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Lithium is a medicine of the first choice in the preventive treatment of bipolar affective disorder. It is also used to enhance the treatment of drug resistant depression. How excatly this element acts is not yet fully understood. Lithium influences the transportation of sodium via cellular membranes (sodium-potassium ATPase dependant), has an inhibitory influence on the second transmitter system (connected with phosphatidylinositol), thus probably acting as a stabiliser of inter cellular processes. Lithium does not associate with plasmatic proteins and is almost entirely excreted by kidneys. The side effects of the medicine are linked to its influence on the central nervous system and on the renal transportation of electrolytes as well as the narrow therapeutic index of the medicine, which can cause intoxication if the recommended doses are not when medical recommendations are not observed. The undesirable effects are more intensive when the level of lithium in the blood plasma increases. Among the most common side effects are stomachaches, nausea, diarrhoea, lack of appetite, polydipsia, polyuria, shaking hands, headaches, sleepiness or deterioration of memory. Complications during lithium therapy listed in literature are ataxia, dysarthria, nystagmus and extrapyramidal symptoms, but the most severe complication is lithium poisoning. Lithium can be applied for a long-term maintenance treatment, which limits recurrence of the disease and improves the patient’s family, social and occupational life. The inferior quality of life among patients with affective disease can result from the disorder itself or can develop on the somatic grounds, appear due to abuse of tobacco or alcohol, or else be a side effect of other medicines taken by the patient. Good co-operation with the patient during the therapy can lessen the pronouncement of undesirable symptoms and complications of a lithium treatment, and this in turn can improve of the quality of the patient’s life.
Anorexia nervosa and bulimia are emotional disorders which are a serious hazard to the physical health or life. They most often affect girls and young women and disorganize their mental and social life. In this paper, complications caused by eating disorders as a result of deficiency or excessive loss of bioelements by an organism are reviewed along their influence on the quality of life. The symptoms of anorexia nervosa are the following: weight loss over 15% of the standard body mass for the age and height, severe fear of body weight gain despite clear evidence of weight deficiency. The main symptoms of bulimia involve uncontrolled overeating and counteracting weight gain which could occur after overeating episodes by self-induced vomitting or overuse of laxatives and diuretics. Medical complications of bulimia are related to the method and frequency of purgation, while in anorexia they are caused by starvation and weight loss. The following deviations are observed in both restrictive and bulimic forms on anorexia: hypokalemia, hypocalcemia, hypophosphatemia and sometimes also hyponatremia, hypomegnesemia and hypochloremic alkalosis. Many electrolytic and acid abnormalities are found in bulimia depending on the method for laxation (self-induced vomitting, misuse of laxatives or diuretics). Most patients adapt well for a relatively long time to low levels of potassium in plasma but sometimes the situation may cause life threatening consequences, like dysrhythmia, paralytic ileus, neuropathy, muscle weakness and paresis. Physicians and patients should understand that anorexia nervosa is a systemic disease and can affect all body organs. Full knowledge about possible complications of anorexia nervosa allows physicians to achieve precise assessment and conduct appropriate treatment of patients when the diagnosis has already been made.
1. The map presented shows complex field investigations undertaken by various institutes and aiming at research on diseases with natural foci. In 1953 and further, in the years 1955-1959 systematical zoological-ecological investigations were carried out in the foci of Szczecin and Lublin areas, the results of which are shown in table I. In the region of the Szczecin province 3 358 mammals were examined, and in the Lublin area 4 501 small mammals (partially other animals, too). 2. Ectoparasites were recovered from 2 200 mammals caught in the Lublin district. In the material collected in the period from 1.7.1957. to 1.7.1959. were found: 4 052 lice, 1946 fleas, 507 ticks of the Ixodidae family and some thousands of small Parasitoformes (tables II, III, IV). 3. From Microtus arvalis caught in natural foci of leptospirosis the following ectoparasites were examined on Brucella and Leptospira: Laelaptidae - 677 individuals, Hoplopleura acanthopus - 299, fleas - 9. The results of microbiological investigations were negative. 4. A negative result was also obtained with larvae and nymphs of Ixodes ricinus fed on 4 guinea pigs, 8 white mice and 4 Microtus arvalis, infected with a Leptospira grippotyphosa strain. 5. 278 lice Hoplopleura acanthopus were fed on Microtus arvalis infected with a virulent Brucella brucei strain, and a pure culture of this microorganism was isolated from them. This may evidence of a possible role of lice in the epizootiology of brucellosis in natural foci.
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