Przegla̧d lekarski
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A large number of publications, primarily clinical studies, demonstrate the increasing use of procalcitonin (PCT) in modern clinical practice. PCT is a propeptide of calcitonin induced by a variety of stimuli including bacterial endotoxins, proinflammatory cytokines and triggering events such as trauma or cardiogenic shock. PCT is not or only slightly induced by viral infections, autoimmune disorders, neoplastic diseases and organs transplantation. The aim of this study was to evaluate the usefulness of PCT as a diagnostic and prognostic tool in patients for early differentiation between bacterial and nonbacterial infection origin.
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Sarcoidosis is a multisystem disorder of unknown aetiology. Pathologically it is characterized by the presence of non-caseating epithelioid-cell granulomas in the lungs, intrathoracic lymph nodes and other affected organs. The clinical course of sarcoidosis is widely variable, ranging from asymptomatic but abnormal findings in chest radiography to progressive multiorgan disease, which leads to fibrosis with organ failure and functional impairment. The aim of this article is to familiarize physicians with clinical features and treatment of this disease.
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The case of a 67-year-old patient, treated for melanoma, who was given a toxic dose of doxorubicin (600 mg/m2), was described. The haemoperfusion was performed a short time after intoxication. No toxic effects were seen during the observation for three weeks. The catheter was removed from the sitting patient by an oncologist. The patient abruptly lost consciousness, there were also cyanosis, loss of muscle tone and apnea. The reanimation was unsuccessful. The air embolism was probably the cause of death. The diagnosis was confirmed by the sudden attack, wide duct after the removal of catheter, sitting position of the patient and the presence of foramen ovale found during autopsy. ⋯ Cannulation as well as decannulation of the central vessels should be performed by experienced doctors. Decannulation should always be done in the Trendelenburg position.
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Proper tracheal tube cuff pressure (CP) can diminish the risk of side effects. Excessive tracheal tube cuff pressure can cause ischaemic changes in the tracheal mucosa, decubitation, granuloma, rupture of a trachea, tracheo-oesophageal fistulae or tracheal stenosis. Too low CP is also undesirable, because it can increase the leakage of colonized subglottic secretions around the tracheal tube cuff, which is the risk factor of ventilatory associated pneumonia. Accidental extubation may also occur. The aim of the study was to find out if there are any differences in maintenance of the proper CP between the staff of intensive therapy unit (ITU) under the supervision of anaesthesiologists and staff of intensive care units (ICU) led by non-anaesthesiologists. ⋯ The data analysis did not reveal any differences between values of CP in both groups of subjects. Over-inflation was more frequent than under-inflation in both groups of patients. Regular measurement of tracheal cuff pressure was not a routine procedure in the controlled units.
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Randomized Controlled Trial Clinical Trial
[The effect of vitamin, macro and microelement supplementation on markers of iron status in blood of pregnant women].
Interest in assessing iron status in the population of women during their child-bearing age has grown recently both in terms of detecting iron stores and evaluating whether they are sufficient to meet increasing needs during pregnancy. The fact that iron deficiency anaemia often develops in pregnancy indicates that that iron stores and dietary iron are insufficient to requirements and iron supplementation is needed. The aim of the present study was to determine the effect of vitamin, macro and microelement supplementation on iron status of pregnant women and of their newborns. ⋯ In serum of umbilical cord blood concentration of total iron, transferin and ferritin were similar in newborns of both groups of mothers. The above results suggested that vitamin, macro and microelement supplementation of pregnant women improved iron status in mothers and in their children. It seems that administration Vibovitmama formula can be recommended as a dietary supplement in pregnancy in order to prevent subclinical deficiency of iron.