Przegla̧d lekarski
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Transoesophageal echocardiography is an effective tool in visualisation of intrathoracic aorta. It is highly sensitive in diagnosis of aneurysms, atheromas, posttraumatic ruptures, abnormalities of aortic valve, and complications of bacterial endocarditis. It is superior to other methods in diagnosis of aortic dissection. ⋯ TEE is especially helpful in patients undergoing cardiac operations. It makes possible the detection of atheromatosis and assessment of plaque morphology in thoracic aorta. In cases with high risk of peripheral embolisation the surgical strategy is changed.
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Clinical and experimental studies indicate that either active or passive cigarette smoke exposure promotes vasomotor dysfunction, atherogenesis, and thrombosis in multiple vascular beds. Although the precise mechanisms responsible remain undetermined, free radical-mediated oxidative stress appears to play a central role in cigarette smoking mediated athero-thrombotic diseases. ⋯ Furthermore, potentiated by multiple prothrombotic and antifibrynolytic effects, intravascular thrombosis is the predominant cause of acute cardiovascular events. Epidemiologic, clinical, and experimental data also suggest that the pathophysiologic effects of cigarette smoke exposure on cardiovascular function may be nonlinear.
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In spite of intensified antitobacco campaigns and decrease in social acceptance for smoking it is still an important issue. In prevention there is a need to make smokers and non-smoking people aware of a level of exposure to tobacco smoke. One of the objective methods to evaluate this exposition is to measure a concentration of the carbon monoxide in exhaled air. ⋯ All the smokers acknowledged the addiction. Routine use of Smokerlyzer in the admission room is limited, mainly by the dyspnea. Despite the practicality of CO level measurement, taking medical history of smoking is still the most important.
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Pus collection between dura matterand arachnoidis not an abscess but an empyema. Complains of severe headache, a lack of cooperation is observed, sometimes high fever, seizures, which may lead to an epileptic like condition. ⋯ We report four different cases of intracranial complications, in the form of dural empyema diagnosed and treated in our Department. In the pre antibiotic therapy era, cerebrospinal meningeal empyema inevitably led to paralysis, paresis and death.
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Based on the rewiew of the literature and own clinical observations, we presented examples of the most common pediatric onco-hematologic malignancies, that are manifested early by osteoarticular complaints. When these complaints predominate in the clinical presentation, they lead the diagnosis towards nonmalignant conditions, that are most common cause of such symptoms in children, like injuries, nonspecific reactive arthritis or inflammatory connective tissue diseases. However, in acute lymphoblastic leukaemia, the most prevalent childhood malignancy, bone and joint pains are present early in 40-60% of cases and they frequently anticipate any abnormalities in complete blood counts. ⋯ Basic and commonly accessible radiological imaging may provide valuable information, because it can reveal tumors, osteolytic lesions or destruction of bone architecture. Laboratory tests of lactate dehydrogenase (LDH) and uric acid level, often raised in malignancies are also helpful. The aim of this study was to focus the attention of pediatricians to the necessity of including malignancy in the differential diagnosis of intensive or unexplained osteoarticular complaints.