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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Vancomycin is widely used against methicillin-resistant Staphylococcus aureus infections, but it is associated with many adverse effects such as nephrotoxicity, ototoxicity, gastrointestinal disturbances, blood disorders, and two types of hypersensitivity reactions - an anaphylactoid reaction known as "red man syndrome" and anaphylaxis. We report a case of a 23-year-old man who developed a vancomycin-induced anaphylactic reaction in the treatment of methicillin-resistant Staphylococcus aureus infection.
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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.
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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
The influence of thoracic epidural anesthesia on liver hemodynamics in patients under general anesthesia.
Hepatic hypoperfusion is regarded as an important factor in the pathophysiology of perioperative liver injury. Although thoracic epidural anesthesia is a widely used technique, limited data are available about the effects on hepatic blood flow with blockade restricted to thoracic segments in humans. The main objective of the present study was to investigate the effects of thoracic epidural anesthesia on hepatic blood flow under general anesthesia in humans. ⋯ In humans, thoracic epidural anesthesia is associated with a decrease in hepatic blood flow. Thoracic epidural anesthesia combined with ephedrine bolus was found to result in further decrease in hepatic blood flow.