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Urodzenie 2 zdrowych dzieci przez pacjentkę z autoimmunizacyjnym zapaleniem i marskością wątroby

Diabetes and kidney clear cell carcinoma in a patient who underwent radiation therapy in childhood

The purpose of this study is to describe the case of a patient with end-stage renal failure who underwent radiotherapy of the abdominal fields in childhood. The results and treatment history are analyzed. The patient was diagnosed with an abdominal tumor at age 1 (1967). Treatment was applied surgery and radiation therapy. At age 25 (1992), she was diagnosed with type 2 diabetes, despite no history of risk factors for the development of this disease. Seven years later (2000) gastrointestinal obstruction caused by adhesions (a probable result of radiation therapy). At that time, a right kidney tumor and left kidney cirrhosis were suspected. In 2008, progressive tumor growth in the right kidney was confirmed. Two years later (2010) The right kidney was removed. Histopathological diagnosis showed clear cell carcinoma. On the third day after surgery, renal replacement therapy (hemodialysis) was started. Currently, dialysis therapy is continued, and the patient is awaiting qualification for transplantation. Conclusions: Based on the analysis, it was concluded that the health problems found in the patient may have been a consequence of radiation therapy in childhood. Very difficult to determine to what extent radiation contributed to the pathology.

Preliminary genetic investigation of the patient with atypical long (55 years) malignant melanoma process

Malignant melanoma of the skin usually has a dramatic course and the prognosis is usually not successful. For this reason, the case of a patient with a 55-year survival after being diagnosed with the said cancer cancer is a relatively unusual event. In an attempt to explain this case, we used a comet assay on the patient's peripheral lymphocytes in between surgical procedures, with γ-ray irradiation of the cells at a dose of 2Gy, compared to two other melanoma patients and four healthy subjects. In both of these comparative melanoma patients, we found increased relative to healthy subjects healthy individuals baseline DNA damage combined with reduced damage repair capacity. The patient, described in this paper, admittedly showed greater radiation damage to genetic material than control patients and healthy subjects, but the kinetics of DNA break repair DNA after a 180-minute incubation was significantly higher in him. Consistent with the hypothesis of a relationship between polymorphisms of cytochrome P-450 genes, encoding detoxification enzymes, with susceptibility to melanoma, we genotyped CYP2D6 (*3,*4), CYP2C9 (*2, *3), CYP2C19 (*2) using the TaqMan technique, showing that with the exception of CYP2C9*2, all other genotyped loci were heterozygous.

Staphylococcal sepsis as a state of imminent threat to life in children - case report

Advances in medicine, especially the use of invasive techniques for diagnosis and treatment, have increased the risk of developing sepsis. Sepsis (Gr. sepsis - decay) in Polish also referred to as septicemia is a generalized inflammatory response syndrome (SIRS) to infection, an episode involving invasion by pathogenic microorganisms such as bacteria, viruses, fungi and others, which triggers a defensive response. SIRS (systemic inflammatory response syndrome) is diagnosed on the basis of two or more of a group of clinical symptoms, changes in hemodynamic, hematological and biochemical parameters, and signs of inflammation: fever - temperature 38oC or in severe cases hypothermia 36oC, tachycardia - heart rate 90/min, tachypnoe - respiratory rate 20/min, arterial blood oxygen partial pressure 32 mmHg, leukocytosis - 12,000 or leukopenia 4,000 cells/ml or 10% immature forms. Septicemia in newborns is most often caused by Escherichia coli and group B streptococcus.

Gaucher's disease - diagnostic challenges and efficacy assessment of Enzyme Replacement Therapy. Report of 4 cases

Gaucher disease is a rare metabolic disease caused by a genetically determined deficiency or lack of lysosomal β-glucocerebrosidase activity. The following occurs glucocerebrosidase storage, with clinical consequences. Based on the history of of four patients with Gaucher disease and the current state of knowledge, we considered the problem of diagnosis and we evaluated the effectiveness of standard therapy

Takotsubo cardiomyopathy - an unusual case of an elderly patient

Tako-tsubo cardiomyopathy, otherwise known as ballooning apical syndrome, is preceded by most often by tremendous psychological or physical stress. With its clinical picture, as in the case described, it usually mimics acute coronary syndrome. Of decisive importance is urgently performed angiography of the coronary arteries, in which there are no lesions. In addition, the disease can be confirmed by imaging studies (echocardiography, magnetic resonance imaging of the heart with contrast), which usually show akinesis of the apical and middle segments of the left ventricle and reduced ejection fraction. Very important for the course of the disease is its early diagnosis, because despite rapid improvement after combined treatment with β-blockers and angiotensin-converting enzyme inhibitors and rest, life-threatening complications can occur in the early stages of the disease. The patient is at risk for pulmonary edema, cardiogenic shock, and the development of life-threatening arrhythmias. We present the case of a 72-year-old patient who was diagnosed with tako-tsubo cardiomyopathy, despite the initial diagnosis of acute coronary syndrome. She was at risk for pulmonary edema, but such a complication did not occur. It is very important, that when diagnosing acute coronary syndrome, other possible causes of chest pain, this significantly facilitates the diagnosis and treatment of

A ten-year-old girl with fever, "urticaria multiforme", and painful joint swelling - case report

We present the case of a 10-year-old girl who was admitted to the Department of Pediatrics, Preventive Cardiology and Immunology of the Developmental Age at the Medical University of Lodz with symptoms of a post-surgical disease-type reaction - with fever, generalized, multiform urticaria, facial edema and arthritis. From the history obtained from the mother indicated that the above symptoms appeared two days ago, a few hours after the the moment the girl played with a leaf of chefflera, the so-called umbrella tree, Schefflera actinophylla. Interestingly, the reaction was accompanied by significantly elevated levels of IgE total. This exotic potted plant, popular in Poland, from the araliacae family (Araliacae), contains falcarinol, a chemical compound responsible for rare cases of allergy inhalation and contact allergies in gardeners or florist workers, among others. So far, no described reaction of the type of septicaemic disease due to contact with this plant.

Late manifestation of gallstones left in the peritoneal cavity - case report

Perforation of the gallbladder during cholecystectomy resulting in bile leakage and gallstones is a fairly common complication, occurring in about 20% of cases. However, serious complications develop in only about 0.2% of patients. Remaining gallstones gallstones can manifest as intra-abdominal abscesses, intra-abdominal abscesses, fistulas and other, rarer complications

Ankle sprain and treatment consequences

Ankle sprain is the most common musculoskeletal injury in the emergency room. In the presented case, after ligament reconstruction, adhesions of the surgical scar with a nearby nerve and a neuroma developed, which was not visible on MRI examination

Bioresorbable Polylactide Implant used in orthopaedic surgery - case report

Diagnosis of disorders of the bone tissue, thanks to the availability of modern imaging methods, standardizes therapeutic management. The key element in the treatment of a patient diagnosed with a solitary bone cyst{index{solitary bone cyst} is to fill the defect in the structure with possible restoration of its function. The treatment of choice is autogenous or allogeneic bone grafting with the consequences and risks discussed later in the aticle.