Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
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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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Pol. Merkur. Lekarski · Feb 2009
Review[Lactose intolerance: pathophysiology, clinical symptoms, diagnosis and treatment].
Lactose malabsorption and milk products intolerance symptoms are the most common alimentary tract disorders. Lactose intolerance is a result of lactase deficiency or lack of lactase and lactose malabsorption. Three types of lactase deficiency were distinguished: congenital, late-onset lactase deficiency and secondary lactase deficiency. ⋯ To the clinical symptoms of lactose intolerance belongs: nausea, vomiting, abdominal distension, cramps, flatulence, flatus, diarrhea and abdominal pain. The diagnosis of lactose intolerance is based on the breath hydrogen test and analysis of lactase activity in the small intestine mucosa. Dietary treatment eliminates clinical symptoms.
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Pol. Merkur. Lekarski · Feb 2009
[Determination of milk and diary products consumption and their connection with lactose malabsorption or lactose intolerance in selected disorders of the alimentary tract in children].
Lactose stimulates proliferation and colonization of acidophilic bacteria, which due to fermentation processes lower colonic pH and simplified absorption of some microelements from the intestine. However, the common problem in children is intolerance of this carbohydrate. Treatment, quite simple, is based on partial or total elimination of lactose from diet. Some substitutional products with equivalent nutritional value should be introduced to prevent deficiencies symptoms during lactose-free diet. ⋯ Frequent (33-55%) decreased sweet milk consumption in children in spite of clinical symptoms after ingestion of milk was observed. The biggest lactose malabsorption and lactose intolerance symptoms frequency was observed in children who didn't drink milk and in children with decreased consumption of sweet milk due to complaints after ingestion of milk. There were no statistically significant difference between frequency of lactose malabsorption and lactose intolerance in children with different dairy products consumption habits.
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Pol. Merkur. Lekarski · Oct 2008
[Left ventricular hypertrophy among hypertensive patients with diminished glomerular filtration rate].
Current guidelines of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC) for the management of arterial hypertension (AH) have recognized the importance of subclinical organ damages such as renal function impairment and left ventricular hypertrophy (LVH) on cardiovascular prognosis in patients with this condition. ⋯ CKD was present in about one-half of AH patients. CKD patients had worse global cardiovascular profile as compared with those with normal renal function. The prevalence of LVH diagnosed with ECHO is more common in this group, eGFR < 60 ml/ min/1.73 m2 increases the odds for LVH diagnosis based upon ECHO. This simple parameter can be helpful for more accurate qualification for ECHO examinations in AH patients.
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Persons exposed to tick bites in endemic areas of Lyme borreliosis are at high risk of repeated infections with Borrelia burgdorferi s.l. Typically, recurrent episodes of Lyme borreliosis present as erythema migrans, but systemic manifestations, like borrelial arthritis and meningitis, have been described. Differentiating reinfection from relapse or chronic sequelae of primary infection should be possible on the basis of epidemiological data, clinical course and careful interpretation of serologic tests results. In case of reinfection, antibiotic treatment should be administered.