Przegla̧d lekarski
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On 27 June 1994 a Japanese terrorist group, Aum Shinrikyo, released sarin in Matsumoto. Some 600 people were exposed: 58 were admitted to six hospitals and all recovered: seven casualties living close to the sarin release died outside hospital. This release followed an earlier attempt by Aum Shinrikyo to use sarin to kill the head of a religious sect perceived as a threat. ⋯ Over 5000 "casualties" sought medical attention of whom 984 were moderately poisoned and 54 were severely poisoned; 12 died. Despite some initial difficulties, Japanese emergency units and local hospitals were able to respond reasonably rapidly. Analysis of the events reveals a number of important lessons for authorities as well as physicians to consider when preparing for such incidents.
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Fire fighters are exposed to a variety of toxic substances in their profession. Additionally, a tobacco smoke leads to a harmful effect on their respiratory tract. ⋯ Questionnaire analysis showed differences in the presence of COPD symptoms in the subgroups of smokers and nonsmokers. Results of spirometryc analysis indicated lower values of results in FMF25-75%, parameter, which may be explained by an obstruction of an air-flow in medium and small airways.
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Surgical treatment for Rathke cleft cysts--Intrasellar and suprasellar cysts are often lesions observed in the neuroradiological examinations. The majority of them (craniopharyngioma, cystic pituitary adenoma) are histologically neoplasmic. The others originate from the remnants of the embryonic diverticulum which arise from the roof of the stomodeum. ⋯ Histological examination confirmed Rathke cleft cyst. There were no serious complications in our group. Follow-up examination comprises periodic endocrinological and radiological investigations.
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Amanita phalloides is a direct life-threatening poisoning because of acute multiorgan failure. Urgent liver transplantation (LTx) is the last chance to save patient's life in severe cases. In many cases of mushroom poisoning the patient dies because of unavailability of a liver graft. Liver albumin dialysis (MARS) is a promising treatment to bridge the patient to LTx or stabilize his or her condition until spontaneous liver regeneration occurs. ⋯ Liver albumin dialysis may be effective in severe Amanita phalloides poisoning to stabilize the condition of a patient until spontaneous liver regeneration occurs or as a bridge to LTx. In cases of a family poisoning, proper coordination and cooperation among toxicology departments and transplant centers is required.
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CO poisoning remains a serious public health problem. Oxygen is the basis of its treatment and HBO has been proven more effective to prevent cognitive sequelae than NBO. Most commonly accepted criteria for HBO treatment are: comatose patient, loss of consciousness, neuropsychological and cardiac symptoms and pregnancy. However, patients not requiring HBO, have to be treated by a correct NBO regimen.