Przegla̧d lekarski
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Review Case Reports
[Acute poisonings and organ donation--case reports and literature review].
Poland is one of the European countries where serious problem of shortage of organ donors is observed. Organ donation from victims following fatal acute intoxications is extremely rare, and there's only several such case reports published in Poland. There's a need to establish guidelines of instrumental confirmatory tests of brain death determination according to acute poisonings. ⋯ Standards of instrumental confirmatory tests in victims following fatal poisonings should be established. Introduction of guidelines concerning donors intensive care procedures that allows successful organ procurement. All organ donations and transplantations from poisoned donors should be registered in national and/or international databases to provide an exchange of experiences and improve understanding of such cases.
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Statins reduce cardiovascular morbidity and mortality but their administration is associated with a broad array of potential adverse effects. The aim of the study was to assess the safety and tolerability of the use of atorvastatin in the dose of 40 mg a day during short-term observation in daily practice--in outpatient clinics, specialized individual practice offices and in-patient health care units. ⋯ Atorvastatin in daily dose of 40 mg is a safe and well tolerable medication for the treatment for dyslipidemic disorders in patients of different clinic profile and cardiovascular risk groups in common medical practice.
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The authors described three groups of patients after acute poisonings. In the first group were 60 patients after carbon tetrachioride poisoning, the second group consisted of 81 patients after mushroom poisoning and 20 patients after ethylene glycol poisoning were in the third group. Besides two patients with rare poisonings after potassium dichromate and after paraquat poisoning were analysed. ⋯ Eighty-four hours after acute potassium dichromate poisoning and 24 hours after exchange blood transfusion during haemodialysis a 41-year old man died in haemorhagic shock, which developed after the extensive chemical burns of mucous membrane of gastrointestinal tract caused by this poison. Our patient after paraquat poisoning was treated by repeated charcoal haemoperfusion and haemodialysis. Despite of that therapy the patient died in severe respiratory insufficiency.
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Extracorporeal membrane oxygenation (ECMO) is an established method of treatment for extremely severe respiratory failure (ARDS, acute respiratory distress syndrome), for mechanical circulatory support after cardiac surgery as well as advanced resuscitation technique in specific cases. Severe multidrug poisoning causing an acute cardiovascular insufficiency combines all of these indications. We report a case of multiple drug poisoning: ACE inhibitor (ACE-I), beta-blockers and calcium channel blockers. Acute heart failure and multiorgan failure, have been successfully cured with the concomitant use of ECMO, hemodiafiltration and oscillatory ventilation.
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The aim of the study was to assess early results after the treatment of femoral neck fractures with the cementless hip arthroplasty as well as complications after the earlier fixation of these fractures in patients aged 55-70 years. ⋯ Based on the very good and good early results of clinical trials can be assumed that the total cementless hip arthroplasty will be an effective and recommended method of treatment of femoral neck fractures and complications after the earlier fixation of these fractures in patients aged 55 to 70 years, but this requires further, long-term observation. Total hip arthroplasty, not the fixation, should be more often considered as a primary care management of fractures of this type because it allows for a pain-free walking faster and faster return to pre-injury functioning.