Przegla̧d lekarski
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Humans are highly adapted to consuming probiotics. Trehalose ("mushroom" sugar) is probably an important reserve compound and stress-responsible metabolite (increases bile and gastric acid resistance) of probiotic bacteria's and trehalase activity, in contrast to lactase activity, is preserved in all human populations, even those not consuming mushrooms. Among traditional Melanesian horticulturists, of whom 4/5 are daily smokers, the diet is rich in pre- and probiotics and there is absence of cancer and cardiovascular disease. ⋯ In one study it was observed that a diet supplemented with Lactobacillus plantarum could be also useful in the prevention of cardiovascular disease in smokers. There is no sufficient data from clinical trials to recommend the routine use of probiotics in prevention of smoking-related diseases. More research is needed to investigate the role of probiotics in this area.
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Transcranial Doppler enables dynamic assessment of cerebral blood flow and is particular important in migraine, associated with impaired vasoreactivity. Majority of studies revealed disturbed mechanisms of autoregulation in patients with migraine with aura in predominance. Visual aura and increased photosensitivity in migraine patients suggest disorders of visual pathway and visually evoked potentials (VEP) enable to detect even subclinical pathologic changes in its course. ⋯ Simultaneous recording of cerebrovascular response to visual stimulation and VEP revealed increase of cerebral blood flow velocity over 10 cml s in 6/15 patients and in 5 of them also amplitudes N75/ P100 or also P100/N145 over 20 mV were recorded. However, analysis of the results did not allow to identify characteristic changes for each type of headache. In order to establish the role of doppler examination in childhood migraine diagnostics further study in this area is needed.
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Case Reports
[A rare case of the extensive Fournier's gangrene developed in the course of a perianal abscess].
Fournier's gangrene is a rare necrotising fascitis of the perineum and genitals caused by mixture of aerobic and anaerobic microorganism. Despite appropriate therapy mortality in this disease is still high. ⋯ Treatment involves extensive soft tissue debridement and broad-spectrum antibiotic therapy. The clinical applicability of the so called Fournier's gangrene severity index score (FGSIS) was discussed.
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The kidneys are the critical organs in the case of a long-term occupational or environmental exposure to heavy metals and tobacco smoke. In diagnostics of renal damage useful are the methods which determine the activity of renal enzymes, quantify in urine (e.g. beta-glucuronidase, N-acetyl-beta-D-glucosaminidase). N-acetyl-beta-D-glucosaminidase (NAG) is one of the most often determined factors of tubular damage, since its activity increases in early stages of renal injury, ahead of appearance of excretory dysfunction. ⋯ About 3-times increase of total NAG's activity was observed in urine of smoking founders and 4-times increase of non-smoking founders in comparison with smoking and non-smoking control group. The highest activity of NAG-B was observed in urine of smoking founders (11.35 +/- 7.85 U/g creatinine), then non-smoking founders (9.7 +/- 8.75 U/ g creatinine). It was confirmed, that the activity of N-acetyl-beta-D-glucosaminidase is a good factor in the assessment of occupational exposure to heavy metals like arsenic, cadmium and lead.
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Posterior shoulder dislocations are diagnosed rarely in every-day practice. Although the methods of radiological imaging have been developing and becoming commonly available, the cases of late diagnosis are still happening. Proper clinical examination and properly conducted and interpretated radiographs allow for identification and implementation of appropriate medical procedures. ⋯ The choice of an appropriate treatment is complicated and requires in-depth theoretical knowledge as well as the knowledge of specific conditions within the shoulder surgery. Based on an algorithm, proposed by Griggs, between 2000-2006 seven patients with locked posterior instability were treated, for all of them defect of the proximal humerus did not exceed 30%. In all these cases the goals of improving stability and range of motion were obtained.