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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 48, Issue 11 (November 2012) – 8 articles

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219 KiB  
Article
Evaluation of Health-Related Quality of Life in Lithuanian Brain Tumor Patients Using the EORTC Brain Cancer Module
by Adomas Bunevičius, Šarūnas Tamašauskas, Arimantas Tamašauskas and Vytenis Deltuva
Medicina 2012, 48(11), 86; https://doi.org/10.3390/medicina48110086 - 2 Jan 2013
Cited by 12 | Viewed by 1031
Abstract
Background and Objective. Health-related quality of life (HRQoL) is considered an important outcome measure in neuro-oncology. The aim of this study was to evaluate the psychometric properties of the brain cancer-specific Quality of Life Questionnaire (QLQ-BN20) of the European Organization for Research [...] Read more.
Background and Objective. Health-related quality of life (HRQoL) is considered an important outcome measure in neuro-oncology. The aim of this study was to evaluate the psychometric properties of the brain cancer-specific Quality of Life Questionnaire (QLQ-BN20) of the European Organization for Research and Treatment of Cancer (EORTC) in Lithuanian brain tumor patients.
Material and Methods
. One hundred consecutive patients (71% of women; mean age, 58±14 years) admitted for elective brain tumor surgery were evaluated for HRQoL using the QLQ-BN20, QLQ-C30 (a core EORTC questionnaire for cancer patients), and SF-36 scale; for motor dysfunction (clinical examination); for cognitive dysfunction (Mini-Mental State Examination); and for disability (Barthel Index).
Results
. The QLQ-BN20 subscales had an adequate internal consistency (Cronbach α, 0.75– 0.90). Motor dysfunction on neurological examination was associated with greater motor dysfunction on the QLQ-BN20; greater disability, with greater future uncertainty, motor dysfunction, communication deficits, headaches, seizures, drowsiness, itchy skin, weakness of legs, and poor bladder control on the QLQ-BN20; and cognitive dysfunction, with greater future uncertainty, visual deficits, motor dysfunction, communication deficits, headaches, drowsiness, and weakness of legs symptoms on the QLQ-BN20, suggesting an adequate clinical validity of the QLQ-BN20. A score for motor dysfunction on the QLQ-BN20 correlated with a score for motor dysfunction on the QLQ-C30 and SF-36 scales; a score for headache on the QLQ-BN20, with a score for pain on the QLQ-C30 and SF-36 scales; and a score for drowsiness symptoms on the QLQ-BN20, with a score for fatigue on the QLQ-C30.
Conclusions
. The Lithuanian version of the EORTC-QLQ-BN20 scale has acceptable psychometric properties and can be reliably used for the assessment of HRQoL in brain tumor patients. Full article
1077 KiB  
Article
Social Determinants of Smoking, Alcohol and Drug Use Among Lithuanian School-Aged Children: Results From 5 Consecutive HBSC Surveys, 1994–2010
by Linas Šumskas, Apolinaras Zaborskis and Vilius Grabauskas
Medicina 2012, 48(11), 87; https://doi.org/10.3390/medicina48110087 - 12 Dec 2012
Cited by 7 | Viewed by 1060
Abstract
The aim of this study was to analyze the changes in the prevalence of smoking, alcohol and drug use among Lithuanian school-aged children in relation to the place of residence, family affluence, and family structure.
Material and Methods
. National surveys (26 556 [...] Read more.
The aim of this study was to analyze the changes in the prevalence of smoking, alcohol and drug use among Lithuanian school-aged children in relation to the place of residence, family affluence, and family structure.
Material and Methods
. National surveys (26 556 anonymous questionnaires analyzed) of schoolchildren aged 11, 13, and 15 years were conducted in 1994, 1998, 2002, 2006, and 2010 in the framework of the international Health Behaviour in School-aged Children (HBSC) study.
Results. In 1994–2010, a significant increase in smoking prevalence was observed both among boys (11.3% to 21.5%, P<0.05) and girls (3.6% to 14.8%, P<0.05). Weekly alcohol consumption increased from 9.6% to 12.9% (P<0.05) among boys and from 4.3% to 7.9% (P<0.05) among girls. The prevalence of “ever use” of any psychoactive substance (data for 15-year-old group only) increased both in boys (14.6% to 33.5%) and girls (6.7% to 18.4%). Urban girls smoked more often than their rural peers. For both genders, such a residential gradient was observed in the use of alcohol and drugs. The respondents from intact families used drugs less frequently than the adolescents from not intact families. The adolescents from affluent families smoked less often, while the prevalence of alcohol and drug use was higher (except weekly alcohol use in girls).
Conclusions
. The study has demonstrated a significant increase in the prevalence of smoking, drinking, and drug use among Lithuanian school-aged children during the period of transition to market economy. This study provides some insight that should be addressed in equity-oriented control policies of substance use. Full article
276 KiB  
Article
Tuberculosis Complications After BCG Treatment for Urinary Bladder Cancer
by Albinas Naudžiūnas, Rūta Juškaitė, Indrė Žiaugrytė, Alvydas Unikauskas, Eglė Varanauskienė and Edita Mašanauskienė
Medicina 2012, 48(11), 82; https://doi.org/10.3390/medicina48110082 - 11 Dec 2012
Cited by 10 | Viewed by 1084
Abstract
Bacillus Calmette-Guérin (BCG) is an attenuated strain of Mycobacterium bovis that has been effectively used in the treatment of non-muscle invasive bladder carcinoma. The complications of this treatment are uncommon, and the causes of dissemination are still discussed. We report a case of [...] Read more.
Bacillus Calmette-Guérin (BCG) is an attenuated strain of Mycobacterium bovis that has been effectively used in the treatment of non-muscle invasive bladder carcinoma. The complications of this treatment are uncommon, and the causes of dissemination are still discussed. We report a case of disseminated tuberculosis in a 66-year-old smoking man without a history of pulmonary diseases, who underwent immunotherapy with BCG after the initial surgical treatment of bladder cancer. After the last BCG instillation, he developed a fever. The diagnosis of sepsis was not confirmed, and miliary pulmonary tuberculosis was suspected. The diagnosis was confirmed by clinical manifestation, computed tomography of the lungs, and histological examination. Full article
376 KiB  
Article
Potential Candidate Genes for Alveolar Hypoxia Identified by Transcriptome Network Analysis
by Bi-li Zhang, Rong-liang Xu, Yong-wen Qin, Xing Zheng, Hong Wu, Xiao-hua You, Jiang Cao, Jian-qiang Hu and Xian-xian Zhao
Medicina 2012, 48(11), 84; https://doi.org/10.3390/medicina48110084 - 10 Dec 2012
Cited by 4 | Viewed by 966
Abstract
Background. Alveolar hypoxia is an important condition related to many disorders such as chronic pulmonary hypertension, pulmonary vasoconstriction, and pulmonary vascular remodeling. The aim of present study was to disclose the biological response and the potential transcriptome networks regulating the hypoxia response [...] Read more.
Background. Alveolar hypoxia is an important condition related to many disorders such as chronic pulmonary hypertension, pulmonary vasoconstriction, and pulmonary vascular remodeling. The aim of present study was to disclose the biological response and the potential transcriptome networks regulating the hypoxia response in the lungs.
Materials and Methods
. In this study, the microarray dataset GSE11341 was used to construct a regulatory network and identify the potential genes related to alveolar hypoxia. In addition, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway and Gene Ontology (GO) term enrichment analyses were also performed.
Results
. Hypoxia inducible factor 1 alpha (HIF-1α), peroxisome proliferator-activated receptor gamma (PPARγ), and nuclear factor of kappa light polypeptide gene enhancer in B cells (NF-кB) were to be the hub nodes in the transcriptome network. HIF-1α may regulate potassium voltagegated channel, shaker-related subfamily, member (5KCNA5), solute carrier family 2 (facilitated glucose transporter), member (1SLC2A1), and heme oxygenase (decycling) 1 (HMOX1) expression through the regulation of membrane potential, glucose metabolism, and anti-inflammation pathways. HMOX-1 mediates signaling pathways that relate to NF-кB. CCND1 (cyclin D1) expression could be regulated by PPARγ and HIF-1α via the cell cycle pathway. In addition, new transcriptional factors and target genes, such as phosphofructokinase (PFKL, liver), aldolase A (ALDOA, fructose-bisphosphate), and trefoil factor 3 (intestinal) (TFF3), were also identified.
Conclusions
. Transcriptome network analysis is a helpful method for the identification of the candidate genes in alveolar hypoxia. The KEGG pathway and GO term analysis are beneficial in the prediction of the underlying molecular mechanism of these identified genes in alveolar hypoxia. Full article
204 KiB  
Article
Tear Nitric Oxide Levels in Behçet’s Disease
by Yalçın İşcan, Ulviye Yiğit, Betül Tuğcu Çakmak, Mehmet Erdoğan, Derya Ars Erdoğan, Veysi Öner, Mehmet Taş and Yılmaz Özyazgan
Medicina 2012, 48(11), 81; https://doi.org/10.3390/medicina48110081 - 5 Dec 2012
Cited by 11 | Viewed by 999
Abstract
The aim of this study was to evaluate the tear nitric oxide (NO) level in patients with Behçet’s disease and to compare it with that in healthy subjects. Material and Methods. The subjects were divided into 3 groups: the active disease, inactive disease, [...] Read more.
The aim of this study was to evaluate the tear nitric oxide (NO) level in patients with Behçet’s disease and to compare it with that in healthy subjects. Material and Methods. The subjects were divided into 3 groups: the active disease, inactive disease, and control groups. NO concentrations were determined by a nitrate/nitrite colorimetric assay kit and measured spectrophotometrically at 540 nm.
Results
. The tear nitrate/nitrite levels were 0.06 nmol/μL (SD, 0.05) in the active disease group, 0.05 nmol/μL (SD, 0.05) in the inactive disease group, and 0.02 nmol/μL (SD, 0.01) in the control group. The tear nitrate/nitrite levels of both active and inactive groups were higher than those of the control group (P=0.001 and P=0.047, respectively), but there was no significant difference between the active and inactive groups.
Conclusion. Our results demonstrated that the tear NO levels were elevated in the patients with Behçet’s disease. We imply that a better understanding of NO function in the pathogenesis of Behçet uveitis is necessary to develop new therapies based on the inhibitors of NO synthases. Full article
213 KiB  
Article
Pharmacovigilance and Principle of Nonmaleficence in Sex Reassignment
by Kristina Zamarytė, Donatas Stakišaitis, Agnė Širinskienė, Andrius Narbekovas and Jonas Juškevičius
Medicina 2012, 48(11), 88; https://doi.org/10.3390/medicina48110088 - 4 Dec 2012
Viewed by 1015
Abstract
Physicians are obliged to provide treatment that is consistent with their commitment to avoid or minimize harm (nonmaleficence) and their commitment to do good (beneficence). Therefore, if patient’s desires were contradictory to the primary aim of medicine, the doctor’s calling would require him/her [...] Read more.
Physicians are obliged to provide treatment that is consistent with their commitment to avoid or minimize harm (nonmaleficence) and their commitment to do good (beneficence). Therefore, if patient’s desires were contradictory to the primary aim of medicine, the doctor’s calling would require him/her to thoroughly analyze the cause of the disease and provide an adequate as well as ethical treatment rather than obediently follow patient’s requests. Yet, chemical and surgical sex reassignment is one of the areas where some physicians surrender to the desire of their patients instead of finding out what their real condition is and trying to manage it in a way the essence of medicine would require. The objective of this article was to provide specific pharmacovigilance search details for the evaluation of the current situation and the scientific background of the treatment of gender dysphoria and to analyze its conformity with one of the two main ethical principles of medicine – nonmaleficence. Literature retrieval was accessed through Medline (1979–2011) using the terms “gender dysphoria,” “replacement hormonal therapy,” and “pharmacovigilance.” The article concludes that hormonal and surgical interventions have not proven to be medically justified and could be harmful, not treating the cause, but resulting in irreversible disability. Thus, these interventions contradict the principle of nonmaleficence and goals of basic therapeutics and pharmacovigilance. They are not based on clinical trials and are lacking a thorough follow-up assessment. Full article
216 KiB  
Article
Assessment of the Effect of Anthropometric Data on the Alterations of Cardiovascular Parameters in Lithuanian Elite Male Basketball Players During Physical Load
by Renata Žumbakytėermukšnienė, Alma Kajėnienė, Kristina Berškienė, Algė Daunoravičienė and Rasa Sederevičiūtė-Kandratavičienė
Medicina 2012, 48(11), 83; https://doi.org/10.3390/medicina48110083 - 4 Dec 2012
Cited by 2 | Viewed by 938
Abstract
Objectives. The aim of the study was to assess the effect of the anthropometric data of basketball players on the alterations of cardiovascular parameters during the physical load applying the model of integrated evaluation.
Material and Methods. The research sample consisted of [...] Read more.
Objectives. The aim of the study was to assess the effect of the anthropometric data of basketball players on the alterations of cardiovascular parameters during the physical load applying the model of integrated evaluation.
Material and Methods. The research sample consisted of 113 healthy Caucasian male basketball players, candidates of the Lithuanian National men’s basketball teams. Basketball players were divided into 2 groups: 69 taller and heavier male basketball players (with a higher percentage of body fat) (TMB) and 44 shorter and less heavy male basketball players (with a lower percentage of body fat) (SMB). The amount of fat, expressed in percentage, was measured using the body composition analyzer TBF–300. “Kaunas-Load,” a computerized ECG analysis system, was used to evaluate the functional condition of the cardiovascular system during the load.
Results. The TMB group had a lower heart rate during the warming-up phase and the steady state of the load as compared with the SMB group (P<0.05). The JT interval in the TMB group was greater during the warming-up and the steady state as compared with the SMB group (P<0.05). The JT/RR ratio index in the TMB group was found to be lower in the warming-up phase and in the steady state compared with the respective parameter in the SMB group (P<0.05).
Conclusions
. T he cardiovascular system of taller and heavier male basketball players with a greater relative amount of body fat functioned more economically. Full article
227 KiB  
Article
Evaluation of Leadership Competencies of Executives in Lithuanian Public Health Institutions
by Mindaugas Stankūnas, Skirmantė Sauliūnė, Tony Smith, Mark Avery, Linas Šumskas and Katarzyna Czabanowska
Medicina 2012, 48(11), 85; https://doi.org/10.3390/medicina48110085 - 5 Nov 2012
Cited by 4 | Viewed by 1179
Abstract
Background and Objective. Lithuanian and international public health experts emphasize the importance of leadership in public health. The aim of this study was to explore the self-assessed level of leadership competencies of executives in Lithuanian public health institutions.
Material and Methods. [...] Read more.
Background and Objective. Lithuanian and international public health experts emphasize the importance of leadership in public health. The aim of this study was to explore the self-assessed level of leadership competencies of executives in Lithuanian public health institutions.
Material and Methods. Data were collected in a cross-sectional survey of executives of Lithuanian public health institutions in 2010. The total number of returned questionnaires was 55 (response rate, 58.5%). Respondents were asked about their competencies in leadership, teamwork, communication, and conflict management. The evaluation was carried out by analyzing the answers provided in the survey, which used a 5-point rating scale. In addition, the Belbin Team-Role Self-Perception Inventory and the Thomas-Kilmann Conflict Mode Instrument were used.
Results
. The results showed that respondents were reserved or limited in their individual capacities through this evaluation of their leadership competencies. The mean score was 3.47 (SD, 0.71). Skills in competency areas of communication, teamwork, and conflict management were scored higher (3.73 [SD, 0.67], 3.73 [SD, 0.62], and 3.53 [SD, 0.63], respectively). Most of executives preferred to choose action-oriented roles (76.2%). The most common role was “implementer” (69.1%). “Avoiding” (52.7%) was the most common conflict solving strategy. The results showed that 89.1% of executives wanted to improve teamwork; 83.6%, leadership competencies; 81.8%, communication; and 80.0%, conflict management.
Conclusions
. The study results suggest that the executives of Lithuanian public health institutions evaluate their leadership competencies moderately. These results indicate the value of leadership training for public health executives. Full article
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