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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 2 (February 2011) – 9 articles

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Open AccessArticle
Activity of Neutrophil β-Glucuronidase in Diabetic and Nondiabetic Patients With Chronic Generalized Periodontitis and Healthy Subjects
Medicina 2011, 47(2), 12; https://doi.org/10.3390/medicina47020012 - 17 Feb 2011
Cited by 1 | Viewed by 255
Abstract
Objective. The aim of the study was to establish the dynamics of β-glucuronidase activity in subjects suffering from type 1 diabetes and chronic untreated generalized periodontitis, subjects suffering from chronic untreated generalized periodontitis only, and control subjects not suffering from generic [...] Read more.
Objective. The aim of the study was to establish the dynamics of β-glucuronidase activity in subjects suffering from type 1 diabetes and chronic untreated generalized periodontitis, subjects suffering from chronic untreated generalized periodontitis only, and control subjects not suffering from generic diseases with healthy periodontal tissue.
Material and Methods. The study involved 165 19–50-year-old subjects who were divided into three groups: healthy subjects (n=55), subjects with chronic untreated generalized periodontitis (n=55), and subjects with type 1 diabetes and chronic untreated generalized periodontitis (n=55). Neutrophilic leukocytes of peripheral venous blood were exposed to bacterial stimuli: opsonized zymosan, nonopsonized Staphylococcus aureus, and prodigiosan. The activity of β-glucuronidase was determined by the spectrofluorimetry method. Results. The diagnostic value of changes in β-glucuronidase activity of neutrophilic leukocytes markedly increased in all study groups after stimulation of neutrophilic leukocytes by opsonized zymosan, nonopsonized Staphylococcus aureus, and prodigiosan as compared to control media not exposed to any stimulus (P<0.001). The strongest relationship (canonical correlation coefficient eta, 0.993) between the intensity of periodontal pathology markers and the activity of β-glucuronidase of neutrophilic leukocytes in incubated media in patients with type 1 diabetes mellitus and periodontitis was found under the effect of nonopsonized Staphylococcus aureus.
Conclusions. If periodontal impairment is severe, diabetes mellitus possibly causes a faster destruction of the periodontal tissue and presents a higher risk of periodontitis for patients with diabetes. Full article
Open AccessArticle
Mikrosatelitų nestabilumas ir heterozigotiškumo praradimas sergant vėžiu
Medicina 2011, 47(2), 18; https://doi.org/10.3390/medicina47020018 - 16 Feb 2011
Viewed by 245
Abstract
Straipsnyje pateikiami literatūros duomenys apie mikrosatelitų nestabilumą ir heterozigotiškumo praradimą sergant įvairių lokalizacijų vėžiu. Šie genetiniai pokyčiai yra svarbūs kancerogenezei. Mikrosatelitų nestabilumo ir heterozigotiškumo praradimas gali būti prognoziniu, o kai kuriais atvejais predikciniu žymeniu (rodyti atsaką į gydymą). Daugiausia duomenų yra apie mikrosatelitų [...] Read more.
Straipsnyje pateikiami literatūros duomenys apie mikrosatelitų nestabilumą ir heterozigotiškumo praradimą sergant įvairių lokalizacijų vėžiu. Šie genetiniai pokyčiai yra svarbūs kancerogenezei. Mikrosatelitų nestabilumo ir heterozigotiškumo praradimas gali būti prognoziniu, o kai kuriais atvejais predikciniu žymeniu (rodyti atsaką į gydymą). Daugiausia duomenų yra apie mikrosatelitų nestabilumą sergant storosios žarnos vėžiu. Duomenys apie mikrosatelitų nestabilumą kitų lokalizacijų vėžio atvejais dar kaupiami, taigi, šia tema publikuojamų straipsnių skaičius auga. Full article
Open AccessArticle
Quality of Obstetric Services: Perspectives of Patients, Obstetricians, and Midwives
Medicina 2011, 47(2), 17; https://doi.org/10.3390/medicina47020017 - 16 Feb 2011
Viewed by 235
Abstract
Objective. The aim of this study was to compare the perspectives of patients and health care staff on the quality of obstetric services in an obstetric department.
Material and Methods
. This study was carried out at the Department of Obstetrics, Hospital [...] Read more.
Objective. The aim of this study was to compare the perspectives of patients and health care staff on the quality of obstetric services in an obstetric department.
Material and Methods
. This study was carried out at the Department of Obstetrics, Hospital of Lithuanian University of Health Sciences, where 68 obstetricians and midwives and 334 female patients completed anonymous questionnaires. Two different versions of the questionnaire for patients and health care staff were prepared with the aim to compare the results of both groups.
Results
. Patients evaluated technical quality of services significantly better than health care staff. Other items were showed to have no significant differences with the exception of sterility of equipment and premises and appearance of physicians. Patients and health care staff had similar opinions about professional relationship between patients and physicians: patients can expect representation of their interests and evaluation of treatment progress. Evaluation of external efficiency revealed that respondents were satisfied with health care and would recommend the current health care institution to their friends and relatives or would use it again when needed.
Conclusions
. Patients evaluated technical quality of services significantly better than health care staff. The different perceptions of patients and health care staff about functional quality and external effectiveness of services in most aspects were insignificant. Full article
Open AccessArticle
Prevention of Amyloid-Beta Oligomer-Induced Neuronal Death by EGTA, Estradiol, and Endocytosis Inhibitor
Medicina 2011, 47(2), 15; https://doi.org/10.3390/medicina47020015 - 16 Feb 2011
Cited by 1 | Viewed by 251
Abstract
Background and objective. Alzheimer’s disease is a progressive neurodegenerative disease that is biochemically characterized by the accumulation of amyloid beta (Aβ) peptides in the brain. The current hypothesis suggests that Aβ oligomers rather than fibrillar aggregates are the most toxic species of [...] Read more.
Background and objective. Alzheimer’s disease is a progressive neurodegenerative disease that is biochemically characterized by the accumulation of amyloid beta (Aβ) peptides in the brain. The current hypothesis suggests that Aβ oligomers rather than fibrillar aggregates are the most toxic species of Aβ though the mechanisms of their neurotoxicity are unclear. The authors have previously shown that small Aβ1–42 oligomers at around 1 μM concentration caused rapid (in 24 h) neuronal death in cerebellar granule cell (CGC) cultures. In this study, we aimed to investigate whether protracted (up to 7 days) incubation of CGC cultures with lower submicromolar concentration of various aggregates of Aβ1–42 had an effect on viability of neurons. In order to get some insight into the mechanism of Aβ-induced cell death, we also sought to determine whether extracellular Ca2+ and process of endocytosis contributed to Aβ oligomer-induced neurotoxicity and whether pharmacological interventions into these processes would prevent Aβ oligomer-induced cell death.
Material and Methods. Primary cultures of CGC were treated with various aggregate forms of Aβ1–42. Cell viability was assessed by fluorescent microscopy using propidium iodide and Hoechst 33342 staining.
Results
. Exposure of neurons to 500 nM Aβ1–42 oligomers for 72–168 h caused extensive neuronal necrosis. Lower concentrations (100–250 nM) were not toxic to cells during 7 days of incubation. Aβ1–42 monomers and fibrils had no effect on neuronal viability even after 7 days of incubation. Treatment of neurons with EGTA, steroid hormone 17β-estradiol, and methyl-β-cyclodextrin significantly reduced Aβ1-42 oligomers-induced neuronal death.
Conclusions
. The results show that submicromolar concentrations of Aβ1-42 oligomers were highly toxic to neurons during protracted incubation inducing neuronal necrosis that can be prevented by chelating extracellular Ca2+ with EGTA, inhibiting endocytosis with methyl-β-cyclodextrin, or by estradiol, which may protect against mitochondrial permeability transition pore opening. Full article
Open AccessArticle
The Comparison of Different Surgical Techniques Used for Repair of Complete Unilateral Cleft Lip
Medicina 2011, 47(2), 11; https://doi.org/10.3390/medicina47020011 - 16 Feb 2011
Cited by 2 | Viewed by 253
Abstract
Up to now, many various techniques have been proposed for the repair of complete unilateral cleft lip. The aim of this study was to compare late results of three different surgical techniques (C. Tennison, R. Millard, and J. Olekas) used for the repair [...] Read more.
Up to now, many various techniques have been proposed for the repair of complete unilateral cleft lip. The aim of this study was to compare late results of three different surgical techniques (C. Tennison, R. Millard, and J. Olekas) used for the repair of complete unilateral cleft lip and to analyze their advantages and disadvantages.
Material and Methods
. Sixty-six patients with nonsyndromic complete unilateral cleft lip, alveolus, and palate were examined. For 19 patients (28.8%), cleft lip repair was performed using the Tennison technique; for 20 patients (30.3%), Millard technique; and for 27 patients (40.9%), Olekas technique. Results were assessed by score, which was given by analyzing standardized photographs of nasolabial triangles. For the assessment, the modified scale according to Mortier and Anastassov was used. Separate anatomical elements – red lip, white lip, scars, and nose – were assessed.
Results
. The best appearance of the red lip and white lip was found after the Tennison technique. Scars and nose looked the best after Olekas cheiloplasty. There were no significant differences in the evaluation of red lip and nose appearance comparing all three analyzed surgical techniques (P>0.05). Tennison technique showed significantly better results in the appearance of the white lip (P<0.05); the appearance of scars was significantly better after the Olekas repair (P<0.001).
Conclusions
. Height of white lip and symmetry of the Cupid’s bow were better restored by using the Tennison technique. The physiological configuration of the white lip and less visible scars were achieved by using the Olekas technique. All techniques were equal in red lip and nose formations. Full article
Open AccessArticle
Attitudes of Lithuanian Secondary School Children Toward Addictive Behaviors, Their Promoting and Preventive Factors with Regard to the Age
Medicina 2011, 47(2), 16; https://doi.org/10.3390/medicina47020016 - 13 Feb 2011
Viewed by 210
Abstract
The aim of this study was to evaluate the attitudes of Lithuanian secondary school children toward addictive behaviors, their promoting and preventive factors with regard to the age.
Material and Methods. The study sample consisted of all 5th-, 9th-, and 12th-grade schoolchildren [...] Read more.
The aim of this study was to evaluate the attitudes of Lithuanian secondary school children toward addictive behaviors, their promoting and preventive factors with regard to the age.
Material and Methods. The study sample consisted of all 5th-, 9th-, and 12th-grade schoolchildren of 6 secondary schools in Kaunas and Šakiai (N=856). Schoolchildren were surveyed with a questionnaire consisting of the questions about their attitudes and experience regarding addictive behaviors and factors promoting and preventing such behaviors.
Results
. Smoking (82.8%), use of illegal drugs (81.0%), and consumption of strong alcoholic beverages (80.6%) were most often indicated as addictive behaviors. Consumption of light alcoholic beverages and computer gaming were least often indicated as addictive behaviors: by 67.2% and 57.1% of respondents, respectively. Less than one-third (32.7%) of respondents answered that they had one or more of potentially addictive behaviors: computer gaming (27.8%), consumption of light alcoholic beverages (24.6%), smoking (16.3%), and consumption of strong alcoholic beverages (12.1%). The most significant difference was observed between the answers of schoolchildren of 5th and 9th grades. Friends (38.4%), TV (37.9%), and Internet (24.6%) were most often mentioned as influencing a wish to try and abstain from addictive behaviors. Fear for one’s health (74.4%) and possible impediment for the life (71.4%) were the most frequently mentioned reasons for abstaining from addictive behaviors.
Conclusions. Involvement in potentially addictive behaviors and acknowledgement of their risks were found to increase with the age of schoolchildren, most significantly from 5th to 9th grades. Consumption of light alcoholic beverages was the second most prevalent behavior among respondents, highly noticed in advertising, but least often acknowledged as addictive behavior. TV and Internet were most often mentioned by respondents as mass media influencing their wish to try or abstain from trying addictive behaviors. Reasons for abstaining from addictive behaviors differed with regard to the age but fears for health and life impediment were most prevalent in all grades. Full article
Open AccessArticle
Trumpam sulaikomo kvėpavimo įtaka širdies ir kraujagyslių sistemai atliekant dozuoto fizinio krūvio mėginį
Medicina 2011, 47(2), 14; https://doi.org/10.3390/medicina47020014 - 13 Feb 2011
Viewed by 227
Abstract
Kvėpavimas yra refleksinis, o kartu ir valingas veiksmas, todėl kvėpavimo intensyvumo pokyčiai arba kvėpavimo sulaikymai gali turėti įtakos organizmo vegetacinėms funkcijoms ir jų pokyčiams fizinių krūvių metu.
Tyrimo tikslas
. Nustatyti, ar nepakinta širdies ir kraujagyslių sistemos (ŠKS) funkcinės būklės rodikliai, kai tiriamieji [...] Read more.
Kvėpavimas yra refleksinis, o kartu ir valingas veiksmas, todėl kvėpavimo intensyvumo pokyčiai arba kvėpavimo sulaikymai gali turėti įtakos organizmo vegetacinėms funkcijoms ir jų pokyčiams fizinių krūvių metu.
Tyrimo tikslas
. Nustatyti, ar nepakinta širdies ir kraujagyslių sistemos (ŠKS) funkcinės būklės rodikliai, kai tiriamieji krūvio pradžioje nevalingai arba valingai trumpam sulaiko kvėpavimą. Metodika. Atlikti du tyrimai. Pirmojo tyrimo metu vertinta sveikų vyrų, pakviestų pirmą kartą atlikti fizinio krūvio mėginį, psichomotorinis tonusas ir išorinio kvėpavimo savybės. Tiriamieji atliko Rufjė fizinio krūvio mėginį (30 pritūpimų per 45 sek., pritūpiant iki 90° per kelio sąnarį). Krūvio metu ir pirmąsias dvi atsigavimo minutes buvo registruojama 12-kos standartinių elektrokardiogramos derivacijų ir matuojamas arterinis kraujo spaudimas. Viso tyrimo metu buvo registruojamos kvėpavimo bangos. Antrojo tyrimo metu buvo vertinta trumpo valingo kvėpavimo sulaikymo įtaka ŠKS funkcinių rodiklių pokyčiams atliekant dozuoto fizinio krūvio mėginį.
Rezultatai.
Tyrimas parodė, kad padidėjusio psichomotorinio tonuso asmenys, atlikdami dozuoto fizinio krūvio mėginį, jo pradžioje dažniau nevalingai sulaiko kvėpavimą. Trumpas kvėpavimo sulaikymas dozuoto fizinio krūvio pradžioje pakeičia širdies ir kraujagyslių sistemos funkcinius rodiklius: lėčiau didėja širdies susitraukimų dažnis, mažiau kinta elektrokardiogramos JT intervalas, sumažėja greitosios adaptacijos fiziniam krūviui greitis, turi tendenciją didėti arterinio kraujo spaudimo rodikliai ir reikšmingai sulėtėja rodiklių atsigavimas po krūvio.
Išvada
. Atliekant dozuoto fizinio krūvio mėginius, santykinai dažnai pasitaikantis nevalingas kvėpavimo sulaikymas pakeičia širdies ir kraujagyslių sistemos funkcinius rodiklius fizinio krūvio ir atsigavimo metu dėl to funkcinė būklė gali būti įvertinta nevisiškai tiksliai. Full article
Open AccessArticle
Arthroscopic Coracoid Transposition for Recurrent Shoulder Anterior Instability. An Operative Technique
Medicina 2011, 47(2), 13; https://doi.org/10.3390/medicina47020013 - 13 Feb 2011
Viewed by 237
Abstract
We report a technique of an arthroscopic concomitant Bankart repair with a transfer of the coracoid bone block and conjoint tendons for revision anterior shoulder instability.
The operative procedure consists of an arthroscopic transfer of the conjoined tendon with a coracoid and arthroscopic [...] Read more.
We report a technique of an arthroscopic concomitant Bankart repair with a transfer of the coracoid bone block and conjoint tendons for revision anterior shoulder instability.
The operative procedure consists of an arthroscopic transfer of the conjoined tendon with a coracoid and arthroscopic Bankart repair. First, a typical Bankart suture anchor procedure with two suture anchors was performed into the antero-inferior part of the glenoid rim. After, tenodesis of the coraco-biceps tendon was performed in the middle of the subscapularis tendon fixing the coracoid bony fragment into a glenoid socket with a bioabsorbable interference screw.
This operative technique is an alternative in the treatment of revision anterior shoulder instability in patients with deficient anterior capsule. Full article
Open AccessArticle
Rationality of Administered Gentamicin Dose in Cerebral Coma Patients Treated in an Intensive Care Unit
Medicina 2011, 47(2), 10; https://doi.org/10.3390/medicina47020010 - 12 Feb 2011
Viewed by 214
Abstract
Gentamicin is still widely used in the treatment of patients in an intensive care unit (ICU). The efficacy of aminoglycosides correlates with the peak serum concentration (Cmax), and the toxicity with the minimum serum concentration (Cmin). The aim of this study was to [...] Read more.
Gentamicin is still widely used in the treatment of patients in an intensive care unit (ICU). The efficacy of aminoglycosides correlates with the peak serum concentration (Cmax), and the toxicity with the minimum serum concentration (Cmin). The aim of this study was to determine Cmax and Cmin in serum of cerebral coma ICU patients when a dosage of gentamicin of 5 mg/kg body weight was administered once daily; to evaluate the rationality of mentioned dose; and to identify factors associated with these concentrations.
Material and Methods
. A total of 24 ICU patients suffering from cerebral coma were included into this analysis. A dosage of gentamicin of 5 mg/kg body weight was administered once a day. Gentamicin concentrations were tested twice after the first dose infusion (immediately and 5 hours after 1-hour infusion). Cmax, Cmin, volume of distribution (Vd), and elimination half-life (T1/2) were obtained.
Results. The mean Cmax was 17.96 (SD, 4.31) μg/mL (range, 10.30–27.87 μg/mL). The desirable Cmax (≥20 μg/mL) was reached only in 6 patients (25%). Cmin was calculated using a special pharmacokinetic program “Kinetica.” Cmin of 0.5 μg/mL was not exceeded in any patient. A correlative analysis indicated a significant inverse direct correlation between Cmax and Vd and between Cmax and treatment duration in the ICU. An inverse correlation was observed between Cmin and T1/2, evaluation of coma according to the Glasgow coma scale, and creatinine clearance.
Conclusions. A dosage of 5 mg/kg body weight once a day was not sufficient in cerebral coma ICU patients. This dose was not associated with the nephrotoxic effect of gentamicin (additional risk factors were absent). It is recommended to obtain gentamicin concentration at two time points following administration of the first dose (e.g., immediately after 1-hour infusion and 5 hours later), and using a special pharmacokinetic software, to calculate a necessary dose and interval of administration. Full article
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