Lithuanian University Research Articles

Adverse Events and Immunogenicity of mRNA-Based COVID-19 Vaccine among Healthcare Workers: A Single-Centre Experience.

Background and Objectives: The safety and effectiveness of vaccines are among the key priorities in COVID-19 pandemic management. Moreover, evidence-based data regarding vaccine safety and immunogenicity can play an important role in building the trust of the community regarding vaccination. The aim of this study was to investigate the safety and immunogenicity of Pfizer-BioNTech vaccine among healthcare workers in one hospital, 21 days after first dose. Materials and Methods: This study was conducted in the Hospital of the Lithuanian University of Health Sciences between February and March 2021. Hospital employees who arrived to receive the second dose of the Pfizer-BioNTech vaccine 21 days after the first one were invited to participate in the study: they were asked to complete an anonymous adverse events questionnaire and were offered a SARS-CoV-2 IgG/IgM rapid test. The study was performed at a single point, 21 days after the first dose of the vaccine. Results: Data of 4181 vaccine recipients were analysed. The first vaccine dose was associated with a 53.6% incidence of adverse events, mainly local reactions. Adverse events occurred more frequently in younger participants and women. Moderate adverse events were experienced by 1.4% of the vaccine recipients; 6.2% were incapacitated. Of the 3439 participants who performed a rapid IgG test, 94.5% were positive for IgG antibodies after the first vaccine dose. Seroconversion rates were lower in participants older than 47 years. Conclusions: Despite 1.4% moderate adverse events, no safety concerns or anaphylaxis were identified. The Pfizer-BioNTech vaccine induced an immune response in the overwhelming majority of recipients after a single dose. Younger participants experienced adverse events and were positive for IgG antibodies more frequently than older counterparts. It is important to mention that this study specifically considered short-term safety and reactions following vaccination and that long-term adverse effects were not investigated in the study. Thus, future research into both long-term adverse reactions and immune system programming is essential.

Examining the Associations between Adverse Childhood Experiences, Health Risk Behaviours, and Psychological Well-Being in a Convenience Sample of Lithuanian University Students.

This study examines the associations between adverse childhood experiences (ACEs), health risk behaviours, and psychological well-being among Lithuanian university students. A cross-sectional survey was carried out with a convenience sample of 393 students (80.7% females and 19.3% males) recruited from mostly undergraduate courses (96.4%) in Lithuanian universities. Participants, aged 18–25 years (21.07 ± 1.53), completed a web-based survey in which they were asked to retrospectively self-report on ACEs while answering questions on health risk behaviours (e.g., smoking, substance use, riding a car with a drunk driver) and psychological well-being. Only 8.7% of the study sample experienced no ACEs, and almost half of the sample (48.9%) experienced ≥4 ACEs. Findings from adjusted models showed that, compared with students with no ACEs, those who experienced ≥4 ACEs had higher odds of lifetime illicit drug use (AOR = 2.73, p < 0.05), riding with a drunk driver (AOR = 2.44, p < 0.05), suicidal ideation before age 18 (AOR = 28.49, p < 0.01) and in the past 12 months (AOR = 5.39, p < 0.01). An increased number of ACEs was also associated with lower psychological well-being (B = −3.94, p < 0.001). Findings from this study have implications for mental health professionals as well as university administrators, as students with a higher number of traumatic experiences may require greater levels of support and services.

Associations of adverse childhood experiences with psychological problems in adulthood. Literature review

Rugilė Klimaitė1, Marija Vaitkevičiūtė1, Darius Leckauskas2 1Lithuanian University of Health Sciences, Academy of Medicine, Kaunas, Lithuania 2 Lithuanian University of Health Sciences, Department of Psychiatry Abstract The aim- to find out how adverse childhood experiences are related to psychological problems in adulthood. Research method- systematic literature review was conducted. Articles, describing assocations of adverse childhood […]

Overview of the epidemiology, risk factors, clinical features, diagnostics and prevention of breast cancer

Vaiva Cechanovičiūtė1, Inga Cechanovičienė2 1 Lithuanian University of Health Sciences, Academy of Medicine, Faculty of Medicine, Kaunas, Lithuania 2 Ministry of Health of The Republic of Lithuania, Specialized Health Care Division, Vilnius, Lithuania Abstract Background. Breast cancer is an uncontrolled, malignant growth of the breast tissue, which generally occurs among middle-aged women. It became the […]

Esophagopleural fistula, hidrothorax. Presentation of a clinical case and review of the literature

Brenda Kintaitė1, Paulina Tekoriutė1, Ieva Petrauskaitė1, Monika Matuliauskaitė1, Aistė Šakalytė1, Julius Vidikas2 1 Lithuanian University of Health Sciences, Academy of Medicine, Faculty of Medicine, Kaunas, Lithuania 2 Lithuanian research center of health sciences Abstract Background: esophagopleural fistula is a rare pathological connection among digestive and respiratory systems. The are many different causes of it but usually, it is related to endoscopic and surgical interventions, oncological processes. The symptoms of this disease are non-specific, patients complain of retrosternal chest pain, fever, dyspnoea, dysphasia, cough. The most valuable test for diagnosing esophagopleural fistula is chest computed tomography (CT) with intravenous contrast. Possible treatments are conservative or invasive Aim: this study aimed to reveal the clinical manifestations and managements of esophagopleural – fistula, to review the latest scientific literature on this topic, and to acquaint doctors of various fields with the clinical features, diagnosis and treatment options of this rare pathology. Methods: a review of the literature using the PubMed database, a selection of scientific publications addressing the topic of esophageal pleural fistula, and a clinical case of the disease was presented. Conclusion: the esophagopleural junction is a rare complication with no specific clinical manifestations which complicates the diagnosis of pathology. A detailed history and prompt diagnosis are essential because esophagopleural fistula is associated with life-threatening complications and high mortality. Chest CT with intravenous contrast is the most accurate method for diagnosing this pathology. Although pleuroesophageal fistula can be treated conservatively in some cases, it is extremely rare for this treatment to be effective. Endoscopic treatment options and sometimes surgical interventions are much more common. Keywords: esophagopleural fistula, pneumohidrothorax, esophageal stents, stents.

Management of cardiovascular manifestations in Loeys – Dietz syndrome: a systematic review

Ieva Daniliauskaitė1, Olivija Gustienė2 1 Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania 2 Department of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania Abstract Loeys – Dietz syndrome (LDS) is an autosomal dominantly inherited genetic disorder associated with significant and often life-threatening cardiovascular damage. The major cause of death in these individuals is aortic dissection. The primary choice for both prophylactic and emergency surgical interventions remains aortic valve-sparing root replacement due to the lower incidence of complications and the need for reoperation. Also, open surgery is more often recommended than endovascular stenting due to the possible accelerated development of aortic aneurysm in the native aortic stent fixation zones. To date, there are no approved guidelines for the treatment of aortic aneurysm and dissection in patients with LDS, but it is well known that multidisciplinary management of this syndrome must involve cardiovascular surgeons, cardiologists and geneticists. Nevertheless, the current literature provides a number of treatment options and recommendations for LDS. Therefore, the purpose of this systematic literature review is to analyze and discuss treatment options for aortic injury in patients with LDS, including both prophylactic and emergency interventions. Keywords: Loeys – Dietz, aortic aneurysm, aortic dissection, management of aortic aneurysm.

Proximal humerus fractures: indications for operative treatment and management options. Literature review

Evaldas Šivickas1, Benediktas Antanas Los1, Mantas Giedraitis2 1Lithuanian University of Health Sciences, Academy of Medicine, Kaunas, Lithuania 2 Department of Orthopedics-Traumatology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania Abstract Introduction: Although proximal humerus fractures are not very common in the current population, there is a tendency for this type of fracture to […]

Lung ultrasonography’s role in diagnosing community-acquired pneumonia in children: Literature review

Gretė Markauskaitė1, Greta Juknaitė1, Marija Gavriljeva2 1 Lithuanian University of Health Sciences, Academy of Medicine, Faculty of Medicine, Kaunas, Lithuania 2 Clinic of Kaunas University of Health Sciences, Clinic of Children’s Diseases, Kaunas, Lithuania Abstract Background. Community-acquired pneumonia (CAP) is a common and potentially fatal acute infection of lung parenchyma. Chest radiography is considered the test of choice for diagnosing pneumonia in children but its main drawback is ionising radiation. Therefore, lung ultrasonography (US) is a great alternative to the chest x-ray and it can be performed at the point of care by novice and advanced sonographers. Aim. To review literature about lung ultrasonography’s role in diagnosing community-acquired pneumonia in pediatrics. Methods. Literature articles were selected from PubMed and SpringerLink databases using the keywords and their combinations: community-acquired pneumonia, lung ultrasonography, lung ultrasound, chest radiography, pediatrics, children. Results. In reviewed publications lung US specificity and sensitivity were ≥ 86%. Lung US has a simple and easy-to-learn technique and is non-ionizing. Lung US cannot show changes of pulmonary tissue in some anatomical areas of the lung. The results of lung US depend on the experience of the investigator. Lung US could be used as an alternative to a chest radiography to clarify the diagnosis of CAP. Conclusions. Lung ultrasound could potentially replace lung x-ray as an additional tool in diagnosing pneumonia. Nevertheless, there are not enough studies with large children populations to absolutely prove the benefits of lung US. Also, there is no standardised training for health care providers on how to perform lung US quickly and correctly interpret the results. Keywords: community-acquired pneumonia, lung ultrasonography, lung ultrasound, chest radiography, pediatrics, children.

Relationship between spermogram parameters, erectile dysfunction and risk of type 2 diabetes mellitus, assessed by FINDRISK questionnaire, in infertile men: the pilot study

Jūratė Pečeliūnienė¹,², Laura Asadauskaitė³, Marius Anglickis4, Irena Žukauskaitė5, Antanas Norkus6, Birutė Žilaitienė6 ¹Vilnius University, Faculty of Medicine, Institute of Clinical Medicine, Department of Internal Medicine, Family Medicine and Oncology; ²Vilnius University, Faculty of Medicine, Institute of Biomedical Sciences, Pharmacy Center; ³Šeškinė polyclinic; 4Vilnius City Clinical Hospital; 5Vilnius University Faculty of Philosophy, Institute of Psychology; 6Institute of Endocrinology, Lithuanian University of Health Sciences Abstract Background: As obesity becomes a global pandemic, the growing numbers of male infertility suggest that chronic non-infectious diseases due to metabolic disorders and lifestyle may have an effect on men’s reproductive health, unexplained infertility. Aim: to evaluate the relationship between the risk of type 2 diabetes mellitus (DM) in infertile men, assessed by FINDRISK, spermogram parameters and erectile dysfunction. Methods. The study included 18 men diagnosed with infertility of unknown origin. Patients were required to complete a FINDRISK questionnaire, sociodemographic data questionnaire. The results of their spermogram (motility, normality of form) were evaluated. Results. The FINDRISK results showed that 4 patients (22.2%) were not at risk for DM. Low risk (FINDRISK < 7) was found in 5 patients (27.8%), slightly increased (FINDRISK 7 – 11 points) – 3 patients (16.7%), moderate (FINDRISK 12 – 14) in 4 patients, high (FINDRISK 15 – 20) in 2 patients (11.1%). Calculated FINDRISK correlations with spermogram parameters showed that the higher the FINDRISK results, the lower the Mobility A. Assessing the correlations of different FINDRISK parameters with spermogram results – the average percentage of sperm in normal form in patients who exercise/otherwise move – 17%, the percentage of those who do not exercise – 5%. Eaters of vegetables, fruits – the average percentage of sperm in normal form was 17%, the average percentage of non-eaters was 5%. Those without a family history of DM had higher Mobility A, higher Mobility B, higher Mobility C and higher sperm counts were normal. Those with erectile dysfunction had higher FINDRISK scores and lower Mobility A scores. Conclusions. According to the FINDRISK questionnaire, men at higher risk for type 2 diabetes also have more pronounced changes in spermogram parameters and erectile dysfunction. More detailed research is needed to assess whether FINDRISK could be a suitable diagnostic tool for early diagnosis of infertility risk. Keywords: infertility, men, FINDRISK, spremogram, erectile dysfunction.

Complementary and alternative medicine remedies in the treatment of oncological patients – possible adverse effects and interactions with drugs: a literature review

Emilija Jacevičiūtė1, Rūta Minelgaitė1, Sigita Liutkauskienė2 1Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania 2Department of Conservative Oncology, Hospital of Oncology, affiliate of Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Kaunas, Lithuania Abstract Herbs and dietary supplements are commonly used by oncological patients. There often is a lack of […]

Native septic arthritis. Diagnostic and treatment principles

Evaldas Šivickas1, Karolina Staškevičiūtė1, Mantas Giedraitis2, Linas Zeniauskas2, Alfredas Smailys2, Justinas Stučinskas2 1 Lithuanian University of Health Sciences, Academy of Medicine, Kaunas, Lithuania 2 Department of Orthopaedics and traumatology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania Abstract Introduction: Native septic arthritis is a complex joint infection that requires urgent diagnosis and adequate treatment. […]

Ovarian hyperstimulation syndrome and its relation to pregnancy

Vytautas Abraitis1, Saulė Kržčonavičiūtė1, Marija Vaitkevičiūtė2 1 Department of Obstetrics and Gynecology, Medical Academy, Lithuanian University of Health Sciences, Eivenių g. 2, LT-50161 Kaunas, Lithuania 2 Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus g. 9, LT-44307 Kaunas, Lithuania Abstract Introduction: Ovarian Hyperstimulation Syndrome (OHSS) is an iatrogenic complication manifested by suprafysiological ovarian stimulation. This syndrome is commonly related to assisted reproduction. OHSS has been associated with an increased risk of miscarriage, multiple pregnancies, and more severe clinical course of the syndrome. However, there are few studies examining the relationship between OHSS and pregnancy, and more consistent studies are needed. The aim – to discuss the characteristics of OHSS and it‘s possible links with pregnancy. Research method: systematic literature review was conducted. Articles, describing OHSS and its links to pregnancy, were selected. The review was done using the electronic database Pub-Med (Medline). Results: OHSS prevention is selected individually based on risk factors, anti-müllerian hormone concentration, and number of tertiary follicles. Mild to moderate OHSS may regress spontaneously and treatment is not always necessary. Patients who develop signs of severe OHSS should be hospitalized and treated with medication and (or) surgery. In case of unclear pathogenesis of the disease, only symptomatic treatment is possible. A correlation was observed between OHSS and an increased risk of miscarriage, preterm birth, gestational hypertension and low birth weight. Conclusions: OHSS is an iatrogenic complication that can occur at different stages and degrees due to variety of risk factors and prevention. Mild to moderate OHSS is often a transient condition, however, severe OHSS can be potentially life-threatening. The complications associated with OHSS are miscarriage and preterm birth, although there are also associations between this syndrome and gestational hypertension as well as low birth weight. Keywords: ovarian hyperstimulation syndrome, OHSS treatment, pregnancy.

Short-Term Continuous Positive Air Pressure Treatment: Effects on Quality of Life and Sleep in Patients with Obstructive Sleep Apnea.

Background and Objectives: The aim of this study was to evaluate short-term continuous positive air pressure (CPAP) treatment for health-related quality of life (HRQL) in patients with obstructive sleep apnea. Materials and Methods: Our subjects were 18–65 years old, diagnosed with moderate-to-severe obstructive sleep apnea and treated with CPAP between January 2020 and June 2021 in Hospital of Lithuanian University of Health Sciences Kaunas clinics. All the patients completed the Epworth Sleepiness Scale (ESS), the 36-Item Short Form Health Survey (SF-36), the and Pittsburgh Sleep Quality Index (PSQI) before and after 3 months of treatment. Polysomnography was also repeated. Statistical analyses were performed using SPSS 27.0 software. The value of p < 0.05 was considered as statistically significant. Results: The active-treatment group comprised 17 subjects with a mean age of 51.9 ± 8.9 years. The total SF-36 questionnaire score improved from 499.8 ± 122.3 to 589.6 ± 124.7 (p = 0.012). The SF-36 role limitations due to emotional problems (p = 0.021), energy (fatigue) (p = 0.035), and general health (p = 0.042) domains score significantly improved after CPAP treatment for 3 months. The PSQI mean score at baseline was 12.6 ± 2.9 and in the post-treatment group, it was −5.5 ± 2.3 (p = 0.001). The ESS also changed significantly from a pretreatment mean score of 10.9 ± 5.7 to −5.3 ± 3.2 (p = 0.002) after 3 months. Conclusions: Improvement in HRQL is seen even after a short treatment period with CPAP. Questionnaires are a good tool to evaluate CPAP treatment efficacy.

Acute appendicitis and pediatric multi-system inflammatory syndrome overlap

Aim. Our aim was to present acute appendicitis cases with pediatric multi-system inflammatory syndrome (MIS-C), how to spot MIS-C and how to treat it. Materials and methods. We analyzed 6 patients, admitted to the Pediatric Surgery Department at the Hospital of Lithuanian University of Health Sciences from 2021 January 7th to March 23rd with acute appendicitis, who were later confirmed to have MIS-C. Results. All were treated with antibiotics and five were operated. All patients were found to have a deteriorating condition and increase in inflammatory markers despite treatment and were found to have MIS-C, with all of them having positive Immunoglobulin G for SARS-CoV-2. Conclusion. During the COVID-19 pandemic, even with clear signs of acute appendicitis, MIS-C must be considered in children with known recent exposure to COVID-19 or in patients where surgical and antibiotic treatment does not improve the condition and other organ system involvement is noticed.

Atrophic gastritis and gastric cancer tissue miRNome analysis reveals hsa-miR-129-1 and hsa-miR-196a as potential early diagnostic biomarkers.

BACKGROUNDGastric cancer (GC) is one of the most frequently diagnosed tumor globally. In most cases, GC develops in a stepwise manner from chronic gastritis or atrophic gastritis (AG) to cancer. One of the major issues in clinical settings of GC is diagnosis at advanced disease stages resulting in poor prognosis. MicroRNAs (miRNAs) are small noncoding molecules that play an essential role in a variety of fundamental biological processes. However, clinical potential of miRNA profiling in the gastric cancerogenesis, especially in premalignant GC cases, remains unclear.AIMTo evaluate the AG and GC tissue miRNomes and identify specific miRNAs’ potential for clinical applications (e.g., non-invasive diagnostics).METHODSStudy included a total of 125 subjects: Controls (CON), AG, and GC patients. All study subjects were recruited at the Departments of Surgery or Gastroenterology, Hospital of Lithuanian University of Health Sciences and divided into the profiling (n = 60) and validation (n = 65) cohorts. Total RNA isolated from tissue samples was used for preparation of small RNA sequencing libraries and profiled using next-generation sequencing (NGS). Based on NGS data, deregulated miRNAs hsa-miR-129-1-3p and hsa-miR-196a-5p were analyzed in plasma samples of independent cohort consisting of CON, AG, and GC patients. Expression level of hsa-miR-129-1-3p and hsa-miR-196a-5p was determined using the quantitative real-time polymerase chain reaction and 2-ΔΔCt method.RESULTSResults of tissue analysis revealed 20 differentially expressed miRNAs in AG group compared to CON group, 129 deregulated miRNAs in GC compared to CON, and 99 altered miRNAs comparing GC and AG groups. Only 2 miRNAs (hsa-miR-129-1-3p and hsa-miR-196a-5p) were identified to be step-wise deregulated in healthy-premalignant-malignant sequence. Area under the curve (AUC)-receiver operating characteristic analysis revealed that expression level of hsa-miR-196a-5p is significant for discrimination of CON vs AG, CON vs GC and AG vs GC and resulted in AUCs: 88.0%, 93.1% and 66.3%, respectively. Compar-ing results in tissue and plasma samples, hsa-miR-129-1-3p was significantly down-regulated in GC compared to AG (P = 0.0021 and P = 0.024, tissue and plasma, respectively). Moreover, analysis revealed that hsa-miR-215-3p/5p and hsa-miR-934 were significantly deregulated in GC based on Helicobacter pylori (H. pylori) infection status [log2 fold change (FC) = -4.52, P-adjusted = 0.02; log2FC = -4.00, P-adjusted = 0.02; log2FC = 6.09, P-adjusted = 0.02, respectively].CONCLUSIONComprehensive miRNome study provides evidence for gradual deregulation of hsa-miR-196a-5p and hsa-miR-129-1-3p in gastric carcinogenesis and found hsa-miR-215-3p/5p and hsa-miR-934 to be significantly deregulated in H. pylori carrying GC patients.

Polskie środowisko naukowe w Republice Litewskiej

The Polish Academic Community in the Republic of LithuaniaIn this article the author presents the results of his research conducted during a scholarship at the Lithuanian Institute of History in Vilnius in autumn 2011. The study describes the activity of the Polish academic community in Lithuania, gathered mainly in the Association of Polish Scientists in Lithuania and in several academic centers of Vilnius. The author discusses their initiatives, such as the establishment of the Polish University in Vilnius or the creation of a subsidiary of the University of Białystok. He also focuses on the role of the University of Vilnius and the Lithuanian University of Educational Sciences. The article is based on print sources – books, academic journals and the Polish-language press in Lithuania – as well as in-depth interviews with a number of representatives of the Polish academic community in the country.

Comorbidity in multiple sclerosis: Emphasis on patient-reported outcomes

BackgroundAim of our study was to estimate the prevalence of comorbid conditions and adverse health behaviors in relapsing-remitting multiple sclerosis (RRMS) patients and evaluate association between comorbidity and MS outcomes (relapse rate, fatigue and quality of life) in Lithuanian setting. MethodsA prospective cohort study was carried out in the MS center of Lithuanian University of Health Sciences Hospital Kaunas clinics from November 2016 to March 2021. People with MS filled a self-report comorbidity and adverse health behavior questionnaire, visual analogue fatigue scale (VAFS), a Short Form 36 (SF-36) v2 health related quality of life questionnaire (QoL). Information about disability and relapses was acquired from medical documentation and Lithuanian MS registry at baseline and after 24-month observational period. Chi square, t-test, ANOVA, Mann-Whitney U were used for basic statistical evaluation. Multivariable logistic regression models were used to prognose MS outcomes in association to comorbidity and adverse health behaviors, adjusting for age and baseline disability. ResultsOf 230 RRMS patients, 167 (72.6%) were women, average age was 42 years. 207 persons were followed through the observational period and included into relapse analysis. 112 (48.7%) of participants reported having at least one comorbidity, the most prevalent were arterial hypertension (19.1%) depression (16.5%) and anxiety (14.8%). People with comorbidities had higher fatigue (6.6 vs. 5.3, p < 0.001) and lower quality of life (overall SF-36 46.3 vs 59.1, p < 0.001). People consuming alcohol had fewer relapses per 24 months (0.56 vs. 0.82, p = 0.01), lower fatigue (5.7 vs. 6.4, p = 0.03), better quality of life (overall SF-36: 56.8 vs. 45.6, p < 0.001), compared to abstinents.In regression models, comorbidities were associated with severe (>7 VAFS) fatigue (Exp(B)=1.98, 95% CI [1.02, 3.86], p = 0.043), diminished (<50 SF-36) QoL (Exp(B)=3.50, 95% CI [1.72, 7.09], p = 0.001). Depression was independently associated with lower QoL (Exp(B)= 2.86, 95% CI [1.04, 7.88], p = 0.042) and severe fatigue (Exp(B)=4.65, 95% CI [2.39, 9.01], p < 0.001); anxiety with diminished QoL (Exp(B)= 4.99, 95%CI [1.67, 14.92], p = 0.002). Light alcohol consumption (compared to abstinents) was associated with decreased risk for: relapse during 24 months (Exp(B)=0.44, 95% CI[0.24, 0.77], p = 0.005), severe fatigue (Exp(B)=0.48, 95% CI [0.24, 0.98], p = 0.042) and lower QoL (Exp(B)= 0.32, 95% CI [0.16, 0.65], p = 0.002). ConclusionComorbidity is a relevant issue in multiple sclerosis as half of people with MS report concomitant conditions. Hypertension, depression, and anxiety are especially prevalent in MS. In our study, comorbidity is associated with quality of life and fatigue, but not relapse rate. Depression and anxiety are independently associated with lower quality of life and higher fatigue. Light alcohol consumption is associated with reduced relapse risk, less fatigue and better quality of life. Overweight and tobacco smoking do not seem to have negative impact on MS outcomes in our sample.

PREVALENCE OF SUBJECTIVE AND OBJECTIVE FACTORS IN PATIENTS WITH TEMPOROMANDIBULAR JOINT DISORDERS

Aim and objectives: the aim of this work is to investigate prevalence of subjective and objective factors in patients with TMJ disorders. Material and methods: this investigation is a part of a prospective study which was started in autumn of 2018. The investigation was performed in Hospital of Lithu­anian University of Health Sciences Kaunas Clinics in the Department of Maxillofacial surgery and in the De­partment of Orthodontics. Investigation comprised of three parts – extraoral and intraoral investigation and two questionnaires about the patient’s symptoms and health. There were 14 questions in patient’s symptoms ques­tionnaire about self-reported pain. In the questionnaire about health there were 9 questions about stress which was felt by the patient. Statistical analysis was performed using “Microsoft Office Excel” and “IBM SPSS Statis­tics 25” software programs. To determine the statistical relationship between independent variables t-test and χ2 test were used. Results: from October 4th, 2019 to February 4th, 2020 72 subjects were reffered to the Department of Maxillofacial surgery, Hospital of Lithuanian University of Health Sci­ences Kaunas Clinics. 50 eligble subjects were included into this research. Other data of additional 50 subjects was taken from the available earlier database. 80% of the subjects were female and 20% were male. 49% of the subjects were younger than 30 years old. 86,60% of included subjects suffered from pain in the temporo­mandibular joint area, in 2/3 of them pain was chronic. 97% of the subjects were diagnosed with TMJ disorders, for 49,98% of them had disc dislocation with reduction was diagnosed and for 50,52% – disc dislocation without reduction. All patients experienced stress. For 82,47% of them stress did not have an effect or had only a small effect on their daily life, for 17,53% stress affected their daily life a lot. The most common malocclusion for all types of TMJ disorders was Angle class II malocclusion. Conclusions: there was a wide range of subjective and objective factors in patients with TMJ disorders. Angle class II malocclusion was the most common in all TMJ disorders.

Procedure-Related Access Site Pain Multimodal Management following Percutaneous Cardiac Intervention: A Randomized Control Trial.

Methods 137 patients who underwent PCI procedure via radial artery were randomly assigned (1 : 1) to the control (CG, n = 68) and intervention (IG, n = 65) groups. IG received MPM (paracetamol, ibuprofen, and the arm physiotherapy), CG received pain medication “as needed.” Outcomes were assessed immediately after, 2, 12, 24, and 48 h, 1 week, and 1 and 3 months after PCI. The primary outcome was A-S pain prevalence and pain intensity numeric rating scale (NRS) 0–10. Results Results showed that A-S pain prevalence during the 3-month follow-up period was decreasing. Statistically significant difference between the groups (CG versus IG) was after 24 h (41.2% versus 18.5, p=0.005), 48 h (30.9% versus 1.5%, p ≤ 0.001), 1 week (25% versus 10.8%, p=0.042), 1 month (23.5% versus 7.7%, p=0.017) after the procedure. The mean of the highest pain intensity was after 2 h (IG-2.17 ± 2.07; CG-3.53 ± 2.69) and the lowest 3 months (IG-0.02 ± 0.12; CG-0.09 ± 0.45) after the procedure. A-S pain intensity mean scores were statistically significantly higher in CG during the follow-up period (Wilks' λ = 0.84 F (7,125) = 3.37, p=0.002). Conclusion In conclusion, MPM approach can reduce A-S pain prevalence and pain intensity after PCI. More randomized control studies are needed.

Explainable Artificial Intelligence-Based Decision Support System for Assessing the Nutrition-Related Geriatric Syndromes

The use of artificial intelligence in geriatrics is very promising and relevant, as the diagnosis of a geriatric patient is a complex, experience-based, and time-consuming process that involves a variety of questionnaires and subjective and inaccurate patient responses. This paper proposes the explainable artificial intelligence-based (XAI) clinical decision support system (CDSS) to assess nutrition-related factors (symptoms) and to determine the likelihood of geriatric patient health risks associated with four syndromes: malnutrition, oropharyngeal dysphagia, dehydration, and eating disorders in dementia. The proposed system’s prototype was tested under real conditions at the geriatric department of Lithuanian University of Health Sciences Kaunas Hospital. The subjects of this study were 83 geriatric patients with various health conditions. The assessments of the nutritional status and syndromes of the patients provided by the CDSS were compared with the diagnoses of the physicians obtained using standard assessment methods. The results show that proposed CDSS can efficiently diagnose nutrition-related geriatric syndromes with high accuracy: 87.95% for malnutrition, 87.95% for oropharyngeal dysphagia, 90.36% for eating disorders in dementia, and 86.75% for dehydration. The research confirms that the proposed XAI-based CDSS is an effective tool, able to assess nutrition-related health risk factors and their dependencies and, in some cases, makes even a more accurate decision than a less experienced physician.