Medicina
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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.
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Neurocognitive dysfunction still remains a frequent problem after heart surgery, complicating early recovery and strongly affecting postoperative quality of life. The aim of our study was to determine incidence of cognitive dysfunction after coronary artery bypass grafting for patients of low risk group and to find operative and postoperative factors associated with early cognitive impairment. ⋯ Incidence of cognitive dysfunction for patients of low risk group was 46.3%. Cognitive decline was associated with prolonged coronary artery bypass, operation time and number of grafts.
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Comparative Study
[Laparoscopic repair of perforated duodenal ulcer: early postoperative results and risk factors].
Clear patient selection criteria and indications for laparoscopic repair of perforated duodenal ulcers are still of relevance. The purpose of our paper is to describe the early outcome results after this operation and to define the risk factors influencing the genesis of postoperative morbidity. ⋯ Size of duodenal ulcer perforation and duration of ulcer perforation symptoms were found to be risk factors influencing the rates of conversion to open repair and genesis of postoperative morbidity.
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Comparative Study
[Neuropsychological outcomes after coronary artery bypass grafting].
Neuropsychological (cognitive) dysfunction has been described as an important complication, affecting up to 80% of patients early after cardiac surgery. Also it has been shown that cognitive abnormalities persist in a later postoperative follow up. The aim of our study was to determine incidence of cognitive complications early after isolated coronary artery bypass grafting using cardiopulmonary bypass, and to identify predictive factors, associated with perioperative cerebral dysfunction. ⋯ Cognitive dysfunction is still important complication after coronary artery bypass grafting persisting during the early follow-up in some patients. Symbol Digit Modalities Test was sensitive instrument for diagnostics of postoperative neuropsychological complications reasons.