Zygmunt Chodorowski

St. John's Hospital, Springfield, Illinois, United States

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Publications (139)37.45 Total impact

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    ABSTRACT: Left ventricular pseudoaneurysm from myocardial infarction is rare but is associated with a high risk of rapid enlargement and rupture. This report describes a 57 year old woman with left ventricular pseudoaneurysm and delayed surgical repair. Seven weeks after myocardial infarction control transthoracic echocardiography revealed a inferolateral left ventricular pseudoaneurysm. Early surgical intervention was recommended but the patient refused hospitalization and surgical repair and continued every day home activity. The symptoms and signs were so mild that she was qualified to 1st class of NYHA classification and 1st class of CCS classification. Six weeks later-ventriculography confirmed the primary diagnosis. During heart surgery the pseudoaneurysm was incised, its fibrous wall with thrombus was resected and the ruptured left ventricular myocardium was satured. She had an uneventful postoperative course. Definitive diagnosis of the pseudoaneurysm was confirmed by histopathological evaluation of the excised left ventricular wall.
    Przegla̧d lekarski 01/2009; 66(6):348-9.
  • Zygmunt Chodorowski, Robert Ciechanowicz, Jacek Sein Anand
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    ABSTRACT: The reduction of suicide death index in 1981 year and 1989 year, that is in the period of temporary and definitive "Solidarity" victory confirms Emile Durkheim theory that revolution processes increase social integration and prevent suicide decisions. In the years 1991-1994 the number of suicide deaths in Poland was distinctly lower than in other countries of the Soviet Block and republics of the Soviet Union.
    Przegla̧d lekarski 01/2009; 66(6):277-8.
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    ABSTRACT: We have described three physicians aged 65-70 years, who had noticed during their insulintherapy significant, periodically recurrent variations of insulin requirement (max. 50 i.u./24h vs 25 i.u./24h) in the periods of 4-16 weeks. They had been characterized by similar diet and physical activity, stable normal body mass (av. BMI 24.6) and normal glycosylated hemoglobin (av. HbA1c 5.9%). The hypothesis was put forward that the cause of this phenomenon may be periodical changes in the incretin system activity or increased proliferation of pancreatic beta cells leading to decrease of insulin requirement.
    Przegla̧d lekarski 01/2009; 66(6):337-8.
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    ABSTRACT: Insulin-treated diabetes influences motor vehicle driving mainly through the possibility to induce hypoglycemia in patients. However, there has never been any consistent evidence to suggest that patients with insulin-treated diabetes cause significantly more accidents than the general population. Diabetes and its complications have very various individual courses in patients, because of that candidates for driver's license should always be qualified individually. Drivers with diabetes complications, especially the elderly, quite often themselves limit driving. The programme facilitating the diagnosis of early hypoglycemic symptoms--Blood Glucose Awareness Training--decreases road traffic collision number.
    Przegla̧d lekarski 01/2009; 66(6):350-1.
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    ABSTRACT: The main target of acetaminophen application is bifunctional enzyme--prostaglandin endoperoxide H2 synthase (PGHS)--which has cyclo-oxygenase and peroxidase activities and synthesizes initial intermediates in prostanoid synthesis. The reaction catalyzed by PGHS is radical-based and it is initiated and then maintained by the constant presence of peroxides especially peroxynitrate, which generate so-called "peroxide tone" in the enzyme surrounding. Currently it is known that inhibitory effect of acetaminophen on PGHS activity is directly connected with the elimination of "peroxide tone". High concentrations of reactive compounds (e.g. peroxynitrate and lipid peroxides)--produced by cellular defending mechanism at inflammatory sites--significantly decrease inhibitory impact of acetaminophen on PGHS activity. Such observation allows explanation of weak antiinflammatory effect of acetaminophen together with its strong analgesic and antipyretic properties.
    Przegla̧d lekarski 01/2009; 66(6):352-3.
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    ABSTRACT: The strong positive relationship between cholesterolaemia and ischaemic heart disease is unquestioned and comes from several lines of evidence. In this paper results of questionnaire studies concerning cholesterolemia performed among patients of the Cardiology Ward of a Regional Hospital in Wejherowo are presented.
    Przegla̧d lekarski 01/2009; 66(6):354-5.
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    ABSTRACT: Daily heart consumption of energy (about 6 kg of ATP) exceeds significantly energy consumption of other organs. Deprivation of energy is considered as one of the main factors in development of heart failure. Currently available research methods permit not only to evaluate more precisely the role of impaired energy metabolism in the heart failure, but also give a hope for the future metabolic therapy.
    Przegla̧d lekarski 01/2009; 66(6):356-8.
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    ABSTRACT: The aim of our study was the evaluation of strategic preparedness of twelve hospitals in Kraków, Warsaw and the Triple City to give aid during massive chemical accidents. The study was carried on 146 persons, including 9 managers, 31 ward heads, 75 assistants, and 31 ward nurses. In statistical analysis the generalized linear model extended by random factors, particularly the Poisson's regression has been used. In any of the investigated hospitals, there were no plans regarding of action in case of chemical accidents. The knowledge about sources of possible contamination as well as environment threats were insufficient. The majority of the medical staff did not know their role as well as the role of their hospitals in case of a chemical accident. There is an urgent need for courses about the procedures which should be used during chemical accidents. The lack of hospital preparedness to act during chemical disasters in the big cities suggests that a similar situation is common in other such medical units all over the country. Further investigations, especially in the hospitals which are placed near the potentially dangerous factories, should be carried on in the near future.
    Przegla̧d lekarski 02/2007; 64(4-5):212-4.
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    ABSTRACT: The aim of the study was the evaluation of some aspects of doctors knowledge about the treatment in case of massive chemical accidents. The study was conducted in twelve hospitals in Kraków, Warsaw, and the Triple City. There were 106 doctors (31 ward heads and 75 assistants) included in the study. The questions contained some aspects of: external decontamination, the usage of 0.5% of sodium hypochlorite, the knowledge about the use of selected antidotes and the symptoms of chosen toxidromes. In statistical analysis the generalized linear model extended by random factors, particularly the Poisson's regression was used. The results confirm, that the medical staff is not well prepared to take an effective action in case of a chemical contamination. The essential knowledge of the medical staff in all investigated aspects of chemical safety has been found out to be not satisfactory. There is an urgent need for medical staff to undergo theoretical and practical courses about toxicity of major chemicals. The clinical toxicologists should be asked to prepare up-to-date, advanced methods and regulations for life support in case of heavy chemical accidents.
    Przegla̧d lekarski 02/2007; 64(4-5):219-21.
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    ABSTRACT: The aim of the study was to evaluate the impact of smoking, verified by the measurement of cotinine levels, on life satisfaction of patients with coronary artery disease. The questionnaire was answered by 36 patients (26 men and 10 women) aged from 48 to 7.6 (mean 63.5) years. The questions regarded the current attitude toward smoking, subjective self-assessment of health and life satisfaction while smoking and after cessation. Cantril's ladder has been used among others to assess life satisfaction. In order to verify the answers regarding current smoking cotinine (nicotine metabolite) serum, urine and saliva levels have been measured. There were 38.8% of current smokers in the studied group of patients after PTCA. The fact of current smoking was negated by 19.4% of smokers during medical exam. Objective verification of smoking is necessary in questionnaire studies on tobacco consumption. Measurement of cotinine in body fluids (serum, urine, saliva) may be useful in these cases. After cessation of smoking 93.9% respondents reported major subjective improvement in self-assessment of health. 54.5% of smokers admitted having been ashamed of the habit, and 60.6% the feeling of disturbing others while smoking. The increase of general life satisfaction measured by Cantril's ladder was observed in 94.7% of responders after cessation of smoking.
    Przegla̧d lekarski 02/2007; 64(4-5):260-2.
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    ABSTRACT: Heme oxygenase (HO) is the rate limiting enzyme in the breakdown of heme into carbon monoxide (CO), iron and biliverdin. To date three mammalian HO isozymes have been identified, and only one of them (HO-1) is inducible. The products of HO-catalyzed reaction, particularly CO and biliverdin/bilirubin have been shown to exert protective effects in the liver against different noxious stimuli. The results of experimental data show that induction of HO-1 expression contributes to protection against liver damage induced by several chemical compounds such as acetaminophen.
    Przegla̧d lekarski 02/2007; 64(4-5):360-2.
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    ABSTRACT: Seventy six patients (55 males and 21 females) aged from 39 to 89 (mean 63.7 +/- 9.7) years with multiple primary cancers were described. Larynx cancer was the most commonly seen multiple primary cancer component (35.5%) followed by lung cancer (12.5%). Combination of larynx cancer and lung cancer was the most often observed connection (21.1%). In seventeen patients two cancers were diagnosed concurrently. In other cases the interval between two cancers varied from 1 to 24 (mean 6.9 +/- 6.1) years. Smoking rate was 80.3% at diagnosis of the second cancer and only 10 patients (13.1%) quit smoking when first cancer was recognized. The results of the research indicate the necessity of conducting wide prophylactic actions.
    Przegla̧d lekarski 02/2007; 64(4-5):374-5.
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    ABSTRACT: Alcohol misuse are severe financial burden for health care system in Poland. AUDIT and CAGE are two questionnaires used for diagnosis of alcohol abuse. We analyzed the incidence of alcohol problem among emergency unit's patients and correlation of this phenomenon with the reason of admittance to the hospital. 30% patients of Clinical Hospital Emergency Unit of Gdańsk misuse alcohol. Injuries and acute intoxications were considerably more frequent reason of attendances to emergency unit in population of patients with drinking problem. AUDIT questionnaire is more effective and sensitive diagnostic instrument comparing to CAGE and may be useful for identification for both, addicted and misusing alcohol patients.
    Przegla̧d lekarski 02/2007; 64(4-5):236-7.
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    ABSTRACT: Fourteen patients were included to the albumin dialysis--MARS in the Clinic of Internal Medicine Geriatry and Clinical Toxicology in the years 2004-2006 because of acute intoxication with Amanita phalloides. The 26 procedures were done. Ten patients recovered, one was transplanted and three patients at the age from 68 to 79 (average 72.6) years died because of acute liver failure (21.4% cases). All deceased patients had significant higher plasma bilirubin level and INR in compare to other probants. The procedures of albumin dialysis caused significant lowering of blood glucose level, red blood cells and platelets, but without the need for intervention.
    Przegla̧d lekarski 02/2007; 64(4-5):255-7.
  • Adam Hajduk, Jacek Sein Anand, Zygmunt Chodorowski
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    ABSTRACT: The case of a 24-year-old female who ingested 45 tablets of clonidine (Iporel á 0.075 mg) in the total dose of 3,375 mg in suicidal attempt was described. At the admission to the hospital the patient had complained of drowsiness and weakness. She was conscious but somnolent. Minimal blood pressure was 90/50 mmHg. The patient was treated with gastric lavage and crystalloids infusion. During two days of observation the symptoms were rapidly retreated.
    Przegla̧d lekarski 02/2007; 64(4-5):312-3.
  • Jacek Sein Anand, Zygmunt Chodorowski
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    ABSTRACT: Drug-induced liver injury might be responsible for 1 of 600 to 3500 of all hospital admissions. About 2-3% of all drug adverse effects may be connected with the liver. There could be pure injury of heaptic cells or impairment of hepatocellular bile secretion. In our case there was cholestatic liver injury after the use of thiamazole with the complete regression after the discontinuation of the drug. For two years' the patient was treated with methyltiouracyl without any side effects. After 19 years, because of thyreotoxicosis, the methimazole was used. The acute cholestatic liver injury with the high serum bilirubin level (41.4 mg/dl) was observed. Despite the discontinuation of the drug the patient was deceased. CONCLUSIONS: There are possible cross reactions among imidazolines in patients who are predispose to develop drug-induced liver failure. The doctors should pay much more attention to possible drug side effects.
    Przegla̧d lekarski 02/2007; 64(4-5):320-1.
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    ABSTRACT: A case of a suicidal oral exposure to xylene has been described. A 33 year-old female ingested 300-500 ml of xylene 2.5 hours before admission to the hospital. Hypotonia, metabolic acidosis, diarrhea and moderate, transient dysphagia were observed. Concentrations of xylene, toluene and ethylbenzene in blood at admission were 11.7; 2.9 and 0.18 mg/l respectively and 1.1; 0.33 and 0 mg/l after 24 hours after therapy. Conclusions: The course of acute xylene intoxication in the described case was relatively uneventful despite high blood concentration of xylene. Further study is necessary to establish the potentially lethal blood concentration of xylene.
    Przegla̧d lekarski 02/2007; 64(4-5):324-5.
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    Jacek Sein Anand, Zygmunt Chodorowski, Roman P Korolkiewicz
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    ABSTRACT: Heat stroke may appear as a result of exposure to high environmental temperature or strenuous exercise. It represents a medical emergency characterized by an elevated core body temperature and multi-organ failure. We have described a case of a 41 year-old female after sun exposure, who was admitted to the hospital with the temperature of 42 degrees C. Because of high plasma bilirubin level the Molecular Adsorbent Recirculating System (MARS) was started. Three sessions of MARS, which lasted for eight hours each, were conducted on 15h, 18th, and 23rd day of hospitalization. The procedure was well tolerated by the patient and resulted in a sustained decline of plasma bilirubin from 33.5 to 14.7 mg/dl. The female was discharged from the hospital in good general condition. The two months follow up showed that the patient felt very well, and the plasma bilirubin was reduced to 2.2 mg/dl.
    Przegla̧d lekarski 02/2007; 64(4-5):344-5.
  • Zygmunt Chodorowski, Jacek Sein Anand
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    ABSTRACT: In the article some merits and some limitations of inhaled insulin (Exubera produced by Pfizer) in the treatment of adult patients with type 1 or 2 diabetes were presented. Up till now about 3500 volunteers usually in short-term study periods (6 months) were examined. Some patients were observed in the course of treatment even 4-7 years. Inhaled insulin was well tolerated by patients and they accepted with satisfaction this new form of drug. Main adverse events were a small decrease in the forced expiratory volume at 1 s (FEV1) and a small decline in carbon monoxide diffusion capacity with no clinical significance a well as a mild or moderate cough occurring temporally. Inhaled insulin is contraindicated in smokers and patients with bronchial asthma, bronchitis and pulmonary emphysema. Despite the approval of inhaled insulin for use in adult patients with type 1 or 2 diabetes in the United States and European Union in January 2006, Pfizer designed Real World Trial to estimate the costleffectiveness of this drug and the effect of the availability of Exubera as a treatment options for glycemic control.
    Przegla̧d lekarski 02/2007; 64(4-5):365-7.
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    ABSTRACT: Five patients with type 2 diabetes, three of them treated with insulin and two with oral antidiabetic drugs, receiving imatinib due to chronic myeolid leukaemia are reported. Treatment with imatinib 400 mg/day for 7 to 37 (mean 24.2) months had no positive effect on clinical course of type 2 diabetes.
    Przegla̧d lekarski 02/2007; 64(4-5):370-1.