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Chemical and organoleptic analysis of honey collected in Spain and Lithuania
No full textThe master‘s thesis was written in 2019–2020 at the Clinic of Large Animals of the Lithuanian University of Health Science. Final thesis includes 49 pages (without appendixes), 17 images, 9 tables, 5 appendixes. The main objective of the study was to compare the quality of honey collected in Spain and Lithuania over the one year‘s time (November 2018 – November 2019) using statistical analysis. Determinations of water content, acidity, minimum allowable invert sugar, diastase activity, artificially invert sugar, sensory analysis, honey microscopy and statistical analysis were performed. The results shows that the water content in fresh Spanish honey was 19.91±4.46% and fresh Lithuanian was 21.66±1.45%, but after a year the water content in Spanish honey dropped to 1% and in Lithuanian honey dropped to 2.5% (P≥0.05). The pH of fresh Spanish honey reached 3.96±1.37 and Lithuanian honey pH reached 5.28±2.28. After a year, the pH of Spanish honey dropped to 3.41±0.91 and pH of fresh Lithuanian honey dropped to 4±2.16 (P≥0.05). Diastase activity in fresh Spanish honey was 11.17±15.82 unit of Goth and in fresh Lithuanian honey was 9.16±3.20 unit of Goth. The amount of invert sugar in both Spanish and Lithuanian honey has not changed over the year. Studies of hydroxymethylfurfural in fresh Lithuanian honey showed a negative reaction, while 62.5% of fresh Spanish honey had a weakly positive hydroxymethylfurfural response and the number of samples increased by 12.5% over the year. During the sensory analysis, no defects were found in fresh Spanish and Lithuanian honey, but after repeating the sensory analysis a year later, the acidity and bitterness of the honey were found in some samples
Assessment of Rational Use and Economy of Anticoagulants
No full textThe aim: to examine the rational use of anticoagulants and to evaluate the cost-effectiveness of their administration. The tasks: to evaluate and compare the rational use of warfarin and direct oral anticoagulants (NOAC) administration in patients with atrial fibrillation (AF) by systematic review of literature. To evaluate and compare the cost-effectiveness of warfarin and NOAC administration in patients with AF by conducting a systematic review of literature. Methodology. Systematic literature review Conclusions. Atrial fibrillation is one of the most common causes of stroke and other thromboembolic complications, heart failure and sudden death. Complications increase the morbidity and mortality of the population and are also associated with higher costs for their treatment. It is important to mention that with proper anticoagulation therapy, that is the rational administration of medications that affect the coagulation system, these complications can be avoided. The two main groups of medications that are used to prevent thromboembolic complications in patients with AF are: NOAC and the vitamin K antagonist warfarin. Direct – acting anticoagulants, also known as NOAC, have been invented, approved and used for only a decade, compared with warfarin, which has been used in clinical practice for more than five decades. A systematic review of the literature revealed no significant differences in the use of either groups of medications. Both, warfarin and NOAC, have their own advantages and disadvantages and should be administrated individually to each patient based on their conditions, the kind of AF (valvular or non-valvular atrial fibrillation) and the pharmacodynamic and pharmacokinetic properties of each group. The researchers in different countries were reviewed to assess the cost-effectiveness. It has been observed that the costs of anticoagulant therapy alone do not differ significantly. However, significant benefits and lower costs have been identified for the treatment of complications with the use of direct-acting anticoagulants (NOAC)
The attitude of academic youth to a healthy lifestyle
No full textAim of the study: Identify the attitudes of academic youth towards a healthy lifestyle. Tasks: 1. To determine the peculiarities of LSMU and VMU students' lifestyle. 2. To find out the attitude of LSMU and VMU students to a healthy lifestyle. 3. To evaluate the links between students' attitudes towards healthy lifestyles and lifestyle features. Methods. The method chosen for the empirical study is a quantitative questionnaire survey. A non-probabilistic selection and a convenient sample were selected for the study. Participants in this study are students studying in chosen higher education institutions, who are 18 years of age and older and are studying for undergraduate and graduate studies. The sample of this research consisted of 181 respondent questionnaires. Statistical analysis of the data was performed using the data collection and analysis program SPSS version 23 and Google forms Excel software package. Student's (t) criteria, Chi-square (χ 2) tests, and Cramer's V correlation coefficient were used to test the hypotheses. The result was considered statistically significant if the error probability was p <0.05. Results. Analyzing the answers to the questions of health perception, it can be seen that the respondents chose the answer, that belongs to the biomedical perception of health, when health manifests itself in the absence of diseases. 81, 2 percent of respondents fully agree with this definition of health. The results of the study shows that 68 percent of respondents have changed their lifestyle and 38.8 percent changed their lifestyle after entering university. Assessing the links between respondents attitudes towards healthy lifestyle and lifestyle features, data analysis revealed that there is a weak, statistically significant relationship between respondents attitudes and lifestyles. Respondents present that the healthy diet is the most significant aspect of healthy lifestyle. Conclusions. The study revealed that students ’lifestyles are changing with health-friendly behaviors. Students ’attitudes toward a healthy lifestyle depend on their own assessment of health. The links between a healthy lifestyle approach and lifestyle are linked by a weak link
The Effectiveness of Monitoring Patients with Chronic Heart Failure in Health Care Institutions
No full textThe aim: To evaluate the effectiveness of monitoring heart failure patients Tasks:1. To evaluate the signs and symptoms of the disease in patients with heart failure, their changes in the course of active monitoring and between groups: patients with higher NYHA functional class (6 MWT 425 m) patients. 2. To evaluate the changes in laboratory parameters of patients with heart failure and their changes during active monitoring and between groups: physically stronger (6 MWT 425 m) patients. 3. To evaluate the quality of life index (according to The Minnesota Living with Heart Failure Questionnaire) and self-care (according to The 12-item European Heart Failure Self-Care Behaviour Scale ) during the first and last visit and between groups: physically stronger(6 MWT 425 m) patients Research methodology: Prospective research was conducted in 2019-2020 in the Department of Cardiology of Lithuanian University of Health Sciences.Based on the LR HM 2015 November 24 Order V - 1330 'On the approval of a description of the requirements for the provision of consultation by a cardiologist and nurse, including patient training, to persons with heart failure', the study included 46 patients who had completed 4 consecutive training consultations. For a more detailed analysis, patients were divided into physically stronger (6 MWT> 425m) and physically weaker (6 MWT <425 m) groups. To evaluate the effectiveness of the program, patients' physical condition, laboratory parameters, quality of life index and self-care statistical methods with IBM SPSS Statistics version of 20.0 program was applied in the analysis. Results and conclusions: During active monitoring, shortness of breath statistically significantly decreased, regardless of physical capacity (p = 0.004). In addition, when comparing groups, during 2 and 3 visits, physically weaker patients were more likely to complain of dyspnoea (p=0.019 and p=0.042). There was no significant difference in other signs and symptoms between groups or observation visits. NT-pro-BNP decreased during the second visit (p=0,028) and gradually decreased during the observation visits. Furthermore, NT-pro-BNP improved regardless of the patient's physical condition (p = 0.004). Other changes in laboratory parameters were not clinically significant between groups and during active monitoring. Both the quality of life (p = 0.012) and self-care (p = 0.023) improve during the active monitoring and between groups. Both the quality of life and self-care are inferior to physically weaker patients (self-care during the first visit p =0,032, and self-care during the last visit p =0,029; quality of life during the first visit p =0,003 and quality of life during the last visit p =0,006). Conclusion Patient education in heart failure has a positive impact on self-care and quality of life. The evaluation scores show a positive effect in both groups after active management. Despite the improvement of heart failure symptoms and decreased NT-pro-BNP levels, patients with higher heart failure functional class rate their quality of life and self-care worse
The Results of the Surgical Treatment of Diffuse Thyrotoxic Goiter
No full textThe aim. To investigate the results of diffuse thyrotoxic goiter surgical treatment in The Hospital of Lithuanian University of Health Sciences Kauno klinikos Surgery Department. The objectives. To review the characteristics of the sample patients. To identify rates of different complications. Find prognostic factors that can impact the results of thyroidectomy. Methods. A retrospective analysis of patients’ case histories was performed. Statistical data analysis was performed using SPSS 23.0 and MS Excel software. Statistically significant differences between qualitative data were established using Student t test, Mann–Whitney U test, Kolmogorov-Smirnov test. Quantitative data was analyzed using χ2 criteria and Fisher exact test. Study sample. Patients who underwent surgical treatment for MTC during 2014 – 2018 years in The Hospital of Lithuanian University of Health Sciences Surgery Clinic were enrolled into the study. Results. There were 111 (75%) females and 37 (25%) males among the sample patients. The mean age of patients was 42,7 (±12,7) years. Most of the patients had one or more comorbidities. Prior to an operation everyone got antithyroid drug treatment. Mean of removed goiters - 58,2 (±42,4). After surgery 4 (2,7%) pacients had developed recurrent laryngeal nerve paresis - 1 (0,7%) left paralysis, 2 (1,4%) - right, 1 (0,7%) - both. During postoperative time in the hospital hypoparathyroidosis was detected in 13 (8,8%) patients, hematoma - 4 (2,7%). Conclusions. Diffuse thyrotoxic goiter was more often diagnosed to females; they experienced more symptoms. Rates of complications after total thyroidectomy performed in Kaunas Klinikos Surgery department were lower than noted in literature. Prognostic factors that could have impact on surgery results were found to be bigger goiter size, prolonged drug treatment, having comorbidities
Stress at work and stress coping factors experienced by nurses performing patient sorting in the emergency department.
No full textSinkevičiūtė V., Stress at work and stress coping factors experienced by nurses performing patient sorting in the emergency department. Master's thesis / scientific supervisor dr. L. Bardauskienė; Lithuanian University of Health Sciences, Clinic of Emergency Medicine - Kaunas, 2020, - p. 63 Objective: To evaluate the factors of nurses' stress at work and stress coping and their connection with the need for training, sorting according to the need for emergency care patients arriving at the Emergency Department (ed) of Kaunas Clinics (LUHS KC). Tasks: 1. To assess the knowledge and skills of nurses working at ED of LUHS KC about the triage according to the categories of patients' care. 2. To identify the sources of triage's training and training needs of nurses working at ED of LUHS KC. 3. To evaluate the stressors at work of nurses performing triage at ED of LUHS KC, and relation with the need of training. 4. To evaluate the stress coping factors of ED of LUHS KC nurses performing triage, and relation with the need of training. Research methodology: The research was performed by ED of LUHS KC. The duration of the study was from 2020 January to 2020 March. The study was conducted using an anonymous survey using standardized questionnaires on stress and stress coping. Subjects. 48 general practice nurses working at ED of LUHS KC. Conclusions of the work. The results obtained suggest that the vast majority of nurses working in the ED would rightly prioritize a critical patient. The most important principle in communicating with the patient was the respectful treatment of the patient by the nurses. During triage, the nurse must take into account the vital parameters of all clinical conditions, but the vast majority of respondents answered incorrectly - they would not assess all the criteria. More than two-thirds of the surveyed nurses said that they learned about patients' triage from theoretical sessions and practical sessions by observing the triage done by an experiened person. Almost 80% would like to participate in training, 90% believes that training would improve the quality of their work. One of four ED nurses experience severe stress due to a lack of support from colleagues, one of six - due to a lack of job control. In most cases, respondents use avoidance and problem-solving techniques to cope with stress, and rarely indicated using social support stress management techniques. According to more than half of the surveyed nurses, training of triage would partially reduce stress at work, and a quarter think that it would significantly reduce stress. The study found that the desire to acquire new knowledge and participate in training reduces stress in patients' triage
Implantų pasekmės pacientams kurie yra susidūrę su periodontologine liga.
No full textObjective: The aim of this systematic review was to assess the survival rate of dental implants placed in patients that have a history of treated periodontal disease and to further evaluate whether a history of periodontal disease increases the risk of having complications after implant placement, such as peri-implant diseases. Materials and Methods: Electronic databases were used to search (PubMed, Cochrane, Science Direct) and to identify articles concerning dental implant placement in patients with previous periodontal disease. After selection of the studies, 8 studies were included in this systematic review. The search of articles on the electronic databases was restricted to articles in the English language and articles published in the last 10 years (January 2010 to February 2020). Results: The results of studies reviewed in this thesis showed that is no negative effect on the survival of dental implants, however they did show a higher risk of peri-implant diseases in patients with a history of periodontal disease compared to patients without a history of periodontal disease. Conclusion: Regardless of the limitations of the systematic review, there is no substantial evidence that a history of periodontal disease may be a risk factor for dental implant failure, however a number of studies showed that there is a correlation between a history of periodontal disease and peri-implant disease. Further research and studies are needed to be able to establish whether or not a history of periodontal disease negatively affects the outcome of the placement of dental implants
Optimization of Surgical Treatment of Extraarticular Distal Tibial Fractures
No full textAim of the study: To compare the methods of surgical treatment of extraarticular fractures of the distal tibia by performing a systematic review of literature. Objectives: 1. To analyze the results of treatment of distal tibia fractures using intramedullary osteosynthesis. 2. To analyze the results of treatment of distal tibia fractures using minimally invasive cortical osteosynthesis technique. 3. To analyze and compare the results of treatment of distal tibial fractures using intramedullary and cortical osteosynthesis techniques. 4. To analyze the significance of osteosynthesis of the fibular fracture on the results of treatment of distal tibial fractures using intramedullary and cortical osteosynthesis techniques. Methods: This is a systematic analysis of literature. The object of the analysis – clinical studies in which intramedullary osteosynthesis is compared to minimally invasive plate osteosynthesis by various authors and published in the last 10 years. Systematic literature analysis was performed based on PRISMA requirements. Literature search was performed using PubMed (Medline) medical database. Selected studies were analyzed and compared on duration of surgery, duration of healing, functional outcomes, and complications. Results: Based on inclusion and exclusion criteria, 7 scientific articles were included in which were 733 patients, of whom 377 were treated with intramedullary osteosynthesis and 356 with cortical osteosynthesis. Duration of surgery, duration of healing, and functional outcome were found similar using both treatment methodologies. In the IMN group a statistically significantly higher number of cases of malunion and knee pain that persisted for more than a year after surgery was found. Meanwhile, there were statistically significantly more superficial surgical wound infections and deep infections which resulted in a higher number of reoperations in the MIPO group. Conclusion: The results of this systematic literature analysis suggest that both intramedullary and minimally invasive cortical osteosynthesis are effective methods in the treatment of extraarticular fractures of the distal tibia. However, cortical osteosynthesis is superior to highly distal fractures in which it is impossible to achieve sufficient fixation using IMN or in cases where there is a high risk of irregular healing, whereas intramedullary osteosynthesis should be used in patients with severe soft tissue injury as the method bypasses the injured soft tissue
Analysis of CT Angiography for Suspected Acute Aortic Dissection in the Emergency Department
No full textAuthor: Kristina Balnė Scientific supervisor: Doc. dr. Antanas Jankauskas Title: Analysis of CT Angiography of Suspected Acute Aortic Dissection in the Emergency Department. The aim: To evaluate prognosis and find correlations between CT angiography findings, clinical aspects and laboratory tests results for patients with suspected acute aortic dissection (AD) in the Hospital of Lithuanian University of Health Sciences (HLUHS), Emergency department (ED). Objectives: 1. To determine and evaluate AD type and prognosis; 2. To compare and find connections between clinical aspects, laboratory tests results and complications in AD and control groups; 3. To evaluate and find correlations between CT angiography findings and laboratory tests results in the AD group; 4. To evaluate timing and delays impact for complications in the ED for patients with acute AD. Methods: We conducted a retrospective analysis of 225 patients with suspected AD in the HLUHS ED during the period from January 1, 2018 to 31 December, 2019. 29 patients were diagnosed with acute AD after CT angiography was performed. Clinical signs, risk factors, CT angiography findings, complications and diagnostic time were compared between AD (n=29) and control (n=58) groups. The data were analyzed using SPSS 25.0 and Microsoft Office Excel 2016 packages. Statistically significant indicators were assessed at p≤ 0.05. Results: The average age of the observed patients in the AD group was 69,8 ± 3,2, control group – 68,5 ± 1,5. AD incidence rate 12,9 % (n=29), 51,7 % (n=15) type A AD, 47,3 % (n=14) type B AD. 82,8 % (n=24) of patients in the AD group were male and 17,2 % (n=5) female. The prevalence of different type of AD did not differ significantly by age and gender. Mortality rate was higher in patients with type A AD (26,7 %) than type B AD (14,3 %) (p=0,004). Hypertension (89,7 % (n=26), dyslipidemia (58,6 % (n=17) and systemic atherosclerosis (72,4 % (n=21) were the most frequent risk factors in the AD group. Chest pain was a typical sign for all the patients in this study. Severe pain (Visual analog scale (VAS) score 7 – 9) in the AD group was established more often than in the control group (55,2 % (n=16) vs 34,5 % (n=20), while mild pain (VAS score 1 -3) was more typical in the control group (15,5 % (n=9) vs 3,4 % (n=1), no significant difference was found. There was no correlation between pain level and AD type. Migrating chest pain was more common in the control group comparing with AD group (62,7 % (n=39) vs 27,6 % (n=8), p=0,001). Increased troponin I level was determined in 51,2 % (n=15) of patients in the AD group and 62,1 % (n=36) in the control group. Occurrence of myocardial infarction was significantly associated with increased troponin I level in the control group (p=0,001). D – dimer tests were performed in 3,4 % (n=1) of patients in the AD group and 10,3 % (n=6) in the control group, data was not sufficient for statistical analysis. Increased CRP level incidence rate was higher in the AD group (62,1 % (n=18) vs 27,6 % (n=16), p=0,001). Shock (37,9 % (n=11), cardiopulmonary insufficiency (41,4 % (n=12), paraplegia (6,9 % (n=2) and death (20,7 % (n=6) were occurred more often in the AD group (p<0,05). Death, shock and cardiopulmonary insufficiency were significantly associated with increased CRP level in the AD group (p<0,05). Correlations between superior mesenteric artery (13,8 % (n=4) derived from false lumen and mesenteric ischemia (p=0,009), death (p=0,045) were established. Atherosclerotic changes of aorta walls were determined in 65,5 % (n=19) of patients in the AD group and were significantly associated with dyslipidemia (p=0,02). The average diagnostic time in ED was 198,3 ± 48,4 minutes. Significant correlation between longer delay time and neurologic deficit, lower - limbs ischemia was proved (p=0,017; p=0,02). Significant correlation between delay time and outcomes was not established even when diagnostic time in patients who died were longer (352 ± 217,1 minutes vs 158,2 ± 24,9 minutes, p=0,546). Conclusions: 1. Significant difference of both types AD incidence rates were not found. Mortality rate significantly higher in the type A AD group. 2. Severe pain more often expressed in the AD group but no significant difference was determined. Migrating pain significantly more often expressed in the control group. Shock, cardiopulmonary insufficiency were most common complications and more frequently observed in patients with acute AD. Increased CRP level significantly associated with shock, death and cardiopulmonary insufficiency was more often determined in the AD group. 3. Superior mesenteric artery derived from the false lumen significantly associated with higher mortality and mesenteric ischemia rates. Correlation between dyslipidemia and atherosclerotic changes of aortic walls was proved. 4. Longer average delay in ED is significantly associated with higher neurologic deficit and lower – limb ischemia rate. No significant correlation between delay time and mortality rate was found
Transient and Persistent Gastric Microbiome: Adherence of Bacteria in Gastric Cancer and Dyspeptic Patient Biopsies after Washing
No full textHelicobacter pylori is a common colonizer of the human stomach, and long‐term colonization has been related to development of atrophic gastritis, peptic ulcers and gastric cancer. The increased gastric pH caused by H. pylori colonization, treatment with antibiotics or proton pump inhibitors (PPI) may allow growth of other bacteria. Previous studies have detected non‐ Helicobacter bacteria in stomach biopsies, but no conclusion has been made of whether these represent a transient contamination or a persistent microbiota. The aim of this study was to evaluate the transient and persistent bacterial communities of gastric biopsies. The washed or unwashed gastric biopsies were investigated by cultivation and microbiota analysis (16S rRNA gene‐targeted amplicon sequencing) for the distribution of H. pylori and other non‐Helicobacter bacteria. The number of cultured non‐Helicobacter bacteria decreased in the washed biopsies, suggesting that they might be a transient contamination. No significant differences in the bacterial diversity were observed in the microbiome analysis between unwashed and washed biopsies. However, the bacterial diversity in biopsies shown H. pylori‐positive and H. pylori‐negative were significantly different, implying that H. pylori is the major modulator of the gastric microbiome. Further largescale studies are required to investigate the transient and persistent gastric microbiota