Bernard Lown y el arte de sanar / Bernard Lown and the art of healing

RESUMEN: Se presenta una semblanza del Dr. Bernard Lown, uno de los más destacados cardiólogos del siglo XX. Muy relevantes fueron sus estudios sobre arritmias ventriculares e isquemia miocárdica, como también la influencia del estrés sobre el umbral de la fibrilación ventricular. Simultáneamente con otros investigadores europeos desarrolló el cardiovertor eléctrico. Se releva particularmente su condición de gran clínico y el trato humano con sus pacientes. Finalmente, se destaca su contribución a evitar una guerra nuclear por lo cual, junto al Dr Chazov, recibió el Premio Nobel de la Paz.

ABSTRACT: This is a biographical note on Bernard Lown MD, recently deceased. He was one of the foremost cardiologist in the XXth century. Relevant were his studies on ventricular arrhythmias and myocardial ischemia, as well the effect of mental stress in lowering the ventricular arrhythmia threshold. Along with European researchs he developed the electric cardiovertor. Special emphasis is placed on his skills as a clinician and is humane approach to patient care. He contributed to international efforts to prevent nuclear war. For this effort he was awarded, along with Dr Chazov, the Nobel Peace Price.

Factors Associated with Persistent Sputum Positivity at the End of the Second Month of Tuberculosis Treatment in Lithuania / 결핵및호흡기질환

BACKGROUND: Non-conversion of sputum smear and culture prolongs the infectivity of the patient and has been associated with unfavorable outcomes. We aimed to evaluate factors associated with persistent sputum positivity at the end of two months of treatment of new case pulmonary tuberculosis (TB). METHODS: Data of 87 human immunodeficiency virus-negative patients with culture-positive drug-susceptible pulmonary TB admitted to local university hospital between September 2015 and September 2016 were reviewed. Factors associated with sputum smear and/or culture positivity at the end of the second month of treatment were analyzed. RESULTS: Twenty-two patients (25.3%) remained smear and/or culture-positive. Male sex, lower body mass index (BMI), unemployment, alcohol abuse, higher number of lobes involved and cavities on chest X-rays, shorter time to detection (TTD) on liquid cultures, higher respiratory sample smear grading and colony count in solid cultures, higher C-reactive protein, erythrocyte sedimentation rate, leukocytosis, thrombocytosis, and anemia were all significantly associated with persistent sputum positivity. However, in the logistic regression analysis only male sex, lower BMI, alcohol abuse, higher radiological involvement, cavitation, higher smear grading, higher colony count in solid cultures and shorter TTD were determined as independent factors associated with persistent sputum positivity at the end of 2 months of treatment. CONCLUSION: In conclusion, higher sputum smear and culture grading at diagnosis, shorter TTD, higher number of lobes involved, cavitation, male sex, alcohol abuse, and lower BMI were independently associated with persistent sputum positivity. These factors should be sought when distinguishing which patients will remain infectious longer and possibly have worse outcomes.

Transanal Endoscopic Microsurgery for Patients With Rectal Tumors: A Single Institution's Experience

PURPOSE: The purpose of this study was to look at our complication rates and recurrence rates, as well as the need for further radical surgery, in treating patients with benign and early malignant rectal tumors by using transanal endoscopic microsurgery (TEM). METHODS: Our study included 130 patients who had undergone TEM for rectal adenomas and early rectal cancer from December 2009 to December 2015 at the Department of Surgical Oncology, National Cancer Institute, Lithuania. Patients underwent digital and endoscopic evaluation with multiple biopsies. For preoperative staging, pelvic magnetic resonance imaging or endorectal ultrasound was performed. We recorded the demographics, operative details, final pathologies, postoperative lengths of hospital stay, postoperative complications, and recurrences. RESULTS: The average tumor size was 2.8 ± 1.5 cm (range, 0.5–8.3 cm). 102 benign (78.5%) and 28 malignant tumors (21.5%) were removed. Of the latter, 23 (82.1%) were pT1 cancers and 5 (17.9%) pT2 cancers. Of the 5 patients with pT2 cancer, 2 underwent adjuvant chemoradiotherapy, 1 underwent an abdominoperineal resection, 1 refused further treatment and 1 was lost to follow up. No intraoperative complications occurred. In 7 patients (5.4%), postoperative complications were observed: urinary retention (4 patients, 3.1%), postoperative hemorrhage (2 patients, 1.5%), and wound dehiscence (1 patient, 0.8%). All complications were treated conservatively. The mean postoperative hospital stay was 2.3 days. CONCLUSION: TEM in our experience demonstrated low complication and recurrence rates. This technique is recommended for treating patients with a rectal adenoma and early rectal cancer and has good prognosis.

Self-reported physical inactivity and health complaints: a cross-sectional study of Lithuanian adolescent schoolgirls / Autorrelato de queixas de inatividade e saúde física: um estudo transversal entre adolescentes / Autoinforme sobre la inactividad física y quejas de salud: un estudio transversal entre las adolescentes

The study aimed to investigate the associations between physical inactivity and health complaints in relation to posttraumatic stress (PTS) symptoms, behavioral and nutritional factors, and sense of coherence (SOC) in eighth-grade girls enrolled in secondary schools in Kaunas, Lithuania. A random sample of girls (N = 862) was interviewed anonymously on health complaints, physical activity level, PTS symptoms, Antonovsky’s SOC scale, health behaviors, and dietary patterns. All health complaints were significantly associated with physical inactivity. Crude odds ratio (OR) for physical inactivity and health complaints was 1.67 (95%CI: 1.09-2.56); after adjusting for PTS symptoms, the OR decreased to 1.57 (95%CI: 0.95-2.45); further adjustment for smoking, daily alcohol intake, daily consumption of fresh vegetables, and SOC decreased the OR to 1.25 (95%CI: 0.76-2.04). The effect of PTS symptoms and sense of coherence remained stable after all adjustments. The significant association between physical inactivity and health complaints was mediated by PTS symptoms.

O estudo tem como objetivo investigar a associação entre queixas de inatividade e saúde física em relação ao transtorno do estresse pós-traumático (TEPT), sintomas comportamentais e fatores nutricionais, bem como o senso de coerência (SOC) entre alunas da oitava série. Uma amostra aleatória de alunas (N = 862) foi entrevistada anonimamente sobre: queixas de saúde, nível de atividade física, sintomas de TEPT, escala SOC de Antonovsky, comportamentos de saúde e padrões alimentares. Todas as queixas de saúde foram significativamente associadas à inatividade física. A razão de odds (OR) não ajustada de inatividade física para queixas de saúde foi de 1,67 (IC95%: 1,09-2,56), e após o ajuste para os sintomas de TEPT reduziu para 1,57 (IC95%: 0,95-2,45); somado-se o ajuste para tabagismo, ingestão de álcool diária, legumes frescos e redução da escala SOC, houve diminuição da OR para 1.25 (IC95%: 0,76-2,04). Observou-se uma associação significativa entre as queixas de inatividade e de saúde física, mediadas pelos sintomas de TEPT.

El objetivo del estudio fue investigar la asociación entre inactividad física y molestias de salud en relación con síntomas de estrés postraumático (SEP), factores nutricionales y de comportamiento, así como el sentido de coherencia (SDC) entre las niñas de octavo grado. Una muestra aleatoria de las niñas (N = 862) fueron entrevistadas de forma anónima sobre las quejas de salud, el nivel de actividad física, los SEP, escala SOC de Antonovsky, conductas de salud, los hábitos alimentarios. Todas las quejas de salud se asociaron significativamente con la inactividad física. El odds ratio (OR) no ajustado de la inactividad física para las quejas de salud fue de 1,67 (IC95%: 1,09-2,56), después del ajuste para los SEP se redujo a 1,57 (IC95%: 0,95-2,45); tras los ajustes debidos al tabaco, bebidas alcohólicas diarias, verduras frescas, el SDC disminuyó a 1,25 (IC95%: 0,76-2,04). Se encontró una asociación significativa entre la inactividad y las quejas de salud fueron medidas por los SEP.