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Tytuł:
Anti-inflammatory activity of Turkey source pumpkin seed oil in rat oedema model
Autorzy:
Arslanbaş, Emre
KARA, Haki
KARAYİĞİT, Mehmet Ö.
DOĞAN, Halef O.
YILDIZ, Şeyma N.
Powiązania:
https://bibliotekanauki.pl/articles/895458.pdf
Data publikacji:
2020-04-29
Wydawca:
Polskie Towarzystwo Farmaceutyczne
Tematy:
rat
Anti-inflammatory
carrageenan
indomethacin
pumpkin seed oil
oedema model
Opis:
This study aimed to determine the effects of Turkey-sourced pumpkin seed oil (PSO), administered orally to rats in different dosages, to research its anti-inflammatory effect in rat oedema model, induced by carrageenan, based on different dosages, and to evaluate its effects comparatively with indomethacin. The study was conducted on 42 rats in total, divided into 7 groups (control, carr, PSO40, PSO100, PSO40+carr, PSO100+carr and indo+carr). In the study, doses of 40 and 100 mg/kg of PSO were found to significantly suppress rat paw oedema in time, and it was observed that this effect was more pronounced in the fourth hour. It was found that MDA and cytokine (TNF-α, IL-6, IL-1β) levels were inhibited, and GPX and SOD activities were enhanced in groups that received PSO and indo+carr groups. Histopathological examinations also support these findings. As a result of the study, the significant anti-inflammatory effect of Turkey-sourced PSO was attributed to the existence of unsaturated fatty acids and enriched phytochemical compounds.
Źródło:
Acta Poloniae Pharmaceutica - Drug Research; 2020, 77, 2; 305-312
0001-6837
2353-5288
Pojawia się w:
Acta Poloniae Pharmaceutica - Drug Research
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
JWH133, a Cannabinoid receptor-2 agonist, attenuates neurological deficits and brain oedema after experimental Intracerebral Haemorrhage in mice
Autorzy:
Iniaghe, Loretta O.
Burchell, Sherrefa R.
Tang, Jiping
Zhang, John
Powiązania:
https://bibliotekanauki.pl/articles/895440.pdf
Data publikacji:
2019-08-30
Wydawca:
Polskie Towarzystwo Farmaceutyczne
Tematy:
oedema
intracerebral haemorrhage
neurological deficit
JWH133
cannabinoid receptor 2
Opis:
Abstract: Intracerebral haemorrhage is a subtype of stroke which has highest mortality and morbidity rates and currently has no cure. Cannabinoid 2 (CB2) receptor expression is up-regulated in neuronal injuries. CB2 receptor agonists were found to be neuroprotective in brain injuries including ischaemic and haemorrhagic stroke. This study was carried out to investigate the effects of cannabinoid 2 receptor (CB2R) activation by JWH133 on intracerebral haemorrhage (ICH) induced blood brain barrier disruption and oedema formation. ICH was induced in experimental animals by collagenase injection which causes significant vascular disruption and concomitant increase in oedema; animals were then treated with JWH133. Sixty CD-1 mice were randomly divided into sham, vehicle, and JWH133-treated groups (1 mg/kg and 10 mg/kg). Neurobehaviour, brain water content, Evans Blue dye extravasation, haemoglobin content, lung water content, and body weights post ICH were assessed. JWH133 treatment attenuated neurological deficits at 24 and 72 hours post-ICH. The treatment also reduced brain water content and Evans blue dye extravasation but had no effect on haemoglobin content and lung water content. Administration of JWH133 treatment mitigated weight loss at 48 and 72 hours after ICH. The reduction in brain water content and Evans blue dye extravasation indicate that CB2 receptor activation decreases blood brain barrier disruption and brain oedema, resulting in improved neurological functioning. This suggests that activation of the CB2 receptor by JWH133 is neuroprotective after ICH and may be a therapeutic target. Further study is needed to explore the mechanisms by which these effects occur.
Źródło:
Acta Poloniae Pharmaceutica - Drug Research; 2019, 76, 4; 735-743
0001-6837
2353-5288
Pojawia się w:
Acta Poloniae Pharmaceutica - Drug Research
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Lower-limb ooedema during pregnancy
Obrzęk kończyn dolnych u kobiet w ciąży
Autorzy:
Ochałek, Katarzyna
Frydrych-Szymonik, Aleksandra
Szyguła, Zbigniew
Powiązania:
https://bibliotekanauki.pl/articles/1798651.pdf
Data publikacji:
2016
Wydawca:
Akademia Wychowania Fizycznego im. Bronisława Czecha w Krakowie
Tematy:
Pregnancy
oedema
chronic vein insufficiency
Ciąża
obrzęk
niewydolność żylna
Opis:
Lower-limb oedemas can be the result of abnormalities in the structure and functioning of the lymphatic system, injuries or inflammation, or can be related to cancer and its treatment; however, they are more often one of the basic symptoms accompanying women in the third trimester of pregnancy due to vein insufficiency. The purpose of this overview is to discuss the current knowledge related to risk factors, prevention and treatment of lower-limb oedemas during pregnancy. The risk factors linked to gravidity-related oedema comprise of increased volume of circulating blood, the augmented uterus, increased body mass and changes to hormonal turnover. Vein insufficiency occurs as a result of venous hypertension caused by insufficiency of the muscle pump and valvar regurgitation. Pregnancy, the application of Caesarean section and the postpartum period predispose to deep vein thrombosis (DVT). The basic and unquestionable method applied in the prophylaxis and treatment of abnormalities to the venous-lymphatic system and corresponding complications consists in compression therapy involving compressive bandaging and the use of compression garments. Compression can be applied either individually or in combination with other methods, such as manual lymph drainage, intermittent pump compression and physical or breathing exercises. Based on the scientific evidence and experts’ recommendations, compression is also considered to be an effective solution in the prevention and treatment of deep vein thrombosis and swelling in pregnant women, but further investigation is needed. Ochałek K., Frydrych-Szymonik A., Szyguła Z. Lower-limb oedema during pregnancy. Med Rehabil 2016; 20(4): 17-21. DOI: 10.5604/01.3001.0009.5481
Autorzy przedstawili przypadek 30-letniego mężczyzny, u którego doszło do nagłego zatrzymania krążenia w wyniku porażenia prądem wysokiego napięcia. Od 2. tygodnia po wypadku przeprowadzano rehabilitację w warunkach szpitalnych, mającą na celu utrzymanie zakresu ruchomości w stawach oraz od 6. tygodnia przeprowadzano intensywną rehabilitację w warunkach domowych. Mimo przeprowadzanego leczenia zaobserwowano całkowite ograniczenie ruchomości stawów biodrowych oraz w oparciu o radiogram i projekcję przestrzenną TK zdiagnozowano masywne neurogenne skostnienia heterotopowe (NSH). Przeprowadzono dwa zabiegi mające na celu usunięcie NSH: najpierw z okolicy lewego (15. miesiąc od wypadku), a następnie prawego stawu biodrowego (18. miesiąc od wypadku). Po interwencji zaobserwowano istotny wzrost ruchomości obu stawów biodrowych oraz zmniejszenie dolegliwości bólowych, co w efekcie znacznie poprawiło możliwości funkcjonalne pacjenta. Dodatkowo wprowadzono profi laktykę zapobiegającą nawrotom NSH, która polegała na utrzymaniu zarówno biernego, jak i czynnego zakresu ruchu oraz na stosowaniu zabiegów fi zykoterapeutycznych w postaci głębokiej oscylacji. W badaniu TK, wykonanym w 41. miesiącu po wypadku, uwidoczniono NSH w mniejszym stopniu, aniżeli miało to miejsce pierwotnie.
Źródło:
Medical Rehabilitation; 2016, 20(4); 17-21
1427-9622
1896-3250
Pojawia się w:
Medical Rehabilitation
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Posterior reversible encephalopathy syndrome – Case report
Autorzy:
Kulczynski, M.
Kuroska, G.
Sapko, K.
Marciniec, M.
Munoz-Niklitschek, E.
Dyndor, P.
Dyndor, K.
Powiązania:
https://bibliotekanauki.pl/articles/2098209.pdf
Data publikacji:
2020
Wydawca:
Instytut Medycyny Wsi
Tematy:
oedema
posterior reversible encephalopathy syndrome
seizure
nausea
neurological deficit
ischaemia
magnetic resonance imaging
Opis:
Introduction. Posterior reversible encephalopathy syndrome (PRES) is a group of clinical disorders typically manifested by the presence of seizures, headache, impaired consciousness, nausea and focal neurological deficits. It is stated that PRES is a result of high blood pressure which leads to impaired self-regulation and hyperperfusion causing endothelial damage and vasogenic oedema or that excessive arteriolar vasoconstriction causes reduced blood flow, thus causing ischemia and cytotoxic oedema. Case Report. A 21-year-old woman was admitted to obstetrics & gynaecology department with symptoms of eclampsia. CT of the head revelaed a holohemispheric watershed pattern. MRI confirmed the presence of vasogenicoedema in the affected regions, typical for PRES. C-section was performed. Ten days after administering treatment, MRI showed complete withdrawal of the lesions. The diagnosis of PRES was based on clinical symptoms and MRI, with typical cortical and subcortical oedema without infarction.
Źródło:
Journal of Pre-Clinical and Clinical Research; 2020, 14, 4; 123-125
1898-2395
Pojawia się w:
Journal of Pre-Clinical and Clinical Research
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Olbrzymie guzy nowotworowe piersi w materiale Oddziału Opieki Paliatywnej
Giant breast tumours. Experience of a regional Palliative Care Unit
Autorzy:
Pietrzyńska, Tatiana
Podwińska, Ewa
Olejek, Anita
Turek, Sebastian
Powiązania:
https://bibliotekanauki.pl/articles/908520.pdf
Data publikacji:
2009
Wydawca:
Medical Communications
Tematy:
breast cancer
giant tumour
lymphatic oedema
palliative care
ulcer
Opis:
Breast cancer is the most common malignant tumour developing in Polish women. Each year, over 11,000 new cases are registered in our country. Breast cancer is the leading cause of mortality due to malignant neoplasms in the females. The aim of paper, apart of presenting extremely advanced clinical cases of breast cancer and management strategies implemented, is to highlight the complexity of this problem, due overlapping of several medical and social factors. Inoperable, locally advanced breast cancer usually presents clinically as a giant primary tumour, frequently with extensive metastases in the axillary fossa. Giant breast tumour, with a diameter exceeding 5 cm, frequently extensively invading skin and deeper tissues, is usually accompanied by lymphatic oedema. Occurrence of such clinically advanced and morphologically gigantic forms of breast cancer in the material of Palliative Care Unit is most often due to one of the following: dynamic progression or recurrence of the disease, refusal of cause-oriented treatment or its interruption and extreme neglect. The main treatment option in this group of patients is aggressive induction chemotherapy. If surgery is contraindicated, patients undergo radical radiotherapy. Principal goal of therapy at a palliative care unit is relief of symptoms and improvement of quality of life, realized by medical and non-medical means. Psychological and spiritual support aims at creating a positive attitude of the patient towards his or her condition. The key factor is partner-like relations with patients, preservation of their autonomy and respect for their decisions concerning continuation of further treatment.
Rak piersi jest najczęstszym nowotworem złośliwym występującym u kobiet w Polsce. Każdego roku w naszym kraju rejestruje się ponad 11 000 nowych zachorowań. Rak piersi jest także przyczyną największej liczby zgonów spowodowanych przez nowotwory złośliwe u kobiet. Celem pracy - oprócz przedstawienia krytycznie zaawansowanych obrazów klinicznych raka piersi i metod postępowania leczniczego - jest zwrócenie uwagi na złożoność problemu i nakładanie się różnorodnych czynników zdrowotnych i społecznych. Nieoperacyjny, miejscowo zaawansowany rak piersi obejmuje przypadki, dla których typowe są duży pierwotny guz oraz najczęściej rozlegle przerzuty w dole pachowym. Olbrzymi guz piersi - o średnicy przekraczającej 5 cm - często nacieka rozlegle skórę, tkanki położone głębiej, zazwyczaj towarzyszy mu obrzęk limfatyczny. Występowanie zaawansowanych klinicznie - często olbrzymich morfologicznie - postaci raka piersi w analizowanym materiale Oddziału Opieki Paliatywnej ma najczęściej trzy źródła: krytyczny rozwój lub nawrót choroby, odmowę leczenia przyczynowego lub jego zaniechanie oraz krytyczne zaniedbania. Podstawowym leczeniem systemowym w tej grupie chorych jest agresywna chemioterapia indukcyjna. W przypadku przeciwwskazań do zabiegu operacyjnego leczeniem z wyboru jest radykalna radioterapia. Zasadniczy cel leczenia na oddziale opieki paliatywnej to przede wszystkim łagodzenie objawów choroby oraz poprawa jakości życia, co uzyskuje się na drodze postępowania medycznego i niemedycznego. Poprzez wsparcie psychologiczne i duchowe dąży się do tego, aby pacjent osiągnął pozytywną ocenę swojego stanu. Istotne jest podmiotowe traktowanie chorego, dbałość o zachowanie jego autonomii i szanowanie jego decyzji co do dalszego postępowania terapeutycznego.
Źródło:
Ginekologia Onkologiczna; 2009, 7, 2; 132-137
1731-5379
Pojawia się w:
Ginekologia Onkologiczna
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Jakość życia i stan zdrowia u pacjentów z obrzękiem kończyn dolnych
Quality of life and state of health of patients with oedema of lower extremities
Autorzy:
Fiodorenko-Dumas, Z.
Paprocka-Borowicz, M.
Dumas, I.
Kolcz-Trzesicka, A.
Powiązania:
https://bibliotekanauki.pl/articles/3993.pdf
Data publikacji:
2012
Wydawca:
Instytut Medycyny Wsi
Źródło:
Medycyna Ogólna i Nauki o Zdrowiu; 2012, 18(47), 3
2083-4543
Pojawia się w:
Medycyna Ogólna i Nauki o Zdrowiu
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Acute dyspnea as a manifestation of Forestiers disease. A case report
Autorzy:
Kuryłowicz, Jagoda
Stodulski, Dominik
Garsta, Ewa
Mikaszewski, Bogusław
Powiązania:
https://bibliotekanauki.pl/articles/1398952.pdf
Data publikacji:
2021
Wydawca:
Index Copernicus International
Tematy:
acute laryngeal dyspnea
diffuse idiopathic skeletal hyperostosis
dysphagia
Forestier’s disease
laryngeal oedema
otolaryngological symptoms
stridor
tracheotomy
Opis:
Introduction: Diffuse idiopathic skeletal hyperostosis (DISH), also known as Forestier’s disease, is a noninflammatory disease and is characterized by ossification of the anterolateral aspect of vertebral bodies, mostly in thoracic part of the spine. Although, usually, DISH is asymptomatic, in rare cases osteophytes located in the cervical part of the spine can cause otolaryngological manifestations, such as dysphagia (most common), hoarseness and stridor Case report: In differential diagnosis of upper respiratory tract symptoms, we should consider DISH. We present case of 82-years old male patient with acute dyspnea, who was diagnosed with osteophytes of C4–C7 vertebral bodies. In this case conservative therapy was not efficient, therefore successful surgical treatment was performed. BMI – Body Mass IndexCRP – C Reactive Protein CT – computed tomography DISH – diffuse idiopathic skeletal hyperostosis GERD – gastro-esophageal reflux disease MRI – magnetic resonance imaging NSAIDs – nonsteroidal anti-inflammatory drugs ORL PPI – proton pump inhibitors Diffuse idiopathic skeletal hypMRerostosis (DISH), also known as Forestier’s disease, was first described under the name “senile ankylosing hyperostisis of the spine” by Jacques Forestier in 1950 [1]. It is a noninflammatory disease, characterized by ossification of the anterolateral aspect of vertebral bodies, mostly in thoracic part of the spine. It may also involve enthesopathy of the extremities. Forestier’s disease is a rather common condition, which affects approximately 40% of older (>65 years old) male patients. Prevalence of DISH increases with age (56% for age >80 years old), BMI and blood pressure [2] and is associated with diabetes mellitus, elevated insulin-like growth factor and hyperuricemia [3].Although usually DISH is asymptomatic, in rare cases osteophytes located in the cervical part of the spine can cause otolaryngological manifestations, such as dysphagia (most common), hoarseness and stridor [4–10]. null null null null An 82-years old man was admitted to the Department of Otolaryngology due to acute dyspnea with stridor at rest. Respiratory disorder was progressing for 2 months. Moreover, patient complained of dysphagia and hoarseness, which were present for a year. The patient was diagnosed with GERD and treatment was administrated. Medical history was significant of duodenal ulcer with perforation and prostate cancer treated with hormonal therapy for 13 months. Flexible nasopharyngoscopy revealed large mass protruding from the posterior wall of hypopharynx and oedema, which concealed interarytenoid notch and partly rima glottis (Fig. 1.). No other abnormalities in ORL examination were present. Increased CRP level and impaired fasting glucose were found in laboratory tests during hospitalization. CT (Fig. 2.) and MRI (Fig. 3.) revealed massive osteophytes on the anterior part of vertebral bodies C4–C7 without intervertebral disc space narrowing, thickened vestibular folds and peri-arytenoid region. X-ray revealed no changes in sacro-iliac joints. Hypopharyngoscopy and microlaryngoscopy were performed in due to rule out neoplastic changes. Antibiotis, steroids and high doses of PPI (proton pump inhibitors) were administered, resulting in oedema decrease and resolution of the symptoms. After 7 months patient was hospitalized again, due to acute dyspnea and stridor. Increased CRP level was found in laboratory tests. Despite conservative therapy (corticosteroids, antibiotics and PPI) no significant respiratory improvement was achieved, therefore decision on surgical treatment was made. Patient was referred to the Department of Neurosurgery where, after elective tracheotomy, cervical osteophytes (C2–C5) were removed, using an anterolateral transcervical approach, without any complications (Fig. 4.). Because of postoperative laryngeal and hypopharyngeal oedema, steroid therapy was maintained. Decannulation was performed on 7th postoperative day, although patient complained of more severe dysphagia with aspiration while swallowing. Nasogastric feeding tube was inserted for 3 weeks. At the 6-month follow up dyspnea and dysphagia are absent, patient successfully swallows solid food and liquids. Endoscopic examination revealed only small protrusion and minor oedema on posterior wall of hypopharynx on the level of arytenoids (Fig. 5., 6.). null null Forestier’s disease otolaryngological manifestations are extremely rare. The most common symptom is dysphagia, aside from it aspiration [11], dyspnea (with or without stridor) and hoarseness [4].Our patient’s main complaint and reason of hospitalization was dyspnea, while dysphagia was secondary problem. Foregoing symptoms can occur not only due to osteophytes compression on larynx and esophagus, but also because of chronic inflammation and chronic or recurrent edema caused by mechanic irritation. Other symptoms, such as aspiration while swallowing, can be caused by impaired movability of epiglottis or vocal chords [8, 11].In presented case symptoms (especially dyspnoe) were increasing during upper respiratory tract infections and due to exacerbation of GERD.In literature authors described similar cases, where inflammation led to oedema, chronic or remitting during infection, which worsened patient’s condition [12, 13] and caused respiratory decompensation, necessitating even urgent tracheotomy [10].During diagnosis of DISH with otolaryngologic manifestations, mirror laryngoscopy and fiberoscopy should be performed. It can reveal fine, firm protrusion on the posterior wall of pharynx, accompanied by oedema and impaired movability of larynx [8].In differential diagnosis of protrusion on the posterior wall of pharynx we should consider retropharyngeal pathologies, such as malignant tumors (including lymphoma), benign tumors, metastases, congenital defects (e.g. vascular malformations), lymphadenopathy, retropharyngeal abscess or massive oedema. Imaging (CT, MRI) can rule out these diseases [14].Forestier’s disease should also be distinguished from other pathologies, which involve vertebral bodies, including ankylosing spondylitis, osteophytes in osteoarthritis or osteomas [3]. Differential diagnosis can be based on Resnick’s radiological classification criteria of DISH [15]: presence of flowing calcification and ossification along with the anterolateral aspects of at least four contiguous vertebral bodies, relative preservation of intervertebral disc height in the involved vertebral segments and absence of apophyseal joint bony ankylosis and sacro-iliac joint erosion, sclerosis or bony fusion.In cases with dysphagia being the main patient’s complaint, esophagogram with barium swallowing should be performed [5, 9, 11]. Elective panendoscopy with biopsy should always be considered to rule out neoplasm [5, 16].If DISH is diagnosed accidently in imaging, we can assume an expectant attitude. Conservative treatment with NSAIDs, steroids and dietary measures can be introduced in cases without weight loss and with minor respiratory symptoms. Gastroesophageal reflux can be symptom-worsening factor, therefore PPI treatment should be considered. If conservative treatment is not effective, osteophytes’ surgical removal is recommended, preferably using anterolateral approach [16].In our case, conservative therapy was not sufficient. Massive hypopharyngeal oedema and stridor were present in spite of high doses of corticosteroids. Due to the pre-operative oedema we decided to perform an elective tracheotomy before neurosurgical intervention, to avoid possible complications [13].It is remarkable, that after surgery dyspnea resolved after few days, whilst dysphagia and aspiration worsened in post-operative time and nasogastric tube insertion was necessary.Authors present this case in aim to draw attention to Forestier’s disease as possible reason for respiratory and gastrointestinal symptoms among elderly people.
Źródło:
Polski Przegląd Otorynolaryngologiczny; 2021, 10, 1; 49-52
2084-5308
2300-7338
Pojawia się w:
Polski Przegląd Otorynolaryngologiczny
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Subthreshold micropulse yellow 577 nm laser therapy of diabetic macular oedema in rural and urban patients of south-eastern Poland
Autorzy:
Latalska, Małgorzata
Prokopiuk, Agata
Wróbel-Dudzińska, Dominika
Mackiewicz, Jerzy
Powiązania:
https://bibliotekanauki.pl/articles/989023.pdf
Data publikacji:
2017
Wydawca:
Instytut Medycyny Wsi
Tematy:
diabetic maculopathy
macular edema
laser treatment
micropulse laser
diabetic retinopathy
Opis:
Objectiv. To evaluate the efficacy of subthreshold micropulse yellow (577 nm) laser photocoagulation in diffuse macular edema (DME) in rural and urban patients of south-eastern Poland. Materials and method. Seventy-five eyes of 75 patients with diffuse DME were treated with subthreshold micropulse yellow laser photocoagulation with a 5% duty cycle at an energy level. The laser exposure time was 20 ms and the spot diameter was 100 μm. Best corrected visual acuity (BCVA), reading vision (Snellen) and optical coherence tomography-determined central retinal thickness (CRT) were estimated before and 2, 4 and 6 months after laser treatment. There were no statistically important differences in: the advancement of DME, HbA1c (glycated hemoglobin) level, duration of diabetes mellitus (DM), the degree of vision damage between rural and urban patients. Results. The follow-up was 6 months later. The baseline BCVA was 0.20 and remained stable- 0.3 after 6 months. The Snellen at baseline was 1.0 and improved to 0.5 finally (p=0.0004). The CRT at baseline was 500 μm and changed to 346 μm (p=0.00000) at the final follow-up. Finally, no retinal damage was observed. Conclusions. Place of residence had no statistically significant effect on the demographics data, baseline visual acuity, reading visual acuity and central retinal thickness. Subthreshold micropulse yellow laser showed a highly significant efficiency in the treatment of DME. The effects of the treatment were more significant in rural patients than in urban ones.
Źródło:
Annals of Agricultural and Environmental Medicine; 2017, 24, 1
1232-1966
Pojawia się w:
Annals of Agricultural and Environmental Medicine
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Hemikraniektomia dekompresyjna w leczeniu związanego z udarem niedokrwiennym złośliwego obrzęku mózgu – przegląd badań klinicznych
Decompressive hemicraniectomy for treatment of malignant cerebral oedema after ischaemic stroke – areview of clinical trials
Autorzy:
Borysowicz, Andrzej
Janik, Piotr
Powiązania:
https://bibliotekanauki.pl/articles/1029818.pdf
Data publikacji:
2017
Wydawca:
Medical Communications
Tematy:
hemikraniektomia dekompresyjna
udar niedokrwienny mózgu
złośliwy obrzęk mózgu
Opis:
Extensive ischaemic strokes resulting from middle cerebral artery occlusion may lead to massive cerebral oedema and cause an abrupt intracranial pressure increase. Life-threatening malignant cerebral oedema, which is found in 1–10% of patients with supratentorial stroke, usually develops from day two to day five after the onset of the symptoms of stroke. It frequently concerns younger patients with no prior history of ischaemic events. Clinical signs include consciousness disorders that accompany profound neurological deficits. Conventional conservative treatment is poorly effective. It seems therefore that decompressive hemicraniectomy may be a promising option. This article is a review of the most important randomised clinical trials and meta-analyses concerning this treatment method. The results indicate that hemicraniectomy in patients younger than 60 years of age is associated with lower mortality but many patients still require permanent or temporary care. The effects of surgical treatment in patients older than 60 years of age are worse. Hemicraniectomy does increase survival, but this effect is achieved at the cost of very severe disability in the vast majority of patients. The decision about hemicraniectomy should be made with caution after discussing the prognosis concerning survival and probable poor performance with the patient and his or her family. According to the current recommendations, there are no grounds for rendering patients ineligible for the procedure due to the dominant hemisphere involvement.
Rozległe udary niedokrwienne wynikające z zamknięcia tętnicy środkowej mózgu mogą prowadzić do rozwoju masywnego obrzęku mózgu i gwałtownego wzrostu ciśnienia śródczaszkowego. Zagrażający życiu złośliwy obrzęk mózgu, występujący u 1–10% chorych z udarami nadnamiotowymi, rozwija się zazwyczaj w okresie od drugiej do piątej doby po wystąpieniu objawów udaru. Często dotyczy młodszych pacjentów, bez wcześniejszych incydentów udarowych w wywiadzie. Klinicznie obserwuje się pogorszenie stanu świadomości towarzyszące głębokiemu deficytowi neurologicznemu. Tradycyjne sposoby leczenia zachowawczego są mało efektywne, wydaje się zatem, iż obiecującą strategią postępowania może być dekompresja neurochirurgiczna. W pracy dokonano przeglądu najważniejszych randomizowanych badań klinicznych i metaanaliz dotyczących tej metody leczenia. Wyniki badań wskazują, że u osób przed 60. rokiem życia hemikraniektomia wiąże się ze spadkiem śmiertelności, jednak wielu chorych wymaga stałej lub czasowej opieki. Efekty operacyjnego leczenia pacjentów po 60. roku życia są gorsze. Hemikraniektomia zwiększa co prawda przeżywalność, niemniej w znakomitej większości przypadków kosztem bardzo ciężkiej niepełnosprawności. Decyzja o przeprowadzeniu hemikraniektomii powinna być podejmowana ostrożnie, po przedstawieniu choremu i jego rodzinie rokowania co do przeżycia i prawdopodobnego złego stanu funkcjonalnego. Zgodnie z aktualnymi rekomendacjami nie ma natomiast podstaw, by wykluczać chorych z zabiegu ze względu na zajęcie półkuli dominującej.
Źródło:
Aktualności Neurologiczne; 2017, 17, 3; 137-143
1641-9227
2451-0696
Pojawia się w:
Aktualności Neurologiczne
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Electrocardiographic changes in lung cancer. Be careful not to misdiagnose: acute coronary event?, meta?, inflammation?
Autorzy:
Styczkiewicz, Katarzyna
Kostkiewicz, Agnieszka
Górecki, Michał
Iwański, Mateusz A.
Powiązania:
https://bibliotekanauki.pl/articles/44427697.pdf
Data publikacji:
2024-04-07
Wydawca:
Medical Education
Tematy:
electrocardiogram
lung cancer
myocardial oedema
Opis:
In cancer patients changes in the electrocardiogram (ECG) may indicate various causes. The presented case concerns a patient with advanced left lung cancer who presented deep inversion of T waves during ongoing chemotherapy. We excluded acute coronary syndrome, acute pulmonary embolism, and myocarditis. Subsequently, we suspected metastases to the myocardium; therefore, we performed cardiac magnetic resonance imaging, which however did not confirm that. The cardiac magnetic resonance imaging showed residual post-inflammatory changes in the left lung. We publish this case to show that the inflammatory process of lung segments adjacent to the heart may cause temporal myocardial oedema, resulting in ECG changes that may mimic acute coronary events.
Źródło:
OncoReview; 2024, 14, 1; 16-20
2450-6125
Pojawia się w:
OncoReview
Dostawca treści:
Biblioteka Nauki
Artykuł
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