Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
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Pol. Merkur. Lekarski · Oct 2004
Review[Pathogenic and clinical significance of Helicobacter pylori infection in chronic urticaria and angioedema].
Urticaria and angioedema are one of the most frequent skin diseases, nevertheless no etiologic factors have been found in a large number of cases. This review summarizes the available medical literature from Medline regarding Helicobacter pylori and mentioned disease. ⋯ However there are several papers, which support lack of relationship between H. pylori infection and the course of urticaria and angioedema. Thus we need further randomized, double-blind and placebo controlled studies including adequate diagnostic schedules, sufficient eradication treatment protocols, confirmation of eradication, and adequate control groups to establish a role of H. pylori in urticaria and angioedema.
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Fournier's gangrene is a necrotizing fasciitis of the genital and scrotal region due to infectious process. The gangrene is rare. Most cases are diagnosed in elderly patients with immunodeficiency, especially in diabetics or alcoholics. ⋯ The development and progression of the gangrene is often fulminating and can rapidly cause multiple organ failure and death. Early surgical debridement of necrotic tissues and antibiotics are fundamental in the treatment of Fournier's gangrene. Despite of advanced management mortality is still high and averages 20-30%.
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Pol. Merkur. Lekarski · May 2004
Review[Transplant coronary artery disease--treatment with statins].
Hypercholesterolemia is a common disorder after heart transplantation and my be associated with the development of transplant coronary artery disease. 3-hydroxy 3-methylglutaryl coenzyme A reductase inhibitors (HMG CoA) are the most effective drugs to lower cholesterol level in transplant patients. However, interaction of immunosuppressants with HMG CoA inhibitors, which are metabolized by cytochrome P 450, increase incidence of skeletal muscle myopathy and rhabdomyolysis.
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Pol. Merkur. Lekarski · May 2004
Review[Adjuvant and salvage radiotherapy after radical prostatectomy].
Currently radical prostatectomy remains the standard mode of treatment for patients with locally and localized stage of prostate cancer. On the other hand, after radical prostatectomy approximately 50% of patients have postoperative positive margin. Therefore implementation of effective mode of adjuvant radiotherapy treatment after radical prostatectomy plays important role in clinic. ⋯ Still remain questions about the following issues: timing of radiotherapy, optimal dose, treatment technique, involved target for radiotherapy, and the role of adjuvant hormonal therapy. The last issue now is evaluating in the randomized clinical trial. In summary, currently until outcomes from well conducted randomized trials will available patients after radical prostatectomy with adverse significant factors for local recurrence or/and increased level of PSA should be considered for postoperative radiotherapy.
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The coadministration of long-acting inhaled beta2-agonists and inhaled corticosteroids is the most effective treatment for persistent asthma. It is often assumed that there is synergy between these medications. ⋯ The combination has a logical role in the treatment of moderate-to-severe asthma, offering the advantage of increased convenience and possibly improved compliance. In addition to improvements in lung function, symptom scores and quality of life, the combination therapy reduces exacerbation rates, an outcome that contributes to favorable cost-effectiveness.