Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
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Pol. Merkur. Lekarski · Aug 2009
Editorial[Thromboelastometry--a new method supporting the therapeutical decisions in the coagulopathy based on the Hartet's thromboelastography].
Thromboelastometry is a diagnostic method presenting in graphs and numbers the dynamics of hemostasis and physical properties of the clot forming. Thromboelastometry allows quick and complete assessment of clotting and fibrinolysis mechanism respecting share of coagulation and fibrinolytic factors and also platelets. Interpretation is based on comparative analysis of model data from computer memory with graphs and numeric data that present clot formation and fibrinolysis in time periods. ⋯ These can indicate type and quantity of blood products and medicines that are necessary to administer. Thromboelastometry is applied in many medical disciplines like cardiothoracic surgery, transplant surgery, obstetrics, multiorgan failures, vascular surgery and intensive care. In this method specialistic laboratory education is unnecessary.
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Pol. Merkur. Lekarski · Jun 2009
[Does the coexistence of cancer have an influence on the course of sepsis].
The guidelines for management of sepsis are constantly updated, nevertheless sepsis is still a difficult clinical problem, especially as its treatment often ends in failure. Hospitalized cancer patients diagnosed with sepsis are especially concerned, as sepsis death rate is significant in that group of patients. The aim of the study was to evaluate and compare cancer- and non-cancer patients diagnosed with sepsis. ⋯ The analysis did not indicate evidently higher risk of more severe sepsis's course in cancer sepsis patients. However the severity of patients' general condition estimated by the APACHE II score and the mortality in this group of patients was higher (statistically insignificant results). Patients in group S+N required larger minimal doses of noradrenaline and larger infusion of colloid at the day of admission. The mortality was determined by the haemodynamic disturbance and the severity of general condition, rather than the cancer diagnosis per se.
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Pol. Merkur. Lekarski · May 2009
Case Reports[Esophageal perforation following anterior cervical fixation of posttraumatic spine fracture--case report].
Esophageal perforation by a fixed plate is a rare complication in cervical spine surgery. Its appearance can lead to mediastinitis, which is an important clinical problem. Diagnosis of this complication should to be recognized as quickly as possible to make causal treatment effective. Endoscopic picture of this kind of complication was presented in the paper.
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Pol. Merkur. Lekarski · Mar 2009
Multicenter Study[Costs of exacerbations of chronic obstructive pulmonary disease in primary and secondary care in 2007--results of multicenter Polish study].
Exacerbations are the key drivers of the costs of chronic obstructive pulmonary disease (COPD). This was the multicenter study of patients with COPD aimed at evaluating direct and indirect cost of exacerbations under usual clinical practice in primary and secondary care form societal perspective. ⋯ Exacerbations of COPD are costly. Cost of exacerbation managed in secondary care is almost 10-fold higher than in primary care. Prevention of moderate-to-severe exacerbations, requiring hospitalization could be very cost-effective strategy.
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Pelvic endometriosis in women is a very common disease. The incidence of this condition in Poland in reproductive age women is about 7-15%, and as much as 50% of cases is diagnosed in patients with co-existing infertility and/or pain and adhesion of a true pelvis. The choice of a therapeutic method depends on the patient's age, stage of the disease, desire for pregnancy, the presence of adhesion, focus localization and a reaction to previous treatment. ⋯ As maintained by the most recent literature, in the case of mild endometriosis (clinical Stage I and II according to the American Society for Reproductive Medicine) endometrial ablation has better effects than observation only, however postoperative pharmacotherapy does not improve the results of treatment. In more severe cases (clinical Stage III and IV), the best results are achieved by the combined treatment. Nevertheless, no randomized research has been carried out on a wide scale in this group of patients.