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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 8 (August 2012) – 8 articles

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426 KiB  
Article
Microvascular Distribution in the Ocular Conjunctiva and Digestive Tract in an Experimental Setting
by Andrius Pranskūnas, Vidas Pilvinis, Žilvinas Dambrauskas, Renata Rasimavičiūtė, Eglė Milieškaitė, Algimantas Bubulis, Vincentas Veikutis, Dinas Vaitkaitis and E. Christiaan Boerma
Medicina 2012, 48(8), 62; https://doi.org/10.3390/medicina48080062 - 4 Sep 2012
Cited by 8 | Viewed by 867
Abstract
microcirculation; conjunctiva; jejunum; rectum; pigs Full article
260 KiB  
Article
Longitudinal Predictors of Aerobic Performance in Adolescent Soccer Players
by João Valente-dos-Santos, Manuel J. Coelho-e-Silva, João Duarte, António J. Figueiredo, João R. Liparotti, Lauren B. Sherar, Marije T. Elferink-Gemser and Robert M. Malina
Medicina 2012, 48(8), 61; https://doi.org/10.3390/medicina48080061 - 4 Sep 2012
Cited by 17 | Viewed by 1084
Abstract
Background. The importance of aerobic performance in youth soccer is well established. The aim of the present study was to evaluate the contributions of chronological age (CA), skeletal age (SA), body size, and training to the longitudinal development of aerobic performance in [...] Read more.
Background. The importance of aerobic performance in youth soccer is well established. The aim of the present study was to evaluate the contributions of chronological age (CA), skeletal age (SA), body size, and training to the longitudinal development of aerobic performance in youth male soccer players aged 10 to 18 years.
Material and Methods
. Players (n=83) were annually followed up during 5 years, resulting in an average of 4.4 observations per player. Decimal CA was calculated, and SA, stature, body weight, and aerobic performance were measured once per year. Fat-free mass (FFM) was estimated from age- and gender-specific anthropometric formulas, and annual volume training was recorded. After testing for multicollinearity, multilevel regression modeling was used to analyze the longitudinal data aligned by CA and SA (Model 1 and 2, respectively) and to develop aerobic performance scores.
Results
. The following equations provide estimations of the aerobic performance for young soccer players: ŷ(Model 1 [deviance from the null model =388.50; P<0.01]) =57.75+9.06×centered CA– 0.57×centered CA2+0.03×annual volume training and ŷ(Model 2 [deviance from the null model= 327.98; P<0.01])=13.03+4.04×centered SA–0.12×centered SA2+0.99×FFM+0.03×annual volume training.
Conclusions
. The development of aerobic performance in young soccer players was found to be significantly related to CA, biological development, and volume of training. Full article
215 KiB  
Article
Does Matrix Metalloproteinase-3 Polymorphism Play a Role in Age-Related Macular Degeneration in Patients With Myocardial Infarction?
by Rasa Liutkevičienė, Diana Žaliaduonytė-Pekšienė, Dalia Žaliūnienė, Olivija Gustienė, Vytautas Jašinskas, Vaiva Lesauskaitė, Abdonas Tamošiūnas and Remigijus Žaliūnas
Medicina 2012, 48(8), 60; https://doi.org/10.3390/medicina48080060 - 4 Sep 2012
Cited by 5 | Viewed by 889
Abstract
Objective. The aim of our study was to determine if the genotype of the matrix metalloproteinase- 3 (MMP-3) gene might carry the risk of age-related macular degeneration (ARMD) in patients with myocardial infarction.
Material and Methods. A total of 499 patients [...] Read more.
Objective. The aim of our study was to determine if the genotype of the matrix metalloproteinase- 3 (MMP-3) gene might carry the risk of age-related macular degeneration (ARMD) in patients with myocardial infarction.
Material and Methods. A total of 499 patients with an acute myocardial infarction or with a history of myocardial infarction were enrolled into the study. They were subdivided into 2 groups: 273 patients with ARMD and 226 patients without ARMD. The control group comprised 560 persons from a random sample of the Lithuanian population. DNA was analyzed using real-time polymerase chain reaction to genotype polymorphism 5A/6A at a position –1171 of the MMP-3 gene promoter.
Results
. Of the 499 patients with myocardial infarction, 47% had early-stage ARMD. The patients with ARMD were older than the patients in the group without ARMD (62.1±10.8 vs. 59.6±11.1, P<0.01). The analysis of MMP-3 gene polymorphism did not reveal any differences in the distribution of 5A/5A, 5A/6A, and 6A/6A genotypes between the ARMD group, non-ARMD group, and the control group (24.2%, 52.5%, and 23.3% in the ARMD group; 28.7%, 51.9%, and 19.4% in non-ARMD group; and 25.7%, 49.3% and 25.0%, in the control group, respectively). Conclusions. MMP-3 gene polymorphism had no predominant effect on the development of ARMD in patients with myocardial infarction. Full article
213 KiB  
Article
The Prevalence of Health Care-Associated Infections and Risk Factors in a University Hospital
by Greta Gailienė, Zita Gierasimovič, Daiva Petruševičienė and Aušra Macijauskienė
Medicina 2012, 48(8), 59; https://doi.org/10.3390/medicina48080059 - 4 Sep 2012
Cited by 9 | Viewed by 1068
Abstract
The aim of the study was to evaluate the prevalence of health care-associated infections, risk factors, and antimicrobial use.
Material and Methods
. The study was carried out as a point-prevalence study in acute care wards, i.e., intensive care, surgical, and medical wards, [...] Read more.
The aim of the study was to evaluate the prevalence of health care-associated infections, risk factors, and antimicrobial use.
Material and Methods
. The study was carried out as a point-prevalence study in acute care wards, i.e., intensive care, surgical, and medical wards, at Vilnius University Hospital Santariškių Klinikos in April 2010. The study variables included the patient’s general data, indwelling devices, surgery, infection and its microbiological investigation, and antimicrobial use. All the variables that were logically related or had a P value of <0.25 in the univariate analysis were included in the stepwise logistic regression in order to study the factors potentially associated with health careassociated infections.
Results
. A total of 731 patients were surveyed. The overall prevalence rate of health care-associated infections was 3.8%. The prevalence of health care-associated infections differed by hospital wards (range 0.0%–19.2%). The lower respiratory tract (32.2%), urinary tract (28.5%), and surgical site infections (32.1%) were the most common health care-associated infections. Moreover, 89.3% of the cases of health care-associated infections were microbiologically investigated. Staphylococcus aureus (28.6%) and Escherichia coli (19.1%) were the most frequently isolated microorganisms. The use of one or more invasive devices was recorded in 332 patients (45.4%). Of the surveyed patients, 20.2% received antimicrobial agents. The most commonly prescribed antimicrobial agents were fluoroquinolones (21.1%), broad-spectrum penicillins (19.1%), and first- or second-generation cephalosporins (18.6%).
Conclusions
. The prevalence of health care-associated infections was found to be similar to the reported overall prevalence rate of health care-associated infections in acute care hospitals in Lithuania. Full article
216 KiB  
Article
Incidence of Inflammatory Bowel Disease in Kaunas Region, Lithuania
by Gediminas Kiudelis, Laimas Jonaitis, Kęstutis Adamonis, Aida Žvirblienė, Algimantas Tamelis, Rima Kregždytė, Rūta Kučinskienė, Jurgita Šventoraitytė and Limas Kupčinskas
Medicina 2012, 48(8), 64; https://doi.org/10.3390/medicina48080064 - 1 Sep 2012
Cited by 4 | Viewed by 1068
Abstract
Objective. The aim of this study was to evaluate the incidence of inflammatory bowel disease in Kaunas and its region during a 3-year period.
Material and Methods.
The study was conducted during the 3-year period (2007–2009) and enrolled the patients from Kaunas [...] Read more.
Objective. The aim of this study was to evaluate the incidence of inflammatory bowel disease in Kaunas and its region during a 3-year period.
Material and Methods.
The study was conducted during the 3-year period (2007–2009) and enrolled the patients from Kaunas with its region, which has a population of 381 300 inhabitants. The data were collected from all practices in the area where the diagnosis of inflammatory bowel disease was made by practicing gastroenterologists and consulting pediatricians along with endoscopists. Only new cases of inflammatory bowel disease were included into analysis. The diagnosis of ulcerative colitis and Crohn’s disease was strictly made according to the Copenhagen criteria. Age- and sex-standardized incidence was calculated for each year of the study period.
Results. A total of 108 new inflammatory bowel disease cases were diagnosed during the study period: 87 had ulcerative colitis, 16 Crohn’s disease, and 5 indeterminate colitis. The incidence of ulcerative colitis, Crohn’s disease, and indeterminate colitis for each study year was 6.85, 5.33, and 7.38 per 100 000; 0.95, 1.11, and 1.57 per 100 000; and 0.47, 0.21, and 0.42 per 100 000, respectively. The average 3-year standardized incidence of ulcerative colitis, Crohn’s disease, and indeterminate colitis was 6.52, 1.21, and 0.37 per 100 000, respectively. The mean patients’ age at onset of ulcerative colitis, indeterminate colitis, and Crohn’s disease was 49.95 (SD, 17.03), 49.80 (SD, 17.71), and 34.94 years (SD, 0.37), respectively.
Conclusions. The average 3-year incidence of ulcerative colitis in Kaunas region was found to be lower as compared with that in many parts of Central and Western Europe. The incidence of Crohn’s disease was low and very similar to other countries of Eastern Europe. Age at onset of the diseases appeared to be older than that reported in the Western industrialized countries. Full article
759 KiB  
Article
Diagnostic Methods, Treatment Modalities, and Follow-up of Extracranial Arteriovenous Malformations
by Birutė Vaišnytė, Donatas Vajauskas, Darius Palionis, Nerijus Misonis, Marius Kurminas, Daiva Nevidomskytė, Mindaugas Matačiūnas, Marijus Gutauskas and Aleksandras Laucevičius
Medicina 2012, 48(8), 58; https://doi.org/10.3390/medicina48080058 - 18 Aug 2012
Cited by 10 | Viewed by 1057
Abstract
Objective. Arteriovenous malformations (AVMs) are an uncommon vascular pathology that remains challenging to accurately diagnose and successfully treat. This study introduces a novel way to evaluate AVM treatment outcomes using transarterial lung perfusion scintigraphy (TLPS) and reports our treatment results.
Material and
[...] Read more.
Objective. Arteriovenous malformations (AVMs) are an uncommon vascular pathology that remains challenging to accurately diagnose and successfully treat. This study introduces a novel way to evaluate AVM treatment outcomes using transarterial lung perfusion scintigraphy (TLPS) and reports our treatment results.
Material and Methods
. The patients treated for extracranial AVMs were studied retrospectively. Diagnosis and outcomes were based on clinical data, ultrasonography, magnetic resonance imaging, computed tomography, angiography, and TLPS studies. The influence of gender; location, form, and stage of AVMs; first attempt at treatment; and treatment modalities was analyzed. Outcomes were defined as positive (cure, improvement, and remission) or negative (no remission and aggravation).
Results
. Of the 324 patients with congenital vascular malformations, 129 (39.8%) presented with AVMs, and the data of 56 treated patients with AVMs were analyzed. Of the 29 patients in the endovascularly treated group, 15 in the surgically treated group, and 12 in the combined treatment group, 24 (82.8%), 14 (93.3%), and 10 patients (83.3%), respectively, had positive outcomes (P>0.05). All outcomes were positive in surgically treated patients with extratruncular limited AVMs, and these patients were more likely to be cured as compared with those who had other forms of AVMs (OR, 5.8; 95% CI, 1.1–29; P=0.02). The patients with more advanced AVMs (stages III and IV) and with AVMs in the gluteal and pelvic region were more likely to have the worst outcomes than those with stage II AVMs (OR, 8.2; 95% CI, 1–72; P=0.03) and with AVMS in other locations (OR, 5.8; 95% CI, 1.1–29; P=0.02), respectively. Gender and age did not significantly influence treatment results (P>0.05). The TLPS data of 17 patients showed AV shunting ranging from 0% to 92%, which combined with other results helped identify 9 patients who needed further interventions, 6 who were treated successfully, and 2 who had insignificant shunting.
Conclusions
. The best outcomes were achieved in surgically treated patients with localized lesions and less advanced AVMs. For the first time in Lithuania, a modified TLPS method has been introduced that enhances a hemodynamic assessment of AV shunting and provides with a more accurate evaluation of AVMs to better serve in planning future treatments. Full article
249 KiB  
Article
Factors Influencing Women’s Preference to Select a Combined Hormonal Contraceptive Method: A Cross-Sectional Survey in Lithuania
by Ramona Čepulienė, Renata Sveikatienė, Kęstutis Gutauskas and Virginija Vanagienė
Medicina 2012, 48(8), 63; https://doi.org/10.3390/medicina48080063 - 4 Aug 2012
Cited by 4 | Viewed by 985
Abstract
Background and Objective. Effectiveness and side effects are the main concerns when selecting a contraceptive method. Therefore, the aim of this study was to identify the preference of a combined hormonal contraception method by Lithuanian women, the reasons for selecting one of them [...] Read more.
Background and Objective. Effectiveness and side effects are the main concerns when selecting a contraceptive method. Therefore, the aim of this study was to identify the preference of a combined hormonal contraception method by Lithuanian women, the reasons for selecting one of them and rejecting other two methods, and the factors determining selection or rejection.
Material and Methods
. A cross-sectional multicenter survey was performed by the Lithuanian Society of Private Obstetricians and Gynecologists. A total of 4134 women, aged 18–49, who visited their physician due to initiation or reinitiation of hormonal contraception completed self-administered questionnaires identifying the reasons to select one method and reject the two remaining ones. Descriptive and inferential statistics methods were used for data analysis.
Results. The vaginal ring was the most accepted contraception method (55.4%), followed by the pill (35.6%). The skin patch was least preferable (9%). The vaginal ring and the skin patch were mainly selected for the frequency of use (72.9% and 51.2%, respectively), convenience (48.5% and 71%, respectively), and lower probability of noncompliance (48.7% and 63.5%, respectively). The main reason for selecting the pill was familiarity with the method (50.7%). The acceptance of vaginal ring increased with age and was higher among women with higher education.
Conclusions
. The most important factors when selecting a contraceptive method among the methods with equal effectiveness and similar safety profile were convenience, frequency of use, and lower probability of noncompliance. Age, education, and employment status were found to be other reasons associated with the choice of contraceptive method. Full article
265 KiB  
Article
Associations Between Procalcitonin and Markers of Bacterial Sepsis
by Veeresh K. Patil, Jaymin B. Morjaria, Francois De Villers and Suresh K. Babu
Medicina 2012, 48(8), 57; https://doi.org/10.3390/medicina48080057 - 7 Jul 2012
Cited by 18 | Viewed by 1196
Abstract
Background. Bacterial sepsis with no bacterial isolates can be a difficult clinical conundrum, where other markers like C-reactive protein (CRP), white cell count (WCC), and neutrophilia are helpful to arrive at a diagnosis. Procalcitonin (PCT) has been shown to be a useful [...] Read more.
Background. Bacterial sepsis with no bacterial isolates can be a difficult clinical conundrum, where other markers like C-reactive protein (CRP), white cell count (WCC), and neutrophilia are helpful to arrive at a diagnosis. Procalcitonin (PCT) has been shown to be a useful biomarker in bacterial sepsis. The aim of the study was to look at the association of PCT with bacterial cultures and compare this to currently used markers of bacterial sepsis.
Material and Methods
. WCC, neutrophil count, and CRP with PCT were compared in patients with a positive bacterial culture from blood/body fluid. The specificity and sensitivity of PCT were compared with those of CRP.
Results
. Of the 99 paired samples obtained, 25 cultures were positive for bacteria. There was a significant difference in CRP (P=0.04) and PCT (P<0.001) levels between culture-positive and culture-negative samples. PCT had a better sensitivity and specificity than CRP (84% and 64.9% vs. 69.6% and 52.9%, respectively), with a combined specificity (CRP and PCT) of 83.5%.
Conclusions
. PCT has a better association with bacterial sepsis and is superior to currently available biomarkers in the clinical setting. The rapid pharmacodynamics of PCT can serve as an early predictor of the diagnosis of bacterial sepsis while awaiting the bacterial culture results avoiding undue delay in the institution of antibiotics, hence, potentially improving the prognosis of patients with bacterial sepsis. Full article
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