Wiadomości lekarskie (Warsaw, Poland : 1960)
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Transvenous pacemaker lead malposition in the left ventricle is a rare complication of pacemaker implantation however, at the moment of diagnosis poses the serious therapeutic problem. The usual morphology for paced events originating from the right ventricle has a left bundle branch block pattern, but sometimes right bundle branch block (RBBB) configuration is identified. The report describes two cases of RBBB configuration in the electrocardiogram (ECG) after pacemaker implantation. ⋯ The following algorithm of procedures during pacemaker implantation is proposed to avoid the lead malposition in the left ventricle. First, obligatory perform 12-lead ECG in pace mode during surgery or immediately after it. Second, in case of RBBB pattern in post implant ECG, make ECHO for precise lead position description.
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Clinically silent adrenal masses (incidentaloma) are incidentally discovered lesions when noninvasive imaging methods (ultrasonography--USG, computer tomography--CT, magnetic resonance imaging--MRI) are performed for the reason other than known or suspected adrenal disease. Most of studies report the prevalence of adrenal incidentaloma range between 1 and 10% in radiological series. ⋯ All malignancies were found in tumors with the diameter over 3 cm. In tumors with diameter over 6 cm malignant cases were found in 70.8%.
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Anorexia nervosa (AN) is thought to appear predominantly in girls and young women. Twenty years ago the incidence of AN was considered as 1 boy to 10-15 girls. Recent data suggest that the girls to boys rate is 4:1. ⋯ Boys and young men reluctantly apply for help to medical professionals trying to hide their symptoms. The diagnosis of AN is established and the treatment is being performed only when they suffer from a marked loss of weight or a severe depression with suicidal thoughts. We report seven male patients with AN and review the differences in a course of this disease between male and female patients.
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Approximately 10% of persons infected with human immunodeficiency virus (HIV) and 75-90% patients with acquired immunodeficiency syndrome (AIDS) present neurological symptoms. This group causes the greatest diagnostic difficulties among AIDS patients. The purpose of the study was to demonstrate the usefulness of the magnetic resonance imaging (MR) of the central nervous system (CNS) in the diagnosis and differentiation of primary and secondary lesions. ⋯ Magnetic resonance imaging has a high sensitivity in identifying lesions of the central nervous system. It is very useful, together with the results of other tests, in the final diagnosis of the lesions in the CNS. Magnetic resonance plays also an important role in the treatment planning and monitoring of the efficacy of therapy used in AIDS patients.
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Dopa-responsive dystonia (DRD) is a rare, autosomal dominant (GTP-cyclohydroxylase gen mutation on chromosome 14q) or rarely recessive (tyrosine hydroxylase gene mutation on chromosome 11p) inherited disorder. Both enzymes take part in dopamine synthesis. Their deficiencies cause the dopamine level reduction. ⋯ The clinical status improved, dystonic movements disappeared completely. The authors indicate that DRD must be taken into account in differential diagnosis of movement disorders in children, mostly in progressive cases. Good effect of L-Dopa treatment is one of the basic phenomena helpful in DRD recognition.