Przegla̧d lekarski
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Urapidil was administered in 69 patients aged between 46-79 age (average 62.7 +/- 8.4 age) to control intra-operative increase in arterial blood pressure accompanying endotracheal intubation, extubation, wakening of the patients, incision of abdominal integument and clamping of abdominal aorta. In presented group 47 patients suffered from arterial hypertension and 22 patients did not. Patients underwent various surgical procedures in general anesthesia and in 13 patients implantation of aortal prosthesis in result of abdominal aortic aneurysm (7 patients) and Leriche syndrome (5 patients) was performed. ⋯ Urapidil administered during monotherapy turned out to be efficacious in 81.1% of treated patients. Other 18.9% required an additional infusion of nitroglycerine, but these were patients operated on due to abdominal aorta. Average dosage of urapidil applied during monotherapy amounted to 26.3 +/- 2.4 mg. Intraoperative administration of urapidil did not result in acceleration of heart rate, and urapidil turned out to be a safe medicine to reduce intraoperative increase in arterial blood pressure also in patients who were previously diagnosed as suffering from arterial hypertension.
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The aim of this study was to determine relations between the clinical state and the severity of liver damage comparing to the amount of ingested paracetamol, time since ingestion and serum concentration of paracetamol with patients after acute intoxication with this drug. A retrospective analysis of medical records of 95 patients hospitalized in the Toxicology Department in Kraków or treated in the Toxicological Admission Room in 2002-2004 years because of acute paracetamol intoxication was performed. The general clinical state connected with intoxication and the severity of liver damage were determined using the Poisoning Severity Score (PSS). ⋯ A positive correlation between time since ingestion of paracetamol to hospitalization and the gravity of poisoning according to PSS scale was also statistically significant. A paracetamol concentration measured during admission to the hospital had no influence on neither the clinical state of patient nor the severity of liver damage. We conclude that the therapeutical approach should consider possibly shortening of the time since drug ingestion to hospitalization and institution of specific treatment (N-acetylcysteine) as well as minimalization of the paracetamol dose, which could be absorbed, by different methods of elimination from the GI tract (eg., gastric lavage, activated charcoal laxatives).
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Randomized Controlled Trial Clinical Trial
[The effect of vitamin-mineral supplementation on the level of MDA and activity of glutathione peroxidase and superoxide dismutase in blood of matched maternal-cord pairs].
The aim of the present study was to investigate the effect of VIBOVITmama (Polfa Kutno S. A.) supplementation on lipid peroxidation (MDA) and activity of superoxide dismutase (SOD) and selenium-dependent glutathione peroxidase (GPx) in blood of pregnant women and in umbilical cord blood of their children. It is shown, that MDA concentration in plasma increased during pregnancy in both studied groups; however in vitamin-mineral C supplemented women it was lower (p < 0.05) than in placebo (p < 0.005). ⋯ In erythrocytes of umbilical cord blood activity of GPx was higher in newborns of women taking vibovit (31.9 U/gHb) than in the control group (29.7 U/gHb), whereas activity of SOD was similar. Our result suggested that vitamin-mineral supplementation of pregnant women improved antioxidant status in mothers and their children. It seems that in order to prevent oxidative damage VIBOVITmama formula can be recommended as a supplement diet in pregnant women.
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Contemporary treatment of cancer (intensive chemotherapy, radiotherapy, radical surgery, stem cell transplantation) and severe non-neoplastic blood diseases resulted in significant improvement of treatment results. Currently over 70% of children with cancer can be cured. However, at the same time number of severe complications, including life-threatening infections began to increase. ⋯ Our presentation will review currently available antifungal drugs and guidelines for treatment of specific fungal infections. The plan of antifungal treatment must include not only the species of fungal pathogen, but also the site and extent of infection, as well as patient status, including stage of primary disease, previous therapy and previous organ damage. Rational management would allow to choose appropriate antifungal drug, optimize dosage and duration of treatment and estimated costs, and above all to improve the chance to effectively control the life-threatening fungal infections.
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Bacterial meningitis is still associated with high mortality rate and severe neurological sequels. The aim of the study was to assess correlation between concentration of proinflammatory cytokines (TNF-alpha, IL-1 beta, IL-8) in the cerebrospinal fluid (CSF) and patient condition described on the basis of Glasgow Coma Scale (GCS), changes in the CSF (pleocytosis, protein and glucose level), mortality rate and occurrence of neurological complications. 42 patients with bacterial meningitis have been analysed. Control group consisted of 25 patients with viral meningitis and 23 patients without meningitis. ⋯ Our investigation confirm that TNF alpha, IL-1 beta, IL-8 are useful in differential diagnosis of neuroinfections. Assessment of patients with bacterial meningitis on the basis of GCS is helpful to establish prognosis, and CGS seems to correlate with the intensity of inflammation in the CSF. High concentration of TNF-alpha, and IL-1 beta in the CSF are associated with the risk of patient death during the course of bacterial meningitis, but IL-1 beta has been the better prognostic marker.