Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
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Pol. Merkur. Lekarski · Jan 2008
Case Reports[Pyoderma gangrenosum--an interdisciplinary diagnostic problem].
Pyoderma gangrenosum is a rare, chronic, progressive and noninfectious necrosis of skin with an unclear etiology. It usually coexists with the systemic disorders. Clinically it appears as a rapidly spreading ulceration in a various location. ⋯ Due to the presumptive diagnosis of phlegmon of the patient's right arm she was initially admitted to surgical ward. Sometimes there are many difficulties with an early diagnosis of pyoderma gangrenosum because of its rarity, distinctness of clinical pictures, lack of characteristic histology and laboratory tests. We would like to emphasize that pyoderma gangrenosum should be always included to the differential diagnosis of a rapidly progressing ulceration of skin especially if there is no response to standard therapy.
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Acromegaly is a slow developing chronic debilitating disease caused by a growth hormone (GH)-producing pituitary adenoma. The clinical consequences of acromegaly result both from excess GH secretion and from mass effect of the pituitary tumour. The disease is associated with increased morbidity and mortality compared to normal population. ⋯ All these forms of treatment attempt to control the disease by reducing GH secretion from the tumour and inhibiting the growth of adenoma. The decision concerning the choice of therapy should depend on age, the severity of acromegaly and the presence of its complications and should also consider the dangers associated with each treatment. This review paper summarizes the contemporary treatment of acromegaly with special emphasis on their established benefits and risks.
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Pol. Merkur. Lekarski · Nov 2007
Comparative Study[Preliminary outcomes of laparoscopic adjustable gastric banding and Roux-en-Y gastric bypass in surgical obesity treatment].
Obesity is an increasing medical and social problem. Besides conservative therapy, resulting in modest weight loss, the available treatment option is bariatric surgery. Surgery is recommended for patients with BMI > 40 or > 35 with comorbidities such as diabetes, hypertension, osteoarthritis and poor quality of life. ⋯ In our opinion bariatric surgery is the most efficient option to achieve weight loss in morbid obesity. Bariatric operations are characterized with relative low rate of complications. LAGB is shorter procedure and its risk is lower than RYGB, moreover after LAGB the anatomy of digestive tract is not modified and it is easy to remove gastric band when necessary.
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Pol. Merkur. Lekarski · Oct 2007
Review[Treatment of stroke in patients with and without diabetes--similarity and differences].
Diabetic patient with the stroke h is the more and more frequent patient of the neurologist. This results from increasing prevalence of the diabetes at keeping morbidity on the stroke. The management with patient in the acute stroke does not deviate considerably from the diagnostics and the therapy of remaining patients. ⋯ The primary and secondary prevention of the stroke at patients with the diabetes is based on similar bases. At patient with the diabetes one ought to trend to the optimization of the glycemy, lower values of the hypertension and lipids than in the population without the diabetes. Some data speak too the greater advantage from using clopidogrel vs aspirin in the secondary prevention at patients with the diabetes.
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Pol. Merkur. Lekarski · Aug 2007
Randomized Controlled Trial Comparative Study[Laparoscopic cholecystectomy for acute cholecystitis].
Laparoscopic cholecystectomy is considered the "gold standard" for the planned treatment of symptomatic cholecystolithiasis. Currently this method is used in 88% of cholecystectomy according to world database. There are evidences that laparoscopic cholecystectomy for acute cholecystitis is a quite safe method which is not connected with many complications. ⋯ Laparoscopic cholecystectomy is a safe method of treatment both acute cholecystitis and chronic cholecystolithiasis.