Medicina
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The aim of this study was to develop a specific questionnaire, designed to evaluate health-related quality of life of children and adolescents with congenital or acquired anomalies of the upper extremity. ⋯ Two versions of questionnaire were developed: one for parents of children and adolescents aged 5-18 years and another - for adolescents aged 11-18 years. Both versions consist of seven scales: self-care, daily activities, sports activities and hobby, self-image, emotional, social health, and patient's satisfaction with treatment. The testing of questionnaire reliability was performed by estimating a Cronbach alfa coefficient which varied from 0.80 to 0.97 for different scales of questionnaire designed for parents. The item-scale correlation was from 0.44 to 0.89. There was a statistically significant difference among separate items for all scales (p<0.001). The intraclass correlation coefficient ranged from 0.84 to 0.89 for all scales. Cronbach alfa coefficients of scales of questionnaire designed for children varied from 0.83 to 0.95, and item-scale correlation was moderate to strong. A statistically significant difference among separate items for all scales was obtained (p<0.001). The intraclass correlation coefficient varied from 0.79 to 0.86. The Pearson's correlation coefficient between questionnaires developed for parents and children was calculated, and strong correlation between corresponding scales was found. Sensitivity to changes was tested, and t-test was performed. A statistically significant difference in all scales was found (p<0.001).
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Review Comparative Study
[Febrile infant and small child: what solution could be rational?].
Fever of infant and small child is one of the greatest parental concerns. Mostly the source of fever is viral infection, but sometimes it can be serious bacterial infection: meningitis, sepsis, osteomyelitis, urinary tract infection, pneumonia and enteritis. Non-identified bacterial infection may be a cause of disablement or even death. ⋯ Criteria introduced in these recommendations demonstrate a safe and effective way of screening febrile infants for a serious bacterial infection. Each management strategy involves criteria such as child's age, temperature, clinical appearance, white blood cell count, urinalysis, cerebrospinal fluid test, stool screening, chest radiography. The purpose of this article is to review the data and to validate optimal recommendation regarding the management of febrile infant and child 3 to 36 months of age.
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The second type of multiple endocrine neoplasia syndromes can be described as rare syndromes, heritable in autosomal dominant manner and linking medullary thyroid carcinoma to different tumors of endocrine organ system and endocrinopathies. This syndrome is divided into multiple endocrine neoplasia syndrome type 2A (MEN 2A), characterized with combination of medullary thyroid carcinoma, pheochromocytoma and primary hyperparathyroidism; type 2B (MEN 2B), characterized with combination of medullary thyroid carcinoma, pheochromocytoma, marfanoid habitus and ganglioneuromatosis, and familial medullary thyroid carcinoma syndrome, characterized with the only indication, which is hereditary medullary thyroid carcinoma. Though type 2 multiple endocrine neoplasia syndrome has been known since 1961, yet, the cause of the syndrome, which is germline mutations of c-ret protooncogene, was detected just a decade ago and syndrome pathogenesis with its characterized endocrine neoplasia carcinogenesis machinery were detected. ⋯ Stated genotype link to phenotype helps to prognosticate possible combinations of endocrine neoplasia and endocrinopathies, and to choose purposeful patient observation. Genetic screening of the inheritors of multiple endocrine neoplasia type 2 syndrome enabled purposeful researches and observations of patients with a huge risk of uprising endocrine neoplasia, it also enabled application of effective prophylaxis methods, avoidance or early diagnostic of malignant tumors and life prognosis improvement for patients with malignant tumors while practicing well-timed treatment adaptation. This literature review contains the newest data on multiple endocrine neoplasia syndrome type 2 and its pathogenesis, diagnostics, patient observation, endocrine cancer prophylaxis and methods of treatment, which are characteristic for syndrome and which are being chosen according to biochemical endocrine neoplasia symptoms and genetic diagnosis.
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Asthma is a chronic airway disease that is a growing problem of public health. The current consensus is based on the Global Initiative for Asthma (GINA) and other guidelines for asthma, and adapted for Lithuania. This Consensus provides physicians with recommendations for asthma management in children and adults.
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Passive smoking has been shown to be a risk factor for respiratory diseases in children. Some authors reported reduced lung function of children exposed to passive smoking. The purpose of the study was to assess the prevalence of exposure to passive smoking and its relation to respiratory health of Kaunas children. ⋯ Multiple regression analysis that included variables such as passive smoking, family history of allergy, smoked mother during pregnancy, gas stove and pets in child's room showed that FEF25 and FEF50 in girls were related to passive smoking. Our data show that more than two fifth of children are exposed to passive smoking which is associated with increased prevalence of chronic cough, wheezing, running nose and sneezing without cold. Passive smoking is also related to decreased lung function, especially for small airway flows.