Galvos smegenų kaverninė malformacija

Cerebral cavernous malformations (CCM) are low-flow vascular lesions in eloquent locations. Their presentation is often marked with symptomatic hemorrhages. Annual brainstem CM rate of hemorrhage is from 2.3% to 4.1%. Surgery for deep-seated or brainstem lesions is less successful and is associated with an early morbidity rate of roughly 30–70% and a mortality rate of 2%. Signs and symptoms of CCM depends on localization in the brain. Approximately 80% of cases are supratentorial caverno­mas. The most frequent injuring zones are frontal, temporal lobes and subcortical region. The most common symptoms are epilepsy and seizures. Also it can effect motor fibers which are situated in the cerebellum branch. Statistically approximately 40% all of CCM are asymptomatic and found accidentally when radiological investigations are taken. A preoperative MRI is essential for understanding the anatomy of the lesion and complete surgical resection of CCM is the only management strategy that can be fully curative. A non-radical resection of CCM is associated with high recurrence risk. From 12% to 17% patients may manifest a neurological deficits after surgery. Permanent neurological deficit rate is 2.6–8%. It consists of symptoms such as severe headache, mild speech dysfunction, ataxia, severe hemiparesis, sensorical dysfunction. MRI is the most sensitive and specific diagnostic test for cerebral cavernous malformations. CCMs can be very small and dif­ficult to identify on routine brain MRI. Due to hemosiderin associated with these lesions, there is marked “blooming” view, resulting in much higher sensitivity for lesion detection.Galvos smegenų kaverninė malformacija (KM, kavernoma, kaverninė angioma, kaverninė hemangioma) – tai įgimtas krauja­gyslinis darinys, sudarytas iš kompaktiškai išsidėsčiusio išsiplėtusių kapiliarų rezginio, kuriame nėra smegenų parenchimos. Dažnai kavernomų simptomatikos pasireiškimas susijęs su pakraujavimu. Tačiau kavernomos gali būti besimptomės, jos nu­statomos atsitiktinai. Kasmetinis kamieno kavernomų pakraujavimo dažnis – nuo 2,3 % iki 4,1 %.Todėl dauguma sunkių ži­dinių tampa neurochirurgijos centrų tikslu. Giliai esančių bei kamieno židinių chirurgija yra ne tokia sėkminga. Kavernomų simptomatika priklauso nuo židinio lokalizacijos. Apie 80 % atvejų kavernomos yra viršdangtinės. Dažniausiai pažeidžiamos kaktinė bei smilkininė skiltys, požievinė zona. Būdingiausi simptomai yra epilepsija ir traukuliai. Šie simptomai yra susiję su kaverninės malformacijos pakraujavimu. Renkantis chirurginį gydymą svarbu įvertinti židinio anatomiją ir lokalizaciją atlikus magnetinio rezonanso tomografiją (MRT). Radikalus kavernomos chirurginis pašalinimas yra vienintelis veiksmingas gydymo metodas.MRT yra jautriausias ir specifiškiausias kavernomų diagnostikos metodas. Mažas kavernomas rutininiu MRT gali būti sunku diagnozuoti

Covariant Lagrange multiplier constrained higher derivative gravity with scalar projectors

We formulate higher derivative gravity with Lagrange multiplier constraint and scalar projectors. Its gauge-fixed formulation as well as vector fields formulation is developed and corresponding spontaneous Lorentz symmetry breaking is investigated. We show that the only propagating mode is higher derivative graviton while scalar and vector modes do not propagate. Despite to higher derivatives structure of the action, its first FRW equation is the first order differential equation which admits the inflationary universe solution.Comment: Physics Letters B published version. LaTeX 12 page

The analysis of pediatric appendicitis clinical progress and treatment changes

Research aim: to evaluate pediatric appendicitis clinical progress and treatment changes in LSMUL KK Pediatric surgery clinic. Tasks: to evaluate a pediatric appendicitis clinical progress and the rate of perforation during the period of research; to evaluate the ratio changes among appendicitis perforation rate and peritoneal drainage rate; to compare perforated and nonperforated appendicitis with the duration of clinical symptoms manifestation; to compare the duration changes of clinical symptoms manifestation in perforated and nonperforated appendicitis during the period of research; to assess the appendicitis duration lengthening until perforation and evaluate the reduction of short time clinical symptoms manifestated and already with perforated appendicitis patients. Retrospective study were performed in two parts. In first part retrospectively analysed the rate of appendectomies with peritoneal drainage and perforated appendicitis rate changes during the period 1998-2013y. In second part was analysed the appendicitis clinical progress changes during the period 2003-2016y. in LSMUL KK Pediatric surgery clinic. Data statistic analysis were performed using package of statistical software (SPSS 23.0, Statistica 8 and MedCalc). To evaluate significance of difference were used linear regresion and correlation methods and for nonparametric median comparison were used Man-Whitney-U and Kruskal-Wallis tests. For parametric samples comparison were used ANOVA test and logistic regresion analysis. The rate of perforated appendicitis statistically significantly decreased during the research period. The ratio, between perforated appendicitis rate and peritoneal drainage rate, statistically significantly decreased. Patients with perforated appendicitis clinical symptoms manifestation were longer than patients with nonperforated appendicitis. During the research period the perforated and nonperforated clinical symptoms manifestation statisticaly significantly increased. During the research period were established increasing number of nonperforated appendicitis cases which symptoms manifestation was over 48h and decreasing number of perforated appendicitis cases which symptoms manifestation was less than 24h

Prevalance of musculoskeletal disorders among physiotherapists practising in Riga

FizioterapijaVeselības aprūpePhysiotherapyHealth CareANOTĀCIJA Darba tēma: Mioskeletālo saslimšanu sastopamība Rīgā praktizējošu fizioterapeitu vidū. Pamatojums: Ar darbu saistītu mioskeletālo saslimšanu sastopamība fizioterapeitu vidū ir augsta, mūža prevalencei sasniedzot no 40% līdz 91 %, bet 12 mēnešu prevalencei no 58% līdz 91%. Fizioterapijas profesijas pārstāvjiem tiek novērotas dažādas mioskeletālas saslimšanas, izplatītas problēmu zonas ir muguras lejasdaļa (48%), kakls (33%), muguras augšdaļa (23%) un īkšķi (23%). Iepriekšējos pētījumos fizioterapeiti ir ziņojuši par darba kavēšanu, darba apstākļu un paradumu maiņu vai profesijas pamešanu, darbā iegūto mioskeletālo saslimšanu rezultātā. Darba mērķis: Noskaidrot ar darbu saistītu mioskeletālo saslimšanu sastopamību un visbiežāk skartās ķermeņa zonas Rīgā praktizējošu fizioterapeitu izlasē. Pētījuma metodes: Pētījuma dizains: kvantitatīvs šķērsgriezuma pētījums. Pētījumā piedalījās 60 Rīgā praktizējoši fizioterapeiti, 8 (13,3%) vīrieši un 52 (86,7%) sievietes, vecumā no 22-54 gadiem. Datu ieguvei tika izmantota adaptēta Standartizētā Ziemeļvalstu Mioskeletālā aptauja. Tika apskatīta mioskeletālo saslimšanu sastopamību deviņās ķermeņa zonās un pārbaudīta saistība starp mioskeletālo saslimšanu sastopamību un dažādādiem darba un individuāliem faktoriem. Rezultāti: 56 (93,3%) no 60 aptaujātajiem dalībniekiem atzīmēja, ka pēdējo 12 mēnēšu laikā ir izjutuši ar darbu saistītas mioskeletālas sāpes vai diskomfortu. Visbiežāk skartās ķermeņa zonas pēdējo 12 mēnešu laikā bija pleci (N=39, 65%), muguras lejas daļa (N=38, 63,3%), krūšu daļa/starplāpstiņu zona (N=37, 61,7%) un kakls (N=34, 56,7%) Tika novērotas statistiski nozīmīgas atšķirības starp mioskeletālo saslimšanu sastopamību konkrētās ķermeņa zonās un dalībnieku darba un individuālajiem faktoriem. Secinājumi: Veiktajā pētījumā vairums Rīgā praktizējošu fizioterapeitu pēdējo 12 mēnešu laikā piedzīvo mioskeletālas saslimšanas un visbiežāk skartās ķermeņa zonas ir plecu zona, muguras lejas daļa, krūšu daļa/starplāpstiņu zona un kakla zona.ABSTRACT Title: Prevalance of musculoskeletal disorders among physiotherapists practising in Riga. Background: The prevalance of work-related musculoskeletal disorders is high among physiotherapists, with a lifetime prevalence of 40% to 91% and a 12-month prevalence of 58% to 91%. Variety of musculoskeletal disorders are observed among physiotherapists, common problem areas have been lower back (48%), neck (33%), upper back (23%) and thumbs (23%). In previous studies, physiotherapists have reported absenteeism from work, making changes in working habits, or leaving job as a result of work-related musculoskeletal disorders. Research Objective: Find out the prevalance of work-related musculoskeletal disorders and the most frequently affected body areas in sample of physiotherapists practicing in Riga. Methods: Study design: quantitative cross-sectional study. The study involved 60 physiotherapists practicing in Riga, 8 (13.3%) men and 52 (86.7%) women, aged between 22-54. An adaption of the Nordic Musculoskeletal Questionnaire was used to obtain data. The prevalance of musculoskeletal disorders in nine areas of the body was examined and the relationship between the prevalance of musculoskeletal disorders and various work and individual factors was examined. Results: 56 (93.3%) of the 60 respondents answered that they had experienced work-related musculoskeletal pain or discomfort in the last 12 months. The most commonly affected areas of the body during the last 12 months were the shoulders (N = 39, 65%), the lower back (N = 38, 63.3%), the chest/thoracic spine area (N = 37, 61.7%) and the neck. (N = 34, 56.7%) Statistically significant differences were observed between the prevalance of musculoskeletal diseases in specific area of the body and the work and individual factors of the participants. Conclusions: In the study, the majority of practising physiotherapists in Riga have experienced musculosceletal diseases over the past 12 months and the most frequently affected body areas are shoulder area, back down, breast/interleaving area and neck area

Characteristics of pre-competitive mental state of middle-distance and long-distance runners.

Bachelor work carried out the investigation revealed that most runners of medium-and long-distance before competitions increased psycho physiological responses (an increase in pulse rate, breathing, sweating), stress, anxiety, fear feel. This is the strongest reaction and emotional condition before the responsible competition. They attempt to overcome self-induction (speech, breathing, images development), thoughts associated with the diversion of competitive