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1

Non-specific low back pain (Evidence Based Medicine)

100%
Brzeziński K.
Ból
|
2011
|
vol. 12
|
issue 4
EN
It is estimated that 80% of the population at least once had to deal with such complaints, while 25% of patients with chronic low back pain is the cause. Treatment of pain in the spine lumbar-sacral deal with doctors of various specialties. Analyzing the proposed treatment regimens for acute and chronic low back pain can be assumed that in both cases, the principles of diagnosis and treatment are very similar. In case of acute back pain medical history, physical examination and differential diagnosis are very important at every stage of treatment, and at the lead to chronic pain. The paper summarizes the European Guidelines 2006, the guidelines developed by a group Manchikanti and guidelines developed in 2010. It highlighted the consistent and contentious points mentioned studies. It is difficult to avoid the burden of belonging to a medical societies, or groups in particular often use some form of therapy. These factors make it despite the best intentions and aspirations to objectivity of the authors, Any development of the available literature should be treated with great caution.
2

The use of strong opioid in combination with naloxone. A case report

100%
Brzeziński K.
Ból
|
2011
|
vol. 12
|
issue 2
EN
The use of opioids in the treatment of pain is often associated with the occurrence of side effects as drowsiness, constipation, nausea, vomiting, or disorders of orientation. These symptoms are caused by activation of opioid receptors. The severity of adverse events is often so large that they force a change of the drug. This case illustrates the different types of side effects (tramadol - dementia, fentanyl - nausea and vomiting) occurred in one patient during treatment with opioid pain syndrome in the course of rheumatoid disease. Obtained after the application of oxycodone, although reduced pain intensity to 3 in a numerical rating scale (NRS), but there were persistent constipation. By introducing the treatment with naloxone combination oxycodone provided both good pain control, as well as normalization of symptoms for the gastrointestinal tract. Orally antagonists of opioid receptors did not reverse the systemic action of opioids, because they are inactivated in the liver. Patient asked after the completion of the rotation of opioids on an assessment of the treatment period, responded that they accept this type of procedure, realizing that this is a way to introduce treatment effective and acceptable to her. She mentioned that if did not have information about the types and schedule of planned change, discontinue treatment.
PL
Stosowanie opioidów w trakcie leczenia zespołów bólowych jest często związane z występowaniem objawów niepożądanych w postaci senności, zaparć, nudności, wymiotów lub zaburzeń orientacji. Objawy te spowodowane są aktywacją receptorów opioidowych. Nasilenie objawów niepożądanych jest niejednokrotnie tak duże, że wymusza zmianę stosowanego leku. Opisany przypadek ilustruje różne rodzaje objawów niepożądanych (tramadol - otępienie, fentanyl - nudności i wymioty) występujące u jednej pacjentki w trakcie leczenia opioidami zespołu bólowego, w przebiegu choroby reumatycznej. Po zastosowaniu oksykodonu uzyskano wprawdzie zmniejszenie natężenia bólu do 3 w skali numerycznej (NRS), lecz pojawiły się uporczywe zaparcia. Wprowadzając do leczenia połączenie oksykodonu z naloksonem uzyskano zarówno dobrą kontrolę bólu, jak również normalizację objawów za strony przewodu pokarmowego. Podane doustnie leki z grupy antagonistów receptorów opioidowych nie odwracają działania systemowego opioidów, bowiem są inaktywowane w wątrobie. Pacjentka pytana po ukończeniu rotacji opioidów o ocenę tego okresu leczenia odpowiedziała, że zaaprobowała ten typ postępowania, zdając sobie sprawę, że jest to sposób na wprowadzenie skutecznego i akceptowanego przez nią leczenia. Nadmieniła również, że gdyby nie miała informacji o planowanych rodzajach i harmonogramie zmian, przerwałaby leczenie.
3
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Sequence determination and analysis of S-adenosyl-L-homocysteine hydrolase from yellow lupine (Lupinus luteus).

51%
Brzeziński K., Janowski R., Podkowiński J., Jaskólski M.
|
EN
The coding sequences of two S-adenosyl-L-homocysteine hydrolases (SAHases) were identified in yellow lupine by screenig of a cDNA library. One of them, corresponding to the complete protein, was sequenced and compared with 52 other SAHase sequences. Phylogenetic analysis of these proteins identified three groups of the enzymes. Group A comprises only bacterial sequences. Group B is subdivided into two subgroups, one of which (B1) is formed by animal sequences. Subgroup B2 consist of two distinct clusters, B2a and B2b. Cluster B2b comprises all known plant sequences, including the yellow lupine enzyme, which are distinguished by a 50-residue insert. Group C is heterogeneous and contains SAHases from Archaea as well as a new class of animal enzymes, distinctly different from those in group B1.
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