Medicina

196 KiB

Open AccessArticle

Coma: Etiology, diagnosis, and treatment

by Dalia Adukauskienė, Brigita Budrytė and Diana Karpec

Medicina 2008, 44(10), 812; https://doi.org/10.3390/medicina44100102 - 13 Oct 2008

Cited by 5 | Viewed by 1875

Coma is the disorder of consciousness because of the damage to diffused bilateral cerebral hemisphere cortex or reticular activating system. Coma can be caused by neurogenic (head brain injury), metabolic (endogenic), and toxic (exogenic) factors. To determine the cause of metabolic and toxic [...] Read more.

Coma is the disorder of consciousness because of the damage to diffused bilateral cerebral hemisphere cortex or reticular activating system. Coma can be caused by neurogenic (head brain injury), metabolic (endogenic), and toxic (exogenic) factors. To determine the cause of metabolic and toxic coma, laboratory tests are performed; in case of neurogenic coma, the neurologic examination is essential, when five systems are evaluated: the level of consciousness (according to Glasgow Coma Scale or Full Outline of Unresponsiveness Scale), photoreaction of pupils and ophthalmoscopic examination, oculomotoric, motoric, and cardiopulmonary systems. For the treatment of coma, adequate oxygenation and correction of blood circulation disorders are important. The treatment of metabolic coma is guided by special schemes; antidotes often are needed in the treatment of toxic coma, and surgery helps if traumatic brain injury is present. The prognosis and outcomes of the comatose patient depend on the age and comorbid diseases of the patient, the underlying cause of coma, timely medical help and its quality, and intensive treatment and care of the patient in coma. Full article

208 KiB

Open AccessArticle

Variability of phenolic compounds in flowers of Achillea millefolium wild populations in Lithuania

by Raimondas Benetis, Jolita Radušienė and Valdimaras Janulis

Medicina 2008, 44(10), 775; https://doi.org/10.3390/medicina44100097 - 13 Oct 2008

Cited by 37 | Viewed by 1681

Abstract

Achillea millefolium L. sensu lato (yarrow) is the best-known species of the genus Achillea due to numerous medicinal applications both in folk and conventional medicine. Phenolic compounds such as flavonoids and phenol carbonic acids are present in yarrow and constitute one of the [...] Read more.

Achillea millefolium L. sensu lato (yarrow) is the best-known species of the genus Achillea due to numerous medicinal applications both in folk and conventional medicine. Phenolic compounds such as flavonoids and phenol carbonic acids are present in yarrow and constitute one of the most important groups of pharmacologically active substances. In the present study, yarrow flowers gathered from native populations in different locations of Lithuania were analyzed for phenolic compound composition. High-performance liquid chromatography (HPLC) was used for chemical analyses. Eight phenolic compounds – chlorogenic acid and flavonoids, namely vicenin-2, luteolin-3',7-di-O-glucoside, luteolin-7-O-glucoside, rutin, apigenin-7-O-glucoside, luteolin, and apigenin – were identified in the extracts from yarrow flowers. Considerable variation in accumulation of phenolic compounds among the flowers from different locations was observed. The samples were divided into two main groups based on chemical composition: the first group was characterized by lower than the mean total amount of the identified phenolics; the second was formed from samples accumulating higher concentrations of investigated secondary metabolites. The total amount of the identified phenolics in yarrow flowers from different populations varied from 13.290 to 27.947 mg/g. Full article

542 KiB

Open AccessArticle

Analysis of antibiotic consumption and microorganism resistance changes

by Daiva Galinytė, Romaldas Mačiulaitis, Vytautas Budnikas, Darius Kubilius, Birutė Varanavičienė, Astra Vitkauskienė, Juozas Jokimas and Laimis Jodkonis

Medicina 2008, 44(10), 751; https://doi.org/10.3390/medicina44100095 - 13 Oct 2008

Cited by 5 | Viewed by 1028

Abstract

Objective. The main goal of this study was to evaluate the variation of antibiotic consumption and relation between antibiotic consumption and microorganism resistance.
Material and methods. This analysis was performed in one of Lithuanian tertiary hospitals. The defined daily dose (DDD) analysis [...] Read more.

Objective. The main goal of this study was to evaluate the variation of antibiotic consumption and relation between antibiotic consumption and microorganism resistance.
Material and methods. This analysis was performed in one of Lithuanian tertiary hospitals. The defined daily dose (DDD) analysis was performed to express drug consumption per every 100 occupied bed days (OBDs) for single units in clinical departments. Average of DDD/100 OBDs was estimated for 2004–2007, and mean values were compared among all four years. The relation between the number of surgical operations and antibiotic consumption in surgery departments was analysed. E. coli and K. pneumoniae resistance for four years (2004–2007) was determined. Moreover, the relation between microorganism resistance and variation of antibiotic consumption was determined. Data were analysed by descriptive and comparative statistics (by Mann–Whitney test for nonparametric criteria and Spearman correlation).
Results. Comparing the DDD/100 OBD data during 2004–2007 revealed a statistically significant increase in piperacillin and tazobactam (877.50%), metronidazole (114.00%), cefuroxime (77.31%), meropenem (47.55%), cefoperazone and sulbactam (173.11%) consumption. The increased usage of these antibiotics was determined in surgery department too. However, the increased number of surgical operations cannot be the only reason of the growing antibiotic consumption. Results revealed a statistically significant decrease in ofloxacin use from 2006 to 2007 (93.94%). E. coli resistance to ampicillin (from 49.80% to 56.60%), ampicillin and sulbactam (from 25.50% to 39.20%), cefuroxime (from 7.40% to 10.10%), ciprofloxacin (from 4.20% to 12.50%), gentamicin (from 11.40% to 13.20%) and K. pneumoniae resistance to ampicillin and sulbactam (from 45.40% to 56.40%), cefuroxime (from 34.00% to 39.10%), ciprofloxacin (from 5.50% to 10.50%), gentamicin (from 32.00% to 35.80%) increased. A statistically significant positive correlation between quinolone consumption and K. pneumoniae resistance to ciprofloxacin was determined (r=1, P<0.05).
Conclusions. In 2004–2007, the usage of piperacillin and tazobactam, metronidazole, cefuroxime, meropenem, cefoperazone, and sulbactam increased. In 2006–2007, ofloxacin consumption decreased. The changes in other antibiotic usage were statistically insignificant. In 2004–2007, E. coli and K. pneumoniae resistance to ampicillin and sulbactam, cefuroxime, ciprofloxacin, gentamicin and E. coli resistance to ampicillin increased. A statistically significant positive correlation between quinolone consumption and K. pneumoniae resistance to ciprofloxacin was determined. Full article

230 KiB

Open AccessArticle

Private or public dental care? Patients’ perception and experience in Lithuania

by Alina Pūrienė, Jadvyga Petrauskienė, Irena Balčiūnienė, Vilija Janulytė, Jelena Kutkauskienė and Margarita Musteikytė

Medicina 2008, 44(10), 805; https://doi.org/10.3390/medicina44100101 - 12 Oct 2008

Cited by 7 | Viewed by 1254

Abstract

Objective. To compare demographic and social groups of patients, their satisfaction with services in public and private dental institutions.
Material and methods. A random sample of 3000 Lithuanian residents was selected; 1801 participants answered a postal questionnaire. The response rate was [...] Read more.

Objective. To compare demographic and social groups of patients, their satisfaction with services in public and private dental institutions.
Material and methods. A random sample of 3000 Lithuanian residents was selected; 1801 participants answered a postal questionnaire. The response rate was 60.0%. Univariate analysis, χ² criterion, z-test, and multiple logistic regression were used to evaluate the association between institution type, demographic and social characteristics of the respondents.
Results. Less than half of Lithuanian residents (41.2%) visited public dental institutions, 35.9% – private, 25.9% – both. They preferred private dental sector due to better quality of service, public – due to closeness to residence or being the treatment place of acquaintances. Patients visiting public institutions required cheaper treatment, while patients visiting private institutions – qualitative, though more expensive, using modern technologies. The number of dental visits in the past year was lower in public institutions than in private ones. The majority of patients treated in public, private, and both institutions were satisfied with dental services. The least satisfied were visiting both institutions. More respondents with secondary and lower education used public services as compared to those with higher education. Urban population visited public institutions more often than rural population. Respondents with a monthly income of less than 500 Lt for one family member used public dental services more often than those receiving a higher income. Older patients visited public dental institutions more often than younger ones.
Conclusions. More Lithuanian residents are treated in public dental institutions (up to 67.1%) than in private. Older, receiving lower income patients preferred public institutions. The majority of patients in public clinics as well as in private sector are satisfied with the service. Those who visited both types of institutions were least satisfied with dental services. Full article

178 KiB

Open AccessArticle

Dietary patterns and their association with sociodemographic factors in Lithuanian adult population

by Vilma Kriaučionienė, Janina Petkevičienė and Jūratė Klumbienė

Medicina 2008, 44(10), 799; https://doi.org/10.3390/medicina44100100 - 12 Oct 2008

Cited by 10 | Viewed by 1078

Abstract

The aim of the study was to determine the association between dietary patterns and sociodemographic factors using the data of Lithuanian health behavior monitoring.
Material and methods. In 1998–2004, four cross-sectional surveys were carried out within the FINBALT HEALTH MONITOR project. For [...] Read more.

The aim of the study was to determine the association between dietary patterns and sociodemographic factors using the data of Lithuanian health behavior monitoring.
Material and methods. In 1998–2004, four cross-sectional surveys were carried out within the FINBALT HEALTH MONITOR project. For every survey, a random sample of 3000 Lithuanians aged 20–64 years was taken from the National Population Register by mailed questionnaires. The response rates varied from 61.7% to 74.4%. Factor analysis was employed in order to reduce the number of food items. Four main factors were defined: “light food,” “sweets,” “heavy food,” and “cereals” factors. The associations between dietary patterns and sociodemographic factors were examined by applying a logistic regression analysis.
Results. Four major factors accounted for 45.9% of the total variance in food intake in men and 46.5% in women. The “sweets” factor was inversely associated with age both in men and women. A strong positive association was found between age and the “cereals” factor. Men and women with a higher level of education were more likely to follow “light food” and “sweets” pattern and less likely “heavy food” if compared with people with a lower level of education. The odds of consuming “light food” were higher in cities than in rural areas. Married men and women were more likely to follow “heavy food” pattern compared to unmarried.
Conclusion. This study identified four main dietary patterns in Lithuanian population. Dietary patterns of people with a higher level of education and inhabitants of cities are closer to the recommendations on healthy nutrition. Full article

186 KiB

Open AccessArticle

Preventing chronic disease risk factors: Rationale and feasibility

by Courtney O. Jordan, Megan Slater and Thomas E. Kottke

Medicina 2008, 44(10), 745; https://doi.org/10.3390/medicina44100094 - 12 Oct 2008

Cited by 18 | Viewed by 1519

Abstract

Objective. The majority of the mortality, morbidity, and disability in the United States and other developed countries is due to chronic diseases. These diseases could be prevented to a great extent with the elimination of four root causes: physical inactivity, poor nutrition, [...] Read more.

Objective. The majority of the mortality, morbidity, and disability in the United States and other developed countries is due to chronic diseases. These diseases could be prevented to a great extent with the elimination of four root causes: physical inactivity, poor nutrition, smoking, and hazardous drinking. The objective of this analysis was to determine whether efficacious risk factor prevention interventions exist and to examine the evidence that populationwide program implementation is justified.
Materials and methods. We conducted a literature search for meta-analyses and systematic reviews of trials that tested interventions to increase physical activity, improve nutrition, reduce smoking and exposure to environmental tobacco smoke, and reduce hazardous drinking.
Results. We found that appropriately designed interventions can produce behavioral change for the four behaviors. Effective interventions included tailored fact-to-face counseling, phone counseling, and computerized tailored feedback. Computer-based health behavior assessment with feedback and education was documented to be an effective method of determining behavior, assessing participant interest in behavior change and delivering interventions. Some programs have documented reduced health care costs associated with intervention.
Conclusions. Positive results to date suggest that further investments to improve the effectiveness and efficiency of chronic disease risk factor prevention programs are warranted. Widespread implementation of these programs could have a significant impact on chronic disease incidence rates and costs of health care. Full article

279 KiB

Open AccessArticle

Bi-modal recovery of quadriceps femoris muscle function after sustained maximum voluntary contraction at different muscle length

by Albertas Skurvydas, Nerijus Masiulis, Aleksas Stanislovaitis and Sigitas Kamandulis

Medicina 2008, 44(10), 782; https://doi.org/10.3390/medicina44100098 - 11 Oct 2008

Cited by 6 | Viewed by 993

Abstract

The aim of this study was to test the hypothesis that contractility of quadriceps femoris muscle during a 15-min period after a sustained maximum voluntary contraction for 1 min is determined by the interaction of posttetanic potentiation, metabolic fatigue, and nonmetabolic fatigue. Eleven [...] Read more.

The aim of this study was to test the hypothesis that contractility of quadriceps femoris muscle during a 15-min period after a sustained maximum voluntary contraction for 1 min is determined by the interaction of posttetanic potentiation, metabolic fatigue, and nonmetabolic fatigue. Eleven healthy untrained men (age, 22.9±1.8 years; body weight, 77.5±5.2 kg) performed isometric 1-min maximum voluntary contraction at long (90° in knee joint) and short (135° in knee joint) muscle length at two different occasions. Contractility of quadriceps femoris muscle was monitored via the evoked contractions at 1, 10, 20, and 50 Hz and maximum voluntary contraction at short and long muscle length on both occasions. Force generating capacity was reduced immediately after 1-min maximum voluntary contraction at short and long muscle length, and then a bi-modal time-course of recovery was observed which consisted of (1) rapid recovery of all measured indexes at 3 min and (2) divergence in the changes of forces at low and high stimulation frequencies, as well as maximal voluntary contraction force at 7 and 15 min after exercising. The decline in force immediately after 1-min isometric load was caused by metabolic and nonmetabolic fatigue; however, factors related to the metabolic fatigue were prevalent. As the effect of metabolic fatigue was diminishing and posttetanic potentiation was still present, force generation capacity recovered at 3 minutes after exercising. Further dynamics of contractility can be explained by the fading influence of posttetanic potentiation and dominant effect of nonmetabolic fatigue. Full article

234 KiB

Open AccessArticle

Characteristics of gender-related circadian arterial blood pressure in healthy adolescents

by Žaneta Drižienė, Eitautė Jakutienė, Donatas Stakišaitis, Birutė Pundzienė and Audrius Sveikata

Medicina 2008, 44(10), 768; https://doi.org/10.3390/medicina44100096 - 8 Oct 2008

Cited by 11 | Viewed by 1136

Abstract

Objective. To define 24-h characteristics of arterial blood pressure in healthy adolescent girls and boys; to determine gender-related differences of blood pressure, its circadian pattern.
Material and methods. The 24-h blood pressure was monitored hourly in healthy girls (n=22, without no [...] Read more.

Objective. To define 24-h characteristics of arterial blood pressure in healthy adolescent girls and boys; to determine gender-related differences of blood pressure, its circadian pattern.
Material and methods. The 24-h blood pressure was monitored hourly in healthy girls (n=22, without no account for the menstrual cycle phase) and boys (n=22). Additionally, blood pressure of adolescent girls (n=15) was examined during different phases of their menstrual cycle (follicular, ovulation, and luteal). Blood pressure was monitored with an auto-cuff automatic outpatient blood pressure monitor.
Results. Investigation showed gender-related differences in 24-h blood pressure. Study results revealed the circadian blood pressure rhythm characterized by a period of low values during nighttime and an early morning increase in both adolescent groups. Nocturnal systolic blood pressure was higher (P<0.05) in boys than in girls in all phases of their menstrual cycle. Diurnal systolic blood pressure in boys was higher than in girls in their follicular phase (P<0.05). The day and night blood pressure differed between boys and girls (P<0.05). A dipping blood pressure pattern as a decrease in mean nighttime blood pressure as compared with mean daytime blood pressure was defined: 10.02±6.7% in girls (n=22) and 13±6.3% in boys (n=22), without genderrelated differences (P>0.05). There were no differences in blood pressure dipping among girls’ groups in different menstrual cycle phases (P>0.05). Adolescent boys showed a significant positive correlation between their mean diurnal blood pressure and height (P<0.05).
Conclusion. The study proved gender-related arterial blood pressure differences in healthy adolescents. The results demonstrate the gender-specific circadian blood pressure rhythm pattern in both gender groups. Full article

226 KiB

Open AccessArticle

The results of nucleic acid testing for viruses in individual donor test and its importance for the safety of blood

by Vytenis Kalibatas

Medicina 2008, 44(10), 791; https://doi.org/10.3390/medicina44100099 - 25 Apr 2008

Cited by 2 | Viewed by 1034

Abstract

The aim of the study was to evaluate the results of nucleic acid testing for viruses in an individual donor test in National Blood Center; the objectives – to analyze the prevalence of infectious disease markers per 100 seronegative remunerated and non-remunerated, first-time [...] Read more.

The aim of the study was to evaluate the results of nucleic acid testing for viruses in an individual donor test in National Blood Center; the objectives – to analyze the prevalence of infectious disease markers per 100 seronegative remunerated and non-remunerated, first-time and regular whole-blood donations and to assess the odds ratio in detecting the infectious disease markers among remunerated and non-remunerated donations.
Materials and methods. All seronegative (for compulsory hepatitis B surface antigen, antibodies against hepatitis C, and antibodies against HIV-1/2 tests) whole-blood donations were tested by Procleix Ultrio (Tigris, Chiron) system at the National Blood Center in 2005–2007 in order to identify HIV-1, hepatitis C, and hepatitis B viruses.
Results. There were 152229 seronegative whole-blood donations tested by nucleic acid test of viruses in individual donor tests (ID-NAT). In 152146 cases, no infectious disease marker was found, and in 83 cases (or 0.05% of all seronegative whole blood donations), infectious disease markers were determined and confirmed. The prevalences of hepatitis C virus (determined by HCV-NAT method) per 100 seronegative blood donations were as follows: 0.061 among first-time remunerated donations and 0.042 among regular remunerated donations. The prevalences of hepatitis B virus (determined by HBV-NAT method) per 100 seronegative blood donations were as follows: 0.111 among first-time remunerated donations, 0.062 among regular remunerated donations, 0.014 among first-time non-remunerated donations, and 0.005 among regular non-remunerated donations. The remunerated donations showed the higher odds ratios in determining the infectious disease marker by ID-NAT test, comparing with non-remunerated ones.
Conclusions. 1. The prevalence of hepatitis B and hepatitis C viruses, determined by ID-NAT test, per 100 seronegative whole-blood donations is statistically significantly higher in remunerated donations. 2. The remunerated donations had the higher odds ratios in determining the infectious disease marker by ID-NAT test, comparing with non-remunerated ones. 3. In order to maximize the safety of blood and blood products, the continuity of promotion of non-remunerated whole-blood donations program should be ensured, and a compulsory blood donor testing for nucleic acids of viruses in an individual donor test should be introduced. Full article

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Medicina, Volume 44, Issue 10 (October 2008) – 9 articles

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