Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
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Pol. Merkur. Lekarski · Apr 2007
Review[The current view on pathophysiology of pulmonary arterial hypertension].
The article refers to actual data on pathophysiology of pulmonary arterial hypertension (PAH). PAH is a group of diseases characterized by a progressive increase of resistance and pressure in pulmonary vascular bed, leading to systolic overload and failure of the right heart ventricle, and in consequence - to premature death. The latest classification of PAH, basing on pathophysiology of the disease, was proposed in 2003 in Venice. ⋯ In some cases secondary risk factors (e.g.: portal hypertension, congenital heart defects, HIV infection, connective tissue disorders, intoxications, myeloproliferative and storage diseases) are also important. In all types of PAH the same four pathological processes are reported: vasoconstriction, inflammation, thrombosis and remodelling. The growing knowledge of pathophysiology of PAH has enabled its better diagnosing and treatment, which has improved both symptoms and survival in the patients suffering from the disease.
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Pol. Merkur. Lekarski · Feb 2007
Case Reports[The case of multiple brain abscesses conservatively treated].
We report the case of patient with rheumatoid arthritis treated by sulfasalazin. He was hospitalized because of general erythrodermia and diarrhoea with dysproteinemia. The consciousness disturbances and the meningitis syndrome occured in the course of disease. ⋯ We couldn't find the primary focus of bacterial infection, although the infection cause was undoubtedly hematogenous (abscesses location on the boundaries of cerebral cortex and white matter). There is no evident therapeutic standards and the choice of the best treatment is still under discussion. However, neuroimagining techniques are very useful in the correct diagnosis and optimal treatment.
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The term subclinical thyroid disorders apply to patients who have an abnormal serum thyroid-stimulating hormone (TSH) concentration but thyroxine and triiodothyronine levels within their reference ranges. Subclinical hypothyroidism occurs in 4% to 10% of the general population, and is especially prevalent in elderly women. Depending on the study, subclinical hyperthyroidism has been found in 0.6-16 % of the population. ⋯ Treatment of subclinical thyroid disorders is controversial. In this paper, we discuss the prevalence, aetiology, clinical presentation, diagnosis, natural history, and potential pathophysiological consequences of subclinical hypothyroidism and subclinical hyperthyroidism. We also provide some screening and management recommendations.
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Pol. Merkur. Lekarski · Nov 2006
Randomized Controlled Trial[The effect of 5-days of cetirizine, desloratadine, fexofenadine 120 and 180 mg, levocetirizine, loratadine treatment on the histamine-induced skin reaction and skin blood flow--a randomized, double-blind, placebo controlled trial].
of this study was to compare the effect of the following antihistamines: cetirizine 10mg, desloratadine 5mg, fexofenadine 120 and 180mg, levocetirizine 5mg, loratadine 10mg, and placebo, administered in the recommended doses over the period of 5 days, on the visually assessed histamine-induced skin reaction, using the Laser Doppler flowmetry (LDF). ⋯ Following the end of the treatment, the effect of the antihistamines on skin reaction was subsiding in such an order: after 24 hours in case of loratadine and desloratadine, after two days for both doses of fexofenadine, and 3-4 days for cetirizine and levocetirizine.
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Pol. Merkur. Lekarski · Oct 2006
Review[Genetic factors in susceptibility to age- and noise-related hearing loss].
Individual susceptibility to age-related hearing loss (AHL) and noise-induced hearing loss (NIHL) varies greatly, and this inter-individual variation is due to an interaction of environmental factors, individual factors, and susceptibility genes. Majority of studies on susceptibility genes for AHL and NIHL have been performed in mice model. These findings suggest the role of the same genes in the development of AHL and NIHL, the more so as the pathogenesis of both diseases is similar with a crucial role of oxidative stress. ⋯ An increased susceptibility to AHL and NIHL may rely on the SNPs of several other genes, including the groups of oxidative stress genes, K+ ions recycling genes, monogenic deafness genes (including Connexin 26 gene, which mutation is responsible for the most frequent hereditary deafness in Caucasians), as well as mitochondrial genes. Several oxidative stress enzyme (sod1-/-, gpx -/-) knock-out mice have been shown to be more susceptible to NIHL than wild strains. Current large-scale cohort studies on AHL and NIHL performed under the European projects in between-lab collaboration along with a dynamic progress in the field of genetics of deafness open up new opportunities to find human AHL and NIHL susceptibility genes and develop methods for AHUNIHL treatment.