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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 48, Issue 6 (June 2012) – 8 articles

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Open AccessArticle
A Population-Based Cross-Sectional Study of Cardiovascular Risk Factor in Latvia
Medicina 2012, 48(6), 46; https://doi.org/10.3390/medicina48060046 - 05 Jul 2012
Cited by 1 | Viewed by 275
Abstract
Background and Objective. To date, the epidemiological studies of noncommunicable diseases in Latvia were more episodic and covered only selected areas. The first national crosssectional population-based survey of cardiovascular risk factors after regaining independence was carried out to provide reliable information on [...] Read more.
Background and Objective. To date, the epidemiological studies of noncommunicable diseases in Latvia were more episodic and covered only selected areas. The first national crosssectional population-based survey of cardiovascular risk factors after regaining independence was carried out to provide reliable information on the cardiovascular risk factor profile in adults.
Material and Methods
. Computerized random sampling from the Registry of Latvian population was carried out. A total of 6000 enrolled subjects aged 25–74 years were divided into 10 age subgroups. The data of 3807 respondents (63.5% of all) were included into the final analysis.
Results. The mean number of cardiovascular risk factors was 2.99±0.026 per subject: 3.45±0.043 and 2.72±0.030 for men and women, respectively. Of all the respondents, 75.2% had an increased total cholesterol level. Hypercholesterolemia was found in almost 56% of men and 41% of women in the age group of 25–34 years. Hyperglycemia was documented in 34.1% of the respondents (41.6% of men and 29.8% of women). More than two-thirds (67.8%) of the persons were overweight, while obesity was found in 25.6% of men and 32.6% of women. Arterial hypertension was identified in 44.8% of the respondents; its prevalence was higher in men than women (52.9% vs. 40.2%). There were more current smokers among men than women (30.5% vs. 11.4%).
Conclusions
. The levels of cardiovascular risk factors in Latvia were found to be relatively high. The data can be utilized as baseline characteristics that can be compared down the road including the monitoring of health prevention activities. Full article
Open AccessArticle
Phenotypic and Genetic Analysis of Biofilm Formation by Staphylococcus epidermidis
Medicina 2012, 48(6), 45; https://doi.org/10.3390/medicina48060045 - 28 Jun 2012
Cited by 3 | Viewed by 250
Abstract
Objective. The most important virulence factor of Staphylococcus epidermidis is their capability to form a biofilm on the surfaces of implanted medical devices. The accumulative phase of biofilm formation is linked to the production of intercellular adhesin encoded by the icaADBC operon [...] Read more.
Objective. The most important virulence factor of Staphylococcus epidermidis is their capability to form a biofilm on the surfaces of implanted medical devices. The accumulative phase of biofilm formation is linked to the production of intercellular adhesin encoded by the icaADBC operon and accumulation-associated protein by the aap gene. The aim of the study was to investigate biofilm formation phenotypically and genetically in clinical strains of S. epidermidis in comparison with commensal strains.
Material and Methods
. The study was carried out in 4 hospitals in Riga, Latvia. In total, 105 clinical strains of Staphylococcus epidermidis isolated from patients’ blood (n=67) and intravenous catheters (n=38) in a case of laboratory-confirmed bacteremia were studied. Moreover, 60 Staphylococcus epidermidis commensal strains isolated from nose epithelium of healthy people were included as a control group. Appearance of the icaA and aap genes was tested by polymerase chain reaction. The microtiter plate method was used.
Results.
Biofilm formation was detected in 50 (47%) of Staphylococcus epidermidis isolates in the clinical group and 15 (25%) of isolates in the control group (P=0.0049). Among 50 biofilmforming clinical isolates, 46 (92%) were positive for the icaA and/or aap genes. The icaA and aap genes were not found only in 4 strains.
Conclusions
. The clinical isolates of Staphylococcus epidermidis were more likely to form biofilms than the commensal strains. The carriage of the icaA or aap gene alone, or their absence, is not applicable as a molecular marker for the discrimination invasive Staphylococcus epidermidis strains from contaminants. Full article
Open AccessArticle
Anemia as a Complication of Parvovirus B19 Infection in Renal Transplant Recipients
Medicina 2012, 48(6), 44; https://doi.org/10.3390/medicina48060044 - 27 Jun 2012
Cited by 4 | Viewed by 219
Abstract
Background. The frequency of B19 infection in renal transplant donors and recipients was studied to determine the significance of active viral infection in the development of anemia.
Material and Methods. Serum, plasma, and peripheral blood leukocyte samples of 47 renal transplant [...] Read more.
Background. The frequency of B19 infection in renal transplant donors and recipients was studied to determine the significance of active viral infection in the development of anemia.
Material and Methods. Serum, plasma, and peripheral blood leukocyte samples of 47 renal transplant donors, 38 recipients with anemia (Group 1), and 25 without anemia (Group 2) after renal transplantation were evaluated for the presence of anti-B19 specific antibodies (ELISA) and B19 DNA (nPCR).
Results. Active persistent B19 infection after renal transplantation was detected in 12 of the 38 in the Group 1 (10 had reactivation and 2 primary infection), and none of the recipients in the Group 2 had it. Of the 12 recipients in the Group 1, 10 were seropositive and 2 seronegative before renal transplantation; 10 received the transplants from the seropositive and 2 from seronegative donors. rHuEPO therapy-resistant severe anemia was detected only in the recipients with active B19 infection after renal transplantation in the Group 1 (7/12). The logistic regression analysis revealed a significant relationship between active B19 infection and severe anemia (OR, 0.039; 95% CI, 0.006–0.257; P=0.001).
Conclusions
. Active B19 infection was documented only in the anemic recipients and could be associated with the development of severe anemia after renal transplantation. This allows us to recommend concurrent screening for viral DNA in plasma and detection of anti-B19 IgM class antibodies. To find the association between B19 infection and the development of anemia, further investigations are necessary. Full article
Open AccessArticle
Postoperative Survival in Patients With Multiple Brain Metastases
Medicina 2012, 48(6), 41; https://doi.org/10.3390/medicina48060041 - 17 Jun 2012
Cited by 1 | Viewed by 254
Abstract
Background and Objective. Although surgery is traditionally performed for patients with a single brain metastasis, an increasing number of patients with multiple brain metastases may also be treated surgically. The objective of the study was to analyze postoperative survival results and the [...] Read more.
Background and Objective. Although surgery is traditionally performed for patients with a single brain metastasis, an increasing number of patients with multiple brain metastases may also be treated surgically. The objective of the study was to analyze postoperative survival results and the clinical factors affecting these results.
Material and Methods
. The records of the patients who underwent surgical resection of 2 or more lesions between January 2005 and January 2010 were retrospectively reviewed. Survival was calculated from the date of surgery to the last follow-up evaluation or death, and different clinical factors were analyzed in regard to patient survival.
Results
. In total, 36 patients underwent one or more craniotomies. The survival of the total group ranged from 16 days to 37.5 months (mean, 29 months). There were 4 deaths within 30 days. When divided into Radiation Therapy Oncology Group RPA classes, the survival time was 11.75, 8.58, and 5.31 months for classes 1, 2, and 3, respectively. Regarding an impact on the survival, a significant association with a favorable outcome was found for the following factors: the number of brain metastases (2–3 vs. 4–6, P=0.046), RPA classes (1 vs. 2 or 3, P=0.0192), and extent of metastasis resection (all vs. partial, P=0.018).
Conclusions. Well-selected patients with multiple brain metastases appear to benefit from surgery compared with historical controls of patients treated with whole-brain radiotherapy alone. Full article
Open AccessArticle
Quality of Life After Endovascular Abdominal Aortic Aneurysm Repair: Nellix Sac-Anchoring Endoprosthesis Versus Open Surgery
Medicina 2012, 48(6), 42; https://doi.org/10.3390/medicina48060042 - 11 Jun 2012
Viewed by 260
Abstract
An increasing number of patients with abdominal aortic aneurysms are treated using endovascular rather than open surgical techniques. The Vascular Surgery Center, P. Stradins Clinical University Hospital, has the largest worldwide experience using a new type of endoprosthesis, which fills and anchors the [...] Read more.
An increasing number of patients with abdominal aortic aneurysms are treated using endovascular rather than open surgical techniques. The Vascular Surgery Center, P. Stradins Clinical University Hospital, has the largest worldwide experience using a new type of endoprosthesis, which fills and anchors the device in the aneurysm sac. Within the framework of a clinical trial, the quality-of-life evaluation of patients treated using this type of device was carried out.
Materials and Method
. A cohort study was conducted from 2008 to 2011 comparing the quality of life (QOL) of patients after abdominal aortic aneurysm repair with either the new endovascular treatment method (EVAR) or open surgery (OS). Each group comprised 20 patients, and the quality-of life-evaluation was performed using the SF-36 questionnaire before operation, 1 month after operation, and 1 year after operation.
Results
. One month after operation, an improved QOL was documented in the EVAR group (47 [SD, 3] in the EVAR group vs. 38 [SD, 3] in the OS group, P<0.001). One year after operation, a significant improvement in QOL persisted although the difference between the groups diminished (48 [SD, 4] in the EVAR group vs. 42 [SD, 3] in the OS group, P<0.001).
Conclusions.
The patients with abdominal aortic aneurysms who underwent EVAR using the new sac-anchoring endoprosthesis have improved health-related quality of life compared to the patients undergoing open surgical repair. The improvement in quality of life remained slightly better in the EVAR group 1 year after operation. Full article
Open AccessArticle
A Novel Approach for Nucleic Acid Delivery Into Cancer Cells
Medicina 2012, 48(6), 48; https://doi.org/10.3390/medicina48060048 - 10 Jun 2012
Cited by 2 | Viewed by 251
Abstract
Background. Liposomal magnetofection is based on the use of superparamagnetic particles and cationic lipids and shows better transfection efficiency than other common nonviral gene delivery methods; however, the distribution of aggregate complexes over the cell surface may be ununiform. The use of [...] Read more.
Background. Liposomal magnetofection is based on the use of superparamagnetic particles and cationic lipids and shows better transfection efficiency than other common nonviral gene delivery methods; however, the distribution of aggregate complexes over the cell surface may be ununiform. The use of a dynamic gradient magnetic field could overcome this limitation. A newly developed device for magnetofection under a dynamic magnetic field was used to compare the transfection efficiency of prostate carcinoma cell line PC3 with that obtained by lipofection and magnetofection.
Material and Methods. Reporter plasmid pcDNA3.1LacZ DNA was used in combination with Lipofectamine2000 reagent and superparamagnetic nanoparticles CombiMag. The effects of incubation time under a dynamic magnetic field and a rotation frequency of magnets on transfection efficiency for PC3 cell line were determined. Alternatively, lipofection and liposomal magnetofection were carried out. Transfection efficiency of delivery methods was estimated by β-galactosidase staining; cell viability, by acridine orange/ethidium bromide staining.
Results
. Liposomal magnetofection under a dynamic gradient magnetic field demonstrated the highest transfection efficiency: it was greater by almost 21% and 42% in comparison with liposomal magnetofection and lipofection, respectively. The optimal incubation time under dynamic magnetic field and the optimal magnet rotation frequency were 5 minutes and 5 rpm, respectively. Liposomal magnetofection under a dynamic gradient magnetic field was less cytotoxic (7%) than that under a permanent magnetic field (17%) and lipofection (11%).
Conclusions. Our new approach, based on the use of a dynamic gradient magnetic field, enhanced the transfection efficiency and had a less cytotoxic effect on prostate cancer cells in comparison with the standard magnetofection and lipofection. Full article
Open AccessArticle
The First Evidence of Hereditary and Familial Gastric Cancer in Latvia: Implications for Prevention
Medicina 2012, 48(6), 47; https://doi.org/10.3390/medicina48060047 - 01 Apr 2012
Viewed by 218
Abstract
Background and Objective. Gastric cancer is a frequent cause of cancer mortality. The prognosis of established tumor is unfavorable due to the propensity to spread and limited treatment efficiency. Therefore, prevention has a high significance. We tested a population screening approach in [...] Read more.
Background and Objective. Gastric cancer is a frequent cause of cancer mortality. The prognosis of established tumor is unfavorable due to the propensity to spread and limited treatment efficiency. Therefore, prevention has a high significance. We tested a population screening approach in order to identify families with an increased gastric cancer load for further surveillance.
Material and Methods
. Population screening was performed by questionnaire reaching 76.6% of the population. Hereditary gastric cancer (HGC) syndrome was diagnosed if 3 mutually first-degree relatives with gastric cancer were reported in the kindred. Additional group (HGC2) of families with 2 first-degree relatives affected by gastric cancer was identified.
Results. The HGC syndrome was diagnosed in 0.11%, but HGC2 syndrome, in 0.4% probands. The gastric cancer frequency among blood relatives was 25.2% (95% CI, 20.6%–30.4%) in HGC, but 16.0% (95% CI, 13.8%–18.5%) in HGC2 families. The mean age at diagnosis of cancer was 56.9 years (95% CI, 53.4–60.3) in HGC and 62.5 years (95% CI, 60.1–64.8) in HGC2. The mean survival was 2.6 years (95% CI, 1.2–4.0).
Conclusions. Population screening identifies reasonable number of families with a high frequency of gastric cancer. The frequency of gastric cancer and an unfavorable course characterized by low survival justify surveillance in families with 2 or 3 first-degree relatives affected by gastric cancer. Population screening provides the age characteristics of the respective tumors in order to adjust the surveillance schedule. Full article
Open AccessArticle
Lipoxygenase-Derived Arachidonic Acid Metabolites in Chronic Obstructive Pulmonary Disease
Medicina 2012, 48(6), 43; https://doi.org/10.3390/medicina48060043 - 05 Nov 2011
Viewed by 267
Abstract
Background and Objective. Chronic obstructive pulmonary disease (COPD) is characterized by a persistence of inflammation in large and small airways. We hypothesized that this could be caused by the inability of an inflammatory process to resolve. In the resolution of inflammation, a [...] Read more.
Background and Objective. Chronic obstructive pulmonary disease (COPD) is characterized by a persistence of inflammation in large and small airways. We hypothesized that this could be caused by the inability of an inflammatory process to resolve. In the resolution of inflammation, a switching of arachidonic acid metabolism from the production of proinflammatory leukotriene B4 (LtB4) to the synthesis of anti-inflammatory lipoxins plays an important role. The aim of our study was to determine the content of lipoxin A4 (LXA4) and LtB4 in induced sputum of patients with exacerbated COPD and to compare it to healthy controls, as well as to analyze the relationship between proinflammatory and anti-inflammatory mediators and an inflammatory cell spectrum in induced sputum.
Material and Methods
. Induced sputum from 17 COPD patients and 7 healthy controls were analyzed for LXA4 and LtB4 content and inflammatory cell spectrum.
Results
. COPD patients had a significantly lower sputum LXA4 concentration and LtB4/LXA4 ratio compared with healthy controls. A significant negative correlation was found between the LXA4 concentration and the relative neutrophil count and between the LtB4/LXA4 ratio and the relative macrophage count.
Conclusions. COPD patients during the late phase of exacerbation had a suppressed production of LXA4 and an elevated LtB4/LXA4 ratio in induced sputum demonstrating a proinflammatory imbalance. The correction of a balance between proinflammatory and anti-inflammatory eicosanoids by the administration of stable analogues of lipoxins could improve the treatment of chronic obstructive pulmonary disease in the future. Full article
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