Przegla̧d lekarski
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Historical Article
[The history of tobacco consumption and nicotine addiction in Europe until the middle of the XXth century].
Tobacco, a plant unknown in the Mediterranean civilization, has made a world-wide carreer in the social and economic areas for the last 500 years. The cultivation of tobacco, although originally taking place mostly in North and South America, quickly spread to the other continents, mainly to Europe and Africa. The huge profit from the cultivation of tobacco, based also on the ruthless exploitation of black slaves brought from Africa, founded the welth of such American states, as Virginia, North Caroline and Louisiana. ⋯ The aforementioned factors created the raising supply of tobacco, which reached its the apogee in the XXth century. On the other hand, the demand for tobacco was the function of unreasonable beliefs in its therapeutic properties, religious prejudices, fashions and social rituals, and most of all by gradually increasing tobacco addiction. The purpose of this study is to analize different factors influencing the consumption of tobacco until the middle of the XXth century.
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Early invasive strategy is one of alternative methods for management of acute coronary syndromes (ACS) without persistent ST-segment elevation. ⋯ Early invasive strategy in patients with ACS without ST-segment elevation is efficacious method of treatment. Independent predictors of in-hospital deaths are: Braunwald's IIIC class angina, congestive heart failure, recurrent angina after revascularization, myocardial infarction complicating hospital course. Stent implantation improves in-hospital prognosis.
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The aim of the study was to assess the diagnostic yield of transbronchial needle aspiration (TBNA) in mediastinal or hilar adenopathy in: sarcoidosis, tuberculosis and malignancy. Transbronchial needle aspiration was performed in 53 patients, preeceded by computed tomography (CT). In 22 patients (41,5%) TBNA enabled to diagnose 10 cases of sarcoidosis, 12 cases of neoplastic infiltrates of the lung. ⋯ In the remaining 7 patients who were followed-up for a period of one year the diagnosis of sarcoidosis was confirmed by clinical, radiological and cytological (BAL) examinations. Transbronchial needle aspiration was shown to be efficient diagnostic method in mediastinal or hilar adenopathy in sarcoidosis and malignancy except lymphoma. Moreover in approximately 60% of cases this technique doesn't allow to establish a diagnosis and in turn implicates the necessity for further diagnostic procedures like mediastinoscopy, or transbronchial or thoracoscopic lung biopsy.
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The aim of the study was to define the frequency of atrial fibrillation early after coronary artery bypass grafting (CABG) and clinical risk factors for the development of atrial fibrillation in the post-operative course. The study population consisted of 1578 patients (1283 men and 295 women ranging in age from 25 to 85 years, mean age 59.373 +/- 8.686 years) undergoing isolated coronary artery bypass grafting in extracorporeal circulation between 1.01.1998 and 21.12.1999. The patients were divided into two groups: group 1 with atrial fibrillation after CABG (193 patients, mean age 62.399 +/- 7.097 years) and group 2 without atrial fibrillation in the postoperative course (1385 patients, mean age 58.952 +/- 9.009 years). Both groups were compared with respect to pre-, intra- and postoperative parameters. Additionally in group 1 the following aspects were taken into account: timing of atrial fibrillation and its relapses in relation to the surgical procedure, serum potassium level, type and efficacy of antiarrhythmic treatment. ⋯ (1) Atrial fibrillation is an important clinical problem early after coronary artery bypass grafting. It is poorly tolerated and shows a tendency to recur. (2) Atrial fibrillation after CABG is most strongly correlated with age over 60 years, arterial hypertension and perioperative withdrawal of beta adrenolytics.
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Urapidil was administered in 69 patients aged between 46-79 age (average 62.7 +/- 8.4 age) to control intra-operative increase in arterial blood pressure accompanying endotracheal intubation, extubation, wakening of the patients, incision of abdominal integument and clamping of abdominal aorta. In presented group 47 patients suffered from arterial hypertension and 22 patients did not. Patients underwent various surgical procedures in general anesthesia and in 13 patients implantation of aortal prosthesis in result of abdominal aortic aneurysm (7 patients) and Leriche syndrome (5 patients) was performed. ⋯ Urapidil administered during monotherapy turned out to be efficacious in 81.1% of treated patients. Other 18.9% required an additional infusion of nitroglycerine, but these were patients operated on due to abdominal aorta. Average dosage of urapidil applied during monotherapy amounted to 26.3 +/- 2.4 mg. Intraoperative administration of urapidil did not result in acceleration of heart rate, and urapidil turned out to be a safe medicine to reduce intraoperative increase in arterial blood pressure also in patients who were previously diagnosed as suffering from arterial hypertension.