Next Issue
Volume 53, October
Previous Issue
Volume 53, June
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 53, Issue 4 (August 2017) , Pages 217-293

  • Issues are regarded as officially published after their release is announced to the table of contents alert mailing list.
  • You may sign up for e-mail alerts to receive table of contents of newly released issues.
  • PDF is the official format for papers published in both, html and pdf forms. To view the papers in pdf format, click on the "PDF Full-text" link, and use the free Adobe Readerexternal link to open them.
Order results
Result details
Select all
Export citation of selected articles as:
Open AccessArticle
Functional and biochemical adaptations of elite level futsal players from Brazil along a training season
Medicina 2017, 53(4), 285-293; https://doi.org/10.1016/j.medici.2017.08.001 - 26 Aug 2017
Viewed by 331
Abstract
Background and objective: Although hard training is mandatory in elite level futsal training, few studies have proposed a biochemical follow up in futsal players during a whole season. Therefore, the aim of this study was to compare functional and biochemical markers in Brazilian [...] Read more.
Background and objective: Although hard training is mandatory in elite level futsal training, few studies have proposed a biochemical follow up in futsal players during a whole season. Therefore, the aim of this study was to compare functional and biochemical markers in Brazilian elite level futsal players throughout a competition season.
Materials and methods: Eight players aged 25.5 ± 5.4 years were evaluated at three time points: preseason (T1), immediately before the FIFA®-Intercontinental-Futsal-Cup (T2), and at the end of the season (T3), with a tapering period of 1 week before T2. Functional parameters (weight, height, body fat, VO2max, heart rate, and distance ran) and blood sampling for cell count and lipid profile (cholesterol, HDL-C, LDL-C, triglycerides) were assessed at each time point. After, a Yo-Yo R2 test was carried out in each time point (T1, T2 and T3) and blood samples to assess skeletal muscle damage (creatine kinase [CK], lactate dehydrogenase [LDH]), inflammation (C-reactive protein [CRP]) and oxidative stress markers (ischemia modified albumin [IMA], and advanced oxidation protein products [AOPP]) were obtained before and after the tests.
Results: Although functional parameters did not change throughout the season, greater total number of erythrocytes (P ≤ 0.05), and hemoglobin (P ≤ 0.05) were found at T2 compared to T1. Similarly, lower LDH (P ≤ 0.05) and CK (P ≤ 0.05) levels were found at T2 compared to T1. CPR levels were also decreased at T2 in comparison to T1 both before and after Yo-Yo R2 test (P ≤ 0.05), while IMA and AOPP levels showed only a season effect (P ≤ 0.05).
Conclusions: The tapering strategy was successful considering players presented lower levels of muscle damage, inflammation and oxidative stress makers before T2, which preceded the main championship of the year. These results are of great relevance, considering the team won the FIFA®-Intercontinental-Futsal-Cup, which happened at T2. Thus, it seems that routine-based biochemical markers may be useful as training control means in this population. Full article
Show Figures

Figure 1

Open AccessArticle
Psychological and physical well-being of Lithuanian youth: Relation to emotional intelligence
Medicina 2017, 53(4), 277-284; https://doi.org/10.1016/j.medici.2017.05.008 - 05 Aug 2017
Viewed by 403
Abstract
Objective: The objective of this article is to unveil the ways in which the emotional intelli- gence (EI) of a young person is linked with subjective assessment of physical state, depressiveness, anxiety, and psychological well-being, as well as to determine whether these factors [...] Read more.
Objective: The objective of this article is to unveil the ways in which the emotional intelli- gence (EI) of a young person is linked with subjective assessment of physical state, depressiveness, anxiety, and psychological well-being, as well as to determine whether these factors are reliable predictors of EI constituents.
Materials and methods: The study was conducted using an original EI test (EI-DARL-V1/V2), which consisted of a traditional 73-item questionnaire; tasks of emotional, social and interpersonal situations; and identification of emotions in facial expressions (pictures). Questionnaire items were multiplexed into 5 subscales using multi-step factor analysis. Special questionnaires were devised and presented to participants together with the EI questionnaire in order to assess subjective assessment of physical and mental health, depressiveness, anxiety, and psychological well-being. There were 1430 participants from various regions of Lithuania who participated in the study. The age of participants varied from 17 to 27 years.
Results: Established inverse linear correlation showed that those participants who experi- enced certain somatic symptoms or unpleasant psychological states had lower EI; a particularly strong correlation was observed between poor subjective assessment of health and understanding and control of one's own emotions. Depressed and anxious participants possessed poorer understanding and ability to regulate emotions of others as well as their own. Also, these participants performed worse when resolving emotional, social, and interpersonal situations. A direct relationship between EI and psychological well-being was established according to three EI indexes i.e. (a) understanding of own emotions; (b) understanding of emotions of other people; (c) control of emotions of others. As perception of psychological well-being increased, participants were able to understand emotions of others better and demonstrated even better ability to understand and control their own emotions. The study failed to determine whether emotion recognition from non-verbal signs (face pictures) was related to at least one of the previously mentioned indexes.
Conclusions: The study revealed that the factors such as subjective assessment of physical and mental health, depressiveness, anxiety, and psychological well-being were reliable predictors of certain EI indexes. Full article
Open AccessArticle
Influences of red blood cell and platelet counts on the distribution and elimination of crystalloid fluid
Medicina 2017, 53(4), 233-241; https://doi.org/10.1016/j.medici.2017.07.005 - 03 Aug 2017
Viewed by 288
Abstract
Background and objective: A high number of blood cells increases the viscosity of the blood. The present study explored whether variations in blood cell counts are relevant to the distribution and elimination of infused crystalloid fluid.
Materials and methods: On three [...] Read more.
Background and objective: A high number of blood cells increases the viscosity of the blood. The present study explored whether variations in blood cell counts are relevant to the distribution and elimination of infused crystalloid fluid.
Materials and methods: On three different occasions, 10 healthy male volunteers received an intravenous infusion of 25 mL/kg of Ringer's acetate, Ringer's lactate, and isotonic saline over 30 min. Blood hemoglobin and urinary excretion were monitored for 4 h and used as input in a two-volume kinetic model, using nonlinear mixed effects software. The covariates used in the kinetic model were red blood cell and platelet counts, the total leukocyte count, the use of isotonic saline, and the arterial pressure.
Results: Red blood cell and platelet counts in the upper end of the normal range were associated with a decreased rate of distribution and redistribution of crystalloid fluid. Simulations showed that high counts were correlated with volume expansion of the peripheral (interstitial) fluid space, while the plasma volume was less affected. In contrast, the total leukocyte count had no influence on the distribution, redistribution, or elimination. The use of isotonic saline caused a transient reduction in the systolic arterial pressure (P < 0.05) and doubled the half-life of infused fluid in the body when compared to the two Ringer solutions. Isotonic saline did not decrease the serum potassium concentration, despite the fact that saline is potassium-free.
Conclusions: High red blood cell and platelet counts are associated with peripheral accumulation of infused crystalloid fluid.
Full article
Show Figures

Figure 1

Open AccessArticle
Utilization of cardiovascular medicines and cardiovascular mortality in Lithuania, Sweden and Norway in 2003–2012
Medicina 2017, 53(4), 259-267; https://doi.org/10.1016/j.medici.2017.07.004 - 31 Jul 2017
Cited by 1 | Viewed by 308
Abstract
Objective: The aim of this ecological study was to evaluate whether any changes in cardio-vascular (CV) medicine utilization, population, socioeconomic and health system factors were associated with CV mortality in Lithuania, Sweden and Norway in 2003–2012.
Materials and methods: CV drug [...] Read more.
Objective: The aim of this ecological study was to evaluate whether any changes in cardio-vascular (CV) medicine utilization, population, socioeconomic and health system factors were associated with CV mortality in Lithuania, Sweden and Norway in 2003–2012.
Materials and methods: CV drug utilization was calculated using the Anatomical Therapeutic Chemical/Defined Daily Dose (DDD) methodology and expressed as a number of DDD per 1000 inhabitants per day (DDD/TID). The CV age-standardized death rate (CV-SDR) and risk factors data were obtained from the WHO, EUROSTAT, and FAOSTAT databases. The multiple linear regression model was used for modeling outcome measures - the relationship between the CV-SDR and CV medicine utilization including socioeconomic (GDP, unemployment and divorce rate), population (alcohol consumption, smoking and amount of kcal per day, consumption of fruit and vegetables, health status self-evaluation) and health system factors (number of hospital beds, practicing physicians and health care expenditure).
Results: The higher CV medicine utilization in Sweden (307–455 DDD/TID, P < 0.001) and Norway (306–394 DDD/TID, P < 0.001) was associated with a definite decline in CV-SDR (in Norway from 215 to 146 and in Sweden from 233 to 174). In Lithuania, the increasing but lower consumption of CV medicines (135–360 DDD/TID, P < 0.001) and twice higher CV-SDR (from 541 to 447) was registered. A significant inverse correlation was observed between CVSDR and DDD/TID. We found a strong association between the DDD/TID and the CV-SDR (R2 = 0.67, P < 0.001). There was a strong correlation between CV-SDR and nine factors (P < 0.05), except the number of practicing physicians, amount of kcal per day. There was a strong correlation between DDD/TID and nine factors (P < 0.05), except the unemployment rate and amount of kcal per day. Association between an increase in the use of medicines and a decrease in CV-SDR was stronger in the case of higher alcohol consumption, higher number of available beds in hospitals and the lower unemployment rate.
Conclusions: We confirmed the strong negative correlation between CV medicine utilization and CV mortality in all countries. The strong correlation was found between CV-SDR and nine factors, also between the use of CV medicines and nine factors. The impact of factors on the medicines induced decrease in CV-SDR showed the stronger influence in case of lower unemployment, higher alcohol consumption and higher number of beds for hospitalization. Full article
Show Figures

Figure 1

Open AccessArticle
Factors influencing renal graft survival: 7-Year experience of a single center
Medicina 2017, 53(4), 224-232; https://doi.org/10.1016/j.medici.2017.07.003 - 29 Jul 2017
Cited by 3 | Viewed by 412
Abstract
Background and objective: The demand for kidney transplants exceeds the existing supply. This leads to a recently growing interest of research in the area of factors that could prolong graft long-term outcomes and survival. In Lithuania, approximately 90% of kidney transplantations are [...] Read more.
Background and objective: The demand for kidney transplants exceeds the existing supply. This leads to a recently growing interest of research in the area of factors that could prolong graft long-term outcomes and survival. In Lithuania, approximately 90% of kidney transplantations are from deceased donors. Donor organs are received and shared only inside the country territory in Lithuania; therefore, donor data is accurate and precise. This study was performed to present particularities of kidney transplantation data in Lithuania and to identify the effect of donor and recipient factors and histologic findings on renal graft outcomes. The aim of this study was to identify the effect of donor and recipient factors and histologic findings on renal graft outcomes.
Materials and methods: We analyzed the influence of deceased donor and recipient factors and histological findings on the graft function in 186 renal transplant patients. Graft survival was estimated within the first year after transplantation.
Results: The donors and recipients were older in worse eGFR group 1 year after transplantation. Dissimilarity of degree of glomerulosclerosis (GS), interstitial fibrosis (IF) and arteriolar hyalinosis (AH) were significant in inferior and superior renal function groups (GS >20% 11.4 vs. 0%, P = 0.017; IF 9.3 vs. 0%, P = 0.034; AH 69 vs. 26.2%, P < 0.001). Nine independent variables were significantly associated with a worse renal transplant function 1 year posttransplantation: AH (OR = 6.287, P < 0.001), an episode of urinary tract infection (OR = 2.769, P = 0.020), acute graft rejection (OR = 3.605, P = 0.037), expanded criteria (OR = 4.987, P = 0.001), female gender donors (OR = 3.00, P = 0.014), cerebrovascular disease caused donor brain death (OR = 5.00, P = 0.001), donor's age (OR = 1.07, P < 0.001), and recipient's age (OR = 1.047, P = 0.022). Worse renal graft survival 1 year posttransplantation was associated with a delayed graft function and a higher level of glomerulosclerosis in time-zero biopsy.
Conclusions: Donor factors, such as age, female gender, brain death of cerebrovascular cause and expanded criteria donor status had a significant negative impact on the renal graft function 1 year after transplantation. Recipients' age, urinary tract infection and acute graft rejection episodes after transplantation were associated with a worse kidney function 1 year after transplantation. Lower 1-year graft survival was related to a delayed graft function (DGF) and a higher degree of glomerulosclerosis.
Full article
Show Figures

Figure 1

Open AccessArticle
Prevalence of cardiovascular disease risk factors in Tallinn, Estonia
Medicina 2017, 53(4), 268-276; https://doi.org/10.1016/j.medici.2017.07.002 - 25 Jul 2017
Cited by 2 | Viewed by 329
Abstract
Background and objective: Cardiovascular diseases are still a major public health concern in Estonia despite the decline in the mortality rate during the past decade. For better preventive strategies we aimed to investigate the prevalence of cardiovascular disease risk factors and their relations [...] Read more.
Background and objective: Cardiovascular diseases are still a major public health concern in Estonia despite the decline in the mortality rate during the past decade. For better preventive strategies we aimed to investigate the prevalence of cardiovascular disease risk factors and their relations with age, gender and ethnicity.
Materials and methods: The cross-sectional study was carried out in Tallinn, Estonia. Two hundred individuals from each of the sex and 10-year age group (range 20–65 years of age) were randomly selected and invited to participate. Final study sample consisted of 511 men and 600 women (mean age of 46 years). Physiological measurements were taken and blood samples were drawn for standard measurements of the following markers: total cholesterol, high- and low-density lipoprotein cholesterol, apolipoproteins, triglycerides, glucose and inflammatory markers.
Results: Overall, 31% of the study subjects had high blood pressure, 23% had metabolic syndrome, and 55% were overweight/obese. The prevalence of all risk factors increased with age amongst both genders. The proportion of individuals having increased cholesterol, apolipoprotein B-100, and homocysteine levels was very high amongst both genders (60–80%). More Russians and other ethnic minorities compared to ethnic Estonians had calculated 10-year CHD risk ≥ 10%.
Conclusions: The study established a high prevalence of cardiovascular disease risk factors in Estonian adults (20–65 years of age). Younger portion of the population and some extent ethnic considerations should be taken into account when designing future studies, health prevention activities and interventions. Full article
Open AccessArticle
Morphometric parameters of the optic disc in normal and glaucomatous eyes based on time-domain optical coherence tomography image analysis
Medicina 2017, 53(4), 242-252; https://doi.org/10.1016/j.medici.2017.05.007 - 18 Jul 2017
Cited by 1 | Viewed by 375
Abstract
Background and objective: Assessment of optic disc morphology is essential in diagnosis and management of visual impairment. The aim of this study was to evaluate associations between optic disc morphometric parameters, i.e., size and shape, and age, gender, and ocular axial length [...] Read more.
Background and objective: Assessment of optic disc morphology is essential in diagnosis and management of visual impairment. The aim of this study was to evaluate associations between optic disc morphometric parameters, i.e., size and shape, and age, gender, and ocular axial length in normal and glaucomatous eyes based on time-domain optical coherence tomography image analysis.
Materials and methods: It was a case–control study of 998 normal and 394 eyes with primary open angle glaucoma that underwent an ophthalmological examination and time-domain optical coherence topography scanning. Areas and shapes of the disc, cup, and neuroretinal rim were analyzed.
Results: The shape of the optic disc did not differ between the study groups, i.e., normal and glaucomatous case groups, but the disc area of the primary open angle glaucoma group was significantly larger. The shape of the small disc was significantly different, but the shape of the medium and the large disc did not differ between the study groups. The central area of the disc, i.e., cup area was significantly larger in the case group and its shape was significantly different between the study groups. No significant differences in the area of the cup and its shape, nerve fibers on the edge of the disc, i.e., neuroretinal rim area, were found between the study groups of the small discs. There were significant associations between age, gender, and ocular axial length and morphometric parameters of the optic disc.
Conclusions: Informative results with regard to the size and shape due to various ocular characteristics between the healthy control group and patients suffering with primary open angle glaucoma were obtained. Both study groups were significant in size, which makes the findings interesting and important contribution in the field. Full article
Open AccessArticle
Mortality prediction in patients with acute kidney injury requiring renal replacement therapy after cardiac surgery
Medicina 2017, 53(4), 217-223; https://doi.org/10.1016/j.medici.2017.06.003 - 14 Jul 2017
Cited by 4 | Viewed by 406
Abstract
Background and objective: Acute kidney injury (AKI) is a common and potentially serious postoperative complication after cardiac surgery, and it remains a cause of major morbidity and mortality. The aim of our study was to assess the prognostic illness severity score and [...] Read more.
Background and objective: Acute kidney injury (AKI) is a common and potentially serious postoperative complication after cardiac surgery, and it remains a cause of major morbidity and mortality. The aim of our study was to assess the prognostic illness severity score and to estimate the significant risk factors for poor outcome of patients with AKI requiring renal replacement therapy (RRT) after cardiac surgery.
Materials and methods: We retrospectively analyzed data of adult (>18 years) patients (n = 111) who underwent open heart surgery and had developed AKI with need for RRT. Prognostic illness severity scores were calculated and perioperative risk factors of lethal outcome were assessed at the RRT initiation time. We defined three illness severity scores: Acute Physiology and Chronic Health Evaluation (APACHE II) as a general score, Sequential Organ Failure Assessment (SOFA) as an organ failure score, and Liano score as a kidney-specific disease severity score. Logistic regression was also used for the multivariate analysis of mortality risk factors.
Results: Hospital mortality was 76.5%. More than 7% of patients remained dialysis-dependent after their discharge from the hospital. The prognostic abilities of the scores were assessed for their discriminatory power. The area under the receiver-operating characteristic (ROC) curve of SOFA score was 0.719 (95% CI, 0.598–0.841), of Liano was 0.661 (95% CI, 0.535–0.787) and 0.668 (95% CI, 0.550–0.785) of APACHE II scores. From 16 variables analyzed for model selection, we reached a final logistic regression model, which demonstrated four variables significantly associated with patients' mortality. Glasgow coma score < 14 points (OR = 3.304; 95% CI, 1.130–9.662; P = 0.003), mean arterial blood pressure (MAP) < 63.5 mmHg (OR = 3.872; 95% CI, 1.011–13.616; P = 0.035), serum creatinine > 108.5 µmol/L (OR = 0.347; 95% CI, 0.123–0.998; P = 0.046) and platelet count < 115 × 109/L (OR = 3.731; 95% CI, 1.259–11.054; P = 0.018) were independent risk factors for poor patient outcome.
Conclusions: Our study demonstrated that SOFA score estimation is the most accurate to predict the fatal outcome in patients with AKI requiring RRT after cardiac surgery. Lethal patient outcome is related to Glasgow coma score, mean arterial blood pressure, preoperative serum creatinine and postoperative platelet count.
Full article
Show Figures

Figure 1

Open AccessArticle
Periodontal status in 18-year-old Lithuanian adolescents: An epidemiological study
Medicina 2017, 53(4), 253-258; https://doi.org/10.1016/j.medici.2017.06.002 - 23 Jun 2017
Cited by 1 | Viewed by 415
Abstract
Objective: The aim of this study was to investigate the periodontal and oral hygiene status of 18-year-old Lithuanian adolescents.
Materials and methods: Cross-sectional data were collected by a multistage sampling approach that was used to draw a representative sample of 1063 [...] Read more.
Objective: The aim of this study was to investigate the periodontal and oral hygiene status of 18-year-old Lithuanian adolescents.
Materials and methods: Cross-sectional data were collected by a multistage sampling approach that was used to draw a representative sample of 1063 adolescents attending schools. In total, 20 schools from the alphabetical list of educational institutions in Lithuania agreed to participate. Periodontal status was evaluated using the Periodontal Screening and Recording (PSR) index. The oral hygiene status was assessed using the Silness-Löe plaque index.Results: The analysis of the PSR index showed that 77.1% of the study population exhibited gum bleeding on probing, had supragingival and/or subgingival calculus, and shallow pockets. Analysis of the composition of the PSR index revealed that in children whose parents had low education levels (18.6%), gum bleeding was more common than in those whose parents had medium education levels (9.5%) (P < 0.05). Our data showed that in 40.0% of the study participants, oral hygiene status was satisfactory, with a statistically significant difference between boys (46.9%) and girls (35.3%) (P < 0.001).
Conclusions: The results of our study showed that the periodontal and oral hygiene status of 18-year-old Lithuanian population could be characterized as poor. In total, 77.1% of the study participants were found to have periodontal conditions such as gum bleeding, dental calculus, and shallow pockets. The anterior teeth of the mandible were most frequently affected. Full article
Previous Issue
Next Issue
Back to TopTop