Wiadomości lekarskie (Warsaw, Poland : 1960)
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Catastrophic antiphospholipid syndrome is the most dangerous form of the antiphospholipid syndrome, which is characterized by rapid onset of thrombosis in small vessels of many organs and intravascular coagulation, thrombocytopenia and hemolytic anemia. The syndrome develops over a short period of time with acute multi-organ failure, including kidney, respiratory, cardiovascular, central nervous system and adrenal glands, often associated with disseminated thrombotic microangiopathy. ⋯ Early diagnosis and aggressive treatment of patients with catastrophic antiphospholipid syndrome is essential to save the life of these patients. In the last 10 years, the mortality in this disease decreased from 50% to 30% with simultaneous treatment with anticoagulants, corticosteroids, plasmapheresis and immunoglobulins.
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Despite cardiopulmonary resuscitation guidelines and their regular updates, the results of cardiac arrest victims treatment are still disappointingly poor. Complex treatment including providing artificial ventilation, circulatory support and prevention of secondary damage from ischemia and hypoxia is a complicated process and its result is unpredictable. The aim of the paper is to present the main steps in post-resuscitation syndrome treatment including ventilatory and circulatory stabilization, central nervous system protection and prognostic value of biochemical and neurophysiological tests.
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Stem cell transplantation is now a routine and successful therapeutic method in many hematopoietic disorders and cancers. Unfortunately, toxicity of the procedure significantly worsens the outcomes, with acute and chronic kidney injury among the others. Etiology of kidney failure is multifactorial with nephrotoxicity of drugs, septic complications, sinusoidal occlusion syndrome, thrombotic microangiopathy and acute/chronic graft-versus-host disease (GvHD). Understanding these syndromes enables early recognition and proper intervention that can reduce incidence and severity of kidney injury and improve outcomes.