Medicina
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This review explores the effects of central neural blockade on cardiovascular system in healthy patients and for patients with common cardiovascular disease (ischemic heart disease, rheumatic valve disorders, cardiomyopathy). Central regional blockade poses these patients at some extent of risk due to possible hemodynamic instability because of effects of blockade on peripheral vessels and heart. ⋯ It increases diameter of epicardial coronary stenosis, reduces the ST segment depression, provides pain relief for patients with unstable angina, does not affect myocardial contractility. Recommendations are made about applying the central regional anesthesia for these patients; prevention and treatment of hypotension are discussed; and peculiarities of central regional anesthesia for patients taking anticoagulants are highlighted.
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Comparative Study
[Possibilities of group psychological correction of depressiveness among adolescents].
The aim of the study was to assess the possibility of psychological correction in groups to decrease depressiveness among senior schoolchildren. Data of 87 (53 girls and 34 boys) depressive schoolchildren, who participated in the sessions for developing communication skills were analyzed. Depressiveness was assessed by the Depression scale of Minnesota Multiphasic Personality Inventory for Adolescents. ⋯ Depressiveness decreased better among girls irrespective of their involvement in the sessions, and among actively involved boys. Self-awareness among boys and girls increased better among adolescents, who attended most sessions. Self-awareness increased better among girls irrespective of their involvement in the sessions, and among actively involved boys.
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Comparative Study
[Dynamics of diabetic nephropathy and other complications of type I diabetes mellitus in the period of 1996-2002 (data from 2 Kaunas outpatient polyclinics)].
Kidney involvement in diabetes mellitus has negative impact on the outcomes of disease. Strong relationship between progressive diabetic kidney disease and the development of other diabetic complications was found by many investigators. In order to evaluate the dynamics of diabetic nephropathy in type I diabetes mellitus during 6-year period and its relationship with other diabetes mellitus complications and control of glycemia and hypertension, in 2002 we reviewed ambulatory case records of patients, who were followed by endocrinologists and who were investigated by us in 1996. ⋯ Progression of diabetic retinopathy and neuropathy over 6 yrs. were more expressed than in diabetic nephropathy. On average retinopathy developed after 14+/-1.8 yrs. after the diabetes mellitus onset, neuropathy--17.8+/-2.2 yrs., renal failure--21.1+/-2.8 yrs., heart failure--22.9+/-1.9 yrs. and arterial hypertension--12.1+/-1.3 yrs. The prevalence and time of incipient diabetic nephropathy appearance remained unknown because the test for microalbuminuria was not available in the primary health care centres.
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Doctors prescribing some medications together are often using unreasonable drug combinations. The rationality of prescribing the medications by means of case-records and computerized data base of the state sicknes fund was investigated. The article addresses the most common cases of unreasonable use of medications, which could be divided into five subgroups: 1) Prescribing drug combinations, that increase the possibility of side-effects; 2) Prescribing some medications, that may suppress the effects of each other together; 3) Using medications, that belong to the same group together; 4) Prescribing the medications either without indication or out of indication; 5) Other cases of the unreasonable medication use. This article discusses the risk of using most common drug combinations and provides recommendations that could help to prevent unreasonable medication use.