Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
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Pol. Merkur. Lekarski · Apr 2016
Case ReportsPosterior reversible encephalopathy syndrome with neurological sequelae - a case report.
Posterior reversible encephalopathy syndrome (PRES) is a set of neurological symptoms including impaired consciousness, cognitive disorders, seizures, blurred vision, dizziness and headache. The symptoms are closely related to the location of pathological changes in the brain; bilateral occipitto-parietal region is most often affected. Both focal neurological symptoms and encephalopathy are usually transient. ⋯ Differential diagnosis included stroke and viral neuroinfection (cytosis 23 cells /ul, protein level of 93 mg/dl); magnetic resonance examination revealed lesions typical for posterior reversible encephalopathy. After 6 weeks of hospitalization patient condition improved, but did not restore to the premorbid state. The patient was discharged with generalized cognitive impairment.
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Phenylketonuria is an inborn error of metabolism treated with a closely monitored low phenylalanine diet. Protein substitutes used for treatment are supplemented with vitamins and micronutrients. ⋯ Low phenylalanine diet using protein substitutes currently available in Poland predisposes to high concentration of plasma folic acid. The security of folic acid hipersupplementation in patients with phenylketonuria requires further detailed research.
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Pol. Merkur. Lekarski · Mar 2016
Editorial Review[Zika virus as a new threat to the health and life].
The newly emerging pathogens are increasingly becoming a threat to health and life, as the cause of epidemic infections. In the last three years there were outbreaks caused by Zika virus, which was transmitted by mosquitoes mainly from the region of South America. However, reports WHO and CDC indicate that infection has now reached to most countries of the world, including European countries. ⋯ Treatment of infected patients boils down to symptomatic, because there is no vaccine or drugs to inhibit the replication of the virus. Underway while work on genetically modified mosquitoes to their offspring quickly wasting away. As part of the preventive measures recommended to bypass areas where the density of mosquitoes is particularly dangerous.
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Pol. Merkur. Lekarski · Dec 2015
Case ReportsAcute clenbuterol overdose manifestations in a suicide attempt--a case report.
A 30-year-old man was admitted to the intensive care unit after a suicide attempt with respiratory difficulties, tremor, sinus tachycardia and significant hypokalemia. On examination, the patient was lucid, fully conscious and did not exhibit positive symptoms. ⋯ Due to its anabolic and lipolytic properties, clenbuterol has become a commonly abused drug in bodybuilding industry and is not routinely detected by toxicology screens. This is the first known report of suicide attempt by clenbuterol overdosing.
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Pol. Merkur. Lekarski · Dec 2015
Review[New definition of ventilator associated pneumonia might not necessarily have been a step in the right direction. Key takeaways from published studies after two years in clinical use].
Ventilator-associated pneumonia (VAP) is one of the most common hospital-acquired infections. VAP is associated with prolonged hospitalization and visibly increased mortality, which in the group of patients with VAP ranges from 25% to 47%. In January 2013 Centers of Disease Control and Prevention introduced a new definition for VAP. ⋯ The latest published studies suggest that most of the complications defined as VAE are patient-related, not modifiable risk factors and these patients had no evidence of hospital-acquired complications. The new definition failed to detect many patients with VAP and it has not resolved the ambiguities related to the diagnosis of this complication. It seems that the new surveillance program will not lead to introducing new prevention strategies that could decrease the mortality in intensive care unit patients.