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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 47, Issue 12 (December 2011) – 8 articles

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Open AccessArticle
The Relationship Between Seropositivity Against Chlamydia pneumoniae and Stroke and its Subtypes in a Latvian Population
Medicina 2011, 47(12), 96; https://doi.org/10.3390/medicina47120096 - 04 Jan 2012
Viewed by 223
Abstract
Background and Objective. Serological evidence of infection with Chlamydia pneumoniae has been associated with cardiovascular diseases, but the relationship with stroke and its risk factors remains not completely understood. The aim of this study was to determine whether serological evidence of infection [...] Read more.
Background and Objective. Serological evidence of infection with Chlamydia pneumoniae has been associated with cardiovascular diseases, but the relationship with stroke and its risk factors remains not completely understood. The aim of this study was to determine whether serological evidence of infection with Chlamydia pneumoniae was associated with the risk of ischemic stroke and any of investigated stroke subtypes.
Material and Methods. Confirmed stroke cases (n=102) were compared with gender- and agematched control patients (n=48). The patients with stroke were divided into 3 groups according to the TOAST criteria: atherothrombotic (n=36), cardioembolic (n=47), and of undetermined etiology (n=19). Plasma levels of IgG antibodies to Chlamydia pneumoniae were measured by enzymelinked immunosorbent assay.
Results. There was a significant association between seropositivity to Chlamydia pneumoniae and stroke. Anti-Chlamydia pneumoniae IgG antibodies were detected in 64 case patients (62.7%) and 17 control patients (35.4%) (χ2=9.8; df=1; P=0.002). IgG seropositivity to Chlamydia pneumoniae was linked to all the analyzed etiological subtypes of stroke.
Conclusion
. This study showed that IgG seropositivity to Chlamydia pneumoniae was associated with stroke and all the analyzed etiological subtypes of stroke. Full article
Open AccessArticle
Factors Influencing Psychoemotional Strain and Fatigue, and Relationship of These Factors With Health Complaints at Sea Among Lithuanian Seafarers
Medicina 2011, 47(12), 99; https://doi.org/10.3390/medicina47120099 - 03 Jan 2012
Cited by 11 | Viewed by 311
Abstract
The aim of the study was to identify the factors influencing psychoemotional strain and, fatigue among Lithuanian seafarers and relationship of these factors to health complaints at sea.
Material and Methods. Two questionnaire surveys were carried out during mandatory health examination at [...] Read more.
The aim of the study was to identify the factors influencing psychoemotional strain and, fatigue among Lithuanian seafarers and relationship of these factors to health complaints at sea.
Material and Methods. Two questionnaire surveys were carried out during mandatory health examination at the Maritime Medicine Center of Klaipėda Seamen’s Hospital in 2003 and 2007. From November to December 2003, 998 seafarers aged 20–64 years were interviewed (first study). The second study carried out during November–December 2007 involved 932 20–64-year-old seafarers. The questionnaire comprised questions on sociodemographic data, factors of maritime industry, experienced psychoemotional strain and fatigue, and subjective evaluation of health.
Results
. The first study showed that older seafarers aged from 35 to 54 years were more likely to experience psychoemotional strain (P<0.001). Long working hours (9–10 hours and 11–12 hours) in harmful conditions and increased eyestrain were associated with psychoemotional strain among seafarers in the first study as well (P<0.001). Higher education level and detrimental factors to health (vibration and noise) were significant risk factors for the occurrence of psychoemotional strain among seafarers in the second study (P<0.05). The relationship between many risk factors related to seafarers’ work, demographic data, and subjectively evaluated psychoemotional strain and fatigue appear to be accumulative in character. Health complains at sea (insomnia, depression, waist and spinal pain) were related to psychoemotional strain, but sleep disorders were associated with fatigue.
Conclusions. Seafarers employed on a certain ship, under particular conditions, and being exposed to risk factors or their combination may experience health disorders related to increased fatigue and psychoemotional strain. Full article
Open AccessArticle
Mortality of Children Under Five and Prevalence of Newborn Congenital Anomalies in Relation to Macroeconomic and Socioeconomic Factors in Latvia
Medicina 2011, 47(12), 98; https://doi.org/10.3390/medicina47120098 - 03 Jan 2012
Viewed by 238
Abstract
Background. Mortality of infants and children younger than 5 years is a globally recognized and broad national welfare indicator. Scientific literature has data on the correlation of mortality indicators with macroeconomic indicators. It is important to study the associations between prevalence and [...] Read more.
Background. Mortality of infants and children younger than 5 years is a globally recognized and broad national welfare indicator. Scientific literature has data on the correlation of mortality indicators with macroeconomic indicators. It is important to study the associations between prevalence and mortality indicators and socioeconomic factors, since deaths from congenital anomalies account for approximately 25%–30% of all deaths in infancy. The aim of the study was to analyze the overall trend in mortality of infants and young children aged 0 to 4 years in relation to macroeconomic factors in Latvia and prevalence of congenital anomalies in newborns in relation to socioeconomic factors.
Material and Methods.
The Newborns’ Register and Causes of Death Register were used as data sources; data on specific socioeconomic factors were retrieved from the Central Statistics Office.
Results.
The results of the study show a strong correlation between mortality in children younger than 5 years and gross domestic product, as well as health budget in LVL per capita and the national unemployment level. The average decrease in infant mortality from congenital anomalies in Latvia was found to be 6.8 cases per 100 000 live births.
Conclusions. There is a strong correlation between child mortality and socioeconomic situation in the country. There is a need to analyze the data on child mortality in a transnational context on a regular basis and studying the correlations between child mortality indicators and socioeconomic indicators and health care management parameters. Full article
Open AccessArticle
Regional Differences in Diagnosing Asthma and Other Allergic Diseases in Estonian Schoolchildren
Medicina 2011, 47(12), 97; https://doi.org/10.3390/medicina47120097 - 03 Jan 2012
Viewed by 257
Abstract
The aim of this study was to estimate the prevalence of asthma and other allergic diseases among Estonian schoolchildren of the cities lacking special (pediatric allergological) health care.
Material and Methods. The study, carried out through 1 March to 8 May, 2003, [...] Read more.
The aim of this study was to estimate the prevalence of asthma and other allergic diseases among Estonian schoolchildren of the cities lacking special (pediatric allergological) health care.
Material and Methods. The study, carried out through 1 March to 8 May, 2003, enrolled 5thto 12th-grade schoolchildren of 4 schools in different regions of Estonia. A three-step protocol was followed: screening questionnaire, examination by a pulmonary resident, and consultation by a pediatric allergologist.
Results
. Of the 3132 questionnaires distributed, 1561 (49%) were returned. A total of 828 schoolchildren answered positively to any of the questions about possible allergic disease. After examination by the pulmonary resident, 255 schoolchildren (15.7%) were referred to an allergologist for final diagnosis. Asthma was diagnosed in 4.8%, allergic rhinoconjunctivitis in 4.9%, and atopic eczema in 8.3% of schoolchildren. Asthma, allergic rhinoconjunctivitis, and urticaria occurred more frequently in Narva as compared with Võru.
Conclusion
. The 12-month prevalence of asthma among Estonian schoolchildren was 4.8%, and the prevalence of allergic diseases varied from region to region. Less than half (40%) of all asthma cases identified during the study were newly diagnosed, and this clearly indicates that there is a considerable underdiagnosis of the disease among schoolchildren living outside of the centers in Estonia. Full article
Open AccessArticle
Characteristics of Carbapenem-Resistant Pseudomonas aeruginosa Strains in Patients with Ventilator-Associated Pneumonia in Intensive Care Units
Medicina 2011, 47(12), 95; https://doi.org/10.3390/medicina47120095 - 03 Jan 2012
Viewed by 266
Abstract
The aim of this study was to determine the characteristics of carbapenem-resistant Pseudomonas aeruginosa (P. aeruginosa) strains and 5-year changes in resistance in a tertiary university hospital.
Material and Methods
. The study included 90 and 101 randomly selected P. aeruginosa [...] Read more.
The aim of this study was to determine the characteristics of carbapenem-resistant Pseudomonas aeruginosa (P. aeruginosa) strains and 5-year changes in resistance in a tertiary university hospital.
Material and Methods
. The study included 90 and 101 randomly selected P. aeruginosa strains serotyped in 2003 and 2008, respectively. The standardized disk diffusion test and E-test were used to determine resistance to antibiotics. P. aeruginosa strains were considered to have high-level resistance if a minimum inhibitory concentration (MIC) for imipenem or meropenem was >32 μg/mL. To identify serogroups, sera containing specific antibodies against O group antigens of P. aeruginosa were used. P. aeruginosa isolates resistant to imipenem or/and meropenem were screened for metallo-β-lactamase (MBL) production by using the MBL E-test.
Results
. Comparison of the changes in resistance of P. aeruginosa strains to carbapenems within the 5-year period revealed that the level of resistance to imipenem increased. In 2003, 53.3% of P. aeruginosa strains were found to be highly resistant to imipenem, while in 2008, this percentage increased to 87.8% (P=0.01). The prevalence of MBL-producing strains increased from 15.8% in 2003 to 61.9% in 2008 (P<0.001). In 2003 and 2008, carbapenem-resistant P. aeruginosa strains were more often resistant to ciprofloxacin and gentamicin than carbapenem-sensitive strains. In 2008, carbapenem- resistant strains additionally were more often resistant to ceftazidime, cefepime, aztreonam, piperacillin, and amikacin than carbapenem-sensitive strains. MBL-producing P. aeruginosa strains belonged more often to the O:11 serogroup than MBL-non-producing strains (51.7% vs. 34.3%, P<0.05). A greater percentage of non-MBL-producing strains had low MICs against ciprofloxacin and amikacin as compared with MBL-producing strains.
Conclusions
. The results of our study emphasize the need to restrict the spread of O:11 serogroup P. aeruginosa strains and usage of carbapenems to treat infections with P. aeruginosa in the intensive care units of our hospital Full article
Open AccessArticle
Microflora of the Oral Cavity in Patients with Xerostomia
Medicina 2011, 47(12), 94; https://doi.org/10.3390/medicina47120094 - 03 Jan 2012
Cited by 2 | Viewed by 291
Abstract
Objective. The aim of this study was to evaluate the dependence of the condition of the microflora of the oral cavity on the etiology of xerostomia, patients’ sex, age, degree of hyposalivation, and duration of the sense of dryness.
Material and Methods [...] Read more.
Objective. The aim of this study was to evaluate the dependence of the condition of the microflora of the oral cavity on the etiology of xerostomia, patients’ sex, age, degree of hyposalivation, and duration of the sense of dryness.
Material and Methods. A total of 64 patients with complaints of oral dryness referred to the Clinic of Oral and Dental Diseases, Hospital of Lithuanian University of Health Sciences, for consultation during the period from 2003 to 2005 were selected for the study. The etiological factors of xerostomia were as follows: radiotherapy (PRT) to the maxillofacial area, Sjögren’s syndrome (SS), and xerogenic medications, tricyclic antidepressants (TCAs).
Results
. There were 50 women and 14 men. Their mean age was 60.5±1.6 years. All the patients in the PRT group had high counts of Candida spp. as compared with percentages of patients in the TCA and SS groups (100% vs. 66.7% and 56.2%, P<0.05). Patients’ age and sex in different etiology groups had no significant impact on the condition of their oral microflora. There were equal percentages of patients with deficient and normal salivation in the TCA group (44% in both the groups; P<0.01). All the patients in the PRT group had pronounced hyposalivation (P<0.002). A significantly greater percentage of patients with severely reduced salivation had high counts of Lactobacillus spp. (P<0.01). Significantly greater percentages of patients with the clinical duration of xerostomia of up to 6 months had high counts of Lactobacillus spp. and Candida spp. colonies.
Conclusions
. In patients with xerostomia, the condition of the microflora of the oral cavity and impairment of major salivary gland function varied according to the etiology of the disease. The level of hyposalivation and the duration of xerostomia were found to have a significant impact on the microflora of the oral cavity. Full article
Open AccessArticle
Comparison of Ankle-Brachial Index in Patients With and Without Atrial Fibrillation
Medicina 2011, 47(12), 93; https://doi.org/10.3390/medicina47120093 - 03 Jan 2012
Viewed by 253
Abstract
The aim of this study was to compare the ankle-brachial index between patients with atrial fibrillation (AF) and those without atrial fibrillation.
Material and Methods. A total of 286 patients admitted to the Departments of Neurology or Cardiology, Kaunas Clinical Hospital, during [...] Read more.
The aim of this study was to compare the ankle-brachial index between patients with atrial fibrillation (AF) and those without atrial fibrillation.
Material and Methods. A total of 286 patients admitted to the Departments of Neurology or Cardiology, Kaunas Clinical Hospital, during 2008–2010 and referred for a consultation with an internist and/or a cardiologist were included in this study. All patients had at least one prevalent cardiovascular disorder and were screened for diagnosis of permanent AF based on medical records and electrocardiogram and evaluated for the ankle-brachial index (ABI). Peripheral artery disease (PAD) was defined as an ABI of <0.9 assessed by using a 5-MHz Doppler ultrasound device.
Results.
The patients with permanent AF had a significantly lower ABI compared with the patients without AF (P<0.001). Binary regression analysis revealed that permanent AF was associated with PAD (OR, 2.5; 95% 1.5–4.2). The likelihood of having an ABI of <0.9 increased with each additional risk factor: AF (OR, 2.2; 95% CI, 1.3–3.8), stroke (OR, 2.3; 95% CI, 1.3–4.2), age of >69 years (OR, 2.4; 95% CI, 1.3–4.7), and myocardial infarction (OR, 2.4; 95% CI, 1.1–5.5). Nearly one-fourth (24.5%) of all patients with an ABI of <0.9 did not report any PAD-specific symptoms.
Conclusions
. The patients with cardiovascular disorders and permanent atrial fibrillation were found to have a significantly lower mean ankle-brachial index and higher prevalence of peripheral artery disease compared with cardiovascular patients without atrial fibrillation. The patients who were found to have a lower ankle-brachial index and permanent atrial fibrillation were older and often had several cardiovascular diseases (angina pectoris, stroke, myocardial infarction, or hypertension). Full article
Open AccessArticle
Cloacal Exstrophy: A Case Report and Literature Review
Medicina 2011, 47(12), 100; https://doi.org/10.3390/medicina47120100 - 03 Jan 2012
Viewed by 306
Abstract
Cloacal exstrophy is an extremely rare congenital malformation resulting in an exstrophy of the urinary, intestinal, and genital organs and associated with anomalies of other organ systems. We present a complicated case of cloacal exstrophy and the recent progress in the management of [...] Read more.
Cloacal exstrophy is an extremely rare congenital malformation resulting in an exstrophy of the urinary, intestinal, and genital organs and associated with anomalies of other organ systems. We present a complicated case of cloacal exstrophy and the recent progress in the management of this probably most complicated anomaly in pediatric urology and surgery. Full article
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