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排序方式: 共有48条查询结果,搜索用时 15 毫秒
1.
Renata Juknevi
ien Vytautas Juknevi
ius Eugenijus Jasinas Beatri
Ra
it Jrat Barysien Mindaugas Mata
inas Dalius Vitkus Aleksandras Laucevi
ius Pranas erpytis 《Medicine》2022,101(29)
High-sensitivity troponin assay brought new challenges as we detect elevated concentration in many other diseases, and it became difficult to distinguish the real cause of this elevation. In this notion, diagnosis of acute coronary syndrome (ACS) remains a challenge in emergency department (ED).We aim to examine different approaches for rule-in and rule-out of ACS using risk scores, copeptin, and coronary computed tomography angiography (CCTA).A prospective observational study was designed to evaluate chest pain patients. Consecutive adult patients admitted to the ED with a chief complaint of chest pain due to any cause were included.All patients were followed-up for 6 months after discharge for major adverse cardiovascular events and readmissions. Admission data, ED processes, and diagnoses were analyzed.One hundred forty-six patients were included, average age was 63 ± 13.4 years, and 95 (65.1%) were male. Global Registry of Acute Coronary Events (GRACE) and History, ECG, Age, Risk factors, Troponin (HEART) scores showed good prognostic abilities, but HEART combination with copeptin improves diagnoses of myocardial infarction (area under the curve [AUC] 0.764 vs AUC 0.864 P = .0008). Patients with elevated copeptin were older, had higher risk scores, and were more likely to be admitted to hospital and diagnosed with ACS in ED. For copeptin, AUC was 0.715 (95% confidence interval 0.629–0.803), and for combination with troponin, AUC of 0.770 (0.703–0.855) did not improve rule-in of myocardial infarction. High-sensitivity troponin I assay alongside prior stroke, history of carotid stenosis, dyslipidemia, use of diuretics, and electrocardiogram changes (left bundle branch block or ST depression) are good predictors of myocardial infarction (χ² = 52.29, AUC = 0.875 [0.813–0.937], P < .001). The regression analysis showed that combination of copeptin and CCTA without significant stenosis can be used for ACS rule-out (χ² = 26.36, P < .001, AUC = 0.772 [0.681–0.863], negative predictive value of 96.25%).For rule-in of ACS, practitioner should consider not only scores for risk stratification but carefully analyze medical history and nonspecific electrocardiogram changes and even with normal troponin results, we strongly suggest thorough evaluation in chest pain unit. For rule-out of ACS combination of copeptin and CCTA holds great potential. 相似文献
2.
Prakas Petras Butkauskas Dalius Švažas Saulius Stanevičius Vitas 《Parasitology research》2018,117(11):3663-3667
Parasitology Research - Having examined 19 great cormorants (Phalacrocorax carbo) hunted in Lithuania, sarcocysts were found in the muscles of two birds. Sarcocysts detected were examined using... 相似文献
3.
Punceviciene Egle Rovas Adomas Puriene Alina Stuopelyte Kristina Vitkus Dalius Jarmalaite Sonata Butrimiene Irena 《Clinical rheumatology》2021,40(8):3153-3160
Clinical Rheumatology - This paper evaluates the prevalence and severity of periodontitis (PD) in patients with rheumatoid arthritis (RA), focusing on the link between the severity of PD with RA... 相似文献
4.
Rokas Serpytis Aurelija Navickaite Emilija Serpytiene Jurate Barysiene Germanas Marinskis Dalius Jatuzis Zaneta Petrulioniene Aleksandras Laucevicius Pranas Serpytis 《The American journal of medicine》2018,131(6):703.e1-703.e5
Objective
Atrial fibrillation is the most common cardiac arrhythmia and a known risk factor for cerebrovascular stroke. Atrial fibrillation and longstanding hypertension may produce ischemic lesions leading to progressive cognitive impairment. The impact of atrial fibrillation alone on cognitive impairment has not been evaluated. Our objective was to compare cognitive function, quality of life, psychological distress, and impulsiveness in people with atrial fibrillation and a matched control group.Methods
The study included 60 patients. The first group of patients were ≥55 years of age, with ≥5 years history of atrial fibrillation, without hypertension (or with well-controlled hypertension), without previous dementia, compared with a matched group of 30 healthy control participants. Demographic and clinical characteristics were recorded. Subjects underwent the following rating scales: Mini-Mental State Examination, Hospital Anxiety and Depression, Heart Quality of Life, and Barratt Impulsiveness Scale.Results
In the atrial fibrillation group there were 63% male (n = 19) and 37% female (n = 11) patients; the control group was 33% male (n = 10) and 67% female (n = 20). Age range was from 55 to 81 years in both groups, mean = 63.9 years (±6.4) in the atrial fibrillation group and 66.1 years (±8.0) in controls.In the atrial fibrillation group, 23.3% had primary or general education, college – 23.3% and university – 53.3%; in the control group – 20%, 23.3%, and 56.7%, respectively. Mini-Mental State Examination score was 27.6 (±1.6) in the atrial fibrillation group vs 29.5 (±0.73) in the control group (P < .0001). Anxiety disorders were observed in 20 patients (66.7%) in atrial fibrillation vs 8 patients (26.67%) in the control group (P = .009). Heart Quality of Life mean score was 1.4 (±0.65) in the atrial fibrillation and 2.6 (±0.35) in the control group (P < .0001). Physical subscale mean scores were 1.4 (±0.74) in atrial fibrillation vs 2.8 (±0.18) in the control group (P < .0001).Conclusion
Individuals with atrial fibrillation are more likely to develop anxiety disorder. Cognitive status is significantly lower in the atrial fibrillation group. In comparison with healthy subjects, individuals with atrial fibrillation have worse quality of life. 相似文献5.
Laura Lukosiene Danguole Ceslava Rugyte Andrius Macas Lina Kalibatiene Dalius Malcius Vidmantas Barauskas 《Journal of pediatric surgery》2013
Purpose
There are no published data regarding value of intercostal block following pectus excavatum repair. Our aim was to evaluate the efficacy of intercostal block in children following minimally invasive repair of pectus excavatum (MIRPE).Methods
Forty-five patients given patient-controlled analgesia (PCA) with morphine postoperatively were studied. Twenty-six patients were given bilateral intercostal blocks after induction of anesthesia (PCA-IB group), and nineteen patients were retrospective controls without regional blockade (PCA group). All patients were followed up 24 h postoperatively.Results
A loading dose of morphine (0,1 ± 0,49 mg/kg) before starting PCA was used in seventeen patients in PCA group vs. no patient in PCA-IB group. Cumulative used morphine doses were lower up to 12 h after surgery in PCA-IB group (0,29 ± 0,08 μg/kg) than in the PCA group (0,46 ± 0,18 μg/kg), p < 0,01. There were no differences in pain scores, oxygen saturation values, sedation scores, and the incidence of pulmonary adverse events between the two groups. There was a tendency towards less morphine-related adverse effects in PCA-IB group compared to PCA group (p < 0,05). No complications related to the intercostal blocks were observed.Conclusion
Bilateral intercostal blocks following MIRPE are safe and easy to perform and can diminish postoperative opioid requirement. Double-blind randomized study is required to confirm the potential to diminish opioid related side effects. 相似文献6.
Andrius Karpavicius Zilvinas Dambrauskas Audrius Sileikis Dalius Vitkus Kestutis Strupas 《World journal of gastroenterology : WJG》2012,18(45):6620-6627
AIM: To analyze the prognostic value of adipokines in predicting the course, complications and fatal outcome of acute pancreatitis (AP).METHODS: We performed the search of PubMed database and the systemic analysis of the literature for both experimental and human studies on prognostic value of adipokines in AP for period 2002-2012. Only the papers that described the use of adipokines for prediction of severity and/or complications of AP were selected for further analysis. Each article had to contain information about the levels of measured adipokines, diagnosis and verification of AP, to specify presence of pancreatic necrosis, organ dysfunction and/or mortality rates. From the very beginning, study was carried out adhering to the PRISMA checklist and flowchart for systemic reviews. To assess quality of all included human studies, the Quality Assessment of Diagnostic Accuracy Studies tool was used. Because of the high heterogeneity between the studies, it was decided to refrain from the statistical processing or meta-analysis of the available data.RESULTS: Nine human and three experimental studies were included into review. In experimental studies significant differences between leptin concentrations at 24 and 48 h in control, acute edematous and acute necrotizing pancreatitis groups were found (P = 0.027 and P < 0.001). In human studies significant differences between leptin and resitin concentrations in control and acute pancreatitis groups were found. 1-3 d serum adiponectin threshold of 4.5 μg/mL correctly classified the severity of 81% of patients with AP. This threshold yielded a sensitivity of 70%, specificity 85%, positive predictive value 64%, negative predictive value88% (area under curve 0.75). Resistin and visfatin concentrations differ significantly between mild and severe acute pancreatitis groups, they correlate with severity of disease, need for interventions and outcome. Both adipokines are good markers for parapancreatic necrosis and the cut-off values of 11.9 ng/mL and 1.8 ng/mL respectively predict the high ranges of radiological scores. However, the review revealed that all nine human studies with adipokines are very different in terms of methodology and objectives, so it is difficult to generalize their results. It seems that concentrations of the leptin and resistin increases significantly in patients with acute pancreatitis compared with controls. Serum levels of adiponectin, visfatin and especially resitin (positive correlation with Acute Physiology and Chronic Health Evaluation II, Ranson and C-reactive protein) are significantly different in mild acute pancreatitis and severe acute pancreatitis patients, so, they can serve as a markers for the disease severity prediction. Resistin and visfatin can also be used for pancreatic and parapancreatic necrosis prediction, interventions needs and possible, outcome.CONCLUSION: High levels of adipokines could allow for prediction of a severe disease course and outcome even in small pancreatic lesions on computed tomography scans. 相似文献
7.
Comparative Activity of Netilmicin, Gentamicin, Amikacin, and Tobramycin Against Pseudomonas aeruginosa and Enterobacteriaceae 总被引:8,自引:7,他引:1
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Netilmicin (Sch 20569), a semisynthetic aminoglycoside antibiotic, was compared with gentamicin, tobramycin, and amikacin against 242 clinical isolates of Pseudomonas and Enterobacteriaceae. The minimum inhibitory concentration (MIC) was determined in both solid and liquid media. Netilmicin exhibited typical aminoglycoside properties, such as little effect of inoculum size on MIC, relatively small gap between MIC and minimum bactericidal concentration, and potentiation of anti-Pseudomonas activity in the presence of carbenicillin. Netilmicin provided no advantage in antimicrobial activity over gentamicin for either Pseudomonas or Enterobacteriaceae. Nearly complete cross-resistance to netilmicin was encountered with isolates resistant to gentamicin in either solid or liquid media. Netilmicin was less active than gentamicin against isolates of Pseudomonas and Providencia. Major discrepancies between MIC values determined in agar as opposed to those determined in broth were encountered for most isolates of Pseudomonas but also, depending upon antibiotic tested, for between 15 and 40% of isolates of Enterobacteriaceae. This new aminoglycoside agent will be useful clinically only if it is shown to be significantly less toxic than presently available analogues. 相似文献
8.
Marciulioniene D Montvydiene D Kiponas D Luksiene B Butkus D 《Environmental toxicology》2004,19(4):346-350
The genotoxic effects on Tradescantia of (137)Cs, (90)Sr, and (236, 242)Pu, a heavy metal mixture [Cd, Cr(VI), Cu, Mn(II), Ni, Pb, Zn] and of a complex mixture of these toxicants were determined. The impact of radionuclides on plants subjected to ionizing radiation exposure was estimated. The number of somatic mutations and the quantity of nonviable stamen hairs were used as end points in the testing. An increase in the quantity of nonviable stamen hairs was observed with increasing internal exposure to (137)Cs, (90)Sr, and (236, 242)Pu; however, the number of somatic mutations was not observed to be dependent on ionizing radiation. The internal dose of individual radionuclides necessary to decrease the quantity of viable stamen hairs in Tradescantia by 50% can be arranged in the following sequence: (236, 242)Pu > (137)Cs > (90)Sr. Tradescantia died in the mixture of the radionuclides (90)Sr, (137)Cs, and (236)Pu (5 x 10(-2), 7 x 10(-5), and 4 x 10(-10) Gy, respectively) after 14 days, whereas the heavy metal mixture caused somatic mutations in 3% of the Tradescantia and nonviable stamen hairs in 7% but no mortality. However, the Tradescantia died in a combined mixture of these heavy metals and the radionuclides after 14 days. On the basis of all these observations, it can be concluded that the toxic effect of radionuclides was more significant than that of heavy metals. 相似文献
9.
The predicted primary structure of the measles virus hemagglutinin 总被引:21,自引:0,他引:21
The complete nucleotide sequence of cloned cDNAs corresponding to the full length of the mRNA encoding the measles virus hemagglutinin (H) protein has been determined. the mRNA contains a single large open reading frame which is capable of encoding a protein of 617 amino acids with a molecular mass of 69,250 Da. The deduced amino acid structure of the protein indicates that the only major hydrophobic region of sufficient length to anchor the molecule in membranes is located near the amino terminus. Comparison of the amino acid structure of the measles virus H protein with that of the hemagglutinin-neuraminidase (HN) molecules of Sendai virus and simian virus 5 (SV5) reveals little homology. However, 11 of the 13 cysteine residues found in the measles H protein can be aligned with cysteines in the Sendai virus HN protein in similar positions relative to one another. Five potential N-linked glycosylation sites are present in the measles H protein sequence. These are relatively closely grouped between amino acids residues 168 and 240 in the amino terminal half of the molecule. No obvious structural features are present in the measles H protein amino acid sequence which might explain the reported absence of neuraminidase activity associated with the molecule. 相似文献
10.
Patel VL Arocha JF Chaudhari S Karlin DR Briedis DJ 《Journal of dental education》2005,69(11):1186-1211
This study investigates the effect of curricular change on knowledge integration and reasoning processes during problem-solving by medical students. The curricular change involved the introduction of problem-based, small group tutorials into a conventional health science curriculum (CC). Students at three levels of training were asked to provide diagnostic explanations of two clinical cases, both before (spontaneous) and after (primed) being exposed to basic science information relevant to the clinical problems. Data were analyzed using techniques of propositional and semantic analysis. Based on theories of instruction and cognition, we expected that the instructional changes would facilitate knowledge integration and influence the reasoning patterns of the students. The results show that students generated fewer inferences and used more information from the basic science text (text-based) to explain the clinical problems. However, they generated a greater number of elaborations during explanations using a mixture of data-driven and hypothesis-driven strategies. The spontaneous and primed problem-solving conditions produced more hypothesis-driven and data-driven strategies, respectively, as would be expected in a hybrid curriculum. We conclude that a) problem-based, small group tutorials facilitate integration of clinical and biomedical knowledge through the use of elaborations and hypothesis-driven strategies, and b) aspects of problem-based learning can be successfully integrated into traditional curricula. 相似文献