Medicina
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Hyperinsulinism is the most common cause of hypoglycemia in infants. In many cases conservative treatment is not effective and surgical intervention is required. ⋯ We present a case of persistent infancy hyperinsulinism. Clinical presentation, conservative treatment modalities, diagnostic possibilities of focal and diffuse forms, and surgical treatment, which led to total recovery, are discussed.
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Case Reports
Sacral insufficiency fracture after pelvic radiotherapy: a diagnostic challenge for a radiologist.
Sacral insufficiency fractures can occur as a complication after pelvic radiotherapy. Despite several recent studies showing high incidence of sacral insufficiency fractures in elderly women after pelvic radiotherapy this condition still remains underdiagnosed. ⋯ Bone scan and single-photon emission-computed tomography with low-dose computed tomography revealed the correct diagnosis. Due to the reasons that sacral insufficiency fractures still remain underdiagnosed this report is important to practical routine work of oncologists and radiologists.
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The incidence of postoperative complications and death is low in the general population, but a subgroup of high-risk patients can be identified amongst whom adverse postoperative outcomes occur more frequently. The present study was undertaken to describe the incidence of postoperative complications, length of stay, and mortality after major abdominal surgery for gastrointestinal, hepatobiliary and pancreatic malignancies and to identify the risk factors for impaired outcome. ⋯ The complication rate after major gastro-intestinal surgery is high. ASA physical status and revised cardiac risk index adequately reflect increased risk for postoperative complications and worse short and long-term outcome.
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The aim of this study was to assess the trends of myocardial infarction (MI) morbidity and evaluate the associations with some meteorological factors. ⋯ The overall morbidity rates of MI increased among Kaunas men aged 25-64 and tended to increase among women, whereas among men aged 65-84 MI morbidity trends were without statistically significant changes and significantly decreased among women during 1995-2007. Weak inverse correlations between atmospheric air temperatures, rainfall level and direct correlation between air wind speed, atmospheric pressure and MI morbidity were established. Months/seasonal variations during analyzed period were observed.
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Additional loading doses and higher maintenance doses (MDs) have been used to overcome hyporesponsiveness of clopidogrel. We aimed to investigate whether genetic polymorphisms of two cytochromes (CYP2C19 and CYP2C9) and ABCB1 modify effect of such dose-adjustment strategy. ⋯ In patients hyporesponsive to a routine clopidogrel doses the potency of additional LD and higher MD of clopidogrel is compromised by presence of CYP2C19*2 allele. The dose-adjustment strategy is not affected by ABCB1 C3435T or CYP2C9 genotypes.