Medicina
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Comparative Study
Prevalence of the metabolic syndrome diagnosed using three different definitions and risk of ischemic heart disease among Kaunas adult population.
The aim of this study was to compare the prevalence of the metabolic syndrome diagnosed using three different definitions and to evaluate its associations with ischemic heart disease in Kaunas adult population. MATERIAL AND METHODS. Data of preventive screening carried out in Kaunas in 2001-2002 according to the MONICA study protocol were used for analysis; a total of 1336 persons aged 35-64 years (603 men and 733 women) were recruited. ⋯ CONCLUSION. In Kaunas population aged 35-64 years, the highest prevalence of the metabolic syndrome was determined according to the International Diabetes Federation definition. Usage of the International Diabetes Federation and the Adult Treatment Panel III definitions in establishing diagnosis of the metabolic syndrome provides more opportunities to identify subjects with ischemic heart disease.
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Comparative Study
Acute kidney injury in pediatric patients: experience of a single center during an 11-year period.
The aim of our study was to determine the causes of acute kidney injury (AKI) in children, to compare outcomes between two periods--1998-2003 and 2004-2008--and to evaluate the influence of new methods of renal replacement therapy on mortality. ⋯ More than half of patients had secondary acute kidney injury of nonrenal origin. More than two-thirds (69.3%) of patients with AKI were treated in the pediatric intensive care unit. Multiple organ dysfunction syndrome was diagnosed for 40.8% of children with AKI. Renal replacement therapy was indicated for one-third of patients with AKI. A 2.5-fold decrease in mortality was observed in the second period as compared to the first one.
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Randomized Controlled Trial Comparative Study
The effects of sevoflurane and propofol on cerebral hemodynamics during intracranial tumors surgery under monitoring the depth of anesthesia.
Hemodynamic effects during cerebral tumor resection surgery under monitoring the depth of anesthesia and during recovery in sevoflurane- or propofol-anesthetized patients have not been previously compared. ⋯ At the comparable depth of anesthesia for intracranial tumors surgery and during recovery, sevoflurane had no major effect on cerebral circulation measured by transcranial Doppler sonography as compared with propofol. Our results add to current knowledge on the safety of sevoflurane in neuroanesthesia.
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Combined oral contraceptives have been known as a well-established contraceptive method already more than 50 years. Unfortunately, this method is not absolutely safe. Combined oral contraceptives include estrogens and progestagens, which may stimulate the blood coagulation and promote the occurrence of deep-vein thrombosis; adverse effects of oral contraceptives are also notably associated with increased risk of stroke and myocardial infarction. The risk of hypercoagulation and venous thrombosis is most likely to be influenced by the dose of estrogens, but recent investigations have showed that the type of progestagens is very important as well.
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Crush injury is defined as compression of extremities or other parts of the body that causes muscle breakdown (traumatic rhabdomyolysis). Systemic consequences of crush injuries are as follows: rhabdomyolysis, electrolyte and acid-base abnormalities, hypovolemia, and acute renal failure. Crush injuries are important injuries in disaster situations: earthquakes, hurricanes, mining and road traffic accidents, war, collapse of buildings, etc. In this review article, there are discussed about epidemiology of crush syndrome, risk factors, pathophysiology (mechanisms of muscle cell injury, release of substances from injured muscles, other consequences of reperfusion), clinical features, differential diagnosis, investigations, complications (acute renal failure, hypovolemic shock, hyperkalemia, infection, compartment syndrome), approach to treatment (adequate rehydration, a forced mannitol-alkaline diuresis, intravenous fluids, management of hyperkalemia, wound care, hyperbaric oxygen, etc.), prognosis, the mortality rate and prevention (timely support may reduce morbidity and mortality).