Medicina
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Review Historical Article
[The International Classification of Functioning, Disability, and Health and experience of its implementation into practice].
The International Classification of Functioning, Disability, and Health (ICF) organizes and classifies health and other related conditions, their consequences, and factors. The aim of this article is to summarize the experience of implementation of the ICF and possibilities for its application based on the recent literature data. This article gives brief information about background and history of the ICF development; essential ICF regulations and aims are defined as well as data on designing the methods of evaluation of health and other conditions related to it according to the ICF and their practical use in various rehabilitation spheres are presented. ⋯ After summarizing the information on experience of the ICF implementation in other countries, the following aspects are emphasized: evaluation methods of functional state for patients and disabled are being developed and implemented according to the Comprehensive and Brief ICF Core Sets; the need for service in rehabilitation, geriatrics, and social security spheres is identified; the effectiveness of rehabilitation programs is evaluated based on the changes of personal functionality, described by the ICF categories. Development of a rehabilitation program is illustrated by the example of practical application of the ICF. According to the experience of other countries, guidelines of the ICF implementation into practice in Lithuania are given.
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Comparative Study
[Use of technologies in maintaining autonomy of frail older persons].
Although Lithuanian population is aging and the number of older persons is increasing, the expectancy of autonomous life is one of the shortest in Europe. An increasing number of the elderly results not only in aging society, but in increasing morbidity as well. Reality of life is encouraging health care systems to take into account the needs of older patients and to seek for comprehensive assessment, which is not limited by physical assessment only but includes evaluation of functional state, cognition, socioeconomic status, home environment, identification of geriatric syndromes and vulnerability factors, and assessment of frailty. ⋯ Gerontechnologies in vulnerable and frail elderly people can compensate impaired orientation and memory, widen the possibility to communicate, exchange information, and move. With the help of gerontechnologies, safe home environment and monitoring of health state can be ensured. In the article, algorithm for maintenance of autonomy in older persons made by the authors is presented.
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Comparative Study
The effect of induced sputum and bronchoalveolar lavage fluid from patients with chronic obstructive pulmonary disease on neutrophil migration in vitro.
The aim of study was to investigate a chemotactic effect of induced sputum and bronchoalveolar lavage fluid on blood neutrophils in patients with chronic obstructive pulmonary disease (COPD) and healthy individuals. ⋯ Migration of neutrophils isolated from patients with COPD was more intensive compared to healthy individuals. Induced sputum and bronchoalveolar lavage fluid directly and with addition of interleukin-8 stimulated chemotaxis, and it was higher in neutrophils from COPD patients. Migration of neutrophils did not depend on smoking status.
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Major obstetric hemorrhage remains the leading cause of maternal morbidity and mortality worldwide. Even though blood transfusion may be a life-saving procedure, an inappropriate usage of blood products in obstetric emergencies especially in cases of massive bleeding is associated with increased morbidity and risk of death. Thorough knowledge of the etiology, pathophysiology, and optimal therapeutic options of major obstetric hemorrhage may help to avoid lethal outcomes. ⋯ The transfusion of each single blood product must be performed only in case of evaluation of expected effect. The need for blood products and for their combination is necessary to estimate for each patient individually in case of obstetric emergencies either. Indications for transfusion of blood components in obstetrics are presented in order to improve the skills of doctors and to optimize therapeutic options in obstetric emergencies.
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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).