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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 49, Issue 1 (January 2013) – 8 articles

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Open AccessArticle
Ultrasonography and Magnetic Resonance Imaging of the Brain in Hypoxic Full-Term Newborns
Medicina 2013, 49(1), 8; https://doi.org/10.3390/medicina49010008 - 05 Feb 2013
Cited by 2 | Viewed by 258
Abstract
The aim of this article was to review the studies on diagnostic and prognostic value of radiological investigations (cranial sonography, Doppler ultrasonography, and magnetic resonance imaging) in the detection of hypoxic-ischemic brain injuries in full-term newborns.
Materials and Methods
. A systematic search [...] Read more.
The aim of this article was to review the studies on diagnostic and prognostic value of radiological investigations (cranial sonography, Doppler ultrasonography, and magnetic resonance imaging) in the detection of hypoxic-ischemic brain injuries in full-term newborns.
Materials and Methods
. A systematic search of studies on the diagnostic and prognostic possibilities of radiological investigations for the detection of hypoxic-ischemic injuries in full-term newborns was performed.
Results. A total of 13 prospective and 4 retrospective studies that analyzed the incidence of hypoxic-ischemic cerebral injuries, determined by means of cranial sonography, Doppler sonography, and magnetic resonance imaging, and associations with the stages of hypoxic-ischemic encephalopathy and long-term neurodevelopmental outcomes were included in this systematic review.
Conclusions
. Magnetic resonance imaging detects lesions in 75%–100% of cases. Magnetic resonance imaging performed at the age of 7–11 days demonstrated a high sensitivity (100%) and negative predictive value (100%) to predict unfavorable outcomes at 4 years of age. In newborns with hypoxic-ischemic encephalopathy, substantial cerebral hemodynamic alterations are detected after birth. The sensitivity and negative predictive value of cerebral blood flow velocities (peak systolic flow velocity, end-diastolic flow velocity) changes at 12±2 hours of age to predict the severity of hypoxic-ischemic encephalopathy and unfavorable outcomes at 18 months of age were found to be high (90% and 94%, respectively). A low resistive index (<0.56) at the age of 1–3 days had a specificity of 95% to predict unfavorable outcomes at 3 years of age. The data on the diagnostic and prognostic potential of cranial sonography are limited scarce and contrary. Full article
Open AccessArticle
Mortality of Lithuanian Population Over 2 Decades of Independence: Critical Points and Contribution of Major Causes of Death
Medicina 2013, 49(1), 7; https://doi.org/10.3390/medicina49010007 - 05 Feb 2013
Cited by 1 | Viewed by 229
Abstract
The aim of the study was to analyze trends in overall mortality and mortality from major causes of death, detect differences in cut points, and estimate the contribution of the major causes of death to the changes in overall mortality throughout 2 decades [...] Read more.
The aim of the study was to analyze trends in overall mortality and mortality from major causes of death, detect differences in cut points, and estimate the contribution of the major causes of death to the changes in overall mortality throughout 2 decades of independence in Lithuania (1991–2000 and 2001–2010).
Material and Methods. Overall mortality and mortality from cardiovascular diseases, cancer, and external causes were analyzed for the periods of 1991–2000 and 2001–2010. Joinpoint analysis was used to identify the best-fitting points wherever a statistically significant change in mortality occurred, and analysis of components was applied for the assessment of the contribution of major causes of death.
Results. The 1991–1994 period was identified as the most negative in terms of increasing mortality from all major causes of death, while the 2007–2010 period was most favorable, when the most significant decline in overall mortality was observed (4.84% per year for males and 4.41% per year for females). External causes contributed most to the growing overall mortality in 1991–1994 both for males and females (37.20% and 25.29%, respectively). Since 2007, all major causes contributed positively to the declining overall mortality of the Lithuanian population. The most significant contribution was made by cardiovascular diseases and external causes.
Conclusions
. Despite the considerable transformations of socioeconomic situation and economic crisis, it is likely that Lithuania is entering into the stage of positive health development. For assuring this trend in the future, investments in sustainable health and social developments are inevitable. Full article
Open AccessArticle
Maternal Age-Associated Congenital Anomalies Among Newborns: A Retrospective Study in Latvia
Medicina 2013, 49(1), 6; https://doi.org/10.3390/medicina49010006 - 05 Feb 2013
Cited by 1 | Viewed by 249
Abstract
Background and Objective. In Latvia, the mean age of women giving birth increased from 27.3 in 2000 to 29.0 years in 2010 during the last 11 years. The aim of this study was to report on major congenital anomalies of newborns at birth [...] Read more.
Background and Objective. In Latvia, the mean age of women giving birth increased from 27.3 in 2000 to 29.0 years in 2010 during the last 11 years. The aim of this study was to report on major congenital anomalies of newborns at birth by the maternal age and to compare the mean maternal age by different diagnosis subgroups and maternal and neonatal characteristics.
Material and Methods
. A cross-sectional retrospective study with the data from the Medical Birth Register (2000–2010) was carried out. The live birth prevalence rate was calculated for the subgroups of major congenital anomalies per 10 000 live births by the maternal age.
Results
. The live birth prevalence rate of major congenital anomalies during the period 2000– 2010 was 211.4 per 10 000 live births. The prevalence rate increased depending on the maternal age. Congenital heart defects, limb defects, and urinary system anomalies were the most common anomalies. The study results showed an age-related risk of abdominal wall defects, orofacial clefts, and chromosomal anomalies. There were significantly higher proportions of preterm births, newborns with low birth weight, and complications during pregnancy among mothers aged 35 years and more.
Conclusions
. The data on congenital anomalies from the Latvian Medical Birth Register can be used for the assessment of epidemiology of congenital anomalies. The results of this retrospective study showed a decrease in the live birth prevalence rate of major congenital anomalies despite an increase in the mean age of mothers in Latvia. Full article
Open AccessArticle
What Are the Predictors of Self-Assessed Health in Lithuanian Health Professionals?
Medicina 2013, 49(1), 5; https://doi.org/10.3390/medicina49010005 - 05 Feb 2013
Viewed by 260
Abstract
Background and Objective. Scientific evidence indicates that patient safety and access to health care is linked to the well-being of health professionals. The self-assessed health status has been widely used as a health measure in different surveys. The aim of this study [...] Read more.
Background and Objective. Scientific evidence indicates that patient safety and access to health care is linked to the well-being of health professionals. The self-assessed health status has been widely used as a health measure in different surveys. The aim of this study was to examine and determine the factors related to the self-assessed health status of health professionals.
Material and Methods
. The cross-sectional questionnaire surveys of nurses and physicians were carried out in randomly selected hospitals. A total of 1025 health professionals (739 nurses and 286 physicians) from 3 hospitals of different size located in 1 geographical region of Lithuania participated in the survey. The response rate among the nurses and the physicians was 89.2% and 52.5%, respectively. The overall response rate was 74.7%. The data on self-assessed health, demographic factors, anthropometric data, blood pressure, cholesterol level in blood, personal history of diseases, smoking, and alcohol consumption were gathered with the help of the questionnaire.
Results
. About two-thirds (64.1%) of the health professionals reported good or quite good health, and only 1.5% of the respondents reported quite poor or poor health. Multivariate logistic regression analysis revealed that the SAH status of health professionals was dependent on age (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.02–1.05 [Model 1]; OR, 1.04; 95% CI, 1.02–1.06 [Model 2]), diseases (OR, 7.32; 95%, 5.18–10.35), heart diseases (OR, 12.09; 95% CI, 2.9–50.35), hypertension (OR, 2.53; 95% CI, 1.55–4.14), cancer (OR, 6.19; 95% CI, 1.27–30.13), gastrointestinal (OR, 3.54; 95% CI, 1.59–7.86) and musculoskeletal diseases (OR, 3.21; 95% CI, 1.71–6.02), smoking (OR, 2.1; 95% CI, 1.28–3.45 [Model 1]; OR, 2.00; 95% CI, 1.26–3.16 [Model 2]), and occupation (OR, 1.47; 95% CI, 1.04–2.07 [ Model 1]; OR, 1.54; 95% CI, 1.11–2.16 [Model 2]).
Conclusions
. Diseases are the main predictors of self-assessed health in health professionals. Advancing age and smoking also contribute to poorer self-assessed health. Full article
Open AccessArticle
Dependence of Reaction Time and Movement Speed on Task Complexity and Age
Medicina 2013, 49(1), 4; https://doi.org/10.3390/medicina49010004 - 05 Feb 2013
Cited by 2 | Viewed by 343
Abstract
The aim of this study was to determine the differences in reaction time, reaction complexity, and movement speed depending on age.
Material and Methods
. The study included 40 healthy subjects (20 young and 20 older women and men). The study was conducted [...] Read more.
The aim of this study was to determine the differences in reaction time, reaction complexity, and movement speed depending on age.
Material and Methods
. The study included 40 healthy subjects (20 young and 20 older women and men). The study was conducted at the Human Motorics Laboratory, Lithuanian Sports University. An analyzer DPA-1 of dynamic upper and lower limb movements was used for the research purposes.
Results
. The reaction time of the right arm of the young subjects was 0.26 s (SD, 0.01) and that of the left arm was 0.25 s (SD, 0.02), when an accuracy task was performed. The reaction time of the older subjects was 0.29 s (SD, 0.03) and 0.28 s (SD, 0.03) for the right and left arms, respectively. The reaction time of the right leg of the young subjects was 0.26 s (SD, 0.02) and that of the left leg was 0.27 s (SD, 0.03). The reaction time of the right and left legs of the older subjects was 0.33 s (SD, 0.02) and 0.35 s (SD, 0.04), respectively. The reaction of the young subjects was almost two times faster compared with the older persons after the accuracy task with each limb was accomplished.
Conclusions
. In case of movements with arms and legs, reaction time and movement speed directly depend on the complexity of a task. Reaction time and movement speed are slower for the older subjects in comparison with the young ones; the results worsen in proportion to the increasing complexity of a task. Full article
Open AccessArticle
Susac’s Syndrome: A Case Presentation and Radiological Approach to this Rare Autoimmune Endotheliopathy
Medicina 2013, 49(1), 3; https://doi.org/10.3390/medicina49010003 - 27 Jan 2013
Viewed by 246
Abstract
Susac’s syndrome is an uncommon neurologic disorder, consisting of the clinical triad of encephalopathy, branch retinal artery occlusions, and hearing loss. We report a case of a sudden vision and hearing impairment in a 35-year-old female patient. Magnetic resonance imaging of the brain [...] Read more.
Susac’s syndrome is an uncommon neurologic disorder, consisting of the clinical triad of encephalopathy, branch retinal artery occlusions, and hearing loss. We report a case of a sudden vision and hearing impairment in a 35-year-old female patient. Magnetic resonance imaging of the brain revealed multiple lesions in the white matter and the corpus callosum, typical of Susac’s syndrome. Full article
Open AccessArticle
A Systematic Review of Phacoemulsification Cataract Surgery in Virtual Reality Simulators
Medicina 2013, 49(1), 1; https://doi.org/10.3390/medicina49010001 - 27 Jan 2013
Cited by 7 | Viewed by 290
Abstract
The aim of this study was to review the capability of virtual reality simulators in the application of phacoemulsification cataract surgery training. Our review included the scientific publications on cataract surgery simulators that had been developed by different groups of researchers along with [...] Read more.
The aim of this study was to review the capability of virtual reality simulators in the application of phacoemulsification cataract surgery training. Our review included the scientific publications on cataract surgery simulators that had been developed by different groups of researchers along with commercialized surgical training products, such as EYESI® and PhacoVision®. The review covers the simulation of the main cataract surgery procedures, i.e., corneal incision, capsulorrhexis, phacosculpting, and intraocular lens implantation in various virtual reality surgery simulators. Haptics realism and visual realism of the procedures are the main elements in imitating the actual surgical environment. The involvement of ophthalmology in research on virtual reality since the early 1990s has made a great impact on the development of surgical simulators. Most of the latest cataract surgery training systems are able to offer high fidelity in visual feedback and haptics feedback, but visual realism, such as the rotational movements of an eyeball with response to the force applied by surgical instruments, is still lacking in some of them. The assessment of the surgical tasks carried out on the simulators showed a significant difference in the performance before and after the training. Full article
Open AccessArticle
Comparison of Changes in Blood Glucose, Insulin Resistance Indices, and Adipokine Levels in Diabetic and Nondiabetic Subjects With Morbid Obesity After Laparoscopic Adjustable Gastric Banding
Medicina 2013, 49(1), 2; https://doi.org/10.3390/medicina49010002 - 26 Jan 2013
Viewed by 251
Abstract
Objective. The aim of the study was to evaluate blood glucose, insulin resistance indices, and adipokine (leptin and adiponectin) levels in morbidly obese individuals with and without type 2 diabetes mellitus and to compare the changes in these parameters 1 year after [...] Read more.
Objective. The aim of the study was to evaluate blood glucose, insulin resistance indices, and adipokine (leptin and adiponectin) levels in morbidly obese individuals with and without type 2 diabetes mellitus and to compare the changes in these parameters 1 year after laparoscopic adjustable gastric banding surgery.
Material and Methods
. In total, 103 patients (37 subjects with and 66 subjects without type 2 diabetes mellitus) were studied preoperatively and again 1 year after laparoscopic adjustable gastric banding.
Results
. One year after laparoscopic adjustable gastric banding, the leptin concentrations decreased significantly in both treatment groups, while the adiponectin levels increased significantly in the nondiabetic patients (11.19 μg/mL [SD 7.20] vs. 15.58 μg/mL [SD 7.8], P=0.003) and tended to increase in the group of the patients with type 2 diabetes mellitus (8.98 μg/mL [SD 6.80] vs. 13.01 μg/mL [SD 12.14], P>0.05). A considerable decrease in the insulin resistance indices was noted in the patients with type 2 diabetes mellitus 1 year after the intervention, and it was followed by a partial or complete remission of type 2 diabetes mellitus in 23 (85.19%) of the 27 investigated diabetic patients. The postoperative insulin resistance indices in the patients with type 2 diabetes mellitus became similar to the values in the nondiabetic subjects.
Conclusions
. Weight loss after laparoscopic adjustable gastric banding is associated with a significant increase in adiponectin secretion in nondiabetic morbidly obese patients and with improvement in adiponectin secretion in type 2 diabetes individuals. In subjects with type 2 diabetes, this surgical intervention results in a significant reduction in blood glucose and insulin resistance. Full article
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