Medicina
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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.
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Comparative Study
[Bleeding after cardiac surgery: risk factors, frequency, and outcomes].
According to the data from different cardiac surgery centers, the incidence of urgent repetitive resternotomy for bleeding after cardiac on-pump operations varies from 2 to 5%. The aim of the study was to determinate the risk factors influencing resternotomy after cardiac surgery, features of early postoperative period, and outcomes. ⋯ The use of antiaggregants and anticoagulants before surgery increases the incidence of resternotomies in the early postoperative period. Postoperative infections that require more expensive treatment with antibiotics are detected much more frequently in patients after resternotomies comparing to the remaining postoperative cardiac patients (15/37 and 69/819, respectively). However, longer hospitalization length (15.8 and 58.0 days, respectively) and higher mortality rate (4.5 and 10.8%, respectively) were observed in patients after resternotomy.
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Randomized Controlled Trial Comparative Study
[Effect of combined treatment methods on quality of life in patients with pancreatic cancer].
In Lithuania, about 400 cases of pancreatic cancer are diagnosed each year, and more than 50% of patients are diagnosed with stage IV disease. Quality of life is an important issue in pancreatic cancer patients. A prospective randomized clinical study on the treatment of patients with resectable and unresectable pancreatic cancer was conducted at the Department of Oncology of Kaunas University of Medicine Hospital, and in this study, quality of life was analyzed. ⋯ The analysis of quality of live assessment showed a statistically significant decrease in quality of life after treatment in patients with resectable pancreatic cancer and treated with radiotherapy and gemcitabine. Decreased quality of life later after treatment was also observed in patients diagnosed with unresectable pancreatic cancer and treated with the same regimen. Treatment with radiotherapy and 5-fluorouracil changed only some aspects of quality of life and did not have a significant impact on quality of life.
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To evaluate trends in the use of antidepressant drugs in Lithuania between 2002 and 2004 and to perform cost-minimization and reference price analysis enabling more rational use of financial resources of national health system. ⋯ The findings suggest that the use of total antidepressant drugs continues to increase because of the increased use of selective serotonin reuptake inhibitors and other (newer) antidepressant drugs. In comparison with the data in other countries, the consumption of antidepressant drugs in Lithuania is low.