Medicina

173 KiB

Open AccessArticle

Vasopressin for treatment of hemodynamic disorders

by Dalia Adukauskienë, Edmundas Ðirvinskas and Egidijus Këvelaitis

Medicina 2008, 44(2), 167; https://doi.org/10.3390/medicina44020021 - 13 Feb 2008

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Vasopressin is a 9-amino acid peptide synthesized by magnocellular neurons of the hypothalamus and released from posterior pituitary gland. The primary physiological role of vasopressin is the maintenance of fluid homeostasis. In this review, the classification of vasopressin receptors, namely V1 vascular, V2 [...] Read more.

Vasopressin is a 9-amino acid peptide synthesized by magnocellular neurons of the hypothalamus and released from posterior pituitary gland. The primary physiological role of vasopressin is the maintenance of fluid homeostasis. In this review, the classification of vasopressin receptors, namely V1 vascular, V2 renal, V3 pituitary, oxytocin receptors, and purinergic receptors, and the effects of vasopressin on vascular smooth muscles, the heart, and the kidneys are discussed. Mortality rates of vasodilatory (or distributive), for example septic shock, are high. The use of vasopressin is an alternative therapy for vasodilatory shock with better outcome. Vasopressin is effective in resuscitation of adults after ventricular fibrillation or pulseless tachycardia, when epinephrine is not effective. Full article

222 KiB

Open AccessArticle

The incidence and diagnostics of congenital heart defects in Kaunas infant population during 1999–2005

by Virginija Dulskienë, Vilija Malinauskienë, Ada Azaravièienë and Renata Kuèienë

Medicina 2008, 44(2), 139; https://doi.org/10.3390/medicina44020018 - 13 Feb 2008

Cited by 4 | Viewed by 799

Abstract

The objective of this study was to determinate the incidence and diagnostics of congenital heart defects in Kaunas infant population in 1999–2005 and to compare the data obtained with the data of years 1995–1998.
Subject and methods. The study population comprised all [...] Read more.

The objective of this study was to determinate the incidence and diagnostics of congenital heart defects in Kaunas infant population in 1999–2005 and to compare the data obtained with the data of years 1995–1998.
Subject and methods. The study population comprised all newborns born in Kaunas city during 1999– 2005. Congenital heart defects were registered based on clinical diagnosis after its verification using the data from consulting centers and pediatric outpatient departments. To assess the incidence of congenital heart malformations in newborn population, we conducted a validated newborn register based on maternal residential district. Modern epidemiological methods were used for data analysis.
Results. In 1999–2005, there were 24 069 live births in Kaunas: 2231 newborns were born with congenital anomalies, 198 had congenital heart malformations. The incidence of congenital heart defects was 8.2 per 1000 live newborns. The majority of congenital heart malformations were diagnosed in delivery units (93.94%). We have analyzed the relationship between birth weight and gestational age of newborns with congenital heart malformations. Newborns with low birth weight were at significantly higher risk of congenital heart malformation than newborns with normal birth weight (OR=3.52, 95% CI, 2.25–5.47). Our data also showed that newborns born before 32 weeks of gestation had a 5-fold increased risk of congenital heart malformation (OR=5.20; 95% CI, 2.50–10.84) and infants born before 37 weeks of gestation had a 4-fold increased risk (OR=4.08; 95% CI, 2.68–6.19) compared with newborns born after 37 weeks of gestation.
Conclusions. This study shows that incidence of congenital heart anomalies in Kaunas newborn population was 8.2 cases per 1000 live newborns in 1999–2005. It was determined that during 1999–2005, the number of above-mentioned anomalies diagnosed in delivery units increased by 23%. Full article

203 KiB

Open AccessArticle

Association of metabolic syndrome with abnormalities of bulbar conjunctival vessels

by Goda Miniauskienë and Vytautas Jaðinskas

Medicina 2008, 44(2), 100; https://doi.org/10.3390/medicina44020013 - 13 Feb 2008

Cited by 2 | Viewed by 798

Abstract

Aim. To examine and evaluate the relationships of the metabolic syndrome and abnormalities of bulbar conjunctival vessels among middle-aged Kaunas population.
Material and methods. Analysis was performed on 383 asymptomatic persons aged 38–39 years (170 men and 212 women). Metabolic syndrome [...] Read more.

Aim. To examine and evaluate the relationships of the metabolic syndrome and abnormalities of bulbar conjunctival vessels among middle-aged Kaunas population.
Material and methods. Analysis was performed on 383 asymptomatic persons aged 38–39 years (170 men and 212 women). Metabolic syndrome was defined using criteria of the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III). For determination of abnormalities in bulbar conjunctiva vessels and microcirculation, each participant underwent noncontact slit lamp examination. The changes of vessel walls and bloodstream, extravasal alterations were evaluated, and conjunctival index was calculated.
Results. Metabolic syndrome was present in 10.7% of individuals. Persons with metabolic syndrome had a 2.35-point higher conjunctival index compared to the controls (P=0.003). After evaluation of various components of metabolic syndrome to conjunctival index, it was determined that the greatest change in the means of conjunctival index was due to hyperglycemia (P=0.02) and central obesity (P=0.05). Metabolic syndrome was related to venular dilatation (OR=3.78; 95% CI, 1.86–7.72), arteriolar narrowing (OR=1.98; 95% CI, 0.97– 4.09), decreased arteriolar-venular ratio (OR=2.35; 95% CI, 1.13–4.98), and increased venular tortuosity (OR=2.24; 95% CI, 1.06–4.82). Multiple logistic analysis revealed that venular dilatation (OR=3.38; 95% CI, 1.43–7.99) and arteriolar narrowing (OR=2.22; 95% CI, 0.98-5.01) were significant factors in the prognosis of metabolic syndrome.
Conclusions. Metabolic syndrome was significantly related to abnormalities of bulbar conjunctival vessels such as venular dilatation, arteriolar narrowing, decreased arteriolar-venular ratio, and increased venular tortuosity. Both conjunctival index and individual conjunctival microvascular changes may be prognostic factors for metabolic syndrome, but long-term studies on associations between metabolic syndrome and changes of bulbar conjunctival vessels are needed. Full article

194 KiB

Open AccessArticle

Genetically modified organisms: Do the benefits outweigh the risks?

by Kristina Hug

Medicina 2008, 44(2), 87; https://doi.org/10.3390/medicina44020012 - 06 Feb 2008

Cited by 38 | Viewed by 26390

Abstract

The objective of this literature review is to analyze the implications of using genetically modified organisms (GMOs) as well as international and European position regarding such organisms.
Method. Review of international and European legal requirements and ethical guidelines and relevant publications, found and [...] Read more.

The objective of this literature review is to analyze the implications of using genetically modified organisms (GMOs) as well as international and European position regarding such organisms.
Method. Review of international and European legal requirements and ethical guidelines and relevant publications, found and accessed with the help of PubMed and Lund University Library databases.
Results. The article discusses the main application areas of GMOs, the expansion of using GMOs in the world as well as the advantages and disadvantages of the implications of their usage. It further provides an overview of the suggested ways to tackle or avoid the GMO-related risks. The international and European positions regarding the application of GMOs are discussed and European Directives, Regulations, and ethical guidelines are overviewed. The article further presents the public attitudes towards GMOs in Europe as well as overviews surveys conducted at the national level.
Conclusion. Suggested steps to tackle the challenge of developing and managing biotechnology for the benefit of public health and the environment are presented. Full article

189 KiB

Open AccessArticle

Psychological factors of delinquent adolescent girls and suicide attempters

by Virginija Ribakovienë, Virginija Adomaitienë, Diana Danytë and Rûta Kalkytë

Medicina 2008, 44(2), 147; https://doi.org/10.3390/medicina44020019 - 06 Feb 2008

Cited by 1 | Viewed by 793

Abstract

The aim of this study was to study and compare externalizing and internalizing difficulties, clinical problems of adolescent girls who attempted a suicide and delinquent girls. A total of 100 adolescent girls aged 11–18 years have participated in this study: 50 of them [...] Read more.

The aim of this study was to study and compare externalizing and internalizing difficulties, clinical problems of adolescent girls who attempted a suicide and delinquent girls. A total of 100 adolescent girls aged 11–18 years have participated in this study: 50 of them were suicide attempters, and the other 50 girls had problems of delinquent behavior. In this study, the questionnaire ASEBA YSR 11–18 was used. To compare averages, Student’s t and Mann-Whitney’s U tests were applied with a 0.05 level of statistical significance. For adolescent girls who attempted a suicide, more prominent internal difficulties were identified. They were more depressive/anxious, presented more somatic complains, and were more closed/anxious. Those girls felt more anxiety and presented more affective problems. The difference in the average scores of scales of the both groups was statistically significant (P<0.05). Externalizing problems of adolescent suicide attempters did not significantly differ from ones of the girls with delinquent behavior. The average scores of scales on braking of rules and aggression were not significantly different. Girls with delinquent behavior had a higher social competency, and the girls who attempted a suicide more often presented significant social difficulties, though there was no statistically significant difference in the scores on the activity competence scale. Conclusions. The adolescent girls who attempted a suicide have more evident internal difficulties than delinquent girls do, though externalizing behavior difficulties of the suicide attempters are similar to those of girls with delinquent behavior. The girls who attempted a suicide experience more social difficulties, and their social competency is lower when comparing to delinquent girls of the same age. Full article

233 KiB

Open AccessArticle

Subacute effects of cadmium and zinc ions on protein synthesis and cell death in mouse liver

by Inga Stanevièienë, Ilona Sadauskienë, Vaiva Lesauskaitë, Laima Ivanovienë, Artûras Kaðauskas and Leonid Ivanov

Medicina 2008, 44(2), 131; https://doi.org/10.3390/medicina44020017 - 06 Feb 2008

Cited by 16 | Viewed by 878

Abstract

Objective. The aim of this study was to evaluate in vivo the effects of cadmium and zinc ions on translational machinery and death of mouse liver cells.
Material and methods. Outbred mice received intraperitoneal injections of cadmium chloride solution (1.4 μmoles [...] Read more.

Objective. The aim of this study was to evaluate in vivo the effects of cadmium and zinc ions on translational machinery and death of mouse liver cells.
Material and methods. Outbred mice received intraperitoneal injections of cadmium chloride solution (1.4 μmoles cadmium per 1 kg of body weight) and/or zinc sulfate solution (4.8 μmoles zinc per kg of body weight) three times per week for six weeks. Analogical volume of saline solution was injected to the control mice. Protein synthesis was evaluated by incorporation of [14C]-labeled leucine into peptides and proteins. Total tRNAs were isolated using deproteinized extract of liver tissue. Postmitochondrial supernatant was as a source of leucyl-tRNA synthetase. Activities of tRNALeu and leucyl-tRNA synthetase were measured by an aminoacylation reaction using [14C]-labeled leucine. Liver cell apoptosis was detected by TUNEL assay using in situ cell death detection kit.
Results. A decrease in incorporation of [14C]-labeled leucine into proteins was detected in liver, kidney, and heart as well as diminution of tRNALeu acceptor activity in cadmium-exposed liver. Cadmium caused activation of the leucyl-tRNA synthetase and induced liver cell apoptosis. Pretreatment of mice with zinc sulfate solution favored to protection of protein synthesis and acceptor activity of tRNALeu against cadmium-induced inhibition. Under co-exposure of mouse liver to cadmium and zinc, activity of the leucyl-tRNA synthetase was at the level of control. Zinc did not influence TUNEL-positive cell number in cadmium-exposed mouse liver.
Conclusions. Under subacute intoxication of mice by cadmium, zinc ions protect the translation machinery against inhibition, but do not decrease the number of apoptotic cells in the liver. Full article

199 KiB

Open AccessArticle

Significance of intracranial pressure and cerebral perfusion pressure in severe pediatric traumatic brain injury

by Dovilë Evalda Grinkevièiûtë, Rimantas Këvalas, Algimantas Matukevièius, Vytautas Ragaiðis and Arimantas Tamaðauskas

Medicina 2008, 44(2), 119; https://doi.org/10.3390/medicina44020015 - 06 Feb 2008

Cited by 28 | Viewed by 1100

Abstract

The aim of the study was to evaluate outcome of children after severe traumatic brain injury treated according to intracranial pressure (ICP)-targeted protocol, to define threshold values of peak ICP and minimal cerebral perfusion pressure (CPP) for decompressive osteoplastic craniotomy, and to determine [...] Read more.

The aim of the study was to evaluate outcome of children after severe traumatic brain injury treated according to intracranial pressure (ICP)-targeted protocol, to define threshold values of peak ICP and minimal cerebral perfusion pressure (CPP) for decompressive osteoplastic craniotomy, and to determine the relationship between ICP, CPP and long-term outcome in these children. All children admitted to Pediatric Intensive Care Unit of Kaunas University of Medicine Hospital after severe head injury from January 2004 to June 2006 and treated according to ICPtargeted protocol for the management of severe head trauma were prospectively included in the study. Raised ICP was defined as a level higher than 20 mmHg. Minimal CPP was considered to be at a level of 40 mmHg. Outcome was defined using Glasgow Outcome Scale (GOS) at discharge from the hospital and after 6 months. Forty-eight patients (32 boys and 16 girls) were included into the study. Favorable outcome (GOS score of 4 and 5) after 6 months was achieved in 43 (89.6%) cases. Mean peak ICP was 24.2±7.2 mmHg and mean minimal CPP – 53.1±14.7 mmHg. Decompressive craniotomy was performed in 13 cases. Threshold values of peak ICP and minimal CPP for decompressive craniotomy were 22.5 mmHg (area under the curve, 0.880) and 46.5 mmHg (area under the curve, 0.898), respectively. The differences in peak ICP and minimal CPP in groups of favorable and unfavorable outcomes were not statistically significant. Treating children after severe traumatic brain injury according to the ICP-targeted protocol for the management of severe pediatric traumatic brain injury resulted in a favorable long-term outcome. Full article

164 KiB

Open AccessArticle

Thickness of cerebral cortex measured using anatomical mesoscopic imaging and magnetic resonance imaging

by Liuda Janauskaitë, Justina Kaèerauskienë, Ugnë Jaðinskaitë, Vytautas Gedrimas and Rimvydas Stropus

Medicina 2008, 44(2), 126; https://doi.org/10.3390/medicina44020016 - 27 Jan 2008

Cited by 1 | Viewed by 800

Abstract

Objective. Magnetic resonance imaging method opened up the possibility for in vivo examination of the anatomy of human brain. For this reason it is interesting and relevant to compare the knowledge accumulated over a number of years during the examination of the [...] Read more.

Objective. Magnetic resonance imaging method opened up the possibility for in vivo examination of the anatomy of human brain. For this reason it is interesting and relevant to compare the knowledge accumulated over a number of years during the examination of the composition of dead brain to that obtained from magnetic resonance images. The aim of this study was to determine and compare the thickness of cerebral cortex in human of different age and sex, measured in different sites of the hemispheres when applying anatomical mesoscopic imaging and magnetic resonance imaging.
Material and methods. The thickness of cerebral cortex was measured in symmetrical Brodmann’s areas of both hemispheres. The anatomical mesoscopic imaging technique was used for the examination of 2×2-cm cortex samples obtained during autopsy and fixed for 4 weeks in 10% paraformaldehyde. In these samples, cortex thickness was measured in sections perpendicular to the convolution, using an operative microscope, in a mesoscopic image at ×16 magnification and with an accuracy of 0.01 mm. Using cerebral magnetic resonance imaging, the thickness of cerebral cortex in live subjects was measured on T1-weighted images of patients examined at the Clinic of Radiology, Kaunas University of Medicine Hospital. The measured cortical field image was magnified to the smallest element of digital image – the pixel – and measured with an accuracy of 0.01 mm. Each of the two techniques was applied for the examination of 20 men and women who were divided into age groups of 20–60 years (n=10) and older than 60 years (n=10).
Results and conclusions. Both examination methods yielded a statistically significant difference in the thickness of cerebral cortex between Brodmann’s areas 1, 4, and 19. No significant difference in cortex thickness was found between different age and sex groups; however, the findings showed that the difference in cortex thickness between the different age male groups was 4.6% and female – 1.6%. No significant difference using different techniques was found, but the cortex thickness in the fixed samples was reduced by 0.5 cm on average. Full article

179 KiB

Open AccessArticle

A prospective comparison of double- and single-bundle anterior cruciate ligament reconstructions

by Rimtautas Gudas, Alfredas Smailys, Kristina Vostrugina, Ramûnas Tamoðiûnas, Donatas Simonaitis and Romas Jonas Kalesinskas

Medicina 2008, 44(2), 110; https://doi.org/10.3390/medicina44020014 - 16 Jan 2008

Cited by 7 | Viewed by 829

Abstract

Objective. A nonrandomized clinical study was performed to compare the clinical and radiological outcome between double-bundle and single-bundle anterior cruciate ligament (ACL) reconstructions with semitendinosus tendon in athletes.
Material and methods. We examined 70 patients with unilateral anterior cruciate ligament injury. [...] Read more.

Objective. A nonrandomized clinical study was performed to compare the clinical and radiological outcome between double-bundle and single-bundle anterior cruciate ligament (ACL) reconstructions with semitendinosus tendon in athletes.
Material and methods. We examined 70 patients with unilateral anterior cruciate ligament injury. They were followed up for a mean of 24 months. Each group of 35 patients underwent either double- or singlebundle ACL reconstruction. The mean age of the patients was 24.7 years (range, 18–35 years). There were no differences between two groups regarding age at surgery, sex, follow-up period, period before surgery, combined meniscus injuries, athletic activity level, and International Knee Documentation Committee (IKDC) and Tegner scores. All patients followed the same postoperative program. They were evaluated using manual knee laxity tests, knee extension and flexion strength testing. General knee condition was evaluated by the IKDC and Tegner scores.
Results. The results were excellent and good in 32 (91.4%) patients after double-bundle ACL reconstruction and in 30 (85.7%) patients after single-bundle ACL reconstruction, evaluating by IKDC system. However, statistical analysis showed no significant difference between the two groups regarding all IKDC-categorized data (P=0.87). The average scores of Tegner activity in double-bundle and single-bundle groups were 8.0 and 8.1, respectively.
Conclusions. This trial showed no significant difference between the double and single-bundle ACL repairs. Full article

203 KiB

Open AccessArticle

Enrichment of the educational environment with information and communication technologies: State of art at the Faculty of Pharmacy of Kaunas University of Medicine

by Edita Butrimienë and Nida Stankevièienë

Medicina 2008, 44(2), 156; https://doi.org/10.3390/medicina44020020 - 28 Nov 2006

Cited by 2 | Viewed by 801

Abstract

Both traditional and new educational environments, the latter enriched with information and communication technologies, coexist in today’s university. The goal of this article is to present the concept of educational environment enriched with information and communication technologies, to reveal the main features of [...] Read more.

Both traditional and new educational environments, the latter enriched with information and communication technologies, coexist in today’s university. The goal of this article is to present the concept of educational environment enriched with information and communication technologies, to reveal the main features of such environment, and to present the results of certain investigation on the application of information technologies in teaching/learning processes at the Faculty of Pharmacy of Kaunas University of Medicine. The discussion object of this paper is the educational environment enriched with information and communication technologies. In designing the environments of this type, positive aspects of traditional teaching models are being developed by integrating them into the new educational environment. The concept of educational environment enriched with information and communication technologies is reviewed in the first part of this paper. The structure and main features of educational environments enriched with information and communication technologies are highlighted in the second part. The results of the study on the application of information technologies in teaching/learning processes at the Faculty of Pharmacy of Kaunas University of Medicine are presented in the third part. Full article

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Medicina, Volume 44, Issue 2 (February 2008) – 10 articles

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