Wiadomości lekarskie (Warsaw, Poland : 1960)
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Extracorporeal membrane oxygenation (ECMO) is a technique involving oxygenation of blood and elimination of carbon dioxide in patients with life-threatening, but potentially reversible conditions. Thanks to the modification of extracorporeal circulation used during cardiac surgeries, this technique can be used in intensive care units. Venovenous ECMO is used as a respiratory support, while venoarterial ECMO as a cardiac and/or respiratory support. ⋯ According to the Extracorporeal Life Support Organization (ELSO) Guidelines, inclusion criteria are: PaO2 / FiO2 < 80 for at least 3 hours or pH < 7.25 for at least 3 hours. Proper ECMO management requires advanced medical care. This article discusses the history of ECMO development, clinical indications, contraindications, clinical complications and treatment outcomes.
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Atrial fibrillation (AF) is the most common cardiac arrhythmia in the adult population. Thromboembolic events are one of the reson of increased mortality in this group of patients. ⋯ Percutaneous left atrial appendage occlusion (LAAO) is effective, non-pharmacological method of treatment through elimination the source of thromi. This procedure is dedicated to patients with high risk of thromboembolism events and contraindications to anticoagulation.
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Introduction: In today's conditions, the aggravation of health and demographic problems in Ukraine arose the urgent need for physical rehabilitation and restoration of the health of our citizens by means of a non-medical nature. Under such conditions, specialists in physical therapy and ergotherapy become subjects of medical, social and psychological assistance, associates of the improvement of physical qualities, psycho-emotional stability and adaptation reserves. The aim of the study is to develop and substantiate the medical aspects of training a specialist in physical therapy and ergotherapy in the system of higher education in Ukraine. ⋯ Conclusions: The theoretical synthesis of domestic and foreign experience is carried out and the author's approach to solving an important and actual scientific problem of forming the medical competence of future specialists in physiotherapy and ergotherapy is proposed. An analysis of the international experience of training physical rehabilitation specialists has made it possible to identify the most promising American and European models that have a number of significant differences in the principles of organization and financing of pedagogical processes, professional etiquette and self-discipline of specialists.
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Hyperkalemia is a medical emergency that requires immediate therapy, followed by interventions aimed at preventing its recurrence. Hyperkalemia occurs especially frequently in patients with chronic kidney disease (CKD), in part because of impaired kidney function and in part due to coexisting comorbidities such as diabetes or heart failure and the medications used to treat them, first of all the inhibitors of renin-angiotensin-aldosterone system (RAASi). Both acute and chronic management of hyperkalemia are equally important, though, with currently available therapeutic possibilities, the effective restoration of potassium homeostasis are in fact limited to the correction of its triggers. The emergence of new medications (patiromer and ZS-9) could lead to a therapeutic paradigm shift from intermittent treatment of incidentally discovered hyperkalemia toward preventive measures preventing fluctuations in serum potassium levels and enabling the continuation of beneficial, but hyperkalemia inducing agents.
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Sarcoidosis is a rare multiorgan granulomatous disease of unknown etiology, mostly affecting young adults, with predilection for hilar lymph nodes and the lung. Despite clinical and histologic similarities between sarcoidosis and tuberculosis, the role of M. tuberculosis in the etiopathogenesis of sarcoidosis is still not clear. Over recent years numerous studies identifying peripheral blood T-cell response to various mycobacterial antigens were published. ⋯ Methotrexate is the most commonly used second-line drug. TNFα-antagonists are the therapeutic option in refractory sarcoidosis. In this article we summarise the present knowledge about the most common localization of sarcoidosis - pulmonary sarcoidosis, with special emphasis on the current etiologic hypothesis, possibility of diagnosis and treatment.