Medicinski pregled
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Review
[Physical medicine in the diagnosis and treatment of functional disorders of the spinal column].
Manual (Physical) Medicine is concerned with physiology, pathophysiology, diagnosis and therapy of the musculoskeletal system functional disorders. Functional disorders are caused by direct or indirect injury (muscular spasm), inflammation, sudden movements etc. Functional disorders in regard to decreased joint volume are also called segmental or peripheral joint dysfunction, somatic dysfunction and function blocking. Blocking means: reversible disorder with decreased functional joint movement; muscular spasms caused by neurophysiological changes including decreased movement; pain and functional disorder of internal organs and tissues being part of the joint. Intervertebral joints, intervertebral discs, muscles and their nerve control belong to such control circles which are integrated within an organism. The basic principles of Manual (Physical) Medicine are good knowledge of functional anatomy and three-dimensional imaging of biochemical functions of the spine. The most important functions of the spinal column are as follows: it is an organ of axis with a protective and supportive function and it enables normal walk and balance. The basic functional unit in the architecture of the vertebral column is the dynamic spinal segment. Its basic function is movement, posture maintenance and protection of spinal nerve roots. The functional disorder of one part of the dynamic segment cannot be isolated from other parts. Thus functional blocks within the fascial joints, abnormalities within intervertebral discs, changes within the ligament apparatus, and muscular disorders may be both causes and consequences at the same time. The dynamic segment is thus included into a mechanical functional circle. Its mechanical function is tightly connected with the statics of the whole body. Different leg length, severe abnormalities of great leg joints may cause blocks within the fascial joints. The vertebral dynamic segment is also a part of the nervous, functional reflex circle. Clinical symptoms associated with functional disorders within intervertebral joints are as follows: restricted joint mobility and nervous reflex disorders (local segmental and peripheral segmental injuries). ⋯ Manual (Physical) therapy comprises numerous techniques and is used in various indications. (ABSTRACT TRUNCATED)
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There has been considerable interest in varicella-zoster virus in the middle of the twentieth century. Virus isolation in 1958 had made it possible to find out the complete DNA sequence of the varicella-zoster virus. Molecular identify of the causative agents of varicella and shingles had been proved. ETIOPATHOGENESIS AND HISTOPATHOLOGY: Varicella-zoster virus is a member of the Herpesviridae family. After primary infection which results in varicella, the virus becomes latent in the cerebral or posterior root ganglia. Some of these individuals develop shingles after several decades because of virus reactivation. It is caused by decline of cellular immune response. Circumstances such as old age, hard work, using of steroids or malignancies contribute to the appearance of shingles. Histopathological findings include degenerative changes of epithelial cells such as ballooning, multinucleated giant cells and eosinophilic intranuclear inclusions. ⋯ The vast majority of immunocompetent persons with shingles should be treated only by symptomatic therapy. Predominantly it is directed toward reduction of fever and avoiding secondary bacterial skin infection in immunocompetent hosts. Acute neuritis and post-herpetic neuralgia require administration of various analgesics, even like amitriptyline hydrochloride and fluphenazine hydrochloride. Acyclovir therapy is limited to ophthal
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The importance of inheritance in the development of schizophrenia was recorded in classic papers by Kraepelin and Bleuler. These observations have been confirmed by the contemporary research. In this paper, we summarize the results of genetic-epidemiological studies that include family, twin and adoption studies, as well as the results of segregation analysis and molecular-genetic research. ⋯ This could explain the departure from Mendelian inheritance, highly variable phenotype and wide ranging age of onset in schizophrenia. Further research in this field could not only clarify the mode of the transmission of the liability for schizophrenia and the relationship of genetic and environmental factors in the development of the disorder, but also determine which characteristics, behavior and physiological variables schizophrenia genes code for. This would, in addition, contribute to our understanding of the biological basis of schizophrenia.
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In the operating room, anaesthetist must provide unconsciousness, analgesia and muscular relaxation. In intensive therapy (IT), the rules are different and not every patient requires sedation, but almost every patient needs analgesia. The patient who is alert, calm and comfortable despite the presence of tubes and cannulas in the nose, mouth, radial artery, central vein, urethra, surgical wounds, pleural space etc. does not need any sedation. However, sedation and analgesia are clinically inseparable. If mechanical ventilation is not well controlled, muscular relaxants must be prescribed. There are a lot of trials in formulating an ideal sedative/analgesic regimen for each individual patient. ⋯ There are two barbiturates in use: thiopentone and pentobarbital. Although the main effect is hypnosis, the most important is anticonvulsant effect. Thiopentone is an agent for cerebral protection. Barbiturates have not achieved popularity in IT because of prolonged elimination and slow recov
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Idiopathic (immune) thrombocytopenic purpura (ITP) is the most frequent hemorrhagic disease in children. It represents the acquired megakaryocytic thrombocytopenia with the shortened life of platelets because of immunologic damage (antibodies absorbed by platelets). In the case of this acquired hemorrhagic disorder, in spite of compensatory increased function of the bone marrow, there is a reduced number of platelets because of their increased destruction by the reticuloendothelial system (destructive thrombocytopenia). There are three forms of ITP: acute, chronic and intermittent. The acute form occurs in 80-90% of cases with bleeding episodes lasting a few days or weeks, but no longer than 6 months. The chronic form occurs in 10-15% of children, while the rarest-intermittent form is characterized by periods of normalization in regard to the number of platelets but also with relapse in intervals of 1-3 months. The disease is caused by an immunological disorder in the sense of an imbalanced immune response. Immunologic damages of platelets cause shortening of the opsonized platelets life span. The most frequent platelet opsonins are the immumoglobulin G (IgG) antibodies directed at the platelet membrane in the form of autoantibodies, alloantibodies or possibly absorbed antigen caused by microorganism infection or drug intake. ⋯ ITP is the most frequent hemorrhagic disease in children. The disease is basically caused by an immunologic disorder with platelet destruction due to increased immunoglobulin on their membrane. (ABSTRACT TRUNCATED)