Przegla̧d lekarski
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Treatment of prostate cancer is a challenge for both urologists and radiation oncologists. Currently two radical methods of treatment are recommended i.e. radical prostatectomy and radiotherapy. Hormonal therapy is mainly indicated for treatment of patients with metastases, but lately has become popular in combination with radical radiotherapy. ⋯ This study showed that 2 years of adjuvant hormonal therapy produced significant prolongation of the 5-year overall survival by 80% in comparison to 69% for patients treated without adjuvant hormonal therapy. Despite these few trials, lacking is still data and the following crucial questions are waiting for answers in the near future: What is the optimal timing of hormonal therapy? Which patients will obtain the greatest benefits due to combined strategy? How does long lasting hormonal therapy influence on patient's quality of life? Future trials (RTOG 9413 and RTOG 9901) will give some answers to the mentioned above questions. Currently we can conclude that in the group of patients with high risk of relapse, hormonal therapy with radiotherapy improve results of treatment.
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Interstitial lung disease (ILD) is one of the most frequent and most serious complications of connective tissue diseases such as systemic sclerosis, systemic lupus erythematosus, dermato- and polymyositis, Sjogren's syndrome, or mixed connective tissue disease. Diagnosis of ILD is often delayed in patients with connective tissue diseases because of the systemic character of the primary condition, restricted physical activity of the patient and insufficient awareness of the physycian. The aim of the current review is to present the up-to-date information on ethiopathology, classification, diagnosis and treatment of ILD in patients with connective tissue diseases.
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Patient satisfaction is increasingly considered to be one of the most important factors in the measurement of quality of medical care. In the paper we show the most important aspects of patient satisfaction and the main reasons for its lack. We also suggest the possibilities of measurement and improvement of patient satisfaction as the main factor of better clinical care and a properly functioning family doctor.
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Cardiac arrest (CA) refers to abrupt cessation of cardiac pump function. Most sudden deaths in young people are of cardiac origin, at the same time most patients have unrecognised prior heart disease. We report a case of a 17-year-old boy with cardiac arrest induced by ventricular fibrillation. ⋯ The patient in a poor general and unconscious state was transferred to the Coronary Care Unit of the Department of Coronary Disease. The patient improved after treatment and without neurological deficit or circulatory insufficiency continued cardiac rehabilitation in a spa hospital. The paper reviews differential diagnosis of cardiac arrest, treatment modalities and describes the course of hospitalisation.
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The development of predictive genetic DNA- tests gives people the choice "to know" or "not to know" a decision with tremendous short-mid- and long-term consequences. Family history of disease can provide information about the increased risk of susceptibility, and these knowledge may have psychosocial implication. The results of studies using genetic testing and their psychological impact are discussed with regard to hereditary cancer (breast, colorectal, prostate) as well as particular neurogenetic disease (e.g. ⋯ Psychological studies on genetic risk concentrating on psychological adjustment, transfer of information within the family and perception of genetic risk in families showed that genetic disease had a considerable impact on family life (e.g. reproductive decisions). Findings showed that people with a family history of cancer (without genetic testing) vary in their illness behaviour, but little is known about the effect of inheredited predisposition to disease (e.g. cancer) on such health related behaviour as smoking, diet, activity level. Genetic information could both increase (strengthening the belief that current behaviour combined with genetic predisposition is putting person at increasing risk of disease) and decrease motivation to change behaviour (weakening belief that changing behaviour will reduce risk of disease because genetic is immutable).