Przegla̧d lekarski
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Clinical and experimental studies indicate that either active or passive cigarette smoke exposure promotes vasomotor dysfunction, atherogenesis, and thrombosis in multiple vascular beds. Although the precise mechanisms responsible remain undetermined, free radical-mediated oxidative stress appears to play a central role in cigarette smoking mediated athero-thrombotic diseases. ⋯ Furthermore, potentiated by multiple prothrombotic and antifibrynolytic effects, intravascular thrombosis is the predominant cause of acute cardiovascular events. Epidemiologic, clinical, and experimental data also suggest that the pathophysiologic effects of cigarette smoke exposure on cardiovascular function may be nonlinear.
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Mutual cooperation between medical doctor and nurses are presented, while analizing new trends in the European Union. Nurse family practice and specialist training are discussed as well as new specializations, i.e. Study nurse trained for participation in clinical trials.
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Transoesophageal echocardiography is an effective tool in visualisation of intrathoracic aorta. It is highly sensitive in diagnosis of aneurysms, atheromas, posttraumatic ruptures, abnormalities of aortic valve, and complications of bacterial endocarditis. It is superior to other methods in diagnosis of aortic dissection. ⋯ TEE is especially helpful in patients undergoing cardiac operations. It makes possible the detection of atheromatosis and assessment of plaque morphology in thoracic aorta. In cases with high risk of peripheral embolisation the surgical strategy is changed.
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Anorexia nervosa and bulimia nervosa are counted among psychosomatic diseases, whose incidence has been rapidly increasing in the last decades. To date, the etiology, diagnostic and therapeutic management of eating disorders have not been uniformly determined. The objective of the study is determination of the role of a pediatric endocrinologist in diagnostics and management of eating disorders. ⋯ The role of a pediatrician in therapeutic management of eating disorders is intervention in life-threatening conditions, treatment of acute complications, differential diagnosis, nutritional treatment, prevention and management of late complications. Because of etiology and special way of treatment the management of anorexia nervosa should have been taken by psychiatrist. The duty of endocrinologists and gynecologists is the late complications treatment, such as an amenorrhea and osteoporosis.
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Electrophysiological examinations still play an important role in initial diagnostics of neuromuscular disorders and monitoring of the disease progress or recovery process. ⋯ Electromyographic examination remains important diagnostic tool of neuromuscular disorders. In order to limit extension of differential diagnostics EMG should be performed in its early stage.