Showing papers in "Przegla̧d lekarski in 1997"

Acute poisoning with clenbuterol--a case report.

Abstract: In the paper we have described a case of acute, unintentional intoxication with clenbuterol, a selective beta 2-agonist A 21-year-old bodybuilder to improve his physical fitness and to increase his muscle bulk was using clenbuterol in a dose of two tablets (20 mg) daily for a week before poisoning On a day of acute intoxication he drank orange juice containing 48 tablets (48 g) of clenbuterol, which had been placed there by his friends The patient was admitted to our clinic with tachycardia at rate 160 bpm, headache, dizziness, tremor, sweats, muscle weakness, agitation Serum potassium concentration was 26 mmol/L, blood glucose level 187 mmol/L All the symptoms and biochemical abnormalities disappeared after intravenous treatment with propranolol (10 mg) and potassium chloride (60 mmol) within five hour period This case indicates that more attention should be paid to clenbuterol widely used as a stimulant by athletes, especially by bodybuilders

Acute work-related poisoning by pesticides in The Netherlands; a one year follow-up study.

Abstract: The National Poisons Control Centre of the National Institute of Public Health and the Environment in the Netherlands conducted a prospective study on acute poisoning arising from exposure to pesticides in agricultural workers. The study was performed to determine the extent and severity of acute pesticide poisoning in the Netherlands and the working conditions that lead to these poisonings. All cases of potential acute occupational intoxication by pesticides in which the Poisons Control Centre was consulted in 1991 were thoroughly studied by an occupational hygienist and a specialist in internal medicine. With the consent of the patients and their physicians, the patients' medical condition and the working conditions leading to exposure were investigated on the spot. After the exclusion of 73 patients (27 non-occupational exposures, 7 occupational exposures in non-agricultural workers, 1 accident occurred abroad, 32 patients with illnesses unrelated to pesticides and 6 who could not be traced for follow-up), 54 cases of possible acute work-related pesticide poisoning remained for study. In 37 of the 54 events there was a direct relation between exposure to pesticides and acute health problems. In one patient doubt remained about the origin of the complaints and in 16 of the 54 cases pesticide poisoning was highly unlikely and the complaints could be attributed to other diseases. In the 37 remaining cases symptoms consisted of skin and/or eye lesions (23 cases) and systemic health effects (14 cases). Exposure to the soil disinfectant 1,3-dichloropropene resulted in severe skin damage. Direct contact of pesticides with the eyes invariability resulted in local irritation. Severe systemic poisonings occurred after exposure to organophosphate and carbamate insecticides and the soil disinfectant methyl bromide. Investigations at the site of the exposure revealed 43 cases of clear exposure to pesticides, in which, except for two cases, 1 worker per incident was involved. In 67% of the cases exposures took not place during pesticide dissemination, but during preparatory activities (35%), repair of application equipment (14%) and during re-entry (14%). In 79% of the cases splashing of pesticides or spray drift led to the exposure. In most accidents (74%) imperfect technical design or technical defects were important risk factors for exposure. Although most workers were aware of the risk of using pesticides, they were still careless in taking adequate protective measures. Especially during preparatory and reparations activities the wearing of protective clothing has to be emphasized.

The assessment of nephrotoxic effect of organophosphorous pesticides based on the determination of the activity of some selected enzymes in urine.

Abstract: Pesticides and their metabolites are excreted mainly by the kidneys. The effect of these compounds on the kidney parenchyma was evaluated on the basis of determinations of the activity of the following enzymes: alkaline phosphate, N-acetylglucosaminidase, lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase and arginase in urine of workers employed at the department producing organophosphorous pesticides (32 males and 53 females) as well as those employed at the production of chlorfenvinphos (35 males). The activity of most of the estimated enzymes was significantly higher as compared to control groups. The dynamic of changes of enzyme activity was traced in the workers employed at the department producing chlorfenvinphos over their first 18 months of employment.

Acute pesticides poisonings in pregnant women.

Abstract: 44 pregnant women were treated at the Department of Clinical Toxicology in years 1986-1996 as a result of acute poisonings with different xenobiotics. Acute pesticide poisoning that involved 4 cases were always severe and had dramatic clinical course. Carbofuran intoxication stated in a 17-year-old woman (18 weeks of pregnancy) resulted in fetus death. Toxicological findings revealed that the level of the poison in the mothers blood was comparable to that in the fetus. Carbofuran evidently passed the placental barrier in concentration which was sufficient to cause the fetus death. In the second woman (20-year-old, 12 weeks pregnant) who was classified as severely poisoned on admission to the clinic a spontaneous abortion was stated on 27th day after poisoning. The highest level of carbofuran in the blood of the mother was 9.71 micrograms/g. A 30-year-old woman, 10 weeks pregnant took formothion (50 ml) per vaginam in order to provoke abortion. She was classified as moderately poisoned. Gynecological examination and ultrasonography confirmed the pregnancy. The fetus heart tones were audible. The patient was discharged from hospital after 3 days at her own request in a good general condition. The concentration of formothion in washings from vagina was similar to the levels observed in blood serum on the patient admission to the Clinic, and 24 hour later. A 21-year-old woman, 5 month pregnant ingested an unknown amount of endosulfan to provoke abortion. Gynecological examination and abdominal ultrasonography revealed longitudinal pelvic presentation of fetus. Neither fetal movement nor heart tones were audible as early as four hours after the clinical symptoms occurred. Such low concentration of endosulfan in the blood of the mother as 0.47 microgram/g of the poison caused relatively quick fetus death. The highest levels of endosulfan were found in the liver and in the fetus kidneys.

The role of respiratory muscles in the impairment of the respiratory system function in the workers of a chemical plant division producing pesticides.

Abstract: Workers of a chemical plant department producing dust and liquid pesticides (37 males and 17 females) exposed to dust containing free silica, organic solvents and active substances, among others: organophosphate compounds, pyrethroids, triazines, carbamates and dithiocarbamates, 2,4-D, captan, carboxine, carbendazim and dodine were studied. Spirometric investigations, including evaluation of vital capacity (VC), 1 second forced expiratory volume (FEV1) and its percentage index (FEV1%VC), peak expiratory flow and maximal end-expiratory flow (MEF25), were performed directly at the workplace. At the same time mouth inspiratory pressures (MIP) and maximal expiratory pressures (MEP) were evaluated. Chronic bronchitis (according to BMRC questionnaire) was diagnosed in every second worker, and in 11 males and females obstructive impairment of pulmonary function was established; 41% of females and 27% of males were found to have diminished peak expiratory flow. Maximal inspiratory pressures were significantly lower both in the studies males (p < 0.001) and females (p < 0.02) than those in the control groups and amounted to 74.4 +/- 21.5 and 58.1 +/- 24.3 cm H2O, respectively. Maximal expiratory pressures were also significantly lower in the studied males (p < 0.001) and females (p < 0.05) and amounted to 116.6 +/- 28.4 and 74.5 +/- 17.9 cm H2O, respectively. Significant correlation between decreased PEF and the force of expiratory muscles-MEP (In males r = 0.3279, p < 0.05; In females r = 0.7049, p < 0.01) was founded. The investigations performed at the workplace allow the assumption that work at the production of pesticides may result in impairment of pulmonary ventilation, development of chronic bronchitis as well as impaired function of respiratory muscles.

Biological indicators for the assessment of human exposure to organophosphorous compounds.

Abstract: UNLABELLED The aim of the present study is to review selected biological effects of organophosphorous compounds used as pesticides and to discuss their significance in terms of occupational exposure. The results of a long-term study of the red cells and plasma ChE in group of workers engaged in the production of pesticides are also presented. Cholinesterase activity in plasma and red blood cells was determined spectrophotometrically by the Ellman modified method. Occupational exposure to pesticides was analysed by the Durham and Wolf method. CONCLUSIONS 1. Cholinesterase activity in blood serum of the workers employed at the production of organophosphorous compounds is statistically significantly lower, compared to the control group and the lower accepted standard limit. 2. Cholinesterase activity in plasma seems to be a more sensitive indicator of exposure, compared to the activity of enzyme contained in erythrocytes after a long-lasting exposure to low levels of organophosphorous compounds. 3. Changes in cholinesterase activity according to the level of exposure show a better correlation if the exposure is expressed in % of the toxic dose/day than in mg/day. Toxicological properties of organophosphorous compounds are of the great importance for this correlation.

Acute pesticides poisoning in the Kraków Department of Clinical Toxicology in 1986-1995.

Abstract: The aim of the study was to evaluate the number and the course of acute pesticides poisoning treated in the Department of Clinical Toxicology in 1986-1995. During that period 264 cases (189 men and 75 women) of acute pesticides poisoning were treated. Suicidal oral ingestion followed by inhalation and dermal exposure was the most common cause of acute intoxication. Organophosphates and carbamates were the most common cause of acute intoxication. Poisonings with dipyridyls and sulfonylurea derivatives are relatively rare. The highest number of poisonings was noted in age group 30-39 years. In 37% of the total analysed cases the co-ingestion of ethanol was noted. As organophosphorous compounds were the most common cause of acute pesticides poisoning, the gastric lavage + intensive care treatment + specific and non-specific antidotes were the most common therapeutic management. Duration of hospitalisation was dependent on the kind of pesticide. The longest hospitalisation required the patients poisoned with organophosphates. A full recovery was noted in 57.6% of poisoned patients. 34.1% of patients suffered different organ injury mostly from respiratory and central nervous system. 22 (8.3%) the fatal cases were noted in analysed period. Language: en

The analysis of organophosphates poisoning cases treated at the Centre for Acute Poisonings in Lublin Provincial Hospital in 1994-1996.

Abstract: Organophosphorous compounds that are widely used in farming in the form of plant protecting preparations, are strong poisons and a source of poisoning, especially in the country. In the period 1994-1996 at the Centre for Acute Poisonings of the Jan Bozy Provincial Hospital in Lublin there were 38 patients hospitalised because of organophosphorous pesticide poisonings. In 24 of these cases the poisoning was suicidal. Six cases of the suicidal consumption of organophosphorous preparations were fatal. Most of the patients were men (31 patients). The age ranged widely from 13 to 85, however most of the patients belonged to a 51-60 age group. The majority of poisoning cases took place in the evening, or at night which could be explained by a specific rhythm of work and rest in the country. A thorough analysis of the cases of organophosphates poisoning will contribute to the generation of a data base that would aid diagnosis and treatment, as well as carrying out effective prevention programmes.

[Right atrial thrombosis--a difficult diagnostic and therapeutic problem].

Abstract: Right atrial thrombi have been diagnosed more frequently since the widespread use of two-dimensional echocardiography. The authors present current opinions on etiology of right heart thrombi. They can originate from two sources: type A thrombi originate in deep peripheral veins; they have worm-shape and they are extremely mobile or they develop within the right heart chambers-type B-they are then parietal and immobile. Clinical significance, prognosis in both types of thrombi is discussed and the guidelines for treatment are presented. Type A patients are a high risk group because of frequent incidence of severe pulmonary embolism and excessive mortality rate so aggressive therapy is required (surgery or fibrinolysis when surgery is contraindicated). Type B thrombi are much more benign, usually they do not lead to the death and treatment with anticoagulants seems to be sufficient.

Subcutaneous self-injection and oral self-administration of metallic mercury--case report

Abstract: This paper presents a case of 16-year-old schoolboy who injected subcutaneously about 6 ml of metallic mercury to both forearms and administered orally about 5 ml of it. The patient was admitted to hospital two weeks after this incident without any clinical symptoms. Physical examination and all laboratory tests, including chest x-ray were unremarkable except for granulomata at the injection sites. X-ray examination showed numerous, dispersed globules of mercury in subcutaneous tissue of both forearms and in the digestive tract, mainly in the appendix. Granulomatous tissue with a part of mercury from both forearms as well as appendix were surgically removed. During a six-month period no toxic effects of mercury have been observed, in spite of the fact, that blood mercury level was 132 micrograms/L and urinary mercury level was 500 micrograms/L. Language: en

The pattern of acute poisonings with pesticides in Poland during the periods 1989-1990 and 1994-1995.

Abstract: Pesticide constitute a large group of commonly used chemicals with diverse chemical structure and toxicity. They are intended mostly to protect plants and plant products from the activity of various harmful organisms but they can also be used as biocides. Pesticide poisonings may be due to suicidal attempts or accidental ingestion associated with improper storage in unlabelled containers. Severe cases are treated at the regional poison units while others in the in-patient and out-patient clinics all over the country. The study made us draw the conclusion that poisonings with organophosphates and dipyridyl derivatives pose an essential toxicological problem. They are usually severe and require long hospitalisation. The highest morality rate was noted also for the poisonings with organophosphates and dipyridyl derivatives. Suicidal attempts constitute the most frequent cause of the poisonings. The results of the analysis imply a necessity to replace the most harmful organophosphate and dipyridyl pesticides with others of a lower toxicity class. It should be underlined that in order to avoid an accidental misuse, pesticides should be stored in the original, labelled containers. Language: en

Acute poisonings with drugs. A review of the data collected at the National Poison Information Centre during the period 1991-1995.

Abstract: An analysis of the files collected in the National Poison Information Centre reveals that drugs are the most frequent causes of acute poisonings (followed by pesticides and other chemical substances) not only in big cities but also in rural areas. Within the drug poisoning category, about 59% of the toxicological advice related to poisonings in children up to 14 years of age. The most frequent poisonings with drugs related to poisonings with sedative and psychotropic drugs, particularly those containing benzodiazepines, phenothiazine derivatives and tricyclic antidepressants. There were frequent inquiries relating to poisonings with drug mixtures. Self-poisonings were the most frequent cause of poisonings among the adults (87.3%), in children below 14 years of age dominated accidental poisonings (96% of all drug poisonings in children). Language: en

[The ob gene product (leptin)--a new hormone of adipose tissue].

Abstract: Obesity--an important problem in modern societies--is caused by energy balance dysregulation and produces numerous adverse effects on health. Recently a particular attention has been paid to molecular and physiological mechanisms in the development of obesity and to the signalling role of adipose tissue in energy stores maintenance on the hypothalamic level. Leptin, the obese gene product discovered in 1995, may play a key role in the feedback system between adipose tissue and the ventromedial nucleus of the hypothalamus (satiety centre). The level of ob gene expression in adipose tissue and plasma leptin concentrations in humans are highly correlated with BMI. So far no mutations in the ob gene in obese subjects have been reported therefore leptin molecule could be active. Despite markedly increased leptin levels found in obesity its central action decreasing food intake and increasing energy expenditure is hindered. Defective ob protein signalling to the brain may be due to receptor and post-receptor defects. Neuropeptide Y, the hypothalamic neurotransmitter involved in the maintaining of energy homeostasis, is a likely candidate for mediating leptin afferent signals. In adipose tissue, the level of ob mRNA is regulated by insulin and glucocorticoids--hormones responsible for glucose homeostasis as well as for the central regulation of feeding behaviour. Until now the character of interactions between leptin and other hormones that regulate energy balance is not known, neither is the exact nature of leptin hypothalamic receptor defect. Defining of the role of leptin in the regulation of satiety and energy expenditure will undoubtedly contribute to a better understanding of the pathogenesis of obesity and its related metabolic complications and may lead to a new treatment approach to human obesity based on leptin or its analogues. At present research work focuses on leptin receptor studies and on ob gene polymorphism and its expression in feeding disorders including obesity and anorexia nervosa. The ob gene is one of a few genes involved in energy balance, however, very promising one.

The role of selected cell growth factors in the wound healing process

Abstract: Growth factors, naturally occurring proteins secreted by different cells or tissues, play very important role in accelerating the wound healing process. Growth factors are mainly released from macrophages, neutrophils, lymphocytes, platelets and fibroblasts and induce cells to migrate, divide or produce other factors required for wound healing. These factors bind to target cells via specific cell-surface receptors and may elicit inhibitory or stimulatory responses, depending on interactions with other factors and the cellular environment into which they are liberated. Systemic growth factors, such as growth hormone and local epidermal growth factor, fibroblast growth factor, platelet-derived growth factor, transforming growth factor i and insulin-like growth factor show to enhance wound healing. Growth factors stimulate fibroblasts proliferation and chemotaxis, collagen synthesis, reepithelialization and angiogenesis. Although growth factors are not widely available for clinical use, many are studied actively to determine their role in the acceleration of wound healing. Results of animal experiments and preliminary clinical trials demonstrate that specific uses growth factors may become the new mode of therapy in wound healing process.

Prolonged use of the femoral catheter as a temporary access for hemodialysis

Abstract: Cannulation of the femoral vein is the safest method of acute vascular access. It is recommended the removal of the femoral catheter after 72 h. The trial was undertaken, if it is possible a safe prolonged use of the femoral cannulation. The observations were performed in 70 patients (31 F, 39 M, age 3-70 years) with acute and chronic renal failure (RF). The femoral catheter was left in place for the period from 7 to 104 days, mean 21 days. None complications occurred in the group of 16 patients in whose the cannula was left up to 14 days. Bt duration of the cannulation above 15 days (54 patients) exist site infections appeared in 10 patients, catheter thrombosis in 12 patients and fiber in 6 patients (all with the catheter in place above 21 days). Noteworthly chronic RF patients were dialysed mostly on the ambulatory basis. Femoral catheter can be left safely in place for 14 days.

Biochemical evaluation of the liver function in workers employed at the production of chlorfenvinphos.

Abstract: In order to assess the liver damage caused by chlorfenvinphos, all the workers employed at the production of this compound were examined twice, 9 years apart. Serum concentration of bilirubin, protein components and the activity of some selected enzymes--red blood cell acetylcholinesterase (AChE), serum alkaline phosphatase (AP), gamma-glutamyltranspeptydase (GGT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and malic dehydrogenase (MDH) were determined in 41 males on the first examination. On the second examination serum bilirubin concentration and the activity of AChE, ChE, AP and ALT were determined in 35 males. As compared to the results obtained in control groups the first study showed that a lower concentration of serum proteins was accompanied by decreased globulin alpha 1 and beta percentage along with an increased globulin gamma percentage; bilirubin concentration and the activity of ALT, AST, and MDH were higher, whereas the activity of AP, GGT and AChE was lower. The results of the second study were similar--lowered activity of ChE and AP, and increased ALT activity. The results of the investigation provide support for a very slight impairment of the liver parenchyma.

The role of cytokines in ocular inflammation

Abstract: In this paper the immunological mechanisms connected with cytokines in the intraocular inflammation were discussed. The attention was paid to the possible involvement of a cytokine--network in the development of uveitis.

Multiorgan damage in acute oral carbamates poisonings.

Abstract: The aim of the study was to evaluate the frequency and the kind of multiorgan damage in acute oral carbamates poisonings. Under analysis there were 36 carbamates orally poisoned patients treated at the Department of Clinical Toxicology in the years 1987-1997. Patients with the liver or biliary tract diseases, chronic circulatory insufficiency symptoms, HBs antigen carriers, who suffered head traumas, CNS illness and heavy drinkers were excluded from the study. The organs damage was noted in 91.7% of the poisoned patients. The respiratory system followed by the CNS and the liver were mostly affected by carbamates toxicity. The frequency of pathological changes in the kidney and circulatory system was relatively lower. Only in a few persons peripheral nervous system injuries were noted. In 15% of the examined group the injuries of one organ only was stated. In 48.5% of the patients simultaneous injury of two and three organs or systems were noted. 36.3% of the patients suffered from multiorgan (four or more) damage. In all the severely poisoned patients (III degree) the organs damage was noted. In 53% of them the simultaneous damage of four or more organs/systems was noted. In the group of patients stated as moderately poisoned on admission to the clinic, the multiorgan damage (2-3 organs/systems) was found in 77% of the patients. The lowest number of organ damage was observed in the group of slightly poisoned patients.

Radiologic diagnosis and densitometry of osteoporosis

Abstract: The principles of densitometric and radiological examination in diagnosing of osteoporosis are presented Peripheral and whole body densitometers are described and their quality is assessed on basis of precision and accuracy of bone mineral density measurements (BMD) WHO criteria of diagnosis, which introduce clinical category of the basis of BMD (expressed in T-scores) are described as follows: normal-(T-score up to -10); osteopenia-(T-score below -10 but more than -25); osteoporosis-(T-score -25 or below); severe osteoporosis-(T-score below -25 and one or more fractures) Evaluation of osteoporotic changes on the spine, pelvis and hand radiographs are discussed Quantitative and possible quantitative analysis of radiographs are described

The role of magnesium in the pathogenesis and therapy of bronchial asthma

Abstract: Magnesium is the fourth most abundant metal found in the body It plays a crucial role in numerous biological processes It is a natural calcium antagonist New experimental data suggest that Mg+2 influences a variety of lung structures Intracellular Mg+2 is thought to modulate smooth muscle contractions and it is known to have a direct effect on calcium uptake, resulting in smooth muscle relaxation Magnesium has been forgotten cation from the therapeutical point of view, but now several clinical reports point to the salutary actions of Mg+2 in various lung diseases Many reports suggests that magnesium sulfate and aspartate has certainly a role as an adjunct to traditional therapy in asthma and asthma-like conditions and have been helpful in the treatment of acute exacerbations of asthma

Some aspects of ozone therapy

Abstract: Authors present ozone-biochemistry, describe ozone production and application method of oxygen-ozone mixture. Authors describe application pf ozone therapy to treatment of virus or bacteria diseases and others as well as contraindications to the ozone therapy, side effects. Authors evaluate also effects of ozone therapy.

Atmospheric air pollution as a factor potentiating the risk of asthma in school children. Epidemiologic studies in Krakow

Abstract: The purpose of this study was to assess the prevalence of asthma in schoolchildren in relation to residency in areas with higher urban air pollution in Krakow. The material consisted of 1129 children aged 9 years among whom health survey based on standardized interviews with parents, together with anthropometry and spirometry has been carried out in 1995. In the asthmatic children allergy diagnosed by doctor was 4 times more prevalent (83.3% vs 20.2%) and asthma or allergy was twofold more prevalent in their biologic parents (42.6% vs 29.3%). The children with asthma resided more frequently in the city areas with the higher air pollution level (62.5% vs 46.2%). Mean spirometric values of FVC, FEV1, FEF25-75% I PEFR did not differ across the groups, however, FEV1/FVC% was significantly higher in nonasthmatic than in asthmatic groups (corresponding values in boys 90.9% vs 88.7%, in girls 92.7% vs 89.8%). After accounting for potential confounders (child's gender, education level of parents, environmental tobacco smoke, cigarette smoking of mothers in pregnancy and household standard) it was estimated from the multiple logistic regression that the separate effect of air pollution category was relatively small (OR = 2.27; 95%, CI = 1.11-3.93) in comparison with that of allergy (20.5; 95% CI = 9.40-44.7), however, combined effect of both risk factors on the occurrence of asthma in children was multiplicative.

[Acute renal insufficiency during Candida albicans candidiasis in a 2-month old infant].

Abstract: In this paper has been described the case of 2-month old infant with acute renal insufficiency caused by mechanical obstacle of fungal bezoars. Bilateral pyelostomy has been performed and fungal masses have been washed out from kidney pelvis. The applied treatment including administration of Fluconazole intravenously caused disappearance of acute renal insufficiency. In this paper authors described pathogenesis, clinical symptoms, and treatment of urinary tract fungal infection.

Release of interleukin-1 beta from peripheral blood monocytes and its concentration in the blood serum of the workers employed at the production of chlorfenvinphos.

Abstract: Our earlier investigations of people exposed to chlorfenvinphos revealed obstructive impairment of pulmonary function and changes in collagen metabolism. In order to evaluate the role of interleukin-1 beta in the development of these changes the serum interleukin-1 beta concentration and the ability of spontaneous and LPS stimulated production of interleukin-1 beta by monocytes were determined in 25 males aged 33-54 years and employed at the department producing chlorfenvinphos (its air concentration did not exceed permissible levels). Higher spontaneous production of interleukin-1 beta was found; the remaining parameters did not differ significantly as compared to the control group of 23 healthy males.

Cannulation of the internal jugular vein under control of USG imaging

Abstract: The internal jugular vein cannulation is a commonly used route for access to the central venous system for therapeutic and diagnostic purposes. Although the great majority of this venous puncture are successfully performed using anatomic landmark technique, serious complication such as pneumothorax, arterial puncture or hemothorax can occur during this procedure, particularly under difficult clinical condition. A simple, ultrasound-guided technique has been developed using a portable scanner with transducer optimized for venous access. The authors experience in over 100 cases of ultrasound-guided central venous cannulations has been described. Ultrasound guidance reduces the number of passes needed to puncture the vein, increases the success rate of venous puncture, and minimizes complications. Ultrasound guidance is usually successful in allowing performance of internal jugular vein cannulation when landmark technique fail.

The influence of passive smoking on the respiratory tract

Abstract: The harmful effects of passive smoking are well known and proved. A cause-and-effect relationship between involuntary inhalation of cigarette smoke and increased number of various respiratory diseases either in children or in adults is now clearly established. Many publications indicate that the respiratory consequences of passive smoking in humans may include nonmalignant disease in addition to lung cancer. It has been observed that children exposed to cigarette smoke have more frequently asthma and other wheezing diseases. An influence of the passive smoking on the pulmonary function tests has been also widely examined. A functional disorders especially of bronchioles have been detected. Since adverse effects of passive smoking on human health are proved there is a necessity to enable life in the environment free from cigarette smoke.

Severe polyneuropathy in a 3-year-old child after dichlorophenoxyacetic herbicide--chwastox intoxication, treated successfully with plasmapheresis (PF).

Abstract: The clinical picture of intoxication with dichlorophenoxy acetic herbicides is well recognised in adults and some treatment recommendations are established. To the best of our knowledge there is scarcity of well documented cases of intoxication with this substance in children. Our report describes the clinical picture of Chwastox intoxication in a 3-year-old child. Some similarities and differences between adults and children are discussed, as well as the indications for plasmapheresis, which could be a valuable mode of treatment in such cases.

Etiology and pathogenesis of urolithiasis

Abstract: For ages nephrolithiasis has been a widespread disease and clinical statistics prove that its morbidity index is still increasing, thus it becomes a social problem. Peak morbidity usually occurs at the age between 30 and 40, that is why many patients professionally active and creative have to leave their jobs for a long period. In contrast to earlier years, frequency of the disease occurrence in females is systematically increasing and nowadays it is only slightly lower from that in males. Etiology and pathogenesis of the disease is also not entirely explained. It is generally accepted that urinary stone formation is determined by multiple factors which affect first of all chemical composition and physical features of urine. Individual properties of the kidneys and urinary tract and infections especially with urease producing pathogens as well as environmental factors are also taken into account. The most favourable circumstances for nephrolithiasis occurrence is co-existence of all these factors.