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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 5 (May 2013) – 7 articles

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197 KiB  
Article
Does Illness Perception Explain Quality of Life of Patients With Prostate Cancer?
by Aušra Mickevičienė, Giedrius Vanagas, Mindaugas Jievaltas and Albertas Ulys
Medicina 2013, 49(5), 38; https://doi.org/10.3390/medicina49050038 - 04 Jun 2013
Cited by 18 | Viewed by 977
Abstract
Background. It is licely that illness perceptions can explain variations in quality of life of patients with prostate cancer across different treatment methods and stages. Therefore, the aim of this study was to determine if illness perception can explain variations in quality [...] Read more.
Background. It is licely that illness perceptions can explain variations in quality of life of patients with prostate cancer across different treatment methods and stages. Therefore, the aim of this study was to determine if illness perception can explain variations in quality of life of patients with prostate cancer.
Material and Methods
. The cross-sectional national-level study was carried out. Quality of life was evaluated with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and the Visual Analogue Scale. Illness perceptions were measured by the revised Illness Perception Questionnaire.
Results
. The response rate was 77.1% (N=501). The variation in global quality of life was explained (32.0%) by levels of emotional representation (β=–0.126; P=0.023) and consequences (β=–0.209; P<0.01); physical functioning (27.0%), by consequences (β=–0.203; P<0.01) and chemotherapy (β=–2.911; P=0.007); role functioning (37.0%), by emotional representations (β=–0.198; P<0.01), timeline cyclical (β=–0.209; P=0.014), and stage of the disease (β=–0.779; P=0.007); emotional functioning (43.0%), by emotional representations (β=–0.361; P<0.01) and education level (β=–0.566; P=0.025); cognitive functioning (34.0%), by educational level (β=0.714; P=0.005), emotional representations (β=–0.118; P=0.019), illness coherence (β=–0.167; P=0.030), consequences (β=–0.187; P=0.001), and hormonal therapy (β=–0.778; P=0.049); and social functioning (39.0%), by consequences (β=–0.320; P<0.01) and combined treatment (β=–1.492; P=0.016).
Conclusions
. Illness perceptions may be important while investigating quality of life in patients with prostate cancer. It may underlie quality-of-life differences in this group of patients and could inform decision makers about the importance of the provision of psychosocial services to patients with prostate cancer. Full article
197 KiB  
Article
Possible Predisposing Factors for Late Intraocular Lens Dislocation After Routine Cataract Surgery
by Lina Krėpštė, Loreta Kuzmienė, Arūnas Miliauskas and Ingrida Janulevičienė
Medicina 2013, 49(5), 37; https://doi.org/10.3390/medicina49050037 - 04 Jun 2013
Cited by 10 | Viewed by 1040
Abstract
Objective. The aim of this study was to evaluate possible risk factors for late intraocular lens (IOL) dislocation after routine cataract surgery.
Material and Methods
. A retrospective analysis of medical records of all the patients who were treated in the university [...] Read more.
Objective. The aim of this study was to evaluate possible risk factors for late intraocular lens (IOL) dislocation after routine cataract surgery.
Material and Methods
. A retrospective analysis of medical records of all the patients who were treated in the university hospital between 2011 and 2012 for late IOL dislocation requiring surgical management after routine cataract surgery was performed. In total, 58 patients (58 eyes) were included into the study.
Results
. The mean time between cataract surgery and late IOL dislocation was 67.8 months (SD, 34.9). A negative correlation was found between the patient age at cataract surgery and the time between cataract surgery and IOL dislocation (r=–0.29; P=0.042). Late in-the-bag dislocation occurred in 87.9% and late out-of-the-bag dislocation in 12.1% of the cases. Pseudoexfoliation was present in 56.9% and 42.9% of the eyes with in-the-bag and out-of-the-bag dislocation, respectively. The odds ratio for IOL dislocation within 43 months after complicated cataract surgery was 24.0 (95% confidence interval [95% CI] 4.5–127.4; P<0.001) and for in-the-bag IOL dislocation 24.9 (95% CI, 4.2–148.0; P<0.001). The odds ratio for in-the-bag IOL dislocation within 43 months after advanced cataract surgery was 18.8 (95% CI, 2.0–180.0; P=0.011). Moreover, in-the-bag IOL dislocation occurred earlier in the patients with past uveitis (P=0.020) or zonule laxity (P=0.037).
Conclusions
. Complicated cataract surgery increased the risk of both late in-the-bag and out-ofthe- bag IOL dislocation, and advanced cataract increased the risk of late in-the-bag IOL dislocation. The time to in-the-bag IOL dislocation shortens with pseudoexfoliation syndrome, advanced age, or past uveitis. These factors must be taken into account while planning a postoperative follow-up. Full article
236 KiB  
Article
Comparison of Long-Term Results After Nephron-Sparing Surgery and Radical Nephrectomy in Treating 4- to 7-cm Renal Cell Carcinoma
by Daimantas Milonas, Giedrius Skulčius, Ruslanas Baltrimavičius, Stasys Auškalnis, Marius Kinčius, Aivaras Matjošaitis, Inga Gudinavičienė, Giedrė Smailytė and Mindaugas Jievaltas
Medicina 2013, 49(5), 36; https://doi.org/10.3390/medicina49050036 - 04 Jun 2013
Cited by 9 | Viewed by 1008
Abstract
Objective. The aim of our study was to compare long-term oncological outcomes following nephron-sparing surgery (NSS) and radical nephrectomy (RN) for renal cell carcinoma (RCC) 4 to 7 cm in diameter.
Material and Methods
. The study included patients who underwent RN [...] Read more.
Objective. The aim of our study was to compare long-term oncological outcomes following nephron-sparing surgery (NSS) and radical nephrectomy (RN) for renal cell carcinoma (RCC) 4 to 7 cm in diameter.
Material and Methods
. The study included patients who underwent RN or NSS for RCC 4 to 7 cm in diameter between 1998 and 2009. The studied groups were compared with respect to the patients’ age, sex, physical status according to the American Society of Anesthesiologists Physical classification, histological type, stage, tumor size, grade, duration of the operation, and complications. Survival was established using the Kaplan-Meier method. The risk factors for survival were analyzed using a multivariate Cox regression model.
Results
. During the study, 351 patients underwent surgery: 317 patients (90.3%) underwent RN, and 34 (9.7%), NSS. The compared groups differed with respect to tumor size (P=0.001) and stage (P=0.006). The overall estimated 12-year survival was 53.7% after RN and 55.2% after NSS (log-rank test P=0.437). The 12-year cancer-specific survival in the RN and NSS groups was 69.6% and 80.6%, respectively (log-rank test P=0.198). Pathological stage and patients’ age were the major factors affecting both overall and cancer-specific survival. The type of surgery (NSS or RN) had no effect on survival.
Conclusions. Our study showed that nephron-sparing surgery is a safe technique compared with radical nephrectomy that ensures good oncological control in the treatment of renal cell carcinoma measuring 4 to 7 cm and may be proposed as the treatment of choice for renal tumors not only up to 4 cm, but also 4 to 7 cm in size. Full article
186 KiB  
Article
Plasma Homocysteine, Folic Acid, and Vitamin B12 Levels in Patients With Pseudoexfoliation Syndrome, Pseudoexfoliation Glaucoma, and Normotensive Glaucoma
by Fatih Mehmet Türkcü, Özlem Gürbüz Köz, Alper Yarangümeli, Veysi Öner and Gülcan Kural
Medicina 2013, 49(5), 34; https://doi.org/10.3390/medicina49050034 - 04 Jun 2013
Cited by 19 | Viewed by 1059
Abstract
Objective. The aim of this study was to evaluate the levels of plasma homocysteine (Hcy), vitamin B12, and folic acid in patients with pseudoexfoliation glaucoma (PEXG), pseudoexfoliation syndrome (PEXS), PEXS plus normotensive glaucoma (NTG).
Material and Methods. In total, 24 [...] Read more.
Objective. The aim of this study was to evaluate the levels of plasma homocysteine (Hcy), vitamin B12, and folic acid in patients with pseudoexfoliation glaucoma (PEXG), pseudoexfoliation syndrome (PEXS), PEXS plus normotensive glaucoma (NTG).
Material and Methods. In total, 24 patients with PEXG, 35 patients with PEXS, 18 patients with PEXS plus NTG, and 35 control subjects were enrolled into study. Their Hcy levels were measured by high performance liquid chromatography (HPLC); the levels of vitamin B12 and folic acid were measured by a competitive electrochemiluminescence immunoassay.
Results. Higher plasma Hcy levels and lower folic acid and vitamin B12 levels were found in all 3 patients’ groups compared with the control group (all P<0.001, expect for folic acid in the PEXG group, P=0.03). Although plasma Hcy levels in the PEXG and PEXS groups were similar, the PEXS plus NTG group had significantly higher Hcy levels compared with these groups (P=0.019 and P=0.032, respectively).
Conclusions. Our study showed that there was an association between hyperhomocysteinemia and PEXS either with or without glaucoma. The patients with PEXS plus NTG had higher plasma Hcy levels than the patients with PEXS or PEXG and the healthy controls. The treatment of hyperhomocysteinemia by taking low-cost vitamin B12 and folic acid preparations may prevent additional vascular problems. Full article
250 KiB  
Article
An Extremely Rare Case of Glioblastoma Multiforme of the Spinal Cord
by Goda Randakevičienė, Rymantė Gleiznienė, Algidas Basevičius and Saulius Lukoševičius
Medicina 2013, 49(5), 39; https://doi.org/10.3390/medicina49050039 - 05 May 2013
Cited by 6 | Viewed by 840
Abstract
Being the most common glial cell tumor of the adult brain, primary glioblastoma multiforme is an extremely rare but excessively devastating condition of the spinal cord. It presents with indistinctive magnetic resonance imaging findings, so the diagnosis is very complicated to make. A [...] Read more.
Being the most common glial cell tumor of the adult brain, primary glioblastoma multiforme is an extremely rare but excessively devastating condition of the spinal cord. It presents with indistinctive magnetic resonance imaging findings, so the diagnosis is very complicated to make. A low-grade glioma may undergo a malignant transformation into glioblastoma multiforme in a very short period, critically impairing treatment possibilities and prognosis, so a correct and timely diagnosis is crucial. We report a case of intramedullary glioblastoma multiforme in a young man and describe the diagnostic difficulties and devastating progression of the entity. Full article
178 KiB  
Article
The Most Important Throat-Related Symptoms Suggestive of Chronic Tonsillitis as the Main Indication for Adult Tonsillectomy
by Rūta Pribuišienė, Alina Kuzminienė, Valdas Šarauskas, Viktoras Šaferis, Kipras Pribuišis and Ieva Rastenienė
Medicina 2013, 49(5), 35; https://doi.org/10.3390/medicina49050035 - 05 May 2013
Cited by 3 | Viewed by 1140
Abstract
Background and Objective. The literature lacks data about the evaluation of throatrelated symptoms proving chronic tonsillitis as the most common indication for adult tonsillectomy. Therefore, the aim of this study was to assess the most important throat-related symptoms suggestive of chronic tonsillitis [...] Read more.
Background and Objective. The literature lacks data about the evaluation of throatrelated symptoms proving chronic tonsillitis as the most common indication for adult tonsillectomy. Therefore, the aim of this study was to assess the most important throat-related symptoms suggestive of chronic tonsillitis in adults.
Material and Methods
. A prospective cohort study was carried out. The analysis of throatrelated symptoms (complaints, tonsillitis rate, pharyngeal signs, and antistreptolysin-O titer) in 81 adults with histologically confirmed chronic tonsillitis was conducted.
Results
. Recurrent tonsillitis was the most common complaint (74.1%). The mean number of tonsillitis episodes was 3.6 (SD, 1.9) times per year. There were no significant differences comparing the frequencies of all the analyzed pharyngeal signs (P>0.05). The antistreptolysin-O titer (mean, 279.8; SD, 211.6 UL) was pathological in 33.3% of patients. The study identified the most important throat-related symptoms revealing chronic tonsillitis: tonsillar cryptic debris (OR, 8.84; 95% CI, 1.93–40.53; P=0.005) and enlarged anterior cervical lymph nodes along with the frequency of tonsillitis episodes exceeding 3 times per year (OR, 8.27; 95% CI, 1.33–51.57; P=0.024). The classification accuracy of 85.2% was obtained.
Conclusions
. Tonsillar cryptic debris and enlarged regional lymph nodes along with recurrent tonsillitis could support the diagnosis of chronic tonsillitis in adults when considering tonsillectomy. Full article
266 KiB  
Article
Proteasomes and Proteasomal Gene Polymorphism in Association with Inflammation and Various Diseases
by Živilė Žemeckienė, Astra Vitkauskienė, Tatjana Sjakste, Brigita Šitkauskienė and Raimundas Sakalauskas
Medicina 2013, 49(5), 33; https://doi.org/10.3390/medicina49050033 - 05 May 2013
Cited by 11 | Viewed by 902
Abstract
A proteasome, a multicatalytic protein complex, is a central particle of the ubiquitinproteasome proteolytic pathway in all eukaryotic cells. Through the degradation of most intracellular proteins, proteasomes play a significant role in cell processes, such as cell cycle and division, posttranslational protein quality [...] Read more.
A proteasome, a multicatalytic protein complex, is a central particle of the ubiquitinproteasome proteolytic pathway in all eukaryotic cells. Through the degradation of most intracellular proteins, proteasomes play a significant role in cell processes, such as cell cycle and division, posttranslational protein quality control, cell signaling, and apoptosis. Therefore, the ubiquitinproteasome system is necessary to ensure the normal functioning of cells and an organism. The associations between alterations in the ubiquitin-proteasome pathway and the development of various autoimmune, neurodegenerative, inflammatory and other diseases in humans have been established. Moreover, the findings of some studies suggest that proteasomes may participate in the pathogenesis of asthma through the regulation of the nuclear factor kappa B signaling pathway. Recently, much attention has been given to the associations between genes encoding the proteasome and their polymorphism, and various diseases. Associations between some proteasomal genes and myocardial infarction, type 2 diabetes mellitus, and other diseases have already been established. However, the results are inconclusive or conflicting and need further clarification. Full article
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