10178 research outputs found
Sort by
Decompression technique - a modified approach for lateral alveolar ridge augmentation: a case report
No full textA particular technique can increase the mucosal and peri-implant bone thickness, prevent compression around implant neck, and obtain proper space for the following prosthetic treatment with an adequate emergence profile
Etiology, diagnostics and treatment possibilities of acute laryngitis: a literature analysis
No full textAcute laryngitis is an inflammation of the larynx that can be caused by viral infection of the nasopharynx which can descend into larynx or a condition, which can damage vocal cords such as non-infectious factors. The main symptoms are hoarseness, sore throat and dry cough. If the symptoms of acute laryngitis persist for more than three weeks, it can progress to chronic laryngitis. Direct or indirect examination of the vocal cords and larynx (red, hyperaemic mucosa with possible presence of exudate) is usually sufficient to establish a diagnosis. Laboratory tests are performed very rarely. Voice saving and quitting smoking are the most important treatments. Aim: To select and analyze expert presented causes, diagnostics and recommendations for the treatment of acute laryngitis. Methods: the review of literature was conducted using the „PubMed“ medical database, selecting publications, investigating the burden of acute laryngitis. Conclusions: After analysis of the literature main causes, diagnostics and treatments methods of acute laryngitis are presented
Prediction of global functional outcome and post-concussive symptoms after mild traumatic brain injury: external validation of prognostic models in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study
No full textThe majority of traumatic brain injuries (TBIs) are categorized as mild, according to a baseline Glasgow Coma Scale (GCS) score of 13-15. Prognostic models that were developed to predict functional outcome and persistent post-concussive symptoms (PPCS) after mild TBI have rarely been externally validated. We aimed to externally validate models predicting 3-12-month Glasgow Outcome Scale Extended (GOSE) or PPCS in adults with mild TBI. We analyzed data from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) project, which included 2862 adults with mild TBI, with 6-month GOSE available for 2374 and Rivermead Post-Concussion Symptoms Questionnaire (RPQ) results available for 1605 participants. Model performance was evaluated based on calibration (graphically and characterized by slope and intercept) and discrimination (C-index). We validated five published models for 6-month GOSE and three for 6-month PPCS scores. The models used different cutoffs for outcome and some included symptoms measured 2 weeks post-injury. Discriminative ability varied substantially (C-index between 0.58 and 0.79). The models developed in the Corticosteroid Randomisation After Significant Head Injury (CRASH) trial for prediction of GOSE <5 discriminated best (C-index 0.78 and 0.79), but were poorly calibrated. The best performing models for PPCS included 2-week symptoms (C-index 0.75 and 0.76). In conclusion, none of the prognostic models for early prediction of GOSE and PPCS has both good calibration and discrimination in persons with mild TBI. In future studies, prognostic models should be tailored to the population with mild TBI, predicting relevant end-points based on readily available predictors
Harmonizing and improving European education in prescribing: An overview of digital educational resources used in clinical pharmacology and therapeutics
No full textAIM: Improvement and harmonization of European CPT education is urgently required. Because digital educational resources can be easily shared, adapted to local situations and re-used widely across a variety of educational systems, they may be ideally suited for this purpose.
METHODS: With a cross-sectional survey among principal CPT teachers in 279/304 European medical schools, an overview and classification of digital resources was compiled.
RESULTS: Teachers from 95 (34%) medical schools in 26 of 28 EU countries responded, 66 (70%) of whom used digital educational resources in their CPT curriculum. A total of 89 of such resources were described in detail, including e-learning (24%), simulators to teach pharmacokinetics and/or pharmacodynamics (10%), virtual patients (8%), and serious games (5%). Together, these resources covered 235 knowledge-based learning objectives, 88 skills, and 13 attitudes. Only one third (27) of the resources were in-part or totally free and only 2 were licensed open educational resources (free to use, distribute and adapt). A narrative overview of the largest, free, and most novel resources is given.
CONCLUSION: Digital educational resources, ranging from e-learning to virtual patients and games, are widely used for CPT education in EU medical schools. Learning objectives are based largely on knowledge rather than skills or attitudes. This may be improved by including more real life clinical case scenarios. Moreover, the majority of resources are not free or open. Therefore, with a view to harmonizing international CPT education, more needs to be learned about why CPT teachers are not currently sharing their educational materials
Valgymo sutrikimų įtaka nėštumo ir gimdymo eigai ir baigtims
No full textEating Disorders including Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder are mental disorders which are highly prevelant worldwide, especially in women. About 8% of women of reproductive age are affected by any form of eating disorder. During the review it became evident that all of the included eating disorder subtypes (Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder and Eating Disorder Not Otherwise Specified) were related to some degree to adverse outcomes of pregnancy and delivery. The complications of Anorexia Nervosa (AN) were commonly attributed to the inability to maintain an adequate weight and included an increase in unplanned pregnancy, excessive gestational weight gain, small for gestational age infants and low birth weight. Among others, Bulimia Nervosa (BN) was associated with a greater incidence of fertility treatment, increased risk of induced abortions and increased rate of miscarriages. Binge Eating Disorder (BED) was frequently related to being overweight and obese and the subsequent complications. All eating disorders were related to a higher incidence of psychological comorbidities and a higher perception of distress about the pregnancy and subsequent changes in body weight and shape. Pregnancy seems to be a window of opportunity for women suffering of BN or AN who showed a significant incidence of remission. However, pregnancy seems to be a window of vulnerability for the onset, relapse and shifting to BED. Offspring born to mothers related to ED were more likely to display long-term complications related to cognitive and functional development, neurobehavioral regulation and childhood wheezing
Influence of season and breed on serum mineral levels in sheep
No full textThe main objective of this study was to assess the concentration of various minerals (Ca, P, Mg, Cu, Zn, Fe) in the blood of sheep, followed by biochemical analysis in order to reveal possible associations of season and breed. The study was conducted by sampling four herds: Suffolk (n=20), Merino (n=20), Lithuanian blackhead (n=20) and Charolaise (n=7). The first blood collection was conducted in April and the last one was performed in February. The highest level of Ca was estimated in Suffolk ewes, lowest (12.61%) in Merino breed; the highest Mg content was found in Lithuanian blackhead breed, lowest (5.26%) in Charolaise; highest P content was determined in Merino, lowest (24.18%) in Suffolk breed (p<0.05). Evaluation of the biochemical parameters during different seasons showed a possible environmental effect on the health of the animals. The difference among minerals content showed the highest level in Ca, Mg, Fe in the autumn, P - in the summer, Cu and Zn - in the winter. The lowest differences between seasons were observed in content of Mg (1.24-4.03% from total average of all seasons) and Ca (0.59-8.18%), the highest – in Cu (2.52-18.36 %) and Zn (4.33-24.33%) (p<0.05). The significance of this work is the possible use of the data in the prevention of metabolic and production diseases
Influence of technologies on chemical indicators and nutritional value of herring products
No full textThese herring products produced in the company X were selected for the research: herring with mushrooms, herring with nuts, herring with marinade, herring with nut, onion and raisin sauce, herring with carrots and onions. The following tests were performed to evaluate the herring products produced in company X: tests of chemical indicators (amount of chloride (table salt), pH, titratable acidity, fat content), comparison of nutritional value on the products labels and sensory tests. Chemical tests showed that the highest salt quantity was found in herring with nuts and the lowest in herring with marinade. The latter herring also had the lowest pH, and the highest pH was found in the herring with mushrooms. The titratable acidity in herring with marinade was higher than in others and the lowest was in herring with mushrooms. In terms of fat content, the highest percentage of it was found in herring with nut, onion and raisin sauce and the lowest in herring with marinade. After the comparison of the labels of herring products, the highest energy value, fat and saturated fat amount identified in herring with mushrooms and the lowest values of these indicators were found in herring with marinade. The highest amount of carbohydrates was found in herring with nut, onion and raisin sauce and the lowest – in herring with carrots and onions. Herring with mushrooms had the highest sugar amount and herring with nuts and herring with carrots and onions had the lowest sugar content. The most sensory acceptable product was herring with mushrooms. The least acceptable was herring with nuts. Statistical analysis revealed that the indicators between the nutritional value of herring products and the acceptability of the total product were statistically significant (p<0.05)
Gastrostomy Tube Related Care Problems and Complications
No full textAim: to evaluate gastrostomy tube related problems and complications and their care. Objectives: 1. To evaluate indications for gastrostomy tube placement. 2. To establish an aim and rate of hospitalizations and emergency room visits. 3. To establish the rate of planned gastrostomy tube replacement and indications repeated gastrostomy tube formation and removal. 4. To compare minor and major complications between low-profile and long- profile gastrostomy tubes. Methods and patients: the single-institution retrospective study was carried out. It included 30 patients with a gastrostomy tube, who were treated in the Hospital of LUHS in the Department of Pediatric Surgery and Department of Pediatrics in 2017 - 2019. Data was collected from the electronic database and outpatient medical records. IBM SPSS Statistics 23 was used for statistical analysis. Results: the median age was 4.5 years. Sixty percent were male (n=18) and 40 % were female (n=12). The mean age at the time of gastrostomy tube placement was 27 ± 41.43 months. The average time of planned gastrostomy tube placements were 9.8 ± 4,167 months. Fourteen patients (47.7 %) required at liest one emergency department visit for gastrostomy-related reasons. The most common reasons for urgent visits were balloon rupture 28.6 %, tube obstruction and dysfunction 14.3 %, breakage of the tube 19 %, leakage 14.3 % and dislodgement 23.8 %. Minor gastrostomy tube related complications occurred in 64.3 % (n=9) of patients in long-profile gastrostomy tubes group and in 68.8 % (n=11) of patients in low-profile gastrostomy tubes group, p=0.796. No major complications occurred in long-profile gastrostomy tubes group, while in low-profile gastrostomy tubes group 6.7 % (n=2) of patients had major complications. Conclusions: 1. The most common reason for gastrostomy tube placement was neurological diseases-related swallowing disorder. 2. The average gastrostomy tube related hospitalizations rate was 2.9 ± 1.398. Almost half of all patients (46.7 %) at least once were consulted in the emergency department. The most common reasons for emergency department visits were balloon rupture, breakage and dislodgement of the tube. 3. The average time of planned gastrostomy tube placements were 9.8 ± 4,167 months. Established reason for repeated gastrostomy tube formation was tube dislodgement with peritonitis and for gastrostomy tube removal - adequate oral nutrition. 4. No significant difference of minor and major complications was determined between long-profile and low-profile gastrostomy tubes groups, p=0.796 and p=0.171.
Importance of Thyroid Hormone Level and Genetic Variations in Deiodinases for Patients After Acute Myocardial Infarction: A Longitudinal Observational Study
No full textThis study aimed to examine the influence of thyroid hormone (TH) levels and genetic polymorphisms of deiodinases on long-term outcomes after acute myocardial infarction (AMI). In total, 290 patients who have experienced AMI were evaluated for demographic, clinical characteristics, risk factors, TH and NT-pro-BNP. Polymorphisms of TH related genes were included deiodinase 1 (DIO1) (rs11206244-C/T, rs12095080-A/G, rs2235544-A/C), deiodinase 2 (DIO2) (rs225015-G/A, rs225014-T/C) and deiodinase 3 (DIO3) (rs945006-T/G). Both all-cause and cardiac mortality was considered key outcomes. Cox regression model showed that NT-pro-BNP (HR = 2.11; 95% CI = 1.18- 3.78; p = 0.012), the first quartile of fT3, and DIO1 gene rs12095080 were independent predictors of cardiac-related mortality (HR = 1.74; 95% CI = 1.04-2.91; p = 0.034). The DIO1 gene rs12095080 AG genotype (OR = 3.97; 95% CI = 1.45-10.89; p = 0.005) increased the risk for cardiac mortality. Lower fT3 levels and the DIO1 gene rs12095080 are both associated with cardiac-related mortality after AMI
Empiric Antimicrobial Treatment in Term Infants in 2011 and 2016.
No full textAim: To compare empirical antimicrobial treatments of term infants in 2011 and 2016. Objectives: Describe and compare the risk factors of early-onset neonatal infection, the clinical symptoms, and the age of infants when treatment was administered to term neonates with a suspected congenital infection in 2011 and 2016. Determine and compare the duration and frequency of treatment as well as the frequency of confirmed infections in 2011 and 2016. Methods: Medical records of 95 term infants born in 2011 and 2016 were obtained from Neonatal Clinic in Hospital of Lithuanian University of Health Sciences Kauno klinikos. All case-subjects had a suspected early-onset infection and received empirical antibacterial treatment at <72 hours after birth. A retrospective quantitative study was carried out using data from 60 and 35 neonates born in 2011 and 2016 respectively. Results: The research groups had no significant statistical differences in relation to the risk factor frequency. In neonates, at least one critical clinical sign occurred 35 % (n=21) in 2011 and 42,9 % (n=15) in 2016, p=0,411. Two or more clinical infection symptoms in 2011 occurred in 81,7 % (n=49), in 2016 – 80 % (n=28) neonates, p=0,842. An aberration in neonates responsiveness was more frequent in 2016 than in 2011 (62.9 % and 35 % respectively), p=0,007, as well as respiratory distress symptoms (68.6 % as compared to 33.3 %), p=0,001, when comparing the clinical infection symptoms. On average the infants age at the time of treatment was 16.8h after birth (SD=14.93) in 2011 and 15.5h (SD=17.50) in 2016, p=0,380. The frequency of empirical antibiotic treatment in neonates with suspected early-onset infection was 2,7 % in 2011 and 1,6 % in 2016, p=0.09. The majority of treatments lasted 5 to 7 days (56.7 % in 2011, 45.7 % in 2016), p=0.706). Blood culture analysis was carried out for all case-subjects. Early-onset neonatal infection was confirmed in 60 % (n=36) infants in 2011 and 62,9 % (n=22) infants in 2016, p=0,783. Conclusion: The distribution of early-onset neonatal infection risk factors and clinical symptoms between groups had no significant differences. The analysis of the clinical symptoms of infants with a suspected infection indicates that the aberration in responsiveness as well as the respiratory distress symptoms were significantly more frequent in 2016 than in 2011. There were no statistically significant differences noticed between the age of live-born infants in both groups that received treatment when an early-onset infection was suspected. In addition, no statistically significant variances were detected in the comparison of frequency and duration of treatment, as well as confirmed congenital infection frequency rates between the two groups of live-born infants