Przegla̧d lekarski
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The development of predictive genetic DNA- tests gives people the choice "to know" or "not to know" a decision with tremendous short-mid- and long-term consequences. Family history of disease can provide information about the increased risk of susceptibility, and these knowledge may have psychosocial implication. The results of studies using genetic testing and their psychological impact are discussed with regard to hereditary cancer (breast, colorectal, prostate) as well as particular neurogenetic disease (e.g. ⋯ Psychological studies on genetic risk concentrating on psychological adjustment, transfer of information within the family and perception of genetic risk in families showed that genetic disease had a considerable impact on family life (e.g. reproductive decisions). Findings showed that people with a family history of cancer (without genetic testing) vary in their illness behaviour, but little is known about the effect of inheredited predisposition to disease (e.g. cancer) on such health related behaviour as smoking, diet, activity level. Genetic information could both increase (strengthening the belief that current behaviour combined with genetic predisposition is putting person at increasing risk of disease) and decrease motivation to change behaviour (weakening belief that changing behaviour will reduce risk of disease because genetic is immutable).
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Between 1994-1997 the Pain and Palliative Care Out-Patient Clinic founded by the Society of Friends of the Sick Hospicium in Kraków undertook hospice home care of 870 cancer patients. Retrospective evaluation of their files revealed that 48.2% of patients on admission were aware of their diagnosis and 61.2% of families did not discuss it with patients. ⋯ During the same time, among the cancer patients not admitted to hospice home care in the city of Kraków, only 23.7% died at home and the rest in institutions. In spite of demonstrated adequate home care, 16.5% of home care patients were admitted to the local hospital, which suggests the need for stationary hospice or palliative care ward cooperation.
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The aim of the study was to assess the diagnostic yield of transbronchial needle aspiration (TBNA) in mediastinal or hilar adenopathy in: sarcoidosis, tuberculosis and malignancy. Transbronchial needle aspiration was performed in 53 patients, preeceded by computed tomography (CT). In 22 patients (41,5%) TBNA enabled to diagnose 10 cases of sarcoidosis, 12 cases of neoplastic infiltrates of the lung. ⋯ In the remaining 7 patients who were followed-up for a period of one year the diagnosis of sarcoidosis was confirmed by clinical, radiological and cytological (BAL) examinations. Transbronchial needle aspiration was shown to be efficient diagnostic method in mediastinal or hilar adenopathy in sarcoidosis and malignancy except lymphoma. Moreover in approximately 60% of cases this technique doesn't allow to establish a diagnosis and in turn implicates the necessity for further diagnostic procedures like mediastinoscopy, or transbronchial or thoracoscopic lung biopsy.
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The paper approximates news relating to pathophysiology, prophylaxis and treatment of postoperative nausea and vomiting, which, besides the pain, remain some of the most unpleasant memories of the recovery phase. In spite of the fact that they belong to very common ailments of the postoperative phase, they are placed low on this list, probably because the common belief that they do not threaten life imminently. However they may cause a varity of undesired symptoms, among them aspiration of stomach contents into the lungs in patients with impaired consciousnesess, also dehydratation, and electrolytic disturbances, especially with children and older patients. This paper has presented methods for their prevention and treatment.
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Baclofen is a lipophilic analogue of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter in central nervous system. The aim of the study was to evaluate some clinical aspects of acute intoxication with baclofen. Fifty two patients (37 females and 15 males) aged from 14 to 58 (mean 30.6 +/- 13.7) years were analyzed. ⋯ Toxic psychoses were observed in 6 cases (11.5%). The dosage of baclofen in patients with acute respiratory failure (ARF) was significantly higher than in patients without ARF. Treatment of patients with acute baclofen intoxication should take place in hospitals appropriately equipped which can provide artificial respiration.