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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 49, Issue 12 (December 2013) – 6 articles

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272 KiB

Open AccessArticle

Increased Use of Antidepressants in Wuhan, China: a Retrospective Study From 2006 to 2012

by Ping Gao, Huanian Zhang, Hua Xu, Chengliang Zhang and Dong Liu

Medicina 2013, 49(12), 83; https://doi.org/10.3390/medicina49120083 - 04 Jan 2014

Cited by 6 | Viewed by 933

Abstract

Objective. The aim of this study was to investigate the trend of antidepressant use and analyze the daily cost of antidepressants in Wuhan, China. Material and Methods. The data on the expenditure of antidepressants in Wuhan from 2006 to 2012 were retrospectively analyzed based on the defined daily dose (DDD) method recommended by the World Health Organization. In addition, the daily cost of antidepressants was calculated for the pharmacoeconomic evaluation.
Results. The overall sales of antidepressants increased by 566.7% over the 7-year period. The utilization of antidepressants increased annually from 1.067 DDDs per 1000 inhabitants per day in 2006 to 4.144 in 2012. This upward trend was mainly driven by an increase in the use of selective serotonin reuptake inhibitors (SSRIs), which accounted for about 60% of antidepressant use. Notably, the use of traditional Chinese patent medicines (TCMs) approved to treat depression in China in 2010 increased from 0.158 DDDs per 1000 inhabitants per day in 2010 to 0.305 in 2012. The daily drug cost analysis indicated that selective serotonin and norepinephrine reuptake inhibitors (SNRIs) and other new antidepressants were more expensive while tricyclic and tetracyclic antidepressants (TCAs) had a low-cost advantage.
Conclusions. Antidepressants were increasingly used over the study period. Among them, SSRIs followed by SNRIs were the most commonly used. After the approval for the treatment of depression, TCMs were generally accepted by physicians and patients. The low-cost advantage allowed TCAs to be used in the antidepressant therapy. Full article

209 KiB

Open AccessArticle

Resources of Residents for Potential Transition from Long-Term Care to Community

by Lina Spirgienė, Pirkko Elina Routasalo and Jūratė Macijauskienė

Medicina 2013, 49(12), 82; https://doi.org/10.3390/medicina49120082 - 04 Jan 2014

Cited by 2 | Viewed by 934

Abstract

Background and Objective. Transition from long-term care to the community can have positive effects on residents’ health and quality of life and promote the feelings of happiness, safety, and independence. The aim of this study was to examine residents’ resources for potential transition to the community after residing in long-term care facilities.
Material and Methods. The study was conducted in 8 long-term care institutions for older persons of Kaunas county. The study population comprised 252 residents. The items contained in the interRAI Long-Term Care Facility assessment instrument were used to evaluate a consistent positive outlook, social activities, and discharge potential. Cognitive impairment was measured using the Cognitive Performance Scale. Activities of daily living were measured using the Activities of Daily Living Hierarchy Scale.
Results. More than 10% of the residents exhibited no cognitive impairment. One-third of the residents preferred to transition back to the community from their long-term care facility. Twothirds expressed that they had familiar surroundings, which could be assumed to increase their feeling of safety at home. Social activities prevalent among residents included taking care of plants and walking outdoors. About 40% of the residents were physically independent in the activities of daily living. In spite of these resources, no residents were involved in a discharge process due to the lack of established nursing and social care services and transitional care plans.
Conclusions. With well-organized community services, some residents in long-term care facilities may have enough resources to live in the community. Full article

277 KiB

Open AccessArticle

Association Between Erectile Dysfunction and Asymptomatic Cardiovascular Damage in Middle-Aged Men

by Vilma Dženkevičiūtė, Žaneta Petrulionienė, Virginijus Šapoka and Vytautas Kasiulevičius

Medicina 2013, 49(12), 80; https://doi.org/10.3390/medicina49120080 - 04 Jan 2014

Cited by 4 | Viewed by 917

Abstract

Background and Objective. It has been proposed that the same cardiovascular risk (CV) factors predispose middle-aged men to the development of both coronary artery disease and erectile dysfunction (ED). Moreover, several recently published studies have identified ED as a possible early marker of CV disease. The aim of this particular study was to evaluate the association between ED and early asymptomatic heart and vascular damage in middle-aged men with CV risk factors.
Material and Methods. In this case-control study, the International Index of Erectile Function (IIEF) questionnaire was employed to assess the erectile function of the study participants and to allocate them either into the ED group (N=21; mean IIEF score, 18.15 [SD, 2.54]; mean age, 48.2 years [SD, 4.4]) or the control group (N=24; mean IIEF score, 23.45 [SD, 0.99]; mean age, 46.8 years [SD, 3.1]). Additionally, pulse wave velocity, augmentation index, pulse pressure, carotid intima media thickness (IMT), and atherosclerotic plaque count were determined, and echocardiography was performed in every subject.
Results. The mean IMT and left ventricular mass index (LVMI) of both carotid arteries in the ED group were significantly higher when compared with controls (598.57 vs. 535.54 mm·10–3, P=0.03, and 107.26 vs. 98.67 g/m2, P=0.04, respectively). Using multiple regression analysis, an independent association between the IIEF score and the LVMI was found (P=0.002). No significant differences in the results of pulse wave velocity, atherosclerotic plaque count, and other laboratory tests were found between the 2 study groups.
Conclusions. The study suggests that ED is associated with a higher LVMI and may be an early marker of CV disease. Full article

181 KiB

Open AccessReview

Functional Significance of Microsatellite Markers

by Tatjana Sjakste, Natalia Paramonova and Nikolajs Sjakste

Medicina 2013, 49(12), 79; https://doi.org/10.3390/medicina49120079 - 04 Jan 2014

Cited by 4 | Viewed by 821

Abstract

The review summarizes literature data on the positive results of association studies between the length of microsatellite repeats and predisposition to pathologies. Actually, the data can be classified according to the localization of the microsatellite: in the gene promoter, in the part of exon 1 coding the signal sequence, in gene introns, in the coding areas of genes, and in 3'-untranslated regions. The functional significance of microsatellite length changes can be evaluated in many cases. The authors came up to the conclusion that further studies on microsatellite associations with diseases remain prospective as they reflect changes in the gene functional activity. Full article

178 KiB

Open AccessArticle

Outcome of the First Successful Heart-Lung Transplantation in the Baltic Countries

by Raimondas Kubilius, Kęstutis Malakauskas, Loreta Jankauskienė, Povilas Jakuška, Ramūnas Bolys, Evelina Pociūtė, Vaidotas Boguševičius and Rimantas Benetis

Medicina 2013, 49(12), 84; https://doi.org/10.3390/medicina49120084 - 21 Nov 2013

Cited by 2 | Viewed by 847

Abstract

Successful heart-lung complex transplantation was performed in a 48-year-old man. During the postoperative period, M. tuberculosis infection was diagnosed, and the treatment subsequently started. One year after, the patient was urgently hospitalized due to myocardial infarction. However, despite the best efforts, the patient died. Antituberculosis treatment is recommended to all the patients with confirmed active tuberculosis. Treatment of tuberculosis in transplant recipients is similar to that of the general population, with the exclusion of rifamycins in the regimen and longer duration of treatment. Full article

175 KiB

Open AccessArticle

The Frequency of CYP2C9, VKORC1, and CYP4F2 Polymorphisms in Russian Patients With High Thrombotic Risk

by Dmitriy Ivashchenko, Ilya Rusin, Dmitriy Sychev and Andrey Grachev

Medicina 2013, 49(12), 81; https://doi.org/10.3390/medicina49120081 - 02 Oct 2013

Cited by 5 | Viewed by 1043

Abstract

Background and Objective. VKORC1, CYP2C9, and CYP4F2 are known to be responsible for the metabolism of warfarin. The aim was to explore the frequencies of these genotypes in the Russian population and compare the results with those for other populations.
Material and Methods. In total, 91 Caucasian subjects with a mean age of 66.17 years (SD, 10.9) were recruited into the study. Of them, 40 patients (48.2%) were men. In order to obtain necessary clinical data, the medical records of the patients were reviewed. Blood (5 mL) was taken from each subject, and DNA was isolated and used for identification of the CYP2C9 allele *1, *2, *3, –1639G/A VKORC1, and CYP4F2 V433M rs2108622 C>T, using the real-time polymerase chain reaction-restriction fragment length polymorphism assay.
Results. The CYP2C9*1/*1 genotype was detected in 67.0%, CYP2C9*1/*2 in 9.9%, CYP2C9* 1/*3 in 11.0%, CYP2C9*2/*2 in 2.2%, CYP2C9*2/*3 in 8.8%, and CYP2C9*3/*3 in 1.1% of the patients. The results for VKORC1 were as follows: 49.5% (GG), 28.6% (GA), and 22.0% (AA); meanwhile, those for the genotype CYP4F2 were 57.1% (CC), 34.1% (CT), and 7.7% (TT). No significant deviations from the Hardy-Weinberg equilibrium were observed. The frequency of the polymorphisms in the Russian population was found to differ from Asian and close to Caucasian. There were no significant interethnic variations in the frequency of CYP4F2 among Russian, Asian, and Caucasian populations.
Conclusion. The frequency of CYP2C9, CYP4F2, and VKORC1 polymorphisms in Russian patients is comparable with other European ethnic groups. Full article

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