Wiadomości lekarskie (Warsaw, Poland : 1960)
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Foot drop is a symptom of many diseases and leads to an unaesthetic limping gait, falls and injuries. The most common cause of foot drop is injury to the common peroneal nerve, which innervates ankle joint and foot extensors. Other causes of foot drop include: sciatic nerve injury, lumbar plexopathies, L4/L5 radiculopathy, central nervous system related neuropathies (anterior horn cell disease, brain tumor). ⋯ The surgical treatment should be connected with the etiology of the foot drop and can include: neurolysis of the nerve, "end to end" repair, autogenous nerve graft procedures, nerve transfers, direct neuromuscular neurotization and tendon transfers. In proximal sciatic nerve lesions, nerve transfers and one-stage nerve repair with concomitant tendon transfer are valuable methods of the treatment of drop foot. The aim of the paper is to present pathogenesis and modes of treatment of foot drop deformity encountered in any orthopedic unit.
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Although adrenal insufficiency is considered a rare condition, recent epidemiological studies indicate a rising incidence of the disease. It may result from the presence of either primary adrenal disorder (Addison's disease) or of pituitary pathology. Addison's disease can present as an isolated entity or in combination with other autoimmune diseases. ⋯ Because the onset of symptoms is gradual while its manifestation is sometimes non-specific, the correct diagnosis may be easily missed. At the present time, there is no absolute agreement among endocrinologists about the optimal management of this condition. In this review article, we discuss the causes, clinical picture, diagnosis and treatment of adrenal insufficiency and provide the reader with some practical guidance concerning dealing with a patient suffering from this disorder.
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Venous thromboembolism is a one of the most common complications of cancer, which contributes to mortality in cancer patients. The prognosis of cancer patients with thrombosis is significantly worse. ⋯ Risk of cancer diagnosis is significantly higher in patients with idiopathic thrombosis compared with those with secondary thrombosis. We present case of 67-year-old man with recurrent vein thromboembolism and pulmonary embolism, who was subsequently diagnosed with disseminated adenocarcinoma, most likely of the lung.
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In patients with central nervous system disease, life-threatening hyponatremia can result from either the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) or cerebral salt wasting syndrome (CSWS). Both clinical entities share many similar laboratory and clinical findings, and are characterized by low serum osmolality, inappropriately high urine osmolality, and high urine sodium levels. ⋯ We present a 24-year-old man who developed CSWS after traumatic brain injury, showing diagnostic and treatment strategies undertaken in this patient and their impact on the course of CSWS. This case report illustrates the need for clinical awareness of CSWS in patients after head trauma.
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The effective laws impose the duty upon TB patients or persons suspected to have TB as well as their close relations to undergo compulsory sanitary, epidemiological and examinations. Furthermore, treatment is also mandatory and in case of infecting patients hospitalization, isolation and treatment. ⋯ Persons suspected of TB have the obligation to provide necessary information helping in diagnosing the disease or helping to find the source of infection and transmission of the disease. TB patients are under obligation to discontinue performing their work in case it may prevent the disease from spreading onto other persons.