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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 9 (September 2007)

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Open AccessArticle
Quality of life in stroke survivors
Medicina 2007, 43(9), 736; https://doi.org/10.3390/medicina43090095
Received: 2 July 2007 / Accepted: 20 September 2007 / Published: 27 September 2007
Cited by 7 | Viewed by 199 | PDF Full-text (231 KB)
Abstract
The aim of the study was to compare the quality of life among stroke survivors and healthy controls and to evaluate the influence of age, sex, and social and demographic factors on the quality of life.
Contingent and methods
. The case group [...] Read more.
The aim of the study was to compare the quality of life among stroke survivors and healthy controls and to evaluate the influence of age, sex, and social and demographic factors on the quality of life.
Contingent and methods
. The case group consisted of 508 inhabitants of Kaunas city who were 25–84 years of age and had experienced their first stroke. The control group consisted of age- and sex-stratified randomly selected 508 stroke-free inhabitants of Kaunas city. The quality of life was evaluated using the SF- 12 questionnaire. The study compared the quality of life between stroke survivors and controls in eight domains of quality of life and compared the evaluation of quality of life considering social and demographic features.
Results
. In the domain of physical and mental health, stroke survivors presented poorer evaluation of their quality of life compared to controls except for the evaluations of mental health in the age groups of 25–34 and 35–44 years. As compared to healthy controls, stroke survivors presented poorer evaluation of their quality of life in all domains except for pain. Only in the control group, females presented poorer evaluation of physical health, whereas no differences in the evaluation of mental health between sexes were found. The evaluation of physical health in both groups worsened with age. Both stroke survivors and controls presented better evaluation of their physical health if they were living not alone, were better educated, and were employed compared to those who were living alone, had poorer education level, and were unemployed. In addition, controls who were currently or previously engaged in mental work evaluated their physical health better.
Conclusions
. Stroke survivors presented poorer evaluations of their quality of life in both physical and mental health domains compared to controls. Only in the control group, females evaluated their physical health worse than males did. In both groups studied, poorer evaluation of physical health was associated with older age and lower social and demographic status. Relationship between mental health and subjects’ social and demographic status was not statistically significant in either of the studied groups. Full article
Open AccessArticle
The effect of combined treatment methods on survival and toxicity in patients with pancreatic cancer
Medicina 2007, 43(9), 716; https://doi.org/10.3390/medicina43090093
Received: 19 June 2007 / Accepted: 20 September 2007 / Published: 27 September 2007
Cited by 10 | Viewed by 179 | PDF Full-text (218 KB)
Abstract
In Lithuania, there were 476 new pancreatic cancer cases in 2005. Based on international scientific literature and the results of our retrospective studies, a prospective study has been designed. The aim of study was a prospective evaluation of the impact of two concomitant [...] Read more.
In Lithuania, there were 476 new pancreatic cancer cases in 2005. Based on international scientific literature and the results of our retrospective studies, a prospective study has been designed. The aim of study was a prospective evaluation of the impact of two concomitant chemoradiation methods on the survival and the time to disease progression in patients diagnosed with resectable and unresectable pancreatic cancer and prospective evaluation of the safety of two concomitant chemoradiation methods for the treatment of resectable and unresectable pancreatic cancer.
Material and methods
. During the period of 2000–2005 at the Clinic of Oncology, Kaunas University of Medicine Hospital, we performed a prospective randomized study to analyze two concomitant chemoradiation treatment methods. The patients were stratified according to the resectability of the tumor: with resectable tumor (stage I–IVA) and with unresectable tumor (stage III–IVA). Treatment for each group of patients was selected randomly choosing concomitant chemoradiation treatment: radiation therapy and 5-fluorouracil or radiation therapy and gemcitabine. Criteria of the efficacy of the treatment methods were median survival, time to disease progression, and treatment safety (qualitative and quantitative analysis).
Results and conclusions
. The treatment methods – radiotherapy and 5-fluorouracil or radiotherapy and gemcitabine – were equally effective when assessing the survival and time to disease progression in patients diagnosed with pancreatic cancer. Treatment of patients diagnosed with pancreatic cancer with radiotherapy and 5-fluorouracil was a safer approach than treatment with radiotherapy and gemcitabine, which induced more severe toxic adverse effects. Full article
Open AccessArticle
Transsphenoidal surgery for prolactinomas: results and prognosis
Medicina 2007, 43(9), 691; https://doi.org/10.3390/medicina43090089
Received: 7 June 2007 / Accepted: 20 September 2007 / Published: 27 September 2007
Cited by 1 | Viewed by 165 | PDF Full-text (199 KB)
Abstract
Objective. The aim of this study was to explore the long-term outcomes of surgery for transsphenoidal prolactinomas and the factors that influence them.
Material and methods
. Transsphenoidal approach for pituitary adenomas has been applied to 329 patients in the Department of [...] Read more.
Objective. The aim of this study was to explore the long-term outcomes of surgery for transsphenoidal prolactinomas and the factors that influence them.
Material and methods
. Transsphenoidal approach for pituitary adenomas has been applied to 329 patients in the Department of Neurosurgery of Kaunas University of Medicine Hospital in the period of 1995 to 2006. Of these, 85 patients were operated for prolactinomas.
Results
. Of the 85 patients operated on for prolactinomas, 68 (80%) were females and 17 (20%) were males. Thirty-two microprolactinomas and 36 macroprolactinomas were diagnosed in women and 16 and 1, respectively, in men. Twenty (23.5%) patients (16 women and 4 men) had visual field defects before the operation. Dopamine agonist therapy was administered in 50 patients (38 women and 12 men) before the operation. Of 10 women, in whom microadenoma was diagnosed and no dopamine agonist therapy was prescribed, remission was achieved in 9 (90%) patients after the operation, while of 22 women, who was treated with dopamine agonists before the operation, remission was achieved only in 10 (45.5%) (P=0.01). Each year of age decreased the chance of remission by 8%.
Conclusions
. Remission after the surgical treatment was achieved in 11.8% of men and 47.1% of women hyperprowith prolactinomas. Remission rate was very high (90%) among women with microprolactinoma not treated with dopamine agonist before the surgical treatment. The probability of a good outcome of surgery among women with prolactinoma was related to younger age of the patient, noninvasive tumor growth, plasma prolactin level less than 2309 mU/L, and no use of dopamine agonist before the surgical treatment. Full article
Open AccessArticle
Renowned scientist, pedagogue, and physician Dedicated to the memory of the 110th anniversary of Bronius Sidaravičius’s birth
Medicina 2007, 43(9), 679; https://doi.org/10.3390/medicina43090087
Received: 28 August 2007 / Accepted: 20 September 2007 / Published: 27 September 2007
Cited by 3 | Viewed by 190 | PDF Full-text (542 KB)
Abstract
This year we celebrate the 110th anniversary of Bronius Sidaravičius’s (1897–1969) birth. He was a renowned Lithuanian dermato-venereologist, professor, head of the Department of Skin and Venereal Diseases at Vytautas Magnus University (1935–1946, 1956–1969), the founder and the chair of the Lithuanian Society [...] Read more.
This year we celebrate the 110th anniversary of Bronius Sidaravičius’s (1897–1969) birth. He was a renowned Lithuanian dermato-venereologist, professor, head of the Department of Skin and Venereal Diseases at Vytautas Magnus University (1935–1946, 1956–1969), the founder and the chair of the Lithuanian Society of Dermato-venereologists, coeditor of the prewar journal “Medicina.” He is an author of more than 100 articles and the very first course book on dermato-venereology in Lithuanian. He completed a part of his medical studies at universities in Germany. In Vienna University (1930), B. Sidaravičius performed clinical and experimental studies on the passive transmission of skin allergy, which had a major impact on the diagnostics of allergic skin diseases and specific desensibilization. He published the results of his study in the foreign literature and in the doctoral dissertation “Skin allergy and its treatment” in 1931. Thanks to the efforts of B. Sidaravičius and his colleagues, a progressive Law on Control and Prevention of Venereal Diseases was enacted in Lithuania. According to this Law, examinations and treatment of venereal diseases became compulsory and free of charge at state- or municipality-financed venereal outpatient units. This article was prepared on the basis of primary sources: protocols of the Council (the Faculty of Medicine, the University of Lithuania; since 1930 – Vytautas Magnus University) kept at the Museum of the History of Lithuania Medicine and Pharmacy as well as documents preserved at the Lithuanian State Archives and also scientific journals and periodicals both in Lithuanian and foreign languages. Full article
Open AccessArticle
Conception of quality of life and health-related quality-of-life investigations in children population
Medicina 2007, 43(9), 746; https://doi.org/10.3390/medicina43090096
Received: 20 June 2007 / Accepted: 10 September 2007 / Published: 17 September 2007
Cited by 2 | Viewed by 161 | PDF Full-text (323 KB)
Abstract
Assessment of the impact of diseases and their treatment on a patient with chronic disease is especially important. When there is no possibility to recover, patients and their closest relatives have to accept changes in lifestyle, which may vary with time. Health professionals [...] Read more.
Assessment of the impact of diseases and their treatment on a patient with chronic disease is especially important. When there is no possibility to recover, patients and their closest relatives have to accept changes in lifestyle, which may vary with time. Health professionals assume that improvements in symptoms show better quality of life of patients. Quality-of-life assessments incorporate not only the impact of illness and treatment on physical functions, but also its effect on lifestyle and emotional well-being. Quality of life deals with a higher order of complexity: the impact of functional impairment on other aspects of life, e.g. the ability of children to go to school or play, and the emotional effect of these restrictions. The aim of this article is to present measurement tools and how to use them and the application of quality-of-life measurement in pediatric medicine. Every investigator has to raise the question to himself/herself, “What is health-related quality of life,” and before planning the investigation, answer this question correctly. Full article
Open AccessArticle
The quality of life of children suffering from oncologic diseases in Lithuania
Medicina 2007, 43(9), 726; https://doi.org/10.3390/medicina43090094
Received: 18 April 2007 / Accepted: 3 September 2007 / Published: 8 September 2007
Cited by 1 | Viewed by 168 | PDF Full-text (220 KB)
Abstract
Nearly 80 new cases of pediatric cancer are diagnosed in Lithuania each year. Since 2005, we have been conducting a study evaluating the quality of life of children suffering from cancer in Lithuania. The participants were children between the ages of 2 and [...] Read more.
Nearly 80 new cases of pediatric cancer are diagnosed in Lithuania each year. Since 2005, we have been conducting a study evaluating the quality of life of children suffering from cancer in Lithuania. The participants were children between the ages of 2 and 18 years, diagnosed with oncologic diseases during the period from March 2005 to March 2006, and their parents. The PedsQLTM (Pediatric Quality of Life InventoryTM) was used. This questionnaire is specifically designed for investigating the quality of life in children between the ages of 2 and 18 years. The PedsQL questionnaire is designed according to the level of cognitive activity of children and applied to children of four age groups: 2–4, 5–7, 8–12, and 13–18 years of age. The questionnaires were completed by children between the ages of 8 and 18 years in addition to parents of children from all age groups. The families of 63 children suffering from cancer participated in the study. A total of 44 children and teenagers between the ages of 5 and 18 years and 53 parents (mother, father, close relative) filled out the questionnaire. Data from the study showed that children suffering from cancer (irrespective of their age) in addition to their parents evaluated their physical health as being worse than their psychosocial health. The parents had the opinion that children from all age groups experienced negative emotions: the younger children were afraid of giving blood for tests, whereas the older children were worried about the future. In the oldest age group of participants (13–18 years), children felt disease-related fatigue more often than their younger counterparts. Full article
Open AccessArticle
Brain natriuretic peptide and other cardiac markers predicting left ventricular remodeling and function two years after myocardial infarction
Medicina 2007, 43(9), 708; https://doi.org/10.3390/medicina43090092
Received: 23 January 2007 / Accepted: 3 September 2007 / Published: 8 September 2007
Cited by 10 | Viewed by 175 | PDF Full-text (223 KB)
Abstract
Background. Left ventricular remodeling is a complex pathologic process of progressive left ventricular dilatation, leading to dysfunction and heart failure in patients after myocardial infarction.
Objective
. To evaluate biochemical markers, reflecting cardiac remodeling process after first myocardial infarction and compare those [...] Read more.
Background. Left ventricular remodeling is a complex pathologic process of progressive left ventricular dilatation, leading to dysfunction and heart failure in patients after myocardial infarction.
Objective
. To evaluate biochemical markers, reflecting cardiac remodeling process after first myocardial infarction and compare those markers with clinical characteristics of left ventricular remodeling.
Material and methods
. Brain natriuretic peptide, troponin I, creatine kinase, creatine kinase MB mass, lactate dehydrogenase levels were measured in 30 patients with acute myocardial infarction on days 1, 2, 3–7 . Brain natriuretic peptide was measured at 3 months, 6 months, and 2 years after myocardial infarction. Echocardiographic parameters of left ventricular remodeling were determined in acute phase (day 1–3), at 3 months, 6 months, and 2 years after MI.
Results
. In acute phase, brain natriuretic peptide level progressively increased according to worsening of left ventricular geometry: in normal left ventricle geometry group, brain natriuretic peptide level was 84.1 (58.7–121) pg/mL, in concentric remodeling group – 125 (69.2–165) pg/mL, in concentric hypertrophy group – 128 (74–368) pg/mL, and in eccentric hypertrophy group – 470 (459–494) pg/mL, P=0.02. Patients who had increased left ventricular end diastolic diameter index during 2-year period had higher brain natriuretic peptide level in the acute phase (584 (249–865) pg/mL vs. 120 (67–202) pg/mL, P=0.04) and also higher peak lactate dehydrogenase and troponin I levels.
Conclusions
. Brain natriuretic peptide level in acute phase of myocardial infarction is strongly associated with the markers of myocardial injury and related to left ventricular geometry changes and remodeling. Brain natriuretic peptide together with troponin I levels in acute phase of myocardial infarction might be useful in predicting subsequent cardiac function. Full article
Open AccessArticle
Changes of electrocardiographic and echocardiographic data after early and late mechanical recanalization of infarct-related artery with and without stent implantation
Medicina 2007, 43(9), 703; https://doi.org/10.3390/medicina43090091
Received: 6 December 2006 / Accepted: 3 September 2007 / Published: 8 September 2007
Cited by 1 | Viewed by 170 | PDF Full-text (175 KB)
Abstract
Objective. To show differences in the changes of electrocardiographic and echocardiographic data after early and late mechanical recanalization of infarct related artery with and without stent implantation and to assess the value of QRS score in the follow-up period.
Material and methods
[...] Read more.
Objective. To show differences in the changes of electrocardiographic and echocardiographic data after early and late mechanical recanalization of infarct related artery with and without stent implantation and to assess the value of QRS score in the follow-up period.
Material and methods
. A total of 248 consecutive patients were divided into these groups: early angioplasty (≤24 hours) without stents (n=114) or with stents (n=6) and later (>24 hours) angioplasty without stents (n=114) or with stents (n=14). The changes in QRS score and echocardiographic left ventricular ejection fraction during the hospital and 3-month follow-up periods were compared between the groups.
Results
. QRS score did not increase in a hospital in early or late angioplasty with stents groups, while in the groups without stents especially of early angioplasty increased (2.6±2.5 vs. 3.6±2.4, P=0.001). Left ventricular ejection fraction increased after 3 months only in early angioplasty groups especially with stents (30.0±3.5 vs. 38.4±5.2, P=0.008), but there were no significant differences between the QRS score at discharge and after 3 months (5.4±4.3 vs. 5.0±1.9).
Conclusions
. Myocardial injury did not increase in a hospital in the cases of early or late angioplasty with stents, while in the cases without stents increased. Left ventricular ejection fraction increased after 3 months only in the cases of early angioplasty especially with the stent implantation, but the QRS score showed no differences, so the QRS score may be not predictive of improvement in ejection fraction at follow-up. Full article
Open AccessArticle
Results of carotid endarterectomy in diabetic patients
Medicina 2007, 43(9), 685; https://doi.org/10.3390/medicina43090088
Received: 18 September 2006 / Accepted: 26 June 2007 / Published: 1 July 2007
Viewed by 166 | PDF Full-text (192 KB)
Abstract
Patients with diabetes mellitus have been shown to have an increased incidence of complications after major vascular surgery. The objective of this study was to evaluate the results of carotid endarterectomy in diabetic patients, to determine if results differ from nondiabetic patients, and [...] Read more.
Patients with diabetes mellitus have been shown to have an increased incidence of complications after major vascular surgery. The objective of this study was to evaluate the results of carotid endarterectomy in diabetic patients, to determine if results differ from nondiabetic patients, and to examine the risk factors for poor outcome among diabetic patients.
Material and methods
. We reviewed all carotid endarterectomies performed in Emergency Hospital of Vilnius University. From 1995 to 2005, 707 carotid endarterectomies were performed. Of these, 100 operations were performed in diabetic patients (14%) and the remaining 607 in nondiabetic patients.
Results
. Diabetic patients were younger (P<0.05) and were obese more often (P<0.001), they smoked less often (P<0.001) than nondiabetic patients. Diabetics were more likely to have severe bilateral carotid stenosis than nondiabetic patients (P<0.01). Postoperative complications (stroke) were more common in diabetic patients than in nondiabetic patients (12.0% vs. 3.4%, P<0.001) as well as intracerebral hemorrhages (3.0% vs. 0.3%, P<0.001); no perioperative myocardial infarction was found in diabetic patients. Risk factors for complications were age ≥75 (odds ratio (OR) 2.2; 95% confidence interval (CI)=1.0–4.9), smoking (OR 2.7; 95% CI=1.8– 4.2), obesity (OR 6.1; 95% CI=3.9–9.5), and bilateral carotid stenosis (OR 2.1; 95% CI=1.3–3.6).
Conclusion
. Diabetes mellitus significantly increased the risk of mortality and intracerebral hemorrhage but not myocardial infarction. It should be taken into consideration in making decisions about the performance and perioperative management of carotid endarterectomy. Full article
Open AccessArticle
Reference and cut-off values for serum ferritin, mean cell volume, and hemoglobin to diagnose iron deficiency in infants aged 9 to 12 months
Medicina 2007, 43(9), 698; https://doi.org/10.3390/medicina43090090
Received: 19 February 2007 / Accepted: 12 April 2007 / Published: 17 April 2007
Cited by 6 | Viewed by 184 | PDF Full-text (195 KB)
Abstract
Background. The number of different laboratory tests and reference values are used to diagnose iron deficiency, but there is no agreement regarding the diagnostic criteria for infants. Aim of study. To establish reference values for serum ferritin, mean cell volume, and hemoglobin in [...] Read more.
Background. The number of different laboratory tests and reference values are used to diagnose iron deficiency, but there is no agreement regarding the diagnostic criteria for infants. Aim of study. To establish reference values for serum ferritin, mean cell volume, and hemoglobin in infants aged from 9 to 12 months in Estonia and to evaluate the diagnostic characteristics of serum ferritin, mean cell volume, and hemoglobin in the diagnosis of iron deficiency. Methods. Altogether 195 healthy infants aged 9–12 months participated in the study. They were randomly selected out of 300 families from seven different counties from all over Estonia. Serum ferritin, hemoglobin, soluble transferrin receptor (sTfR) levels and mean cell volume were measured. The best cut-off values for serum ferritin, mean cell volume, and hemoglobin to diagnose iron deficiency, defined by sTfR>2.45 mg/L (n=25), were determined by receiver operating characteristic curves. Results. The mean and reference values (5th and 95th centiles) for ferritin was 24 µg/L (4– 55), 73 fl (68–80) for mean cell volume, and 112 g/L (101–128) for hemoglobin. The best cut-off values to diagnose iron deficiency were <10.9 µg/L for serum ferritin (sensitivity of 83% and specificity of 80%), <71 fl for mean cell volume (86% and 83%, respectively), and <107 g/L for hemoglobin (67% and 87%, respectively). The sensitivity and specificity of serum ferritin and mean cell volume in the diagnosis of iron deficiency were better than those of hemoglobin. Conclusion. For the diagnosis of iron deficiency in infants aged 9–12 months, the cut-off values of <10.9 µg/L and <71 fl should be used for serum ferritin and mean cell volume, respectively. Full article
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