Przegla̧d lekarski (Przegl Lek)

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ISSN 0033-2240
OCLC 320522930
Material type Periodical
Document type Journal / Magazine / Newspaper

Publications in this journal


  • No preview · Article · Feb 2016 · Przegla̧d lekarski

  • No preview · Article · Nov 2015 · Przegla̧d lekarski
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    ABSTRACT: RF ablation is an acknowledged method of treatment for many arrhythmias. During the ablation procedure the cause of the arrhythmia is eliminated, which results in resolution of cardiac arrhythmia and related clinical manifestations and therefore removes restrictions in the functioning of the patient, which were associated with the presence of arrhythmias. Was to assess quality of life in patients undergoing RF ablation due to atrioventricular nodal reciprocating tachycardia--VNRT, atrioventricular reciprocating tachycardia -AVRT and ventricular ectopic beats --EB's using the SF-36 questionnaire, DASI and Manolis. MMATERIAL AND METHODS The study included 81 patients (56 women and 25 men), who had undergone the RF abla-ion due to AVRT (24 patients), AVNRT (30 patients) or VEB (27 patients). Qual-ty of life was assessed using three questionnaires: the SF-36, DASI and Manolis that patient completed twice: on admission to hospital and after 6 months after ablation. RRESULTS The study showed im-rovement in all scales in the total study population. Subgroup analysis revealed that for each of the group score increased after ablation. The greatest improvement in scores (the biggest difference after-before) in the SF-36 was observed in patients with VEB. Our study found that the greatest improvement in quality of life after ab-ation in patients with a baseline larg-st number of additional ventricular beats (high negative correlation coef-icient -0.77; p <0 .0001 between point difference (after-before ablation) in the SF-36 questionnaire and the reduction of the amount of VEB's). There was no differences observed in improve-ent between patients with AVRT and AVNRT for the SF-36. CoONCLUSIONS Treatment of arrhyth-ias using RF ablation significantly improves the quality of life in patients with cardiac arrhythmias: AVNRT, AVRT, VEB. The largest improvement in quality of life refers to patients with VEBs. Among patients with VEB the greatest benefit had patients with baseline highest amount of ventricle extrasystoles.
    No preview · Article · Jun 2015 · Przegla̧d lekarski
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    ABSTRACT: Napoleon Cybulski, generally recognised the father of Polish physiology, was first a student and later an assistant of Tarchanoff at the Chair of Medical and Surgical Physiology of the Imperial Medical-Surgical Academy in St Petersburg. A Professor of the Jagiellonian University himself (whose nomination, by the way, was supported among others on the recommendations from Tarchanoff), Cybulski was a co-discoverer of adrenaline, and one of the first researchers in the world to make an EEG recording. Tarchanoff's ties with Poland are far greater than his biographers would admit. He was more than just a teacher and a friend of Cybulski: after being dismissed from the Academy in St Petersburg , the scientist not only used to visit Kraków but published his scientific works here, built a house in the vicinity of the city, and here he died on 24th August 1908. His wife, Helena Antokolska-Tarchanoff was active in Kraków's artistic circles. Hints suggesting that Tarchanoff planned to spend the rest of his life in what at the time was Galicia are plenty.
    No preview · Article · Jun 2015 · Przegla̧d lekarski
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    ABSTRACT: Electroconvulsive therapy (ECT) is an important method of biological treatment in serious psychic disturbances. Similarly to drug therapy it is marked by a determined schematics of applying including the list of indications, contraindications, procedures of the performance, as well as the list of adverse invents. Applying defined schemas allows for minimizing the risk and influences the final effectiveness of therapy.
    No preview · Article · Jun 2015 · Przegla̧d lekarski
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    ABSTRACT: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis syndrome (TEN) also known as Lyell's syndrome, are acute autoimmune dermatoses, which are potentially life threatening. They are both forms of necrotic skin reactions which causes epidermis to separate from dermis as a result of abnormal process induced by drugs or infections. Historically they were classified as a form of exudative erythema multiforme, but nowadays they are categorized as different disease entities. The reason is more severe clinical course in case of SJS and TEN, and known causes (medicines, infections). The criterion for distinguishing the two forms is based on the quantitative evaluation of the surface of affected skin. In case of SJS the affected area comprise up to 10% of body surface area, while in Lyell's syndrome it is over 30%. If affected skin surface ranges from 10% to 30%, it is defined as overlapping syndrome.
    No preview · Article · Jun 2015 · Przegla̧d lekarski
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    ABSTRACT: Lungs are the target organ in chronic hyperglycemia, but its large reserves causes a subclinical course of these changes. Given the results of other researchers indicating reduced active surface of gas exchange and pulmonary capillary damage, it can be assumed that diabetes and other hyperglycemic states diminish these reserves and impair effectiveness of respiratory gas exchange during pneumonia. So it is plausible to observe coexistence of glucose metabolism disorders and respiratory failure in patients hospitalized with lower respiratory tract infection. An observational study was conducted on 130 patients hospitalized with bacteriologically confirmed pneumonia. 63 patients suffering from chronic glucose metabolism disorders (A) and 67 randomly selected patients in control group (B) were observed on laboratory and clinical findings. There was no significant difference in prevalence of acute respiratory failure, although in the study group a slightly greater number of patients diagnosed with acute respiratory failure was observed. There was a significantly greater number of patients with previously confirmed chronic respiratory failure using long-term oxygen theraphy in A group (p = 0.029). The B patients with average blood glucose level > 108 mg/dl had significantly lower partial pressure of oxygen (PaO2)(gIc ≤ 108: 58.6 +/- 9.8; glc > 108: 51.7 +/- 11.1; p = 0.042). There was a statistically significant negative correlation of the average blood glucose level and PaO2 in the control group (p = 0.0152) and a significant inverse association between the average blood glucose level and the partial pressure of oxygen in patients without COPD belonging to the control group (p = 0.049). Respiratory failure is frequent in patients hospitalized with pneumonia. In patients without chronic glucose metabolism disorders with blood glucose level rising the oxygen tension decreases The association is stronger in patients without COPD.
    No preview · Article · Jun 2015 · Przegla̧d lekarski
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    ABSTRACT: Family medicine has been recognized as the key element of a good health care system. Despite the significance of the family physician's role the number of medical students choosing to train in family medicine has been declining in recent years. The aim of this study was to describe opinions about family medicine and family medicine teaching among medical students. A cross sectional study with an anonymous questionnaire was carried out. The study population was all sixth-year students in Faculty Medicine of Jagiellonian University Medical College, who completed family medicine course in winter semester of academic year 2012/2013. 111 students filled in the questionnaire. The response rate was 84.1%. Less than one third of respondents (30.6%) considered family medicine as a future career choice. Almost all students recognized responsibility of the family doctor for the health of community. 52% of respondents agreed that the family doctor is competent to provide most of the health care an individual may require. Experience from family medicine course was according to the students the most important factor influencing their opinions. Medical students appreciate the social role of family doctors. Family medicine teachers should not only pass on knowledge, but they also should encourage medical students to family medicine as a future career choice.
    No preview · Article · Jun 2015 · Przegla̧d lekarski
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    ABSTRACT: Tetany is a disorder with a very heterogeneous clinical manifestation. It includes neuromuscular hyperactivity, decreased attention, fatigue, constant anxiety. Attacks of tetany range from mild symptoms, which includes circumoral and distal paresthesias, hyperventilation, accompanied by shortness of breath, palpitation, dizziness, nausea and carpopedal spasm, through more severe symptoms like generalized seizures, loss of consciousness, muscle crumps to life-threatening emergencies like laryngospasm or arrhythmias. Tetany can be a result of many electrolyte disturbances, like hypocalcaemia, hypomagnesemia, hypokalaemia, alkalosis and electrolyte disturbances following hyperventilation. These disorders may occur in many clinical situations including diet deficiencies, alcoholism, endocrine diseases, genetic disorders, iatrogenic causes like proton pump inhibitors therapy and many, many others. It happens that tetany is diagnosed too late and therefore insufficiently cured. For these reason it deserves closer attention.
    No preview · Article · Jun 2015 · Przegla̧d lekarski
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    ABSTRACT: The surgical treatment of hallux valgus deformity is connected with significant postoperative pain. Spinal and general anesthesia as well as peripheral blocks are successfully used in foot surgery. The purpose of this study was to evaluate the influence of local anesthetic infiltration before hallux valgus one-day surgery on postoperative pain and the need for analgesics. 134 patients underwent chevron or miniinvasive Mitchell-Kramer osteotomy of the first distal metatarsal. After general anesthesia each patient randomly received an infiltration of 7ml of local anesthetic (4 ml of 0.25% bupivacaine and 3 ml of 2% lidocaine) or the same amount of normal saline 15 minutes before the skin incision. Both the patient and the surgeon were blinded. The patient was discharged after approximately 2 hours of observation. 2, 4, 8, 12, 16, 24 and 72 hours after the release of the tourniquet the level of pain was assessed by the visual analogue scale (VAS). Rescue analgesia, side effects and the use of painkillers were noted. Preemptive local anesthetic infiltration significantly decreased pain during the first 24 hours after the surgery. None of the patients from the injected group and 38 from the placebo group received 100 mg of ketoprofen intravenously for rescue analgesia in the first 2 hours after the release of the tourniquet. During the first 24 hours we noted significantly decreased use of 1000 mg of paracetamol and 100 mg mg of ketoprofen orally in the injected group. No systemic adverse effects were noted. One patient from placebo group had allergic rush after use of 100 mg ketoprofen. Preemptive local anesthetic infiltration in one-day hallux valgus surgery significantly decreases postoperative pain. It is safe, efficient and allows fast discharge.
    No preview · Article · Jun 2015 · Przegla̧d lekarski
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    ABSTRACT: Polish physicians are obliged by legislation to prescribe drugs authorized for the sale in the Republic of Poland, based on registration documentation, including the Summaries of Product Characteristics (SPC). So called 'off label' treatment occurs in case of the conflict between prescription and information contained in the SPC, which may be considered as a 'medical experiment'. In case of adverse drug reactions, such classification excludes the responsibility of the marketing authorization holders, and damages are not covered by obligatory third party insurance, which can pose financial and legal consequences to the doctor. Deviations from SPC-compliant prescription may include a different way of drug administration, drug administration compliant with the indications yet in patients for whom there is no specified drug dosage, or in case of an indication not contained in the SPC. Medicinal products with equivalent active component, form and dose can have different registration indications in the SPC, and the actively promoted dispensation of less expensive substitutes by the pharmacists may, against doctor's will, result in the use that is non-compliant with registration of the substitute drug. Pharmacotherapy of 'orphan diseases', for which there are no registered medicinal products, also becomes an essential issue as it forces doctors into 'off-label' prescriptions. Moreover, the reimbursement of drugs in most cases is limited to medicinal products that are prescribed according to the registration indications. The pleas by medical professionals to make ordination and reimbursement of drugs depend on active pharmaceutical ingredient and evidence of efficacy, as well as to introduce Evidence Based Medicine (EBM) standards for the treatment of diseases, did not receive proper attention from the governing bodies. Therefore, a fundamental question remains unanswered as to what should be the principal gauge for physicians' therapeutic decision: the ethics, conscience, recent scientific evidence or legal and administrative regulations?
    No preview · Article · Jun 2015 · Przegla̧d lekarski
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    ABSTRACT: Systemic sclerosis is a complex autoimmune disease characterized by immune activation, fibrosis of the skin and internal organs and vasculopathy affecting predominantly the microvessels with a predilection for women. The genetic background of systemic sclerosis is still full of unanswered questions, with classical genetics able to explain only some systemic sclerosis cases. Novel advances concerning epigenetics give us new insight into pathogenesis of systemic sclerosis. This review focuses on results of recent reports on epigenetic modifications of the gene functions and X inactivation changes in pathogenesis of systemic sclerosis. Current evidence demonstrates DNA heavy methylation (FLI1, NOS3, BMPRII) and hypomethylation of regulatory genes (CD40L, CD70), histone code modifications, abnormal expression of large spectrum of microRNAs.
    No preview · Article · Jun 2015 · Przegla̧d lekarski