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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they 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.

Medicina, Volume 47, Issue 6 (June 2011) – 8 articles

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132 KiB  
Article
Inequalities in Mortality From Infectious Diseases and Tuberculosis by the Level of Education in Lithuania
by Snieguolė Kaselienė and Ramunė Kalėdienė
Medicina 2011, 47(6), 49; https://doi.org/10.3390/medicina47060049 - 5 Jul 2011
Cited by 2 | Viewed by 884
Abstract
The aim of this study was to evaluate changes in inequalities in mortality from infectious diseases and tuberculosis by educational level among men and women in Lithuania.
Material and Methods. The data on mortality from infectious diseases in the Lithuanian population aged [...] Read more.
The aim of this study was to evaluate changes in inequalities in mortality from infectious diseases and tuberculosis by educational level among men and women in Lithuania.
Material and Methods. The data on mortality from infectious diseases in the Lithuanian population aged more than 30 years for the years 1989 and 2001 gathered from the Department of Statistics and censuses were used for the analysis. The relative and slope indices of inequality were calculated.
Results. Mortality from infectious diseases and tuberculosis among persons with primary education was higher than that among persons with university education, and these inequalities were found to be increased in 2000–2002 as compare with 1988–1990 due to declining mortality among persons with university education and increasing mortality among less educated persons. Similar tendencies were observed while evaluating the inequalities in mortality from tuberculosis. In 1988– 1990, the relative indices of inequality for mortality from all infectious diseases and tuberculosis among men were 9 and 13, respectively. In 2000–2002, the relative indices of inequality increased significantly to 16.5 and 28.8, respectively. Inequalities in mortality from abovementioned causes for women with different educational levels were lower than those for men. The slope indices of inequality for mortality from infectious diseases among men with different educational levels were considerably higher than among their female counterparts, and in 2000–2002, they were greater compared with 1988–1990.
Conclusions
. While implementing tuberculosis prevention and control program and planning prevention and control measures, greater attention should be paid to less educated Lithuanian population at highest risk of this disease. Full article
906 KiB  
Article
Propolio ekstrakto komponentų atsipalaidavimo iš emulsinių dispersijų tyrimai
by Kristina Ramanauskienė, Modestas Žilius and Vitalis Briedis
Medicina 2011, 47(6), 50; https://doi.org/10.3390/medicina47060050 - 2 Jul 2011
Cited by 1 | Viewed by 859
Abstract
Tyrimo tikslas. Pagrindo sukūrimas yra vienas pagrindinių uždavinių kuriant pusiau kietąją vaisto formą, skirtą išoriniam vartojimui. Pusiau kietojo preparato stabilumą saugojimo metu galima prognozuoti remiantis klampos tyrimais. Tinkama pusiau kietojo preparato pagrindo sudėtis lemia jo stabilumą ir reikiamą vaistinės medžiagos atsipalaidavimo kinetiką. Įvertinant [...] Read more.
Tyrimo tikslas. Pagrindo sukūrimas yra vienas pagrindinių uždavinių kuriant pusiau kietąją vaisto formą, skirtą išoriniam vartojimui. Pusiau kietojo preparato stabilumą saugojimo metu galima prognozuoti remiantis klampos tyrimais. Tinkama pusiau kietojo preparato pagrindo sudėtis lemia jo stabilumą ir reikiamą vaistinės medžiagos atsipalaidavimo kinetiką. Įvertinant kremų technologiją, ypač kompleksinių vaistinių medžiagų (pvz., skystųjų, tirštųjų, sausųjų ekstraktų) įterpimo į pagrindą sudėtingumą, aktualios išlieka kremų pagrindų sudėties paieškos, norint išvengti ilgai trunkančių šildymo bei lydymo procesų. Tirštasis propolio ekstraktas, pasižymintis antimikrobiniu, antivirusiniu, priešuždegiminiu bei antioksidaciniu poveikiu, buvo pasirinktas kaip kompleksinė biologiškai veiklioji medžiaga kuriamos emulsinės dispersinės sistemos tyrimams. Tyrimų tikslas buvo nustatyti fizikinių ir cheminių savybių bei veikliųjų medžiagų išsiskyrimo greičio iš modeliuojamos vaisto formos in vitro rodiklio tarpusavio priklausomybę ir, remiantis tuo, pagrįsti emulsinio (vanduo-aliejus) kremo sudėties ir technologijos priimtinumą.
Tyrimo medžiaga ir metodai
. Propolio tirštasis ekstraktas (1–3 proc. nuo bendrosios sistemos masės) buvo įterptas į emulsinę sistemą vanduo-aliejus. Modelinių emulsinių sistemų kokybė įvertinta pagal jų klampą, polifenolinių junginių kiekį bei jų išsiskyrimo iš pagrindo greitį pritaikius in vitro modelį. Polifenolinių junginių kiekis μg/ml apskaičiuotas pritaikius ferulo rūgšties standartinę kalibracinę kreivę, naudojant spektrofotometrinį metodą.
Rezultatai
. Tyrimų duomenimis, tinkama emulsiklio koncentracija, būtina modeliuoti homogenišką, stabilią pusiau kietąją emulsinę sistemą su propolio tirštuoju ekstraktu, yra nuo 3 iki 12 proc. Klampos tyrimai parodė, kad emulsiklio kiekis modeliuojamose pusiau kietosiose sistemose turi įtakos jų klampai ir beveik nekeičia polifenolinių junginių išsiskyrimo iš kremo matricos greičio. Tyrimais nustatyta, kad tirštasis propolio ekstraktas emulsinėse sistemose klampos pokyčiui turi mažiau įtakos nei kremo temperatūra.
Išvada. Patvirtinta, kad klampos pokytis emulsinėse dispersinėse sistemose, didėjant temperatūrai, neturėjo įtakos modelinių dispersinių sistemų stabilumui, o tai būtina įvertinti nustatant modeliuojamų preparatų laikymo sąlygas jų saugojimo metu. Full article
217 KiB  
Article
Synthesis and Antimicrobial Properties of Naphthylamine Derivatives Having a Thiazolidinone Moiety
by Vilma Petrikaitė, Eduardas Tarasevičius and Alvydas Pavilonis
Medicina 2011, 47(6), 47; https://doi.org/10.3390/medicina47060047 - 28 Jun 2011
Cited by 1 | Viewed by 902
Abstract
Objective. The aim of this study was to evaluate the influence of pharmacophores having naphthylamine and nitro groups on the antimicrobial (antibacterial and antifungal) activity of thiazolidinone derivatives.
Materials and Methods
. The initial 5-substituted-2-methylmercaptothiazolidin-4-ones were subjected to S-demethylation to yield 2-amino-substituted [...] Read more.
Objective. The aim of this study was to evaluate the influence of pharmacophores having naphthylamine and nitro groups on the antimicrobial (antibacterial and antifungal) activity of thiazolidinone derivatives.
Materials and Methods
. The initial 5-substituted-2-methylmercaptothiazolidin-4-ones were subjected to S-demethylation to yield 2-amino-substituted thiazolidinones. 4-Nitro-1-naphthylamine, nitrofuran aldehydes, and nitrobenzene aldehydes were used as pharmacophoric compounds having amino or aldehyde groups. Antimicrobial (antibacterial and antifungal) activity of the new compounds was tested in vitro against bacterial cultures – Staphylococcus aureus, Escherichia coli, Bacillus subtilis, Klebsiella pneumoniae – and fungal cultures – Candida albicans, Candida glabrata, Candida krusei, Candida kefyr, Candida tropicalis, and Candida parapsilosis.
Results
. Microbiological analysis showed that all new thiazolidinone derivatives with nitronaphthylamine substituent possessed antibacterial and antifungal properties. New compounds 2a-b showed similar antibacterial activity in vitro against S. aureus and B. subtilis as aminopenicillins. The lowest antibacterial activity of all newly synthesized compounds was against capsule-forming bacteria K. pneumoniae and against gram-negative bacteria E. coli (minimum inhibitory concentration range, 500–1000 μg/mL).
Conclusions
. The minimum inhibitory concentration of naphthylamine derivatives varied in the range of 0.4–1000 μg/mL, and activity of some newly synthesized compounds was similar to the activity of aminopenicillins and fluconazole, an antifungal preparation. Based on the results, it is possible to separate the perspective group of potential antimicrobial compounds. Full article
268 KiB  
Article
Comparison of Long-Term Stability of Parenteral All-in-One Admixtures Containing New Lipid Emulsions Prepared Under Hospital Pharmacy Conditions
by Michal Janů, Helena Brodská, Marek Vecka, Ruta Masteiková, Eva Kotrlíková, Robertas Lažauskas, Rimantas Pečiūra and Jurga Bernatonienė
Medicina 2011, 47(6), 46; https://doi.org/10.3390/medicina47060046 - 28 Jun 2011
Cited by 5 | Viewed by 1246
Abstract
All-in-one (AIO) admixtures for parenteral nutrition are common in hospital pharmacy practices. They are extemporaneously prepared and should be stable during preparation, storage, and administration. Lipid emulsion is a clinically important and very susceptible component of instability. The objective of study was to [...] Read more.
All-in-one (AIO) admixtures for parenteral nutrition are common in hospital pharmacy practices. They are extemporaneously prepared and should be stable during preparation, storage, and administration. Lipid emulsion is a clinically important and very susceptible component of instability. The objective of study was to evaluate the long-term stability of AIO admixtures containing modern lipid emulsions.
Material and methods. AIO admixtures with two different emulsions (SMOFlipid and Lipoplus) containing the same amount of glucose and complex amino acid solution, and variable amounts of ions were prepared. Samples were evaluated at 2, 5, 8 and 30 days after preparation. The main indicator of AIO system stability was the amount of lipid globules greater than 5 μm in diameter, which is limited by pharmacopoeia. Optical microscopy was used for particle size measurement.
Results
. All prepared AIO admixtures remained stable during observation. The counts of overlimit lipid particles were within pharmacopeial limit nevertheless tended to increase in time. After 30-day storage, their value was influenced mainly by concentration of calcium ions, which at lower concentrations had a greater impact on SMOFlipid-based admixtures, whereas at the highest concentration on Lipoplus-based admixtures. The concentration of ions and osmolarity remained without changes; pH of admixtures slightly decreased.
Conclusions
. Both lipid emulsions were found to be suitable for preparation AIO admixtures with different concentrations of electrolytes. The formulations were stable even if contained high concentrations of divalent ions. The comparison of emulsions revealed the superiority of Lipoplus – electrolyte concentrations and duration of storage had a greater impact on admixtures with SMOFlipid. Full article
381 KiB  
Article
Superficial Siderosis: A Case Report
by Nuno Canto Moreira, Rūta Nylander, Inesa Briaukaitė, Severina Vėlyvytė, Rymantė Gleiznienė and Eglė Monastyreckienė
Medicina 2011, 47(6), 45; https://doi.org/10.3390/medicina47060045 - 28 Jun 2011
Cited by 2 | Viewed by 911
Abstract
Superficial siderosis of the central nervous system is the result of chronic recurrent hemorrhages (e.g., arteriovenous malformations, tumors, or trauma), which leads to the accumulation of cytotoxic hemosiderin and presents with hearing loss, cerebellar dysfunction, and myelopathy. This article presents a clinical case [...] Read more.
Superficial siderosis of the central nervous system is the result of chronic recurrent hemorrhages (e.g., arteriovenous malformations, tumors, or trauma), which leads to the accumulation of cytotoxic hemosiderin and presents with hearing loss, cerebellar dysfunction, and myelopathy. This article presents a clinical case of an 11-year-old boy in whom the diagnosis of medulloblastoma was established. He underwent surgery, and after a few years, he began to complain of hearing loss. Magnetic resonance imaging revealed the cause of the hearing disturbance. The aim of this article is to review the recent literature related to the etiology, clinical and radiologic features of superficial siderosis, emphasizing the role of magnetic resonance imaging. Full article
153 KiB  
Article
The Prevalence of Problem Drug Use in Lithuania
by Audronė Astrauskienė, Valerij Dobrovolskij and Rimantas Stukas
Medicina 2011, 47(6), 48; https://doi.org/10.3390/medicina47060048 - 27 Jun 2011
Viewed by 1081
Abstract
The aim of this study was to estimate and assess the prevalence of problem drug use in Lithuania.
Materials and Methods
. The capture-recapture method was used to estimate the prevalence of problem drug use. For the study, the data concerning problem drug [...] Read more.
The aim of this study was to estimate and assess the prevalence of problem drug use in Lithuania.
Materials and Methods
. The capture-recapture method was used to estimate the prevalence of problem drug use. For the study, the data concerning problem drug users were collected from the databases of health care and law enforcement institutions. The target group consisted of permanent users (aged 15–64 years) of heroin and other opioids and/or a combination of drugs.
Results. In Lithuania, 431 monitored problem drug users were identifi ed in 2005, 482 in 2006, and 447 in 2007. The male-to-female ratio among the monitored problem drug users was 6:1 in 2006 and 4:1 in 2005 and 2007. The mean age of the monitored problem drug users was 26.8 years in 2005, 27.6 years in 2006, and 28.0 years in 2007. In total, 5699 problem drug users were identified (95% CI, 5552 to 5849) in 2005, 5800 (95% CI, 5652 to 5951) in 2006, and 5458 (95% CI, 5314 to 5605) in 2007. According to the gathered data, the prevalence of problem drug use was 2.3 cases per 1000 Lithuanian population aged 15–64 years in 2005, 2.5 in 2006, and 2.4 in 2007.
Conclusions
. The study showed one of the lowest prevalence of problem drug use in Lithuania as in Germany, the Netherlands, Greece, and Cyprus. In 2005–2007, problem drug users were mainly young men of employable age in Lithuania. Full article
123 KiB  
Article
Executive Functions in Adolescents With Idiopathic Generalized Epilepsy
by Giedrė Gelžinienė, Giedrė Jurkevičienė, Vitalija Marmienė, Virginija Adomaitienė and Milda Endzinienė
Medicina 2011, 47(6), 44; https://doi.org/10.3390/medicina47060044 - 27 Jun 2011
Cited by 17 | Viewed by 1063
Abstract
Disorders of executive functioning have recently been reported in patients with juvenile myoclonic epilepsy (JME); however, data on other syndromes of generalized idiopathic epilepsy (IGE) other than JME, especially in adolescence, are scarce. The aim of this study was to explore specific executive [...] Read more.
Disorders of executive functioning have recently been reported in patients with juvenile myoclonic epilepsy (JME); however, data on other syndromes of generalized idiopathic epilepsy (IGE) other than JME, especially in adolescence, are scarce. The aim of this study was to explore specific executive functions in a group of adolescents with IGE of short duration and to evaluate the possible factors that might influence these functions.
Material and Methods
. Neuropsychological investigation of executive functions (the Verbal Fluency Test, the Five-Point Test, the Trail-Making Test, and the Stroop test) was performed in 59 patients aged 14–17 years and meeting the diagnostic criteria for IGE, and in the group of 59 agematched controls without any history of epilepsy.
Results
. The IGE group subjects scored worse than the controls in most of the executive function tests: phonemic (P=0.008) and semantic (P=0.001) word fluency, figural fluency (P=0.008), visual search and sequencing of numbers (P=0.001), and alternate number-letter sequencing (P=0.018). None of the test scores differed between the new-onset and the established IGE groups, or between the groups of cases with and without myoclonias. No relationship between executive functioning and gender, age, duration or activity of epilepsy, treatment, or epileptiform discharges on electroencephalography was found.
Conclusions. Executive dysfunction was present in adolescents with JME and other syndromes of IGE, manifesting with generalized tonic-clonic seizures without myoclonias, despite short duration and benign course of epilepsy Full article
182 KiB  
Article
The Impact of Myocardial Revascularization After Acute Coronary Syndromes on One-Year Cardiovascular Mortality
by Dalia Lukšienė, Irena Milvidaitė, Rimvydas Šlapikas, Gediminas Jaruševičius, Adakrius Siudikas, Jonė Venclovienė and Remigijus Žaliūnas
Medicina 2011, 47(6), 43; https://doi.org/10.3390/medicina47060043 - 27 Jun 2011
Cited by 2 | Viewed by 912
Abstract
The aim of this observational study was to evaluate the impact of myocardial revascularization performed after acute coronary syndromes on one-year cardiovascular mortality.
Material and Methods. The study population comprised 1226 consecutive patients who were admitted to the Clinic of Cardiology in [...] Read more.
The aim of this observational study was to evaluate the impact of myocardial revascularization performed after acute coronary syndromes on one-year cardiovascular mortality.
Material and Methods. The study population comprised 1226 consecutive patients who were admitted to the Clinic of Cardiology in 2005 because of acute coronary syndromes with significant (≥70%) coronary artery stenoses. The relationship between myocardial revascularization and oneyear cardiovascular mortality was evaluated by applying multivariable logistic regression. Cardiovascular mortality was evaluated using the Kaplan-Meier method.
Results
. Of all the patients included into the study, 540 had Q-wave myocardial infarction, 339 patients had non–Q-wave myocardial infarction, and 347 patients were treated for unstable angina pectoris. During hospitalization, 496 patients underwent percutaneous transluminal coronary angioplasty, 373 patients underwent coronary artery bypass grafting within 60 days following acute coronary syndromes, and 357 patients received pharmacological treatment alone. During one-year follow-up, 105 cases of cardiovascular death were registered. The one-year cardiovascular mortality was significantly lower in patients who underwent percutaneous transluminal coronary angioplasty or coronary artery bypass grafting comparing with those patients who received only pharmacotherapy (5.4% and 7.8% vs. 14.3%, P<0.05). Multivariate logistic regression analysis revealed that myocardial revascularization independently reduced one-year cardiovascular mortality (adjusted odds ratio for percutaneous transluminal coronary angioplasty, 0.304; 95% CI, 0.18 to 0.53; P<0.001, and coronary artery bypass grafting, 0.540; 95% CI, 0.32 to 0.90; P=0.018) in patients who were admitted because of acute coronary syndromes.
Conclusions. Myocardial revascularization performed after acute coronary syndromes was significantly associated with the reduction of cardiovascular mortality within one-year period independently of clinical variables. Full article
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