Przegla̧d lekarski
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Pediatric neuropsychology is currently one of the most expansive fields of psychology, developing between clinical neurology and other neurosciences. ⋯ the knowledge of possibilities and the necessity of the neuropsychological evaluation in children should become much more common, especially in the medical environment. The status of the neuropsychologist in Poland need a precise legal regulation.
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Human hydrocarbon exposures have the potential to cause significant morbidity and mortality. To determine which hydrocarbons were associated with the most severe adverse outcomes, human exposure data reported to American poison information centers were analyzed. ⋯ These data demonstrate that hydrocarbons that are absorbed systemically and those with low viscosities are associated with higher hazard factors. The risks associated with hydrocarbons often implicated in abuse by older children and adolescents are also confirmed.
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Case Reports
[Acute intoxication with hydrogen peroxide with air emboli in central nervous system--a case report].
54-year-old woman with brain gas emboli after an accidental ingestion of concentrated hydrogen peroxide was described. Hydrogen peroxide (H2O2) is a water-soluble, caustic liquid. Exposure to concentrated (> 30-35%) hydrogen peroxide may cause cardiorespiratory insufficiency, shock, convulsions, coma, and chemical burns of skin and mucous membranes. Arterial gas embolization in central nervous system is a relatively rare complication. There are three possible mechanisms of gas embolization: persisting patent foramen ovale, pulmonary gas emboli caused by aspiration of hydrogen peroxide to the lower respiratory tract, formation of gas emboli after reaching the brain. Absence of gas emboli and cerebral infarction in CT does not exclude intoxication. Hyperbaric therapy is most effective for brain air embolism complicating hydrogen peroxide poisoning in acute phase. Some authors suggested that this therapy is also effective if administered during the subacute phase. ⋯ Neurologic symptoms after ingestion of hydrogen peroxide may suggest gas embolism of the cerebral vasculature. The absence of atrial septal defect does not exclude the possibility of cerebral air embolism. The absence of gas and cerebral infarction in CT scans does not exclude brain gas embolism. The use of hyperbaric therapy should be considered in treating severe cases of hydrogen peroxide poisoning.
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Sodium azide poisonings occur very rarely. The mechanism of sodium azide toxic effect has not yet been fully explained. Despite the lack of an explicit procedure for the cases of sodium azide poisonings, in vitro tests and rare case reports suggest that treatment with antidotes for cyanide poisoning victims can be effective. ⋯ However, available literature data are scarce and lack systematization, most of them coming from several decades ago. The lack of patient's consent for detailed examination of circulatory system and liver made it impossible to gather further knowledge on the subject. The efficacy of treatment with antidotes for cyanide poisoning has not been unequivocally determined for this kind of intoxication.
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Twelve hospitals--five form Warsaw, three from Kraków, and four from Gdańsk and Gdynia were randomized for the study. The logistic preparedness of hospitals during massive chemical accidents has been investigated. There were 146 probands (9 managers, 31 ward heads, 75 assistants and 31 ward nurses) included in the study. ⋯ There was no individual protective equipment in any of the analyzed hospitals. There were serious deficits in assortment and amount of antidotes which can be used in the treatment of contaminated patients. As much as 97.2% of respondents pointed the poison information centers as a main source of information in case of chemical accidents.