergert D, Beery T, Baas L. Bringing nursing informatics into the undergraduate classroom. Comput Nurs 1994; 12:227-231. [PMID: 7954066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Nursing informatics is not formally addressed in most undergraduate nursing education programs. Nurses usually rely on their employer and/or device vendors to provide this education. Few nurses are able to capitalize on the potential of computer technology because they have not been sufficiently exposed to nursing informatics during their nursing education. Biomedical computer technology/informatics needs to be brought into the classroom, away from the pressures of the work environment. Informatics training needs to be incorporated into undergraduate nursing education through an integrated systems approach, combining elements of nursing, systems analysis, and engineering. In this article, a university-based state-of-the-art classroom and education plan using an integrated approach to educate nurses in nursing informatics is described.
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Affiliation(s)
- J Vanderbeek
- Miami University, Department of Nursing, Middletown, OH 45042
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31
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Jaworski R, McLean R, Choong K, Smart R, Edmonds J. Re-evaluating the need for hospitalization following synovectomy using Yttrium-90 silicate. Br J Rheumatol 1993; 32:1012-7. [PMID: 8220922 DOI: 10.1093/rheumatology/32.11.1012] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
In 51 patients treated with Yttrium-90 (Y-90) synovectomy for rheumatoid (inflammatory) arthritis (IA) and OA of the knee we found that decreased retained knee activity (RKA) and increased extra-articular activity in lymph nodes and liver are more likely to be found in IA than OA and following bilateral knee injections. Joint inflammation, as assessed by radionuclide blood pool scan but not by SF white cell count, correlates with decreased RKA and increased activity in lymph nodes. Intra-articular steroid had no significant effect on retention or extra-articular uptake. Strict hospital immobilization improves RKA of Y-90 in IA but not in OA. Y-90 synovectomy in OA shows good RKA and low extra-articular uptake. We recommend strict immobilization following Y-90 synovectomy, particularly in IA patients and/or those with high joint blood flow.
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Affiliation(s)
- R Jaworski
- Department of Rheumatology, St George Hospital, Sydney, Australia
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32
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Wright RG, Samaratunga ML, Jaworski R. Absence of human papillomavirus in cervical adenocarcinoma. J Clin Pathol 1992; 45:271-2. [PMID: 1313458 PMCID: PMC495504 DOI: 10.1136/jcp.45.3.271-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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33
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Leary J, Jaworski R, Houghton R. In-situ hybridization using biotinylated DNA probes to human papillomavirus in adenocarcinoma-in-situ and endocervical glandular dysplasia of the uterine cervix. Pathology 1991; 23:85-9. [PMID: 1660591 DOI: 10.3109/00313029109060802] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
In-situ hybridization using biotinylated probes to human papillomavirus (HPV) DNA was performed on formalin fixed paraffin embedded tissue in 30 patients with histologically confirmed adenocarcinoma-in-situ (AIS). Thirteen of the 30 cases contained areas of endocervical glandular dysplasia (EGD) admixed with AIS. Twenty one patients showed positive staining of the AIS nuclei for HPV DNA. Ten cases (33%) were positive for HPV 16 DNA and 11 cases (37%) were positive for HPV 18 DNA. No case showed synchronous expression of HPV 16 and 18 DNA. All cases of AIS were negative for HPV 6b and 11 DNA. Four cases of EGD were positive for HPV 18 DNA and 2 cases were positive for HPV 16 DNA. Four of 6 cases of intestinal dysplasia/AIS were positive for HPV 18 DNA. Associated squamous abnormalities (HPV +/- CIN +/- SCC) were noted in 15 cases. Of these, 7 showed positive staining for HPV DNA in the squamous lesion. Moreover, 5 of these were positive in both the AIS and squamous lesion. In-situ hybridization using biotinylated DNA probes is a sensitive and safe technique readily adaptable to routine histopathology.
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Affiliation(s)
- J Leary
- Department of Obstetrics and Gynaecology, University of Sydney, Westmead Hospital
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34
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Miller AC, Walker J, Jaworski R, de Launey W, Paver R. Hookworm folliculitis. Arch Dermatol 1991; 127:547-9. [PMID: 2006880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A case of persistent folliculitis in a 21-year-old man was demonstrated to be due to Ancylostoma caninum larvae. Treatment with oral thiabendazole was curative. Cutaneous larva migrans may be due to A caninum, but this presentation appears to be unique. The literature concerning etiology and pathogenesis of larva migrans is discussed with reference to this case.
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Affiliation(s)
- A C Miller
- Skin and Cancer Foundation, Westmead, New South Wales, Australia
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35
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Abstract
A case of cutaneous Mycobacterium chelonae infection with sporotrichoid spread and extensive antibiotic resistance is presented. Control of this problem was only achieved after extensive debridement and grafting of the involved limb. The importance of surgery in management is discussed and the literature is reviewed.
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36
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Sambrook PN, Champion GD, Browne CD, Cairns D, Cohen ML, Day RO, Graham S, Handel M, Jaworski R, Kempler S. Corticosteroid injection for osteoarthritis of the knee: peripatellar compared to intra-articular route. Clin Exp Rheumatol 1989; 7:609-13. [PMID: 2692894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Intra-articular injection of micro-crystalline corticosteroid is used to treat symptomatic osteoarthritis (OA) of the knee, but its duration of effect and efficacy are uncertain. From the observation that pain in OA of the knee can often be blocked by infiltration of the soft tissues at the patella margin with local anaesthetic, this study investigated an injection technique in which corticosteroid was infiltrated around the patella. Thirty-eight patients with radiologically demonstrable and painful OA of the knee were treated either with peripatellar or intra-articular methylprednisolone in a randomised double blind study. Assessments of response to either injection were made at one week, one month and three months. Eleven of 15 measures improved significantly over time in both groups, but the differences between groups were not statistically significant. Analysis of individual responses showed that the majority of good outcomes were in the peripatellar group. Five patients receiving intra-articular injections but only one receiving a peripatellar injection withdrew because of treatment failure. Peripatellar injection is an alternative method of local administration of corticosteroid which is highly effective in a proportion of patients and merits further evaluation.
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Affiliation(s)
- P N Sambrook
- Department of Rheumatology, St. Vincent's Hospital, Darlinghurst, Australia
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37
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McKay MJ, Carr PJ, Jaworski R, Kalnins I. Cancer of distant primary site relapsing in the nasopharynx: a report of two cases and review of the literature. Head Neck 1989; 11:534-7. [PMID: 2684908 DOI: 10.1002/hed.2880110611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Cancers metastatic to the nasopharynx are rarities. We present here two more such tumors. Although the clinical features of primary and secondary tumors in the nasopharynx are indistinguishable, a past history of treatment for malignant disease is an obvious clue to the correct diagnosis.
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Affiliation(s)
- M J McKay
- Department of Radiation Oncology, Westmead Hospital, Australia
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38
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Abstract
The authors calculated 442 values of resting ankle-arm indices in 222 patients, of whom 114 reported exercise pain of the lower extremities (51.3%) and 34 reported rest pain (15.3%). Tissue necrosis was diagnosed in 55 patients (24.8%) and other disorders in 19 (8.6%). Obliterating atherosclerosis was found in 186 patients (83.8%), Buerger's disease in 16 (7.2%), and other vascular diseases in 20 patients (9%). The studied index value in 262 examined lower extremities was 1.3-1.0 in 54, 0.9-0.8 in 29, 0.7-0.6 in 66, 0.5-0.4 in 55, and 0.3-0.0 in 58 lower extremities. Respective values for contralateral lower extremities (180) were the following: 69, 54, 33, 14, and 10.
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Affiliation(s)
- T Piecuch
- Surgical Clinic, Military Hospital, Wroclaw, Poland
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39
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Affiliation(s)
- M J Hollands
- Department of Surgery, Westmead Hospital, NSW, Australia
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40
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Abstract
Two neonates with acute infantile cerebral Gaucher's disease had prominent collodion skin. Ichthyosis has been described in some cases of metabolic lipid disorders, however, this is the first report of the association of lamellar desquamation of the newborn (collodion baby) with Gaucher's disease.
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Affiliation(s)
- K Lui
- Westmead Hospital, New South Wales, Australia
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41
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42
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Jaworski R. [Crural perforating veins in the phlebographic picture]. Wiad Lek 1988; 41:635-40. [PMID: 3238998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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43
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Magiera R, Jaworski R. [Congenital absence of the gallbladder complicated by duodeno-biliary fistulas]. Wiad Lek 1987; 40:1327-9. [PMID: 3445613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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44
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Jaworski R. Unusual proliferating trichilemmal cyst. Am J Dermatopathol 1987; 9:459-61. [PMID: 3688371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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45
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46
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47
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Jaworski R. [Perforating veins of the median ankle]. Wiad Lek 1987; 40:233-5. [PMID: 3617745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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48
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Jaworski R. [Dynamic crural phlebography in primary varicose veins with compression of superficial veins above or below the ankles]. Wiad Lek 1986; 39:1657-61. [PMID: 3577176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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49
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Syska M, Jaworski R, Piecuch T, Syty L. [Hematoma of the rectus abdominis muscle as a surgical problem]. Wiad Lek 1984; 37:884-6. [PMID: 6239455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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50
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Piecuch T, Polak LL, Jaworski R. [Evaluation of the ankle-arm index at rest in patients referred for consultation and surgical treatment]. Wiad Lek 1984; 37:249-54. [PMID: 6464461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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