[Diabetes mellitus and cognitive dysfunction].
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Biomedical subjects
Publications and source records attributed to Krzysztof Marczewski.
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Jacques Caroli for the first time described in the year 1958, cavernous dilatation of the hepatic bile ducts. It's the rare abnormality; there have been reported less than 200 cases until now. The disease is caused by defects in the genetic program which are transmitted in an autosomal recessive way. There are two basic types of the disease: focal (so called. "simple type") and diffuse, embracing entire bile tree. Both types maybe associated with congenital hepatic fibrosis and then the abnormality is usually called "Grumbach disease". There is an excessive risk of cancer (cholangiocarcinoma) in patients with Caroli's disease. Dominant symptoms are due to recurrent cholangitis, sometimes with signs of portal hypertension. Basic treatment is hepatic resection (focal form) and internal bypass of the biliary tree (diffuse form). The prognosis of the disease is reserved one.
Unstable angina in chronically haemodialysed patients has poor clinical outcome. Surgical treatment of these patients is a procedure of high risk. According to guidelines left main coronary artery stenosis is the indication for by-pass grafting. In some cases the alternative to surgical treatment could become percutaneous coronary intervention. We present the case of the patient in which we have perform multivessel percutaneous coronary angioplasties including left main coronary artery.
The patient with acute infection and the presence of bacterium Kingella kingae cultured from cerebrospinal fluid is presented. The analysis of clinical picture and the results of all performed tests did not allow to diagnose cerebrospinal meningitis. Despite of being not sure if Kingella kingae was an etiopathogenetic factor in the described subject, we decided to discuss this interesting case.
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In the paper, issues connected with chronic dehydration were discussed from the point of view of medical ethics. Rudimentary definitions concerning the issues were mentioned. An attempt was made at analysing critically the views on chronic voluntary dehydration as a possible form of causing death. Some pathophysiological and psychopathological aspects were discussed. "The pyramid" of physician doubts were presented.