Medicina

171 KiB

Open AccessArticle

Research for practice: a new in vitro test for identification of tuberculosis infection

by Edita Hansted, Brigita Šitkauskienė, Rimantas Kėvalas, Andrea Tattersall and Toni Day

Medicina 2007, 43(7), 519; https://doi.org/10.3390/medicina43070065 - 04 Jul 2007

Cited by 3 | Viewed by 816

Tuberculosis is one of the biggest global health problems. One-third of the world’s population (2 billion) is latently infected with tuberculosis. The tuberculin skin test is commonly used to diagnose tuberculosis infection. This test has poor specificity and sensitivity, cross-reactivity with bacille Calmette-Guérin [...] Read more.

Tuberculosis is one of the biggest global health problems. One-third of the world’s population (2 billion) is latently infected with tuberculosis. The tuberculin skin test is commonly used to diagnose tuberculosis infection. This test has poor specificity and sensitivity, cross-reactivity with bacille Calmette-Guérin vaccination and many environmental mycobacteria, and poor sensitivity (only 75–90% in active tuberculosis). Mycobacterium tuberculosis activates a strong T cell-mediated immune response. That is why, a better marker for tuberculosis infection could be the presence of mycobacteria specific interferon-y-secreting T cells. These cells can be identified in blood or any other sample, which contains T cells. The test specificity is 99.9% (in low-risk control groups), and the sensitivity is 97.2% (in subjects with culture-confirmed active disease). New in vitro diagnostic test of tuberculosis, based on tuberculosis-induced immunological mechanisms, seems to be more specific and useful as previous methods. Full article

211 KiB

Open AccessArticle

Analysis of anthocyanin content in bilberry (Vaccinium myrtillus L.) fruit crude drugs by high-performance liquid chromatography method

by Deividas Burdulis, Liudas Ivanauskas, Valdas Jakštas and Valdimaras Janulis

Medicina 2007, 43(7), 568; https://doi.org/10.3390/medicina43070072 - 03 Jul 2007

Cited by 3 | Viewed by 934

Abstract

Bilberry (Vaccinium myrtillus L.) is rich in flavonoids (major part anthocyanins), tannins, phenolic and organic acids, and other biologically active compounds. Anthocianins possess a broad spectrum of therapeutic properties. Variation in anthocyanin content of bilberry fruit crude drugs is significant in optimizing [...] Read more.

Bilberry (Vaccinium myrtillus L.) is rich in flavonoids (major part anthocyanins), tannins, phenolic and organic acids, and other biologically active compounds. Anthocianins possess a broad spectrum of therapeutic properties. Variation in anthocyanin content of bilberry fruit crude drugs is significant in optimizing collection conditions. Bilberry (Vaccinium myrtillus L.) crude drug samples were collected in July–September of 2006 in natural environment in the territory of Lithuania. Ultrasonic extraction was applied using methanol as solvent. Acidic hydrolysis was performed. Qualitative and quantitative composition of five major anthocyanidins (delphinidin, cyanidin, petunidin, peonidin, and malvidin) was estimated by high-performance liquid chromatography in frozen fruits. Cyanidin predominated in all crude drug samples. Dynamics of variation in qualitative and quantitative composition of anthocyanidins was estimated in bilberry fruits collected during vegetation period. The greatest total amount of all analyzed anthocyanidins was determined at the end of investigated period. Variation in qualitative and quantitative content of anthocyanidins in bilberry fruits collected in different regions of Lithuania was estimated as well. The greatest total amounts of anthocyanidins were found in samples collected in Krikštoniai forest (1.78%) and Prienai pinewood (2.13%) and the lowest amounts – in samples collected in Balkasodis forest (1.14%) and Ryliškės forest (0.99%). Significant variation in anthocyanidin content reaching 28.40% (delphinidin) was determined in bilberry fruits. It is important for the standardization of bilberry fruit crude drugs. Full article

419 KiB

Open AccessArticle

Models of intracranial aneurysms for angiographic imaging modalities. A technical note

by Edvardas Žurauskas, Jurgita Ušinskienė, Virginija Gaigalaitė, Raphael Blanc, Andrius Ušinskas and Arvydas Laurinavičius

Medicina 2007, 43(7), 562; https://doi.org/10.3390/medicina43070071 - 03 Jul 2007

Cited by 1 | Viewed by 759

Abstract

Objective. To delineate technical aspects of vascular models with intracranial aneurysm in vitro production, suitable for angiographic imaging.
Material and methods. Wax (K2 exact, S-U-CERAMO-CAPS-WAX), Girtl’s mass, gelatin, and silicone (Silicone 10015 Den Braven, Elastosil 7683/25, Elite Double 32 Shore-A, Rema-Sil) [...] Read more.

Objective. To delineate technical aspects of vascular models with intracranial aneurysm in vitro production, suitable for angiographic imaging.
Material and methods. Wax (K2 exact, S-U-CERAMO-CAPS-WAX), Girtl’s mass, gelatin, and silicone (Silicone 10015 Den Braven, Elastosil 7683/25, Elite Double 32 Shore-A, Rema-Sil) were used for model production. Construction of models was based on T-shaped plastic tube connections and lost core techniques. Images of rotational angiography, glass tubes with aneurysm, and casts obtained in human specimen were used as samples of cerebral arteries.
Results. Technical aspects of vascular models production were delineated in experience of eight silicone models produced. M1 was hand made with basilar tip aneurysm; M2 was obtained according to angiography images with internal carotid artery supraclinoid part bifurcation to anterior and middle cerebral artery aneurysm. BM1 and BM2 casts were made using glass tubes with lateral aneurysm, M3 – from T-shaped plastic tubes with lateral aneurysms. M4, M5, and M6 were formed using casts obtained in human specimen with basilar tip aneurysm.
Conclusions. Silicone of two components is practical for casts of cerebral arteries in human specimen production. Gelatinous solution 50°C diluted 1:1 with water can be used for copies of arterial casts production. Wax materials are unsuitable for making casts in a human specimen. Full article

385 KiB

Open AccessArticle

Relationship of arterial wall parameters to cardiovascular risk factors and cardiovascular risk assessed by SCORE system

by Milda Kovaitė, Žaneta Petrulionienė, Ligita Ryliškytė, Jolita Badarienė, Alma Čypienė, Vilma Dženkevičiūtė and Aleksandras Laucevičius

Medicina 2007, 43(7), 529; https://doi.org/10.3390/medicina43070067 - 17 Jun 2007

Cited by 4 | Viewed by 759

Abstract

Objective. To investigate the relationship of arterial wall parameters (flow-mediated dilatation of the brachial artery, augmentation index, pulse wave velocity, stiffness index, carotid intima-media thickness) to conventional cardiovascular risk factors and cardiovascular risk assessed by SCORE system. Material and methods. A [...] Read more.

Objective. To investigate the relationship of arterial wall parameters (flow-mediated dilatation of the brachial artery, augmentation index, pulse wave velocity, stiffness index, carotid intima-media thickness) to conventional cardiovascular risk factors and cardiovascular risk assessed by SCORE system. Material and methods. A total of 209 subjects aged 40–65 years without clinically overt cardiovascular disease were examined. Parameters of arterial stiffness were obtained by two methods: augmentation index and carotid-radial pulse wave velocity by applanation tonometry and stiffness index by the means of finger photoplethysmography. Flow-mediated dilatation of the brachial artery, reflecting endothelial function, and carotid intima-media thickness was determined using a high-resolution B-mode ultrasonography.
Results. Age and the presence of diabetes strongly influenced all parameters of the arterial wall (diabetes was not independent predictor when evaluating augmentation index). Mean arterial pressure and gender were independent predictors for arterial stiffness parameters – carotid-radial pulse wave velocity and augmentation index. Flow-mediated dilatation was strongly dependent on the diameter of the brachial artery, age, and body mass index. Using logistic regression, it was found that pulse wave velocity (P=0.014), intima-media thickness (P=0.004), and flow-mediated dilatation (P=0.020) were important parameters dividing subjects to the groups of increased (³5%) and low (<5%) cardiovascular risk assessed by SCORE system. The cutoff values for intima-media thickness and pulse wave velocity were 0.078 cm and 8.95 m/s, respectively.
Conclusions. Arterial wall parameters are closely associated with conventional risk factors; they are influenced by age and the presence of diabetes. Arterial stiffness parameters are also influenced by mean arterial pressure; high-density lipoprotein cholesterol has influence on carotid intima-media thickness. Cutoff values for carotid intima-media thickness and carotid-radial pulse wave velocity could help to discriminate patients with increased cardiovascular risk. Full article

207 KiB

Open AccessArticle

Clinical forms of infective endocarditis in Kaunas University of Medicine Hospital in 2002–2005

by Diana Žaliaduonytė-Pekšienė, Regina Jonkaitienė, Petras Zabiela and Reda Aržanauskienė

Medicina 2007, 43(7), 523; https://doi.org/10.3390/medicina43070066 - 13 Jun 2007

Cited by 3 | Viewed by 875

Abstract

Objectives. To determine the incidence and distribution of clinical forms of infective endocarditis and to compare these data with data of 1983–1993.
Material and methods. A retrospective analysis of clinical data of 116 patients with infective endocarditis treated in Kaunas University [...] Read more.

Objectives. To determine the incidence and distribution of clinical forms of infective endocarditis and to compare these data with data of 1983–1993.
Material and methods. A retrospective analysis of clinical data of 116 patients with infective endocarditis treated in Kaunas University of Medicine Hospital in 2002–2005 was performed. The data were compared with analogical data of 1983–1993.
Results. During 2002–2005, 55 (47.4%) patients presented with classic symptoms of infective endocarditis. In 61 cases, atypical clinical manifestations were observed: 19 patients presented with heart failure symptoms, 14 patients with embolic symptoms, 9 with pulmonary manifestations, and 5 patients with septic manifestations. There were three cases of nephritic form, three cases of rheumatic form, three cases of meningoencephalitic form, and two cases of ophthalmic form. In three cases, pacemaker endocarditis was seen. During the period of 1983–1993, 15 patients with infective endocarditis were treated annually in Kaunas University of Medicine Hospital; in 2002–2005, this number increased to 29 cases per year. More cases of embolic and pulmonic clinical forms of infective endocarditis were diagnosed as compared to the data of 1983–1993 (P<0.05). There were more cases of primary endocarditis in 2002–2005 than in 1983–1993 (36.2% and 23.8%, respectively, P<0.05).
Conclusions. Typically, infective endocarditis manifests as classical symptoms, but in more than half of cases, atypical forms were observed, the most common of which were heart failure form and embolic form. Primary infective endocarditis was detected more frequently. Full article

179 KiB

Open AccessArticle

Short-term and one-year prognosis of diabetic patients with a first-ever myocardial infarction

by Lina Jančaitytė and Daiva Rastenytė

Medicina 2007, 43(7), 555; https://doi.org/10.3390/medicina43070070 - 09 Jun 2007

Cited by 4 | Viewed by 711

Abstract

Objectives. To clarify the importance of clinical features and changes in the first electrocardiogram in 28-day and 1-year mortality in patients with diabetes.
Material and methods. Men and women of Kaunas city aged 25–64 years with the first-ever myocardial infarction during [...] Read more.

Objectives. To clarify the importance of clinical features and changes in the first electrocardiogram in 28-day and 1-year mortality in patients with diabetes.
Material and methods. Men and women of Kaunas city aged 25–64 years with the first-ever myocardial infarction during 1983–1992 and with the first electrocardiogram were enrolled in the study. Electrocardiograms were coded using the WHO MONICA Project Protocol criteria and the Minnesota Code. The Kaunas Ischemic Heart Disease Register was the source of data; deaths from ischemic heart disease were identified via death register.
Results. Diabetes was diagnosed in 124 patients: 65 (52.4%) men and 59 (47.6%) women. The 28-day (P=0.01) and 1-year mortality rates (P<0.001) were higher in diabetic than in nondiabetic patients with myocardial infarction. Among diabetic patients, who died during 28 days or one year, myocardial infarction was more often complicated by acute heart failure, and changes in ECG were more often detected than among those who were alive. Female gender (RR=30.2, P=0.02) was associated with an increased risk of death from a first-ever myocardial infarction during the first 28 days, while acute heart failure (RR=4.48, P=0.01) and anterior location of Q wave in the first ECG (RR=2.71, P=0.04) increased the risk of death from ischemic heart disease during one year after a first-ever myocardial infarction.
Conclusions. Acute heart failure and Q-wave in derivations of the first electrocardiogram reflecting anterior site of myocardial infarction increased the risk of death from ischemic heart disease during the first year, and female gender – during the first 28 days in diabetic patients with myocardial infarction. Full article

211 KiB

Open AccessArticle

ß-adrenergic receptor blocker poisoning

by Dagmara Reingardienė

Medicina 2007, 43(7), 587; https://doi.org/10.3390/medicina43070075 - 23 May 2007

Cited by 3 | Viewed by 813

Abstract

ß-adrenergic receptor blocking drugs are used in the treatment of hypertension, angina, myocardial infarction, cardiac dysrhythmia, cardiomyopathy, migraine headache, thyrotoxicosis, and glaucoma. ß-adrenergic receptor blocking agents are competitive antagonist at ß₁, ß₂, or both types of adrenergic receptors. Overdoses [...] Read more.

ß-adrenergic receptor blocking drugs are used in the treatment of hypertension, angina, myocardial infarction, cardiac dysrhythmia, cardiomyopathy, migraine headache, thyrotoxicosis, and glaucoma. ß-adrenergic receptor blocking agents are competitive antagonist at ß₁, ß₂, or both types of adrenergic receptors. Overdoses of ß-adrenergic receptor blockers are uncommon, but are associated with significant morbidity and mortality. This review article discusses the properties of ß-adrenergic receptor blockers, presents the doses of these drugs causing toxicity and doses, after ingestion of which, referral to an emergency department is recommended. Clinical presentation of overdose (the cardiovascular, neurologic manifestations, pulmonary and other complications), diagnosis, and treatment (gastrointestinal decontamination; the usage of atropine, phosphodiesterase inhibitors, glucagon, insulin; indications for cardiac pacing, extracorporeal procedures of drug removal, etc.) are analyzed. In addition, this article focuses on clinical course and prognosis of beta-blocker overdose. Full article

282 KiB

Open AccessArticle

The importance of T-lymphocyte subsets on overall survival of colorectal and gastric cancer patients

by Vida Milašienė, Eugenijus Stratilatovas and Violeta Norkienė

Medicina 2007, 43(7), 548; https://doi.org/10.3390/medicina43070069 - 23 May 2007

Cited by 29 | Viewed by 922

Abstract

The aim of this study was to evaluate the influence of cellular immunity parameters on overall survival of colorectal and gastric cancer patients after surgery. The parameters of cellular immunity (CD3⁺, CD4⁺, CD8⁺, CD20⁺, and [...] Read more.

The aim of this study was to evaluate the influence of cellular immunity parameters on overall survival of colorectal and gastric cancer patients after surgery. The parameters of cellular immunity (CD3⁺, CD4⁺, CD8⁺, CD20⁺, and CD16⁺) were determined by immunofluorescence method. Cox regression analysis showed no impact of the estimated preoperative and postoperative parameters of cellular immunity on overall survival of colorectal cancer patients and similarly of gastric cancer patients in stage II. However, the analysis showed that the survival of colorectal and gastric cancer patients in stage III depended on immunological parameters determined before surgery: CD3⁺ (P=0.007 and P=0.007, respectively), CD4⁺ (P=0.021 and P=0.011, respectively), and CD8⁺ (P=0.047 and P=0.007) counts. Only the survival of colorectal cancer patients depended on natural killer cell number (P=0.009). Kaplan-Meier analysis showed that patients with stage III colorectal and gastric cancer had better survival rates when absolute number of CD3⁺ lymphocytes, determined before surgery, was greater than 0.8×10⁹/L, CD4⁺ – greater than 0.25×10⁹/L, CD8⁺ – greater than 0.3×10⁹/L. Colorectal cancer patient survived longer when the number of natural killer cells CD16⁺ was more than 0.25×10⁹/L. This study suggests that higher levels of the absolute number of lymphocyte subsets before surgery have a beneficial effect on overall survival of gastric and colorectal cancer patients in stage III. Full article

247 KiB

Open AccessArticle

Late radiographic findings after the anterior cervical fusion for the cervical subaxial compressive flexion and vertical compression injuries in young patients

by Bronius Špakauskas, Kazys Vytautas Ambrozaitis, Arimantas Tamašauskas and Egidijus Kontautas

Medicina 2007, 43(7), 542; https://doi.org/10.3390/medicina43070068 - 23 May 2007

Cited by 2 | Viewed by 742

Abstract

Objective. The aim of this study was to investigate the influence of patients’ age on the development of radiologic signs of degeneration of adjacent levels after the anterior fusion for the cervical spine injuries.
Material and methods. A total of 45 [...] Read more.

Objective. The aim of this study was to investigate the influence of patients’ age on the development of radiologic signs of degeneration of adjacent levels after the anterior fusion for the cervical spine injuries.
Material and methods. A total of 45 patients who had compressive flexion and vertical compression injuries of the cervical spine (by Ferguson–Allen mechanistic classification) were included in the study. There were 40 male and 5 female patients with a mean age of 31.5 years (range 15–64). These patients were treated with anterior decompression, iliac bone grafting, and anterior plating. Twenty-two patients aged less than 30 years were in the first group; 23 individuals more than 30 years of age were in the second group. A long-term radiologic followup involved assessment of the fusion and examination of the changes at levels immediately above and below the fused vertebrae.
Results. Hypermobility of the disc space above the fused vertebra was found in 9 (40.9%) patients from the first group vs. 3 (13%) from the second one (P<0.05). Narrowing and osteophytes of the disc space below the fused vertebra was found in 2 (9.1%) patients from the first group vs. 10 (43.5%) from the second one (P<0.05).
Conclusions. Hypermobility of the motion segment above the fused vertebra was found more frequently in patients aged less than 30 years. Narrowing and osteophytes of the disc space below the fused vertebra were found more frequently in older patients. Full article

180 KiB

Open AccessArticle

The approach of medical students towards studies of the humanities and social sciences

by Irayda Jakušovaitė and Aurelija Blaževičienė

Medicina 2007, 43(7), 580; https://doi.org/10.3390/medicina43070074 - 06 Feb 2007

Cited by 4 | Viewed by 897

Abstract

Objective. To analyze the attitudes of the medical students from Kaunas University of Medicine, Krakow Jagiellonian University, and St. Petersburg State University towards the studies of the humanities and social sciences.
Materials and methods. The survey was carried out in three [...] Read more.

Objective. To analyze the attitudes of the medical students from Kaunas University of Medicine, Krakow Jagiellonian University, and St. Petersburg State University towards the studies of the humanities and social sciences.
Materials and methods. The survey was carried out in three universities (Kaunas University of Medicine, Krakow Jagiellonian University, and St. Petersburg State University) during 2004– 2005. The questionnaire for the investigation was developed based on R. D. Stenberg’s works on the ways of knowledge-, practice-, and personality-oriented thinking.
Results. After the analysis of students’ attitudes towards the importance of the disciplines of ethics, philosophy, sociology, and psychology at the universities of Kaunas, Krakow, and St. Petersburg, important differences have been found among them. Students gave the highest priority to ethics in their profession. Answering the question, “Are philosophical studies important in medical studies,” statistically significant differences appeared among Krakow, Kaunas, and St. Petersburg universities. Students of all the universities agreed that sociology and psychology studies were important for their future profession.
Conclusions. Having estimated the opinions of medical students’ attitudes towards the importance of the humanities and social sciences, we may state that the students of Krakow and St. Petersburg universities more often agreed that ethics and philosophy were important for their studies. The importance of psychology science was emphasized by the students of all universities, and the students of Kaunas University of Medicine and St. Petersburg State University agreed more often that the discipline of sociology was important for the future studies. Full article

170 KiB

Open AccessArticle

Acute and transient psychotic disorders in a rapidly developing country, State of Qatar

by Taher Shaltout, Abdulbari Bener, Majid Al Abdullah, Zahra Al Mujalli and Hany T. Shaltout

Medicina 2007, 43(7), 575; https://doi.org/10.3390/medicina43070073 - 18 Nov 2006

Cited by 10 | Viewed by 1020

Abstract

Background. Little is known about acute and transient psychotic disorders, which is a diagnostic group, introduced with International Classification of Disease, 10th revision. It is an interesting area of research receiving a lot of attention.
Objective. The aim of the study [...] Read more.

Background. Little is known about acute and transient psychotic disorders, which is a diagnostic group, introduced with International Classification of Disease, 10th revision. It is an interesting area of research receiving a lot of attention.
Objective. The aim of the study was to find the incidence of acute and transient psychotic disorders in the population and determine its sociodemographic features in the State of Qatar.
Design. This is a retrospective descriptive study.
Setting. The study was conducted in the Department of Psychiatry of the Rumaillah Hospital, Hamad Medical Corporation, Doha, Qatar.
Methods. All Qatari, non-Qatari Arabs, and expatriate patients who were hospitalized with psychotic disorders in the inpatient wards or treated in the outpatient clinics of the Department of Psychiatry over a 7-year period were enrolled in the study. Data were collected from the medical records of patients. The study was conducted from August 1, 1996, to January 1, 2004, amongst the patients with acute and transient psychotic disorders. The diagnostic classification of definite psychotic disorders was made in accordance with criteria based on the International Classification of Disease, 10th revision (ICD-10).
Results. A total of 174 patients were treated during a 7-year period. Among them, 69% were males and 31% females. No cases were found in children aged less than 15 years. The highest frequency (43.7%) was found in the early adulthood (16–29 years of age). The incidence of acute and transient psychotic disorders was higher in the expatriates (66.7%). More than half (63.8%) of the patients were employed. Most of the cases (35.6%) had acute schizophrenia-like psychotic disorders (F23.2). There was no statistically significant difference in the frequency of acute and transient psychotic disorders between males and females, Qatari and non-Qatari Arabs, and single and married.
Conclusion. The study found markedly lower incidence rate of acute and transient psychotic disorders in females than males. The highest frequency was found in the early adulthood (16–29 years). No cases were found in children aged less than 15 years. It is important to find ways to promote healthier lifestyles in this population in order to prevent the onset of psychotic disorders. Full article

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Medicina, Volume 43, Issue 7 (July 2007) – 11 articles

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