Wiadomości lekarskie (Warsaw, Poland : 1960)
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Review Historical Article
[Patient's consent to treatment with reference to the development of medical ethics].
In the paper the development of the patient's rights to informed consent to treatment has been discussed with reference to codes of medical ethics. The expression of the patient's rights and recognition of his/her active part in the course of treatment was proceeding gradually and parallel to the evolution of the subjective term "patient". Nowadays the patient's rights are determined by many declarations and international conventions, e.g. the Human Rights and Dignity Convention (1996). ⋯ Patients who are unconscious and those with limited consciousness constitute the problem that is still being solved. It is expected that along with the development of medical ethics, the medico-legal regulations concerning the above mentioned issues will be specified soon. Besides the obligatory legal regulations, in many difficult cases the assessment and decision whether the patient's consent is informed or not, burden only a physician's conscience.
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In the nearest future cervical cancer incidence may be significantly reduced thanks to specific antiviral vaccine use. In the paper we analyzed current literature concerning human papillomavirus (HPV) infection epidemiology and possibility of prophylactic and therapeutic vaccine use.
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Cardiac surgery with cardiopulmonary bypass (CPB) can lead to postoperative complications like systemic inflammatory response syndrome (SIRS). These changes are associated with a risk of postoperative organ dysfunction and increased morbidity and mortality in the postoperative period. Its etiology is not yet clarified in details, but this thought to be of immunologic origin. ⋯ Cardiac surgery induces neutrophil activation, degranulation and endothelial dysfunction. The nature of the participation of the neutrophil and its time course in the post CPB inflammatory response remains controversial. The aim of this work is to review state-of-the-art knowledge about neutrophil and the role of this cell as a regulator of immune response after cardiovascular surgery.
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Although beneficial effects of wound infestation with maggots had been known for many centuries, it was not until dr Zacharias recognized medical importance of maggots during the American Civil War. He intentionally introduced maggots into the wound for its debridement. Baer successfully used maggots in treatment of osteomyelitis in 4 children in the 1930'. ⋯ Its beneficial effect was noted in diabetic foot and in destroying malignant tissue as well. Easiness in application, safety, near no side effects and often exceptional efficiency in wound debridement makes maggots therapy the first line therapeutic tool in both hospital and out-patient surgery. Clinical experience has demonstrated that maggot therapy may reduce costs of treatment considerably by shortening hospital stay and decrease usage of antibiotics.
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Case Reports
[Lance-Adams syndrome in patient with anoxic encephalopathy in the course of bronchial asthma].
Lance-Adams syndrome, described in 1963, is caused by anoxia of central nervous system, generally in the course of primary respiratory failure. It is characterized mainly by action myoclonus, associated cerebellar ataxia and very mild intellectual deficit. Occurrence of Lance-Adams syndrome is rare; about 100 cases have been described yet. ⋯ CT of the brain was normal. Action myoclonus responded appropriately to sodium valproate. The authors indicate the importance of the correct diagnosis and proper treatment.