Medicina
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Comparative Study
[The results of nucleic acid testing for viruses in individual donor test and its importance for the safety of blood].
The aim of the study was to evaluate the results of nucleic acid testing for viruses in an individual donor test in National Blood Center; the objectives--to analyze the prevalence of infectious disease markers per 100 seronegative remunerated and non-remunerated, first-time and regular whole-blood donations and to assess the odds ratio in detecting the infectious disease markers among remunerated and non-remunerated donations. ⋯ 1. The prevalence of hepatitis B and hepatitis C viruses, determined by ID-NAT test, per 100 seronegative whole-blood donations is statistically significantly higher in remunerated donations. 2. The remunerated donations had the higher odds ratios in determining the infectious disease marker by ID-NAT test, comparing with non-remunerated ones. 3. In order to maximize the safety of blood and blood products, the continuity of promotion of non-remunerated whole-blood donations program should be ensured, and a compulsory blood donor testing for nucleic acids of viruses in an individual donor test should be introduced.
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Comparative Study
Management of cerebrospinal fluid leak after surgical removal of pituitary adenomas.
The aim of the study was to evaluate the frequency and the causes of the intra- and postoperative cerebrospinal fluid (CSF) leaks and to discuss the sella closure methods. ⋯ The technique of covering the sella membrane and dural defects with Surgicel and TachoSil in the presence of intraoperative CSF leakage appeared to be the most reliable one, as no postoperative CSF leakage applying this technique has been observed.
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Epilepsy surgery has been established as an effective treatment in pharmacoresistant focal epilepsies. Most candidates for epilepsy surgery are patients with partial epilepsy syndromes refractory to medical treatment. The curative surgery procedure is resection of the epileptogenic zone; therefore, precise detection of the site responsible for seizure generation is necessary. ⋯ Results in extratemporal epilepsies are also satisfactory. Despite worldwide expansion during the recent decade, epilepsy surgery remains underutilized. Better understanding of advances in presurgical evaluation should reduce fears of epilepsy surgery and help to select patients who could achieve complete seizure control or significant amelioration after surgery.
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Comparative Study
Significance of intracranial pressure and cerebral perfusion pressure in severe pediatric traumatic brain injury.
The aim of the study was to evaluate outcome of children after severe traumatic brain injury treated according to intracranial pressure (ICP)-targeted protocol, to define threshold values of peak ICP and minimal cerebral perfusion pressure (CPP) for decompressive osteoplastic craniotomy, and to determine the relationship between ICP, CPP and long-term outcome in these children. All children admitted to Pediatric Intensive Care Unit of Kaunas University of Medicine Hospital after severe head injury from January 2004 to June 2006 and treated according to ICP-targeted protocol for the management of severe head trauma were prospectively included in the study. Raised ICP was defined as a level higher than 20 mmHg. ⋯ Threshold values of peak ICP and minimal CPP for decompressive craniotomy were 22.5 mmHg (area under the curve, 0.880) and 46.5 mmHg (area under the curve, 0.898), respectively. The differences in peak ICP and minimal CPP in groups of favorable and unfavorable outcomes were not statistically significant. Treating children after severe traumatic brain injury according to the ICP-targeted protocol for the management of severe pediatric traumatic brain injury resulted in a favorable long-term outcome.
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Acute liver failure (ALF) is a life-threatening condition that can rapidly progress into coma and death due to the cerebral edema and multi-organ dysfunction. The ALF etiology and risk factors have been investigated in West Europe, North America, and Asia; however, there are still no published data about the causes and prognosis of ALF in Central and East European countries. The aim of our study was to analyze the causes, outcomes, and prognostic factors of ALF in patients referred to tertiary care center in Lithuania. ⋯ Acute viral hepatitis B, drug-induced liver injury, and indeterminate hepatitis are the main ALF causes in Lithuania. In non-transplanted patients, the main predictors of lethal outcome were severe coagulopathy and metabolic acidosis. Improvement of liver donation system for urgent liver transplantation is essential requirement for amelioration of ALF patient's survival.