Mirosław Dziekiewicz

Publications of Mirosław Dziekiewicz

• Peritoneal dialysis as a therapeutic approach in congestive heart failure resistant to pharmacological treatment: case report.

  Authors: Agnieszka Próchnicka, Anna Olszowska, Daniel Baczyński, Grzegorz Zelichowski, Arkadiusz Lubas, Magdalena Wiśniewska, Mirosław Dziekiewicz, Zofia Wańkowicz

  Polskie archiwum medycyny wewnȩtrznej. 12/2009; 119(12):834-7.

  This report describes the use of continuous peritoneal dialysis (PD) as an alternative to hemodialysis (HD) in a patient with type 2 cardiorenal syndrome in the course of congestive heart failureThis report describes the use of continuous peritoneal dialysis (PD) as an alternative to hemodialysis (HD) in a patient with type 2 cardiorenal syndrome in the course of congestive heart failure resistant to standard pharmacological treatment. A 39-year-old man presented with a 24-year history of progressive heart failure. Ineligibility for heart transplant and previous inefficient treatment with different modifications of HD reduced his treatment options to PD. After 7 months of continuous PD (1 overnight exchange with icodextrin and 2 daily standard continuous ambulatory PD exchanges) his overall condition significantly improved compared with his status while on HD. An increase from NYHA class IV to class II, increase in left ventricular ejection fraction from 50% to 55%, decrease in right ventricular systolic pressure from 73 to 53 mmHg, and improvement in the quality of life enabled him to resume his daily activities.

• [Abdominal angina syndrome--case report]

  Authors: Paweł Babski, Mirosław Dziekiewicz, Jerzy Gil, Stanisław Wojtuń, Marek Maruszyński

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 06/2009; 26(155):475-7.

  Bowel atherosclerotic ischemia is one of the type of clinical presentation of this general inflammatory arterial disease. In this article was depicted a case of 58-year-old female with clinicalBowel atherosclerotic ischemia is one of the type of clinical presentation of this general inflammatory arterial disease. In this article was depicted a case of 58-year-old female with clinical presentation of chronic bowel ischemia, e.g., chronic stomach pain, defecation disturbance and cachexia. Diagnostic process, difficulties during diagnostic and therapy were presented. The patient was referred to the surgery The diagnostic process and surgical treatment performed in our hospital were compared with actual recommendations of specialists and standards.

• [Combined management of pancreatic injury after airgunshot--case report]

  Authors: Paweł Babski, Mirosław Dziekiewicz, Jerzy Gil, Stanisław Wojtuń, Marek Maruszyński

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 06/2009; 26(155):483-5.

  Pancreatic trauma is a big diagnostic and therapeutic challenge for physicians. Because of retroperitoneal localization pancreas is protected from damages. Isolated pancreatic injury is rare. UsuallyPancreatic trauma is a big diagnostic and therapeutic challenge for physicians. Because of retroperitoneal localization pancreas is protected from damages. Isolated pancreatic injury is rare. Usually it is connected with a multiple trauma. Damages of the other organs mask the symptoms of pancreas disorders and delay the diagnosis. On the other hand the prognosis is strictly connected with the state of the other organs. Early diagnosis and precise evaluation of the trauma extensiveness determines the appropriate method of the treatment. Surgery is a main therapy but the combined method of management is often necessary, including endoscopy. Computed tomography (CT) is the first diagnostic method showing the pancreatic parenchymas damage and its complications. Endoscopic Retrograde Cholangiopancreatography (ERCP) is the best tool to show the major ductal injury. The status of the major pancreas duct determines surgery management. Often the placement of stents is required. This therapy can save the patient from pancreatectomy. In this article was depicted a case of 19th patient with pancreatic injury who sustained airgun shot. Despite laparotomy and surgery external drainage the pancreatocutaneous fistula appeared. It was successfully treated by endoscopic placement of stent during ERCP.

• [Vascular access for hemodialysis--own experiences].

  Authors: Mirosław Dziekiewicz, Przemysław Wierzbicki, Monika Prokopiuk-Wierzbicka, Andrzej Obara, Zofia Wańkowicz, Marek Maruszyński

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 04/2008; 24(142):316-20.

  We present own experiences in creation and/or reconstruction of vascular access for hemodialysis. 91 pts (63 men, 28 female) aged 18 to 89 years, with irreversible renal failure qualified for renalWe present own experiences in creation and/or reconstruction of vascular access for hemodialysis. 91 pts (63 men, 28 female) aged 18 to 89 years, with irreversible renal failure qualified for renal replacement therapy, 47% of them with diabetic nephropathy. In years 1996-2006, 167 surgical procedures of creation or reconstruction of vascular access for hemodialysis were performed. In the qualification for surgical procedure we used clinical assessment as well as Doppler ultrasound or computed tomography angiography. In 3 cases from all 167 patients we performed fistula ligation due to transfer to peritoneal dialysis. In the 164 others cases we performed 18 types of different procedures among other thing: 95 first or second degree arteriovenous fistulas creation, 35 procedures of revascularisation and 34 procedures of fistula reconstruction. In our material own modification of Cimino-Brescia arteriovenous anastomosis was introduced with positive hemodynamic effects in all cases. In the discussion we stressed the necessity of selection of creation/reconstruction methods individually for every patient especially in ageing and diabetic population of patients with chronic kidney disease with many cardiovascular complications both in predialysis stage of kidney failure as well as in the course of long term dialysotheraphy. The assurance in optimal vascular access for hemodialysis is still big challenge especially in patients of advanced age. Individual approach to every case gives the chance of choice the best surgical procedures for optimal vascular access for hemodialysis.

• [Asymptomatic intraperitoneal adhesions disease as the potential cause of unfeasibility of creation dialysis access to peritoneal cavity--case reports].

  Authors: Mirosław Dziekiewicz, Andrzej Obara, Monika Prokopiuk-Wierzbicka, Przemysław Wierzbicki, Zofia Wańkowicz, Marek Maruszyński

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 04/2008; 24(142):325-7.

  Peritoneal dialysis is one of three, complementary methods of renal replacement therapy, including also hemodialysis and kidney transplantation. After qualification for peritoneal dialysis programPeritoneal dialysis is one of three, complementary methods of renal replacement therapy, including also hemodialysis and kidney transplantation. After qualification for peritoneal dialysis program special attention should be paid for creation proper dialysis access through correct implantation of peritoneal catheter. On the basis of three cases we present difficulties of Tenckhoff peritoneal catheter implantation in patients with massive peritoneal adhesions without previous surgical interventions and other risk factors for peritoneal adhesions.

• [The role of sentinel node biopsy in breast cancer surgery]

  Authors: Marek Stańczyk, Mirosław Dziekiewicz, Marek Maruszyński, Waldemar L Olszewski

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 09/2005; 19(110):245-8.

  Mastectomy with axillary lymph node dissection remains the routine surgical treatment of breast cancer in Poland. Lymph edema of the upper extremity is one of the major long-term complications ofMastectomy with axillary lymph node dissection remains the routine surgical treatment of breast cancer in Poland. Lymph edema of the upper extremity is one of the major long-term complications of axillary dissection. Axillary lymph node status is the most valuable prognostic indicator and decision factor on adjuvant chemotherapy or radiotherapy for breast cancer patients. Level I and II axillary lymph node dissection provides prognostic information, maintains local control in the axilla and determines the need for adjuvant systemic treatment, but it is also associated with 30% rate of lymph edema. Multiple studies confirm that sentinel lymphadenectomy accurately stages cancer advancement and is associated with less morbidity than axillary dissection. Over 40% of breast cancer patients in Japan are submitted to breast conserving therapy with sentinel node biopsy. In our opinion sentinel node biopsy may be accepted as an alternative staging procedure for the axilla in breast cancer. Sentinel node biopsy is especially valuable tool for breast cancer patients undergoing breast sparing surgery (IIA), due to excellent cosmetic outcome, minimal morbidity and high degree of histological accuracy associated with the procedure. This article reviews current literature in breast conserving therapy and sentinel node biopsy. Author would like to thank to Professor Kenji Ogawa, Chairman of Surgical Department of Tokyo Women's Medical University Daini Hospital, Professor Fujio Kasumi Chief of Breast Surgical Department of Cancer Institute Hospital and the Japan Society for the Promotion of Science for the scientific support during research visit in Tokyo.

• [Report from the 3rd International Congress of Vascular Access Society--Lisbon]

  Authors: Mirosław Dziekiewicz

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 09/2004; 17(98):192-4.

• ["Abdominal catastrophe" in peritoneal dialysis]

  Authors: Anna Olszowska, Mirosław Dziekiewicz, Zofia Wańkowicz

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 09/2004; 17(98):183-6.

  Abdominal catastrophe in peritoneal dialysis is defined as peritonitis secondary to visceral injury with enteric organisms in dialysate. This complication is associated with a high mortality rate.Abdominal catastrophe in peritoneal dialysis is defined as peritonitis secondary to visceral injury with enteric organisms in dialysate. This complication is associated with a high mortality rate. Peritonitis associated with abdominal catastrophe is extremely difficult to diagnose. This review refers to the special aspects of pathogenesis, diagnosis and therapy of peritonitis due to visceral injury.

• [Pseudoaneurysms after femoral arteries cannulations in hemodialysed patients--preliminary data]

  Authors: Przemysław Wierzbicki, Monika Prokopiuk-Wierzbicka, Grzegorz Kade, Mirosław Dziekiewicz, Zofia Wańkowicz

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 09/2004; 17(98):123-7.

  Patients undergoing chronic haemodialysis (HD) therapy have higher risk of arterial injury during cannulation for diagnostic and therapeutic procedures. Aim of our study was to evaluate frequency ofPatients undergoing chronic haemodialysis (HD) therapy have higher risk of arterial injury during cannulation for diagnostic and therapeutic procedures. Aim of our study was to evaluate frequency of femoral pseudoaneurysms (FPA) occurring after femoral artery (FA) cannulation (FAC) as well as presentation of ultrasound guided compression (USGC) of FPA. MATERIAL AND METHODS: From the group of 340 HD patients in our Centre in years 1996-2003 37 consecutive HD patients (23M, 14F, aged 55, 5 +/- 8, 2years, on HD 24, 2 +/- 22,6 months) after FAC, indicated from cardiological point of view, underwent regular femoral colour duplex USG. RESULTS: In 21 pts we found no local complications. In 16 of 37 pts 7 hematomas (HM) and 9 femoral pseudoaneurysms (FPA) were found. All HM were treated conservatively. From 9 FPA cases, 2 thrombosed spontaneously and the remaining 7 pts were treated firstly with USG guided controlled compression (UGCC). UGCC resulted in successful thrombosis of FPA in 3 pts with mean volume of FPA 40 +/- 12 ml but failed in 4 other pts with mean volume of FPA 39 +/- 17 ml. CONCLUSION: Our preliminary results show, for the first time in the literature, that occurrence of FA damage might occur rather often in HD pts qualified for this procedure from cardiological point of view. Pseudoaneurysms of FA, being in our material the most frequent pathology, should be promptly diagnosed with colour duplex USG and subsequently treated non surgically with USG guided controlled compression.

• [Surgical access for hemodialysis and peritoneal dialysis]

  Authors: Mirosław Dziekiewicz, Marek Maruszyński

  Polskie archiwum medycyny wewnȩtrznej. 11/2003; 110(4):1245-51.

• [Pseudoaneurysm of arteriovenous fistula for haemodialysis]

  Authors: Grzegorz Kade, Magda Zagrodzka, Monika Prokopiuk, Przemysław Wierzbicki, Mirosław Dziekiewicz, Zofia Wańkowicz

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 12/2002; 13(77):399-402.

  On the basis of two cases of haemodialysed patients we present the usefulness of spiral computed tomography in the diagnosis of pseudoaneurysm as a complication of arteriovenous fistula forOn the basis of two cases of haemodialysed patients we present the usefulness of spiral computed tomography in the diagnosis of pseudoaneurysm as a complication of arteriovenous fistula for haemodialysis.