Medicina
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Comparative Study
The value of clinical prognostic factors for survival in patients with invasive urinary bladder cancer.
The aim of the study was to evaluate the value of clinical prognostic factors for survival of patients with invasive urinary bladder cancer treated with radical cystectomy, chemotherapy, and radiotherapy. ⋯ The best 3-year overall survival was in the radical cystectomy group. Chemoradiation with gemcitabine could be offered as an alternative to patients refusing cystectomy. Better overall survival in the chemoradiation group was for patients without comorbidities and when treatment protocol was completed.
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The transformation from the early to late modernity initiated in the Western societies has touched the medicine and entered Lithuania as well. Changes affect not only human values, but also attitude toward a patient. A patient is seen more as a person with social needs until the end of his/her life. It is especially difficult to retain such attitude to the patient in intensive care units. Studies conducted abroad report the importance of the contacts and support of the relatives to the patients in intensive care units. Attention from the medical personnel, easy understandable information, liberated visiting--all together increases the satisfaction and confidence with medical care provided. In Lithuania, the above-mentioned attitude toward patients is still not common. The objective of this study was to reveal the important aspects of the transformation of attitude to the patient and his/her social environment by analyzing the possibilities of social interactions in an intensive care unit. ⋯ The relationship between the medical personnel and the patients is restricted to instrumental communication, which is a feature of the early modernity. The process of attitude transformation, common in the Western countries, when a patient is treated not only as biological but also as a social person, is only at the initial stage in Lithuania.
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Crush injury is defined as compression of extremities or other parts of the body that causes muscle breakdown (traumatic rhabdomyolysis). Systemic consequences of crush injuries are as follows: rhabdomyolysis, electrolyte and acid-base abnormalities, hypovolemia, and acute renal failure. Crush injuries are important injuries in disaster situations: earthquakes, hurricanes, mining and road traffic accidents, war, collapse of buildings, etc. In this review article, there are discussed about epidemiology of crush syndrome, risk factors, pathophysiology (mechanisms of muscle cell injury, release of substances from injured muscles, other consequences of reperfusion), clinical features, differential diagnosis, investigations, complications (acute renal failure, hypovolemic shock, hyperkalemia, infection, compartment syndrome), approach to treatment (adequate rehydration, a forced mannitol-alkaline diuresis, intravenous fluids, management of hyperkalemia, wound care, hyperbaric oxygen, etc.), prognosis, the mortality rate and prevention (timely support may reduce morbidity and mortality).
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Pain is a common problem in diabetic neuropathy, but relatively little has been published regarding the extent to which it needs to be addressed in clinical practice. ⋯ Standard pain questionnaires were useful in identifying pain sufferers. At the same intensity, deep neuropathic pain was more unpleasant than superficial. Pain manifestation was associated with female gender and lower level of glycosylated hemoglobin.
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Comparative Study
Prevalence of the metabolic syndrome diagnosed using three different definitions and risk of ischemic heart disease among Kaunas adult population.
The aim of this study was to compare the prevalence of the metabolic syndrome diagnosed using three different definitions and to evaluate its associations with ischemic heart disease in Kaunas adult population. MATERIAL AND METHODS. Data of preventive screening carried out in Kaunas in 2001-2002 according to the MONICA study protocol were used for analysis; a total of 1336 persons aged 35-64 years (603 men and 733 women) were recruited. ⋯ CONCLUSION. In Kaunas population aged 35-64 years, the highest prevalence of the metabolic syndrome was determined according to the International Diabetes Federation definition. Usage of the International Diabetes Federation and the Adult Treatment Panel III definitions in establishing diagnosis of the metabolic syndrome provides more opportunities to identify subjects with ischemic heart disease.