Acta Medica Lituanica最新文献

{"title":"Role of Interventional Radiology in Management of C-Section Scar Ectopics.","authors":"Utsav Rajvanshi, Puneet Garg, Geetika Sindhwani, Resham Singh","doi":"10.15388/Amed.2026.33.1.14","DOIUrl":"https://doi.org/10.15388/Amed.2026.33.1.14","url":null,"abstract":"<p><strong>Background: </strong>Cesarean Scar Ectopic Pregnancy (CSEP) is an uncommon but potentially fatal syndrome defined by the implantation of the gestational sac inside the scar tissue of a prior cesarean surgery. The incidence of cesarean deliveries is rising, currently accounting for up to 6% of all ectopic pregnancies. CSEP causes unique challenges in diagnosis and treatment because it can lead to serious problems like uterine rupture, placenta accreta spectrum, bleeding, and infertility.</p><p><strong>Case report: </strong>This report describes two patients with Type I CSEP who were treated by using a less invasive method that involved injecting methotrexate and potassium chloride (KCl) guided by ultrasound. Both patients showed improvement, quickly lost fetal heart activity, and had lower blood beta hCG levels without any issues during the procedure. Transvaginal ultrasonography was important in diagnosis and therapy planning. Interventional radiology approaches, especially image-guided targeted therapy, provide promising fertility-preserving options compared to the traditional surgery. The research backs this careful approach for patients who are stable, with Uterine Artery Embolization (UAE) being helpful in some cases.</p><p><strong>Conclusion: </strong>Our study highlights the importance of using a team of specialists and shows that interventional radiology is a key part of improving treatment for CSEP, making it safer for patients, lowering risks of complications, and protecting their ability to have children in the future.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"33 1","pages":"169-176"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Forecasting the Impact of Knowledge of International Humanitarian Law Acquired by Ukrainian Medical Students on Their Practical Activities and the Formation of Humanity in Society.","authors":"Oksana Soroka, Volodymyr Voloshynovych, Yulia Kotsyubynska","doi":"10.15388/Amed.2026.33.1.12","DOIUrl":"https://doi.org/10.15388/Amed.2026.33.1.12","url":null,"abstract":"<p><strong>Purpose: </strong>International humanitarian law (IHL) and the principle of medical neutrality are vital for safeguarding human life and dignity during armed conflicts. This study aimed to evaluate the current state of IHL education in Ukrainian medical institutions and forecast its impact on future healthcare professionals' professional practice and humanistic orientation.</p><p><strong>Methods: </strong>A mixed-methods design was applied, including content analysis of curricula from 17 higher education institutions across different ministries and an online sociological survey of 174 respondents, primarily medical students and healthcare professionals. Quantitative data were analyzed by using frequency distributions and Spearman correlation, while qualitative analysis explored the respondents' ethical reasoning in conflict-related scenarios.</p><p><strong>Results: </strong>Only one-third of Ukrainian medical universities included dedicated IHL courses, primarily as electives. Self-reported awareness of IHL was low to moderate, with 23% rating their knowledge as good and 26% as poor. Despite this, 81.4% of medical students agreed with impartial medical assistance to all victims, regardless of affiliation. A weak but positive correlation (ρ=0.15) was found between IHL knowledge and humanitarian attitudes. Female students demonstrated stronger humanitarian orientations compared to males.</p><p><strong>Conclusion: </strong>IHL education in Ukraine remains fragmented and insufficient, yet students display a high ethical potential aligned with humanitarian principles. Structured, value-oriented IHL curricula, including practical training and case-based learning, are needed to strengthen medical neutrality, enhance ethical decision-making, and foster the formation of humanistic values in Ukrainian society.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"33 1","pages":"149-160"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Local Beats Systemic: Durable Control of Metastatic Undifferentiated Uterine Sarcoma and Surveillance Uncovering a Second Primary.","authors":"Ignas Lapeikis, Vakarė Baranauskytė, Dainius Jančiauskas, Lina Pužauskienė, Erika Korobeinikova","doi":"10.15388/Amed.2026.33.1.18","DOIUrl":"10.15388/Amed.2026.33.1.18","url":null,"abstract":"<p><strong>Introduction: </strong>Undifferentiated uterine sarcoma (UUS) is a rare, aggressive uterine mesenchymal malignancy with poor prognosis, for which, evidence supporting metastasis-directed treatment strategies is limited.</p><p><strong>Case presentation: </strong>A 59-year-old woman underwent total hysterectomy with bilateral salpingo-oophorectomy (R0) for stage IB UUS in 2016, followed by adjuvant doxorubicin-ifosfamide. Three years later, surveillance CT identified bilateral pulmonary metastases. Video-assisted thoracoscopic resection confirmed metastatic UUS, and stereotactic body radiotherapy (SBRT) was delivered to residual and subsequent lung lesions, achieving sustained local control without systemic therapy. The patient remained progression-free for almost three years. In 2024, follow-up imaging showed no active sarcoma but incidentally detected a left breast lesion; biopsy revealed invasive ductal carcinoma with mucinous features. She underwent breast-conserving surgery with sentinel lymph node biopsy (pT1N0(sn)), followed by adjuvant whole-breast radiotherapy and endocrine therapy with tamoxifen.</p><p><strong>Outcomes: </strong>At 8.5 years from UUS diagnosis and one year after breast cancer treatment, the patient remains alive with no evidence of recurrent or metastatic disease and with excellent performance status (ECOG 0).</p><p><strong>Conclusions: </strong>This case demonstrates prolonged, chemotherapy-free control of metastatic UUS using a metastasis-directed strategy combining surgery and SBRT, and highlights the importance of continued surveillance for secondary primary malignancies. It supports considering an oligometastatic treatment paradigm and multidisciplinary management in selected UUS patients despite the absence of prospective data.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"33 1","pages":"204-213"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Triglycerides in the Development of Atherosclerosis.","authors":"Vaida Cerebiejūtė, Živilė Girkantaitė, Egidija Rinkūnienė, Silvija Gimžauskaitė, Jolita Badarienė","doi":"10.15388/Amed.2026.33.1.4","DOIUrl":"10.15388/Amed.2026.33.1.4","url":null,"abstract":"<p><strong>Background: </strong>Atherosclerotic cardiovascular disease (ASCVD) is a chronic inflammatory disease of the arteries. The primary driver of atherosclerosis is the progressive accumulation of low-density lipoprotein cholesterol (LDL-C) and other apolipoprotein (Apo) B containing lipoproteins within the arterial wall. Despite the intensive LDL-C lowering therapy, a substantial residual risk of ASCVD persists and is significantly associated with elevated triglyceride concentrations.</p><p><strong>Objective: </strong>To review the pathogenesis of triglycerides (TG), triglyceride-rich lipoproteins (TRL) and their remnants as well as their role in the development of atherosclerosis and clinical relevance for assessing residual ASCVD risk.</p><p><strong>Materials and methods: </strong>A literature search was conducted using keywords relevant to the topic and their combinations. A targeted PubMed search prioritized English-language guidelines, consensus statements, randomized clinical trials, cohort studies, and meta-analyses published between 2019 and 2025, with older landmark publications included where necessary. Reference lists of key articles were also manually screened to identify additional relevant studies.</p><p><strong>Results: </strong>The literature shows that elevated TG concentrations are associated with a higher risk of ASCVD, regardless of LDL-C. Given that no clear signal indicates which features of TRL give rise to risk of ASCVD, plasma TG levels remain a reasonable surrogate marker for risk assessment. Evidence suggests that the atherogenicity of TRL is driven primarily by the cholesterol carried within TRL and their remnants rather than TG themselves. TRL remnants may be at least as atherogenic as, and potentially more atherogenic than, low-density lipoproteins (LDL) because they can be taken up by intimal macrophages without prior oxidative or structural modification, persist longer within the intima, are larger in size, and carry more cholesterol per particle. They also more effectively promote foam-cell formation and contribute to low-grade inflammation. Given the conflicting results of large-scale randomized clinical trials, it is not yet possible to conclude that lowering TG concentrations alone reduces the ASCVD risk.</p><p><strong>Conclusions: </strong>Elevated plasma TG concentrations are associated with an increased risk of ASCVD, independent of LDL-C levels. Given the ongoing need to identify the most reliable metric for risk stratification, TG remain a rational surrogate marker for estimating residual ASCVD risk related to TRL and their remnants.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"33 1","pages":"48-57"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined Anatomical Variation of Axillary Artery and Biceps Brachii Muscle: A Case Report.","authors":"Dibakar Borthakur, Parul Kaushal, S B Ray","doi":"10.15388/Amed.2026.33.1.21","DOIUrl":"10.15388/Amed.2026.33.1.21","url":null,"abstract":"<p><p>Anatomical variations of the axillary artery and its branches are clinically relevant as they may complicate surgeries in the axilla and shoulder. Accessory heads of the biceps brachii can compress key neurovascular structures. The present report describes these variations observed on the left upper limb of a 79-year-old male cadaver during cadaveric dissection. We observed that the usual branches of the 3^rd part of the axillary artery as well as the profunda brachii artery originated from the 2^nd part of the axillary artery via a common trunk in the left axilla. In addition to that, a small accessory head of the biceps brachii was observed on the left arm originating from the shaft of the humerus. Knowledge about variant branches of the axillary artery is surgically important for establishment of collateral circulation around the scapula following shoulder surgeries. The accessory head of biceps brachii may cause nerve entrapment neuropathy leading to mysterious pain syndrome in the upper limb.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"33 1","pages":"232-237"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathological Fractures in Rare Bone Diseases: Clinical Cases.","authors":"Vanna Bottai, Federico Di Sacco, Martina Cordoni, Vittoria Bettarini, Luca Orsetti, Paolo Domenico Parchi, Lorenzo Andreani","doi":"10.15388/Amed.2026.33.1.17","DOIUrl":"10.15388/Amed.2026.33.1.17","url":null,"abstract":"<p><p>Rare bone diseases, though uncommon, present significant diagnostic and therapeutic challenges due to their clinical variability and overlapping symptoms with more prevalent conditions. This article describes a clinical case series of three patients with bone fragility fractures caused by rare bone diseases - primary hyperparathyroidism with brown tumor, Gorham-Stout disease, and alkaptonuria - treated at the Department of Orthopedic and Traumatology of Pisa University Hospital between 2018 and 2023. Each case highlights the diagnostic complexities, including inconclusive biopsies, nonspecific imaging findings, and the necessity of a multidisciplinary approach for accurate diagnosis and management. Advanced imaging techniques, such as MRI, CT, and PET, alongside genetic and biochemical analyses, were instrumental in guiding treatment. The cases underscore the importance of early differential diagnosis, which is critical for optimizing both surgical and non-surgical interventions, preventing long-term complications, and improving the patient outcomes. This study emphasizes the need for a collaborative, multidisciplinary approach to effectively diagnose and manage rare bone diseases, ensuring that patients receive timely and appropriate care.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"33 1","pages":"190-203"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges in the Diagnosis of Multiple Sclerosis: A Case Report.","authors":"Kristina Galinytė, Gintarė Butenytė, Gintarė Žemgulytė, Jurgita Makštienė, Renata Balnytė","doi":"10.15388/Amed.2026.33.1.20","DOIUrl":"10.15388/Amed.2026.33.1.20","url":null,"abstract":"<p><strong>Introduction: </strong><b>:</b> Multiple sclerosis (MS) may present as a tumor-like, or tumefactive demyelinating lesion, that is indistinguishable clinically and radiologically from a brain tumor. This poses a diagnostic challenge.</p><p><strong>Case presentation: </strong>We present a case report of a 23-year-old woman who was hospitalized in the Neurosurgery Department for biopsy of a brain mass. She had been diagnosed with Hodgkin's lymphoma at the age of 12, underwent surgery and chemotherapy, and had been in remission ever since. During her annual follow-up a magnetic resonance imaging (MRI) of the brain was performed that revealed a lesion in the right temporal lobe. It was interpreted as central nervous system (CNS) lymphoma. Before arranged neurosurgical intervention, a follow-up MRI scan revealed multiple new small lesions in both hemispheres. Biopsy was not performed, and the patient was referred to the Neurology Department for clarification of the diagnosis. No abnormalities were detected in the tests performed. Cerebrospinal fluid (CSF) was not tested due to the patient's refusal to repeat the unsuccessful procedure. The patient was discharged from the hospital. Three months later, she arrived at the Emergency Department abroad with impaired coordination and hypoesthesia on the right side of the body. Two MRI scans revealed a new lesion in the left posterior periventricular area. CNS lymphoma was suspected again. The patient received treatment with levetiracetam and dexamethasone. Upon her return, an MRI scan was repeated, which revealed an enlargement of the lesion. CSF testing showed indistinct oligoclonal bands. As CNS lymphoma could not be excluded, a lesion biopsy was performed after discontinuation of the steroids therapy. Histological examination excluded malignancy. Later, an MRI scan was repeated; it showed two new contrast-enhancing lesions. Relapsing-remitting multiple sclerosis (RRMS) diagnosis was confirmed, and treatment with disease-modifying therapies (DMTs) was planned.</p><p><strong>Conclusions: </strong>Open-ring enhancement with little or no mass effect on MRI suggests a tumefactive demyelinating lesion (TDL). Moreover, TDLs tend to have a lower relative cerebral blood volume, and higher minimum and average apparent diffusion coefficient values compared to CNS lymphomas. Flow cytometry shows a monotypic B lymphoid population in cases of CNS lymphoma, not in MS.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"33 1","pages":"222-231"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Psychological Interventions on Depression Symptoms in Oncology Patients: A Systematic Review.","authors":"Ignas Lapeikis, Ieva Armonaitė, Vakarė Baranauskytė, Irina Banienė","doi":"10.15388/Amed.2026.33.1.5","DOIUrl":"10.15388/Amed.2026.33.1.5","url":null,"abstract":"<p><strong>Background: </strong>Depression is one of the most common psychological comorbidities among cancer patients and contributes substantially to a reduced quality of life and impaired treatment adherence. A range of psychosocial interventions have been proposed to address depressive symptoms in oncology, but evidence across intervention types remains heterogeneous.</p><p><strong>Aim: </strong>To evaluate the effectiveness of psychological interventions in reducing depressive symptoms among cancer patients.</p><p><strong>Methods: </strong>A systematic search of <i>PubMed, ScienceDirect, Web of Science</i>, and <i>Clinical Key</i> databases was conducted for studies published between 2016 and 2026. Randomized controlled trials and controlled intervention studies assessing psychological interventions for depressive symptoms in adult cancer patients were included. Data on the study design, patient characteristics, intervention type, depression assessment scales, and outcomes were extracted. Due to heterogeneity in interventions and outcome measures, the findings were synthesised narratively.</p><p><strong>Results: </strong>Twenty studies met the inclusion criteria. Interventions included cognitive behavioural therapy (CBT), mindfulness-based interventions (MBIs), mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT), and positive psychology approaches. Most studies reported significant reductions in depressive symptoms measured by using validated scales such as PHQ-9, HADS, BDI, and SDS. CBT- and mindfulness-based approaches demonstrated the most consistent improvements, although several trials reported no significant differences compared with control groups.</p><p><strong>Conclusions: </strong>Psychological interventions, and particularly CBT- and mindfulness-based approaches, are associated with reductions in depressive symptoms among cancer patients. However, substantial heterogeneity in the intervention design and outcome reporting limits direct comparison across studies. Further large-scale randomized trials using standardised outcome measures are needed to establish optimal psychosocial treatment strategies in oncology.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"33 1","pages":"58-73"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Injuries Caused by Sharp Objects in Different Suicide Cases.","authors":"Jekaterina Strelčenko, Sigitas Chmieliauskas, Sigitas Laima, Diana Vasiljevaitė, Jurgita Stasiūnienė, Paulius Petreikis","doi":"10.15388/Amed.2026.33.1.11","DOIUrl":"10.15388/Amed.2026.33.1.11","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Suicide, defined as the act of taking one's own life, is a common cause of death worldwide, with more than 720,000 people dying by suicide each year. However, suicide by sharp objects is relatively rare, accounting for only a small percentage of all cases. In some cases, self-inflicted injuries may be mistaken for other causes, such as assault or accidental trauma. The mortality rate from self-inflicted injuries with sharp objects is low, and most such suicide attempts do not lead to death. The low fatality rate associated with self-inflicted sharp force injuries may prompt the use of an additional method, which characterizes a complex suicide. Therefore, in this article, we will analyze the injuries caused by sharp objects in different suicide cases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;In this retrospective study, we analyzed injuries caused by sharp objects in complex suicides with the objective to identify correlations with the suicide methods used. From 2019 to 2024, 98 nonconsecutive, impersonalized suicide autopsy cases (71 men and 27 women) involving self-inflicted cuts or stab wounds were selected from data provided by the State Forensic Medicine Service of Lithuania. All victims underwent full autopsies, including toxicological testing for alcohol and drugs. A literature search was conducted in the &lt;i&gt;PubMed&lt;/i&gt; database by using relevant keywords. The analysis focused primarily on studies from the last 10 years but also included older studies developing strong arguments.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean age of the deceased in the study sample was 45.1 ± 17.9 years, with no difference between the sexes. In more than half of the cases (n = 52), suicides occurred while sober. Among alcohol-intoxicated individuals (n = 46), the mean blood alcohol concentration (BAC) was 1.96‰ ± 1.06. The most frequent main cause of death after unsuccessful self-inflicted injuries with sharp objects was hanging, followed by exsanguination and drug poisoning. In cases of hanging, the mean age was 45 ± 15, 60% were intoxicated (n = 32), with a mean BAC of 2.04‰ ± 1.08. A median of 13 trial cuts was found, most commonly on the forearms. When the primary cause of death was exsanguination due to cut/stab wounds, 41% were intoxicated with alcohol (mean BAC was 1.92‰ ± 0.76). In this group, 59% (n = 10) had cut neck wounds affecting major vessels, 23% (n = 4) had stabbed wounds to the chest with damage to the heart and main blood vessels, 18% had cuts to the upper limbs involving arteries. The mean age of individuals varied by injury location, notably, neck at 61 ± 20 years, chest at 39 ± 12 years, upper limbs at 71 ± 9 years. In all cases, no clothes damage was observed. A mean of 8 ± 4 (median 8) superficial neck cuts were found near the main wound in fatal neck injuries, 5 ± 2 (median 6) in the lethal chest injuries, and 6 ± 1 (median 6) in the death-causing upper limb injuries. The number of trial wounds on the ","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"33 1","pages":"141-148"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authentic Leadership in Lithuanian Healthcare: A Qualitative Exploratory Study of Health Managers' Views and Experiences.","authors":"Miglė Lazinkaitė, Mark Avery, Richard Olley, Aurima Stankūnienė, Katarzyna Czabanowska, Mindaugas Stankūnas","doi":"10.15388/Amed.2026.33.1.6","DOIUrl":"10.15388/Amed.2026.33.1.6","url":null,"abstract":"<p><p>Authentic Leadership (AL) is a value-based approach to leadership that focuses on self-awareness, relational transparency, balanced processing, and an internalized moral perspective. AL nurtures a supportive, high-trust work environment that boosts team cohesion, productivity, and ethical standards. In the healthcare workforce, the challenges and demands of person-centred care are significant, making AL a valuable opportunity to enhance the effectiveness of leadership and management. This study explored the key constructs and opportunities of AL within the context of the Lithuanian health system. A qualitative interpretative phenomenological approach was used to conduct semi-structured interviews with senior healthcare managers in Lithuania. The goal was to explore how these leaders understood and practiced AL. Thematic analysis was performed on the transcriptions of study participants' semi-structured interviews about perceptions of AL's four theoretical dimensions. The findings identified that Lithuanian healthcare leaders view self-awareness, moral integrity, and adaptability as central to effective leadership. Leaders emphasized self-reflection, openness to feedback, and moral consistency as crucial to their roles, enabling them to manage complex ethical responsibilities and strengthen organizational trust. AL has been shown to promote resilience in dynamic healthcare settings, thereby enabling adaptability and innovation. Leaders valued transparency and inclusive decision-making to ensure that diverse perspectives informed the team strategies. This study indicates that AL is an effective leadership approach for healthcare management in Lithuania. Our findings suggest that healthcare organizations could benefit from AL-based training programs, which may improve leaders' self-reflective practices, ethical decision-making, and collaboration skills.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"33 1","pages":"74-85"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}