Medicina
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Review Comparative Study
[Present-day approach to pharmacological and clinical aspects of novel antidepressants].
Depression is the most common illness that affects a large number of individuals in all countries. Recent evidence suggest that depressive episodes if left untreated may heighten severity of subsequent episodes and may increase need for more health care resources. The first antidepressants, tricyclics and monoamine oxidase inhibitors, became available in the late 1950s. ⋯ The combination of antidepressants is an important clinical issue. There are the following principles of combining antidepressants: 1. to combine mechanisms of action not just drugs, 2. to combine antidepressants and to promote pharmacological synergy and tolerability, 3. to use important synergies within the serotonin, noradrenaline and even dopamine monoaminergic systems. Adequate treatment of depression including modern treatment approaches has the potential to reduce suffering and disability substantially and minimise the risk of suicide.
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Comparative Study
[Survival after myocardial infarction among the middle-aged Kaunas men and women].
The aim of the present study was to determine and compare the short-term and long-term survival after myocardial infarction (MI) in the Kaunas men and women aged 25-64 during 1983 to 1998, according to ischemic heart disease register data. The source of the data--Kaunas population-based ischemic heart disease register. The diagnosis of MI was based on the criteria defined by the WHO MONICA Project. All myocardial infarction events that occurred among Kaunas population aged 25-64 years during 1983-1998 were recorded. Myocardial infarction survival was evaluated using Kaplan-Meier method and using z test for comparing the survival curves. ⋯ The data of 3,613 persons with a first myocardial infarction and 528 with a recurrent myocardial infarction were analyzed. Detected, that among men and women a short-term (28 days) survival probability was significant different. In the men aged 25-64 short-term survival after a first myocardial infarction was better comparing with the women survival (z = 4.63, p = 0.03). The short-term survival among men aged 25-64 with a recurrent myocardial infarction comparing with woman did not differ. The long-term survival probability in patients, who survived the first 28 days, among men and women with a first and recurrent myocardial infarction aged 25-64 was without statistically significant differences.
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The aim of the article is to review Lithuanian cardiac surgery development, as well as authors and timing of the first operations performed. Historical review involves two periods: initial (1900-1964) and contemporal (1964-2002). Benevolent rivalry between Vilnius and Kaunas heart surgeons is given to show their contribution into Lithuanian surgery. Chronological development and amelioration of the main heart surgery fields are described: heart injuries, ischemic heart disease, congenital and acquired defects, heart rhythm disturbances, heart transplantation.
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The aim of the study was to analyze the tendencies of public and private health care expenditure in Lithuania during 1994-1999. Crude examination of statistical data show, that the growth rate of health care spending per capital is largely determined by growth of national gross domestic product (GDP). We have estimated that health care spending in Lithuania have risen twice faster than GDP during 1994-1999. (Percentage of rise in health care spending, divided by percentage rise of GDP, is +2.26). ⋯ The tendency of increasing private spending shows, the evidence, that households are facing more financial risk of purchasing health care. This should be an implication for health care policy makers. Further decisions to increase private payments have to be based on evidence after detailed analysis of impact of consequences on health care access for various social economic groups of population.
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Adrenogenital syndrome, or so called congenital adrenal hyperplasia, is caused by a congenital insufficiency of the enzyme 21-hydroxylase, which is responsible for converting cortisol into cholesterol. Because of virilizing effect of androgens overproduction girls develop clitoral hypertrophy and persistent urogenital sinus (common channel for urethra and vagina). Surgical treatment is recommended in order to repair those developmental faults. ⋯ Postoperatively the patients were observed for 0.5-5 years, the close results showed to be good. There were 4 cases of vaginal stenosis and 2 cases of urethrovaginal fistula (all successfully repaired later). Early one staged genitoplasty and postoperative vaginal dilatations for the period of 6-12 months is recommended.