Publications (44)47.88 Total impact
-
Article: Enterobacteriaceae Infections of Very Low Birth Weight Infants in Polish Neonatal Intensive Care Units: Resistance and Cross-transmission.
[show abstract] [hide abstract]
ABSTRACT: BACKGROUND:: The aims of our study were analysis of the occurrence of infections by members of the Enterobacteriaceae family in six Polish NICUs in 2009, their drug-resistance, the epidemiology of ESBL-producing strains and the possibility of using modern tools of microbiology diagnosis in infection control, especially for the reduction of antimicrobial resistance. METHODS:: A prospective surveillance covered 910 newborns. Case patients were defined as neonates with very low birth weight (VLBW) who had clinical signs of septicemia, pneumonia or necrotizing enterocolitis. Early onset infection (EOI) was defined as infection diagnosed within 3 days after delivery. RESULTS:: The incidence of Enterobacteriaceae infections was 2.6/1,000 patient days. The risk of Enterobacteriaceae pneumonia increased with the length of hospitalization (p=0.0356). The most common pathogen was Escherichia coli, (12.4% of all strains, in EOI 18.5%) and Klebsiella spp. (9.1% of all). The ESBL phenotype was found in 37% of isolates, of which 89.3% were producing CTX-M-type, 70.2% TEM-type and 8.5% SHV-type. Epidemic clones were detected in the two studied NICUs: 6/9 ESBL-positive Enterobacter cloacae and 16/18 ESBL-positive Klebsiella pneumoniae strains were classified into one epidemic clone, that showed resistance to penicillin without inhibitors, amoxycillin/clavulanic acid, cephalosporins, aztreoname, aminoglycosides and trimethoprim/sulfamethoxazole. CONCLUSIONS:: Enterobacteriaceae bacilli are a significant problem in NICUs, especially in EOI and for long hospitalized VLBW infants. The observed high drug-resistance was in large part related to the dominance of epidemic strains as a result of horizontal transmission. The best way to reduce drug-resistance would be adequate procedures of isolation and hand hygiene.The Pediatric Infectious Disease Journal 02/2013; · 3.58 Impact Factor -
Article: [The use of therapeutic whole body cooling in treating hypoxic-ischemic encephalopathy in the newborn--the first case in Poland].
[show abstract] [hide abstract]
ABSTRACT: Hypoxic-ischemic encephalopathy (ENN) concerns neonates born after 35 completed weeks of gestation. The incidence rate has been shown to be 1-6/1000 births and can lead to significant permanent neurological damage, cerebral palsy and even death. Until the whole body cooling and selective brain cooling methods have been accepted, the treatment of children with ENN was only symptomatic. The article describes the first case of ENN neonatal treatment with the whole body hypothermia in Poland, which took place at the Department of Neonatology Poznań University of Medical Sciences. Currently both methods--whole body hypothermia and selective brain cooling--offer a chance for a normal neurological development and a better life for children born with ENN. Both methods are accessible in a few centers in Poland.Ginekologia polska 08/2012; 83(8):630-2. · 0.41 Impact Factor -
Article: [The first application of therapeutic hypothermia in Poland--selective head cooling (Cool-Cap) with whole-body moderate hypothermia in a newborn with features of hypoxic ischemic encephalopathy].
[show abstract] [hide abstract]
ABSTRACT: The authors present the first application of therapeutic hypothermia in a newborn in Poland. The female newborn, born with severe asphyxia, was transported to a referral perinatal center where the method of brain cooling was possible. Severe hypoxic ischemic encephalopathy was confirmed by an integrated EEG. During the cooling procedure (which lasted 72 hours), no important side effects were noticed. The neurodevelopmental outcome of the baby assessed during the first 2 years of her life is normal.Ginekologia polska 05/2012; 83(5):384-7. · 0.41 Impact Factor -
Article: Early-onset infections of very-low-birth-weight infants in Polish neonatal intensive care units.
[show abstract] [hide abstract]
ABSTRACT: The objective of this study was to investigate the incidence, causes, the risk factors, etiologic agents and the outcomes of early-onset infections (EOIs) in very-low-birth-weight newborns in Polish neonatal intensive care units. Continuous prospective infection surveillance conducted during 2009 at 6 Polish neonatal intensive care units and included 910 newborns whose birth weight was lower than 1500 g. Infections were defined according to the Gastmeier's criteria. EOIs were diagnosed <3 days after delivery. The frequency of early-onset septicemia (EOS) was 7.0% and of early-onset pneumonia (EO-pneumonia) 8.6%. The factors significantly increasing the risk of EOS were low gestational age, small birth weight, low score in the Clinical Risk Index for Babies and Apgar score as well as maternal chorioamnionitis. The perinatal prophylaxis did not have an influence on the occurrence of EOS. The factors considerably increasing the risk of EO-pneumonia were low scores in the Clinical Risk Index for Babies and Apgar scores, a low gestational age and bacterial vaginosis in the child's mother during pregnancy. The most important etiologic organisms were Gram-positive cocci (39.7% of all the infections, 47.8% in EOS), Streptococcus agalactiae (20% of the EOS), Gram-negative bacilli (33.3% isolates), yeast-like fungi (isolated in 7.9% of cases) and atypical bacteria (22% of the cases of EO-pneumonia). The observed frequency of EOS did not differ from the one described in the literature, whereas the frequency of EO-pneumonia was higher. The bacterial etiologies suggest the vertical transmission of the pathogens and a close relationship between the observed EOIs with maternal environment. The applied perinatal antibiotic prophylaxis was ineffective.The Pediatric Infectious Disease Journal 03/2012; 31(7):691-5. · 3.58 Impact Factor -
Article: [Therapeutic hypothermia for neonatal hypoxic-ischemic encephalopathy].
[show abstract] [hide abstract]
ABSTRACT: Hypoxia-ischemia in the perinatal period is a serious condition affecting infants, which can result in death and cerebral palsy and associated disabilities. There has been significant research progress in hypoxic-ischemic encephalopathy over the last 2 decades. Many new molecular mechanisms of asphyxia have been identified. Despite all these advances, therapeutic interventions in HIE remain to be limited. Recently it has been revealed that mild therapeutic hypothermia is the only modality shown to improve neurologic outcome. The authors present a summary of pathogenesis of HIE, animal studies of cooling for hypoxic and ischemic models, and first publications on human therapeutic hypothermia trials. The diagnosis of encephalopathy in full-term neonates and enrollment criteria for hypothermia are also discussed. The current data from randomized control trials of hypothermia as neuroprotection for full and near-term infants are presented along with the results of meta-analyses of these trials. Finally the status of ongoing neonatal hypothermia trials as well as status of therapeutic hypothermia in Poland is summarized.Ginekologia polska 03/2012; 83(3):214-8. · 0.41 Impact Factor -
Article: [Antibiotic consumption and its costs of purchase in Polish neonatology networks units].
[show abstract] [hide abstract]
ABSTRACT: The study presents the results of the analysis of antibiotic consumption and its direct costs in selected neonatal units. Data were collected retrospectively (the year 2007) in five hospitals, during the pilot phase of the Polish Neonatal Network . Antibiotic consumption was assessed using the Defined Daily Dose (DDD). The costs were assessed as the costs of purchase of one DDD. The study included 11 922 children hospitalized in the period from 1.01 to 31.12.2007. In this group, 731 infants have birth weight < 1500 grams (from 2.2% to 64.2% in individual units, median--7.3%). The mean consumption of antibacterial drugs was 48.52 DDD/1 000 person-days (P-D) of stay among the entire study population (median--42,52), and varied from 23.13 to 85.82 DDD/1,000 P-D. However, this difference has not been statistically significant. The most commonly used group of antibiotics were beta-lactams--in four out of five units the percentage of its usage ranged from 48.71% to 74.67%. Next group were aminoglicosides--in one unit its usage reached 56.97% and in other ranged from 5.01% to 22.53%. Glycopeptides and macrolides were also used in every unit of the studied group. The usage of glycopeptides ranged from 1.7% to 10.81% and of macrolides from 1.32% to 15.71%. Different kinds of antibiotics were used occasionally. The differences of costs of purchase of one DDD between hospitals were greater and varied from 17,64 PLN/ DDD to 84,58 PLN/ DDD (average costs). A considerable range of costs index values was also noted for different groups of antibiotics. The costs of purchase of one DDD of beta-lactams varied from 19.54 PLN/ DDD to 68.35 PLN/ DDD; for aminoglicosides the cost varied from 4.61 PLN/ DDD to 122.9 PLN/ DDD, for glycopeptides--from 31.40 PLN/ DDD to 283.13 PLN/ DDD and in case of macrolides: from 12.05 PLN/ DDD to 90.77 PLN/ DDD. This differentiation of the cost of purchasing a single defined daily dose, taking into account the specific groups of antibiotics, did not have the characteristics of statistical significance. As expected, the antibiotic regimens in the studied wards were similar. This is due to a homogeneous population of hospitalized patients. However, the differences of costs of purchase of antibiotics observed in the study, indicate the considerable variety of the treatment patterns in Polish neonatology units and the need to develop and implement recommendations of effective pharmacotherapy for patients in intensive neonatal care units and the implementation of a unified model of infections surveillance.Przegla̧d epidemiologiczny 01/2012; 66(3):513-9. -
Article: [Nonimmune hydrops fetalis associated with congenital small bowel atresia--a case study].
[show abstract] [hide abstract]
ABSTRACT: Nonimmune hydrops fetalis is observed with the frequency of 1:3000 cases diagnosed pre- and postnatally. In the following paper the authors analyzed the course of pregnancy complicated by fetal ascites and polyhydramnios with the appearance of colonic ileus and they presented the postnatal condition of the baby The preliminary diagnosis was confirmed after birth and the newborn was operated in the second day of his life. The congenital small bowel atresia was qualified as a III B type (Grossfeld qualification), which is called the "pagoda" syndrome [3]. The colonic atresia is located then around the superior mesenteric vessels, which leads to colonic necrosis (Figure 1).Ginekologia polska 09/2011; 82(9):709-14. · 0.41 Impact Factor -
Article: [Obstetric consequences of uncontrolled gestational diabetes--a case study].
[show abstract] [hide abstract]
ABSTRACT: This paper presents a case of a pregnant woman who was admitted to the obstetrics and gynecology department because of a new onset of uncontrolled diabetes in 27 weeks gestation. The maternal and fetal diabetic complications suggested a chronic character of the disease which must have been undiagnosed before pregnancy. Many of the co-existing infections caused a life-threatening ketoacidosis. Fortunately with the adequate treatment it was possible to ensure appropriate birth weight of the newborn baby despite the ultrasound markers for LGA (Large For Gestational Age) observed during pregnancy. Intensive insulin therapy was obligatorily continued by the mother after the delivery.Ginekologia polska 08/2011; 82(8):627-31. · 0.41 Impact Factor -
Article: [Are in-utero interventions justified? Perspective of neonatologists. Part III. Twin to Twin Transfusion Syndrome and Congenital Heart Defects].
[show abstract] [hide abstract]
ABSTRACT: TTTS complicates from 10 to 15% of monochorionic diamniotic pregnancies. Expectant management is associated with 80 - 100% mortality First in-utero intervention in the fetus with CHD was performed in 1991. However only recently have they attained wider acceptance of cardiologists and perinatologists. Our main objective was to analyze the studies evaluating prenatal interventions in pregnancies complicated by TTTS or CHD, and to determine whether given the available data, those interventions are justified. Pubmed and Cochrane database were searched for all studies related to in-utero interventions in fetuses with TTTS or CHD. Emphasis was placed on randomized controlled trials. Meta-analysis published in Cochrane database concludes that laser photocoagulation of communicating vessels improves outcome in all stages of TTTS. Additional studies are required to elucidate the role of amnioreduction. For interventions in fetuses with CHD published data is limited to the case series. Potentially selected patients with CHD would benefit from in-utero intervention, but additional studies are required. Prenatal interventions in TTTS improve the outcome. Further studies are required to define their role in patients with CHD. For all procedures selection criteria and indications for interventions need to be clarified. More precise prenatal diagnosis and improvements in the area of fetal monitoring during the procedure might positively impact survival Preterm birth and premature rapture of membranes remain significant adverse outcomes. Complications associated with prematurity might counteract the positive effect of fetal intervention. Most cases of in-utero interventions should only be performed in specialized centers as a part of a clinical trial protocol.Ginekologia polska 07/2011; 82(7):525-32. · 0.41 Impact Factor -
Article: Use of heliox in the management of neonates with meconium aspiration syndrome.
[show abstract] [hide abstract]
ABSTRACT: Helium-oxygen mixture (heliox) ventilation has been known as an alternative treatment in patients with airway obstruction. Because of the physical properties of heliox, mechanical ventilation with this gas mixture may offer advantages in the management of respiratory failure associated with meconium aspiration syndrome (MAS). The purpose of this pilot study was to assess the effect of short-term mechanical ventilation with heliox in newborns with MAS on vital signs, oxygenation, acid-base balance and respiratory function parameters. The study was carried out in newborns with respiratory failure requiring mechanical ventilation due to MAS. Eight patients were ventilated using pressure-controlled synchronized intermittent mandatory ventilation. Parameters of respiratory function, oxygenation, acid-base balance and vital signs were recorded at baseline, then twice during 1 h of heliox ventilation and finally twice during 1 h after switching back to air-oxygen ventilation. Mechanical ventilation with heliox did not affect vital signs and the infants' clinical condition remained stable during the study. Heliox ventilation was associated with a nonsignificant increase in tidal volume, minute ventilation and peak expiratory flow rate values. Mechanical ventilation with heliox allowed the use of significantly lower FiO(2), with a significant decrease in alveolar-arterial oxygen tension difference and a decrease in the oxygenation index which was not statistically significant. There was also a significant increase in the PaO(2)/FiO(2) ratio during heliox ventilation. Ventilation with a helium and oxygen mixture had a positive effect on the selected parameters of oxygenation, while its effects on other respiratory parameters were relatively small.Neonatology 06/2011; 100(3):265-70. · 2.66 Impact Factor -
Article: [Are in-utero interventions justified? - perspective of neonatologists. - Part II. Spina bifida, obstructive uropathy, pleural effusion].
[show abstract] [hide abstract]
ABSTRACT: Spina bifida, obstructive uropathy and congenital pleural effusion (PE) belong to the group of congenital defects in which attempts of in-utero treatment were undertaken. Main objective of our study was to search for scientific evidence that would justify offering, and performing, in utero interventions in fetuses with spina bifida, obstructive uropathy and PE. Using Pubmed as the main source, all publications relevant to the subject of in-utero interventions in fetuses with spina bifida, obstructive uropathy and PE were sought and carefully reviewed. An extra effort was made to identify all randomized controlled trials and meta-analyses. Up to date, none of the aforementioned in-utero interventions was evaluated in the randomized controlled trial. Two ongoing studies, one for patients with spina bifida, and one for patients with obstructive uropathy are still actively recruiting the subjects. As suggested by the results of meta-analysis, vesico-amniotic shunt might be recommended for selected group of fetuses with obstructive uropathy. For fetuses with unilateral or bilateral PE, in-utero drainage seems to improve the outcome only in cases complicated by hydrops fetalis. However only case series are available. Because of insufficient scientific evidence, offering in utero intervention to women with pregnancy complicated by spina bifida, obstructive uropathy and fetal PE on the routine basis is not justified. Until more data, preferably from randomized controlled trials are available, these procedures should only be performed in specialized centers as a part of carefully designed clinical trial.Ginekologia polska 06/2011; 82(6):460-7. · 0.41 Impact Factor -
Article: [Are in-utero interventions justified?--perspective of neonatologists. Part I. Congenital diaphragmatic hernia (CDH)].
[show abstract] [hide abstract]
ABSTRACT: In-utero interventions are often perceived by parents as the only hope for their unborn child. Because it is neonatologists who have to deal with a sick newborn and sometimes unrealistic optimism of the parents after delivery we have taken on the task of reviewing the current knowledge concerning fetal surgeries from the neonatologist's perspective. In the first of three parts we have analyzed the data for in-utero interventions for CDH. Our main objective was to evaluate available data and to ascertain whether performing fetal surgeries for CDH is justified. Review of available literature on the subject of in-utero interventions in the fetuses with CDH was performed. Pubmed and Cochrane library were searched for relevant publications, in particular for randomized controlled trials. In randomized controlled trial (RCT), the in-utero intervention did not improve the outcome. The results of uncontrolled clinical trials suggest that it may be beneficial in cases with severe lung hypoplasia. The RCT testing the efficacy of the procedure performed later in pregnancy in moderately severe cases in currently under way In-utero interventions might improve survival in a carefully selected group of patients with CDH. However the evidence to support this claim is not strong, and until more data is available, in-utero interventions for CDH should only be performed in specialized centers as part of controlled clinical trial.Ginekologia polska 05/2011; 82(5):371-7. · 0.41 Impact Factor -
Article: Phase 3 trial evaluating the immunogenicity, safety, and tolerability of manufacturing scale 13-valent pneumococcal conjugate vaccine.
[show abstract] [hide abstract]
ABSTRACT: 13-valent pneumococcal conjugate vaccine (PCV13) includes polysaccharide conjugates from six pneumococcal serotypes in addition to those in the licensed 7-valent vaccine, thereby offering expanded protection against pneumococcal disease. The phase 3 trial reported here was conducted per a regulatory requirement to evaluate the immunogenicity, safety, and tolerability of two lots of the final PCV13 formulation that differed with respect to production scale but not the manufacturing process. The anti-pneumococcal polysaccharide immunogenicity and safety/tolerability were found to be similar between the two PCV13 vaccine lots.Vaccine 02/2011; 29(16):2947-55. · 3.77 Impact Factor -
Article: When you smoke your baby smokes: advancing maternal and child health through an academic alliance to improve health of mothers and their infants.
[show abstract] [hide abstract]
ABSTRACT: The detrimental effect of tobacco exposure prior to conception and during pregnancy has been receiving much worldwide attention. Maternal smoking during pregnancy is associated with early-onset wheezing, increased respiratory illnesses, and a 2-fold increased risk for Sudden Infant Death Syndrome (SIDS). Adverse effects on the infant include altered infant behaviors such as an increased occurrence of infant colic or Attention Deficit Disorders (ADD). Studies have shown that a significant number of smoking woman "quit" smoking during pregnancy. However, a majority of women, 67% by 3 months and up to 90% by 6 month, resume smoking following delivery. An infant's birth related hospitalization is a "teachable moment" to address parental smoking, and to advocate for reducing fetal exposure to tobacco smoke. Academic alliance focused on well designed educative program can further increase rate of smoking free pregnant women and decrease smoking relapse rates significantly.Przegla̧d lekarski 01/2010; 67(10):821-3. -
Article: [Nicotine in infancy--QUIT for kids].
[show abstract] [hide abstract]
ABSTRACT: Environmental tobacco smoke (ETS) during pregnancy as well as during postnatal period has been shown to be potentially responsible for variety of diseases, including premature delivery, upper and lower respiratory illnesses, asthma or behavioral disturbances (colic, attention deficient disorders). It is estimated that up to 70 to 80% of children are exposed to ETS, and most often they are forced to inhale air contaminated by tobacco smoke in public places such as kindergartens, schools, play grounds, but also cars and in other forms of transportation. Nevertheless one of the most significant sources of nicotine and other toxicants of tobacco smoke is breast milk from the smoking mother, or even among mothers exposed to ETS. Lack of individual educational approach focused on prevention of ETS exposure by infants lead our academic collaboration and establishment of "The QUIT for kids" program.Przegla̧d lekarski 01/2010; 67(10):1045-7. -
Article: Congenital midgut volvulus associated with fetal anemia.
[show abstract] [hide abstract]
ABSTRACT: Congenital volvulus is a life-threatening condition, both for the fetus and for the newborn. A volvulus is a twist of small bowel loops or a proximal part of the colon around the mesenteric artery or its branches. The potential consequences of volvulus are ileus and necrosis of the intestinal wall. Prenatal diagnosis of midgut volvulus is difficult. It should be suspected antenatally when polyhydramnios, intestinal dilatation, ascites and/or signs of fetal anemia are present on ultrasound assessment. We report a case of a congenital midgut volvulus associated with fetal anemia. The fetal ultrasound performed at 32 weeks' gestation showed a polyhydramnios, hydrothorax, thick ascites accumulation around the liver and the suspicion of a dilated bowel loop. Additionally, Doppler examination showed an increased value of peak systolic velocity in the middle cerebral artery. Cordocentesis confirmed significant fetal anemia. At 34 weeks, because of the suspicion of idiopathic meconium ileus and secondary anemia, a Cesarean section was performed after the administration of steroids. During the laparatomy, performed postnatally, a midgut volvulus was diagnosed. The affected portion of the ileum was resected and end-to-end anastomosis performed. An antenatal diagnosis of midgut volvulus should be considered when signs of fetal anemia, including an increased value of peak systolic velocity in the middle cerebral artery, are present with polyhydramnios, fetal ascites, dilated bowel loops on antenatal ultrasound. An assessment of the fetal hemodynamic status should be a part of the ultrasound assessment for patients with nonspecific fetal bowel pathologies, including congenital volvulus.Fetal Diagnosis and Therapy 01/2010; 28(2):119-22. · 1.05 Impact Factor -
Article: One-year follow-up of very preterm infants who received lucinactant for prevention of respiratory distress syndrome: results from 2 multicenter randomized, controlled trials.
[show abstract] [hide abstract]
ABSTRACT: The benefits of exogenous surfactants for prevention or treatment of respiratory distress syndrome are well established, but there is a paucity of long-term follow-up data from surfactant-comparison trials. We sought to determine and compare survival and pulmonary and neurodevelopmental outcomes through 1 year corrected age of preterm infants who received lucinactant and other surfactants in the SELECT (Safety and Effectiveness of Lucinactant Versus Exosurf in a Clinical Trial) and STAR (Surfaxin Therapy Against Respiratory Distress Syndrome) trials individually and, secondarily, from analysis using combined data from these 2 trials. All infants from both trials who were randomly assigned to administration of lucinactant (175 mg/kg), colfosceril palmitate (67.5 mg/kg), beractant (100 mg/kg), or poractant alfa (175 mg/kg) were prospectively followed through 1 year corrected age, at which point masked assessment of outcomes was performed for surviving infants. One-year survival was a key outcome of interest. Other parameters assessed included rates of rehospitalization and respiratory morbidity and gross neurologic status. Data were analyzed by comparing the different surfactants within each trial and, in secondary analysis, combining data from both trials to compare lucinactant versus the animal-derived surfactants (beractant and poractant) used in these trials. Survival rates over time were compared by using the Wilcoxon test for survival through 1 year corrected age and logistic regression for comparison of fixed time points. The latter analyses were performed by using the prespecified approach, where loss to follow-up or withdrawal of consent was imputed as a death, and also using raw data. Other outcomes were analyzed by using the Cochran-Mantel-Haenszel test or logistic regression for categorical data, and analysis of variance on ranks was used for continuous data. Very few cases were lost to follow-up in either trial (29 of 1546 enrolled in both trials [1.9%]). In the primary analysis of the SELECT trial comparing lucinactant to either colfosceril or beractant, there were no significant differences in the proportion of infants who were alive through 1 year corrected age. Fixed-time-point estimates of mortality at 1 year corrected age imputing loss to follow-up as a death were 28.1% for lucinactant, 31.0% for colfosceril, and 31.0% for beractant. By using raw data without imputing loss to follow-up as a death, mortality estimates at 1 year corrected age were computed to be 26.6%, 29.1%, and 28.3%, respectively. In the primary analysis of the STAR trial, significantly more infants treated with lucinactant were alive through 1 year corrected age compared with those who received poractant alfa. Fixed time estimates of mortality at 1 year corrected age imputing loss to follow-up as a death were 19.4% for lucinactant and 24.2% for poractant. These estimates using raw data that did not impute loss to follow-up as a death were 18.6% and 21.9%, respectively. In the combined analysis, survival through 1 year corrected age was higher for infants in the lucinactant group versus that of the infants in the animal-derived surfactants (beractant and poractant) group. The fixed-time-point estimates of mortality at 1 year corrected age imputing loss to follow-up as a death for lucinactant and animal-derived surfactants were 26.0% and 29.4%, respectively. However, the 1-year-corrected-age estimates using combined raw data were 24.6% for the lucinactant group and 26.7% for the animal-derived surfactant group. The incidence of postdischarge rehospitalizations, total number of rehospitalizations, incidence of respiratory illnesses, and total number of respiratory illnesses were generally similar among those in the treatment groups. Neurologic status at 1 year corrected age was essentially similar between infants who received lucinactant and those who received all other surfactants used in these 2 trials. Findings from this 1-year follow-up of both lucinactant trials indicate that this new peptide-based synthetic surfactant is at least as good, if not superior, to animal-derived surfactants for prevention of respiratory distress syndrome and may be a viable alternative to animal-derived products.PEDIATRICS 07/2007; 119(6):e1361-70. · 4.47 Impact Factor -
Article: Evolution of pulmonary surfactants for the treatment of neonatal respiratory distress syndrome and paediatric lung diseases.
[show abstract] [hide abstract]
ABSTRACT: This review documents the evolution of surfactant therapy, beginning with observations of surfactant deficiency in respiratory distress syndrome, the basis of exogenous surfactant treatment and the development of surfactant-containing novel peptides patterned after SP-B. We critically analyse the molecular interactions of surfactant proteins and phospholipids contributing to surfactant function. CONCLUSION: Peptide-containing surfactant provides clinical efficacy in the treatment of respiratory distress syndrome and offers promise for treating other lung diseases in infancy.Acta Paediatrica 10/2006; 95(9):1036-48. · 2.07 Impact Factor -
Article: [Clinical estimation of effects of therapy thoraco-amniotic shunt method in the group of four patient with prenatal diagnosis CCAM TYP I in Polish mothers memorial hospital research institute in years 1991-2004].
[show abstract] [hide abstract]
ABSTRACT: Congenital cystic adenomatoid malformation (CCAM) is a rare congenital malformation of the respiratory tract which could be diagnosed and treated prenatally. The aim of the retrospective assessment was to determine the efficiency of the treatment in four patients' with CCAM type I treated both prenatally and after birth in Polish Mother's Memorial Hosiptal Research Institute in years 1991-2004. We assessed clinical course in 4 children with CCAM type I. They were diagnosed and treated prenatally in Obsteric and Gynecologic Ultrasonography Department of Polish Mother's Memorial Hospital Research Institute in years 1991-2004. Fetal examinations were performed by Accuson 128X i HDI 5000 device with a transducer 3,5 or 4 Mhz. Prenatal diagnosis was verified postnatally based on radiological examinations. In 4 patients prenatal diagnosis of CCAM type I was established in mean average gestational age of 23 weeks and prenatal treatment was performed in mean average gestational age of 30 weeks. Postnatally children had surgical treatment in average age of 14 day of life. In follow-up of these children (average 2 years) normal psycho-physical development (according to the Denver scale assessment) was found and there had not been shown any significant deviations in circulatory system (based on echocardiography). 1. CCAM type I should be diagnosed prenatally in obstetrical ultrasonographic examinations and than referred to the Perinatal Reference Centre in the aim of the further complex medical care. 2. In some cases of the CCAM type I successful "in utero" treatment can be attempted by thoraco-amniotic shunt which protects complications development, especially when the fetal circulatory system assessment is positive.Ginekologia polska 03/2006; 77(2):95-102. · 0.41 Impact Factor -
Article: [The analysis of failure diode laser treatment of active phase of retinopathy of prematurity].
[show abstract] [hide abstract]
ABSTRACT: The aim of this study was to analyze risk factors influencing diode laser treatment of active phase of retinopathy of prematurity. 106 premature infants were treated with the use of diode laser at Department of Neonatology since 1.01.2003-30.11.2004. The mean gestational age was 27.3, mean birth weight 1022 g. The earliest age of laser therapy was 37th day of life and the latest one 104th day (mean 64.3 days). 18 neonates were excluded from the study because they were from other departments, and 2 because they died. The results of treatment of the rest 86 children were evaluated. The occurence of retinal detachment or macular ectopy was classified as unfavorable outcome. The complete remission was obtained in 143 eyes (83.2%),the macular ectopy was diagnosed in 10 eyes (5.8%), the retinal detachment in 19 eyes (11%). Children with unfavorable outcomes were divided in two groups. The first one included 6 extremely immature infants, born between 24 to 25th week of gestation. The ROP in this group was diagnosed in I zone with plus disease. The second group included children with gestation age from 28 to 32 Hbd. 9 of them had severe infection (sepsis, congenital pneumonia, urinary tract infection), 1 serious maternal history (R type of diabetes). The procedure of laser therapy was performed on average at 72th day of life at the first group, and at 50th day at the second one. (1) Important risk factors of treatment failure of active phase of retinopathy of prematurity, is low gestational age and infections which take place in perinatal period. (2) In the second group of infants (gestational age from 28-32 Hbd), with treatment failure the retinopathy of prematurity occured much more earlier then in the group with successful treatment. (3) When making decision of the patient treatment besides estimation of the eye fundus and the progress of changes, we should also consider risk factors which have influence on retinopathy of prematurity, after treatment.Klinika oczna 02/2006; 108(1-3):39-42.
Top co-authors
Top Journals
- Ginekologia polska (18)
- Przegla̧d lekarski (6)
- Klinika oczna (3)
- PEDIATRICS (3)
- Biology of the Neonate (2)
Institutions
-
2004–2011
-
Poznan University of Medical Sciences
- Department of Neonatology
Poznań, Greater Poland Voivodeship, Poland
-
-
2002–2011
-
Instytut Centrum Zdrowia Matki Polki
Łódź, Lodz Voivodeship, Poland
-
-
2010
-
Uniwersytet Medyczny im.Karola Marcinkowskiego w Poznaniu
Poznań, Greater Poland Voivodeship, Poland
-
