Przegla̧d lekarski
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Diabetic nephropathy is a leading cause of end-stage renal disease. In this paper the role of renin-angiotensin-aldosterone system (RAA) in the pathogenesis of diabetic nephropathy is discussed and clinical effects of multilevel pharmacological blockade of RAA system by combined treatment with ACE inhibitors, angiotensin receptor blockers (ARB) and aldosterone antagonists is described.
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Smoking cigarettes poses a number of relevant medical and social problems. Impact of smoking on pain threshold and tolerance may be of significance for surgical patients, who are prompted to abstain from cigarettes before operation. Association between smoking and pain perception is complex. ⋯ Smokers also present with altered mechanism of stress-induced analgesia and both gender and pain modalities influence their pain perception. Some studies demonstrate increased requirements for postoperative opioid analgesia in smoking patients. Strategies for postoperative pain treatment in smokers should involve regional techniques and clonidine.
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Pediatric neuropsychology is currently one of the most expansive fields of psychology, developing between clinical neurology and other neurosciences. ⋯ the knowledge of possibilities and the necessity of the neuropsychological evaluation in children should become much more common, especially in the medical environment. The status of the neuropsychologist in Poland need a precise legal regulation.
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Human ecology makes a scientific base for more effective prevention against contamination of the air, water and food, and other environmental factors making common risk factors for human health. It integrates interdisciplinary cooperation of experts from natural, technological, socio-economical and other sciences. Complex study is necessary for better estimation of real risk factors for an individual person. ⋯ It would be useful to focus this activity on crucial problems and selected regions. Let me propose as the top priority for inhabitants of Tarnow region as well as pilot projects for Poland; utilization of all possible achievements of science and technology for primary prevention of health hazard for inhabitants of Gmina Szczucin that is very polluted by asbestos, and also model management reducing risk factors for the natural environment and health of inhabitants in the regions of new motor-ways, as well as better primary prevention against flood accidents and connected with their effects (higher humidity of housing environment and its contamination by toxinogenic moulds) risk factors for health of communities living in rivers regions. For the purpose of optimisation of preventive action, it is necessary not only to apply the results of studies on human ecology and exchange experiences with specialists (e. g. within European projects), but also to perform better integration of the activities of experts, local society and regional administration.