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Introduction. Fibromyalgia syndrome (FMS) and myofascial pain syndrome (MFPS) can be ranked among disease entities being difficult to diagnose clinically, manifesting themselves mainly through pain in specific hypersensitivity points. Aim. To present the current state of medical knowledge about pain spots appearing on hypersensitive points of soft tissue in the context of selected disease entities. Summary of the knowledge. MFPS is defined as sensory, motor and autonomic complaints, caused by the occurrence of trigger points (TrP). Yet the FMS is stated during the anamnesis on the basis of generalized pain, and pressure achiness of at least 11 out of 18 tender points (TP) of precisely determined location. Patients with FMS report numerous additional complaints – apart from the above mentioned ones; these are however highly non-specific and are not confirmed during routine medical check-ups. There are also no laboratory tests that can confirm presence of TrP being characteristic to MFPS and differentiating it from other muscles’ disease entities. Such points are identified only with the use of palpation. Unfortunately while examining a patient this way TrP – being symptoms of MFPS – can be quite easily confused with TP – being symptoms of FMS. Patients with MFPS which is developing in consequence of long-lasting global disorder of muscle tension balance and sensitivity of nociceptors as a result of chronically remaining pain, frequently suffer from achiness fulfilling the criteria of generalized pain. Moreover – in effect of static overload of soft tissues (especially of tonic muscles) – there occur hypersensitive palpable areas (points). Stimulating them cause lively reaction of the patient. Described symptoms can suggest a suspicion of FMS – the more so that making a diagnosis of MFPS does not exclude its coexistence. Having this in mind, there is a pretty large group of authors who raise a supposition that the differential diagnosis between TrP and TP should be observed in the quantitative rather than in the qualitative categories, despite the still binding definition and nomenclature. Recapitulation. Looking at the MFPS and at the FMS from the perspective of evolution of knowledge about them and from the point of view of period when scientific researches were conducted and their results published, it must be stated that during last years a considerable progress has been obtained in scope of better understanding of pathogenesis and pathophysiology of pain in specified points of soft tissue hypersensitivity, and the parallel clinical studies – confirming the hypotheses that were made – clearly increased the diagnostic and therapeutic capabilities of clinical practice.
The work reports a rare case of canine two primary malignant tumours concurrent with one benign tumour occurring within a single organism. Soft palate malignant melanoma with metastases to the regional lymph nodes and internal organs was classified as the index tumour, while thyroid carcinoma was defined as incidentaloma. The third tumour recognised was a large lipoma located in the abdominal cavity. The presented case proves that in the animal organism affected with a malignant tumour, other tumours may develop.
The structural organisation of tunica intima in the aorta is important for its integrity, prediction, and diagnosis of atherosclerosis. The goat is a suitable model for cardiovascular studies, but the structure of its tunica intima is scarcely reported. This study, therefore, aimed to describe features of the goat aortic tunica intima by light and transmission electron microscopy. Sixteen healthy male domestic goats (capra hircus) aged between 6 and 24 months were used: 8 for light and 8 for electron microscopy. The animals were euthanised with sodium pentabarbitone 20 mg/mL and fixed with 3% phosphate buffered glutaraldehyde. For light microscopy, specimens from various regions of the aorta were routinely processed for paraffin embedding and 7 μm sections stained with Mason’s trichrome. Those for transmission electron microscopy were post fixed in osmium tetroxide, embedded in Durcupan, and ultrathin sections stained with uranyl acetate and counter stained with lead citrate. Endothelium comprises round and squamous cells, linked to the subendothelial material by a simple and sometimes lamellated basement membrane. In the subendothelial zone, a heterogenous population of cells are connected with interlinked collagen and elastic fibres. Both cells and fibres are connected to the internal elastic lamina. The composite structure and interlinkages in the tunica intima permit unitary function and increase mechanical strength, thus enabling it to withstand haemodynamic stress. (Folia Morphol 2010; 69, 3: 164–169)
Surface electromyography (sEMG) is generally considered by neurologists as an unacceptable diagnostic tool for examination of changes in the activity of muscle motor units in patients with non-specifi c back pain. The aim of this review is to demonstrate the usefulness of neurophysiological findings for the application of sEMG in differentiation of root-conflict and non-root-conflict sources of muscle pathologies with pain as the main symptom. In the first experiment carried out on 30 patients with clinically recognized myofascial pain, an attempt was undertaken to find out whether surface electromyographic (sEMG) readings during relaxation and maximal contraction revealed differences in the activity of muscles with or without trigger points (TrPs) detected by palpation. In the second experiment carried out on 40 office workers similar methodologies of clinical and neurophysiological examination were used, however, with the aim to verify a hypothesis about the dysfunction of cervical and shoulder girdle muscle motor units as the cause of cervicogenic headache (CEH). The results of both experiments led to the following conclusions: 1. Surface EMG performed at rest and during maximal contraction is a precise diagnostic tool that can be used for detection of changes in the activity of motor units in patients with myofascial pain syndrome and cervocogenic headache; 2. Surface EMG readings at rest, with an amplitude exceeding 25μV, may be helpful for evaluation of increased muscle tension, which leads to a decrease of the activity of muscle motor units during maximal contraction.
Lymphadenomegaly is the enlargement of the lymph node/nodes, due to various nonneoplastic or neoplastic processes, observed mainly in dogs, rarely in other animal species. The first step of a diagnostic procedure in cases of lymph nodes enlargement, apart from physical examination and morphological blood analysis, should be a cytological examination of an enlarged lymph node/nodes. The aim of the present study was to determine the character and the cause of the lymph node/nodes enlargement in dogs and to evaluate the usefulness of fine-needle cytology in a diagnosis of lymphadenomegaly. The study was performed on dogs submitted to consultation in the Small Animal Clinic of Department of Clinical Sciences, Warsaw University of Life Sciences, due to generalized or local lymphadenomegaly, and in which fine-needle biopsy was made. A signalement, general state of dog, the presence and duration of clinical signs, the character (generalized vs. localized) and intensity (mild, moderate or severe) of lympadenomegaly were recorded during physical examination. The average age of dogs examined was 8 years, 64 were males and 36 were females of various breeds; however the majority of them were greater than 25 kg in weight. The cytological diagnosis including most often lymphoma and reactive hyperplasia, more seldom metastatic neoplasm and lymphadenitis were recognized, some of the samples were considered nondiagnostic/nondefined. On the basis of the present results it can be concluded that cytological examination of good quality samples allows to obtain final diagnosis in over 90% of lymphadenomegaly. Higher incidence of canine lymphomas in males is suggested.
We aimed to study the neurovascular relationships between the anterior inferior cerebellar artery (AICA) and the abducens nerve to help determine the pathogenesis of abducens nerve palsy which can be caused by arterial compression. Twenty-two cadaveric brains (44 hemispheres) were investigated after injected of coloured latex in to the arterial system. The anterior inferior cerebellar artery originated as a single branch in 75%, duplicate in 22.7%, and triplicate in 2.3% of the hemispheres. Abducens nerves were located between the AICAs in all hemispheres when the AICA duplicated or triplicated. Additionally, we noted that the AICA or its main branches pierced the abducens nerve in five hemispheres (11.4%). The anatomy of the AICA and its relationship with the abducens nerve is very important for diagnosis and treatment. (Folia Morphol 2010; 69, 4: 201–203)
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Dizziness - pathogenesis, diagnosis and treatment

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Dizziness is a symptom of many diseases. Patients very frequently come with such ailment to the hospital emergency department. It is a state which may last a few seconds or minutes and increase or recede with time. Therefore, the admitted patients frequently cannot assess their own illness in a precise and objective way. The dizziness definition is also quite ambiguous. Dizziness is defined as the sensation of one own’s body movement or spinning and movement of the surrounding. It is very important to record the patient’s medical history since the diagnostic procedure may depend on the symptoms’ character. Dizziness may be a symptom of a serious disease, although it is not easy to find its cause. It appears not only in case of the labyrinth and nervous system disorders, but also in the systemic and functional diseases. Dizziness and balance disorder are the direct cause of admitting one in every thirty patients. The symptom indicated the directly life-threatening disease only within the 3-8.5% of patients (cerebral circulation insufficiency - 6%, cardiac dysrhythmia – 1.5%, brain tumour < 1%). Analyzing the data concerning the problem of dizziness occurrence within the general population, it has been noticed that this symptom has been reported two or three times more frequent by women than by men. Dizzinesses are classified pathogenetically and clinically into labyrinthine and non-labyrinthine, paroxysmal and permanent, acute and chronic. Dizziness is hard to diagnose because the symptoms reported by patients are only their own subjective sensations. The data presented in the article implicate the increasing number of patients with such disorders. Apart from dizziness, the patients complain also about the hearing disorders and nausea, which make their proper functioning impossible. It is inappropriate to start the treatment without knowing the cause. Establishing, on the basis of patient’s medical history and physical examination, whether the dizziness is of peripheral or central origin, is essential for the further diagnosis. After establishing the main diagnosis, the casual and symptomatic treatment is implemented, in some cases - there is a vestibular rehabilitation or even a surgical treatment.
Antibiotic therapy in the cystic fibrosis (CF) mouse model has been shown to result in reduced bacterial load of the intestine and significant body mass gain. The effect was suggested to be linked to the improvement of intestinal digestion and absorption. Therefore, we aimed to assess the influence of routinely applied antibiotic therapy in CF patients on fat assimilation. Twenty-four CF patients aged 6 to 30 years entered the study. Inclusion criteria comprised confirmed exocrine pancreatic insufficiency and bronchopulmonary exacerbation demanding antibiotic therapy. Exclusion criteria comprised: antibiotic therapy six weeks prior to the test, liver cirrhosis, diabetes mellitus, oxygen dependency, the use of systemic corticosteroids. In all enrolled CF subjects, 13C-labelled mixed triglyceride breath test (13C MTG-BT) was performed to assess lipid digestion and absorption, before and after antibiotic therapy. Sixteen subjects were treated intravenously with ceftazidime and amikacin, eight patients orally with ciprofloxacin. Cumulative percentage dose recovery (CPDR) was considered to reflect digestion and absorption of lipids. The values are expressed as means (medians). The values of CPDR before and after antibiotic therapy did not differ in the whole studied group [4.6(3.3) % vs. 5.7(5.3) %, p = 0.100] as well as in the subgroup receiving them intravenously [4.6(3.2) % vs. 5.7(5.3) %, p = 0.327] or in that with oral drug administration [4.6(3.4) % vs. 5.7(5.4) %, p = 0.167]. In conclusion, antibiotic therapy applied routinely in the course of pulmonary exacerbation in CF patients does not seem to result in an improvement of fat digestion and absorption.
Background. Within the medical facilities provided by state healthcare services, a universally applied technique for patient diagnosis and treatment relies on ionising radiation; for example in radiotherapy and X-ray (ie. examination). Human exposure to such radiation is not however entirely free of associated health risks. Objectives. To determine and estimate the numbers and types of X-ray based medical procedures that are performed in general and dental radiography, mammography and computer tomography on patients from the Mazovian province in Poland, which included children, women and men subjects. Material and Methods. The numbers of patient subjects undergoing X-rays was estimated by surveying the patient intake in X-ray testing rooms within the healthcare facilities of the Mazovian province. Questionnaires were either dispatched by mail to such healthcare centres or were completed by the X-ray operating staff during the testing of quality control. Results so obtained from the latter, were compared to entries from the X-ray rooms’ register Results. During 2009, the number of X-rays performed were 7612046 equivalent to 1460 examinations per 1000 inhabitants. The majority were done on women ie. 3847961 (50.55%), followed by 3193781 (41.96%) on men and 570 304 (7.49%) for children. Conclusions. Results indicated that the predominating medical procedure used of this type, was for making general diagnoses; especially through using chest radiography. Others included, in descending order; dental X-ray (mainly intra-oral examination), computer tomography (mainly CT head examinations) and mammography procedures. It was also found that the annual numbers of having X-rays has increased compared to previous years.
Human body is a complex system that is affected by a significant number of microscopic organisms called the microbiomes. The dynamic development of science has led to innovative discoveries in the field of microbiology. This in turn has extracted new field, metagenomics, thanks to which it became possible to perform detailed analysis of individual groups of bacteria and to determine their effects on preserving a good health. One of the biggest scientific projects that would investigate the influence of microbiomes on humans is HMP (Human Microbiome Project). As part of it the research is being conducted leading to characterize human microbiome at the level of nucleotide sequence of the entire genomic DNA. The microflora of the skin, oral cavity, respiratory tract, digestive tract (intestines), genitourinary system has an essential role in the homeostasis. In the last year the carried research proved that it is a vital part of the human organism in preserving a good health. Any changes in its composition may lead to systemic diseases. Pathological changes affect the outcome of the interaction within the microflora that includes species of commensal and pathogenic bacteria, as well as immunology and genetics of the host. Metagenomics research will contribute not only to the recognition of new, so far unidentified by the bacteriological methods microorganisms, but most of all they will serve as a basis to understand the relationships between the human organism and in-dwelling microorganisms. Thanks to the development of the metagenomics or the NGS (Next Generation Sequencing) it will be possible to discover new metabolic pathways and bidirectional links of bacteria with human metabolism. This will help in finding new therapeutic methods in the treatment of many noninfectious diseases so far considered as civilization diseases or genetically conditioned.
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