Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
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Pol. Merkur. Lekarski · Sep 2014
Review[Selected problems in the forensic-psychiatric evaluation of persons posing a likelihood of repeating a criminal act].
In the current penal code, compared to previous regulations, there have been alterations concerning medical security measures. These amendments have been prompted by socio-politic circumstances in Poland as well as implementation of Mental Health Act. ⋯ In legal-medical practice those less experienced expert psychiatrists may encounter difficulties producing expertise for the court, especially evaluating probability of recurrence of committing a criminal act and resulting request for psychiatric detention. In order to make this issue more acquainted we present a review of literature concerning it.
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Pol. Merkur. Lekarski · Sep 2014
Review[Perioperative risk assessment tailored to elderly patients].
Proper preparation of the patient for surgery has a crucial impact on the outcome. Due to the continuous increase in life expectancy more and more often the problem of proper perioperative preparation of the patients over 65 years of age burdened with a higher risk of perioperative complications is undertaken. Proper assessment of the health condition and physical capacity allows to optimize treatment and thus minimize the risk of complications. ⋯ So far, there is no general practice guidelines for patients over 65 years of age. But it seems reasonable to perform the CGA in case of an unfavorable outcome of abbreviated assessment or when the threat of frailty syndrome is suspected. This procedure enables to select the best method of treatment, the implementation of appropriate prevention, thus improving the outcome of treatment and quality of life.
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Pol. Merkur. Lekarski · Aug 2014
Review[Utility of point-of-care ultrasound in lung disease diagnosis].
A new method in the diagnostics of respiratory failure is lung ultrasound (LUS). The test assesses the pleural line and its related artefacts caused by the changing content of extravascular lung water which conditions the degree of lung aeration. ⋯ The advantage of LUS is the possibility of assessing lung function in real time, and the possibility of obtaining information about aeration of the examined part of lung parenchyma. In comparison to other imaging methods, ultrasound is characterized by a considerable specificity and sensitivity in diagnostics and differentiation of numerous diseases, such as pneumothorax, pneumonia, ARDS, and pulmonary edema.
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Pol. Merkur. Lekarski · Jul 2014
Editorial Practice Guideline[The Polish Task Force position statement on safety of biologic treatment with monoclonal antibodies and soluble receptors].
The introduction of biologic therapies for treatment in many fields of medicine such as rheumatology oncology, dermatology, hematology and allergology, became one of the most important achievements of the modem medicine. The first biological therapeutics have already reached patent expiration date and corresponding biosimilars were approved by EMA (European Medicine Agency) and FDA (Food and Drug Administration). Many more biosimilar products are currently under review for marketing authorization around the world. The approval of products similar, but not identical to already known innovative biologics, due to complexity of structure and manufacturing technology, stirs a lot of discussions regarding safety concerns related to differences in posttranslational processing and in immunogenicity between reference and biosimilar products, and relevance of these differences to the clinical practice. Critical issues involve extrapolation to different clinical indication, automatic substitution and switching. Despite EMA recommendation and advocacy for biosimilars, it is beyond this regulatory authority to establish definitive regulation for each EU member, which it is expected to be country related. The aim of the study was an attempt to define the stance regarding particular aspects of biological treatment conducted in Poland is undertaken. ⋯ The Task Force agreed that introduction of biosimilars is an important achievement in the biological therapies, with potential for reduction of treatment cost and increased treatment availability. Experts also agree that the safety of biological treatment should be monitored more carefully in Poland. Other discussed issues sparked more questions. There is no consensus among experts as to the automatic interchangeability of biosimilar and their innovative biopharmaceuticals. However, the switching might be acceptable in clinical practice on the case by case basis. There is an unmet need in Poland to create registry collecting data sufficient for assessment of safety and efficacy of both biosimilars and reference products in accordance with the experience and principles introduced in the European countries.
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Pol. Merkur. Lekarski · May 2014
Comparative Study[The use of Saunders lumbar traction in physiotherapy of patients with chronic lower back pain].
Pain of the lower back is one of the most common ailments in modem society. Such frequent occurrence of back pain syndromes is a serious medical and social problem. Despite numerous attempts, there have not been comprehensive or decisive publications on the therapeutic standard for back pain syndromes that would cover all the aspects of the ailment. Partial report can change the attitude and shed new light on the treatment of these syndromes. The aim of this study was to evaluate the use of Saunders lumbar tractions in patients with chronic lower back pain in comparison with the group of patients undergoing pharmacological treatment. ⋯ The pharmacological treatment applied in Group II showed an analgesic action and influenced positively the functional parameters of the patients. The effects, however, were much worse than in Group 1 where axial Saunders traction was applied to the lumbar part of the vertebral column.