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Volume 52, June
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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.
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Table of Contents

Medicina, Volume 52, Issue 2 (April 2016) – 9 articles , Pages 69-138

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Open AccessArticle
Relationship between the mandibular cortical index and calcaneal bone mineral density in postmenopausal women
Medicina 2016, 52(2), 125-131; https://doi.org/10.1016/j.medici.2016.02.005 - 11 Mar 2016
Cited by 1 | Viewed by 322
Abstract
Background and objective: In clinical practice, a comparative analysis of bone mineral density (BMD) is carried out by examining different skeletal bones. This is useful for screening of postmenopausal osteoporosis (OP). The objective of this study was to determine the relation between the [...] Read more.
Background and objective: In clinical practice, a comparative analysis of bone mineral density (BMD) is carried out by examining different skeletal bones. This is useful for screening of postmenopausal osteoporosis (OP). The objective of this study was to determine the relation between the mandibular cortical index (MCI) and calcaneal BMD among postmenopausal women.
Materials and methods: The study sample included 129 randomly selected postmenopausal women aged 50–77 years. The participants were examined using panoramic radiography for the analysis of the cortical layer in the mandibular base for MCI determination and using DXL for the examination of calcaneal BMD. According to T scores, the subjects were divided into three groups (Groups 1, 2, and 3). The panoramic radiographic examination of the mandible was performed; the MCI was determined and distributed into groups (C1; C2; C3). The MCI validity in determining the calcaneus BMD status was analyzed.
Results: The differences in BMD were statistically significant between Groups C1 and C3 (P < 0.01), Groups C2 and C3 (P = 0.01), and between the calcaneal BMD groups (P < 0.001). There was a statistically significant inverse correlation between the MCI and calcaneal BMD (r = −0.3; P < 0.001). The changes characteristic of Group C2 were documented more frequently than those of other morphological groups. The analysis of the MCI validity in BMD status showed low sensitivity (69.4%) and specificity (53.9%).
Conclusions: The relation between MCI and calcaneal BMD was determined. The diagnostic discrimination of the MCI was found to be not sufficient in screening the women with postmenopausal osteoporosis and its application in clinical practice might be limited. Full article
Open AccessArticle
Detection of miRNAs in urine of prostate cancer patients
Medicina 2016, 52(2), 116-124; https://doi.org/10.1016/j.medici.2016.02.007 - 11 Mar 2016
Cited by 23 | Viewed by 467
Abstract
Background and aim: Prostate cancer (PCa) is the second most prevalent oncologic disease among men worldwide. Expression of various transcripts, including miRNAs, is markedly deregulated in cancerous prostate tissue. This study aimed at identifying a PCa-specific expression profile of miRNAs for subsequent use [...] Read more.
Background and aim: Prostate cancer (PCa) is the second most prevalent oncologic disease among men worldwide. Expression of various transcripts, including miRNAs, is markedly deregulated in cancerous prostate tissue. This study aimed at identifying a PCa-specific expression profile of miRNAs for subsequent use in noninvasive diagnostics.
Materials and methods: MiRNA expression was profiled in 13 PCa tissues using human miRNA microarrays. Highly expressed miRNAs were selected for the analysis in urine of patients with PCa (N = 143) and benign prostate hyperplasia (BPH; N = 23) by means of real time PCR, while miRNAs showing the expression differences in relation to clinical variables were further analyzed in 52 PCa and 12 noncancerous prostate tissues (NPT) on TaqMan Low Density Arrays (TLDA).
Results: Analysis of miRNA expression in prostate tissue linked miR-95 to aggressive form of PCa. This miRNA was up-regulated in high grade (P = 0.041), the TMPRSS2-ERG fusionpositive tumors (P = 0.026), and in patients with subsequently developed biochemical recurrence (BCR; P = 0.054) after radical prostatectomy. MiRNAs highly expressed in PCa tissues were also detectable in urine from PCa patients. Moreover, the urinary levels of miR- 21 had significant discriminatory power (P = 0.010) to separate PCa patients from BPH, while the combined analysis of urinary miR-19a and miR-19b was prognostic for BCR. In PCa, the diagnostic potential of urinary miRNA panel (miR-21, miR-19a, and miR-19b) was higher than that of the PSA test (AUC = 0.738 vs. AUC = 0.514).
Conclusions: Measurement of urinary levels of PCa-specific miRNAs could assist in more specific detection of PCa and prediction of BCR. Full article
Open AccessArticle
Association between the use of renin-angiotensin system blockers and development of in-hospital atrial fibrillation in patients with ST-segment elevation myocardial infarction
Medicina 2016, 52(2), 104-109; https://doi.org/10.1016/j.medici.2016.02.006 - 11 Mar 2016
Cited by 2 | Viewed by 328
Abstract
Background and aim: Atrial fibrillation (AF) is the most common supraventricular arrhythmia following ST-segment elevation myocardial infarction (STEMI). We evaluated the associa- tion between use of previous angiotensin converting enzyme inhibitors and/or angiotensin receptor blockers (renin-angiotensin system [RAS] blockers) and started RAS blockers [...] Read more.
Background and aim: Atrial fibrillation (AF) is the most common supraventricular arrhythmia following ST-segment elevation myocardial infarction (STEMI). We evaluated the associa- tion between use of previous angiotensin converting enzyme inhibitors and/or angiotensin receptor blockers (renin-angiotensin system [RAS] blockers) and started RAS blockers after MI and development of AF in patients presenting with acute STEMI.
Materials and methods: This retrospective study enrolled 1000 patients with acute STEMI who were admitted to the coronary care unit. Patients were divided into groups according to the use of RAS blockers before MI and development of AF rates was compared. Predictors of AF were determined by multiple logistic regression analysis.
Results: Of the 1000 patients presenting with STEMI, 247 received and 753 did not receive RAS blockers. The incidence of AF was 7.9%. The incidence of AF in patients receiving RAS blockers and did not receiving RAS blockers before MI were similar (5.7% vs. 8.6% respectively, P = 0.13). On the other hand, AF rate was lower in patients in whom RAS blockers were administered during MI as compared to those in whom these agents were not administered (7.2% vs. 28.6%, P < 0.001). Multiple regression analysis results showed that administration of RAS blockers or statins during hospitalization and left atrial diameter were associated with development of AF in patients with acute STEMI.
Conclusions: Previous therapy with RAS blockers does not reduce the incidence of AF in STEMI. Administration of RAS blockers at the hospital may decrease the AF rate in STEMI. Full article
Open AccessArticle
Mean platelet volume and mean platelet volume/platelet count ratio in risk stratification of pulmonary embolism
Medicina 2016, 52(2), 110-115; https://doi.org/10.1016/j.medici.2016.03.001 - 10 Mar 2016
Cited by 8 | Viewed by 338
Abstract
Background and objective: Recently, some of the hemogram parameters were reported to predict early death in acute pulmonary embolism (PE). The aim of this study was to investigate the role of mean platelet volume (MPV) and MPV/platelet count ratio (MPV/P), WBC and red [...] Read more.
Background and objective: Recently, some of the hemogram parameters were reported to predict early death in acute pulmonary embolism (PE). The aim of this study was to investigate the role of mean platelet volume (MPV) and MPV/platelet count ratio (MPV/P), WBC and red cell distribution width (RDW) in risk stratification of patients with acute PE.
Materials and methods: We retrospectively reviewed the medical records of patients with acute PE admitted to the Emergency Department. In addition to the clinical evaluation, the hemogram parameters were measured on admission.
Results: A total of 152 patients were included. Patients with RV dysfunction had significantly higher MPV levels and MPV/P than patients without RV dysfunction. Receiver operating char- acteristiccurveanalysisrevealedthataMPVcut-offof7.85 fLprovidedasensitivityof53.3%anda specificity of 68.5%, and a MPV/P cut-off of 0.0339 fL/(109/L) provided a sensitivity of 69.6% and a specificity of 65% for the prediction of RV dysfunction. There was a positive correlation between MPV and systolic pulmonary artery pressure (SPAP) and between MPV and RV diameter. There was a positive correlation between MPV/P and SPAP and between MPV/P and RV diameter. The low-risk PE group had lower MPV and MPV/P than the massive PE and submassive PE groups.
Conclusions: MPV and MPV/P were found to be associated with RV dysfunction and clinical severity in acute PE. Low MPV and MPV/P levels may be an indicator of low risk and, high WBC levels may be an indicator of high risk in patients with acute PE. RDW levels may not reflect severity of acute PE. Full article
Open AccessReview
Hypertension, serum lipids and cancer risk: A review of epidemiological evidence
Medicina 2016, 52(2), 89-98; https://doi.org/10.1016/j.medici.2016.03.002 - 10 Mar 2016
Cited by 39 | Viewed by 571
Abstract
Although the association between blood pressure, serum lipids and cancer risk has been investigated, the results are controversial. The aim of this literature review was to examine the epidemiological evidence and provide overview of the association between blood pressure, serum lipids and cancer [...] Read more.
Although the association between blood pressure, serum lipids and cancer risk has been investigated, the results are controversial. The aim of this literature review was to examine the epidemiological evidence and provide overview of the association between blood pressure, serum lipids and cancer risk. The arterial hypertension is closely linked with renal cell cancer development. Risk of renal cell cancer was 2–4 times higher for persons with arterial hypertension, independently of sex. In some studies arterial hypertension as one of the components of the metabolic syndrome, was associated with a higher risk of colorectal, prostate cancer and malignant melanoma. Studies suggest that a higher total serum cholesterol level is linked with higher risk of colorectum, colon, prostate and testicular cancer and lower risk of stomach, liver and hematopoietic and lymphoid tissues cancer. There was positive association between serum triglycerides and esophageal, colorectal, lung, renal, thyroid cancer. Given that hypertension is a common risk factor worldwide and its control remains inadequate, our analysis supports the relevance of public health programs aimed at reducing hypertension to reduce the incidence of a number of cancers including renal cell cancer. Effective cholesterol control may lower the risk of cancer, but further studies with longer follow-up and repeated measurements of cholesterol and other lipids are needed. Full article
Open AccessReview
Genetic factors associated with the development of age-related macular degeneration
Medicina 2016, 52(2), 79-88; https://doi.org/10.1016/j.medici.2016.02.004 - 10 Mar 2016
Cited by 10 | Viewed by 385
Abstract
Age-related macular degeneration (AMD) affects the macula and is the leading cause of significant and irreversible central visual loss. It is the most common cause of visual loss in people aged more than 60 years. This disease affects 2.5 million individuals in Europe. [...] Read more.
Age-related macular degeneration (AMD) affects the macula and is the leading cause of significant and irreversible central visual loss. It is the most common cause of visual loss in people aged more than 60 years. This disease affects 2.5 million individuals in Europe. AMD is caused by both environmental and genetic factors. Numerous risk factors have been reported, but the pathogenesis of AMD is complex and fairly understood. Age, female gender, obesity, race, education status, family history, hyperopia, iris color, cigarette smoking, previ- ous cataract surgery, history of cardiovascular and cerebrovascular disease, diabetes, sunlight exposure and many other factors have been shown to be associated with AMD development. Scientific evidence shows that genes may play a role in the development of nearly 3 out of 4 cases of this devastating eye disease. The genes that have been shown to be associated with AMD are genes encoding complement system components such as CFH, C2, C3, CFB, and other. Full article
Open AccessArticle
Smoking during pregnancy in association with maternal emotional well-being
Medicina 2016, 52(2), 132-138; https://doi.org/10.1016/j.medici.2016.02.003 - 03 Mar 2016
Cited by 4 | Viewed by 353
Abstract
Objective: The aim of the study was to investigate psychosocial predictors of smoking during pregnancy.
Materials and methods: It was a cross-sectional analysis of a prospective birth-cohort study. The participants were 514 mothers of full-term infants. Women completed questionnaires during hospital stay after [...] Read more.
Objective: The aim of the study was to investigate psychosocial predictors of smoking during pregnancy.
Materials and methods: It was a cross-sectional analysis of a prospective birth-cohort study. The participants were 514 mothers of full-term infants. Women completed questionnaires during hospital stay after delivery. Questionnaire included items on sociodemographic characteristics, planning and emotional acceptance of pregnancy, reproductive history, health-related behavior, emotional well-being, and relationships with a partner.
Results: Smoking during pregnancy was reported by 14.8% of the participants. Prenatal smoking was associated with secondary or lower education, maternal age less than 20 years, childbirth outside of marriage, history of elective abortion, unplanned pregnancy, lack of positive emotional acceptance of pregnancy by mother and father, emotional distress and alcohol consumption during pregnancy. Smoking during pregnancy remained significantly associated with prenatal alcohol consumption, previous elective abortion, and lack of positive emotional acceptance of pregnancy by mother even after adjustment for maternal age, education, and family structure.
Conclusions: Results support an idea of complexity of the relationships among smoking, alcohol use, and emotional well-being. Lack of positive emotional acceptance of pregnancy by mother and history of elective abortions can be considered as possible associates of smoking during pregnancy and suggest that strengthening of positive attitudes toward motherhood could add to lower smoking rates among pregnant women. Full article
Open AccessReview
Multidrug-resistant tuberculosis in Lithuania – Still a long way ahead
Medicina 2016, 52(2), 69-78; https://doi.org/10.1016/j.medici.2016.02.002 - 03 Mar 2016
Cited by 2 | Viewed by 270
Abstract
Despite the recent advances in the diagnosis of tuberculosis, treatment of the disease, for the most part, remains the same as it was half a century ago. In recent years only two new antituberculosis drugs have been approved by the European Medicines Agency [...] Read more.
Despite the recent advances in the diagnosis of tuberculosis, treatment of the disease, for the most part, remains the same as it was half a century ago. In recent years only two new antituberculosis drugs have been approved by the European Medicines Agency and Food and Drug Administration. Though the prevalence of this disease is slowly decreasing all over Europe, new challenges appear. One of them is multidrug-resistant tuberculosis (MDR-TB). This problem is especially prominent in Lithuania, which is one of the 27 high MDR-TB burden countries in the world and falls behind neighboring countries in terms of the prevalence of the disease. The objective of this paper was to review the situation of tuberculosis and MDR-TB in Lithuania, and current available methods of treatment, control and diagnosis of this disease. Full article
Open AccessArticle
N-carboxymethyllysine as a biomarker for coronary artery disease and age-related macular degeneration
Medicina 2016, 52(2), 99-103; https://doi.org/10.1016/j.medici.2016.02.001 - 22 Feb 2016
Cited by 1 | Viewed by 301
Abstract
Background and objective: An association between coronary artery disease (CAD) and agerelated macular degeneration (ARMD) has long been postulated, but exact mechanisms remain unclear. The global prevalence of CAD and ARMD increases and early biomarkers for early diagnosis of these diseases are necessary. [...] Read more.
Background and objective: An association between coronary artery disease (CAD) and agerelated macular degeneration (ARMD) has long been postulated, but exact mechanisms remain unclear. The global prevalence of CAD and ARMD increases and early biomarkers for early diagnosis of these diseases are necessary. The aim of this study was to investigate the plasma level of oxidative stress biomarker CML in patients with and without angiographic findings of atherosclerosis in the coronary arteries (CADath+ and CADath, respectively) and to assess if there was an association of CAD with ARMD.
Materials and methods: The study enrolled 233 subjects. Based on cardiologic and ophthal- mologic examinations, the patients were divided into four subgroups: CADath+ARMD+, CADath+ARMD−, CADath−ARMD+, and CADath−ARMD−. The enzyme-linked immunosorbent assay was used for the measurement of plasma CML levels. Serum lipid levels were determined by an automatic analyzer using conventional enzymatic methods.
Results: CADath+ patients had higher CML concentration compared to CADath subjects (1.04 ± 0.6 vs. 0.83 ± 0.4 ng/mL, P < 0.001). The highest mean CML level (1.12 ± 0.7 ng/mL) was found in CADath+ARMD+ patients. The mean plasma CML concentration was higher in subjects with any of the analyzed diseases compared to CADath−ARMD− subjects. A significant positive association of CADath+ (OR = 2.50, 95% CI 1.60–3.90, P = 0.0001), ARMD (OR = 2.08, 95% CI 1.40–3.11, P = 0.0001) and both analyzed diseases (OR = 4.67, 95% CI 2.29– 9.53, P = 0.0001) with an increased level of plasma CML in a logistic regression model adjusting by age was identified.
Conclusions: The level of CML, an oxidative stress biomarker, reflects the presence of atherosclerosis in coronary arteries and shows a possible link between ARMD and CADath+ via oxidative status. Full article
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