Wojciech Gaszyński - Academia.edu (original) (raw)
Uploads
Papers by Wojciech Gaszyński
Anestezjologia intensywna terapia
Anaesthesia of a patient with myasthenia gravis requires special preoperative management and prop... more Anaesthesia of a patient with myasthenia gravis requires special preoperative management and proper choice of intraoperative agents. The disease should be treated until surgery and some anaesthetics (e.g. barbiturates, benzodiazepines) eliminated. Moreover, the choice of opioids providing suitable intraoperative analgesia is relevant. We present a case of a 68-year-old male patient, ASA II, with the 10-year history of myasthenia gravis scheduled for glaucoma surgery. Premedication was not administered. Anaesthesia was induced with fentanyl and propofol. After endotracheal intubation, anaesthesia was maintained with the mixture of N(2)O and O(2) (1:2), the infusion of propofol and remifentanil. Remifentanil was administered in iv continuous infusion in the dose of 0.04 microg kg(-1) min(-1) followed by 0.08 microg kg(-1) min(-1). Muscle relaxants were not used. Anaesthesia was uneventful, except for transient bradycardia (HR-43 min(-1)). The patient recovered 5 min after surgery and ...
Polski przeglad chirurgiczny, 2012
Anestezjologia intensywna terapia
Patient satisfaction with perioperative care plays an important role in the assessment of quality... more Patient satisfaction with perioperative care plays an important role in the assessment of quality of care. Written evaluation forms are commonly used all over the world for this purpose. The aim of this study was to assess the quality of perioperative care, with special attention being directed to anaesthesia-associated side effects. Forty-two adult patients, of both sexes, scheduled for abdominal surgery, were asked to complete a questionnaire consisting of 11 questions on anaesthesia, side effects and the general quality of perioperative care. The results were analysed using the X2 test, and p < 0.05 was considered significant. The Pearson correlation coefficient was used for comparison. There was a strong correlation between the quality of the pre-anaesthesia visit, including the information obtained on possible complications and alternative methods of anaesthesia, and the assessment of quality of the anaesthesia service. Post-anaesthesia care facilities were also found to be ...
Chirurgia narzadów ruchu i ortopedia polska
According to recent WHO reports, body traumas are ranked third with respect of frequency of occur... more According to recent WHO reports, body traumas are ranked third with respect of frequency of occurrence right after cardiovascular diseases and tumours, and are considered one of the major medical problems. Trauma is a kind of energy (mechanical, thermal or chemical) affecting the human body. After crossing the threshold of tissue endurance, an injury or damage occurs. A common problem of all the centres that treat traumas is a reliable and comparable assessment of injury severity. Constant improvement of the trauma scores, contributes to increased objectivity of the assessment of injury severity and makes trauma research easier. To a large extent, commonness of the scores enables the exchange of experiences with respect to treating patients after trauma. An ideal scale should be reliable, easy to use, and most of all commonly used, thus enabling the employment of a common "traumatologic" language. In the following research, the test group was comprised of 137 adult patient...
Medycyna doświadczalna i mikrobiologia, 2008
In the period of 2002-2006, total 5152 isolates were obtained from 1330 patients in the Intensive... more In the period of 2002-2006, total 5152 isolates were obtained from 1330 patients in the Intensive Care Unite (ICU) of the Lodz Medical University Hospital No.1. A detailed analysis of the epidemiological situation concerned, first of all, MRSA, Ps. aeruginosa, Acinetobacter and Enterobacteriacae. As a result of extended action aimed at reducing the infections caused by these pathogens, a permanent improvement of the epidemiological situation in the ICU was observed in 2005-2006. However, in spite of a decrease in the total number of the infections, the concentration of ESBL(+) and carbapene-resistant strains increased. These results are indicative of the need for cooperation between clinicians and microbiology laboratory towards a strictly controlled antibiotic policy in the hospital.
Drug Design, Development and Therapy, 2014
Doripenem is a novel wide-spectrum antibiotic, and a derivate of carbapenems. It is an ideal anti... more Doripenem is a novel wide-spectrum antibiotic, and a derivate of carbapenems. It is an ideal antibiotic for treatment of serious nosocomial infections and severe sepsis for its exceptionally high efficiency and broad antibacterial spectrum of action. Doripenem is eliminated mainly by the kidneys. In cases of acute kidney injury, dosing of doripenem depends on creatinine clearance and requires adjustments. Doripenem is eliminated during hemodialysis because its molecular weight is 300-400 Da. The aim of this study was to establish the impact of continuous renal replacement therapy (CRRT) slow low-efficiency dialysis (SLED) on doripenem serum concentrations in a population of intensive-therapy patients with life-threatening infections and severe sepsis. Ten patients were enrolled in this observational study. Twelve blood samples were collected during the first administration of doripenem in a 1-hour continuous infusion while CRRT SLED was provided. Fluid chromatography was used for measurement of the concentration of doripenem in serum. In all collected samples, concentration of doripenem was above the minimum inhibition concentration of this antibiotic. Based on these results, we can draw the conclusion that doripenem concentration is above the minimum inhibition concentration throughout all of CRRT. The dosing pattern proposed by the manufacturer can be used in patients receiving CRRT SLED without necessary modifications.
International journal of surgery (London, England), Jan 18, 2015
The aim of this study is the assessment of the regional cerebral oximetry - NIRS (near infrared s... more The aim of this study is the assessment of the regional cerebral oximetry - NIRS (near infrared spectroscopy) as an intraoperative monitoring system to protect the patient against the incidents of brain desaturations. We hypothesize that patients monitored with NIRS present a smaller range of postoperative cognitive dysfunctions (POCD) in comparison with those without NIRS monitoring during lumbar spine surgery in a prone position. This study was performed at the Clinical Department of Neurosurgery and Oncology of the Central Nervous System, Medical University of Lodz, Poland. The study completed 43 adult patients qualified for the surgical treatment of lumbar spondylosis. Before the procedures they were randomized into two subgroups: one monitored intraoperatively by means of NIRS cerebral oximetry (INVOS 5100), which numbered 13 patients - 30.2% (13 NIRS devices were made available to the authors) and the other without NIRS intraoperative monitoring, totaling 30 people - 69.8%. Th...
Polish Journal of Surgery, 2008
Textiles which have direct contact with the skin should have appropriate biophysical pro- perties... more Textiles which have direct contact with the skin should have appropriate biophysical pro- perties. There are especially high requirements of textiles used by hospitalised patients, who remain in bed in a prone position for a long time. The paper will present the results of the analysis connected with designing sheet fabrics with biophysical properties aimed at creating an appropriate surrounding for the patient's body. In the textile selection the following elements will be analysed: composition (hydrophilic fibres - cotton; hydrophobic fibres - polypropylene fibres and their spatial distribution), the product's weave and con - struction (embossed fabrics and satin fabrics). The paper will present the following results of laboratory research examining hygienic comfort under the following categories: vapour permeability, air permeability and water absorption. The paper will also present the results of their assessment when confronted with the results of the application rese...
Anaesthesia, resuscitation, and intensive therapy
The purpose of this study was to assess the effect of endotracheal anaesthesia on the activity of... more The purpose of this study was to assess the effect of endotracheal anaesthesia on the activity of lysosomal enzymes in peripheral blood granulocytes. The determinations were carried out before anaesthesia, after 1 hour of anaesthesia and 1 hour after awakening. The activity of lysosomal enzymes was assessed on the basis of the activity of marker-enzymes, i.e. acid phosphatase, acid protease and neutral protease. The lysosomal fraction was prepared by Choduker's method and the activity of lysosomal enzymes was calculated for 100 mug of protein. The obtained results showed a statistically not significant rise in the activity of these enzymes in the lysosomes during anaesthesia without a similar rise in the supernatant. The activity of marker enzymes in lysosomes rose to the initial values after the awakening of patients. Such rapid changes in the activity of lysosomal enzymes seem to depend mainly on the mobilization of the reserve pool of granulocytes from other sources than the ...
Anestezjologia intensywna terapia
Anaesthesia of a patient with myasthenia gravis requires special preoperative management and prop... more Anaesthesia of a patient with myasthenia gravis requires special preoperative management and proper choice of intraoperative agents. The disease should be treated until surgery and some anaesthetics (e.g. barbiturates, benzodiazepines) eliminated. Moreover, the choice of opioids providing suitable intraoperative analgesia is relevant. We present a case of a 68-year-old male patient, ASA II, with the 10-year history of myasthenia gravis scheduled for glaucoma surgery. Premedication was not administered. Anaesthesia was induced with fentanyl and propofol. After endotracheal intubation, anaesthesia was maintained with the mixture of N(2)O and O(2) (1:2), the infusion of propofol and remifentanil. Remifentanil was administered in iv continuous infusion in the dose of 0.04 microg kg(-1) min(-1) followed by 0.08 microg kg(-1) min(-1). Muscle relaxants were not used. Anaesthesia was uneventful, except for transient bradycardia (HR-43 min(-1)). The patient recovered 5 min after surgery and ...
Polski przeglad chirurgiczny, 2012
Anestezjologia intensywna terapia
Patient satisfaction with perioperative care plays an important role in the assessment of quality... more Patient satisfaction with perioperative care plays an important role in the assessment of quality of care. Written evaluation forms are commonly used all over the world for this purpose. The aim of this study was to assess the quality of perioperative care, with special attention being directed to anaesthesia-associated side effects. Forty-two adult patients, of both sexes, scheduled for abdominal surgery, were asked to complete a questionnaire consisting of 11 questions on anaesthesia, side effects and the general quality of perioperative care. The results were analysed using the X2 test, and p < 0.05 was considered significant. The Pearson correlation coefficient was used for comparison. There was a strong correlation between the quality of the pre-anaesthesia visit, including the information obtained on possible complications and alternative methods of anaesthesia, and the assessment of quality of the anaesthesia service. Post-anaesthesia care facilities were also found to be ...
Chirurgia narzadów ruchu i ortopedia polska
According to recent WHO reports, body traumas are ranked third with respect of frequency of occur... more According to recent WHO reports, body traumas are ranked third with respect of frequency of occurrence right after cardiovascular diseases and tumours, and are considered one of the major medical problems. Trauma is a kind of energy (mechanical, thermal or chemical) affecting the human body. After crossing the threshold of tissue endurance, an injury or damage occurs. A common problem of all the centres that treat traumas is a reliable and comparable assessment of injury severity. Constant improvement of the trauma scores, contributes to increased objectivity of the assessment of injury severity and makes trauma research easier. To a large extent, commonness of the scores enables the exchange of experiences with respect to treating patients after trauma. An ideal scale should be reliable, easy to use, and most of all commonly used, thus enabling the employment of a common "traumatologic" language. In the following research, the test group was comprised of 137 adult patient...
Medycyna doświadczalna i mikrobiologia, 2008
In the period of 2002-2006, total 5152 isolates were obtained from 1330 patients in the Intensive... more In the period of 2002-2006, total 5152 isolates were obtained from 1330 patients in the Intensive Care Unite (ICU) of the Lodz Medical University Hospital No.1. A detailed analysis of the epidemiological situation concerned, first of all, MRSA, Ps. aeruginosa, Acinetobacter and Enterobacteriacae. As a result of extended action aimed at reducing the infections caused by these pathogens, a permanent improvement of the epidemiological situation in the ICU was observed in 2005-2006. However, in spite of a decrease in the total number of the infections, the concentration of ESBL(+) and carbapene-resistant strains increased. These results are indicative of the need for cooperation between clinicians and microbiology laboratory towards a strictly controlled antibiotic policy in the hospital.
Drug Design, Development and Therapy, 2014
Doripenem is a novel wide-spectrum antibiotic, and a derivate of carbapenems. It is an ideal anti... more Doripenem is a novel wide-spectrum antibiotic, and a derivate of carbapenems. It is an ideal antibiotic for treatment of serious nosocomial infections and severe sepsis for its exceptionally high efficiency and broad antibacterial spectrum of action. Doripenem is eliminated mainly by the kidneys. In cases of acute kidney injury, dosing of doripenem depends on creatinine clearance and requires adjustments. Doripenem is eliminated during hemodialysis because its molecular weight is 300-400 Da. The aim of this study was to establish the impact of continuous renal replacement therapy (CRRT) slow low-efficiency dialysis (SLED) on doripenem serum concentrations in a population of intensive-therapy patients with life-threatening infections and severe sepsis. Ten patients were enrolled in this observational study. Twelve blood samples were collected during the first administration of doripenem in a 1-hour continuous infusion while CRRT SLED was provided. Fluid chromatography was used for measurement of the concentration of doripenem in serum. In all collected samples, concentration of doripenem was above the minimum inhibition concentration of this antibiotic. Based on these results, we can draw the conclusion that doripenem concentration is above the minimum inhibition concentration throughout all of CRRT. The dosing pattern proposed by the manufacturer can be used in patients receiving CRRT SLED without necessary modifications.
International journal of surgery (London, England), Jan 18, 2015
The aim of this study is the assessment of the regional cerebral oximetry - NIRS (near infrared s... more The aim of this study is the assessment of the regional cerebral oximetry - NIRS (near infrared spectroscopy) as an intraoperative monitoring system to protect the patient against the incidents of brain desaturations. We hypothesize that patients monitored with NIRS present a smaller range of postoperative cognitive dysfunctions (POCD) in comparison with those without NIRS monitoring during lumbar spine surgery in a prone position. This study was performed at the Clinical Department of Neurosurgery and Oncology of the Central Nervous System, Medical University of Lodz, Poland. The study completed 43 adult patients qualified for the surgical treatment of lumbar spondylosis. Before the procedures they were randomized into two subgroups: one monitored intraoperatively by means of NIRS cerebral oximetry (INVOS 5100), which numbered 13 patients - 30.2% (13 NIRS devices were made available to the authors) and the other without NIRS intraoperative monitoring, totaling 30 people - 69.8%. Th...
Polish Journal of Surgery, 2008
Textiles which have direct contact with the skin should have appropriate biophysical pro- perties... more Textiles which have direct contact with the skin should have appropriate biophysical pro- perties. There are especially high requirements of textiles used by hospitalised patients, who remain in bed in a prone position for a long time. The paper will present the results of the analysis connected with designing sheet fabrics with biophysical properties aimed at creating an appropriate surrounding for the patient's body. In the textile selection the following elements will be analysed: composition (hydrophilic fibres - cotton; hydrophobic fibres - polypropylene fibres and their spatial distribution), the product's weave and con - struction (embossed fabrics and satin fabrics). The paper will present the following results of laboratory research examining hygienic comfort under the following categories: vapour permeability, air permeability and water absorption. The paper will also present the results of their assessment when confronted with the results of the application rese...
Anaesthesia, resuscitation, and intensive therapy
The purpose of this study was to assess the effect of endotracheal anaesthesia on the activity of... more The purpose of this study was to assess the effect of endotracheal anaesthesia on the activity of lysosomal enzymes in peripheral blood granulocytes. The determinations were carried out before anaesthesia, after 1 hour of anaesthesia and 1 hour after awakening. The activity of lysosomal enzymes was assessed on the basis of the activity of marker-enzymes, i.e. acid phosphatase, acid protease and neutral protease. The lysosomal fraction was prepared by Choduker's method and the activity of lysosomal enzymes was calculated for 100 mug of protein. The obtained results showed a statistically not significant rise in the activity of these enzymes in the lysosomes during anaesthesia without a similar rise in the supernatant. The activity of marker enzymes in lysosomes rose to the initial values after the awakening of patients. Such rapid changes in the activity of lysosomal enzymes seem to depend mainly on the mobilization of the reserve pool of granulocytes from other sources than the ...