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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 4 (April 2007)

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Open AccessArticle
Antioxidative activity of Ginkgo, Echinacea, and Ginseng tinctures
Medicina 2007, 43(4), 306; https://doi.org/10.3390/medicina43040038
Received: 28 June 2006 / Accepted: 29 August 2007 / Published: 3 September 2007
Cited by 15 | Viewed by 186 | PDF Full-text (233 KB)
Abstract
The aim of this study was to determine the amount of phenol compounds in tinctures prepared from Ginkgo leaves, Echinacea plant, and Ginseng roots and to evaluate the antioxidative activity of these preparations. We studied the antioxidative activity using the standard 2,2-diphenyl-1-picrylhydrazyl (DPPH·) [...] Read more.
The aim of this study was to determine the amount of phenol compounds in tinctures prepared from Ginkgo leaves, Echinacea plant, and Ginseng roots and to evaluate the antioxidative activity of these preparations. We studied the antioxidative activity using the standard 2,2-diphenyl-1-picrylhydrazyl (DPPH·) radical cation scavenging and tyrosine nitration inhibition tests. The obtained findings showed that the amount of phenol compounds in the studied tinctures differed and ranged between 114 to 340±29 gallic acid equivalents (GAE) mg/100 mL. We found that the amount of phenol compounds in Ginkgo tincture was statistically significantly greater than that in Echinacea or Ginseng tinctures. The effectiveness of Ginkgo tincture was by 52.7% (P<0.01) lower (from 1343±11 µmmol catechin/100 mL solution to 637±64 catechin/100 mL solution), compared to Echinacea tincture. Ginseng tincture was the weakest scavenger of free radicals – only 8±1 µmmol catechin/100 mL solution. The inhibition of tyrosine nitration was by 34% (P<0.01) greater in Echinacea tincture, compared to Ginkgo tincture (from 892±36 µmmol catechin/100 mL solution to 588±17 µmmol catechin/100 mL solution). Ginseng tincture was the weakest inhibitor of tyrosine nitration – only 20±8 µmmol catechin/100 mL solution, which was by 44.6 times less, compared to Echinacea tincture. Tests on DPPH· radical cation scavenging and inhibition of nitration showed that the antioxidative activity of Echinacea tincture was statistically significantly greater compared to that of Ginkgo or Ginseng tinctures. This allows us to conclude that antioxidative activity is determined not only by phenol compounds, but also by a complex of other components of medicinal raw material. Full article
Open AccessArticle
Meta-analysis of prophylactic parenteral antibiotic use in acute necrotizing pancreatitis
Medicina 2007, 43(4), 291; https://doi.org/10.3390/medicina43040036
Received: 18 July 2006 / Accepted: 5 April 2007 / Published: 10 April 2007
Cited by 23 | Viewed by 231 | PDF Full-text (267 KB)
Abstract
Background. Acute pancreatitis is a potentially serious condition. It carries an overall mortality rate of 10–15%. Infectious complications account for approximately 80% of deaths from acute pancreatitis, and the question arises whether or not prophylactic antibiotics are useful in the prevention of [...] Read more.
Background. Acute pancreatitis is a potentially serious condition. It carries an overall mortality rate of 10–15%. Infectious complications account for approximately 80% of deaths from acute pancreatitis, and the question arises whether or not prophylactic antibiotics are useful in the prevention of these complications. Therefore, we performed an evidence-based analysis to assess the effect of available prophylactic antimicrobial treatment on the development of infected necrosis and sepsis, need for surgery, and mortality.
Methods
. A comprehensive PubMed search was performed evaluating the value of prophylactic administration of parenteral antibiotics in patients with acute necrotizing pancreatitis. Only articles published in English language between January 1990 and May 2006 were included. The search strategy initially generated 692 articles related to antibiotics in the treatment of acute pancreatitis. This number was reduced to 97 publications related to clinical trials on the same topic. Finally, 10 randomized clinical trials concerning prophylactic parenteral antibiotics in patients with acute necrotizing pancreatitis were identified. We have performed a meta-analysis using the random-effects model to assess the impact of prophylactic antibiotics on development of infected pancreatic necrosis and sepsis, need for surgery, and overall mortality.
Results
. Patients with necrotizing acute pancreatitis should receive effective antibiotic prophylaxis (i.e., carbapenems intravenously) to decrease the risk of infected necrosis and sepsis and need of surgery.
Conclusions
. While providing new insights into key aspects of antibiotic prophylaxis, this evidence-based analysis highlights the need for further clinical trials regarding the indications for antibiotic prophylaxis. Full article
Open AccessArticle
Public health and bioterrorism: renewed threat of anthrax and smallpox
Medicina 2007, 43(4), 278; https://doi.org/10.3390/medicina43040034
Received: 15 February 2006 / Accepted: 4 April 2007 / Published: 9 April 2007
Cited by 17 | Viewed by 244 | PDF Full-text (187 KB)
Abstract
Bioterrorism is one of the main public health categorical domains. According to sociological analytics, in postmodern society terrorism is one of the real threats of the 21st century. While rare, the use of biological weapons has a long history. Recently, anthrax has been [...] Read more.
Bioterrorism is one of the main public health categorical domains. According to sociological analytics, in postmodern society terrorism is one of the real threats of the 21st century. While rare, the use of biological weapons has a long history. Recently, anthrax has been evaluated as one of the most dangerous biological weapons. Naturally occurring anthrax in humans is a disease acquired from contact with anthrax-infected animals or anthrax-contaminated animal products. Usually anthrax infection occurs in humans by three major routes: inhalational, cutaneous, and gastrointestinal. Inhalational anthrax is expected to account for most serious morbidity and most mortality. The clinical presentation of inhalation anthrax has been described as a two-stage illness. Many factors contribute to the pathogenesis of Bacillus anthracis. Antibiotics, anthrax globulin, corticosteroids, mechanical ventilation, vaccine are possible tools of therapy. Smallpox existed in two forms: variola major, which accounted for most morbidity and mortality, and a milder form, variola minor. Smallpox spreads from person to person primarily by droplet nuclei or aerosols expelled from the oropharynx of infected persons and by direct contact. In the event of limited outbreak with few cases, patients should be admitted to the hospital and confined to rooms that are under negative pressure and equipped with high-efficiency particulate air filtration. In larger outbreaks, home isolation and care should be the objective for most patients. Progress in detection, suitable vaccines, postexposure prophylaxis, infection control, and decontamination might be serious tools in fight against the most powerful biological weapon. To assure that the public health and healthcare system can respond to emergencies, the government should direct resources to strengthen the emergency-response system, create medication stockpiles, and improve the public health infrastructure. Full article
Open AccessArticle
Importance of prostate volume for detection of prostate cancer by first sextant biopsy in high-risk patients
Medicina 2007, 43(4), 285; https://doi.org/10.3390/medicina43040035
Received: 2 January 2007 / Accepted: 3 April 2007 / Published: 8 April 2007
Cited by 3 | Viewed by 180 | PDF Full-text (208 KB)
Abstract
The aim of this study was to evaluate the relevance of prostate gland volume, transitional zone volume, and transitional zone index for the detection of prostate cancer by the first sextant biopsy.
Material and methods
. A total of 121 men with high [...] Read more.
The aim of this study was to evaluate the relevance of prostate gland volume, transitional zone volume, and transitional zone index for the detection of prostate cancer by the first sextant biopsy.
Material and methods
. A total of 121 men with high risk of prostate cancer were included in our study (prostate-specific antigen level higher than 4 ng/mL and/or pathological digital rectal examination). We consulted the patients in Outpatient Department of Kaunas University of Medicine Hospital during 2003–2006. Total prostate volume and transition zone volume were measured, and all patients underwent transrectal ultrasoundguided sextant biopsy of the prostate. According to histological results of prostate biopsy, patients were divided into two groups: benign group (benign prostate hyperplasia and high-grade intraepithelial neoplasia) and prostate cancer group. Statistical analysis was made by SPSS (Statistical Package for Social Sciences) 12.0.1 for Windows.
Results. After histological examination, prostate cancer was detected in 20.7% of patients (n=25). Prostate cancer was found in 24.6% of patients with a total prostate volume of less than 60 cm3 and only in 8.2% of patients with a total prostate volume greater than 60 cm3 (P=0.026). Prostate cancer was found in 27.1% of patients with transition zone volume smaller than 30 cm3 and only in 7.5% of patients with transition zone volume greater than 30 cm3 (P=0.007). A statistically significant difference was found when patients were divided into the groups according to transition zone index: when transition zone index was lower than 0.45, prostate cancer was detected in 37.1% of patients, and when transition zone index was higher than 0.45, prostate cancer was observed in 9.1% of patients (P=0.001). The possibility to detect prostate cancer was 5.9 times higher in patients with transition zone index lower than 0.45.
Conclusions
. Prostate cancer detection rate by first sextant prostate biopsy in patients with elevated prostate-specific antigen level and/or pathological digital rectal examination was higher when total prostate volume was less than 60 cm3, transition zone was less than 30 cm3, and transition zone index was less than 0.45. Full article
Open AccessArticle
Factors influencing outcomes in patients with stroke
Medicina 2007, 43(4), 269; https://doi.org/10.3390/medicina43040033
Received: 2 January 2007 / Accepted: 3 April 2007 / Published: 8 April 2007
Cited by 5 | Viewed by 178 | PDF Full-text (228 KB)
Abstract
Outcomes of stroke result in long-term disability in most of the patients. It has been confirmed by scientific studies that rehabilitation can improve functional status and quality of life of poststroke patients. The effectiveness of rehabilitation and the outcomes often differ among patients. [...] Read more.
Outcomes of stroke result in long-term disability in most of the patients. It has been confirmed by scientific studies that rehabilitation can improve functional status and quality of life of poststroke patients. The effectiveness of rehabilitation and the outcomes often differ among patients. For effective utilization of the rehabilitation resources, it is important to prognosticate the possible outcomes of the disorder. Recently, studies are performed with the aim to determine and evaluate factors possibly influencing functional recovery in poststroke patients and helping to distinguish patients with good outcome from those with poor outcome. Age, gender, initial severity of the stroke, functional status at admission to hospital, urinary incontinence, impairment in cognitive function, unilateral neglect syndrome are most often analyzed in scientific studies as factors determining the outcomes of the disorder. Full article
Open AccessArticle
Comparison in vitro felodipine release rate from the original versus generic product with controlled release of the drug
Medicina 2007, 43(4), 326; https://doi.org/10.3390/medicina43040040
Received: 11 April 2006 / Accepted: 30 March 2007 / Published: 4 April 2007
Cited by 12 | Viewed by 195 | PDF Full-text (234 KB)
Abstract
After patent protection of original brand is over, there are a lot of generic products occurring on the pharmaceutical market. It may be the way to reduce the price, but on the other hand, one should expect the same quality and almost identity [...] Read more.
After patent protection of original brand is over, there are a lot of generic products occurring on the pharmaceutical market. It may be the way to reduce the price, but on the other hand, one should expect the same quality and almost identity with original brand, because the development of generic drugs is based on pharmacological properties of the original brand. The aim of this study was to compare the similarity of two products with controlled release of felodipine – generic product Presid® and original brand Plendil® – which are commercially available in Czech Republic, based on in vitro dissolution testing. The dissolution test in three dissolution media of increasing pH (1.2, 4.5, and 6.5) for the simulation of physiological pH within the gastrointestinal tract confirmed controlled release of felodipine from the original product Plendil ER 5 mg and Plendil ER 10 mg during the period of 24 hours. The release of felodipine from generic products Presid 5 mg and Presid 10 mg was not controlled for 24 hours as it is indicated in the information leaflet. In the generic products, felodipine release was controlled just for 12 or 18 hours and in this respect did not show similarity with the original brand. Since patients take the drug just once a day in the morning, the controlled release of felodipine, which lasts only 12 to 18 hours, can cause insufficient blood pressure control especially in the most critical morning hours and higher cardiovascular risk. Full article
Open AccessArticle
QTc-prolonging drugs and the risk of sudden death
Medicina 2007, 43(4), 347; https://doi.org/10.3390/medicina43040043
Received: 26 May 2006 / Accepted: 16 March 2007 / Published: 21 March 2007
Cited by 4 | Viewed by 175 | PDF Full-text (524 KB)
Abstract
Various drugs can be associated with QT prolongation. A prolonged QT interval leads to an increased risk for the development of ventricular tachyarrhythmias, particularly polymorphic ventricular tachycardia (torsades de pointes). Polymorphic arrhythmia may rapidly develop into ventricular fibrillation and cause sudden [...] Read more.
Various drugs can be associated with QT prolongation. A prolonged QT interval leads to an increased risk for the development of ventricular tachyarrhythmias, particularly polymorphic ventricular tachycardia (torsades de pointes). Polymorphic arrhythmia may rapidly develop into ventricular fibrillation and cause sudden death. Torsades de pointes is classically associated with early depolarization. This review article discusses the mechanisms of QTc prolongation and triggering factors for proarrhythmia, drugs that prolong QT interval (class III antiarrhythmic agents, antimicrobial agents – fluoroquinolone and macrolide antibiotics, antipsychotic and antidepressant drugs, agents used in general anesthesia, antimycotics, and several other drugs), nonpharmacological and pharmacological risk factors for arrhythmias (due to pharmacokineticpharmacodynamic interactions), the treatment and recommendations to prevent arrhythmia related to QT prolongation. Full article
Open AccessArticle
Muscle size satisfaction and predisposition for a health harmful practice in bodybuilders and recreational gymnasium users
Medicina 2007, 43(4), 338; https://doi.org/10.3390/medicina43040042
Received: 12 April 2006 / Accepted: 14 March 2007 / Published: 19 March 2007
Cited by 7 | Viewed by 204 | PDF Full-text (221 KB)
Abstract
The aim of this study was to investigate muscle size satisfaction and predisposition to health harmful muscle gain practice in bodybuilders and recreational gymnasium users and to evaluate its relationship with sport mastery. The sample consisted of 132 men (51 bodybuilders and 81 [...] Read more.
The aim of this study was to investigate muscle size satisfaction and predisposition to health harmful muscle gain practice in bodybuilders and recreational gymnasium users and to evaluate its relationship with sport mastery. The sample consisted of 132 men (51 bodybuilders and 81 recreational gymnasium users). The muscle size satisfaction and related variables were evaluated using a 23-item questionnaire (α=0.6, test-retest reliability 0.7). The difference between the actual and the desired girths of the widest site of the upper arm and the thigh was determined based on the subjects’ reported data. The study showed that the majority of the gymnasium users (61.2%) wanted to gain muscle mass, but the tendency was observed that muscle size dissatisfaction, preoccupation with body shape, obligatory motivation, and obsessive attitude towards exercising depended on the sport mastery – the lower mastery predicted higher values. Entering bodybuilding competitions was associated with a 3.2-time (95% CI 1.14–9) higher muscle size dissatisfaction and a 4.8-fold increase (95% CI 1.4–16) in reported predisposition for health harmful muscle gain practice; however, being a bodybuilder was associated with 5.7-time (95% CI 1.9–17) higher predisposition for a health harmful practice. In conclusion, bodybuilders have lower muscle size satisfaction and significantly higher predisposition to health harmful muscle gain practice as compared to recreational gymnasium users. Our findings service for understanding that competitive bodybuilders are not body image homogeneous group if their sport mastery is ignored. Full article
Open AccessArticle
The links between learning load and well-being of high school seniors
Medicina 2007, 43(4), 332; https://doi.org/10.3390/medicina43040041
Received: 4 July 2006 / Accepted: 8 March 2007 / Published: 13 March 2007
Cited by 2 | Viewed by 168 | PDF Full-text (257 KB)
Abstract
Objective. To evaluate the links between learning overload and psychoemotional well-being of 12th grade students.
Material and methods
. In April 2006, an anonymous survey of 184 high school seniors was conducted in six secondary schools and one gymnasium of Kaunas.
Results
[...] Read more.
Objective. To evaluate the links between learning overload and psychoemotional well-being of 12th grade students.
Material and methods
. In April 2006, an anonymous survey of 184 high school seniors was conducted in six secondary schools and one gymnasium of Kaunas.
Results
. The total learning load of students was too high and made up 54.79±0.98 hours on average. The learning load of 61.4% of children was too high; girls mentioned this problem two times more often than boys did. Students suffered from psychoemotional problems: about half of them felt stress at school; every fifth fell asleep with difficulties. Students whose total learning load was too high (more than 48 hours per week) felt stress, tiredness, stomach or abdominal, head or back pains, vertigo or weakness significantly more often in comparison with those who had normal learning load.
Conclusions
. The total learning load of the majority of investigated high school seniors was too high. The psychoemotional well-being of 12th graders was unsatisfactory; girls complained about worse well-being than boys more frequently, they used medicine more frequently in comparison to the students whose learning load was normal. Full article
Open AccessArticle
Investigation of radiofrequency ablation process in liver tissue by finite element modeling and experiment
Medicina 2007, 43(4), 310; https://doi.org/10.3390/medicina43040039
Received: 21 August 2006 / Accepted: 8 March 2007 / Published: 13 March 2007
Cited by 25 | Viewed by 316 | PDF Full-text (1218 KB)
Abstract
Background. The character of ablation processes with high-frequency electrical current is similar in most biological tissues; however, quantitative characteristics are very different. Consequently, mathematical models of the process have a lot of specific aspects. In this study, we developed mathematical model of [...] Read more.
Background. The character of ablation processes with high-frequency electrical current is similar in most biological tissues; however, quantitative characteristics are very different. Consequently, mathematical models of the process have a lot of specific aspects. In this study, we developed mathematical model of radiofrequency ablation in liver tissues with experimental validation of model in ex vivo porcine liver.
Methods
. The finite element nonlinear computational model for the simulation of the radiofrequency ablation processes and taking into account coupled electrical and thermal phenomena has been developed. The radiofrequency electric current processes are dominated by the active electric conductivity. The heat generation in biological tissues is determined by the electric current density. Simultaneously, the conductivity of the tissue is nonlinearly dependent upon the temperature of the tissue. The model has been implemented in COMSOL Multiphysics computational environment. Tests on physical characteristics of the thermal effect in ex vivo liver tissue have been performed and results compared.
Results. Two oval-shaped zones of total and relative tissue destruction were highlighted. The principal distribution of the thermal effect is congruous with the theoretical model; however, the discrepancy of temperatures in experimental and theoretical models increases distally from active perfusion electrode.
Conclusions
. Distribution of the thermal effect is congruous in the theoretical and experimental model; however, discrepancies of temperatures imply certain inadequacies of the mathematical models. Differences of computed and actual temperatures should be regarded predicting tissue ablation in clinical setting. Full article
Open AccessArticle
Study of apoptosis in normal skin tissues
Medicina 2007, 43(4), 301; https://doi.org/10.3390/medicina43040037
Received: 18 May 2006 / Accepted: 16 January 2007 / Published: 21 January 2007
Cited by 2 | Viewed by 194 | PDF Full-text (524 KB)
Abstract
The aim of the study was to investigate the apoptosis in normal human skin by examination of all epidermal layers.
Material and methods
. The normal skin epidermis of 15 healthy subjects was investigated by TUNEL (terminal deoxynucleotidyl transferase-mediated dUTP-X nick end labeling) [...] Read more.
The aim of the study was to investigate the apoptosis in normal human skin by examination of all epidermal layers.
Material and methods
. The normal skin epidermis of 15 healthy subjects was investigated by TUNEL (terminal deoxynucleotidyl transferase-mediated dUTP-X nick end labeling) technique. Apoptotic cells were evaluated in the germinative and differential compartments and stratum corneum. Only highly TUNEL-positive cells with typical morphological DNA fragmentation signs were calculated.
Results
. In vital strata (except stratum corneum) of normal skin epidermis, 37.5% of all TUNEL-positive cells were observed in the germinative compartment and 41.7% in the granular layer of differential compartment.
Conclusions
. The study showed that apoptosis occurs in all layers of normal skin epidermis. It demonstrates that apoptosis is highly important in the renewal of cells and formation of epidermal structure within all compartments. Full article
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