Przegla̧d lekarski
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The case of acute venlafaxine poisoning with fatal outcome is shown. The 52-year-old woman with depression disorder ingested 56 pills of Symfaxin ER 150 venlafaxine as a suicidal attempt. Initially she was observed in the Neurology Department because of seizures, but after her husband found empty packages of medicine she was sent to the Toxicology Department being suspected of venlafaxine poisoning. ⋯ In the course of poisoning rhabdomiolysis, hypotension and consecutive acute renal failure were observed. Finally, severe ventricular tachyarrhythmia occurred leading do cardiac arrest. Despite intensive symptomatic and supportive treatment the patient died.
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Smoking is well established and important risk factor for cardiovascular disease. Cessation of smoking clearly decreases the risk of cardiovascular events. ⋯ Nicotine replacement therapy (NRT) increases the probability of quitting smoking. Studies have indicating no increase in cardiovascular events in smokers with known cardiovascular disease.
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The aim of this study was the evaluation of diagnostic and prognostic value of prenatal US and MRI in fetuses with central nervous system abnormalities, and of the influence of incorporating MRI to diagnostic algorithm on the therapeutic decisions. ⋯ Prenatal MRI in congenital central nervous system defects allows to obtain much more important therapeutic data and complement or correct the fetal sonographic diagnosis. Prenatal MRI allows to plan gynaecological, neonatal, neurosurgical treatment, and to predict neurological defects. It also improves prenatal guidance.
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The aim of this study is to present a case of delirium -the state occurring frequently in elderly patients. A 80-year-old woman was hospitalized in the department of internal diseases for internal medical examinations before scheduled operation of femoral osteosynthesis. In ward, she was given analgesic medicines from the group of non-steroidal anti-inflammatory drugs (NSAID), paracetamole and opioids influencing central nervous system. ⋯ Its occurrence was ascribed to the application of strong medicines influencing central nervous system. Treatment was modified then; the opioid medicine was replaced with NSAID, which had already been used before, applied intravenously. Subsidence of delirium clinical symptoms and cognitive functions' improvement was observed.
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There were 10 636 toxicological information given in 2004-2008 by the Poison Information Center Jagiellonian University Medical College. 538 of them concerned NonSteroidal Anti-Inflammatory Drugs (NSAIDs); 336 cases of NSAIDs ingested alone and 202 co-ingested with other drugs and/or with ethanol. 58,9% of them were intentional and 29,6% were accidental. Children (1-6 years) and adolescents (15-19 years) were mostly involved.