Medicina
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Objective of the paper was to review the latest scientific reference data on chemoprevention possibilities of lung cancer. Lung cancer is the leading cause of cancer death in Lithuania. The current lung cancer therapy includes surgery, radiation and chemotherapy. ⋯ Whether primary, secondary or tertiary prevention has the potential to improve the dismal statistics associated with this cancer? Several randomized clinical or translational chemoprevention trials have been conducted. All have so far produced either neutral (using retinal, retinyl palmitate, N-acetyl cysteine or isotretinoin) or harmful (using beta-carotene) primary endpoint results showing that lung cancer was not prevented in smokers. Secondary results supporting treatment with isotretinoin in "never" and former smokers and data from prevention trials involving selenium and vitamin E, however, are encouraging and offer a promising direction for future clinical study.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Controlled hypotension in transthoracic esophageal resection].
This study was performed in order to evaluate effectiveness of controlled hypotension decreasing blood lose in transthoracic esophageal resection. ⋯ We conclude that controlled hypotension is an effective method to decrease blood loos and blood transfusions. It creates better conditions for surgery and reduces operation time. There were no serious cardiac, neurological and renal intra-operative and post-operative complications resulting from the use of controlled hypotension.
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Despite advances in the diagnosis and treatment of infections diseases, sepsis and ensuing multiorgan failure are the major causes of morbidity and mortality in the intensive care units. Such manifestations of systemic inflammation as fever, leukocytosis, tachycardia, etc. may be noninfectious in origin and are neither specific nor sensitive for sepsis. Procalcitonin is a new potential marker for detection of bacterial, fungal and protozoal infections. ⋯ This review article discusses biology of procalcitonin, its laboratory determination, usage as an indicator for severe infection and sepsis, and comparison with circulating cytokines in severe infection. It also reviews value of procalcitonin in differentiation of infectious vs non-infectious inflammatory host response, possible elevation of procalcitonin in the absence of infection, its use for differentiation of viral and non-viral infections and as marker for prognosis and evaluation of therapy. Specific indications for determination of procalcitonin are also discussed.
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Discussions about the goals of medicine and health care have significantly increased through the last decade of the past century. This was determined by the highly increased extent of health care, scarce health care resources, fundamental changes of health care technologies and well-established market relationships in health care. For a long time medicine attempted to achieve three main goals: to save and prolong life, fight and prevent diseases, reduce pain and sufferings. ⋯ Often the society tries to escape from number of social problems medicalizing them. Spiritual and social problems of human are often supposed to be as medical ones, thus it is crucial to separate the main goals of medicine, which represent its values and targets, from the secondary ones, related to social or individual welfare, crime, dilemmas of poverty or morality. The aim of the article is to reveal the key values of medicine and health care, which determine the goals of medicine and health care.
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Comparative Study
[The changes of characteristics of burn injuries and treatment data of burned adults in Kaunas University of Medicine Hospital in 1981-2001].
About 8000 people get burned in Lithuania every year; over 2000 of them have to be hospitalized. About 500 adults and children, who have heavy burn accidents, are treated in the specialized burn centers in Kaunas and Vilnius. With the flow of time, causes of burn accidents change; new treatment methods appear and are applied, the duration of treatment in the hospital as well as other burn accident data change. ⋯ The number of patients undergoing an operation has grown. Active surgery tactics and early operations gave the possibility to decrease almost twice the duration of in-patient treatment in 2001 in comparison to 1981. The time till the first operation decreased from 19.1 days in 1981 to 7 days in 2001.