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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 52, Issue 1 (February 2016) – 9 articles , Pages 1-68

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695 KiB  
Article
Prevalence and severity of dental caries among 18-year-old Lithuanian adolescents
by Miglė Žemaitienė, Rūta Grigalauskienė, Ingrida Vasiliauskienė, Kristina Saldūnaitė, Jaunė Razmienė and Eglė Slabšinskienė
Medicina 2016, 52(1), 54-60; https://doi.org/10.1016/j.medici.2016.01.006 - 29 Jan 2016
Cited by 25 | Viewed by 1267
Abstract
Objective: The aim of the study was to evaluate the prevalence and severity of dental caries among 18-year-old Lithuanian adolescents and to disclose possible differences in the prevalence and severity of dental caries related to gender, urbanization, and different county.
Material and methods: [...] Read more.
Objective: The aim of the study was to evaluate the prevalence and severity of dental caries among 18-year-old Lithuanian adolescents and to disclose possible differences in the prevalence and severity of dental caries related to gender, urbanization, and different county.
Material and methods: A total of 1063 18-year-old adolescents attending school, 427 boys and 636 girls from 10 Lithuanian counties including urban and rural areas, were included in the cross-sectional study on dental caries. The method of multistage cluster sampling was used. The dental examination was performed according to the methodology of oral status evaluation recommendations by the World Health Organization (WHO). The prevalence of dental caries, DMFT score, Significant Caries Index, and dental care index were deter- mined.
Results: The overall prevalence of dental caries among 18-year-old Lithuanian adolescents was 78.3%. The study population had a mean DMFT score of 2.93 [SD, 2.81]. Considering the gender, a higher DMFT score was observed among girls than boys (3.03 [SD, 2.88] versus 2.73 [SD, 2.71]) and in rural than urban areas (3.02 [SD, 2.98] versus 2.89 [SD, 2.73]). The Significant Caries Index and the dental care index among 18-year-old adolescents were 6.14 and 62.3%, respectively.
Conclusion: This study showed a relatively high prevalence of dental caries. The existing differences of caries experience between the urban and the rural areas as well as between the counties could be influenced by the socioeconomic differences in the country. Full article
564 KiB  
Review
Hypertension and physical exercise: The role of oxidative stress
by Monica Korsager Larsen and Vladimir V. Matchkov
Medicina 2016, 52(1), 19-27; https://doi.org/10.1016/j.medici.2016.01.005 - 29 Jan 2016
Cited by 135 | Viewed by 2465
Abstract
Oxidative stress is associated with the pathogenesis of hypertension. Decreased bioavailability of nitric oxide (NO) is one of the mechanisms involved in the pathogenesis. It has been suggested that physical exercise could be a potential non-pharmacological strategy in treatment of hypertension because of [...] Read more.
Oxidative stress is associated with the pathogenesis of hypertension. Decreased bioavailability of nitric oxide (NO) is one of the mechanisms involved in the pathogenesis. It has been suggested that physical exercise could be a potential non-pharmacological strategy in treatment of hypertension because of its beneficial effects on oxidative stress and endothelial function. The aim of this review is to investigate the effect of oxidative stress in relation to hypertension and physical exercise, including the role of NO in the pathogenesis of hypertension. Endothelial dysfunction and decreased NO levels have been found to have the adverse effects in the correlation between oxidative stress and hypertension. Most of the previous studies found that aerobic exercise significantly decreased blood pressure and oxidative stress in hypertensive subjects, but the intense aerobic exercise can also injure endothelial cells. Isometric exercise decreases normally only systolic blood pressure. An alternative exercise, Tai chi significantly decreases blood pressure and oxidative stress in normotensive elderly, but the effect in hypertensive subjects has not yet been studied. Physical exercise and especially aerobic training can be suggested as an effective intervention in the prevention and treatment of hypertension and cardiovascular disease via reduction in oxidative stress. Full article
2312 KiB  
Article
Association between the outcome of traumatic brain injury patients and cerebrovascular autoregulation, cerebral perfusion pressure, age, and injury grades
by Vytautas Petkus, Solventa Krakauskaitė, Aidanas Preikšaitis, Saulius Ročka, Romanas Chomskis and Arminas Ragauskas
Medicina 2016, 52(1), 46-53; https://doi.org/10.1016/j.medici.2016.01.004 - 28 Jan 2016
Cited by 16 | Viewed by 835
Abstract
Background and objective: The aim of this study was to explore the association of cerebrovascular autoregulation (CA) and optimal cerebral perfusion pressure (CPP) managing conditions with the outcome of traumatic brain injury (TBI) patients including additional information about the patients' age and grade [...] Read more.
Background and objective: The aim of this study was to explore the association of cerebrovascular autoregulation (CA) and optimal cerebral perfusion pressure (CPP) managing conditions with the outcome of traumatic brain injury (TBI) patients including additional information about the patients' age and grade of diffuse axonal injury (DAI).
Materials and methods: The CA monitoring of 28 TBI patients was performed by using ICM+ software (Cambridge, UK). The CA status estimating pressure reactivity indexes (PRx) and CPP data were processed in order to obtain information on the patient-specific treatment conditions by calculating the optimal CPP.
Results: There was a negative correlation between the Glasgow outcome scale (GOS) score and PRx (r = -0.448 at hospital discharge and r = -0.402 after 6 months). The estimated threshold value PRx of >0.24 was associated with mortality. The correlation coefficients between the GOS score and the difference CPP-optimal CPP were 0.549 at hospital discharge and 0.484 after 6 months. The threshold value of CPP declination from DCPPopt per -6 mmHg was associated with mortality. Poorer outcome was predicted for elderly TBI patients (aged >47 years) and patients having a DAI grade of 3.
Conclusions: The association of the GOS score with CPP, CA impairment conditions, age and diffuse axonal injury (DAI) grade showed that the outcomes of TBI patients were associated with patient-specific CPP management and better outcomes were obtained for younger patients, for patients having lower DAI grade and for patients whose CPP was kept within the range from the optimal CPP to the optimal CPP + 10 mmHg. Full article
391 KiB  
Article
The importance of MTHFR C677T/A1298C combined polymorphisms in pulmonary embolism in Turkish population
by Nursah Basol, Nevin Karakus, Asli Yasemen Savas, Ilker Kaya, Kayhan Karakus and Serbulent Yigit
Medicina 2016, 52(1), 35-40; https://doi.org/10.1016/j.medici.2016.01.003 - 28 Jan 2016
Cited by 7 | Viewed by 779
Abstract
Background and objective: Pulmonary embolism (PE) is an important cardiovascular emergency with high mortality. There are still problems related to the diagnosis of PE and genetic research may play a key role on diagnosis as well as determining risk stratification. In the present [...] Read more.
Background and objective: Pulmonary embolism (PE) is an important cardiovascular emergency with high mortality. There are still problems related to the diagnosis of PE and genetic research may play a key role on diagnosis as well as determining risk stratification. In the present study, the aim was to evaluate MTHFR C677T and A1298C polymorphisms that play a role on folate metabolism in PE patients.
Materials and methods: A total of 118 PE patients and 126 controls were enrolled in the current study. Genomic DNA was isolated and genotyped using polymerase chain reaction (PCR) analyses for the MTHFR C677T and A1298C polymorphisms.
Results: There was no association between clinical and demographic characteristics of PE patients and both MTHFR C677T and A1298C polymorphisms. Allele frequencies showed a significant difference between patients and controls. T allele frequency was significantly higher in the patients' group than the control group. There was an association between PE and combined MTHFR C677T and A1298C polymorphisms.
Conclusion: We found an association between MTHFR C677T/A1298C combined mutations and PE in the Turkish population. Future genetic studies investigating combined mutations could be very helpful to identify risk population in PE. Full article
420 KiB  
Article
Effects of cluster vs. traditional plyometric training sets on maximal-intensity exercise performance
by Abbas Asadi and Rodrigo Ramírez-Campillo
Medicina 2016, 52(1), 41-45; https://doi.org/10.1016/j.medici.2016.01.001 - 16 Jan 2016
Cited by 30 | Viewed by 1754
Abstract
Objective: The aim of this study was to compare the effects of 6-week cluster versus traditional plyometric training sets on jumping ability, sprint and agility performance.
Materials and methods: Thirteen college students were assigned to a cluster sets group (N = 6) [...] Read more.
Objective: The aim of this study was to compare the effects of 6-week cluster versus traditional plyometric training sets on jumping ability, sprint and agility performance.
Materials and methods: Thirteen college students were assigned to a cluster sets group (N = 6) or traditional sets group (N = 7). Both training groups completed the same training program. The traditional group completed five sets of 20 repetitions with 2 min of rest between sets each session, while the cluster group completed five sets of 20 [2 × 10] repetitions with 30/90- s rest each session. Subjects were evaluated for countermovement jump (CMJ), standing long jump (SLJ), t test, 20-m and 40-m sprint test performance before and after the intervention. Results: Both groups had similar improvements (P < 0.05) in CMJ, SLJ, t test, 20-m, and 40-m sprint. However, the magnitude of improvement in CMJ, SLJ and t test was greater for the cluster group (effect size [ES] = 1.24, 0.81 and 1.38, respectively) compared to the traditional group (ES = 0.84, 0.60 and 0.55). Conversely, the magnitude of improvement in 20-m and 40- m sprint test was greater for the traditional group (ES = 1.59 and 0.96, respectively) compared to the cluster group (ES = 0.94 and 0.75, respectively).
Conclusions: Although both plyometric training methods improved lower body maximal- intensity exercise performance, the traditional sets methods resulted in greater adaptations in sprint performance, while the cluster sets method resulted in greater jump and agility adaptations. Full article
529 KiB  
Review
Moving into the wide clinical spectrum of consciousness disorders: Pearls, perils and pitfalls
by Rocco Salvatore Calabrò, Demetrio Milardi, Alberto Cacciola, Angela Marra, Giuseppina Digangi, Carmela Casella, Alfredo Manuli, Rosaria De Luca, Rosalia Silvestri and Placido Bramanti
Medicina 2016, 52(1), 11-18; https://doi.org/10.1016/j.medici.2016.01.002 - 15 Jan 2016
Cited by 7 | Viewed by 817
Abstract
The last few years have been characterized by a growing interest of the medical and scientific world for the field of consciousness and its related disorders. Medically speaking, conscious- ness can be defined as the state of awareness of self and environment and [...] Read more.
The last few years have been characterized by a growing interest of the medical and scientific world for the field of consciousness and its related disorders. Medically speaking, conscious- ness can be defined as the state of awareness of self and environment and the alertness to external stimulation, besides responsiveness to inner need.
Transient loss of consciousness can be due to alterations in cerebral blood flow leading to fainting or syncope, migraine, metabolic dysfunctions, unexpected intracranial pressure increases, epileptic seizures, and sleep disorders. Chronic disorders of consciousness are a tragic success of high-technology treatment, in an attempt to maintain or reestablish brain function, which is to be considered as the main goal of therapeutics. Management of vegetative or a minimally conscious state individuals involves charily getting the right diagnosis with an evidence-based prognosis, also taking into account the medical, ethical, and legal key factors of the ideal treatment. This paper is aimed at exploring the wide spectrum of consciousness disorders and their clinical differential diagnosis, with particular regards to those with a negative impact on patient and their caregiver quality of life, including epilepsy, sleep disorders, and vegetative/minimally conscious state. Full article
826 KiB  
Review
Clinical relevance of high sensitivity C-reactive protein in cardiology
by Dalia Adukauskienė, Aušra Čiginskienė, Agnė Adukauskaitė, Daiva Pentiokinienė, Rimvydas Šlapikas and Indrė Čeponienė
Medicina 2016, 52(1), 1-10; https://doi.org/10.1016/j.medici.2015.12.001 - 15 Jan 2016
Cited by 65 | Viewed by 1135
Abstract
Coping with cardiovascular diseases (CVD), which are of the main causes of death worldwide, has influenced investigation of high sensitivity CRP (hsCRP) and its role in pathogene- sis, prognosis and prevention of CVD. hsCRP can be synthesized in vascular endothelium, atherosclerotic plaques, and [...] Read more.
Coping with cardiovascular diseases (CVD), which are of the main causes of death worldwide, has influenced investigation of high sensitivity CRP (hsCRP) and its role in pathogene- sis, prognosis and prevention of CVD. hsCRP can be synthesized in vascular endothelium, atherosclerotic plaques, and theory of inflammatory origin of atherosclerosis is being more widely debated, raising questions, whether higher hsCRP plasma concentration might be the cause or the consequence. Summing up controversial data from multiple studies, guidelines recommend hsCRP testing for both, primary (stratifying CVD risk groups, selecting patients for statin therapy) and secondary CVD prevention (prognosis of CVD and its treatment complications, evaluation of treatment efficacy in moderate CVD risk group). hsCRP testing also has role in heart failure, atrial fibrillation, arterial hypertension, valve pathology and prognosis of coronary stent thrombosis or restenosis. Medications (the well-known and the new specific – CRP binding) affecting its concentration are being investigated as well. Full article
1033 KiB  
Review
Effect of probiotics on glucose metabolism in patients with type 2 diabetes mellitus: A meta-analysis of randomized controlled trials
by Qingqing Zhang, Yucheng Wu and Xiaoqiang Fei
Medicina 2016, 52(1), 28-34; https://doi.org/10.1016/j.medici.2015.11.008 - 29 Dec 2015
Cited by 129 | Viewed by 2466
Abstract
Objective: Our aim was to investigate the effects of probiotics on glucose metabolism in patients with type 2 diabetes mellitus using a meta-analysis of randomized, controlled trials. Materials and methods: Online databases Embase, Web of Science, and PubMed were searched until August 2014 [...] Read more.
Objective: Our aim was to investigate the effects of probiotics on glucose metabolism in patients with type 2 diabetes mellitus using a meta-analysis of randomized, controlled trials. Materials and methods: Online databases Embase, Web of Science, and PubMed were searched until August 2014 to identify eligible articles. Finally, 7 trials were included.
Results: Probiotic consumption significantly changed fasting plasma glucose (FPG) by -15.92 mg/dL (95% confidence interval [CI], -29.75 to -2.09) and glycosylated hemoglobin (HbA1c) by -0.54% (95% CI, -0.82 to -0.25) compared with control groups. Subgroup analysis was conducted to trials with non-yogurts control. Meta-analysis of trials with multiple species of probiotics found a significant reduction in FPG (weighted mean difference [WMD]: -35.41 mg/dL, 95% CI: -51.98 to -18.89). The duration of intervention for ≥8 weeks resulted in a significant reduction in FPG (WMD: -20.34 mg/dL, 95% CI: -35.92 to -4.76). Subgroup analysis of trials with species of probiotics did not result in a significant meta-analysis effect. Furthermore, the duration of intervention <8 weeks did not result in a significant reduction in FPG. The results also showed that probiotic therapy significantly decreased homeostasis model assessment of insulin resistance (HOMA-IR) and insulin concentration (WMD: -1.08, 95% CI: -1.88 to -0.28; and WMD: -1.35 mIU/L, 95% CI: -2.38 to -0.31, respectively).
Conclusions: The present meta-analysis suggests that consuming probiotics may improve glucose metabolism by a modest degree, with a potentially greater effect when the duration of intervention is ≥8 weeks, or multiple species of probiotics are consumed. Full article
474 KiB  
Article
Evaluation of daily outpatient multidisciplinary rehabilitative treatment of patients with musculoskeletal, neurological and traumatic disorders in a municipality outpatient setting
by Giedrė Sakalauskienė, Vidmantas Obelienius, Rugilė Pilvinienė and Dovilė Jauniškienė
Medicina 2016, 52(1), 61-68; https://doi.org/10.1016/j.medici.2015.11.007 - 11 Dec 2015
Cited by 2 | Viewed by 772
Abstract
Background and objective: Musculoskeletal, neurological, and traumatic injuries are a consid- erably increasing problem. There is a lack of studies evaluating the results of outpatient rehabilitative treatment of patients with the abovementioned diseases. The aim of this study was to determine the effectiveness [...] Read more.
Background and objective: Musculoskeletal, neurological, and traumatic injuries are a consid- erably increasing problem. There is a lack of studies evaluating the results of outpatient rehabilitative treatment of patients with the abovementioned diseases. The aim of this study was to determine the effectiveness of daily outpatient multidisciplinary rehabilitation.
Materials and methods: This observational study enrolled 223 adult people undergoing outpatient rehabilitation performed in a municipality outpatient clinic during 14 days. The functional assessment of disability was performed by using the Barthel index (BI), functional performance was estimated by the modified Keitel functional test (MKFT), and pain perception was evaluated by the visual analogue scale (VAS). The mean scores of the tests were compared before and after outpatient multidisciplinary rehabilitation.
Results: Significantly reduced disability and pain perception as well as increased functional performance were documented after outpatient rehabilitation. The mean scores of BI, MKFT, and VAS before and after rehabilitation did not differ significantly among patients ranked to each cluster of diseases. Increased functional performance of patients had a moderate-to- weak association with decreased disability and pain perception. The positive changes in health status considering disability, functional performance, and pain perception were documented after 14-day rehabilitation.
Conclusions: Multidisciplinary outpatient rehabilitation can be considered as effective treatment. However, it is necessary to implement specific, well-adapted consuming assessment instruments in order to evaluate the outcomes of daily multidisciplinary outpatient rehabilitative treatment. Full article
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