Przegla̧d lekarski
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Case Reports
[Epistaxis in Rendu-Osler-Weber disease treated with selective embolization--case report].
Hereditary hemorrhagic telangiectasia (HHT), known as well as Osler-Weber-Rendu syndrome (ORW disease) is autosomal dominant inheritance disease with the worldwide prevalence of 1 case per 5000-10000 population. The pathophysiology of the disease consists of disorders in the growth and migration of endothelial cells, which leads to telangiectasias and arterio-venous malformations (AVM) development. Vascular abnormalities can form in various organs. ⋯ Advanced stage disease can result in extensive bleeding with dicrease in hemoglobin levels. Unfortunately, the only available treatment options for Osler-Weber-Rendu syndrom fight the symptoms, not the essential cause, and because of the rarity of the disease there are no guidelines for effective therapy. We are presenting a case of a patient suffering from recurrent episodes of nose bleeding due to hereditary hemorrhagic telangiectasia, who was successfully treated using low-invasive, intravascular arterial embolisation in interventional radiology department.
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Midfoot bones fractures are usually unisolated and associated with a high-energy trauma. Unfortunately a such fracture it is often missed or delayed in primary diagnosis. Isolated medial cuneiform fracture is a very rare injury. A review of the literature reveals only few cases and none of bilateral. ⋯ Cuneiform bones fractures are much more common than previously reported. Computed tomography should be considered even in cases of low energy trauma.
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The carbon monoxide poisoning still remains a main cause of fatal poisoning. The carbon monoxide poisoning occurs after inhalation of carbon monoxide. Carbon monoxide binds strongly to molecules, such as cytochrome oxidase, myoglobin, hemoglobin, causing hypoxia of tissues and organs. ⋯ We present the cases of two young people with no history of chronic diseases (a 24-year-old man and a 39-year-old woman) who were diagnosed NSTEMI in the course of severe carbon monoxide poisoning. Both poisoning cases were severe, both patients were unconscious when they were admitted to our hospital. We observed elevation of serum troponin level and changes in ECG (e.g. atrial fibrillation) significant for myocardial infarction.
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Operational treatment of trochanteric fractures of the femur, independently of the applied connecting implant, carries the risk of various types of complications. In this paper the incidence of mechanical complications in performed osteosynthesis of trochanteric fractures of the femur was analyzed as well as the risk factors influencing them and their extent were assessed. The results showed statistically significant influence of the type of implant, the type of fracture and the patients' age. It has been proven that the use of Gamma nail decreases the risk of mechanical complications almost twofold in comparison with the Ender's posts, disregarding the type of trochanteric fracture of the femur.
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Broncholitis in infant is most commonly results from viral infection, typically RS virus will be responsible. Treatment is difficult due to limited efficacy of available methods of causal and symptomatic therapies. Therefore it is specially important to seek preventive measures. ⋯ In the above mentioned cases the effects of passive immunotherapy of prophylaxis with initially intravenous anti RSV-immunoglobulin G, then intramuscular monoclonal antibody palivizumab have been assessed. Palivizumab is currently recommended by American Academy of Pediatrics for RSV infection prophylaxis with children at risk like infants with broncho-pulmonary dysplasia, preterm infants depending on gestational age and infant age in infection season as well as infants with hemodynamically significant congenital heart defects. So far there is no possibility to prevent infection within the whole population.