Polskie Archiwum Medycyny Wewnętrznej
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A hiccup is involuntary, paroxysmal inspiratory movements of the chest wall associated with diaphragm and accessory respiratory muscle contractions, with the synchronized closure of glottis. The mechanism underlying this common primitive reflex plays an important role in protecting airways against esophageal aspiration. The hiccup reflex mechanism is based on the afferent pathway (vagus and phrenic nerve and sympathetic fibers innervating chest organs, the abdomen, the ear, the nose and the throat stimulation, and the stimulation of hiccup center in the central nervous system, mainly reflecting psychogenic or metabolic disorders) and the efferent pathway (phrenic nerves). ⋯ The most common causes of pathologic symptomatic hiccups are nervous system diseases, either the central nervous system (proliferative, angiogenic, inflammatory disorders), or the peripheral nervous system: the irritation of the phrenic nerve (proliferative disorders, goitre) and the vagus nerve (otolaryngologic diseases, meningitis, esophageal, stomach and duodenal diseases, hepatitis, pancreatitis, enteritis). The vagus nerve irritation with subsequent hiccups may be caused by chest disorders (injury, surgery) and heart diseases (myocardial infarction). In the present paper we describe the case of a 62-year-old male with recurrent hiccups associated with exertion as a secondary symptom of myocardial ischemia.
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Pol. Arch. Med. Wewn. · Jan 2008
Case ReportsSpinal epidural abscess penetrating into retroperitoneal space in patient with diabetes mellitus type 2: early diagnosis and treatment requirement.
Spinal epidural abscess (SEA) is a rare condition with very serious prognosis. Predisposing factors for SEA include bacterial infections, immunocompromised states such as diabetes mellitus, intravenous drug abuse, alcoholism, AIDS, as well as spinal surgery and modern techniques of epidural anesthesia. The most common causative agent for SEA is Staphylococcus aureus. ⋯ Unless the typical presentation of SEA correct diagnosis of this illness is often overlooked and not considered initially. It delays suitable management and leads to poor outcome. We report a classic case of SEA in a woman with a history of diabetes mellitus.
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Pol. Arch. Med. Wewn. · Jan 2008
Biography Historical ArticleStanisław Skalski (1870-1937): an eminent Lódź doctor.
: Stanisław Skalski was an eminent Polish specialist in internal medicine. He lived at the turn of the 20th century. ⋯ His professional career and social activity were associated with Lódź where he performed a variety of management functions, among others he held the office of the Chancellor of the City School Board and the Head of the Health Department of the Provincial Office of Lódź. It was the accomplishment of doctor Stanisław Skalski to introduce obligatory anti-smallpox vaccinations in Lódź (1914) and to promote activities for the improvement of school hygiene and children health.