Przegla̧d lekarski
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The aim of the study was estimation of the IgE value, circulating immunocomplexes and the activity of complement system in allergic contact as well as atopic dermatitis in patients with skin nickel hypersensitivity. The study was done in 30 patients in the age range of 18-53 yrs suffering from allergic contact dermatitis (15 patients) and atopic dermatitis (15 patients) with positive skin patch test to nickel. ⋯ The results of the study indicated an increase of concentration of circulating immuno-complexes in 80% of the patients of both groups, an increase of total IgE in 50% of patients with atopic dermatitis and in 25% of the patients with contact dermatitis. There were no changes in the activity of C1inh and the value of CH50 in both groups of patients.
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Infective endocarditis especially where blood culture is negative frequently causes problems in diagnosis despite of many nonspecific inflammation parameters. Procalcitonin (PCT) concentration is a new marker of severe bacterial and fungal infection. The aim of this study was to evaluate the usefulness of PCT concentration assessment in the diagnosis of uncomplicated infective endocarditis of bacterial etiology. The study group consisted of 30 patients with ongoing infective endocarditis in the course of acquired valvular heart disease. The diagnosis of bacterial endocarditis was established according to the Duke criteria on the basis of: clinical examination, laboratory investigations (inflammatory parameters, transthoracic and transesophageal echocardiography) and positive blood cultures. Patients with sepsis, concomitant infections and in an early postoperative period were excluded. Two control groups consisted of: 10 patients without endocarditis and other infections and another 10 patients without endocarditis and with an urinary tract infection. Serum procalcitonin concentrations were measured by an immunoluminometric assay (LUMItest PCT set). Mean serum PCT concentrations in patients with endocarditis (0.12 +/- 0.13, range 0-0.4 ng/ml) were significantly higher than in control group without infection (0.03 +/- 0.05, range 0-0.1 ng/ml) and higher than in control group with an urinary tract infection (0.02 +/- 0.04, range 0-0.1 ng/ml). However in 12 patients (of 30) were below sensitivity of the method and in the rest were within normal range (< 0.5 ng/ml). ⋯ Serum PCT concentration assessment seems to have no value in the diagnosis of uncomplicated infective endocarditis.
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Urological complications constitute significant problem following renal transplantation. Incidence ranges from 4 to 14% in graft recipients. The most important aspects concerning these complications are early diagnosis and prompt treatment, any delay in diagnosis and management may lead to deterioration of renal graft function or graft loss. ⋯ Subsequently percutaneous nephrostomy was performed which lead to immediate diuresis. Next, distal ureter stenosis (located by the urinary bladder) was surgically removed and reimplantation of the ureter was carried out. Due to early diagnosis and surgical reconstruction of the transplanted ureter, renal graft function returned to normal requiring only one hemo-dialysis session.
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In the last few years, physiological changes, symptoms, diagnostic tools, and treatment of abdominal compartment syndrome interest surgeons, trauma surgeons and anaesthetists. Sudden, dangerous basic vital function deterioration in patients managed in the intensive care unit, may be results of abdominal compartment syndrome. Abdominal compartment syndrome is secondary to massive intraabdominal haemorrhages, hepatic or retroperitoneal space "packing", fluid collection in tissues, including abdominal organs. ⋯ During decompression abdominal organs reperfusion may produce arterial hypotension and asystole. Abdominal closure must prevent abdominal hypertension. Temporary plastic patch, simple and cheap is the most popular technique.
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There are four major forms of child abuse: physical abuse, emotional abuse, sexual abuse and neglect. Various combination of these four aspects often exists in the individual child and clinical manifestation can not be so clear-cut. In this paper the authors present some problems of child abuse syndrome (taking into consideration risk factors, clinical symptoms, recognition and methods of treatment) whose knowledge may be helpful for the family doctor who comes into contact with such children.