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3. Mass polytoxic industrial poisonings They are caused by a complex etiological factor, in which several types of toxic compounds are simultaneously effective. Investigations show that they considerably diversify the consistence of the complex toxicological agent and increase its harmful effect. The polytoxic gas mixtures formed after thermal-acid destruction of organic compounds and after explosion are highly aggressive. 3.1. Poisonings by thermally-produced gas combinations from plastic compounds They are produced during thermal impact on a number of plastics, widely spread in everyday life of modern humanity. The basic compounds of the oftenproduced poisonous gas complexes, provoking toxic aggression on the injured, are as follows: carbon oxide, toluol evaporation, phormaldehydes, phenol, isocyanates, hydrocyan, ammonia compounds, chlorine gases etc. Injuring mechanisms. The enumerated poisons in the combined gas agent, penetrating the organism during mass intoxication mainly through the respiratory system and the skin and mucosa, mutually potentiate the injuring effect. This leads to the multiplication of the pathological processes in the patient's cells and tissues, equally concerning degree and rapidity of effect. The injuring mechanisms can be local - with destructive effect mainly on the respiratory tract and the contact mucosa and general - enzyme blocking, dysmetabolite and dystrophic. They affect almost all organs and systems, but before all - respiratory tract, CNS, blood, cardiovascular system and others. Clinical manifestation. It is characterised by a great variety of syndromes in the different affected organs on the background of a severe general condition. Most often observed are the following phenomena: a ; pulmotoxic syndrome: severely laboured breathing with acute respiratory insufficiency, combined with chemical and bacterial pulmonitis, toxic oedema, bronchial spasm and atelectatic areas; b ; cerebral syndrome, expressed by disordered consciousness, reaching coma, often convulsions and vision and auditory analysers' function disorders; c ; cardiovascular syndrome - characterised mainly by shock states and rhythm disorders; d ; haemotoxic syndrome - expressed mostly by haemolysis, metahaemoglobinaemia or carboxyhaemoglobinaemia; e ; parenchymal-toxic syndrome - characterised by hepatotoxic and renal-toxic phenomena, mostly present in the extremely severe forms of affection. Treatment. It is carried out by means of the following medication: 1. Interrupting the contact with the gas mixture and taking the patient out of the polluted and triamterene and singulair, because lisinopril.
Identify the role s ; of the nurse in the health care environment to maintain and restore health.

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22. Murray, Michael T. Encyclopedia of Nutritional Supplements, 1996, Rocklin, CA, Prima Publishing, p. 124 23. Passwater, Richard A. Cancer Prevention and Nutritional Therapies, 1993, New Canaan, CT, Keats Publishing Inc., p. 182 24. Butterworth, Charles E., Jr., et al. Folateinduced regression of cervical intraepithelial neoplasia in users of oral contraceptive agents. American Journal of Clinical Nutrition, Vol. 33, 1980, p. 926 25. Giovannucci, Edward, et al. Multivitamin use, folate, and colon cancer in women in the Nurses' Health Study. Annals of Internal Medicine, Vol. 129, October 1, 1998, pp. 517-24 26. Kim, Young-In, et al. Colonic mucosal concentrations of folate correlate well with blood measurements of folate status in persons with colorectal polyps. American Journal of Clinical Nutrition, Vol. 68, October 1998, pp. 866-72 and pp. 763-64 editorial ; 27. Kato, I., et al. Serum folate, homocysteine and colorectal cancer risk in women: a nested casecontrol study. British Journal of Cancer, Vol. 79, No. 11 12, April 1999, pp. 1917-21 28. Murray, Michael T. Encyclopedia of Nutritional Supplements, 1996, Rocklin, CA, Prima Publishing, pp. 123-24 29. Robinson, Killian, et al. Hyperhomocysteinemia confers an independent increased risk of atherosclerosis in end-stage renal disease and is closely linked to plasma folate and pyridoxine concentrations. Circulation, Vol. 94, No. 11, December 1, 1996, pp. 2743-48 30. Hultberg, B., et al. Poor metabolic control, early age at onset, marginal folate deficiency are associated with increasing levels of plasma homocysteine in insulin-dependent diabetes mellitus. Scand. J. Clin. Lab. Invest., Vol. 57, No. 7, November 1997, pp. 595-600. Organized on a "first come, first served" basis. The person s ; organizing this area can ensure that this principle is maintained, and can also reiterate information on the purpose of the vaccine and possible reactions to the vaccine. The entrances and exits must be at different ends of the site. A registration point must be placed at the entrance next to the waiting area. Here, the individual's details are entered in the register and he or she is given a card. The vaccine administration site is located after the registration point. Two trained health personnel should be allocated to this area, one drawing up the vaccine and the other injecting. There may be more than one vaccine administration team. At the exit point, a supervisor must check that the individual has received the card, is registered and has received the vaccine.
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Dijs, F. P. L. van der. Sickle cell disease and x-thalassemia in Curacao. 28-1-2004 ; University Medical Center Groningen, University of Groningen, Muskiet, F. A. J. Eriksson, H. J. C. Analytical techniques and formulation strategies for the therapeutic protein alkaline phosphatase. 5-7-2004 ; p. 1-200 Jong, G. J. de and Frijlink, H. W. Schnog, J. B. Studies on the pathophysiology, disease severity assessment and management of sickle cell disease. 30-62004 ; University Medical Center Groningen, University of Groningen, Rojer, R. A., Muskiet, F. A. J., and Cate, H. ten Linden, H. van der, Olthuis, W., Bergveld, P. An efficient method for the fabrication of temperature-sensitive hydrogel microactuators. Lab Chip 4: 619-624, 2004. Machtejevas, E., John, H., Wagner, K., Stndker, L., Marko-Varga, G., Forssmann, W. G., Bischoff, R., Unger, K. K. Automated multidimensional HPLC: sample preparation and identification of peptides from human blood filtrate. Journal of Chromatography B 803: 121-130, 2004. Muskiet, F. A. J., Fokkema, M. R., Schaafsma, A., Boersma, E. R., Crawford, M. A. Is docosahexaenoic acid DHA ; essential? Lessons from DHA status regulation, our ancient diet, epidemiology and randomized controlled trials. Journal of Nutrition 134 1 ; : 183-186, 2004. Permentier, H. P., Bruins, A. P. Electrochemical oxidation and cleavage of proteins with on-line mass spectrometric detection: development of an instrumental alternative to enzymatic protein digestion. Journal of the American Society for Mass Spectrometry 15: 1707-1716, 1-1-2004. Schnog, J. B., Duits, A. J., Muskiet, F. A. J., Cate, H. ten, Rojer, R. A., Brandjes, D. P. M. Sickle cell disease; a general overview. Netherlands Journal of Medicine 62 10 ; : 364-374, 2004. Schnog, J. J. B., Jager, E. H., Dijs, F. P. L. van der, Duits, A. J., Moshage, H., Muskiet, F. D., Muskiet, F. A. J. Evidence for a metabolic shift of arginine metabolism in sickle cell disease. Annals of Hematology 83 6 ; : 371-375, 2004. Seifar, R. M., Cool, R. H., Quax, W. J., Bischoff, R. Characterization of the interaction between human complement protein C4 and a single-chain variable fragment antibody by capillary electrophoresis and surface plasmon resonance. Electrophoresis 25 10-11 ; : 1561-1568, 2004. Smit, E. N., Muskiet, F. A. J., Boersma, E. R. The possible role of essential fatty acids in the pathophysiology of malnutrition: a review. Prostaglandins Leukotrienes and Essential Fatty Acids 71 4 ; : 241-250, 2004. Spehar, A. M., Koster, S., Kulmala, S., Verpoorte, E, Rooij, N. F. de, Koudelka-Hep, M. The quenching of electrochemiluminescence upon oligonucleotide hybridization. Luminescence 19: 287-295, 2005. Zomeren, P. V. van, Hoogvorst, A., Coenegracht, P. M. J., Jong, G. J. de. Optimisation of high-performance liquid chromatography with diode array detection using an automatic peak tracking procedure based on augmented iterative target transformation factor analysis. Analyst 129: 241-248, 2004.

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