Medicina
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Comparative Study
[Survival after myocardial infarction among the middle-aged Kaunas men and women].
The aim of the present study was to determine and compare the short-term and long-term survival after myocardial infarction (MI) in the Kaunas men and women aged 25-64 during 1983 to 1998, according to ischemic heart disease register data. The source of the data--Kaunas population-based ischemic heart disease register. The diagnosis of MI was based on the criteria defined by the WHO MONICA Project. All myocardial infarction events that occurred among Kaunas population aged 25-64 years during 1983-1998 were recorded. Myocardial infarction survival was evaluated using Kaplan-Meier method and using z test for comparing the survival curves. ⋯ The data of 3,613 persons with a first myocardial infarction and 528 with a recurrent myocardial infarction were analyzed. Detected, that among men and women a short-term (28 days) survival probability was significant different. In the men aged 25-64 short-term survival after a first myocardial infarction was better comparing with the women survival (z = 4.63, p = 0.03). The short-term survival among men aged 25-64 with a recurrent myocardial infarction comparing with woman did not differ. The long-term survival probability in patients, who survived the first 28 days, among men and women with a first and recurrent myocardial infarction aged 25-64 was without statistically significant differences.
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The objective of our paper was to show the data of our treated patients with malignant pleural mesothelioma. In the Department of Thoracic Surgery of Oncology Institute at Vilnius University from 1980 till 01.06.2002, 33 patients (pts), to whom diagnosis of pleural mesothelioma was confirmed by pathologist, were treated in the Clinic. A malignant pleural mesothelioma was diagnosed in 31 pts, two pts had a non-malignant form of mesothelioma. Among patients were 19 men and 14 women. The distribution of pts according to the stage of the disease was: I stage - 3, II - 1, III - 17, IV - 10. Videothoracoscopy is the best method for diagnosing pleural mesothelioma. Radical operations were performed only in 17 cases: 6 - pulmonectomy with pleuroectomy, 1 - lobectomy, 3 - atypical segmentectomy, 4 - pleuroectomy, 4 - tumorectomy. Thoracotomy was performed in 9 cases. Insufflation of talc was performed in 6 pts. Adjuvant therapy (chemotherapy or radiotherapy) was given to 10 pts. ⋯ 1. Diagnosis of malignant pleural mesothelioma is difficult and confirmation of the disease is possible only after histological examination of tumor. 2. The best results of treatment were achieved after combined treatment: surgery, after chemotherapy and radiotherapy. 3. In cases of pleural effusion of diffuse pleural mesothelioma insufflation of talc or other chemical substances into pleural cavity is recommended.
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During the flowering of cardiothoracic surgery over the past 50 years, surgery of the major airway failed to develop correspondingly. The relative rarity of such cases accounts in past for this laggardness. Surgical diseases of the trachea, whether inflammatory or neoplastic, largely are presented as an obstructive problems of the airway. Surgical management of these lesions is based on simple concept of resection of the involved area of the trachea, when the larynx has not been lost because of affection by the primary disease. Primary end-to-end reconstruction of the trachea has been generally recognized as the ideal method of repair following resection. However, based on Belsey's experience it was widely believed, that only 2 cm at most could be removed and the trachea reconstruction by end-to-end suture in any dependable fashion. During the period of 30 years tracheobronchial surgical reconstructions have been accomplished in 187 patients. ⋯ Management of the patients with stenosis of the trachea and main bronchi must be started promptly. Emergency treatment for the patients with severe tracheal stenosis is rigid bronchoscopy under general anesthesia. Circular tracheal resection is the best method of radical treatment for patients with benign and malignant tracheal narrowing. Sleeve resection is the ideal form of excisional therapy for benign endobronchial tumors, neoplasms of low-grade malignant potential, and bronchostenosis. For patients with tracheobronchial stenosis who are no candidates for surgical reconstruction, tracheobronchial stenting is the management of choice.