Medicina

119 KiB

Open AccessArticle

Pharmaceutical Care as Described by Home-Dwelling Older People in Finland

by Sini Eloranta, Sanna Hannukainen, Pirkko Routasalo, Matti Viitanen and Seija Arve

Medicina 2011, 47(11), 91; https://doi.org/10.3390/medicina47110091 - 05 Dec 2011

Cited by 3 | Viewed by 1015

Background and Objective. Pharmaceutical care is one of the most important therapeutic tools in older people care. The aim of this study was to describe the knowledge and attitudes of older home-dwelling people’s about their perceptions of pharmaceutical care and use of [...] Read more.

Background and Objective. Pharmaceutical care is one of the most important therapeutic tools in older people care. The aim of this study was to describe the knowledge and attitudes of older home-dwelling people’s about their perceptions of pharmaceutical care and use of medication.
Material and Methods. The data were collected using theme interviews with 16 older Finnish people (born 1920). Inductive content analysis was used in analyzing the data.
Results. Older people’s knowledge about their pharmaceutical care varied widely: some had precise knowledge whereas others had none. Guidance in pharmaceutical care was not readily available. The interviewees took a positive attitude toward their pharmaceutical care and favored a minimum use of medication. Being able to cope independently with their pharmaceutical care strengthened the older people’s sense of control over their lives.
Conclusions. The study offers new knowledge about the significance of older people’s individual pharmaceutical care at home. By listening to and utilizing older people’s experiences, we can recognize the factors that promote the independent coping and inclusion of older people in their pharmaceutical care. This enables health care providers to increase the safety and quality of pharmaceutical care for older people. Full article

307 KiB

Open AccessArticle

Comparison of the Properties of Brand-Name and Generic Nadifloxacin Creams

by Yutaka Inoue, Miruto Matsumoto, Masayuki Kimura, Toru Tanaka and Ikuo Kanamoto

Medicina 2011, 47(11), 89; https://doi.org/10.3390/medicina47110089 - 05 Dec 2011

Cited by 2 | Viewed by 1061

Abstract

Background and Objective. In external preparations, types and ratios of additives are not necessarily the same for brand-name drugs and generic drugs. Thus, the physicochemical properties of preparations may differ despite the fact that they contain the same ingredients or additives. This [...] Read more.

Background and Objective. In external preparations, types and ratios of additives are not necessarily the same for brand-name drugs and generic drugs. Thus, the physicochemical properties of preparations may differ despite the fact that they contain the same ingredients or additives. This study examined differences in brand-name and generic versions of nadifloxacin (NFX) creams.
Material and Methods. Three types of NFX creams (NFX-A, NFX-B, and NFX-C) were used. The viscosity of each preparation was determined, its yield value was calculated, and each preparation was subjected to light microscopy, x-ray powder diffraction, and near-infrared absorption spectroscopy.
Results. Comparison of viscosity of different preparations revealed that NFX-B had a lower viscosity than NFX-A and NFX-C (14.5 vs. 24.6 and 17.9 Pa·s). NFX-B also had a lower yield value than NFX-A and NFX-C. Microscopy revealed that NFX-A and NFX-B had satisfactory emulsification although crystallization was observed with NFX-C. Near-infrared absorption spectroscopy revealed changes in the absorption spectra of NFX-B in comparison with those of NFX-A and NFX-C that were due to differences in water content and differences in fat and oil content.
Conclusions. These findings confirmed that there were differences in the viscosity and flattening of NFX-A, NFX-B, and NFX-C. In addition, microscopy revealed differences in emulsification and it revealed the precipitation of NFX crystals in NFX-C. Near-infrared absorption spectroscopy revealed that differences in the type and amount of additives and water content in the creams had contributed to differences in the preparations. Full article

134 KiB

Open AccessArticle

Prevention of Posterior Capsule Opacification With 3 Intraocular Lens Models: a Prospective, Randomized, Long-Term Clinical Trial

by Reda Žemaitienė and Vytautas Jašinskas

Medicina 2011, 47(11), 85; https://doi.org/10.3390/medicina47110085 - 05 Dec 2011

Cited by 8 | Viewed by 807

Abstract

The aim of this prospective randomized study was to evaluate the impact of different sharp-edged intraocular lenses (IOLs) (hydrophobic acrylic or silicone) on posterior and anterior lens capsule opacification (PCO and ACO) at 3-year postoperative follow-up.
Material and Methods. A total of [...] Read more.

The aim of this prospective randomized study was to evaluate the impact of different sharp-edged intraocular lenses (IOLs) (hydrophobic acrylic or silicone) on posterior and anterior lens capsule opacification (PCO and ACO) at 3-year postoperative follow-up.
Material and Methods. A total of 96 eyes (89 patients) having a standard uncomplicated phacoemulsification procedure for age-related cataract were included in a prospective clinical study: 34 eyes with a 3-piece acrylic hydrophobic (AcrySof, MA3OBA), 32 eyes with a 1-piece acrylic hydrophobic (AcrySof, SA3OAL), and 30 eyes with a 3-piece silicone (CeeOn 911A) IOL. Visual acuity, capsulorrhexis/optic overlapping, ACO and PCO (using EPCO2000 system) were evaluated at 3-year follow-up. Capsulotomies performed by means of neodymium-yttrium-aluminum-garnet (Nd:YAG) laser were recorded.
Results. Three years after surgery, the grade of ACO of the capsulorrhexis rim area and the capsule/optic area was significantly greater in the silicone IOL group than in the acrylic IOL groups (P<0.05). During 3 postoperative years, there were no significant differences in the PCO values either in the entire IOL optic area or in the central 3-mm optic zone comparing the groups. Three years after surgery, 9% of eyes with a 3-piece acrylic IOL, 3.1% of eyes with a 1-piece acrylic IOL, and no case in the silicone IOL group had Nd:YAG capsulotomy (P>0.05).
Conclusion. The 3-year follow-up after cataract surgery showed no difference in PCO development (EPCO2000) between acrylic hydrophobic and silicone sharp-edged IOLs. However, the need for Nd:YAG laser capsulotomy was higher in the acrylic IOL groups than the silicone IOL group, though the difference was not significant. ACO was greatest in the eyes with 3-piece silicone IOLs Full article

254 KiB

Open AccessArticle

Carcinoma of Two Parathyroid Glands Caused by a Novel MEN1 Gene Mutation – a Rare Feature of the MEN 1 Syndrome

by Linas Juodelė, Danielius Serapinas, Gintaras Sabaliauskas, Aurelija Krasauskienė, Virgilijus Krasauskas, Rasa Verkauskienė, Diana Barkauskienė and Elona Juozaitytė

Medicina 2011, 47(11), 92; https://doi.org/10.3390/medicina47110092 - 04 Dec 2011

Cited by 13 | Viewed by 898

Abstract

Multiple endocrine neoplasia type 1 (MEN 1) is a rare syndrome inherited in an autosomal dominant pattern, characterized by combinations of tumors of the parathyroid glands, pituitary gland, and pancreatic islet cells and more rare tumors of endocrine organs and nonendocrine tissues. Germline [...] Read more.

Multiple endocrine neoplasia type 1 (MEN 1) is a rare syndrome inherited in an autosomal dominant pattern, characterized by combinations of tumors of the parathyroid glands, pituitary gland, and pancreatic islet cells and more rare tumors of endocrine organs and nonendocrine tissues. Germline mutations in the MEN1 gene are responsible for the MEN 1 syndrome, leading to an inactive form of menin protein. Benign lesions of the parathyroid glands are characteristic in patients with the MEN 1 syndrome; however, patients can develop parathyroid carcinomas very rarely. This report presents a clinical case of the MEN 1 syndrome: a 39-year-old woman underwent surgery for carcinoma of two parathyroid glands as well as was treated for pituitary prolactinoma, which caused infertility, and malignant insulinoma; the patient had multiple subcutaneous lipomas as well. Genetic analysis revealed a novel germline mutation in the MEN1 gene – a nucleotide insertion at codon 43 in exon 2 (c.129insA), which caused the occurrence of the MEN1 syndrome. The clinical case of the MEN 1 syndrome presented here is relevant in gathering the data on etiopathogenesis of not only MEN 1 syndrome, but an extremely rare pathology – parathyroid carcinoma – as well. Full article

122 KiB

Open AccessArticle

The Influence of Health Care Reforms on Work-Related Attitudes and Anxieties of Primary Care Physicians

by Tolga Günvar, Mehtap Kartal, Aynur Toksun, Beyazıt Yemez and Dilek Güldal

Medicina 2011, 47(11), 90; https://doi.org/10.3390/medicina47110090 - 04 Dec 2011

Cited by 2 | Viewed by 933

Abstract

Background and Objective. Reforming primary healthcare services has been the core agenda of health policies of the developing countries in accordance with the recommendations of the World Health Organization. In Turkey, the Transformation in Health Project brings along many changes in all [...] Read more.

Background and Objective. Reforming primary healthcare services has been the core agenda of health policies of the developing countries in accordance with the recommendations of the World Health Organization. In Turkey, the Transformation in Health Project brings along many changes in all aspects of primary health care services, such as organization and financing of services and employment of healthcare workers. The aim of this study was to determine the effects of health care reforms on primary care physicians working in Izmir.
Material and Methods. A questionnaire and an anxiety scale were applied to a sample of primary care physicians in Izmir in 2007 and 2009. The questionnaire consisted of questions about demographic characteristics and expressions regarding the effect of reforms on physicians organized on a 7-point Likert scale. The State-Trait Anxiety Inventory was used as an anxiety scale.
Results. The mean scores given by physicians working in family health centers were significantly higher than those of physicians working in public institutions. The score for “My responsibilities are well defined” statement given by physicians working in family health centers decreased significantly in the second survey. The necessity of reforms in the health care system and primary care health services was more significantly favored by physicians working in family health centers. Persistent anxiety of physicians working in community health centers was significantly higher in both surveys.
Conclusions. Our study showed that health reforms had a substantial impact on work-related attitudes and anxieties of primary care physicians, and this effect was maintained over time. Full article

395 KiB

Open AccessArticle

Recovery of Infarcted Myocardium in an In Vivo Experiment

by Raimondas Širmenis, Antanas Kraniauskas, Rasa Jarašienė, Daiva Baltriukienė, Audronė Kalvelytė and Virginija Bukelskienė

Medicina 2011, 47(11), 88; https://doi.org/10.3390/medicina47110088 - 04 Dec 2011

Cited by 4 | Viewed by 817

Abstract

Acute myocardial infarction leads to the loss of functional cardiomyocytes and structural integrity. The adult heart cannot repair the damaged tissue due to inability of mature cardiomyocytes to divide and lack of stem cells. The aim of this study was to evaluate the [...] Read more.

Acute myocardial infarction leads to the loss of functional cardiomyocytes and structural integrity. The adult heart cannot repair the damaged tissue due to inability of mature cardiomyocytes to divide and lack of stem cells. The aim of this study was to evaluate the efficiency of introduced autologous skeletal musclederived stem cells to recover the function of acutely infarcted rabbit heart in the early postoperative period.
Material and Methods. As a model for myocardium restoration in vivo, experimental rabbit heart infarct was used. Autologic adult myogenic stem cells were isolated from skeletal muscle and propagated in culture. Before transplantation, the cells were labeled with 4´,6-diamidino-2-phenylindole and then, during heart surgery, introduced into the rabbit acutely infarcted myocardium. Postoperative cardiac function was monitored by recording electrocardiograms and echocardiograms. At the end of the experiment, the efficiency of cell integration was evaluated histologically.
Results. Rabbit cardiac function recovered after 1 month after the induction of experimental infarction both in the control and experimental groups. Therefore, the first month after the infarction was the most significant for the assessment of cell transplantation efficacy. Transplanted cell integration into infarcted myocardium was time- and individual-dependent. Evaluation of changes in left ventricular ejection fraction after the induction of myocardial infarction revealed better recovery in the experimental group; however, the difference among animals in the experimental and control groups varied and was not significant.
Conclusions. Autologous myogenic stem cells repopulated infarcted myocardium with different efficiency in each individual. This variability may account for the observed difference in postoperative cardiac recovery in a rabbit model. Full article

224 KiB

Open AccessArticle

by Mile Vranes, Milos Velinovic, Natasa Kovacevic-Kostic, Dragutin Savic, Dejan Nikolic and Radmila Karan

Medicina 2011, 47(11), 87; https://doi.org/10.3390/medicina47110087 - 04 Dec 2011

Cited by 18 | Viewed by 970

Abstract

In the current article, 3 cases of aortic aneurysm and dissection in pregnant patients with Marfan’s syndrome are reported. It is well known that pregnancy is a risk factor for the development of aortic aneurysm and dissection in women with Marfan’s syndrome since [...] Read more.

In the current article, 3 cases of aortic aneurysm and dissection in pregnant patients with Marfan’s syndrome are reported. It is well known that pregnancy is a risk factor for the development of aortic aneurysm and dissection in women with Marfan’s syndrome since it is shown that dissection can develop both before and after labor. Marfan patients with an aortic root diameter greater than 4 cm should undergo preconceptual counseling for surgical aortic repair before pregnancy. Pregnant Marfan patients with an aortic aneurysm should be closely and continuously evaluated by multidisciplinary specialists in order to prevent possible aortic dissection that could be fatal for both the mother and the fetus. Full article

310 KiB

Open AccessArticle

Large Omental Metastases of a Gastrointestinal Stromal Tumor

by Povilas Ignatavičius, Tomas Petraitis, Žilvinas Saladžinskas, Lilija Butkevičienė and Kristina Žvinienė

Medicina 2011, 47(11), 86; https://doi.org/10.3390/medicina47110086 - 30 Nov 2011

Viewed by 809

Abstract

Gastrointestinal stromal tumors are rare tumors, originating from the interstitial cells of Cajal. They are the most common mesenchymal tumors of the gastrointestinal tract. Metastatic tumor is treated with imatinib mesylate. A case of large metastases of a gastrointestinal stromal tumor to the [...] Read more.

Gastrointestinal stromal tumors are rare tumors, originating from the interstitial cells of Cajal. They are the most common mesenchymal tumors of the gastrointestinal tract. Metastatic tumor is treated with imatinib mesylate. A case of large metastases of a gastrointestinal stromal tumor to the omentum, diagnosis and treatment principles are presented in this case report. Full article

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Medicina, Volume 47, Issue 11 (November 2011) – 8 articles

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