Medicina
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The aim of the study was to evaluate trends in out-of-hospital mortality from ischemic heart disease (IHD) in Kaunas population aged 25-64 years during 1983-1998, according to the ischemic heart disease register data. ⋯ During 1983-1994, out-of-hospital mortality rates of Kaunas middle-aged men increased and during 1995-1998--significantly decreased. Out-of-hospital mortality rates of Kaunas women increased during 1983-1990, but in 1995-1998--tended to decline. Out-of-hospital deaths from IHD accounted on the average for 76.5% of all deaths from IHD among men and for 66.9% of women deaths, and biggest part of these deaths were among younger persons.
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Comparative Study
["Off-pump" myocardial revascularization: experience in the Clinic of Cardiosurgery, Kaunas University of Medicine].
According to indications there is no difference in results of grafts patency and left ventricle function after minimal invasive myocardial revascularization in comparison to typical operation with cardiopulmonary bypass and cardioplegia. Only ranges of troponin T (TnT), CK and CK-MB are statistically significantly lower in the group of operations without cardiopulmonary bypass and cardioplegia. ⋯ According to indications minimally invasive ("off-pump") operation is alternative method to traditional myocardial revascularization with cardiopulmonary bypass and cardioplegia. In these cases lower level of perioperative myocardial injury is observed; improvement of left ventricle function and high postoperative graft patency are similar to those after traditional operations.
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To compare the results of plastic reconstructions of the infected chest wall defects using either muscular, or omental flaps. ⋯ The pedicled omental flaps could be used safely and successfully for reconstruction of infected chest wall defects.
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The aim of our study was to evaluate patients survival, changes of functional status after repair of ischemic mitral insufficiency and coronary artery bypass grafting in acute period of myocardial infarction. In the Clinic of Cardiosurgery of Kaunas University of Medicine (since January 2001 till July 2003) 82 patients with acute myocardial infarction underwent surgery. Patients were operated on the 1(st)-21(st) day after myocardial infarction. Among 82 operated patients with acute myocardial infarction, 64 (78%) underwent coronary artery bypass grafting and 18 (22%) - coronary artery bypass grafting with mitral valve repair. Ten patients (55.6%) were in NYHA functional class II and 44.4% - in NYHA functional class III. Before myocardial infarction ischemic heart disease was diagnosed in 12 (66.7%) patients; 8 (44.4%) patients had a history of myocardial infarction. Patients were not operated during the first 24 hours of myocardial infarction. All patients were evaluated by means of 2 Doppler-echocardiography and transesophageal echocardiography before, during and a few days after operation. Eighteen patients underwent mitral valve repair: in 9 (50%) - annulocompression (original technique), in 7 (39%) - annulocompression with shortening of papillary muscles, in 1 case - Kay valvuloplasty was performed. One patient needed mechanical mitral valve prosthesis due to rheumatic mitral valve disease. After correction of ischemic mitral incompetence improvement of left ventricular function was observed. Medial-lateral mitral valve ring diameter was reduced from 36.8+/-2.6 mm to 23.9+/-0.56 mm (p<0.01) resulting in decrease of degree of mitral incompetence - 2.9+/-0.2 to 0.7+/-0.8, mean LVEDD - 53.3+/-6 to 50+/-4.1 mm, improvement of LVEF - 35.9+/-6.3 to 38.4+/-9.5, LVWSI from 2.61+/-0.22 to 1.81+/-0.43. ⋯ 1. Patients suffering acute myocardial infarction with >II degrees mitral valve incompetence, should receive coronary artery bypass grafting with mitral valve repair. 2. Repair of ischemic mitral incompetence should consist of annulocompression with/without papillary muscle shortening. 3. Early results surgery in patients with acute myocardial infarction and mitral valve incompetence are similar to the results of surgery on stable ischemic heart disease with mitral valve incompetence if operation is performed on the 3(rd) day of acute myocardial infarction.
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S. aureus causative agent is relatively pathogenic to humans and is found on the skin and mucosa of up to 40% of all population. Burn injuries are infected with S. aureus in 30% of cases; however, in many cases the injuries heal without the antibiotic therapy, solely by applying dressing with antiseptic solutions, early removal of necrotic masses and covering the injury with a skin graft. ⋯ The study included 100 patients who had S. aureus grown in the samples of their injuries. The article compares the severity of the trauma and the results of treatment in groups of patients with methicillin-resistant S. aureus and methicillin-sensitive S. aureus.