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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 6 (June 2007)

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Open AccessArticle
Evaluation of biologically active compounds in roots and rhizomes of Rhodiola rosea L. cultivated in Lithuania
Medicina 2007, 43(6), 487; https://doi.org/10.3390/medicina43060061
Received: 23 February 2007 / Accepted: 11 June 2007 / Published: 16 June 2007
Cited by 18 | Viewed by 239 | PDF Full-text (700 KB)
Abstract
Salidroside and rosavins (rosavin, rosarin, and rosin), biologically active compounds of Rhodiola rosea L., were analyzed in dried roots and rhizomes of the plants cultivated in Lithuania and naturally growing in Altai geographical region in Russian Federation. The quantitative analysis of the aqueous-ethanolic [...] Read more.
Salidroside and rosavins (rosavin, rosarin, and rosin), biologically active compounds of Rhodiola rosea L., were analyzed in dried roots and rhizomes of the plants cultivated in Lithuania and naturally growing in Altai geographical region in Russian Federation. The quantitative analysis of the aqueous-ethanolic extracts prepared by percolation was performed employing solid-phase extraction and thin-layer chromatography followed by densitometric determination. Similar amounts of salidroside were found in the extracts (1.35–1.62 mg/mL), irrespective of the origin of the crude plant; however, the differences in the profile of rosavins were substantial with higher content of total rosavins in the extracts obtained from the plant cultivated in Lithuania (7.4 vs. 4.2 mg/mL). It was demonstrated that extracts prepared with 70% (v/v) ethanol contained low concentration of salidroside (0.16–0.17 mg/mL), while the extraction of rosavins with 70% (v/v) ethanol was more efficient compared to 40% (v/v) ethanol. Full article
Open AccessArticle
Access to information supporting availability of medicines for patients suffering from rare diseases looking for possible treatments: the EuOrphan Service
Medicina 2007, 43(6), 441; https://doi.org/10.3390/medicina43060054
Received: 2 April 2007 / Accepted: 11 June 2007 / Published: 16 June 2007
Cited by 12 | Viewed by 181 | PDF Full-text (185 KB)
Abstract
Currently in Europe, approximately 30 million people suffer from rare diseases, and a major problem is that many patients do not have access to quality healthcare for their disorders. Moreover, there is also a lack of quality information and a networking system aimed [...] Read more.
Currently in Europe, approximately 30 million people suffer from rare diseases, and a major problem is that many patients do not have access to quality healthcare for their disorders. Moreover, there is also a lack of quality information and a networking system aimed at supporting interaction among patients, clinicians, researchers, pharmaceutical industries, and governmental bodies. The purpose of this article is to inform physicians, public health care professionals, and other health care providers about EuOrphan service, the aim of which is to ensure easier access to quality information on rare diseases and their treatment. A set of web-based services is available at www.euorphan.com where information for target-users on treatments and products available worldwide for rare disease care as well as indications about healthcare centers are provided. Moreover, the service aims at providing consultancies for pharmaceutical companies to ultimately support the European legislation in bringing new drugs of a high ethical standard to the market and to exert a positive impact on the large population of patients suffering from rare diseases in Europe. The services provided by EuOrphan can facilitate concrete networking among patients, patient associations, doctors, and companies and also support the organization of clinical trials. In this perspective, EuOrphan could become a very valuable tool for globalizing the information about the availability of treatment (authorized or under development) of orphan patients. Full article
Open AccessArticle
Diagnostics of laryngopharyngeal form of gastroesophageal reflux disease for adults (Lithuanian clinical practice guidelines)
Medicina 2007, 43(6), 508; https://doi.org/10.3390/medicina43060064
Received: 16 March 2007 / Accepted: 7 June 2007 / Published: 12 June 2007
Cited by 1 | Viewed by 192 | PDF Full-text (223 KB)
Abstract
The laryngopharyngeal form of gastroesophageal disease represents one of the atypical manifestations of supraesophageal gastroesophageal reflux disease characterized by morphologic and functional changes in the larynx and pharynx with the associated clinical symptoms. The article presents diagnostic algorithm (guidelines) for laryngopharyngeal form of [...] Read more.
The laryngopharyngeal form of gastroesophageal disease represents one of the atypical manifestations of supraesophageal gastroesophageal reflux disease characterized by morphologic and functional changes in the larynx and pharynx with the associated clinical symptoms. The article presents diagnostic algorithm (guidelines) for laryngopharyngeal form of gastroesophageal disease, elaborated by the group of Lithuanian experts in otorhinolaryngology and gastroenterology. The guidelines are based on the data of evidence-based medicine and results of the scientific studies in Lithuania. Diagnostics of laryngopharyngeal form of gastroesophageal disease has to be based on: (1) patient’s complaints (permanent hoarseness, throat itching and clearing, cough, heartburn, “globus” sensation) for more than 3 months; (2) typical laryngoscopic findings (edema, erythema, roughness, hypertrophy of mucosa of the posterior glottis); (3) detection of reflux esophagitis as a subsequence of pathological gastroesophageal reflux; (4) assessment of relationship between reflux and morphological/functional changes. The guidelines are designed for the otorhinolaryngologists, gastroenterologists, and general practitioners. Full article
Open AccessArticle
Evaluation of the quality of life in the population of Kaunas city using the SF-12 questionnaire
Medicina 2007, 43(6), 501; https://doi.org/10.3390/medicina43060063
Received: 2 May 2007 / Accepted: 7 June 2007 / Published: 12 June 2007
Cited by 6 | Viewed by 191 | PDF Full-text (197 KB)
Abstract
The aim of the study was to evaluate the suitability of the SF-12 questionnaire for the evaluation of the quality of life in 25–84-year-old inhabitants of Kaunas city and to compare quality of life between men and women as well as between socially [...] Read more.
The aim of the study was to evaluate the suitability of the SF-12 questionnaire for the evaluation of the quality of life in 25–84-year-old inhabitants of Kaunas city and to compare quality of life between men and women as well as between socially and demographically different groups.
Material and methods
. The study sample consisted of randomly selected inhabitants of Kaunas city, stratified by age and sex. The suitability of the questionnaire for the evaluation of the quality of life in the selected contingent was verified using Cronbach’s alpha coefficient. The convergent validity of the questionnaire was assessed by the strength of the linear relationship between the domains of the questionnaire, calculating Pearson’s correlation coefficients. We calculated mean ranges of the values of the questionnaire and compared the distribution of values.
Results
. Cronbach’s alpha values indicated a very strong internal consistency of the mental and physical domains of the SF-12 questionnaire (0.87 and 0.88, respectively). Women reported lower quality of life in the domains of mental health and physical health-pain as compared to men. People who were not living alone, with higher level of education, and employed reported better physical and mental health than those living alone, with lower level of education, or unemployed. In addition to that, people who were engaged in mental work during the study or had worked such work before reported better physical and mental health.
Conclusions
. The questionnaire SF-12 is suitable for the evaluation of the quality of life in the population of Kaunas city. Women reported lower quality of life in mental health domain than men did. The evaluations of the quality of life worsened with increasing age and lower social and demographic status. Full article
Open AccessArticle
Heart fibroma: an unusual cause of ventricular tachycardia in a child
Medicina 2007, 43(6), 482; https://doi.org/10.3390/medicina43060060
Received: 16 March 2007 / Accepted: 7 June 2007 / Published: 12 June 2007
Viewed by 172 | PDF Full-text (485 KB)
Abstract
Ventricular tachycardia with underlying structural heart disease is a potential dangerous pathology in children. In most cases, ventricular tachycardia occurs after ventricular surgery for congenital anomalies. Ventricular tachycardia associated with primary heart tumors is extremely rare. A 4-year-boy presented with primary heart tumor, [...] Read more.
Ventricular tachycardia with underlying structural heart disease is a potential dangerous pathology in children. In most cases, ventricular tachycardia occurs after ventricular surgery for congenital anomalies. Ventricular tachycardia associated with primary heart tumors is extremely rare. A 4-year-boy presented with primary heart tumor, fibroma, manifesting as ventricular tachycardia. Manifestation of the disease was ventricular tachycardia. The complete resection of the tumor was performed successfully. The diagnosis was confirmed histologically. Full article
Open AccessArticle
The ability of Lithuanian ambulance services to provide first medical aid in trauma cases
Medicina 2007, 43(6), 463; https://doi.org/10.3390/medicina43060057
Received: 7 August 2006 / Accepted: 6 June 2007 / Published: 11 June 2007
Cited by 2 | Viewed by 189 | PDF Full-text (252 KB)
Abstract
Objective. To evaluate the ability of country ambulance services to provide first medical aid in trauma cases.
Material and methods. A survey of chiefs of emergency medicine service was performed in October–November 2005, in which 34 of the 59 institutions (58%) [...] Read more.
Objective. To evaluate the ability of country ambulance services to provide first medical aid in trauma cases.
Material and methods. A survey of chiefs of emergency medicine service was performed in October–November 2005, in which 34 of the 59 institutions (58%) were participating. The questionnaire presented questions concerning physical and human resources, performance values, and system configuration. The study has shown that emergency medicine service operates in radius of 23 km, each team providing service for about 40 000 inhabitants. Taking into consideration distance and average on-scene time values, emergency medicine service is capable to render the first medical aid within so-called “golden hour” in case the accident is reported immediately. The physical resources are not quite complete. Not all the cars are equipped with essential first aid measures. Among more rarely found resources are vacuum pumps, intubation sets, defibrillators, vacuum splints, back immobilization devices, and hammock immobilization devices. There are less mentioned resources than working teams and even more than two times less than emergency cars at all. Two-thirds of the operating emergency medicine services do not provide advanced life support procedures. The evaluation of theoretical/practical ability to provide some important medical procedures used in emergency medical care showed that medical staff quite often fails to perform defibrillation, intubation, and pleural cavity drainage.
Conclusions
. Country ambulance service network configuration according to area under service, number of people served, and response frequency comply with the requirement set. The ambulance vehicles lack complete set up as well as some important supplies. Only rarely the staff is skilled enough to perform such advanced life support procedures as intubation, defibrillation, and pleural drainage. Full article
Open AccessArticle
Morbidity of textile industry workers in Kaunas
Medicina 2007, 43(6), 495; https://doi.org/10.3390/medicina43060062
Received: 6 April 2006 / Accepted: 27 April 2007 / Published: 2 May 2007
Cited by 3 | Viewed by 192 | PDF Full-text (190 KB)
Abstract
Objective. According to the Department of Statistics at the beginning of 2003, 551 textile industry and garment enterprises operated in Lithuania. The purpose of the study was to evaluate morbidity among workers in textile industry enterprises in Kaunas and analyze the data [...] Read more.
Objective. According to the Department of Statistics at the beginning of 2003, 551 textile industry and garment enterprises operated in Lithuania. The purpose of the study was to evaluate morbidity among workers in textile industry enterprises in Kaunas and analyze the data obtained in relation to sex, age, profession, and occupational health hazards.
Material and methods
. A sick-leave-based case-control study was conducted in the units of four textile enterprises where 1842 workers were employed. Data were categorized in relation to sex, profession, and kind of sickness. Age was grouped in the following way: under 29 years, 30–39 years, 40–49 years, and over 50 years.
Results
. In the period of survey, 1482 cases of sick leave were reported in the enterprises where 1842 workers were employed. The main cause of absence because of sickness was respiratory diseases – 37.3% (30.27 cases per 100 workers), nursing took the second place –17.0% (13.76 cases per 100 workers). Accidents and injuries made up 9.3% (7.5 cases per 100 workers), musculoskeletal and connective tissue disorders – 7.9% (6.4 cases per 100 workers). Data were analyzed using statistical programs SPSS 97, Epi-Info 6.0.
Conclusions. Main morbidities reported included respiratory diseases (37.3%), nursing (17.0%), accidents and injuries (9.3%), musculoskeletal and connective tissue disorders (7.9%). The incidence of morbidity among workers engaged in workplace where occupational risk factors exceeded hygienic standards was higher. The rate of morbidity also increased with age and sex; morbidity among women was 1.5 higher than among men. Full article
Open AccessArticle
The bullet in the dural sac. How to catch it? A report of two cases
Medicina 2007, 43(6), 478; https://doi.org/10.3390/medicina43060059
Received: 2 June 2006 / Accepted: 27 April 2007 / Published: 2 May 2007
Viewed by 160 | PDF Full-text (891 KB)
Abstract
Objective. The purpose of this article is to present two cases of penetrating gunshot injuries to the lumbar spine with migration of the bullets within the dural sac and to describe the method of removal of the bullet from the dural sac. [...] Read more.
Objective. The purpose of this article is to present two cases of penetrating gunshot injuries to the lumbar spine with migration of the bullets within the dural sac and to describe the method of removal of the bullet from the dural sac.
Material and methods. Two cases of penetrating gunshot injuries to the lumbar spine with migration of the bullets within the dural sac are presented. Clinical course, diagnostic tools, and management of two patients who suffered from these injuries are illustrated. The method of removal of the bullet from the dural sac is described too.
Results. The wounds in these two cases healed without infection. The neurological status of our patients improved gradually. Radiographs taken 2 years after the injury did not demonstrate the postoperative instability of the lumbar spine.
Conclusions
. The bullet in the dural sac at the level of the cauda equina must be removed. The method proposed by us can facilitate this procedure. Full article
Open AccessArticle
Results of surgical treatment of carcinoma of papilla of Vater
Medicina 2007, 43(6), 455; https://doi.org/10.3390/medicina43060056
Received: 18 November 2005 / Accepted: 3 December 2006 / Published: 8 December 2006
Cited by 1 | Viewed by 196 | PDF Full-text (224 KB)
Abstract
Adenocarcinoma is the most common malignant tumor of the ampulla, but in general, it is still rare. Therefore, these tumors are difficult to study, and most reports are of retrospective design. To evaluate immediate postoperative and long-term results, we have collected data prospectively [...] Read more.
Adenocarcinoma is the most common malignant tumor of the ampulla, but in general, it is still rare. Therefore, these tumors are difficult to study, and most reports are of retrospective design. To evaluate immediate postoperative and long-term results, we have collected data prospectively in a specially created database on 21 consecutive patients with adenocarcinoma of the papilla of Vater, operated on at the Department of Surgery, Kaunas University of Medicine Hospital. All patients have undergone classical or pylorus-preserving pancreatoduodenectomy. Postoperative mortality was 4.8% and overall morbidity – 28.6%. Pancreas-associated morbidity was 14.3% in the series. Actuarial 3-year survival among our patients was 89%. Stage I–II patients with T1–T2 and/or N negative tumors had significantly better 3-year survival when compared with stage III–IV patients, T3–T4 and/or N positive tumors. Patients with highly or moderately differentiated tumors (G1, G2) survived better than patients with poor cell differentiation (G3), though significant difference was not achieved. Results are satisfactory in terms of overall postoperative morbidity and mortality. Long-term survival pattern concerning T, N, and G status corresponds with other reports in literature, while the 3-year survival results are promising and speaks in favor of our surgical strategy. Full article
Open AccessArticle
Subintimal angioplasty for superficial femoral artery occlusions: first experience in Kaunas University of Medicine Hospital
Medicina 2007, 43(6), 447; https://doi.org/10.3390/medicina43060055
Received: 13 December 2005 / Accepted: 3 December 2006 / Published: 8 December 2006
Viewed by 168 | PDF Full-text (214 KB)
Abstract
Objective. To assess prospectively the first experience of subintimal angioplasty of superficial femoral artery occlusions.
Patients and methods
. Within a period of 36 months, 45 patients with 45 chronic occlusions in superficial femoral artery were treated at Kaunas University of Medicine [...] Read more.
Objective. To assess prospectively the first experience of subintimal angioplasty of superficial femoral artery occlusions.
Patients and methods
. Within a period of 36 months, 45 patients with 45 chronic occlusions in superficial femoral artery were treated at Kaunas University of Medicine Hospital.
Results. The technical success rate was 84.4%, and four failures were treated by conventional surgery. The following complications occurred: one hematoma at the arterial puncture site, one artery spasm, and two distal embolizations. The mean length of occlusions was 14.2±1.4 cm. The mean ankle-brachial index improved from 0.41±0.15 to 0.81±0.04 after successful subintimal angioplasty (P<0.001). Primary assisted patency rates were 94.7%, 92.1%, 84.2%, 81.6%, and 81.6% at 1, 3, 6, 12, and 24 months, respectively. The limb salvage rates were 100% and 97.8% at 1–3 and 6–12–24 months, respectively. There were no treatmentrelated amputations.
Conclusions. Subintimal angioplasty of occluded superficial femoral artery is a safe and minimally invasive procedure with a high initial technical success rate, low complication rate, and good early results, and in case of failure, subsequent surgery can be performed. Full article
Open AccessArticle
Some aspects of long-term results of treatment of acute hematogenous osteomyelitis
Medicina 2007, 43(6), 472; https://doi.org/10.3390/medicina43060058
Received: 15 June 2006 / Accepted: 3 October 2006 / Published: 8 October 2006
Cited by 3 | Viewed by 163 | PDF Full-text (212 KB)
Abstract
Objective. The aim of the study was to evaluate the treatment results of acute hematogenous osteomyelitis over 10 years and to determine the relationship between them and clinical course of the disease.
Materials and methods
. The patients with acute hematogenous osteomyelitis [...] Read more.
Objective. The aim of the study was to evaluate the treatment results of acute hematogenous osteomyelitis over 10 years and to determine the relationship between them and clinical course of the disease.
Materials and methods
. The patients with acute hematogenous osteomyelitis diagnosed 10 years ago (1995–1996) were enrolled in the study. The post mail or phone contacts with them or their parents were obtained, the questions were submitted, and the patients were invited for medical examination. The current complaints and limitations in physical activity were assessed. The amplitude of joint movements, tenderness during palpation, and deformations were evaluated during physical examination. Patients were divided into two groups: with and without complaints. The duration and severity of the disease, age, gender, presence of sepsis, arthritis, and subperiosteal abscess, the type of bone affected and bone lesion on x-ray, duration of fever, and maximal erythrocyte sedimentation rate during the acute period were compared between groups.
Results
. We made 50 phone calls and sent seven letters to the patients with acute hematogenous osteomyelitis who were treated in our department. In 14 (28%) cases, phone contact was obtained, and 7 of them were examined. Five answers (71%) to the letters were received. The overall response rate was 33%. Thirteen (68%) former patients had no any complaints; six (32%) had minor complaints, which were probably linked to acute hematogenous osteomyelitis. Fifteen (79%) former patients had no limitations in any physical activities, and four (21%) of them limit their physical activities. Seven patients were examined, but neither visible deformities and tenderness nor limitations in movement amplitude were found. Comparing the groups with complaints and without complaints by age, gender, presence of sepsis and arthritis, duration of the disease, and the presence of periosteal abscess, no statistically significant difference in any of variables was found.
Conclusions
. According to our data, 37% of the patients have complaints 10 years after acute hematogenous osteomyelitis, and these complaints are not associated with the clinical course of the disease. Full article
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