Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
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The functioning of health care depends mainly on the level and method of financing. Countries choose between different models. Bismarck's model is financing based mainly on the contributions that are obligatory for employers and employees, decentralized model of managing and contracting services. ⋯ Siemaszko's model in his assumption is based on the financing of benefits by the state budget, provides permanent control of the state and equal access to all the benefits for citizens. Choice of a specific financing model entails certain impact on all of the system's participants. The purpose of this article is to introduce subject of health care financing based on the literature and the authors' own thoughts.
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Pol. Merkur. Lekarski · Nov 2012
Review[Possibilities of therapeutic intervention in severe infections].
Severe infections of the respiratory system are the most important causes of hospital mortality and often unfold as severe sepsis or septic shock. Systemic inflammatory response syndrome (SIRS) with infection evidence (known as sepsis) and septic shock (severe sepsis with hemodynamic instability relentless on fluid resuscitation) are major healthcare problems, affecting millions of individuals around the world and killing about one-third affected every year. Similarly to myocardial infarction or severe trauma rapid onset and appropriateness of medical management in the first hours of sepsis are key point for clinical outcome.
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Fungal infections are becoming more common causes of respiratory disease, since most species of pathogenic fungi occurring in Europe are responsible for developing opportunistic infections. Most cases of fungal infections of the respiratory system are caused by a species commonly encountered in the environment or colonizing saprophytic species such as the gastrointestinal tract. Some recognition of fungal diseases can be determined on the basis of: breeding material taken from the affected places, or blood, or microscopic histopathology. In the treatment of fungal infections of the respiratory system are currently used 3 classes of antifungal drugs: antifungal polyene antibiotics, triazoles and echinocandines.
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Pol. Merkur. Lekarski · Oct 2012
Editorial[Diagnostic and treatment of chronic obstructive pulmonary disease based on GOLD statement 2011].
Chronic obstructive pulmonary disease (COPD) is one of the most important diseases because of high and constantly increasing prevalence, morbidity and mortality. An update of the Global strategy for the diagnosis, management, and prevention of COPD - GOLD report was published in the last days of 2011. ⋯ The most interesting new information concerning diagnosis of COPD are following: post-bronchodilator ratio of FEV1/FVC < 0.7 still confirms the presence of airflow limitation in COPD; assessment of COPD symptoms is based on CAT and mMRC tests; acute bronchodilator reversibility test is no longer recommended for making COPD diagnosis; introduction of a new division of COPD patients into 4 groups (A, B, C or D) based on the level of airflow limitation, risk of exacerbations and severity of symptoms. The last change has fundamental impact on treatment guidelines, as in the past it was based only on spirometric classification, whereas currently it is guided by A-D groups selection.
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Traditionally, women gave birth surrounded by other, experienced women. Modern women not only require continuous support during labor, but they also want to have a part in decision-taking. That is why some of them, regardless of how much or how little medical knowledge they have, want to decide about the way of birth on their own. The aim of this study was to find the underlying cause of the growing percentage of cesarean sections and cesarean sections on request and to find an answer to the question of what can be done to reduce that number. ⋯ Better access of pregnant women to information about pharmacological and non-pharmacological methods of reducing labor pain, coupled with the availability of those methods, can reduce the number of cesarean sections on request even by half. In the group of pregnant women determined to have cesarean section, one in four would give it up if they had access to epidural anesthesia, and one in ten if they had access to non-pharmacological methods of reducing labor pain (mainly acupuncture).