Medicina
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Sepsis and its complications are the most common cause of the death in the intensive care unit. In spite of the treatment mortality remains up to 28-50%, and 60-90% of the patients are lost because of the complications of sepsis. So it is very important to diagnose this pathology and start the treatment early. ⋯ In the case of infection the level of procalcitonin rapidly increases during 2-6 hours and reaches the maximum level after 6-12 hours. The measurement of procalcitonin levels can be used for instant diagnosis as well as for evaluation of the treatment effectiveness. In our article we review the new literature data on the importance of procalcitonin level for sepsis diagnosis in comparison with other parameters of systemic inflammatory reaction, and discuss the indications for procalcitonin analysis.
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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
Changes in serum electrolyte levels and their influence on the incidence of atrial fibrillation after coronary artery bypass grafting surgery.
Our study was designed to assess the incidence of atrial fibrillation, changes of serum electrolyte concentrations following coronary artery bypass grafting surgery. ⋯ 1. The incidence of atrial fibrillation after coronary artery bypass surgery remains relatively high (26.83%). 2. Serum electrolyte concentration after coronary artery bypass grafting varies within normal ranges. 3. Patients with postoperative atrial fibrillation had higher chloride and lower phosphate concentration immediately after surgery and lower ionized calcium and phosphate level 18-20 hours after the surgery.
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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.