Folia medica Cracoviensia
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Folia medica Cracoviensia · Jan 2001
Review Comparative Study[Point systems for evaluating coma in patients with injuries of the central nervous system (CNS)].
Paper reviews various coma scales which are used to monitor consciousness after sustaining severe injuries of CNS. Glasgow Coma Scale, at present the most frequently used, was compared to recently developed scales, which are more useful for monitoring persistent comas, allows to evaluate discrete changes in patient's state more precisely and to predict the outcome. The necessity of evoked potentials' measurements, such as Trigeminal-Auditory Glasgow (Coma Scale) has been stressed.
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Folia medica Cracoviensia · Jan 2001
ReviewEvaluation on the effectiveness of perioperative nutritional therapy.
In the last three decade very important advances in venous access, enteral feeding techniques and parenteral and enteral nutrient formulations have made it possible to provide sufficient nutritional support to almost all patients. The clinical nutritional therapy became a progressive medical subspecialty. Despite the widespread use of nutritional management of different patient groups, many fields of nutritional support remain controversial. ⋯ The historical background and development of perioperative artificial nutritional therapy are cited. Whenever possible, prospective randomised clinical trials (PRCTs) are evaluated because this is the most reliable method for evaluating clinical efficacy of a treatment. The incidence of postoperative complications, the length of postoperative hospitalisation and the mortality are considered good general indicator of effectiveness of perioperative nutritional therapy.
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Folia medica Cracoviensia · Jan 2001
Review[Biological properties and sensitivity to induction therapy of differentiated cells expressing atypical immunophenotype in acute leukemia of children].
The atypical immunophenotype (expression of determinant from the another cell lines than line of origin) of acute leukaemia blast cells are noted in a part of cases. The characteristics and classification of atypical immunophenotypes are not unified and the clinical significance is not yet fully described. The purpose of the study was: precise description of atypical immunophenotypes and analysis of their frequency in different types of acute leukaemia, analysis of association between expression of atypical immunophenotypes and the level of initial leukocytosis, percentage of blast cells in peripheral blood, expression of CD34, analysis of frequency of multidrug resistance molecule (MDR) expression and association between MDR and immunophenotypes of leukaemia cells, analysis of association between atypical immunophenotypes and proliferation, secretion of cytokines (IL-6, TNF) and spontaneous apoptosis of leukaemia cells, analysis of association between atypical immunophenotypes and sensitivity to induction therapy. ⋯ In AML the combined expression of CD34 and atypical immunophenotype were associated with response to induction therapy by reaching the complete remission, but without any influence on the time of reaching this remission. The results of analysis of cytoreduction time and time of reaching the remission improved the usefulness of these parameters for the estimation of response to the induction therapy. The clinical importance of these observations consist in characterisation of leukaemia cells potentially resistant to the induction therapy what may suggest the modification and individualization of the induction therapy.
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Folia medica Cracoviensia · Jan 2001
[Reasons for optimizing perioperative anesthesia methods in neurosurgical patients--personal observations and innovations].
Own observations and experiments in neuroanaesthesia were presented, some of them controversial and in present day even historical, other put into practice for safety and comfort of patients and neurosurgical team.