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

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

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

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

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

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

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

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

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

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