Wiadomości lekarskie (Warsaw, Poland : 1960)
-
Peripartum cardiomyopathy, a type of dilated cardiomyopathy of unknown origin, occurs in previously healthy women in the final month of pregnancy and up to 5 months after delivery. Although the incidence is low--less than 0.1% of pregnancies--morbidity and mortality rates are high at 5% to 32%. The etiology of left ventricular dysfunction is unknown. ⋯ The prognosis is best when peripartum cardiomyopathy is diagnosed and treated early. Fortunately, despite a high risk of recurrence in subsequent pregnancies, many patients with peripartum cardiomyopathy recover within 3 to 6 months of disease onset. Future pregnancy is not recommended especially in patients with persistent left ventricular dysfunction because of the risk of dangerous complications.
-
Catastrophic antiphospholipid syndrome is the most dangerous form of the antiphospholipid syndrome, which is characterized by rapid onset of thrombosis in small vessels of many organs and intravascular coagulation, thrombocytopenia and hemolytic anemia. The syndrome develops over a short period of time with acute multi-organ failure, including kidney, respiratory, cardiovascular, central nervous system and adrenal glands, often associated with disseminated thrombotic microangiopathy. ⋯ Early diagnosis and aggressive treatment of patients with catastrophic antiphospholipid syndrome is essential to save the life of these patients. In the last 10 years, the mortality in this disease decreased from 50% to 30% with simultaneous treatment with anticoagulants, corticosteroids, plasmapheresis and immunoglobulins.
-
Stem cell transplantation is now a routine and successful therapeutic method in many hematopoietic disorders and cancers. Unfortunately, toxicity of the procedure significantly worsens the outcomes, with acute and chronic kidney injury among the others. Etiology of kidney failure is multifactorial with nephrotoxicity of drugs, septic complications, sinusoidal occlusion syndrome, thrombotic microangiopathy and acute/chronic graft-versus-host disease (GvHD). Understanding these syndromes enables early recognition and proper intervention that can reduce incidence and severity of kidney injury and improve outcomes.
-
In July 2012, the act on preventing and counteracting infections and infectious diseases in humans was amended. Many changes concerning duties of physicians looking after patients with tuberculosis were proposed. ⋯ It is also essential that the national sanitary inspector be notified as to which health-care institution the patient with tuberculosis was referred to for treatment, and also about an evasion of antituberculous therapy by the patient. Many paragraphs concerning the control of infectious diseases were formulated more precisely.
-
The Act on preventing and counteracting infections and infectious diseases in humans effective in Poland requires the heads of health care outlets and institutions to counteract spreading of TB in units under their management. They are, by all means, responsible for monitoring infections in their respective units, including development, implementation and monitoring of the implementation of procedures into practice, aiming at limiting the dissemination of TB in hospitals and outpatient clinics. Medical service unit managers are also responsible for providing members of their staff with means of individual protection against infection with Mycobacterium tuberculosis bacillus. ⋯ TB is an infectious diseases included in the occupational disease list. Assessment of TB as an occupational disease is the responsibility of provincial TB prevention clinics. The Act also provides principles of financing of individual benefits available for the insured TB patients as well as those not insured.