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EN
Introduction: Proton-pump inhibitors (PPIs) are a class of drugs which decrease gastric acid production, their overuse is becoming increasingly common. Purpose: The aim of this study was to evaluate medical indications for PPIs in a cohort of prevalent hemodialysis (HD) patients and their awareness about the medical effects of these drugs. Materials and methods: The study was performed in 78 HD patients enrolled in a chronic dialysis program in a single academic dialysis unit. The study was based on medical history obtained from the patients (survey about drugs they take with intention of revealing PPIs, indications for the treatment, their awareness of the mechanism of action of these drugs).Results: 46 patients (59%) took or have been taking PPIs. Almost half (49%; n=22) had no clear medical indications for the drugs. Prescription of PPIs without medical indications was more common among nephrologists (27%), when compared with gastroenterologists (5%; p<0.05). Only 29% (n=13) of patients taking PPIs were aware of the mechanism of action of the drugs. Conclusions: Results of this study reveal the problem of PPI overuse among HD patients. Gastroenterologists usually prescribed PPIs according to medical indications. Lack of patients’ knowledge about the indications for PPI therapy is overwhelming.
EN
The purpose of the study was to estimate the incidence of urinary system congenital malformations and to analyze their clinical manifestations. The study comprised children hospitalized in the Department of Pediatric Nephrology, University Children's Hospital, Lublin, between 2000 and 2003. Urinary system congenital malformations were diagnosed in 16,2% of studied children. The most common urinary system congenital malformations was vesico-ureteral reflux (75,2%). The most common clinical manifestation was urinary tract infections, urinary incontinence and/or nocturnal enuresis, and abdominal pain. In 2% of patients, urinary system congenital anomalies were detected accidentally.
EN
A retrospective study was conducted among 498 patients with urinary tract infections (UTI) referred to our department from January 2013 to December 2015. This study was performed to evaluate the etiology of UTI and the antibiotic susceptibility profile of Escherichia coli (E.coli) as the main etiological factor in different age groups. Urine samples were examined using standard microbiological methods. Three hundred sixty-three samples (72.9%) were identified as E.coli, of which 29 (8.0%) can produce extended-spectrum β-lactamases (ESBL). E.coli was highly sensitive to imipenem (100.0%), gentamicin (91.0%), nitrofurantoin (89.4%), amikacin (88.2%), piperacillin/tazobactam (87.0%) and cephalosporins (79.7–89.5%). Low sensitivity was found in relation to fluoroquinolones (60.3–70.4%). E.coli was least sensitive to ampicillin (30.2%) and amoxicillin/clavulanic acid (49.9%). We observed a significant fall in susceptibility level to piperacillin/tazobactam (68.4% vs. 88.8%; p=0.017), amikacin (61.1% vs. 90.7%; p=0.001), gentamicin (70.0% vs. 93.2%; p=0.002), cefalexin (41.2% vs. 83.3%; p<0.001), cefotaxime (63.6% vs. 89.4%; p=0.002), ceftazidime (61.9% vs. 85.6%; p=0.008), cefepime (73.7% vs. 91.1%; p=0.025), ciprofloxacin (54.1% vs. 72.2%; p=0.024) and norfloxacin (40.5% vs. 62.5%; p=0.011) among patients with catheter-associated UTI (CAUTI) compared to those with non-CAUTI. A similar susceptibility profile was observed between different age groups. In the longevity, E.coli showed a higher sensitivity to cephalosporins than in the young-old group. E.coli susceptibility to fluoroquinolones was low, which excludes them as a first-line drug in our department. Nitrofurantoin may be used as an alternative drug to carbapenems. Monitoring of susceptibility pattern is of great importance.
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Content available Kliniczne zastosowania tomografii dwuenergetycznej
72%
PL
Głównym celem publikacji jest wyjaśnienie i ustalenie zastosowania najnowszych technik obrazowania tomografii komputerowej w medycynie przy użyciu dwuenergetycznego źródła promieniowania. Technika ta powszechnie została wdrożona dopiero w 2005 roku ze względu na ograniczenia technologiczne, co stanowi novum w tej dziedzinie nauki.
EN
The main purpose of the publication is to explain and determine the application the latest tomography imaging techniques in medicine using dual energy radiation sources. This technique has been widely implemented only in 2005 due to technological limitations, which is a novelty in this field of science.
PL
Postęp we wczesnym rozpoznawaniu ostrego uszkodzenia nerek jest związany z metodami obrazowymi oraz oznaczaniem przesączania kłębuszkowego w czasie rzeczywistym niezależnie od wartości kreatyniny i diurezy.
PL
Czynnik wzrostu fibroblastów FGF23 produkowany w osteoblastach i osteocytach jest określany jako istotny element w regulacji gospodarki wapniowo-fosforanowej, zwiększając wydalanie fosforanów i w nadmiarze prowadząc do hipofosfatemii. Działa również poprzez zahamowanie syntezy witaminy 1,25 (OH)2 D. Szczególna rola jest mu przypisywana w indukowaniu tak pośrednio, jak i przez bezpośredni wpływ na przerost lewej komory, niekorzystnych zmian w układzie sercowo-naczyniowym, będących przyczyną zwiększonej śmiertelności w przewlekłej niewydolności nerek, charakteryzującej się wzrostem stężenia FGF23. Brak jest jeszcze udokumentowanych klinicznych badań randomizowanych potwierdzających korzyści z obniżania stężenia FGF23 w PChN.
EN
Fibroblast growth factor 23 (FGF23) produced in osteoblasts is described as a new element regulating calcium-phoshate metabolism. It increases phosphate urinary excretion and in excess causes hypophoshatemia. It also acts by inhibiting vitamin 1.25 (OH)2 D synthesis. It plays particular role in inducing cardiovascular changes indirectly as well as by a direct impact on left ventricular hypertrophy. These changes are responsible for increased mortality in chronic kidney disease, in which the serum level of FGF23 is elevated. However there are still no randomized clinical trials demonstrating better outcome associated with the therapeutic reduction of FGF23 in CKD.
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