Przegla̧d lekarski
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To compare predicted death rate (PDR) numbers, computed in commonly used severity-of-illness and prognostic scoring systems (Portsmouth-POSSUM, SAPS 2, MPM 2, MPM for cancer patients, LODS, ODIN i TRIOS) on the first and on the third postoperative days with the mean PDR calculated from the scales. Assessment of the mean PDR values. Analysis of the main risk factors that affect postoperative mortality. ⋯ There is no commonly used severity-of-illness scoring system that could properly evaluate intensive care unit patients. Discriminative abilities of the scoring systems do not present any unique features that might affect selection of one of them. The mean PDR value computed from available scales is a reasonable descriptive and prognostic alternative.
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Intracranial arteriovenous posterior circulation malformation was planned to embolize by onyx injection after acute coil embolization of ruptured flow-realeted aneurysm of posterior cerebral artery. Control angiography revealed completely embolized malformation with normal vessel patency at the end of procedure. There were no adverse events related to this procedure and no neurologic deficit at the discharge.
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Aneurysms within internal carotid artery in extracranial segment occur very rarely. The treatment of choice is surgery, which is difficult and poses a risk of serious complications. ⋯ The case of internal carotid artery aneurysm treated with self-expandable stent, covered with fabric PTFE was introduced. The total exclusion of aneurysm from the circulation was obtained.
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The basis of the medicine doctor actions legality is the receipt of permission from patient upon providing him with health care service. A goal of this article was to learn more about knowledge and practical implementation of this requirement among doctors as well as their patients. ⋯ Actions are still needed to improve doctors and patients motivations to know and obey patients law. The most attention from specialists needs the right for medical information as it is the most often breaking law in both doctors and patients opinion.
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Review Case Reports
[Severe paracetamol poisoning complicated with liver and renal failure--case report and review of literature].
Paracetamol is a widely known over-the-counter analgesic and antipyretic which, in acute poisoning usually causes liver damage, and less commonly damage to the kidney, heart, and pancreas. In the present paper we report a case of acute suicidal paracetamol intoxication complicated by acute hepatic and renal failure. The discussion covers the pathogenesis, clinical course, and treatment of acute renal failure in the course of paracetamol poisoning. ⋯ In acute acetaminophen poisoning, in addition to standard monitoring of liver function, the monitoring of kidney function is necessary because of the risk of acute renal failure due to acute tubular necrosis. Kidney damage is likely to be transient and generally will not need long-term renal replacement therapy.