Przegla̧d lekarski
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The authors examined intellectual and socio-emotional functioning of 39 subjects suffering from Duchenne muscular dystrophy. Their school situation, access to rehabilitation and a quality of familial upbringing attitude were characterized, as well. No significant differences concerning I. Q. between sick children and healthy population were found.
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Infective endocarditis especially where blood culture is negative frequently causes problems in diagnosis despite of many nonspecific inflammation parameters. Procalcitonin (PCT) concentration is a new marker of severe bacterial and fungal infection. The aim of this study was to evaluate the usefulness of PCT concentration assessment in the diagnosis of uncomplicated infective endocarditis of bacterial etiology. The study group consisted of 30 patients with ongoing infective endocarditis in the course of acquired valvular heart disease. The diagnosis of bacterial endocarditis was established according to the Duke criteria on the basis of: clinical examination, laboratory investigations (inflammatory parameters, transthoracic and transesophageal echocardiography) and positive blood cultures. Patients with sepsis, concomitant infections and in an early postoperative period were excluded. Two control groups consisted of: 10 patients without endocarditis and other infections and another 10 patients without endocarditis and with an urinary tract infection. Serum procalcitonin concentrations were measured by an immunoluminometric assay (LUMItest PCT set). Mean serum PCT concentrations in patients with endocarditis (0.12 +/- 0.13, range 0-0.4 ng/ml) were significantly higher than in control group without infection (0.03 +/- 0.05, range 0-0.1 ng/ml) and higher than in control group with an urinary tract infection (0.02 +/- 0.04, range 0-0.1 ng/ml). However in 12 patients (of 30) were below sensitivity of the method and in the rest were within normal range (< 0.5 ng/ml). ⋯ Serum PCT concentration assessment seems to have no value in the diagnosis of uncomplicated infective endocarditis.
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There are four major forms of child abuse: physical abuse, emotional abuse, sexual abuse and neglect. Various combination of these four aspects often exists in the individual child and clinical manifestation can not be so clear-cut. In this paper the authors present some problems of child abuse syndrome (taking into consideration risk factors, clinical symptoms, recognition and methods of treatment) whose knowledge may be helpful for the family doctor who comes into contact with such children.
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In the last few years, physiological changes, symptoms, diagnostic tools, and treatment of abdominal compartment syndrome interest surgeons, trauma surgeons and anaesthetists. Sudden, dangerous basic vital function deterioration in patients managed in the intensive care unit, may be results of abdominal compartment syndrome. Abdominal compartment syndrome is secondary to massive intraabdominal haemorrhages, hepatic or retroperitoneal space "packing", fluid collection in tissues, including abdominal organs. ⋯ During decompression abdominal organs reperfusion may produce arterial hypotension and asystole. Abdominal closure must prevent abdominal hypertension. Temporary plastic patch, simple and cheap is the most popular technique.
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The International Classification of Epilepsies and Epileptic Syndromes distinguishes four types of idiopathic generalized epilepsies with typical absences: childhood absence epilepsy (CAE), juvenile absence epilepsy (JAE), juvenile myoclonic epilepsy (JME) and epilepsy with generalized grand mal on awakening (EGMA). It is essential in any case when sizures occur to classify the type of epileptic syndrome in order to make prognosis and to choose correct treatment. But it is not always possible to establish diagnosis at the beginning of the disease. Often prolonged observation of the patient and evolution of clinical and EEG features lead to define the epileptic syndrome. The aim of the work was to define the type and frequency of epileptic syndromes and their long-term observation in patients with absences occurred as the first (or the only) type of seizures. ⋯ 5.2% of all subjects were patients with idiopathic epilepsies who experienced absences as a first (or the only) type of seizures when absences occur one should consider first of all childhood absence epilepsy and juvenile absence epilepsy. Recognition of juvenile myoclonic epilepsy and epilepsy with generalized grand mal on awakening is less probable.