Przegla̧d lekarski
-
Scleroderma is a connective tissue disease characterized by fibrosis confined only to skin (scleroderma circumscripta, morphea) or to skin and internal organs (systemic sclerosis, SSc) as a result of vascular changes, immune dysfunction and increased production of collagen and other extracellular matrix (ECM) components. Both types of scleroderma present clinical and histological similarities in skin changes but their pathogenic relationship is still not elucited. The aim of our study was to evaluate vascular changes in both types of scleroderma on the basis of: serum levels of gelatinases--MMP-2 and MMP-9, vascular endothelial growth factor (VEGF) and its soluble receptor 2 (sVEGFR2) and expression of CD34 antigen in skin changed samples. ⋯ Mean value of immunoexpression of CD34 was statistically significantly higher in the control group (2.8 +/- 0.42) compared to SSc group (1.59 +/- 0.69) and morphea (1.42 +/- 0.50) (p<0.001). There was no statistically significant difference between immunoexpression of CD34 in skin samples of both types of scleroderma (p=0.27). The obtained results seem to confirm pathogenic similarities in endothelial cells disturbances in both types of scleroderma--SSc and morphea.
-
Case Reports
[Severe nonfatal poisoning after intravenous abuse of transdermal fentanyl--a case report].
Fentanyl is a potent synthetic opioid with short-acting analgesic activity after intravenous or subcutaneous administration. The potency and lipid solubility of fentanyl make it suitable for delivery via the transdermal therapeutic system in the treatment of chronic pain. ⋯ The present case demonstrates the possibility of intravenous abuse of transdermal patches and the risk of severe intoxication. In the cases of suspected fentanyl overdose specific assays should be utilized for the detection of fentanyl because it may not be detected by the routine opiate screening procedure.
-
HBSC (Health Behaviour in School-aged Children) study can serve as a basis for monitoring smoking prevalence in school-aged children. Previous studies 1990-1998 have shown an increase in tobacco smoking among 15-year-old students, followed by a decrease in 1998-2002. The aim of this study was to present current international comparisons of selected indicators and changes in 2002-2006. ⋯ However, in most countries the improvement was higher than in Poland, especially in girls. More attention should be paid to divergent trends in smoking among adolescent boys and girls. Despite favorable trends in Polish boys, smoking prevalence is still too high by comparison to other countries and age of smoking initiation is very low.
-
Smoking cessation in the perioperative period allows a substantial reduction of a number of anesthetic and surgical complications. They primarily include pathology and adverse reactions of respiratory, cardiovascular and nervous systems and also alterations in wound and bone healing. There is no doubt that long-term (several months) tobacco abstinence reduces the complication risk; however, the significance of short-term smoking cessation is being discussed. ⋯ Interventions for preoperative smoking cessation effectively change smoking behavior and should be widely offered to surgical patients. Oral recommendations should possibly be supported by pharmacotherapy. Nicotine replacement therapy and bupropion proved to be effective and safe in the perioperative period.
-
Levels of toxic substances in tobacco smoke are undeniably influenced by temperature-oxygen conditions in which the smoke is generated. These conditions depend on the way the cigarette is smoked (smoking topography). Smoking topography may be characterized by such factors as: puff volume and its velocity, intervals between puffs and a number of puffs per cigarette. ⋯ However, mean interval between puffs in our group was 20 sec.--threefold lower than in the ISO method (60 sec.). Moreover, examining the variability of subsequent puffs, the authors found out that the puff volume lowers as the cigarette is smoked. All measured smoking topography parameters were highly dispersed within the examined population of smokers.