Medicina
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More than 5 million people are bitten by venomous snakes annually and more than 100,000 of them die. In Europe, one person dies due to envenomation every 3 years. There is only one venomous snake species in Lithuania--the common adder (Vipera berus)--which belongs to the Viperidae family; however, there are some exotic poisonous snakes in the zoos and private collections, such as those belonging to the Elapidae family (cobras, mambas, coral snakes, etc.) and the Crotalidae subfamily of the Viperidae family (pit vipers, such as rattlesnakes). ⋯ In Europe, a polyvalent antiserum against Viperidae family snakes (including the common adder) can be used. Antivenins often may cause severe hypersensitivity reactions because of their protein nature. The bite of the common adder (the only poisonous snake in such countries as Lithuania and Great Britain) relatively rarely results in death; thus, considering the risk of dangerous reactions the antivenin causes itself, the usage of it is recommended to be limited only to life-threatening conditions.
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Various health care measures have been identified over the years as indicators of health care quality. However, studies evaluating the quality of nursing care among different patient groups are scarce. Patients undergoing abdominal surgery may be a group that has different views, needs, expectations, and evaluation of the quality of nursing care. ⋯ The analysis revealed that the quality of nursing care was usually rated as high according to the perceptions of patients and/or nurses. The following factors associated with the quality of nursing care were identified: nurse staffing, organizational characteristics, patients' characteristics, nurses' characteristics, nursing care needs, and nursing documentation. Further research should be focused on the measurement and evaluation of the quality of abdominal surgical nursing care from nurses', patients' and their relatives' perceptions by using nonexperimental and experimental study designs for gaining the knowledge how to improve the quality in practice.
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Comparative Study
The value of clinical prognostic factors for survival in patients with invasive urinary bladder cancer.
The aim of the study was to evaluate the value of clinical prognostic factors for survival of patients with invasive urinary bladder cancer treated with radical cystectomy, chemotherapy, and radiotherapy. ⋯ The best 3-year overall survival was in the radical cystectomy group. Chemoradiation with gemcitabine could be offered as an alternative to patients refusing cystectomy. Better overall survival in the chemoradiation group was for patients without comorbidities and when treatment protocol was completed.
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The transformation from the early to late modernity initiated in the Western societies has touched the medicine and entered Lithuania as well. Changes affect not only human values, but also attitude toward a patient. A patient is seen more as a person with social needs until the end of his/her life. It is especially difficult to retain such attitude to the patient in intensive care units. Studies conducted abroad report the importance of the contacts and support of the relatives to the patients in intensive care units. Attention from the medical personnel, easy understandable information, liberated visiting--all together increases the satisfaction and confidence with medical care provided. In Lithuania, the above-mentioned attitude toward patients is still not common. The objective of this study was to reveal the important aspects of the transformation of attitude to the patient and his/her social environment by analyzing the possibilities of social interactions in an intensive care unit. ⋯ The relationship between the medical personnel and the patients is restricted to instrumental communication, which is a feature of the early modernity. The process of attitude transformation, common in the Western countries, when a patient is treated not only as biological but also as a social person, is only at the initial stage in Lithuania.
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Pain is a common problem in diabetic neuropathy, but relatively little has been published regarding the extent to which it needs to be addressed in clinical practice. ⋯ Standard pain questionnaires were useful in identifying pain sufferers. At the same intensity, deep neuropathic pain was more unpleasant than superficial. Pain manifestation was associated with female gender and lower level of glycosylated hemoglobin.