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  • 1
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    Effect of high-dose intravenous ascorbic acid on microcirculation and endothelial glycocalyx during sepsis and septic shock: a double-blind, randomized, placebo-controlled study
    Springer Science and Business Media LLC ; 2023
    In:  BMC Anesthesiology Vol. 23, No. 1 ( 2023-09-12)
    Details
    In: BMC Anesthesiology, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2023-09-12)
    Abstract: Previous studies indicate supplemental vitamin C improves microcirculation and reduces glycocalyx shedding in septic animals. Our randomized, double-blind, placebo-controlled trial aimed to investigate whether a high dose of intravenous ascorbic acid (AA) might improve microcirculation and affect glycocalyx in septic patients. In our study, 23 septic patients were supplemented with a high dose (50 mg/kg every 6 h) of intravenous AA or placebo for 96 h. Sublingual microcirculation was examined using a handheld Cytocam-incident dark field (IDF) video microscope. A sidestream dark field video microscope (SDF), connected to the GlycoCheck software (GlycoCheck ICU®; Maastricht University Medical Center, Maastricht, the Netherlands), was employed to observe glycocalyx. We found a significantly higher proportion of perfused small vessels (PPV) 6 h after the beginning of the trial in the experimental group compared with placebo. As an indicator of glycocalyx thickness, the perfused boundary region was lower in capillaries of the 5–9 μm diameter in the AA group than placebo after the first dose of AA. Our data suggest that high-dose parenteral AA tends to improve microcirculation and glycocalyx in the early period of septic shock. The study was retrospectively registered in the clinicaltrials.gov database on 26/02/2021 (registration number NCT04773717).
    Type of Medium: Online Resource
    ISSN: 1471-2253
    URL: Article
    DOI: 10.1186/s12871-023-02265-z
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2091252-3
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  • 2
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    Modulation of Endothelial Glycocalyx and Microcirculation in Healthy Young Men during High-Intensity Sprint Interval Cycling-Exercise by Supplementation with Pomegranate Extract. A Randomized Controlled Trial
    MDPI AG ; 2020
    In:  International Journal of Environmental Research and Public Health Vol. 17, No. 12 ( 2020-06-19), p. 4405-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 17, No. 12 ( 2020-06-19), p. 4405-
    Abstract: The natural components of the pomegranate fruit may provide additional benefits for endothelial function and microcirculation. It was hypothesized that supplementation with pomegranate extract might improve glycocalyx properties and microcirculation during acute high-intensity sprint interval cycling exercise. Eighteen healthy and recreationally active male volunteers 22–28 years of age were recruited randomly to the experimental and control groups. The experimental group was supplemented with pomegranate extract 20 mL (720 mg phenolic compounds) for two weeks. At the beginning and end of the study, the participants completed a high-intensity sprint interval cycling-exercise protocol. The microcirculation flow and density parameters, glycocalyx markers, systemic hemodynamics, lactate, and glucose concentration were evaluated before and after the initial and repeated (after 2 weeks supplementation) exercise bouts. There were no significant differences in the microcirculation or glycocalyx over the course of the study (p 〈 0.05). The lactate concentration was significantly higher in both groups after the initial and repeated exercise bouts, and were significantly higher in the experimental group compared to the control group after the repeated bout: 13.2 (11.9–14.8) vs. 10.3 (9.3–12.7) mmol/L, p = 0.017. Two weeks of supplementation with pomegranate extract does not influence changes in the microcirculation and glycocalyx during acute high-intensity sprint interval cycling-exercise. Although an unexplained rise in blood lactate concentration was observed.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph17124405
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2175195-X
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  • 3
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    444 Peer versus expert assessment in medical training: a reliability analysis of student and teacher evaluations of endotracheal intubation skill taught by HybridLab® methodology
    Elsevier BV ; 2023
    In:  Resuscitation Vol. 192 ( 2023-11), p. S169-
    Details
    In: Resuscitation, Elsevier BV, Vol. 192 ( 2023-11), p. S169-
    Type of Medium: Online Resource
    ISSN: 0300-9572
    URL: Article
    DOI: 10.1016/S0300-9572(23)00733-5
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 2010733-X
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  • 4
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    SUNKIA IR VIDUTINE ASTMA SERGANČIŲ VAIKŲ PATIRIAMAS NUOVARGIS
    Association of Lithuanian Serials (Publications) ; 2018
    In:  Visuomenės sveikata Vol. 28, No. 5 ( 2018-11-29), p. 13-17
    Details
    In: Visuomenės sveikata, Association of Lithuanian Serials (Publications), Vol. 28, No. 5 ( 2018-11-29), p. 13-17
    Abstract: Lėtinės ligos – svarbus padidėjusio vaikų nuovargio rizikos veiksnys. Kadangi astma yra viena labiausiai paplitusių lėtinių vaikų ligų, ženkliai veikianti kas­dienį paciento ir jo šeimos narių gyvenimą, šio tyrimo tikslas - įvertinti sunkia ir vidutine astma sergančių vaikų patiriamą nuovargį vaikų ir tėvų vertinimu bei jį sąlygojančius veiksnius. Į tyrimą įtrauktas 151 sunkia ir vidutine astma sergan­tis 2-17 metų amžiaus vaikas ir jų tėvai. Pagrindinis tyrimo instrumentas – klausimynų komplektas, kurį pildė vaikai ir jų tėvai, atvykę planinio vizito pas vaikų pulmonologą. Vaikų patiriamo nuovargio ver­tinimui naudota PedsQL daugiamatė nuovargio skalė, nuovargis vertintas 100 balų sistema, didesnis balas rodo mažesnį nuovargį. Siekiant nustatyti svarbiau­sius veiksnius, susijusius su didesniu vaikų patiriamu nuovargiu, atlikta logistinė regresija. Sunkia ir vidutine astma sergančių vaikų suminis nuo­vargio balas buvo 66,4 (±16,3) vaikų ir 69,8 (±17,4) tėvų vertinimu. Svarbiausi sunkia ir vidutine astma sergančių vaikų didesnio nuovargio rizikos veiksniai buvo astmos simptomų buvimas ir dažnis, taip pat šeimos gaunama socialinė parama.
    Type of Medium: Online Resource
    ISSN: 2335-867X
    URL: Article
    DOI: 10.5200/sm-hs.2018.053
    Language: Unknown
    Publisher: Association of Lithuanian Serials (Publications)
    Publication Date: 2018
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  • 5
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    The self‐reported quality of life of Lithuanian children with asthma was comparable to Western populations
    Wiley ; 2018
    In:  Acta Paediatrica Vol. 107, No. 2 ( 2018-02), p. 333-338
    Details
    In: Acta Paediatrica, Wiley, Vol. 107, No. 2 ( 2018-02), p. 333-338
    Abstract: Quality of life (QoL) has been widely researched among children with asthma in Western countries, but there is a lack of data from eastern Europe, where the prevalence is relatively low, but hospital admission rates are higher. We evaluated the overall level and major determinants of QoL in Lithuanian children aged 5–11 years with asthma. Methods This study was carried out in six asthma outpatient clinics in the two largest cities of Lithuania from January 2015 to July 2016. The children's QoL was measured using the Pediatric Quality of Life Inventory (Peds QL ) asthma module, which was completed by the child and one parent. Results We collected questionnaires from 226 children (68% boys) with a mean age of eight (±2) years: 65% had mild asthma, 31% had moderate asthma and 4% had severe asthma. One in 10 had been hospitalised in the preceding 6 months. The mean self‐reported QoL score was 74 and the parent‐reported QoL score was 73. QoL was associated with asthma severity and control, shortness of breath and the child's general health, but not socioeconomic factors. Conclusion The overall level and major determinants of QoL in children with asthma in Lithuania were comparable with Western populations.
    Type of Medium: Online Resource
    ISSN: 0803-5253 , 1651-2227
    URL: Issue
    URL: Article
    DOI: 10.1111/apa.2018.107.issue-2
    DOI: 10.1111/apa.14140
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 1492629-5
    detail.hit.zdb_id: 1501466-6
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  • 6
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    Hospitalinės infekcijos ekonominis įvertinimas vaikų intensyviosios terapijos skyriuose Lietuvoje
    MDPI AG ; 2011
    In:  Medicina Vol. 46, No. 11 ( 2011-11-09), p. 781-
    Details
    In: Medicina, MDPI AG, Vol. 46, No. 11 ( 2011-11-09), p. 781-
    Abstract: Tyrimo tikslas. Įvertinti trijų Lietuvos vaikų intensyviosios terapijos skyrių tiesiogines išlaidas, susijusias su hospitalinių infekcijų atvejais bei apžvelgti hospitalinių infekcijų prevencijos programos (intervencijos) ekonominį efektyvumą. Metodika. Perspektyvusis stebėsenos tyrimas atliktas trijuose Lietuvos vaikų intensyviosios terapijos skyriuose 2005 m. sausio – 2007 m. gruodžio mėn. Tikslinės atrankos būdu į tyrimą įtraukti visi 1 mėn. – 18 metų vaikai, kurie gydyti vaikų intensyviosios terapijos skyriuose ilgiau nei 48 val. Tiesioginės vaikų intensyviosios terapijos skyrių hospitalinių infekcijų sąlygotos išlaidos apskaičiuotos vienam hospitaline infekcija susirgusiam ligoniui ir vienam hospitalinės infekcijos atvejui. Vidutiniam vieno lovadienio įkainiui apskaičiuoti panaudoti hospitalinių infekcijų registro duomenys, taip pat remtasi ligoninių gaunamų lėšų už suteiktas vaikų reanimacijos paslaugas analize pagal 2005 m. spalio 27 d. Lietuvos Respublikos sveikatos apsaugos ministro įsakymu Nr. V-802 patvirtintus stacionarinių sveikatos priežiūros paslaugų įkainius. Pagal gydymo trukmę reanimacijos paslaugų įkainius ir hospitalinių infekcijų sąlygotas išlaidas visi ligoniai suskirstyti į dvi grupes – įgiję ir neįgiję hospitalinių infekcijų. Vertinant intervencijos ekonominį efektyvumą, ligoniai suskirstyti į kitas dvi grupes – prieš ir po intervencijos. Ekonominis įvertinimas apskaičiuotas nacionaline šalies valiuta – litais. Rezultatai. Tyrime dalyvavo 755 pacientai. Pagal daugialypės tiesinės regresijos modelį (r2=0,47), vienam ligoniui įgijus hospitalinę(-es) infekciją(-as), vaikų intensyviosios terapijos skyriaus gydymo trukmės pailgėjimas sudarė vidutiniškai 6,32 (95 proc. PI: 4,32–8,33; p=0,003) lovadienio. Vieno ligonio įgytos(-ų) hospitalinės(-ių) infekcijos(ų) sąlygotos vidutinės išlaidos sudarė 5215,47 litų (95 proc. PI: 3565,00–6874,19). Vieno hospitalinės infekcijos atvejo sąlygotos vidutinės išlaidos sudarė 4070,61 litų (95 proc. PI: 2782,44–5365,22). Hospitalinių infekcijų profilaktikos programos (intervencijos) bendrasis ekonominis efektas buvo 20046,14 litų. Apsaugojus vieną ligonį nuo hospitalinės(-ių) infekcijos(-ų), išlaidų sumažėjimas sudarė 1336,41 litų, pavykus išvengti vieno hospitalinės infekcijos atvejo, išlaidų sumažėjimas sudarė 1113,67 litų, o sąnaudų ir naudos santykis – 1:4. Išvados. Vaikų intensyviosios terapijos skyrių hospitalinių infekcijų sąlygotos išlaidos buvo pakankamai didelės. Įdiegus hospitalinių infekcijų profilaktikos programoje numatytas priemones, užfiksuotas teigiamas ekonominis efektyvumas – hospitalinių infekcijų profilaktikai panaudojus 1 litą, sutaupyti 4 litai lėšų.
    Type of Medium: Online Resource
    ISSN: 1648-9144
    URL: Article
    DOI: 10.3390/medicina46110110
    Language: English
    Publisher: MDPI AG
    Publication Date: 2011
    detail.hit.zdb_id: 2088820-X
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  • 7
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    Time Evolution of Sublingual Microcirculatory Changes in Recreational Marathon Runners
    Hindawi Limited ; 2017
    In:  BioMed Research International Vol. 2017 ( 2017), p. 1-7
    Details
    In: BioMed Research International, Hindawi Limited, Vol. 2017 ( 2017), p. 1-7
    Abstract: We aimed to evaluate changes in sublingual microcirculation induced by a marathon race. Thirteen healthy male controls and 13 male marathon runners volunteered for the study. We performed sublingual microcirculation, using a Cytocam-IDF device (Braedius Medical, Huizen, Netherlands), and systemic hemodynamic measurements four times: 24 hours prior to their participation in the Kaunas Marathon (distance: 41.2 km), directly after finishing the marathon, 24 hours after the marathon, and one week after the marathon. The marathon runners exhibited a higher functional capillary density (FCD) and total vascular density of small vessels at the first visit compared with the controls. Overall, we did not find any changes in sublingual microcirculation of the marathon runners at any of the other visits. However, in a subgroup of marathon runners with a decreased FCD compared to the subgroup with increased FCD, the subgroup with decreased FCD had shorter running time ( 190.37 ± 30.2 versus 221.80 ± 23.4  min, p = 0.045 ), ingested less fluids ( 907 ± 615 versus 1950 ± 488  mL, p = 0.007 ) during the race, and lost much more weight ( - 2.4 ± 1.3 versus - 1.0 ± 0.8  kg, p = 0.041 ). Recreational marathon running is not associated with an alteration of sublingual microcirculation. However, faster running and dehydration may be crucial for further impairing microcirculation.
    Type of Medium: Online Resource
    ISSN: 2314-6133 , 2314-6141
    URL: Article
    DOI: 10.1155/2017/7120785
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2017
    detail.hit.zdb_id: 2698540-8
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  • 8
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    Short- and long-term survival after out-of-hospital cardiac arrest in Kaunas (Lithuania) from 2016 to 2018
    Springer Science and Business Media LLC ; 2022
    In:  BMC Cardiovascular Disorders Vol. 22, No. 1 ( 2022-12-03)
    Details
    In: BMC Cardiovascular Disorders, Springer Science and Business Media LLC, Vol. 22, No. 1 ( 2022-12-03)
    Abstract: No studies analysing out-of-hospital cardiac arrest (OHCA) epidemiology and outcomes in Lithuania were published in the last decade. Methods We conducted a retrospective analysis of prospectively collected data. The incidence of OHCA and the demographics and outcomes of patients who were treated for OHCA between 1 and 2016 and 31 December 2018 at Kaunas Emergency Medical Service (EMS) were collected and are reported in accordance with the Utstein recommendations. Multivariable logistic regression analysis was used to identify predictors of survival to hospital discharge. Results In total, 838 OHCA cases of EMS-treated cardiac arrest (CA) were reported (95.8 per 100.000 inhabitants). The median age was 71 (IQR 58–81) years of age, and 66.7% of patients were males. A total of 73.8% of OHCA cases occurred at home, 59.3% were witnessed by a bystander, and 54.5% received bystander cardiopulmonary resuscitation. The median EMS response time was 10 min. Cardiac aetiology was the leading cause of CA (78.8%). The initial rhythm was shockable in 27.6% of all cases. Return of spontaneous circulation at hospital transfer was evident in 24.9% of all cases. The survival to hospital discharge rate was 10.9%, and the 1-year survival rate was 6.9%. The survival to hospital discharge rate in the Utstein comparator group was 36.1%, and the 1-year survival rate was 27.2%. Five factors were associated with improved survival to hospital discharge: shockable rhythm, time from call to arrival at the patient less than 10 min, witnessed OHCA, age  〈  80 years, and male sex. Conclusion This is the first OHCA study from Lithuania examining OHCA epidemiology and outcomes over a three year period. Routine OHCA data collection and analysis will allow us to track the efficacy of service improvements and should become a standard practice in all Lithuanian regions. Trial registration : This research was registered in the clinicaltrials.gov database: Identifiers: NCT04784117, Unique Protocol ID: LITOHCA. Brief Title: Out-of-hospital Cardiac Arrest Epidemiology and Outcomes in Kaunas 2016–2021.
    Type of Medium: Online Resource
    ISSN: 1471-2261
    URL: Article
    DOI: 10.1186/s12872-022-02964-4
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2059859-2
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  • 9
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    Bronchial asthma and child physical activity in Lithuania
    Elsevier BV ; 2007
    In:  World Allergy Organization Journal Vol. &NA; ( 2007-11), p. S121-
    Details
    In: World Allergy Organization Journal, Elsevier BV, Vol. &NA; ( 2007-11), p. S121-
    Type of Medium: Online Resource
    ISSN: 1939-4551
    URL: Article
    DOI: 10.1097/01.WOX.0000301650.86519.b6
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2007
    detail.hit.zdb_id: 2581968-9
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  • 10
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    The ability of Lithuanian ambulance services to provide first medical aid in trauma cases
    MDPI AG ; 2007
    In:  Medicina Vol. 43, No. 6 ( 2007-06-11), p. 463-
    Details
    In: Medicina, MDPI AG, Vol. 43, No. 6 ( 2007-06-11), p. 463-
    Abstract: Objective. To evaluate the ability of country ambulance services to provide first medical aid in trauma cases. Material and methods. A survey of chiefs of emergency medicine service was performed in October–November 2005, in which 34 of the 59 institutions (58%) were participating. The questionnaire presented questions concerning physical and human resources, performance values, and system configuration. The study has shown that emergency medicine service operates in radius of 23 km, each team providing service for about 40 000 inhabitants. Taking into consideration distance and average on-scene time values, emergency medicine service is capable to render the first medical aid within so-called “golden hour” in case the accident is reported immediately. The physical resources are not quite complete. Not all the cars are equipped with essential first aid measures. Among more rarely found resources are vacuum pumps, intubation sets, defibrillators, vacuum splints, back immobilization devices, and hammock immobilization devices. There are less mentioned resources than working teams and even more than two times less than emergency cars at all. Two-thirds of the operating emergency medicine services do not provide advanced life support procedures. The evaluation of theoretical/practical ability to provide some important medical procedures used in emergency medical care showed that medical staff quite often fails to perform defibrillation, intubation, and pleural cavity drainage. Conclusions. Country ambulance service network configuration according to area under service, number of people served, and response frequency comply with the requirement set. The ambulance vehicles lack complete set up as well as some important supplies. Only rarely the staff is skilled enough to perform such advanced life support procedures as intubation, defibrillation, and pleural drainage.
    Type of Medium: Online Resource
    ISSN: 1648-9144
    URL: Article
    DOI: 10.3390/medicina43060057
    Language: English
    Publisher: MDPI AG
    Publication Date: 2007
    detail.hit.zdb_id: 2088820-X
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