Medicina
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Photosensitive skin reactions occur when human skin reacts to ultraviolet radiation or visible light abnormally. The forms of photosensitivity are phototoxicity and photoallergy. ⋯ In order to avoid photosensitive reactions it is essential to determine the photosensitizing properties of such substances before drugs are introduced in therapy or products made available on the market. The article reviews the mechanisms of photosensitization, explains the most important differences between phototoxic and photoallergic reactions, summarizes the most common photosensitizers, and presents the clinical features and diagnostic procedures of phototoxic and photoallergic reactions.
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Nosocomial pneumonia, especially ventilator-acquired pneumonia, has the greatest impact on patients' management in intensive care unit. Inappropriate initial antimicrobial treatment increases attributable and crude mortality from ventilator-acquired pneumonia. De-escalation therapy improves short-term survival of patients with ventilator-acquired pneumonia without increasing the emergence of resistant organisms.
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Review Comparative Study
[Severe pediatric head injury: is there any optimal solution?].
Traumatic brain injury in children is a worldwide problem. The incidence of trauma cases is increasing over the world, and in Lithuania it is several times higher than in the most developed European countries. The article reviews data about the most modern means of managing pediatric traumatic brain injury. ⋯ The role of intracranial pressure and cerebral perfusion pressure is crucial. Immediate management of intracranial pressure reduces mortality and improves outcomes. Techniques of intracranial pressure monitoring and management strategies of intracranial hypertension, their advantages and possible disadvantages are described.
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Epinephrine is an adrenergic agonist used to treat bronchospasm, anaphylactic reactions, bradycardia, cardiac arrest, and hypotension. Its toxicity is usually caused by iatrogenic errors. In overdose there is a typical rapid onset of agitation, hypertension, tachycardia, and dysrhythmias. This review article focuses on the causes of overdose, signs and symptoms, treatment and expected course, and prognosis of this iatrogenic pathology.
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Comparative Study
Experience of treatment of moyamoya disease at the Clinic of Neurosurgery of Kaunas University of Medicine.
Moyamoya disease was first described in Japan and represents characteristic appearance on cerebral angiography an abnormal network ("puff of smoke") of collaterals around stenotic arteries. This disease is characterized by progressive intracranial vascular obliterations of the circle of Willis, resulting in successive ischemic or hemorrhagic events. Moyamoya disease primarily occurs among orient people (Japanese, Koreans, Caucasians) and is very rare in Lithuania. ⋯ Cerebral angiography is the main diagnostic procedure which confirms the diagnosis of moyamoya disease. Cerebral hypoperfusion on single photon emission computed tomography is the main criterion for selection of patients for cerebral revascularization. Extra-intracranial anastomosis is an effective procedure for preventing both ischemic and hemorrhagic events in moyamoya patients.