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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 7 (July 2013) – 7 articles

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Article
Treatment of Tuberculosis in South Kazakhstan: Clinical and Economical Aspects
Medicina 2013, 49(7), 52; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina49070052 - 04 Aug 2013
Cited by 4 | Viewed by 425
Abstract
Background and Objective. Since 1990, the tuberculosis incidence rate in Eastern Europe and post-Soviet republics has been increasing in many countries including Kazakhstan. This problem is particularly important in Kazakhstan regions with limited financial resources, among them – in South Kazakhstan province. [...] Read more.
Background and Objective. Since 1990, the tuberculosis incidence rate in Eastern Europe and post-Soviet republics has been increasing in many countries including Kazakhstan. This problem is particularly important in Kazakhstan regions with limited financial resources, among them – in South Kazakhstan province. The aim of this study was to investigate the main clinical and antibiotic-related economic aspects of tuberculosis treatment in South Kazakhstan province.
Material and Methods
. In total, 502 patients participated in the study. They were hospitalized to the tuberculosis dispensary of Sayram district (South Kazakhstan province) in 2007–2013. Statistical analysis included logistic regression for better treatment outcomes and analysis of antibiotic treatment costs.
Results
. Two-thirds of patients had infiltrative tuberculosis (67%). Positive treatment outcomes were determined in 85% of cases. The patients were mostly treated with cycloserine, protionamide, capreomycin, and ofloxacin. The majority of antibiotic costs were related to the treatment with capreomycin. In case of the positive results of the test for Mycobacterium tuberculosis, antibiotic expenses were almost 3 times greater than in case of negative test results (P<0.001).
Conclusions. The majority of patients had extensively drug-resistant tuberculosis. The negative results of the test for Mycobacterium tuberculosis at discharge were not related to pretreatment factors. Antibiotic-related costs were significantly higher in case of the positive results of the test of Mycobacterium tuberculosis, but were not associated with gender, residence place, hospitalization recurrence, or main blood test results before treatment. Full article
Article
Heredity of Cognitive Functions and Personality in Twins
Medicina 2013, 49(7), 50; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina49070050 - 04 Aug 2013
Viewed by 661
Abstract
Background and Objective. The inheritance of cognitive functions and personality is still a problem under investigation. A classical method, investigation of twins, is often used to find relative contributions from genetics and the environment to quantitative traits. The aim of this study [...] Read more.
Background and Objective. The inheritance of cognitive functions and personality is still a problem under investigation. A classical method, investigation of twins, is often used to find relative contributions from genetics and the environment to quantitative traits. The aim of this study was to investigate a possible influence of heredity on cognitive functions (by applying the Raven test) and personality traits (according to the Eysenck’s theory) in twins.
Material and Methods
. In total, 139 pairs of same-sex twins were investigated. The zygosity of the twin pairs was confirmed through genotyping with 15 molecular DNA markers. Constructive thinking was assessed using the Raven test. Personality assessment was conducted using the Eysenck Personality Questionnaire (EPQ) in Lithuanian.
Results
. The difference in the total number of incorrect solutions between monozygotic (MZ) and dizygotic (DZ) twin pairs younger than 15 years was not significant; however, in the group older than 15 years, this difference was found to be significant. Based on the total number of incorrect solutions, the concordance in the MZ twins was greater than in the DZ twins. The same tendency was found with cumulative EPQ scores on the extraversion scale.
Conclusions
. The results imply that the quality of cognitive functions and personality traits (extraversion) can be influenced by heredity. This confirms previous findings on the heritability of cognitive factors and personality traits. Full article
Article
Insufficient Assessment of Sexual Dysfunction: A Problem in Gynecological Practice
Medicina 2013, 49(7), 49; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina49070049 - 04 Aug 2013
Cited by 8 | Viewed by 491
Abstract
Background and Objective. Sexual health is an important part of a woman’s life and well-being. Female sexual dysfunction is a complicated problem, it is often underestimated in the healthcare process, and its management is complex. Giving women the opportunity to talk about [...] Read more.
Background and Objective. Sexual health is an important part of a woman’s life and well-being. Female sexual dysfunction is a complicated problem, it is often underestimated in the healthcare process, and its management is complex. Giving women the opportunity to talk about sexual problems is a fundamental part of healthcare and may improve their quality of life. The aim of this study was to find out patients’ experience and attitudes toward the involvement of gynecologists addressing sexual issues, to disclose the main barriers to initiate a conversation, and to assess the prevalence of sexual disorders among patients in a gynecological clinic.
Material and Methods
. A questionnaire-based approach was used to survey 18- to 50-year-old voluntary patients in the gynecological clinic. The study population comprised 300 different gynecological (except oncologic) patients independently of reasons for being in the clinic. The duration of the study was 6 months.
Results
. Only one-third of the patients had ever been asked about their sexual life by a gynecologist, whilst the majority (80%) of the respondents reported they would like to be asked and discuss sexual issues. The patients mostly did not complain because of psychoemotional barriers, and shame was the main barrier for patients to talk about their problems. Sexual dysfunction was a frequent disorder among gynecological patients, reaching especially high levels in the arousal (46.41%) and lubrication (40.67%) domains.
Conclusions
. The assessment of sexual health is insufficient in gynecological care, and sexual history-taking and evaluation of sexual functions should be included in routine gynecological health assessments. Full article
Article
The Effect of Nebulized Dorzolamide/Timolol Fixed Combination Mist versus Drops on Retrobulbar Blood Flow and Intraocular Pressure in Glaucoma Patients
Medicina 2013, 49(7), 48; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina49070048 - 04 Aug 2013
Cited by 1 | Viewed by 413
Abstract
Objective. The aim of this study was to evaluate intraocular pressure (IOP), retrobulbar blood flow (RBF), and ocular side effects after the application of topical dorzolamide/timolol fixed combination (DTFC) drops vs topical nebulized DTFC mist in patients with primary openangle glaucoma.
Material
[...] Read more.
Objective. The aim of this study was to evaluate intraocular pressure (IOP), retrobulbar blood flow (RBF), and ocular side effects after the application of topical dorzolamide/timolol fixed combination (DTFC) drops vs topical nebulized DTFC mist in patients with primary openangle glaucoma.
Material and Methods
. A total of 15 POAG patients were enrolled in a prospective study. Retrobulbar blood flow was measured in the ophthalmic (OA) and central retinal (CRA) arteries using color Doppler imaging. DTFC mist or drops were applied to the experimental eye, and it was examined after 15 and 60 minutes. DTFC mist was applied 6 times for 30 seconds using a misting device.
Results
. DTFC mist significantly increased peak-systolic (PSV) and end-diastolic (EDV) velocities after 15 and 60 minutes in both the arteries (OA: increase of 12.5% and 9.6% in PSV, P=0.01; increase of 25.8% and 23.1% in EDV, P=0.03; CRA: increase of 11.5% and 8.7% in PSV, increase of 32% and 21.6% in EDV, respectively, P<0.05). DTFC drops had a similar effect on PSV and EDV in the CRA after 15 and 60 minutes (increase of 8.1% and 9.6% in PSV; increase of 17.1% and 23% in EDV, respectively, P=0.03), but a significant effect on PSV and EDV in the OA was documented only after 15 minutes (increase of 9% and 21.4%, respectively, P=0.02). DTFC mist reduced the resistance index in the CRA after 15 and 60 minutes (decrease of 8.5% and 10.2%, respectively, P=0.04). Both methodologies showed a significant decrease in IOP after 15 and 60 minutes (P<0.05). All patients complained of ocular irritation after drop application, and 1 patient complained of general weakness after mist treatment.
Conclusions
. Nebulized DTFC mist significantly reduced IOP and increased blood flow in the OA and the CRA, causing no ocular irritation as compared with traditional DTFC drop methodology. Full article
Review
Mildronate and its Neuroregulatory Mechanisms: Targeting the Mitochondria, Neuroinflammation, and Protein Expression
Medicina 2013, 49(7), 47; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina49070047 - 04 Aug 2013
Cited by 13 | Viewed by 507
Abstract
This review for the first time summarizes the data obtained in the neuropharmacological studies of mildronate, a drug previously known as a cardioprotective agent. In different animal models of neurotoxicity and neurodegenerative diseases, we demonstrated its neuroprotecting activity. By the use of immunohistochemical [...] Read more.
This review for the first time summarizes the data obtained in the neuropharmacological studies of mildronate, a drug previously known as a cardioprotective agent. In different animal models of neurotoxicity and neurodegenerative diseases, we demonstrated its neuroprotecting activity. By the use of immunohistochemical methods and Western blot analysis, as well as some selected behavioral tests, the new mechanisms of mildronate have been demonstrated: a regulatory effect on mitochondrial processes and on the expression of nerve cell proteins, which are involved in cell survival, functioning, and inflammation processes. Particular attention is paid to the capability of mildronate to stimulate learning and memory and to the expression of neuronal proteins involved in synaptic plasticity and adult neurogenesis. These properties can be useful in neurological practice to protect and treat neurological disorders, particularly those associated with neurodegeneration and a decline in cognitive functions. Full article
Article
Rare Refractory Kawasaki Disease in an Adolescent Boy With Cardiac and Diffuse Coronary Artery Involvement
Medicina 2013, 49(7), 53; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina49070053 - 05 Jul 2013
Cited by 1 | Viewed by 460
Abstract
Kawasaki disease is an acute multisystemic vasculitis occurring predominantly in infants and young children and rarely in adolescents and adults. At elderly age, Kawasaki disease may remain unrecognized with a subsequent delay in appropriate therapy and an increased risk of coronary artery aneurysms. [...] Read more.
Kawasaki disease is an acute multisystemic vasculitis occurring predominantly in infants and young children and rarely in adolescents and adults. At elderly age, Kawasaki disease may remain unrecognized with a subsequent delay in appropriate therapy and an increased risk of coronary artery aneurysms. We report a case of intravenous immunoglobulin- and aspirin-resistant Kawasaki disease and severe cardiovascular damage in an adolescent boy. The article discusses major issues associated with the management of refractory Kawasaki disease. Full article
Article
Vitamin D Status and Its Seasonal Variations and Association With Parathyroid Hormone Concentration in Healthy Women in Riga
Medicina 2013, 49(7), 51; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina49070051 - 22 Jun 2013
Cited by 4 | Viewed by 438
Abstract
The aim of the study was to describe the vitamin D status and its seasonal variations in women living in Riga, Latvia, to examine an association between the concentrations of plasma 25-hydroxyvitamin D [25(OH)D] and parathyroid hormone (PTH), and to determine the threshold [...] Read more.
The aim of the study was to describe the vitamin D status and its seasonal variations in women living in Riga, Latvia, to examine an association between the concentrations of plasma 25-hydroxyvitamin D [25(OH)D] and parathyroid hormone (PTH), and to determine the threshold for plasma 25(OH)D above which there is no further suppression of PTH.
Material and Methods
. The data of 189 healthy Caucasian women were analyzed. The serum levels of 25(OH)D, PTH, and phosphorus were measured twice a year. All the participants were divided into 3 groups according to vitamin D supplementation and the reproductive status.
Results.
The overall mean level of 25(OH)D was 32.8 ng/mL with significantly lower levels being in winter when compared with those in summer (28.2 ng/mL vs. 37.5 ng/mL, respectively; P<0.05). PTH was negatively associated with 25(OH)D. A threshold level of plasma 25(OH)D above which no further suppression of PTH occurred was found to be 38 ng/mL. Postmenopausal women not taking vitamin D supplements and without exposure to sunlight had 25(OH)D deficiency in winter and summer (92% and 88%, respectively). The most significant seasonal fluctuations were seen in the women of the reproductive age not taking vitamin D supplements and without exposure to sunlight, of which 47% had 25(OH)D deficiency in summer and 69% in winter.
Conclusions.
An optimal concentration of 25(OH)D was found to be 38 ng/mL. According to this definition, 70.4% of all the healthy women were classified as vitamin D deficient in winter and 59.8% in summer. The highest proportion of vitamin D deficient individuals was found in the group representing the postmenopausal women not taking vitamin D supplements. Full article
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