Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
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Pol. Merkur. Lekarski · Mar 2009
[Control of asthma symptoms and cellular markers of inflammation in induced sputum in children and adolescents with chronic asthma].
After the GINA 2006 publication, asthma therapy is based on control of symptoms. However there are suggestions of monitoring of airway inflammation. Aim of the study was to compare clinical criteria of asthma control with cellular markers of lower airway inflammation in induced sputum in a group of young asthmatics. To assess relationship between sputum eosinophilia, asthma severity and spirometry. ⋯ In this study of young asthmatics, control of asthma symptoms was observed in 67.8% of patients. However, cellular markers of lower airway inflammation were present in 1/4 of patients with controlled asthma and in 3/4 with uncontrolled disease. Sputum eosinophilia was related to asthma severity. FEV1/FVC and MMEF were more important that FEV1 for estimating control of asthma. Improvement of asthma control scoring is needed as well as availability of simple methods of inflammation monitoring.
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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.