Medicina
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Breastfeeding is the most healthful method of feeding neonates and infants. In 2001 about 98% of new mothers in Lithuania started breastfeeding their neonates. One-third of nursing women (34%) discontinued breastfeeding at the time when infant reached the age of 3 months. ⋯ Such data suggest that there is a lack of information often leading physicians to advise mothers to discontinue breastfeeding because of medication use. The aim of this article was to survey the situation about classification of drugs used during breastfeeding and factors influencing drug transfer into milk in order to give more information for physician concerning the use of medication during breastfeeding. In this review, a short description of main pharmacokinetic characteristics, influencing drug transfer into milk; information on the classification of drugs used during breastfeeding; some considerations on drug safety and possible adverse effects of medications on breastfed infant; the list of drugs preferred for nursing women are presented.
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This article presents a review of current literature on impact of thoracic epidural anesthesia on functions of organs and systems. Its role in anesthetic management of pulmonary resection is discussed. Thoracotomy is one of the most painful surgical procedures followed by intense, acute, and chronic pain associated with post-thoracotomy. ⋯ Sympathetic blockade during thoracic epidural anesthesia reduces the rate of perioperative myocardial ischemia and cardiac mortality. It also reduces the number of thromboembolic and gastrointestinal complications and has a positive effect on immune function. Due to numerous benefits, thoracic epidural anesthesia can be recommended as a standard in pulmonary resection surgery.
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To determine the incidence and variety of microorganisms of positive urine culture in patients of intensive care units of Kaunas University of Medicine Hospital and to estimate the risk factors for colonization, development of urinary tract infection, and outcome during the period of 2003-2004. ⋯ Positive urine culture was found in 3.9% of patients, three-quarters of them were due to urinary tract infection. Rods were the predominant pathogens in urinary tract infection. E. coli in urinary tract always resulted in urinary tract infection. Catheterization of urinary bladder resulted in urinary tract infection or colonization. Each day of urinary bladder catheterization increased the risk of development of urinary tract infection by 21.7%. Rods in urine culture were associated with lethal outcome. Development of urinary tract infection increased the risk of lethal outcome 5.5 times.
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The aim of the study was to investigate the causative agents of bacteremia in burned patients during 1999-2003. ⋯ Bacteremia was diagnosed at the beginning of the third week of hospital stay. More than half of bacteremic patients (67%) survived. The most common causative agents of bacteriemia were methicillin-resistant Staphylococcus aureus and gentamicin-sensitive strains of Pseudomonas aeruginosa.
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Review Comparative Study
[An update on multiple insulin injection therapy in type 1 and 2 diabetes].
Achieving and maintaining glycemic control (glycated hemoglobin--HbA(1c)< or =7.0% according to American Diabetes Association and < or =6.5% according to International Diabetes Federation) is the primary goal in treating diabetes, which lowers the risk for diabetes-related complications. Insulin therapy is essential for type 1 diabetes treatment. Insulin therapy in type 2 diabetes is initiated when glycemic control is inadequate despite the combination of antihyperglycemic drugs. ⋯ Basal insulins include intermediate-acting human insulins (neutral protamine Hagedorn) and long-acting insulin analogs (insulin glargine, insulin detemir). The latter are the optimal choice covering basal insulin requirement. Compared to neutral protamine Hagedorn insulin, long-acting insulin analogs have no pronounced concentration peak and reduce nocturnal hypoglycemia risk and weight gain.