Improving Outcomes of CT-Guided Malignant Lung Lesion Microwave Ablation by Tract Sealing Using Venous Blood Clot.

Complications, particularly pneumothorax, are common following lung interventions and occasionally necessitate further examinations, extend hospital stays, increase treatment costs, and result in long-term health impairment or even death. A few lung intervention tract sealants have been explored to reduce procedure-related complications. The primary objective of this prospective non-randomized study was to assess the complication rates and risk factors for computed tomography-guided lung microwave ablation (MWA) with autologous blood clot as a tract sealant.

Improving Infectious Disease Treatment Response via Adherence to Clinical Practice Guidelines.

() is a predominant nosocomial infection, and guidelines for improving diagnosis and treatment were published in 2017. We conducted a single-center, retrospective 10-year cohort study of patients with primary infectious disease (CDID) at the largest referral Lithuanian university hospital, aiming to evaluate the clinical and laboratory characteristics of CDID and their association with the outcomes, as well as implication of concordance with current Clinical Practice Guidelines. The study enrolled a total of 370 patients.

Clinical Features and Outcomes of VAP Due to Multidrug-Resistant spp.: A Retrospective Study Comparing Monobacterial and Polybacterial Episodes.

VAP due to multidrug-resistant (MDR) bacteria is a frequent infection among patients in ICUs. Patient characteristics and mortality in mono- and polybacterial cases of VAP may differ. A single-centre, retrospective 3-year study was conducted in the four ICUs of a Lithuanian referral university hospital, aiming to compare both the clinical features and the 60-day ICU all-cause mortality of monobacterial and polybacterial MDR spp.

Clinical Features and Outcomes of Monobacterial and Polybacterial Episodes of Ventilator-Associated Pneumonia Due to Multidrug-Resistant .

Multidrug-resistant A. baumannii (MDRAB) VAP has high morbidity and mortality, and the rates are constantly increasing globally. Mono- and polybacterial MDRAB VAP might differ, including outcomes.

Ventilator-Associated Pneumonia due to Drug-Resistant : Risk Factors and Mortality Relation with Resistance Profiles, and Independent Predictors of In-Hospital Mortality.

High mortality and healthcare costs area associated with ventilator-associated pneumonia (VAP) due to (). The data concerning the link between multidrug-resistance of strains and outcomes remains controversial. Therefore, we aimed to identify the relation of risk factors for ventilator-associated pneumonia (VAP) and mortality with the drug resistance profiles of () and independent predictors of in-hospital mortality.

Mortality prediction in patients with acute kidney injury requiring renal replacement therapy after cardiac surgery.

Background And Objective: Acute kidney injury (AKI) is a common and potentially serious postoperative complication after cardiac surgery, and it remains a cause of major morbidity and mortality. The aim of our study was to assess the prognostic illness severity score and to estimate the significant risk factors for poor outcome of patients with AKI requiring renal replacement therapy (RRT) after cardiac surgery.

Materials And Methods: We retrospectively analyzed data of adult (>18 years) patients (n=111) who underwent open heart surgery and had developed AKI with need for RRT.

Clinical relevance of high sensitivity C-reactive protein in cardiology.

Coping with cardiovascular diseases (CVD), which are of the main causes of death worldwide, has influenced investigation of high sensitivity CRP (hsCRP) and its role in pathogenesis, prognosis and prevention of CVD. hsCRP can be synthesized in vascular endothelium, atherosclerotic plaques, and theory of inflammatory origin of atherosclerosis is being more widely debated, raising questions, whether higher hsCRP plasma concentration might be the cause or the consequence. Summing up controversial data from multiple studies, guidelines recommend hsCRP testing for both, primary (stratifying CVD risk groups, selecting patients for statin therapy) and secondary CVD prevention (prognosis of CVD and its treatment complications, evaluation of treatment efficacy in moderate CVD risk group).

Correlation of magnesium deficiency with C-reactive protein in elective cardiac surgery with cardiopulmonary bypass for ischemic heart disease.

Background And Objective: Cardiac surgery is associated with systemic inflammatory response, which is triggered by cardiopulmonary bypass (CPB) and possibly with underlying magnesium deficiency. Animal studies have shown that magnesium deficiency intensifies oxidative stress and inflammatory processes. We aimed to find a link between serum, erythrocyte, cardiac tissue magnesium concentration and C-reactive protein (CRP) as an inflammatory marker in patients undergoing elective cardiac surgery with CPB.

High prevalence of PROP1 defects in Lithuania: phenotypic findings in an ethnically homogenous cohort of patients with multiple pituitary hormone deficiency.

Context: PROP1 gene mutations cause multiple pituitary hormone deficiency (MPHD).

Objective: We sought to expand experience with PROP1 mutation carriers by studying a large cohort of Lithuanian patients.

Patients And Methods: Sixty-seven MPHD patients were tested for PROP1 defects.

Cesarean delivery in severe pulmonary hypertension: a case report.

Pregnancy in a woman with pulmonary hypertension carries a prohibitively high risk of maternal mortality, and pregnancy is contraindicated in such patients. Some women decide to continue with their pregnancy despite being aware of possible fatal maternal outcome. The management of pulmonary hypertension in pregnancy is a challenge and requires a multiprofessional approach.

Venomous snakebites.

More than 5 million people are bitten by venomous snakes annually and more than 100,000 of them die. In Europe, one person dies due to envenomation every 3 years. There is only one venomous snake species in Lithuania--the common adder (Vipera berus)--which belongs to the Viperidae family; however, there are some exotic poisonous snakes in the zoos and private collections, such as those belonging to the Elapidae family (cobras, mambas, coral snakes, etc.

Changes in antibiotic resistance level of nosocomial Pseudomonas aeruginosa isolates in the largest university hospital of Lithuania.

Unlabelled: The aim was to estimate changes in the resistance rates of Pseudomonas aeruginosa (P. aeruginosa) strains isolated from patients treated in intensive care units of the largest university hospital.

Materials And Methods: Isolates were identified with the Phoenix ID system (Becton Dickinson, USA).

The usage of blood components in obstetrics.

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.

[Combined oral contraception and hypercoagulation].

Combined oral contraceptives have been known as a well-established contraceptive method already more than 50 years. Unfortunately, this method is not absolutely safe. Combined oral contraceptives include estrogens and progestagens, which may stimulate the blood coagulation and promote the occurrence of deep-vein thrombosis; adverse effects of oral contraceptives are also notably associated with increased risk of stroke and myocardial infarction.

[Caustic ingestions].

Caustic ingestions (alkalis, acids) may cause severe chemical burns and lifelong complications, which worsen life quality. Approximately 80% of caustic ingestions occur in children. They mostly intoxicate because of chemical substances kept insecurely or in inappropriate containers.

[Candidemia in an intensive care unit].

Candidemia is becoming more actual because of better survival of even critically ill patients, wide use of antimicrobials, and increased numbers of invasive procedures and manipulations. Diagnosis of candidemia remains complicated, and costs of treatment and mortality rates are increasing. OBJECTIVE.

[Infusion solutions of gelatin derivates].

Besides crystalloids, colloids are used for the treatment of hypovolemia and shock. They are high-molecular-weight proteins of bovine origin with properties of more rapid replacement of circulating blood volume. Iso-oncotic character provides the volume effect (approximately equal to 100%) close to the volume intravenously infused with the duration of action for 2-4 hours.

[Pseudomonas aeruginosa bacteremia: associations with a source of infection and antibiotic resistance].

Aim Of The Study: To determine the associations between the source of infection and antibiotic resistance in patients with Pseudomonas aeruginosa bacteremia.

Material And Methods: A retrospective analysis of 50 patients with Pseudomonas aeruginosa bacteremia was carried out. If sepsis was suspected, blood culture was incubated in an automatic system BACTEC 9240.

[Indications for platelet transfusion].

Relevance of platelet transfusion is related to an increasing number of indications due to conditions with an increased risk for hemorrhage and a lack of standard protocols both for treatment and prophylaxis of thrombocytopenia, in the presence of high costs of this procedure. The appropriate use of platelet transfusion is associated with reduction of thrombocytopenia, which actually in a critically ill patient is associated with increased length of stay both in intensive care unit and hospital. In 2003, the Professional Consensus was established to define the main recommendations for platelet transfusion.

[Coma: etiology, diagnosis, and treatment].

Coma is the disorder of consciousness because of the damage to diffused bilateral cerebral hemisphere cortex or reticular activating system. Coma can be caused by neurogenic (head brain injury), metabolic (endogenic), and toxic (exogenic) factors. To determine the cause of metabolic and toxic coma, laboratory tests are performed; in case of neurogenic coma, the neurologic examination is essential, when five systems are evaluated: the level of consciousness (according to Glasgow Coma Scale or Full Outline of Unresponsiveness Scale), photoreaction of pupils and ophthalmoscopic examination, oculomotoric, motoric, and cardiopulmonary systems.

Acute liver failure in Lithuania.

Objectives: Acute liver failure (ALF) is a life-threatening condition that can rapidly progress into coma and death due to the cerebral edema and multi-organ dysfunction. The ALF etiology and risk factors have been investigated in West Europe, North America, and Asia; however, there are still no published data about the causes and prognosis of ALF in Central and East European countries. The aim of our study was to analyze the causes, outcomes, and prognostic factors of ALF in patients referred to tertiary care center in Lithuania.

[Transfusion of autologous blood].

Recently the use of allogeneic (donor) blood transfusion is widely accepted in the clinical practice. Despite of good quality and safety of preparation of allogeneic blood, there are some risks related with transfusion: hemolytic, febrile, and allergic reactions, transfusion related acute lung injury, negative immunomodulatory effect, transmission of infections diseases, dissemination and recurrence of cancer. This is why the indications for donor blood transfusion are restricted, so new safer methods are discovered to avoid or to decrease the heed for allogeneic blood transfusion.

[Vasopressin for treatment of hemodynamic disorders].

Vasopressin is a 9-amino acid peptide synthesized by magnocellular neurons of the hypothalamus and released from posterior pituitary gland. The primary physiological role of vasopressin is the maintenance of fluid homeostasis. In this review, the classification of vasopressin receptors, namely V1 vascular, V2 renal, V3 pituitary, oxytocin receptors, and purinergic receptors, and the effects of vasopressin on vascular smooth muscles, the heart, and the kidneys are discussed.

Hypertonic hydroxyethyl starch solution for hypovolaemia correction following heart surgery.

Background: The aim of the study was to evaluate the effect of hypertonic NaCl hydroxyethyl starch solution on haemodynamics and cardiovascular parameters in the early postoperative period in patients for correction of hypovolaemia after heart surgery.

Methods: Eighty patients undergoing myocardial revascularisation at the Clinic of Cardiac Surgery of the Heart Centre (Kaunas University of Medicine) were randomly divided into two groups. The HyperHaes group (n = 40) received 250ml 7.

[Electrical injuries].

Electrical trauma can be caused by low-voltage current (from 60 to 1000 V, usually 220 or 360 V), high-voltage (more than 1000 V) current, lightning, and voltaic arc. Often victims are little children, teenagers, and working-age adults. Electrical injuries and clinical manifestations can vary a lot and range from mild complaints not demanding serious medical help to life-threatening conditions.