Medicina
-
The aim of this study was to determine the efficiency of individual balanced replacement diet in treatment of children with atopic dermatitis, to compare the course of atopic dermatitis and gastrointestinal disorders, as well as the data of skin patch test after a one-year period of dietary treatment. ⋯ Individual balanced replacement diet for children with atopic dermatitis helped to fully control nutrition of sick children from various age groups and had a positive effect on the clinical course of atopic dermatitis. Patients who followed their individual dietary recommendations suffered from severe allergic rash more rarely and they had to take fewer medicines against allergy as compared to children who did not follow dietary recommendations. Clinical course of atopic dermatitis in children who followed individual dietary recommendations was easier as compared to children who did not follow such recommendations. One-third of children with atopic dermatitis became more tolerant to earlier food allergens during a one-year period. After a one-year dietotherapy treatment, positive patch test reactions to many food products appeared to be more rarely, except for buckwheat, oat, beef, and cacao. Besides, children who followed their dietary recommendations suffered from gastrointestinal disorders (abdominal pain, abdominal distention, and constipation) significantly more rarely as compared to children who did not follow their dietary recommendations.
-
Review Comparative Study
[Nonpharmacological correction of low back pain by single or integrated means of medical rehabilitation and the evaluation of their effectiveness].
Low back pain is a global worldwide problem. A great attention is given to correction of this health status by a wide range of rehabilitation specialists. Some single or integrated physical factors, physiotherapy, specific and nonspecific physical exercises, alternative methods of treatment, also the complex of multidisciplinary rehabilitation means are applied in the management of low back pain. The evidence-based data are analyzed in order to identify which nonpharmacological means are effective in pain correction; in addition, the effectiveness of various methods and models of low back pain management are compared in this article. ⋯ Research data evaluating the impact effectiveness of single or integrated means of rehabilitation are very controversial. There are no evidence-based specific recommendations for the correction of this health status objectively assessing advantages of physiotherapy or physical factors and referring the definite indications of their prescription. It is thought that multidisciplinary rehabilitation is most effective in management of chronic low back pain. The positive results depend on the experience of a physician and other rehabilitation specialists. A patient's motivation to participate in the process of pain control is very important. It is recommended to inform a patient about the effectiveness of administered methods. There is a lack of evidence-based trials evaluating the effectiveness of nonpharmacological methods of pain control in Lithuania. Therefore, the greater attention of researchers and administrative structures of health care should be given to this problem in order to develop the evidence-based guidelines for an effective correction of low back pain.
-
Besides crystalloids, colloids are used for the treatment of hypovolemia and shock. They are high-molecular-weight proteins of bovine origin with properties of more rapid replacement of circulating blood volume. Iso-oncotic character provides the volume effect (approximately equal to 100%) close to the volume intravenously infused with the duration of action for 2-4 hours. ⋯ Gelatin solutions may cause compensatory hyperemia and increase of cardiac output, cardiac index, myocardial contractility, mean arterial blood pressure, and diuresis; in addition, oxygen delivery to the tissues improves. The dosage depends on clinical condition of a patient, and it is suggested to be 100-2000 mL and even more, for isovolemic hemodilution--20 mL/kg of body weight. Adverse reactions such as anaphylactoid or anaphylactic to gelatin derivates are rare and similar to other colloids.
-
The prevalence of allergic diseases is increasing in Lithuania as in the world. The prevalence of allergic sensitization is often higher than 50% of the population. The "hygiene hypothesis" proposed that reduced immune-stimulation by infections may have resulted in the more widespread clinical expression of atopic disease. ⋯ This review also presents the current options on the treatment and prevention of virus-induced asthma. Further studies are needed in order to differentiate between the response to viruses of healthy and atopic or nonatopic asthmatic children and adults. New research data may lead to novel strategies in treatment and prevention of asthma exacerbations as well as prevention of asthma induction.
-
Comparative Study
[Treatment outcome of locally advanced stage IIIA/B lung cancer].
To determine survival of patients with stage IIIA/B non-small cell lung cancer considering disease stage and treatment methods. ⋯ Disease stage had an influence on the survival of patients with non-small cell lung cancer: patients with stage IIIA (T3N0-1M0) cancer without metastases to mediastinal lymph nodes (N factor) survived longer than patients with stage IIIB (T4N1-2M0) cancer, where not only N factor had an impact but T factor as well. Better treatment outcomes, i.e. longer survival, can be achieved when a combination of three treatment types - surgery, chemotherapy, and radiation therapy - is applied to patients with stage IIIA or IIIB non-small cell lung cancer. The patients with stage IIIA disease who received surgery and radiation therapy (total dose, >40 Gy), and combinations of surgery, chemotherapy, and radiation therapy and second-line chemotherapy showed a significantly longer survival than those who received surgery alone.