Medicina

576 KiB

Open AccessCase Report

by Indrė Petraitienė, Giedrius Barauskas, Antanas Gulbinas, Dalius Malcius, Khalid Hussain, Gilvydas Verkauskas and Rasa Verkauskienė

Medicina 2014, 50(3), 190-195; https://doi.org/10.1016/j.medici.2014.08.006 - 13 Aug 2014

Cited by 7 | Viewed by 683

Abstract

Hyperinsulinism is the most common cause of hypoglycemia in infants. In many cases conservative treatment is not effective and surgical intervention is required. Differentiation between diffuse and focal forms and localization of focal lesions are the most important issues in preoperative management.
We [...] Read more.

Hyperinsulinism is the most common cause of hypoglycemia in infants. In many cases conservative treatment is not effective and surgical intervention is required. Differentiation between diffuse and focal forms and localization of focal lesions are the most important issues in preoperative management.
We present a case of persistent infancy hyperinsulinism. Clinical presentation, conservative treatment modalities, diagnostic possibilities of focal and diffuse forms, and surgical treatment, which led to total recovery, are discussed. Full article

665 KiB

Open AccessArticle

Trends of myocardial infarction morbidity and its associations with weather conditions

by Ričardas Radišauskas, Gailutė Bernotienė, Miglė Bacevičienė, Rūta Ustinavičienė, Jolita Kirvaitienė and Daina Krančiukaitė-Butylkinienė

Medicina 2014, 50(3), 182-189; https://doi.org/10.1016/j.medici.2014.08.003 - 13 Aug 2014

Cited by 20 | Viewed by 685

Abstract

Objective: The aim of this study was to assess the trends of myocardial infarction (MI) morbidity and evaluate the associations with some meteorological factors.
Materials and methods: Data on MI morbidity were collected from Kaunas ischemic heart disease registry and information about meteorological [...] Read more.

Objective: The aim of this study was to assess the trends of myocardial infarction (MI) morbidity and evaluate the associations with some meteorological factors.
Materials and methods: Data on MI morbidity were collected from Kaunas ischemic heart disease registry and information about meteorological factors from Kaunas meteorological station was collected.
Results: The overall morbidity rates of acute MI among men aged 25–64 increased by 2.0%/yr. (P = 0.02), whereas among women did not change significantly (+1.2%/yr., P = 0.2) during 1995–2007. Among men aged 65–84 the overall morbidity rates of MI were without significant changes (−1.0%/yr., P = 0.3) and among women decreased significantly by −1.7%/yr. (P = 0.03). During 1995–2000, a weak inverse significant correlation between atmospheric air temperature and morbidity of MI (r = −0.05, P = 0.019) was documented (in women and the elderly r = −0.045 and −0.048, respectively, P < 0.05). Weak correlation between atmospheric air wind speed and MI morbidity in women (r = −0.042, P = 0.05) and in population of older age (r = −0.056, P = 0.099) was determined. In men and in elderly population a direct weak correlation between atmospheric pressure and MI morbidity was found (r = 0.114 and 0.166, respectively, P < 0.01). In this study monthly and seasonal variation of MI rates were observed. In winter period MI rates were higher to compare with other seasons (χ² = 18.682, df = 3, P < 0.0001).
Conclusions: The overall morbidity rates of MI increased among Kaunas men aged 25–64 and tended to increase among women, whereas among men aged 65–84 MI morbidity trends were without statistically significant changes and significantly decreased among women during 1995–2007. Weak inverse correlations between atmospheric air temperatures, rainfall level and direct correlation between air wind speed, atmospheric pressure and MI morbidity were established. Months/seasonal variations during analyzed period were observed. Full article

397 KiB

Open AccessArticle

Antimicrobial usage among hospitalized children in Latvia: A neonatal and pediatric antimicrobial point prevalence survey

by Inese Sviestina and Dzintars Mozgis

Medicina 2014, 50(3), 175-181; https://doi.org/10.1016/j.medici.2014.08.005 - 13 Aug 2014

Cited by 13 | Viewed by 746

Abstract

Background and objective: The point prevalence survey was conducted as part of the Antibiotic Resistance and Prescribing in European Children (ARPEC) Project. The study aimed at analyzing pediatric and neonatal antimicrobial prescribing patterns in Latvian hospitals, to identify targets for quality improvement.
Materials [...] Read more.

Background and objective: The point prevalence survey was conducted as part of the Antibiotic Resistance and Prescribing in European Children (ARPEC) Project. The study aimed at analyzing pediatric and neonatal antimicrobial prescribing patterns in Latvian hospitals, to identify targets for quality improvement.
Materials and methods: A one day cross-sectional point prevalence survey on antibiotic use in hospitalized children was conducted in November 2012 in 10 Latvian hospitals, using a previously validated and standardized method. The survey included all inpatient pediatric and neonatal beds and identified all children receiving an antimicrobial treatment on the day of survey.
Results: Overall 549 patients were included in the study; 167 (39%) patients admitted to pediatric wards and 25 (21%) patients admitted to neonatal wards received at least one antimicrobial. Pediatric top three antibiotic groups were third-generation cephalosporins (55 prescriptions, 28%), extended spectrum penicillins (n = 32, 16%) and first-generation cephalosporins (n = 26, 13%). Eleven pediatric patients (85%) received surgical prophylaxis more than 1 day; 143 pediatric patients (86%) received antibiotics intravenously. Lower respiratory tract infections were the most common indications for antibiotic use both in pediatric (n = 60, 35.9%) and neonatal patients (n = 9, 36%). The most used antibiotics for neonatal patients were benzylpenicillin (n = 12, 32%), and gentamicin (n = 9, 24%).
Conclusions: We identified a few problematic areas, which need improvement: the high use of third-generation cephalosporins for pediatric patients, prolonged surgical prophylaxis, predominant use of parenteral antibiotics and an urgent need for local antibiotic guidelines. Full article

657 KiB

Open AccessArticle

Preoperative assessment of skin tumor thickness and structure using 14-MHz ultrasound

by Vesta Kučinskienė, Daiva Samulėnienė, Aistė Gineikienė, Renaldas Raišutis, Rymantas Kažys and Skaidra Valiukevičienė

Medicina 2014, 50(3), 150-155; https://doi.org/10.1016/j.medici.2014.08.002 - 13 Aug 2014

Cited by 21 | Viewed by 815

Abstract

Objective: The aim of this study was to compare the relationship between skin tumor thickness and homogeneity and to evaluate the accuracy of 14-MHz ultrasound while measuring the thickness of different skin tumors.
Material and methods: The ultrasonographic and histological analysis of 72 [...] Read more.

Objective: The aim of this study was to compare the relationship between skin tumor thickness and homogeneity and to evaluate the accuracy of 14-MHz ultrasound while measuring the thickness of different skin tumors.
Material and methods: The ultrasonographic and histological analysis of 72 skin tumors was performed. Preoperative vertical tumor thickness (T) and structure of 12 melanomas, 34 melanocytic nevi and 26 basal cell carcinomas was assessed by 14-MHz ultrasonography. After the tumors were excised the vertical thickness measurement (Breslow index, pT) was performed by pathologist. According to the histological thickness all skin tumors were divided to thin (≤1 mm) and thick (>1 mm). The accuracy of the 14-MHz ultrasound measurements and correlation between the ultrasonographic and histological tumor thickness were estimated.
Results: Homogeneous structure was assessed for all thin (≤1 mm) and the majority (81.3%) of thick (>1 mm) melanocytic skin tumors. Nonhomogeneous structure was estimated in thin and thick basal cell carcinomas, accordingly 42.9% and 31.9%. Measurements of T and pT correlated moderately in thick (>1 mm) tumors (r = 0.694), while in thin (≤1 mm) tumors correlation was low (r = 0.336). Moderate correlation between ultrasonographic and histological thickness was computed for melanocytic skin tumors as well as for basal cell carcinomas (r = 0.564 and r = 0.690).
Conclusions: Medium frequency ultrasound is not a reliable tool for the precise measurement of thin (≤1 mm) skin tumors. Ultrasonography using a 14-MHz frequency transducer enables more precisely to measure the thickness of basal cell carcinoma than melanocytic skin tumors. The 14-MHz ultrasound is support tool to suggest the morphologic type of skin tumor. Full article

404 KiB

Open AccessArticle

Comparison of the pharmacokinetic and pharmacodynamic properties of two recombinant granulocyte colony-stimulating factor formulations after single subcutaneous administration to healthy volunteers

by Audrius Sveikata, Gintautas Gumbrevičius, Kastytis Šeštakauskas, Rima Kregždytė, Vytautas Janulionis and Vidmantas Fokas

Medicina 2014, 50(3), 144-149; https://doi.org/10.1016/j.medici.2014.08.001 - 13 Aug 2014

Cited by 6 | Viewed by 749

Abstract

Background and objective: The aim of this randomized, single dose, two-period crossover study with two weeks wash-out period was the demonstration of bioequivalence of two recombinant human granulocyte colony-stimulating factor (rG-CSF) formulations after subcutaneous administration of 300 μg comparing their pharmacokinetic (primary endpoints [...] Read more.

Background and objective: The aim of this randomized, single dose, two-period crossover study with two weeks wash-out period was the demonstration of bioequivalence of two recombinant human granulocyte colony-stimulating factor (rG-CSF) formulations after subcutaneous administration of 300 μg comparing their pharmacokinetic (primary endpoints AUC_0–24, AUC_0–∞ and C_max) and pharmacodynamic (primary endpoints ANC AUC_0–72, ANC AUC_0–∞ and ANC_max) profiles in healthy male subjects.
Materials and methods: A total of 36 (23.0 ± 6.0 years, 76.6 ± 7.2 kg) healthy subjects were recruited. Using a 1:1 randomization ratio, subjects were randomly assigned to one of two possible treatment-sequence groups to receive the single dose of test formulation (Gp-02) and reference product (Neupogen^TM) concentrations were measured by enzyme-linked immunosorbent assay (ELISA) up to 24 h and the Absolute Neutrophil Count (ANC) was determined using hematology analyzer Coulter STKS^TM (Beckman Coulter) up to 72 h after injection. The geometric mean of primary pharmacokinetic and pharmacodynamic variables were considered bioequivalent if the 90% confidence intervals (CI) would fall in the bioequivalence range of 80%–125%.
Results: AUC_0–24 (ratio of means 103.4, 90% CI: 95.6–111.9), AUC_0–∞ (103.4, 90% CI: 95.7–111.7), C_max (99.6, 90% CI: 89.0–111.4), ANC AUC_0–72 (100.0, 90% CI: 96.6–103.5), ANC AUC_0–∞ (100.8, 90% CI: 96.5–105.3), and ANC_max (100.2, 90% CI: 95.4–105.1) were determined. Single doses of test and reference formulations were well tolerated. The incidence of AEs was equally distributed across treatment groups with the most frequent AEs being headache, fever, and back pain.
Conclusions: The study results demonstrated the bioequivalence of Gp-02, a new formulation of filgrastim, and the reference product Neupogen^TM. Full article

439 KiB

Open AccessReview

5-Aminolevulinic acid-based fluorescence diagnostics of cervical preinvasive changes

by Rasa Vansevičiūtė, Jonas Venius and Simona Letautienė

Medicina 2014, 50(3), 137-143; https://doi.org/10.1016/j.medici.2014.08.004 - 12 Aug 2014

Cited by 10 | Viewed by 620

Abstract

The purpose of this article is to review the diagnostic possibilities of 5-aminolevulinic acid (5-ALA)-based fluorescence diagnosis of preinvasive cervical changes.
Reviewed papers were selected from the PubMed database with keywords combining the terms individual cervical neoplasia and fluorescence diagnostics. The regular colposcopy [...] Read more.

The purpose of this article is to review the diagnostic possibilities of 5-aminolevulinic acid (5-ALA)-based fluorescence diagnosis of preinvasive cervical changes.
Reviewed papers were selected from the PubMed database with keywords combining the terms individual cervical neoplasia and fluorescence diagnostics. The regular colposcopy procedure lacks specificity; therefore, new methods are continually sought for superior diagnosis of cervical pathology. 5-ALA-based fluorescence diagnostics is under investigation as an up-to-date diagnostic technique for cervical intraepithelial neoplasia (CIN). This method is grounded on the topical or systemic application of 5-ALA, which induces excess production of the endogenous photosensitizer protoporphyrin IX (PpIX) in tissues where carcinogenesis has begun. The conversion of PpIX to the heme is less efficient in tumors; therefore, higher amounts of PpIX tend to accumulate in premalignant and malignant tissues. Illumination with light of the appropriate wavelength initiates excitation of PpIX fluorescence, which in turn helps to localize PpIX-rich areas and identify potentially malignant tissues. A number of investigations suggest that because of its high selectivity for tumors and low toxicity to healthy tissues, 5-ALA-based diagnosis seems a promising tool for the noninvasive identification of cervical intraepithelial neoplasia. Full article

378 KiB

Open AccessArticle

Importance of alcohol-related expectations and emotional expressivity for prediction of motivation to refuse alcohol in alcohol-dependent patients

by Justina Slavinskienė and Kristina Žardeckaitė-Matulaitienė

Medicina 2014, 50(3), 169-174; https://doi.org/10.1016/j.medici.2014.07.002 - 29 Jul 2014

Cited by 5 | Viewed by 793

Abstract

Background and objective: The aim of this study was to evaluate the importance of alcoholdependent patients' emotional expressivity, alcohol-related expectations and socio- demographic factors for prediction of motivation to refuse alcohol consumption.
Materials and methods: The study sample consisted of 136 alcohol-dependent patients [...] Read more.

Background and objective: The aim of this study was to evaluate the importance of alcoholdependent patients' emotional expressivity, alcohol-related expectations and socio- demographic factors for prediction of motivation to refuse alcohol consumption.
Materials and methods: The study sample consisted of 136 alcohol-dependent patients (100 men and 36 women) undergoing treatment in Kaunas center for addictive disorders.
Results: Only higher expression of negative alcohol-related expectations (std. beta = 0.192, P = 0.023), higher emotional impulse intensity (std. beta = 0.229, P = 0.021) and higher expression of positive emotional expressiveness (std. beta = 0.021, P = 0.020) as well as gender (std. beta = 0.180, P = 0.049), education (std. beta = –0.137, P = 0.038) and alcohol dependency treatment conditions (members of support group after rehabilitation program) (std. beta = 0.288, P = 0.001; std. beta = 0.608, P = 0.001) were significant factors for predicting the different level of alcohol-dependent patients motivation to refuse alcohol consumption.
Conclusions: Negative alcohol-related expectations, emotional impulse intensity and positive emotional expressiveness were significant even though quite weak triggers for alcohol-dependent patients' different level of motivation to refuse alcohol consumption. An assumption could be made that by changing these triggers it is possible to change addictive behavior. Full article

434 KiB

Open AccessArticle

The role of parental education and socioeconomic status in dental caries prevention among Lithuanian children

by Kristina Saldūnaitė, Eglė Aida Bendoraitienė, Eglė Slabšinskienė, Ingrida Vasiliauskienė, Vilija Andruškevičienė and Jūratė Zūbienė

Medicina 2014, 50(3), 156-161; https://doi.org/10.1016/j.medici.2014.07.003 - 29 Jul 2014

Cited by 54 | Viewed by 1118

Abstract

Background and objective: The aim of this study was to disclose parental attitudes toward their children's dental care and preventive measures used as well as to evaluate their associations with parental education and socioeconomic status.
Materials and methods: A total of 1248 parents [...] Read more.

Background and objective: The aim of this study was to disclose parental attitudes toward their children's dental care and preventive measures used as well as to evaluate their associations with parental education and socioeconomic status.
Materials and methods: A total of 1248 parents of 7-, 9-, and 12-year-old children from 5 largest Lithuanian cities were enrolled in the study. The questionnaire comprised 34 items, which were grouped into 4 clusters.
Results: The parents with a high educational level scored better than those who had a low educational level (2.13 [SD, 0.39] vs. 2.2 [0.43], P = 0.002). The parents who reported sufficientfamily income scored their child's and their own health significantly better than those reporting insufficient-family income (2.02 [SD, 0.37] vs. 2.27 [SD, 0.41], P < 0.001). The parents cared about their child's health more than about their own (1.53 [SD, 0.51] vs. 2.15 [0.61], P < 0.001). The parents with a high educational level and those receiving sufficient income cared about education on oral hygiene and regular preventive dental check-ups more than those with a low educational level and insufficient income (36.7% and 40.8% vs. 30.2% and 28.7%, P < 0.01 and P < 0.001, respectively). The children whose parents had a high educational level brushed their teeth 2 times a day more frequently than those of the parents with a low educational level (48.5% and 42.4%, respectively, P < 0.001).
Conclusions: Greater attention to children's dental care as well as keeping their teeth healthy was paid by the parents with a high educational level and sufficient income. Full article

414 KiB

Open AccessArticle

Self-reported cannabis products and other illicit drugs consumption in older school-age children in Northern Lithuania: A comparison between 2006 and 2012

by Dalia Miniauskienė, Dalia Jurgaitienė and Birutė Strukčinskienė

Medicina 2014, 50(3), 162-168; https://doi.org/10.1016/j.medici.2014.07.001 - 28 Jul 2014

Cited by 2 | Viewed by 796

Abstract

Background and objective: Cannabis use is widespread among young people in Europe. The aim of this study was to analyze and to compare the associations between the self-reported consumption of cannabis products and other illicit drugs among older schoolchildren in 2006 and in [...] Read more.

Background and objective: Cannabis use is widespread among young people in Europe. The aim of this study was to analyze and to compare the associations between the self-reported consumption of cannabis products and other illicit drugs among older schoolchildren in 2006 and in 2012.
Materials and methods: Two cross-sectional surveys were conducted in 2006 and 2012 in Northern Lithuania. In total 3447 young people aged 17–19 years were investigated (1585 male and 1862 female). For this survey, the ESPAD questionnaire was used.
Results: In Northern Lithuania, the schoolchildren aged 17–19 years self-reported that 16.7% in 2006 and 23.9% in 2012 of them tried cannabis products. The consumption of cannabis products in the age group of 17 years increased from 14.9% in 2006 to 21.5% in 2012. The consumption of cannabis together with alcohol increased from 7.6% to 14.3%. Cannabis consumers more often tried amphetamines, heroin, LSD, cocaine, crack, ecstasy, hallucino- genic mushrooms, and injective drugs. In 2012, cannabis consumers girls less than boys used only crack and injective drugs; all other illicit drugs they used the same often as boys.
Conclusions: The cannabis products consumption in schoolchildren has increased by 7%. Nearly twofold increase was observed in the consumption of cannabis together with alcohol. Young people who used cannabis products more often tried other illicit drugs. There were no differences by gender in the consumption of illicit drugs among cannabis consumers Full article

Journal Menu

Journal Browser

Medicina, Volume 50, Issue 3 (June 2014) – 9 articles , Pages 137-195

Further Information

Guidelines

MDPI Initiatives

Follow MDPI