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  1. Article ; Online: Two cases of takotsubo syndrome related to tracheal intubation/extubation.

    Jakobson, Triin / Svitškar, Nikolai / Tamme, Kadri / Starkopf, Joel / Karjagin, Juri

    Medicina (Kaunas, Lithuania)

    2012  Volume 48, Issue 2, Page(s) 77–79

    Abstract: Takotsubo cardiomyopathy is an acute, reversible left ventricular dysfunction with characteristic contractility disorder and is usually preceded by emotional or physical stress. Two cases of Takotsubo cardiomyopathy related to tracheal manipulation are ... ...

    Abstract Takotsubo cardiomyopathy is an acute, reversible left ventricular dysfunction with characteristic contractility disorder and is usually preceded by emotional or physical stress. Two cases of Takotsubo cardiomyopathy related to tracheal manipulation are presented. Both the patients had all the typical symptoms and signs of Takotsubo cardiomyopathy, and both of them recovered completely within weeks. Tracheal manipulation is a well-known stress factor during the perioperative period, and experience from these two cases stresses the crucial role of measures aimed to stress reduction. Proper premedication and calm environment are recommended to produce anxiolysis before intubation. The administration of α- and β-blockers is also recommended to inhibit sympathetic stress caused by tracheal manipulation.
    MeSH term(s) Adrenergic alpha-Antagonists/therapeutic use ; Adrenergic beta-Antagonists/therapeutic use ; Aged ; Electrocardiography ; Female ; Humans ; Intubation, Intratracheal/adverse effects ; Middle Aged ; Takotsubo Cardiomyopathy/diagnosis ; Takotsubo Cardiomyopathy/drug therapy ; Takotsubo Cardiomyopathy/etiology
    Chemical Substances Adrenergic alpha-Antagonists ; Adrenergic beta-Antagonists
    Language English
    Publishing date 2012
    Publishing country Netherlands
    Document type Case Reports ; Journal Article
    ZDB-ID 2188113-3
    ISSN 1648-9144 ; 1010-660X
    ISSN (online) 1648-9144
    ISSN 1010-660X
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Postoperative complications and mortality after major gastrointestinal surgery.

    Jakobson, Triin / Karjagin, Juri / Vipp, Liisa / Padar, Martin / Parik, Ants-Hendrik / Starkopf, Liis / Kern, Hartmut / Tammik, Olavi / Starkopf, Joel

    Medicina (Kaunas, Lithuania)

    2014  Volume 50, Issue 2, Page(s) 111–117

    Abstract: Background and objective: The incidence of postoperative complications and death is low in the general population, but a subgroup of high-risk patients can be identified amongst whom adverse postoperative outcomes occur more frequently. The present ... ...

    Abstract Background and objective: The incidence of postoperative complications and death is low in the general population, but a subgroup of high-risk patients can be identified amongst whom adverse postoperative outcomes occur more frequently. The present study was undertaken to describe the incidence of postoperative complications, length of stay, and mortality after major abdominal surgery for gastrointestinal, hepatobiliary and pancreatic malignancies and to identify the risk factors for impaired outcome.
    Material and methods: Data of patients, operated on for gastro-intestinal malignancies during 2009-2010 were retrieved from the clinical database of Tartu University Hospital. Major outcome data included incidence of postoperative complications, hospital-, 30-day, 90-day and 1-year mortality, and length of ICU and hospital stay. High-risk patients were defined as patients with American Society of Anesthesiologists (ASA) physical status ≥3 and revised cardiac risk index (RCRI) ≥3. Multivariate analysis was used to determine the risk factors for postoperative mortality and morbidity.
    Results: A total of 507 (259 men and 248 women, mean age 68.3±11.3 years) were operated on for gastrointestinal, hepatobiliary, or pancreatic malignancies during 2009 and 2010 in Tartu University Hospital, Department of Surgical Oncology. 25% of the patients were classified as high risk patients. The lengths of intensive care and hospital stay were 4.4±7 and 14.5±10 days, respectively. The rate of postoperative complications was 33.5% in the total cohort, and 44% in high-risk patients. The most common complication was delirium, which occurred in 12.8% of patients. For patients without high risk (ASA<III; RCRI<3) in-hospital, 30-, 90-day and 1-year mortality were 2%, 5%, 12.7% and 26.0%. Patients with ASA≥III and RCRI≥3 had 2.3% in-hospital mortality, and at 30-, 90 days and 1 year the mortality was 8.5%, 17.8%, and 42.2%, respectively (P=0.001, P<0.0001 and P<0.0001 compared to the lower risk patients). On multivariate analysis, age above 70 years, ASA≥III, RCRI≥3, duration of surgery >130min, and positive fluid balance >1300mL after the 1st postoperative day, were identified as independent risk factors for the development of complications.
    Conclusion: The complication rate after major gastro-intestinal surgery is high. ASA physical status and revised cardiac risk index adequately reflect increased risk for postoperative complications and worse short and long-term outcome.
    MeSH term(s) Aged ; Digestive System Neoplasms/mortality ; Digestive System Neoplasms/surgery ; Digestive System Surgical Procedures/adverse effects ; Digestive System Surgical Procedures/statistics & numerical data ; Female ; Humans ; Incidence ; Lithuania/epidemiology ; Long Term Adverse Effects/mortality ; Male ; Postoperative Complications/mortality ; Treatment Outcome
    Language English
    Publishing date 2014
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2188113-3
    ISSN 1648-9144 ; 1010-660X
    ISSN (online) 1648-9144
    ISSN 1010-660X
    DOI 10.1016/j.medici.2014.06.002
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 6270: Show issues Location:
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  3. Article: Prevalence of malnutrition in various political, economic, and geographic settings.

    Klek, Stanislaw / Krznaric, Zeljko / Gundogdu, Riza Haldun / Chourdakis, Michael / Kekstas, Gintautas / Jakobson, Triin / Paluszkiewicz, Piotr / Vranesic Bender, Darija / Uyar, Mehmet / Demirag, Kubilay / Poulia, Kalliopi Anna / Klimasauskas, Andrius / Starkopf, Joel / Galas, Aleksander

    JPEN. Journal of parenteral and enteral nutrition

    2015  Volume 39, Issue 2, Page(s) 200–210

    Abstract: Background: Disease-related malnutrition (DRM) represents a critical public health concern. Therefore, Fight Against Malnutrition (FAM) should be a state priority, but the degree to which this is true appears to differ considerably among European ... ...

    Abstract Background: Disease-related malnutrition (DRM) represents a critical public health concern. Therefore, Fight Against Malnutrition (FAM) should be a state priority, but the degree to which this is true appears to differ considerably among European countries. The aim of this study was to put the problem into perspective by comparing the prevalence of malnutrition in countries from opposite parts of the continent.
    Methods: Six countries-Croatia, Estonia, Greece, Lithuania, Poland, and Turkey-participated in the study. A short questionnaire was used to assess DRM: its prevalence, the current situation in hospitals, regulations for reimbursement, and general healthcare circumstances. Data from ESPEN's NutritionDay 2006 were used to broaden the perspective.
    Results: At admission in October 2012, 4068 patients were assessed. The study was performed in 160 hospitals and 225 units with 9143 beds. The highest proportions of patients with 3 or more points on the Nutritional Risk Screening 2002 were observed in Estonia (80.4%) and Turkey (39.4%), whereas the lowest were in Lithuania (14.2%). The provision of nutrition support was best in Turkey (39.4% required intervention, 34.4% received intervention) and Poland (21.9% and 27.8%, respectively). Nutrition support teams (NSTs) are active in some countries, whereas in others they virtually do not exist.
    Conclusion: The prevalence of malnutrition was quite high in some countries, and the nutrition approach differed among them. It could be the result of the lack of reimbursement, inactive or nonexistent NSTs, and low nutrition awareness. Those facts confirmed that the continuation of FAM activities is necessary.
    MeSH term(s) Adult ; Croatia/epidemiology ; Estonia/epidemiology ; Female ; Greece/epidemiology ; Hospitalization ; Humans ; Lithuania/epidemiology ; Male ; Malnutrition/diagnosis ; Malnutrition/economics ; Malnutrition/epidemiology ; Malnutrition/ethnology ; Malnutrition/etiology ; Malnutrition/therapy ; Middle Aged ; Nutrition Assessment ; Nutritional Status ; Poland/epidemiology ; Politics ; Prevalence ; Risk Assessment ; Surveys and Questionnaires ; Turkey/epidemiology
    Language English
    Publishing date 2015-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 800861-9
    ISSN 0148-6071
    ISSN 0148-6071
    DOI 10.1177/0148607113505860
    Database MEDical Literature Analysis and Retrieval System OnLINE

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