Medicina
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Comparative Study
[Association of metabolic syndrome and oxidative stress with ischemic heart disease in middle-aged persons].
The aim of this study was to evaluate the association of metabolic syndrome and oxidative stress with ischemic heart disease in middle-aged persons (men and women aged 45-64 years). ⋯ Metabolic syndrome and oxidative stress are significantly associated with ischemic heart disease among 45-64-year-old persons.
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Case Reports
Aorto-caval fistula clinically presenting as left renal colic. Findings of multislice computed tomography.
Spontaneous aorto-caval fistula is a rare complication of abdominal aortic aneurysm. A definitive diagnosis is sometimes difficult, as the classic diagnostic signs (pulsatile abdominal mass with bruit, high-output hearth failure, and acute dyspnea) are present in about half of the patients. Diagnosis may be suspected from clinical symptoms, but sometimes atypical clinical features may obscure the actual situation. ⋯ Prompt radiological diagnosis is of key importance in the management of these patients. We describe findings of multislice computed tomography of the patient with dissecting aortic aneurysm and aortocaval fistula, clinically presenting as left renal colic. Multislice computed tomography is the imaging modality of choice for diagnosis of abdominal vascular pathology as it is noninvasive, fast and demonstrates a high diagnostic accuracy.
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Comparative Study
[Private or public dental care? Patients' perception and experience in Lithuania].
To compare demographic and social groups of patients, their satisfaction with services in public and private dental institutions. ⋯ A random sample of 3000 Lithuanian residents was selected; 1801 participants answered a postal questionnaire. The response rate was 60.0%. Univariate analysis, chi(2) criterion, z-test, and multiple logistic regression were used to evaluate the association between institution type, demographic and social characteristics of the respondents. RESULTS. Less than half of Lithuanian residents (41.2%) visited public dental institutions, 35.9%--private, 25.9%--both. They preferred private dental sector due to better quality of service, public--due to closeness to residence or being the treatment place of acquaintances. Patients visiting public institutions required cheaper treatment, while patients visiting private institutions--qualitative, though more expensive, using modern technologies. The number of dental visits in the past year was lower in public institutions than in private ones. The majority of patients treated in public, private, and both institutions were satisfied with dental services. The least satisfied were visiting both institutions. More respondents with secondary and lower education used public services as compared to those with higher education. Urban population visited public institutions more often than rural population. Respondents with a monthly income of less than 500 Lt for one family member used public dental services more often than those receiving a higher income. Older patients visited public dental institutions more often than younger ones. CONCLUSIONS. More Lithuanian residents are treated in public dental institutions (up to 67.1%) than in private. Older, receiving lower income patients preferred public institutions. The majority of patients in public clinics as well as in private sector are satisfied with the service. Those who visited both types of institutions were least satisfied with dental services.
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When the patient condition contraindicates major surgery for descending thoracic aneurysms, the surgeon should consider using an ascending aorta to abdominal aorta bypass graft, leaving the diseased segment undisturbed. Our experience with eight patients is presented. ⋯ In complex aortic coarctation, extra-anatomic bypass operation remains an effective procedure. The usage of these procedures in patients with descending aortic aneurysms remains complicated.