Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
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In 2004 cervicogenic headache was introduced into ICD-10 classification. The reasons of cervicogenic headache are changes within bones, soft tissue and nervous structures of cervical spine section. The pain may spread to the neck, occipital area of skull, area of jaw and eyeballs, and arms. ⋯ In doubtful cases, diagnostic blockade of greater occipital nerve, resulting in headache relief, supports finally a diagnosis. Any treatment includes pharmacotherapy, rehabilitation, psychotherapy and surgical methods. The purpose of the study is to view literature on cervicogenic headache which causes many diagnostic problems and hence makes it difficult to choose effective treatment.
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Statins are well-established and effective drugs in the treatment of hyperlipidemias and coronary heart disease. However the effects of statins extend beyond their lipid-lowering actions, due to their capacity to inhibit prenylation of some intracellular regulatory proteins. Recent studies have shown that statins could modulate inflammantory response, improve endothelial function, exert antiarrhytmic properties, have beneficial effects on renal function and bone tissue. ⋯ Although statins therapy is generally well-tolerated, sometimes they lead to objective adverse effects, mainly in muscular system. Combination therapy with fibrates, coenzyme Q and other substances may increase and even extend therapeutic effects of statins. Further studies will help to clarify the clinical role of statins.
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Pol. Merkur. Lekarski · Jun 2008
[The role of strong opioids in the treatment of the chronic musculoskeletal pain].
This article concentrates on recent evidence about opioid analgesics for persistent musculoskeletal pain. Chronic musculoskeletal pain is a major health problem for which opioids provide one treatment option. Pain is an experience that affects all aspects of a patient's life and effective pain management with strong opioids may help the patient to focus on the positive aspects of life, decreasing the focus on pain. ⋯ Several reviews and our experience have shown that opioids are typically reserved for moderate to severe musculoskeletal pain that cannot be relieved by other drugs. In this article are presented the strong opioid drugs, routes of administration, dosage guidelines and potential adverse effects. The management of patients with chronic musculoskeletal pain is a common clinical challenge.
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Pol. Merkur. Lekarski · Jun 2008
[Diminished glomerular filtration rate as a marker of chronic kidney disease in hypertensive patients].
Recent 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 renal function impairment on cardiovascular (CV) prognosis in patients with this condition. Chronic kidney disease (CKD) is associated with increased risk of CV risk and end-stage renal disease (ESRD) particularly among patients with AH. ⋯ According to the ESH/ESC guidelines, CKD among AH patients is associated with high risk of CV complications and ESRD. This group of AH patients requires a integrative therapeutic strategy including optimal blood pressure control together with modification of traditional cardiovascular risk factors and treatment of established CV diseases. To identify this high risk population the systematic assessment of GFR and other CV factors should be done in every case of AH, especially in older and female patients.
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Pol. Merkur. Lekarski · May 2008
Comparative Study[Comparison between two methods of inguinal hernia surgery--Lichtenstein and Desarda].
A preferable method of inguinal hernia repair nowadays is the use of mesh graft in tension-free techniques. In the past few years a new technique developed by a surgeon from India, Mohan P. Desarda, was introduced. This method is based on the use of an undetached strip of the external oblique aponeurosis which strengthens the posterior wall of the inguinal canal. The aim of this study was to compare the results of primary inguinal hernia repair in two groups of patients. One of the groups included the patients treated with Desarda technique (group I), and the second group included patients after Lichtenstein repair (group II). ⋯ The Desarda and Lichtenstein methods of primary inguinal hernia repair do not differ in the means of procedure complexity and surgery time. The number of local complications and pain intensity were comparable and similar to the literature data. The patients after Desarda and Lichtenstein hernia repair were satisfied with the surgery results. Desarda primary hernia repair is as effective as Lichtenstein surgery and six months after the surgery the treatment results are similar in both groups.