Leczenie uzdrowiskowe w przewlekłej chorobie nerek

Thermal therapy is not likely to consider as partof a treatment strategy in chronic kidney diseases(CKD). National Health Fund statistics informed thatnephro-urological patients count below 1% in theoverall volume of patients referred for thermal therapyin Poland. The first part of the paper describesmain balneological methods and adaptogenic influenceson the body with particular attention to theetiology of CKD. The second part support thesis thatmultifactorial thermal therapy would be consideredas part of complementary medicine in nephrologicalcare. Finally, practical information on how to referCKD patients for thermal therapy has been included.Leczenie uzdrowiskowe w chorobach nerek jest rzadko wykorzystywaną formą terapii. Według statystyk Narodowego Funduszu Zdrowia pacjenci o profilu nefrologiczno-urologicznym stanowią poniżej 1% osób kierowanych co roku na leczenie uzdrowiskowe. W artykule opisano główne metody leczenia balneologicznego oraz mechanizmy oddziaływania adaptogennego na organizm z uwzględnieniem głównych wtórnych przyczyn przewlekłej choroby nerek. Przedstawiono przesłanki do określenia wieloskładnikowej terapii uzdrowiskowej jako terapii komplementarnej w opiece nefrologicznej. Omówiono zasady kierowania na leczenie uzdrowiskowe pacjentów z przewlekłą chorobą nerek

Ocena gruczołu krokowego u pacjentów kwalifikowanych do transplantacji nerki

Prostate cancer is the second most common cancer among men in Poland. Most of the people dialyzed in Poland are men. In the group of people over 60 years of age referred for kidney transplantation, men constitute more than 80% of the list. The study evaluated the urological qualification of men with “active” status on the National Waiting List (pol. Krajowa Lista Oczekujących). Current standards of prostate assessment in the general population and patients with chronic kidney disease treated with renal replacement therapy are discussed in context of anticipated transplantation.Rak prostaty jest drugim co do częstości nowotworem rozpoznawanym w Polsce wśród mężczyzn.Większość osób dializowanych w Polsce to mężczyźni. W grupie osób powyżej 60. rokużycia zgłoszonych do transplantacji nerki stanowią 80%. W opracowaniu dokonano oceny kwalifikacji urologicznej mężczyzn ze statusem „aktywny” na Krajowej Liście Oczekujących (KLO). W uzupełnieniu omówiono aktualne standardy postępowania w zakresie oceny gruczołu krokowego w populacji ogólnej oraz u pacjentów z przewlekłą chorobą nerek leczonych nerkozastępczo

Authorisation of organ procurement — is it influential factor for the identification of potential organ donors?

For many years, the authorisation of organ procurement has been discussed as a contributory factor to the number of potential organ donors. This paper presents different forms of authorisation and their influence on the decisions of both individuals and society. The general legal framework for the authorisation of organ procurement in Poland is described along with the solutions implemented by countries in which both implicit and explicit consent models are in effect. The presented arguments suggest that the form of authorisation does not directly influence the number of organs procured for transplantation.For many years, the authorisation of organ procurement has been discussed as a contributory factor to the number of potential organ donors. This paper presents different forms of authorisation and their influence on the decisions of both individuals and society. The general legal framework for the authorisation of organ procurement in Poland is described along with the solutions implemented by countries in which both implicit and explicit consent models are in effect. The presented arguments suggest that the form of authorisation does not directly influence the number of organs procured for transplantation

Brain death criteria formulated for transplantation purposes: fact or myth?

  Medical progress has moved the boundaries of life that were set many centuries ago. The development of medical techniques has allowed us to witness cases that were unknown prior to the introduction of reanimation procedures and mechanical ventilation. Towards the end of the 1950s, the term “irreversible coma” was coined, and has evolved into what is currently known as the “brain death” concept. This latter concept, proposed in 1968, is very often referred to as the new definition of death, even in medical circles. What, up until this time, used to be the classic definition of death, namely cessation of circulation and respiration, should now be recognized as the classic criteria for death. Indeed, the new criteria for recognizing death has not resulted in changing the current criteria, but in complementing them. The first part of this paper presents brief descriptions of death in the humanities over the centuries and the impact of progress in medicine on changes in how death is defined today. The second part brings to light the complexity of creating the foundations of the neurological criteria for death. The integration of concepts from two complementary medical fields — neurology and transplantology — is described. Although for some period of time they have been linked together, they may grow independently in the future. The jargon phrase “brain death” is nowadays recognized as synonym of death, but in fact should be considered tantamount to declaring pronouncing a person’s death.

Zapalny ból kręgosłupa — co możemy zrobić przed wypisaniem wniosku rentowego?

Inflammatory-mediated back pain (IBP) is the main criterion to work up in the direction of the disease from a spectrum of spondyloarthropathies. In Europe, the delay in establishing chronic inflammatory-mediated axial spondyloarthropathy as the cause of back pain takes an average of 6–7 years. In P oland, upon national health insurance company statistics, diagnoses related to back pain are the main reason for work disability. The disproportion between the frequency of diagnosis the spondyloarthropathy and back pain as a cause of sick leave assumes to summarize the algorithm and management available at the general practitioners level based upon the current Assessment of SpondyloArthritis International Society (ASAS) recommendation.Ból pleców wywołany zapaleniem jest głównym kryterium dla rozpoznania choroby z kręgu spondyloartropatii (SpA). W Europie opóźnienie w rozpoznaniu pr zewlekłego zapalenia szkieletu osiowego jako przyczyny bólu pleców wynosi średnio 6–7 lat. W Polsce, na podstawie statystyk Zakładu Ubezpieczeń Społecznych (ZUS), rozpoznania powiązane z dolegliwościami bólowymi pleców są najczęstszą przyczyną absencji chorobowych. Mając na względzie nieproporcjonalnie niski odsetek pacjentów z diagnozą osiowej SpA do liczby rozpoznań z kręgu „bólu pleców”, w artykule przedstawiono algorytm diagnostyczny oraz możliwości postępowania. Uwzględniono działania dostępne w ramach podstawowej opieki zdrowotnej (POZ) w sytuacji podejrzenia zapalnego bólu kręgosłupa zgodne z aktualnymi wytycznymi Międzynarodowego Towarzystwa Oceny Spondyloartropatii (ASAS, Assessment in Ankylosing Spondylitis)

Toxicological pitfalls in ICU practice

Either analgosedation or central nervous system dysfunction may be a side effect of implemented pharmacologicaltreatment, as well as a consequence of intentional or unintentional poisoning. In traumatic lesions or anoxia of thecentral nervous system, a question arises after a recommended follow-up period about the effects of xenobiotics onnervous system function. Although therapeutic drug monitoring is the gold standard in such cases, usually a singletoxicological estimation of “a neurodepressive compound” is performed after treatment discontinuation in order todetermine the type and amount of exogenous substances, or their metabolites, in a patient’s bodily fluids, whichallows for an assessment of its actual effects on central nervous system functions. The aim of this paper was to describethe aspects of diagnostic toxicology which are essential for improved determination of the type and amountof exogenous substances present in biological fluids of intensive care patients. We present examples of clinical casesin order to discuss the most common discrepancies in interpretation related to the ordering of toxicology tests

Lend me your ear: Frank’s sign as a non-invasive method of vascular disease risk assessment

Cardiovascular diseases are the most common cause of unfitness for work and mortality in Polish people. The recommendations of all scientific associations emphasise the key role of primary prevention of diseases of affluence; however, demographic forecasts and the actual data concerning prevention do not indicate any trend for reduced morbidity and mortality in Poland. The article discusses Frank’s sign (earlobe crease), which appears on the earlobe in the fifth or sixth decade of life and correlates with atherosclerosis-related vascular diseases. The article presents the most important epidemiological data, description of the sign as well as important information from the literature on this simple physical assessment for the diagnosis of atherosclerosis-related vascular diseases. Checking whether the patient has Frank’s sign is a non-invasive and cost-free diagnostic tool for screening for atherosclerosis complications. Sensitivity of 62% indicates a chance for early detection of ischaemic heart disease in the asymptomatic population

Cross-Sectional Inverse Associations of Obesity and Fat Accumulation Indicators with Testosterone in Non-Diabetic Aging Men

Introduction/Objective: The aim of the study was to show which of the adipose tissue accumulation indicators correlate with testosterone disorders in non-diabetic aging men. Material and methods: 455 non diabetic men, recruited at primary care facilities, aged 50–75 participated in the study. The participants underwent anthropometric measurement and ELISA determination of total testosterone (TT), estradiol (E2), dehydroepiandrosterone sulphate (DHEA-S), sex hormone binding protein (SHBG), and the determination of fasting glucose (FPG), high-density lipids cholesterol (HDL-Ch), and triacylglycerols (TAG) in serum. The following indicators were calculated: body mass index (BMI), waist-to-hip ratio (WHR), lipid accumulation product (LAP), and visceral adiposity index (VAI). Results: Men with testosterone deficiency syndrome (TDS) differed in each of the assessed obesity indices from those without TDS. All of the studied parameters correlated significantly negatively with TT concentration in blood serum, with VAI being the strongest predictor of TDS. It was shown that the threshold value at which the risk of TDS increased was 28.41 kg/m2 for BMI, 1.58 for VAI, 104 cm for WC, and 37.01 for LAP. Conclusions: Indicators of fat accumulation that take into account biochemical parameters in assessing lipid metabolism are better markers of actual body fat deposition than indicators based solely on anthropometric measurements. Among them, VAI seems the most suitable biomarker of TDS in non-diabetic aging men

Mapping trust relationships in organ donation and transplantation: a conceptual model.

The organ donation and transplantation (ODT) system heavily relies on the willingness of individuals to donate their organs. While it is widely believed that public trust plays a crucial role in shaping donation rates, the empirical support for this assumption remains limited. In order to bridge this knowledge gap, this article takes a foundational approach by elucidating the concept of trust within the context of ODT. By examining the stakeholders involved, identifying influential factors, and mapping the intricate trust relationships among trustors, trustees, and objects of trust, we aim to provide a comprehensive understanding of trust dynamics in ODT. We employ maps and graphs to illustrate the functioning of these trust relationships, enabling a visual representation of the complex interactions within the ODT system. Through this conceptual groundwork, we pave the way for future empirical research to investigate the link between trust and organ donation rates, informed by a clarified understanding of trust in ODT. This study can also provide valuable insights to inform interventions and policies aimed at enhancing organ donation rates