Przegla̧d lekarski
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The pathogenesis of primary headaches is differential, with a neurogenic inflammation participation. ⋯ 1. Changes of the level of IL-6, IL-1beta, TNF and sTNFRI in the blood of children with idiopathic headache do not indicate a significant role of inflammatory process in its pathogenesis. 2. Although the significant increase in IL-6 levels observed in several children in the first hour of the migraine attack may suggest that neurogenic inflammation participates in the pathogenesis of migraine.
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Antidote ethanol is the basic treatment in ethylene glycol (EG) poisoning. EG ingestion is occasionally combined with ethanol. The objective was to evaluate the course of intoxications due to concurrent EG and ethanol ingestion. ⋯ Because of high-ingested dose six patients received haemodialysis. All seven patients from our study survived. The course and outcome of EG intoxication in this group of patients was very probably positively influenced by concurrent ingestion of EG and ethanol.
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186 case records of patients who overdosed pharmaceuticals (confirmed by toxicological lab analysis) hospitalized at the Department of Clinical Toxicology during three months of 2000 were analyzed for age, sex, type of medication, reason for poisoning (intentional or accidental overdosing). Patients poisoned with prescription medication (Rx group) were compared with those who overdosed nonprescription (OTC-group) medications (alone or combined with Rx). Relative frequency of medication drug poisoning was highest in the 40-49 age group (28.5%) and was followed by the group of young adults (20-29 years; 24.2%). ⋯ Most adults attempting suicide used Rx with the highest incidence in the 40-49 age group (31.1%). Adolescents (14-19 years) with female over-representation ingested rather OTC pharmaceuticals (40.9%). Acetaminophen (alone or combined with benzodiazepines or/and ethanol) and nonsteroidal anti-inflammatory drugs (NSAIDs) were the most common OTC medications used for deliberate self-poisoning.
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Amitriptyline is a potent anticholinergics, rarely used as a drug of abuse. Two cases of amitriptyline dependency lasting for almost twelve months were described. According to the patients the abuse with amitriptyline guarantee them safety not to be uncovered by parents and doctors who systematically checked their urine with typical narcotic tests. ⋯ Antidepressants should be treated as a drugs with possible abuse ability.
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Prevalence of type 2 diabetes has increased greatly over the past decade and focus of care for people with diabetes has shifted from specialists to general practitioners (GPs). Because of lack of the central registry, a real number of diagnosed diabetes in Poland is unknown, as unknown is the prevalence of diabetes in patients attending primary health care, provided treatment and a prevalence of chronic diabetic complications registered by GPs. ⋯ 1. The prevalence of diabetes registered in primary health care in Szczecin is higher than expected on the basis of European data. 2. Low number of type 2 diabetics is treated with diet alone and quite high number is treated with insulin. 3. Low number of chronic diabetic complications reported by GPs, despite long duration of disease, indicates the necessity of special training in delivering care for diabetic people, diagnosis of diabetic complications, increased access to secondary care and better cooperation between primary and secondary care.