Medicina

774 KiB

Open AccessArticle

Inherited Macular Dystrophies and Differential Diagnostics

by Rasa Liutkevičienė, Vaiva Lesauskaitė, Virginija Ašmonienė, Arvydas Gelžinis, Dalia Žaliūnienė and Vytautas Jašinskas

Medicina 2012, 48(9), 72; https://doi.org/10.3390/medicina48090072 - 05 Oct 2012

Cited by 5 | Viewed by 1001

Abstract

The inherited macular dystrophies are characterized by different grade central visual loss and different character macula atrophy, because of retinal pigment epithelium lesion. The cause of photoreceptors degeneration is still not known. In this article, we review subjective and objective ophthalmological examines essential [...] Read more.

The inherited macular dystrophies are characterized by different grade central visual loss and different character macula atrophy, because of retinal pigment epithelium lesion. The cause of photoreceptors degeneration is still not known. In this article, we review subjective and objective ophthalmological examines essential to diagnosis and differential diagnosis of inherited autosomal dominant and autosomal recessive macular dystrophies. It is known seven gene mutations (ABCA4, ELOVL4, PROML1, VMD2, Peripherin/RDS, TIMP3, XLRS), which may cause inherited macular dystrophies development. Inheritance type of inherited macular dystrophies, prevalence, beginning of disease, spread of the disease between female and male, clinic, electroretinography, electrooculography, differential diagnosis, genetic research and prognosis are also reviewed. Full article

226 KiB

Open AccessArticle

Burnout among Lithuanian Cardiac Surgeons and Cardiac Anesthesiologists

by Audrius Mikalauskas, Edmundas Širvinskas, Irena Marchertienė, Andrius Macas, Robertas Samalavičius, Šarūnas Kinduris and Rimantas Benetis

Medicina 2012, 48(9), 71; https://doi.org/10.3390/medicina48090071 - 05 Oct 2012

Cited by 22 | Viewed by 1191

Abstract

Objective. The aim of this study was to determine the prevalence of burnout among Lithuanian cardiac surgeons and cardiac anesthesiologists, and associations between burnout and the personal and professional characteristics of physicians.
Material and Methods. A total of 29 cardiac surgeons and [...] Read more.

Objective. The aim of this study was to determine the prevalence of burnout among Lithuanian cardiac surgeons and cardiac anesthesiologists, and associations between burnout and the personal and professional characteristics of physicians.
Material and Methods. A total of 29 cardiac surgeons and 30 cardiac anesthesiologists employed in Vilnius and Kaunas university hospitals as well as in Klaipėda Hospital were surveyed. Data on personal characteristics (age, gender, marital status, number of children, sleeping hours, and addictions), professional characteristics (years in practice, work character, work profile, and workload), career satisfaction, and symptoms of depression were collected by using an anonymous questionnaire. Burnout was measured by the Maslach Burnout Inventory-Human Services Survey (MBI-HSS).
Results. More than half (54.3%) of the physicians surveyed had been in practice for >15 years, 71.2% reported working more than 40 hours per week, and 62% reported of being burned out. As much as 19.3% of physicians reported high emotional exhaustion, 25.9% had high depersonalization, and 42.3% demonstrated low personal accomplishment at work. Nearly 95% of respondents would become a physician and 82.8% would choose to become a cardiac surgeon or a cardiac anesthesiologist again. Physicians who worked more than 40 hours per week, smokers, and those who were desperate were more likely to be burned out.
Conclusions. Burnout was found to be prevalent among Lithuanian cardiac surgeons and cardiac anesthesiologists. Some personal and professional characteristics were significantly related to burnout. Burnout relief measures should be developed in order to prevent a further increase of burnout syndrome among Lithuanian cardiac surgeons and cardiac anesthesiologists. Full article

368 KiB

Open AccessArticle

Particulate Air Pollution and Its Impact on Health in Vilnius and Kaunas

by Hans Orru, Aida Laukaitienė and Ingrida Zurlytė

Medicina 2012, 48(9), 70; https://doi.org/10.3390/medicina48090070 - 05 Oct 2012

Cited by 8 | Viewed by 849

Abstract

Particulate matter in outdoor air has a significant impact on health. Small particles, composed of a variety of organic and inorganic compounds, are inhaled deep into the respiratory tract. The mechanisms and outcomes are manifold, resulting mainly in cardiopulmonary diseases. The current study [...] Read more.

Particulate matter in outdoor air has a significant impact on health. Small particles, composed of a variety of organic and inorganic compounds, are inhaled deep into the respiratory tract. The mechanisms and outcomes are manifold, resulting mainly in cardiopulmonary diseases. The current study aimed to quantify the health effects of particulate pollutants in Vilnius and Kaunas.
Material and Methods. For risk estimation, the methodology of health impact assessment was employed. The exposure was defined as annual PM2.5 levels for long-term exposure effects and daily PM10 averages for short-term exposure effects. The baseline mortality/morbidity data were retrieved from health registers and exposure-response relationships from previous epidemiological studies. For health impact calculations, the WHO-developed tool AirQ was also applied.
Results. The annual average concentration of PM2.5 was 11 μg/m3 in Vilnius and 17.5 μg/m3 in Kaunas. The exposure above the natural background corresponded annually to 263 (95% CI, 68– 464) and 338 (95% CI, 86–605) premature deaths in Vilnius and Kaunas. This resulted in 3438 (95% CI, 905–5952) and 3693 (95% CI, 983–6322) years of life lost and in an average decrease in life expectancy of 0.43 (95% CI, 0.11–0.74) and 0.69 (95% CI, 0.18–1.19) years, respectively. In addition, 143 (95% CI, 86–200) and 129 (95% CI, 78–179) respiratory and 297 (95% CI, 188–377) and 267 (95% CI, 169–338) cardiovascular hospitalizations per year could be expected in Vilnius and Kaunas, respectively.
Conclusions. There is substantial exposure to particulate matter in the main Lithuanian cities, which causes considerable adverse health effects. Traffic and domestic heating are considered locally the most important contributing factors to the degradation of air quality. Full article

459 KiB

Open AccessArticle

Dependence of Perceived Purity of a Chromatic Stimulus on Saturation Adaptation

by Varis Karitans and Maris Ozolinsh

Medicina 2012, 48(9), 68; https://doi.org/10.3390/medicina48090068 - 05 Oct 2012

Viewed by 830

Abstract

Background and Objective. The purpose of sensory adaptation of the visual system is to adjust sensitivity of the photoreceptors to optimize the dynamic range of response of the visual system. It has been shown in numerous research papers that chromatic adaptation influences both [...] Read more.

Background and Objective. The purpose of sensory adaptation of the visual system is to adjust sensitivity of the photoreceptors to optimize the dynamic range of response of the visual system. It has been shown in numerous research papers that chromatic adaptation influences both color appearance and color discrimination. However, there are almost no studies in which the influence of chromatic adaptation on perceived purity has been investigated. Therefore, the aim of this study was to investigate how chromatic adaptation to stimuli with certain saturation influences perceived purity of test stimuli with the same hue but different saturation.
Material and Methods. As the stimuli were modulated in saturation only, we refer to the type of chromatic adaptation used in our study as saturation adaptation. Two types of psychophysical methods – the method of adjustment and the method of constant stimuli – were used.
Results. The results obtained with the method of constant stimuli reveal that saturation adaptation seems to be nonlinear much the same way as the Bezold-Brücke and the Abney effect. In addition, hysteresis of saturation adaptation can be observed in the method of adjustment.
Conclusions. Pronounced hysteresis of perceived color purity was observed when approaching to the point of subjective equality from the side of low saturation of the matching stimulus compared with the side of high saturation of the matching stimulus. There was a time course of mechanisms of saturation adaptation similar to those of chromatic adaptation previously quoted in literature. Full article

212 KiB

Open AccessArticle

Volumetric MRI Assessment of Brain and Spinal Cord in Finnish Twins Discordant for Multiple Sclerosis

by Hanna Kuusisto, Xingchen Wu, Prasun Dastidar, Tiina Luukkaala and Irina Elovaara

Medicina 2012, 48(9), 65; https://doi.org/10.3390/medicina48090065 - 05 Oct 2012

Cited by 5 | Viewed by 830

Abstract

Background and Objective. Brain size, white matter hyperintensity, and the development of brain atrophy are known to be highly heritable. The decrease of brain volume starts from the very onset of multiple sclerosis and is 10-fold compared with normal aging. The aim of [...] Read more.

Background and Objective. Brain size, white matter hyperintensity, and the development of brain atrophy are known to be highly heritable. The decrease of brain volume starts from the very onset of multiple sclerosis and is 10-fold compared with normal aging. The aim of this study was to assess whether the brain and spinal cord volumes and the volume of white matter lesions differed between twins with multiple sclerosis and their asymptomatic co-twins.
Material and Methods. A co-twin control method was used to evaluate whether the brain and spinal cord volumes differ between twins with multiple sclerosis and their co-twins. Nineteen twin pairs were studied neurologically, and the volumes of T1, T2, FLAIR, and gadolinium-enhanced lesions and those of the brain and the spinal cord were obtained by magnetic resonance imaging. Results. Significant differences in the brain (P=0.064) or spinal cord (P=0.648) volumes were not detected. Four of the 7 monozygotic and 5 of the 12 dizygotic co-twins had focal brain white matter lesions, but none fulfilled the magnetic resonance imaging criteria of Barkhof. Spinal cord lesions were not seen in any of the co-twins.
Conclusions. The absence of a significant difference in the brain or spinal cord volume between the twins with multiple sclerosis and their co-twins supports the recent observation of brain size and the development of brain atrophy being highly heritable. Full article

233 KiB

Open AccessArticle

T-Wave Normalization during Follow-Up After Early and Late Mechanical Recanalization of Infarct-Related Artery With and Without Stent Implantation

by Eglė Kalinauskienė and Albinas Naudžiūnas

Medicina 2012, 48(9), 67; https://doi.org/10.3390/medicina48090067 - 05 Aug 2012

Viewed by 804

Abstract

Objective. The aim of this study was to evaluate T-wave normalization during the 6-month follow-up in the patients who underwent early or late mechanical recanalization of the infarct-related artery with and without stent implantation.
Material and Methods. A total of 248 [...] Read more.

Objective. The aim of this study was to evaluate T-wave normalization during the 6-month follow-up in the patients who underwent early or late mechanical recanalization of the infarct-related artery with and without stent implantation.
Material and Methods. A total of 248 consecutive patients were divided into the following groups: early angioplasty (≤24 hours) without (n=114) or with stents (n=6) and late angioplasty (>24 hours) without (n=114) or with stents (n=14). The changes in T-wave recovery, QRS score, and echocardiographic left ventricular ejection fraction were compared between the groups.
Results. At 3 months, a greater percentage of patients in the group of early angioplasty with stents had again positive T wave than in the group of early angioplasty without stents (75% vs. 35%, P=0.05). After 6 months, all patients in the group of early angioplasty with stents had again positive T wave. A significant increase in left ventricular ejection fraction after 3 months was also observed only in the groups of early angioplasty, especially that with stents (30.0% [SD, 3.5%] vs. 38.4% [SD, 5.2%], P=0.008). However, there was no significant difference in the QRS score in this group comparing the data at discharge and after 3 months (5.4 [SD, 4.3] vs. 5.0 [SD, 1.9], P>0.05).
Conclusions. The group of early angioplasty with stents showed the best recovery of T wave and left ventricular ejection fraction, but the QRS score did not change significantly from discharge to the 3-month follow-up, so the evolution of T wave corresponded to an improvement in ejection fraction at follow-up better than the evolution of QRS score. Full article

996 KiB

Open AccessArticle

Peripheral Blood Th17 Cells and Neutrophils in Dermatophagoides pteronyssinus-induced Early- and Late-Phase Asthmatic Response

by Ieva Bajoriūnienė, Kęstutis Malakauskas, Simona Lavinskienė, Jolanta Jeroch, Edita Gasiūnienė, Astra Vitkauskienė and Raimundas Sakalauskas

Medicina 2012, 48(9), 66; https://doi.org/10.3390/medicina48090066 - 22 Jul 2012

Cited by 3 | Viewed by 789

Abstract

Background and Objective. Biphasic cellular immune reactions, which follow allergen inhalation, are a specific feature of inflammation in allergic asthma. The aim of this study was to determine the changes in the percentage of peripheral blood Th17 cells and neutrophil functions after Dermatophagoides [...] Read more.

Background and Objective. Biphasic cellular immune reactions, which follow allergen inhalation, are a specific feature of inflammation in allergic asthma. The aim of this study was to determine the changes in the percentage of peripheral blood Th17 cells and neutrophil functions after Dermatophagoides pteronyssinus-induced early- and late-phase asthmatic response in patients with allergic asthma.
Material and Methods. A total of 19 patients with allergic asthma were examined. Eleven patients developed an isolated early-phase asthmatic response (EAR), whereas 8 developed both earlyand late-phase (dual) asthmatic responses (DAR) after the bronchial challenge with Dermatophagoides pteronyssinus. The control group included 15 healthy subjects. Peripheral blood collection was performed 24 hours before as well as 7 and 24 hours after the bronchial challenge. The percentage of Th17 cells, and chemotaxis and apoptosis of neutrophils were analyzed by flow cytometry. The serum IL-8 and IL-17 levels were determined by ELISA.
Results. After the bronchial challenge, the percentage of Th17 and IL-17 levels increased considerably 7 and 24 hours after the challenge in both groups of patients. Moreover, 24 hours after the challenge, the percentage of Th17 cells and IL-17 levels were significantly higher in the patients with the DAR than those with the EAR or healthy controls. Seven and 24 hours after the challenge, neutrophil chemotaxis was greater in the patients with the DAR as compared with those with the EAR and healthy controls as well. The apoptotic activity of neutrophils was lower 24 hours after the challenge in the patients with the DAR than those with the EAR.
Conclusions. Dermatophagoides pteronyssinus-induced early- and late-phase asthmatic response in patients with allergic asthma was found to be accompanied by an increased percentage of peripheral blood Th17 cells and elevated serum IL-17 levels as well as altered neutrophil functions. Full article

393 KiB

Open AccessArticle

Changes in Psychosocial Adjustment of Adolescent Girls in the Lessons of Physical Education

by Šarūnas Klizas, Romualdas Malinauskas, Diana Karanauskienė, Žibuoklė Senikienė and Irina Klizienė

Medicina 2012, 48(9), 69; https://doi.org/10.3390/medicina48090069 - 25 May 2012

Cited by 4 | Viewed by 944

Abstract

Objective. The aim of the present study was to establish the changes in psychosocial adjustment of adolescent girls in the modified lessons of physical education.
Material and Methods. An experimental design was used in the study. The experimental group included 14- [...] Read more.

Objective. The aim of the present study was to establish the changes in psychosocial adjustment of adolescent girls in the modified lessons of physical education.
Material and Methods. An experimental design was used in the study. The experimental group included 14- to 15-year-old adolescent girls (n=128), and the control group comprised adolescent girls of the same school and the same age (n=137). The girls of the experimental group participated in modified physical education lessons. Once a month, they had a theory class where they received knowledge on communication disorders among adolescents and ways of preventing them by means of physical activities. In practical classes, the girls of the experimental group had sports games (basketball, volleyball, and football), enhancing physical abilities, and Pilates exercises. For the estimation of the level of adolescents’ psychosocial adjustment and its components (self-esteem and domination), an adapted questionnaire developed by Rogers and Dymond was applied. An adapted questionnaire developed by Huebner was administered to measure students’ satisfaction with life.
Results. The analysis of the data demonstrated that when comparing the psychosocial adjustment of the adolescent girls in the experimental group before and after the experiment, a significant differences in the score of the psychosocial adjustment scale was established (53.81±8.34 vs. 59.41±7.66, P<0.05). After the experiment, high life satisfaction was reported by 42.19% of the girls (P<0.05).
Conclusions. After the educational experiment, the index of the psychosocial adjustment scale in the experimental group improved statistically significantly. Full article

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Medicina, Volume 48, Issue 9 (September 2012) – 8 articles

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