Przegla̧d lekarski
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Amanita phalloides is a direct life-threatening poisoning because of acute multiorgan failure. Urgent liver transplantation (LTx) is the last chance to save patient's life in severe cases. In many cases of mushroom poisoning the patient dies because of unavailability of a liver graft. Liver albumin dialysis (MARS) is a promising treatment to bridge the patient to LTx or stabilize his or her condition until spontaneous liver regeneration occurs. ⋯ Liver albumin dialysis may be effective in severe Amanita phalloides poisoning to stabilize the condition of a patient until spontaneous liver regeneration occurs or as a bridge to LTx. In cases of a family poisoning, proper coordination and cooperation among toxicology departments and transplant centers is required.
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The pathogenesis of primary headaches is differential, with a neurogenic inflammation participation. ⋯ 1. Changes of the level of IL-6, IL-1beta, TNF and sTNFRI in the blood of children with idiopathic headache do not indicate a significant role of inflammatory process in its pathogenesis. 2. Although the significant increase in IL-6 levels observed in several children in the first hour of the migraine attack may suggest that neurogenic inflammation participates in the pathogenesis of migraine.
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An integration of clinical and forensic toxicologist society enjoys its 40-year tradition. A practice in this field proves that the cooperation can be fruitful in both the scientific and preventative and organizational areas provided the concentration of the participants' efforts is focused. The article shows the examples of such collaboration, the illustration of which are the presented works. The articles constitute the original papers and casuistic works as well concerning problems of contemporary toxicology such as: epidemiology of poisoning, complex evaluation of ethanol, carbon monoxide, pesticides, drugs of abuse, pharmaceuticals and other poisonings.
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Case Reports
[Carbamazepine "CR"--clinical picture of intoxication: the kinetics of extracorporeal elimination].
Carbamazepine (CBZ) intoxication is an important issue in acute poisonings practice. Pathological reflexes, central breathing depression and cardiac disturbances are the characteristic features of carbamazepine poisoning. The clinical picture is variable and does not always correlate with CBZ serum concentration. ⋯ CBZ pharmacokinetics makes the drug move rapidly between the compartments during the HP. This movement may cause a reduction in CBZ concentrations in receptors' vicinity. Probably this mechanism accounts for the improvement of the patients' clinical state despite low kinetic values of the procedure.
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Prevalence of type 2 diabetes has increased greatly over the past decade and focus of care for people with diabetes has shifted from specialists to general practitioners (GPs). Because of lack of the central registry, a real number of diagnosed diabetes in Poland is unknown, as unknown is the prevalence of diabetes in patients attending primary health care, provided treatment and a prevalence of chronic diabetic complications registered by GPs. ⋯ 1. The prevalence of diabetes registered in primary health care in Szczecin is higher than expected on the basis of European data. 2. Low number of type 2 diabetics is treated with diet alone and quite high number is treated with insulin. 3. Low number of chronic diabetic complications reported by GPs, despite long duration of disease, indicates the necessity of special training in delivering care for diabetic people, diagnosis of diabetic complications, increased access to secondary care and better cooperation between primary and secondary care.