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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.

Table of Contents

Medicina, Volume 43, Issue 12 (December 2007)

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Open AccessArticle
Evaluation of sensorimotor reactions during early rehabilitation for patients after cerebral stroke
Medicina 2007, 43(12), 942; https://doi.org/10.3390/medicina43120122
Received: 21 September 2007 / Accepted: 6 December 2007 / Published: 11 December 2007
Cited by 1 | Viewed by 167 | PDF Full-text (168 KB)
Abstract
Early inpatient rehabilitation is extremely important in functional improvement of patients suffering from cerebral stroke. From our point of view, in rehabilitation of patients after cerebral stroke, the estimation of sensorimotor reactions that enables the evaluation of sensorimotor functional changes is highly relevant. [...] Read more.
Early inpatient rehabilitation is extremely important in functional improvement of patients suffering from cerebral stroke. From our point of view, in rehabilitation of patients after cerebral stroke, the estimation of sensorimotor reactions that enables the evaluation of sensorimotor functional changes is highly relevant. The article describes the comparison of sensorimotor reactions in two subgroups – stroke patients and healthy individuals – by applying Sensoneck system. The evaluation was performed before early stage of rehabilitation and thereafter (following early rehabilitation). In order to estimate the correlation between changes in functional independence and sensorimotor reactions, Functional Independence Measure was used. The study revealed that stroke patients had sensorimotor dysfunctions. During early rehabilitation, the quality of motion performance improved slightly, and sensorimotor reactions improved statistically significantly (P<0.05). The relationship between Functional Independence Measure and Sensoneck scores was not significant (P>0.05). Full article
Open AccessArticle
Admission hyperglycemia and abnormal glucose tolerance at discharge in patients with acute myocardial infarction and no previous history of diabetes mellitus
Medicina 2007, 43(12), 935; https://doi.org/10.3390/medicina43120121
Received: 30 March 2007 / Accepted: 6 December 2007 / Published: 11 December 2007
Cited by 4 | Viewed by 173 | PDF Full-text (226 KB)
Abstract
The objective of this study was to determine frequency of admission hyperglycemia and abnormal glucose tolerance at discharge in patients with acute myocardial infarction and no previous history of diabetes mellitus.
Methods and results. Data on 1522 patients with acute myocardial infarction [...] Read more.
The objective of this study was to determine frequency of admission hyperglycemia and abnormal glucose tolerance at discharge in patients with acute myocardial infarction and no previous history of diabetes mellitus.
Methods and results. Data on 1522 patients with acute myocardial infarction and no previous history of diabetes mellitus were analyzed. Before discharge from hospital, standardized oral glucose tolerance test was performed in 197 patients with admission hyperglycemia.
Results
. Admission hyperglycemia (≥6.1 mmol/L) was determined in half of the patients with acute myocardial infarction: glucose concentration of 6.1–6.99 mmol/L was in 21.5% and ≥7.0 mmol/L in 30.1% of the patients. By using glucose tolerance test, normal glucose metabolism was noted in 57.9% of the patients with admission hyperglycemia; abnormal glucose tolerance was diagnosed newly in more than one-third and glucose concentration of ≥11.1 mmol/L in 10.1% of the patients.
Conclusions
. Abnormal glucose tolerance is a frequent feature in nondiabetic patients with admission hyperglycemia during acute myocardial infarction, and glucose tolerance test should be considered in all patients with ischemic heart disease for early modification of this risk factor. Full article
Open AccessArticle
Pulmonary arterial hypertension
Medicina 2007, 43(12), 978; https://doi.org/10.3390/medicina43120128
Received: 4 September 2007 / Accepted: 5 December 2007 / Published: 10 December 2007
Cited by 1 | Viewed by 208 | PDF Full-text (293 KB)
Abstract
Pulmonary arterial hypertension is a life-threatening, progressive disorder of pulmonary blood vessels leading to an increase in pressure in pulmonary artery. Diagnosis is based on a mean pulmonary artery pressure of more than 25 mmHg at rest or more than 30 mmHg during [...] Read more.
Pulmonary arterial hypertension is a life-threatening, progressive disorder of pulmonary blood vessels leading to an increase in pressure in pulmonary artery. Diagnosis is based on a mean pulmonary artery pressure of more than 25 mmHg at rest or more than 30 mmHg during exercise. No cure exists for it yet. However, specialized treatment can lower pulmonary pressure, reduce symptoms, increase the capacity to be active, and prolong lifespan. In this review article, we attempt to summarize the current knowledge regarding clinical classification, risk factors and associated conditions, pathology and pathogenesis of this disease, diagnostic tests and detection of it, clinical course, current therapeutic strategies for the treatment of pulmonary arterial hypertension (calcium channel blockers, prostacyclin analogues, endothelin receptor antagonists, phosphodiesterase-5 inhibitors, etc.). Interventional procedures, combination therapy, and new strategies (selective serotonin reuptake inhibitors, antivascular endothelial growth factor agents, potassium channel openers, etc.) for the management of pulmonary arterial hypertension and prognosis of this rare disease are also discussed. Full article
Open AccessArticle
Issues of the practical value of ethics in healthcare
Medicina 2007, 43(12), 930; https://doi.org/10.3390/medicina43120120
Received: 11 September 2007 / Accepted: 4 December 2007 / Published: 9 December 2007
Cited by 1 | Viewed by 151 | PDF Full-text (185 KB)
Abstract
In November 2006, the “Journal of Medical Ethics” published an article where prominent medical specialists stated that medical ethics, as a teaching and a theory, has no practical value. The article was based on the physicians’ clinical experience and view that the theory [...] Read more.
In November 2006, the “Journal of Medical Ethics” published an article where prominent medical specialists stated that medical ethics, as a teaching and a theory, has no practical value. The article was based on the physicians’ clinical experience and view that the theory of ethics has little in common with its application in daily practice and provides generalized guidelines for behavior, but is ineffective in decisionmaking in individual cases. At the same time, when describing conflict situations in healthcare, Lithuanian public press raises the role of ethics to the absolute and states that the lack or violation of ethics is the sole cause of all problems in healthcare, and there would be no problems if physicians behaved morally. From the viewpoint of an ethics professional, both controversial opinions deserve attention, and this paper is devoted to the analysis of these opinions. Ethical collisions and conflicts emerging in providing healthcare are not signs of the helplessness of medical ethics. Both viewpoints – the one disclaiming the role of medical ethics and the one attributing the absolute role to medical ethics – are equally erroneous. Decisions of the society and physicians are aggravated by health policy and the organization of healthcare in the country, as well as by a concrete individual’s level of ethical thinking, worldview, and knowledge. Sometimes ethical collisions arise when there is a conflict among ethical principles themselves, and healthcare specialists have to decide which principle should be given priority. There are cases where setting priorities is impossible, and one has to admit that one single specialist is unable to solve the problem without his/her colleagues’ assistance. Collective and collegial professionals’ work helps to solve such ethical collisions. Full article
Open AccessArticle
Influenza virus
Medicina 2007, 43(12), 919; https://doi.org/10.3390/medicina43120119
Received: 28 August 2007 / Accepted: 3 December 2007 / Published: 8 December 2007
Cited by 3 | Viewed by 190 | PDF Full-text (729 KB)
Abstract
Every year, especially during the cold season, many people catch an acute respiratory disease, namely flu. It is easy to catch this disease; therefore, it spreads very rapidly and often becomes an epidemic or a global pandemic. Airway inflammation and other body ailments, [...] Read more.
Every year, especially during the cold season, many people catch an acute respiratory disease, namely flu. It is easy to catch this disease; therefore, it spreads very rapidly and often becomes an epidemic or a global pandemic. Airway inflammation and other body ailments, which form in a very short period, torment the patient several weeks. After that, the symptoms of the disease usually disappear as quickly as they emerged. The great epidemics of flu have rather unique characteristics; therefore, it is possible to identify descriptions of such epidemics in historic sources. Already in the 4th century BC, Hippocrates himself wrote about one of them. It is known now that flu epidemics emerge rather frequently, but there are no regular intervals between those events. The epidemics can differ in their consequences, but usually they cause an increased mortality of elderly people. The great flu epidemics of the last century took millions of human lives. In 1918–19, during “The Spanish” pandemic of flu, there were around 40–50 millions of deaths all over the world; “Pandemic of Asia” in 1957 took up to one million lives, etc. Influenza virus can cause various disorders of the respiratory system: from mild inflammations of upper airways to acute pneumonia that finally results in the patient’s death. Scientist Richard E. Shope, who investigated swine flu in 1920, had a suspicion that the cause of this disease might be a virus. Already in 1933, scientists from the National Institute for Medical Research in London – Wilson Smith, Sir Christopher Andrewes, and Sir Patrick Laidlaw – for the first time isolated the virus, which caused human flu. Then scientific community started the exhaustive research of influenza virus, and the great interest in this virus and its unique features is still active even today. Full article
Open AccessArticle
Cigarette smoking and waiting time to pregnancy: results of a pilot study
Medicina 2007, 43(12), 959; https://doi.org/10.3390/medicina43120125
Received: 4 April 2007 / Accepted: 28 November 2007 / Published: 3 December 2007
Cited by 3 | Viewed by 155 | PDF Full-text (189 KB)
Abstract
Waiting time to pregnancy is an important characteristic of human reproductive health, which has not been investigated in Lithuania until now. Data on waiting time to pregnancy have been collected from medical records of 111 women admitted to the Department of Obstetrics, Klaipėda [...] Read more.
Waiting time to pregnancy is an important characteristic of human reproductive health, which has not been investigated in Lithuania until now. Data on waiting time to pregnancy have been collected from medical records of 111 women admitted to the Department of Obstetrics, Klaipėda Hospital. Seven women in whom pregnancy was the result of infertility treatment were excluded from the analysis, and the rest 104 cases were analyzed. We evaluated waiting time to pregnancy in respect to the age of couples, contraceptive use, cigarette smoking of both partners, and some other features of obstetric history. The mean waiting time to pregnancy in the cohort was 5.21±7.03 months. If both partners smoked, the mean waiting time to pregnancy was significantly longer than in nonsmoking couples (7.68±9.41 vs. 4.30±5.73, P<0.05). Risk to have waiting time to pregnancy longer than 6 months was significantly higher if both partners smoked as compared to nonsmoking couples (OR 3.32, 95% CI 1.07–10.30, P=0.03), while paternal smoking and smoking of any partner did not increase this risk significantly. The other possible factors – age, living place (rural or city), previous contraceptive use, regularity of menstrual cycle, and frequency of intercourse – did not influence waiting time to pregnancy significantly. Results obtained from this pilot study enable us to plan and implement a larger-scale study of waiting time to pregnancy in Lithuanian population. Full article
Open AccessArticle
Study of diversity of anthocyanin composition in bilberry (Vaccinium myrtillus L.) fruits
Medicina 2007, 43(12), 971; https://doi.org/10.3390/medicina43120127
Received: 30 October 2007 / Accepted: 20 November 2007 / Published: 25 November 2007
Cited by 23 | Viewed by 231 | PDF Full-text (232 KB)
Abstract
Qualitative and quantitative composition of anthocyanins in bilberry (Vaccinium myrtillus L.) fruits was assayed. The aim of our study was to evaluate total anthocyanin content and their composition in bilberries collected from various regions and at different time. For the quantification of [...] Read more.
Qualitative and quantitative composition of anthocyanins in bilberry (Vaccinium myrtillus L.) fruits was assayed. The aim of our study was to evaluate total anthocyanin content and their composition in bilberries collected from various regions and at different time. For the quantification of total anthocyanins in frozen fruits, the spectrophotometrical assay was performed. The highest amount of anthocyanins in bilberry fruits, collected in Lithuania, was found in samples from Šilutė (0.399%), the lowest one – from Valkininkai region (0.264%), but higher amounts of anthocyanins were found in the samples collected in Russia (Archangelsk region) and Sweden (Stockholm region). High-performance liquid chromatography was applied for qualitative evaluation of individual anthocyanins in the different material. Quantification of anthocyanidin content was performed after acidic hydrolysis of anthocyanin glycosides. Chromatographic analysis has shown that there are no differences in qualitative composition of anthocyanidins. In all samples, cyanidin was found in the highest quantities (mean amount 0.053 µg/mL). Delphinidin and petunidin was found in quantities 2.5 fold lower than cyanidin, and malvidin and peonidin were found in the smallest quantities. Only in the blueberries collected in Sweden, malvidin was found in the highest amount. It was 1.5 fold higher than amounts of petunidin and delphinidin. Full article
Open AccessArticle
Successful rescue therapy with mycophenolate mofetil in kidney transplantation improves the long-term graft survival
Medicina 2007, 43(12), 953; https://doi.org/10.3390/medicina43120124
Received: 15 May 2007 / Accepted: 17 November 2007 / Published: 22 November 2007
Cited by 2 | Viewed by 154 | PDF Full-text (177 KB)
Abstract
Objective. The aim of this study was to compare the graft survival after kidney transplantation in patients treated with azathioprine (AZA) or mycophenolate mofetil (MMF) and analyze the significance of different risk factors for graft survival.
Material and methods
. A total [...] Read more.
Objective. The aim of this study was to compare the graft survival after kidney transplantation in patients treated with azathioprine (AZA) or mycophenolate mofetil (MMF) and analyze the significance of different risk factors for graft survival.
Material and methods
. A total of 137 patients, transplanted between January 1996 and June 2001, were retrospectively divided into two groups: patients who received AZA together with cyclosporine A and methylprednisolone (AZA group, n=72) and patients who received MMF either immediately or were switched from AZA to MMF during 3 months (MMF group, n=65).
Results. According to Kaplan-Meier analysis, a 1-year graft survival was 79% in the AZA group and 85% in the MMF group; a 6-year graft survival was 51% and 67%, respectively (P=0.046). Multivariate Cox survival model demonstrated that MMF therapy reduced the risk of graft loss by 34% (P=0.028), while delayed graft function increased the risk of graft loss (risk ratio 2.26, P=0.009). A statistically significant difference in total cholesterol level (6.7 vs. 5.7 mmol/L, respectively; P=0.002), mean systolic blood pressure (145 vs. 134 mmHg, P=0.009), and cyclosporine A daily dose (238 vs. 203 mg, P=0.015) between the AZA and MMF groups at 1 year was revealed.
Conclusion
. MMF rescue therapy improves the long-term graft survival compared to AZA despite high early rejection rate and avoids the negative impact of acute rejections on graft survival. Full article
Open AccessArticle
Collagen network changes in basilar artery in aging
Medicina 2007, 43(12), 964; https://doi.org/10.3390/medicina43120126
Received: 1 March 2007 / Accepted: 16 November 2007 / Published: 21 November 2007
Cited by 3 | Viewed by 153 | PDF Full-text (607 KB)
Abstract
Objective. The aim of this study was to examine and evaluate morphometrically age-related changes in collagen network in the tunica media of human basilar artery.
Materials and methods
. Histological analysis of the basilar arteries obtained from 89 individuals, aged 20 to [...] Read more.
Objective. The aim of this study was to examine and evaluate morphometrically age-related changes in collagen network in the tunica media of human basilar artery.
Materials and methods
. Histological analysis of the basilar arteries obtained from 89 individuals, aged 20 to 85 years, was performed. The study has been carried out by standard histological technique; histological samples were stained with picrosirius red. Detailed quantitative analysis of collagen bundle network in the tunica media of basilar artery was performed.
Results. We analyzed collagen network area, perimeter and number of collagen bundles in the tunica media of the basilar artery. After investigation of age-related changes in collagen network area in men and women, we determined that in both genders collagen network area in the tunica media of the basilar artery increased with age. Analyzing the perimeter and number of collagen bundles in both genders by different age groups, it was found that they decreased with age. We found a statistically significant correlation between all the measured parameters and the age.
Conclusions. The area of collagen bundles increased, the number and perimeter of collagen bundles decreased with age in both genders in the tunica media of human basilar artery. While aging, the structure of collagen bundle network became less branchy, collagen fibers merged, their cross section area enlarged. Full article
Open AccessArticle
Prevalence and causes of iron deficiency anemias in infants aged 9 to 12 months in Estonia
Medicina 2007, 43(12), 947; https://doi.org/10.3390/medicina43120123
Received: 4 June 2007 / Accepted: 12 October 2007 / Published: 17 October 2007
Cited by 23 | Viewed by 168 | PDF Full-text (187 KB)
Abstract
Objective. To investigate the prevalence and causes of iron deficiency anemia in infants aged 9 to 12 months in Estonia.
Material and methods
. Every second child aged 9–12 months was randomly selected from primary medical centers in seven counties from all [...] Read more.
Objective. To investigate the prevalence and causes of iron deficiency anemia in infants aged 9 to 12 months in Estonia.
Material and methods
. Every second child aged 9–12 months was randomly selected from primary medical centers in seven counties from all over Estonia. A questionnaire concerning eating habits and lifestyle was sent to their parents. Sixty-five percent (n=195) of contacted families agreed to participate in the study. Mean corpuscular volume and hemoglobin, serum ferritin, and soluble transferrin receptor levels were measured in 171 infants. Anemia was defined when hemoglobin level was lower than 105 g/L, and iron deficiency when ferritin level and mean corpuscular volume were lower than 12 µg/L and 74 fL, respectively.
Results
. The prevalence of iron deficiency was 14.0% and iron deficiency anemia 9.4%. Birthweight less than 3000 g was the main risk factor for iron deficiency (OR=9.4; P<0.0005). Infants fed with breast milk and solid food had lower ferritin concentration (18.5 µg/L, 95% CI 14.0–23.0) than infants fed with formula and solid food (32.8 µg/L, 95% CI 26.6–39) (P<0.005).
Conclusion. Iron deficiency anemia is common among 9–12-month-old Estonian infants. The main risk factor for iron deficiency was birthweight less than 3000 g. Full article
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