Przegla̧d lekarski
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Case Reports
[Metformin poisoning--clinical features, diagnostics and treatment--case presentations].
Metformin has been used for many years as oral anti-hyperglycaemic agent in the treatment of type 2 diabetes mellitus either in Poland or in the world. Metformin is the most commonly prescribed agent, but acute poisonings of this agent are rare. ⋯ Physician must be vigilant to recognize anti-hyperglycaemic agent poisonings like biguanides when hypoglycaemia and acidosis are present in laboratory results. We present patients with metformin toxicity, some of them with fatal course.
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Methoxetamine (MXE) is a novel synthetic drug, structurally related to phencyclidine, with ketamine-like properties. Available in Poland since 2010, with no legal control, is adverti. sed as the "ideal dissociation drug". The aim of this study was to present a case of nasal methoxetamine acute poisoning in a 28-year-old man, the course of treatment, and the method of identification of this substance in serum and urine. ⋯ The period of acute poisoning was covered by amnesia. The MXE concentrations in serum and urine were determined using liquid chromatography-mass spectrometry (LC-MS-MS) method, and were respectively 270 ng/ml and 660 ng/ml. Confirmed MXE poisoning increases our knowledge about this new substance, providing relevant clinical and analytical data.
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Intracranial hypertension is a common life-threatening syndrome caused by a variety of neurological and non-neurological diseases. Enlargement of the optic nerve sheath has been described in patients with raised intracranial pressure (ICP). Optic nerve sonography offers rapid bedside assessment of the optic nerve sheath diameter (ONSD) and has recently been introduced for the noninvasive detection of raised ICP. This study explains the pathophysiology of optic nerve sheath enlargement as a result of intracranial hypertension, describes the technique and clinical use of optic nerve sonography.
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The incidence of acute kidney injury (AKI) at neonatal intensive care units (NICU) is estimated as 6-24%. Traditional AKI markers i.e. serum creatinine (SCr) concentration, fractional sodium exertion, urine sodium concentration and renal failure index--are low sensitivity and low specificity markers but beside remain very late ones. ⋯ The most current reports about chosen AKI biomarkers in newborns with uncomplicated clinical course and in children with AKI within the course of sepsis or after cardiopulmonary bypass surgery--were discussed. Disposing of the reliable clinical data referring to early AKI biomarkers constitutes a valuable aid for clinicians who having got to know about the actual risk possess the time for proper clinical interventions.
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Brain injury due to hypoxia, trauma, stroke, poisoning, and other pathological conditions may result in chronic disorders of consciousness in the form of vegetative state (VS) or minimally conscious state (MCS). VS is a condition defining patients who have awaken from coma, open eyes spontaneously or on command, but still are not aware of themselves or their environment, showing only a reflex motor responses. MCS is a condition in which patients are not able to communicate consistently, but they are not already in the VS, because of evident signs of awareness of themselves and the environment. The paper discusses the diagnostic criteria, etiology as well as diagnostic procedures and treatment of VS and MCS