Acta Medica Lituanica最新文献

{"title":"Changes in NR2ab Antibody Levels in the Blood of Patients Depending on their Condition: Acute or Chronic Cerebral Ischaemia.","authors":"Zauresh Akhmetzhanova, Altynshash Jaxybayeva, Aliya Imanova, Vitaliy Kamkhen, Serik Akshulakov","doi":"10.15388/Amed.2026.33.1.8","DOIUrl":"10.15388/Amed.2026.33.1.8","url":null,"abstract":"<p><strong>Aim: </strong>The study aimed to determine the efficacy of antibodies to the NR2ab subunits of the N-methyl-D-aspartate (NMDA) receptor (NR2ab) as a biomarker for the differential diagnosis of acute and chronic cerebral ischaemia (CCI) among patients in Kazakhstan.</p><p><strong>Materials and methods: </strong>The study involved 52 patients with CCI classified as second-degree according to the Fazekas scale and 47 patients with acute ischaemic stroke (AIS), rated at 16-20 on the National Institutes of Health Stroke Scale (NIHSS), who were hospitalised in stroke centres within 24 hours of the first symptoms of stroke and confirmed by magnetic resonance imaging. Serum samples were collected to determine NR2ab antibody levels.</p><p><strong>Results: </strong>The results of the study showed that the mean level of NR2ab in patients with CCI was 1.42 ng/ml (95% CI: 1.2-1.6), while in patients with AIS it was 1.99 ng/ml (95% CI: 1.7-2.3). Statistical analysis revealed a significant difference between the groups (<i>p</i>=0.003), and logistic regression determined the prognostic significance of NR2ab with a coefficient of 1.885. The <i>Receiver Operating Characteristic</i> (ROC) curve analysis showed a diagnostic accuracy of 0.675, which indicates the prospects of using this biomarker to detect acute cerebral ischaemia.</p><p><strong>Conclusions: </strong>The results confirm that determining the level of NR2ab can be a useful tool for a timely diagnosis and selection of adequate treatment, especially in conditions of limited access to neuroimaging. Incorporation of this method into the standard diagnostic process can improve the efficiency of detecting ischaemic disorders and optimise patient care.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"33 1","pages":"99-115"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798838","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":"Ultrasound Elastography in Evaluation of Peripheral Pulmonary Lesions.","authors":"Abdul Rouf, Uma Debi, Shritik Devkota, Mandeep Garg, Navneet Singh, Amanjit Bal, Harish Bhujade, K T Prasad","doi":"10.15388/Amed.2026.33.1.7","DOIUrl":"10.15388/Amed.2026.33.1.7","url":null,"abstract":"<p><strong>Background: </strong>Differentiating benign from malignant peripheral pulmonary lesions (PPLs) remains a clinical challenge, especially in resource-limited settings. While computed tomography is the standard imaging modality, it involves radiation exposure and often lacks specificity. <i>Shear Wave Elastography</i> (SWE) is a non-invasive ultrasound technique that quantifies tissue stiffness and may aid in the evaluation of PPLs.</p><p><strong>Methods: </strong>In this prospective observational study, 42 patients with peripheral pulmonary lesions underwent transthoracic SWE prior to histopathological evaluation. Elastography values were compared between benign and malignant lesions. Statistical analysis included ROC curve assessment, logistic regression, and correlation with histopathological and microbiological outcomes.</p><p><strong>Results: </strong>Of the 42 patients, 64.3% had malignant and 35.7% had benign lesions. The mean SWE value for malignant lesions was significantly higher (6.82 ± 2.27 kPa) than for benign lesions (3.72 ± 2.23 kPa; <i>p</i> <0.001). The AUROC for mean SWE values in predicting malignancy was 0.849 (95% CI: 0.713-0.986), demonstrating good diagnostic performance with statistically significant difference (<i>p</i> = <0.001), with a cutoff of ≥4.8 kPa yielding 85% sensitivity and 80% specificity. Squamous cell carcinoma exhibited the highest stiffness among malignancies. Certain benign lesions, particularly tuberculosis, showed elevated stiffness, resulting in false positives. Logistic regression identified mean SWE as an independent predictor of malignancy (OR = 2.11, <i>p</i> = 0.030).</p><p><strong>Conclusion: </strong>Transthoracic SWE is a non-invasive, radiation free and promising tool for evaluating PPLs, offering good diagnostic accuracy in distinguishing malignant from benign lesions. It holds particular promise in settings where access to advanced imaging or biopsy is limited, and may assist in triaging patients for early tissue diagnosis.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"33 1","pages":"86-98"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798781","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 Influence of Meteorological Factors on Osteoarthritis Symptoms and Physical Activity: A Narrative Review.","authors":"Karolis Strašunskas, Matas Mikalauskas, Ona Montvydaitė-Kreivaitienė","doi":"10.15388/Amed.2026.33.1.3","DOIUrl":"10.15388/Amed.2026.33.1.3","url":null,"abstract":"<p><strong>Background: </strong>Meteorological conditions are suspected to influence osteoarthritis (OA) symptoms, but findings across climates and populations are inconsistent. Understanding how temperature, humidity, and barometric pressure affect pain, stiffness, and physical activity is relevant for clinical counselling and study design.</p><p><strong>Objective: </strong>To synthesize recent evidence on associations between natural weather variation and OA symptomatology, including impacts on physical activity and rehabilitation participation.</p><p><strong>Methods: </strong>We searched <i>PubMed, ScienceDirect</i>, and <i>Google Scholar</i> for peer-reviewed human studies published from January 2010 to May 2024 by using terms related to osteoarthritis and meteorological factors (temperature, humidity, barometric pressure, precipitation, seasonal variation) combined with pain, stiffness, function, or physical activity. Inclusion criteria comprised clinically or radiographically confirmed OA and quantitative outcomes linked to measured meteorological exposures. Interventional artificial heat/cold studies and non-primary data were excluded. Two reviewers independently screened, selected, and extracted data with consensus resolution.</p><p><strong>Results: </strong>Temperature showed the most consistent patterns: colder and more variable conditions were linked to increased pain and stiffness, whereas warmer, stable conditions favored mobility. Humidity and barometric pressure fluctuations showed modest effects, particularly under cool and damp conditions. Precipitation, sunlight, and wind had minimal or inconsistent associations. Adverse weather was associated with a reduced outdoor activity and lower rehabilitation participation.</p><p><strong>Conclusions: </strong>Weather acts as a contextual modifier rather than a primary determinant of OA symptoms. Recognizing meteorological influences may aid patient counselling, season-sensitive rehabilitation planning, and the design of outcome studies.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"33 1","pages":"33-47"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798769","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":"Pulmonary Artery Thromboembolism (PATE) in Paediatrics: Three Clinical Case Presentations.","authors":"Gabija Asipauskaitė, Greta Miškinaitė, Algirdas Dagys, Vaidotas Gurskis","doi":"10.15388/Amed.2026.33.1.24","DOIUrl":"https://doi.org/10.15388/Amed.2026.33.1.24","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary artery thromboembolism in children is an exceptionally rare condition. Since its clinical presentation and associated risk factors differ from those observed in adults, the condition is frequently underdiagnosed.</p><p><strong>Case description: </strong>We present three cases of paediatric pulmonary artery thromboembolism, each with distinct clinical presentations and differing risk factors. The first case involved a 15-year-old boy who developed fatal massive bilateral pulmonary artery thromboembolism after having spinal trauma, surgery, immobility, and central venous catheter placement. The second case concerned a 17-year-old girl with Prader-Willi syndrome and multiple comorbidities, who presented with severe respiratory failure and laboratory evidence suggesting pulmonary thromboembolism, although imaging to confirm the diagnosis was limited. The third case involved a previously healthy 17-year-old boy with upper-extremity deep venous thrombosis and confirmed pulmonary artery thromboembolism despite the absence of identifiable provoking factors.</p><p><strong>Conclusions: </strong>These cases illustrate the heterogeneity of paediatric PATE presentation, the variability of the underlying risk factors, and the diagnostic challenges encountered in clinical practice, underscoring the need for heightened awareness among clinicians.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"33 1","pages":"252-259"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798620","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":"An Unusual Case of a Vulva Tumor in an Adolescent: A Case Report and Literature Review.","authors":"Hayriye Nihan Karaman Ayyildiz, Zekeriya İlçe, İlkay Tosun, Funda Tekkesin","doi":"10.15388/Amed.2026.33.1.19","DOIUrl":"https://doi.org/10.15388/Amed.2026.33.1.19","url":null,"abstract":"<p><strong>Background: </strong>We present the case of a 15-year-old adolescent with swelling in the left vulva that was found to have a tumor measuring approximately 20x15 cm in her vulva. Ewing's sarcoma/primitive neuroectodermal tumors (ES/PNET) are rare and malignant.</p><p><strong>Materials and methods: </strong>Preoperative magnetic resonance imaging and computed tomography performed to screen for metastasis were negative. The mass was surgically excised in total.</p><p><strong>Results: </strong>Immunohistochemistry showed the mass to be ES/PNET. The patient underwent positron emission tomography-computed tomography which revealed metastasis to inguinal lymph nodes and bone. While under chemotherapy for stage-4 ES/PNET, the patient was found to have lung metastasis. She died due to recurrent chemotherapy complications during treatment.</p><p><strong>Conclusions: </strong>This rare case highlights that significant of early diagnosis and multidisciplinary approach to treatment of ES/PNET cases.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"33 1","pages":"214-221"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798926","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":"Bilateral Accessory Head of First Lumbrical: Anatomical Insight and Surgical Implications during Carpal Tunnel Release.","authors":"Anand Verma, Karan Kumar, Madhumita Patnaik, Manisha R Gaikwad, Praveen Kumar Ravi","doi":"10.15388/Amed.2026.33.1.15","DOIUrl":"https://doi.org/10.15388/Amed.2026.33.1.15","url":null,"abstract":"<p><p>Lumbrical muscles are essential for the coordination and precise movement of the hand; although anatomical variation in these muscles is rare, they can have significant clinical consequences, especially when they affect the carpal tunnel. Accessory heads of lumbrical are infrequent, typically unilateral, and often asymptomatic. However, when these variants pass through the carpal tunnel, they may decrease the tunnel's volume, compress the median nerve, and contribute to the onset of Carpal Tunnel Syndrome (CTS). We present a rare case of a bilateral Accessory Head of the first Lumbrical Muscle (AHFL) discovered during a routine cadaveric dissection of a 65-year-old male. Recognizing such variations is crucial in clinical practice, as abnormal muscle tissue can complicate the diagnosis and surgical treatment of CTS. Preoperative imaging and thorough intraoperative examination can assist in identifying these variants, thus enhancing surgical planning and reducing complications.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"33 1","pages":"177-183"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798929","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":"Gastrointestinal Symptoms in Systemic Sclerosis: Prevalence and Severity across Disease Subtypes and Autoantibody Profiles.","authors":"Marina Vujović Šestakov, Sretko Lukovic, Ivana Pavlovic, Maja Zlatanovic, Predrag Ostojic","doi":"10.15388/Amed.2026.33.1.13","DOIUrl":"10.15388/Amed.2026.33.1.13","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the prevalence and severity of gastrointestinal (GI) symptoms in patients with systemic sclerosis (SSc), their impact on social functioning and emotional well-being, and to compare findings between patients with limited cutaneous systemic sclerosis (lcSSc) and diffuse cutaneous systemic sclerosis (dcSSc), as well as between patients positive for anticentromere (ACA) or anti-topoisomerase I (ATA) antibodies.</p><p><strong>Materials and methods: </strong>Forty-two consecutive patients with SSc were included: 31 with lcSSc and 11 with dcSSc. ACA antibodies were detected in 26 patients, and ATA antibodies in 16 patients. The UCLA SCTC GIT 2.0 self-assessment questionnaire was used to assess the severity of GI symptoms across seven subscales: reflux, distention/bloating, diarrhea, fecal soilage, constipation, social functioning, and emotional well-being.</p><p><strong>Results: </strong>Symptoms of reflux (lcSSc/dcSSc = 64.5%/81.8%), distention/bloating (lcSSc/dcSSc = 61.3%/81.8%), constipation (lcSSc/dcSSc = 45.2%/45.5%), and fecal soilage (lcSSc/dcSSc = 6.4%/18.2%) were similarly frequent in lcSSc and dcSSc. Diarrhea was more common in dcSSc (45.5% vs. 16.1%, <i>p</i> = 0.04), with a higher median index value (0.25 vs. 0.00, <i>p</i> = 0.02), thus indicating more severe symptoms. No differences were observed in the prevalence or severity of GI symptoms between ACA- and ATA-positive patients. Median index values for social functioning and emotional well-being did not differ by the disease subtype or antibody status.</p><p><strong>Conclusions: </strong>Diarrhea was more prevalent and more severe in patients with dcSSc, while other gastrointestinal manifestations showed no major differences between subtypes. Symptom prevalence and severity did not differ according to the antibody status, and their impact on social and emotional functioning was similar across the groups.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"33 1","pages":"161-168"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798624","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":"Cement Spacer versus Endoprosthesis as Reconstruction Modality after Limb Salvage for Shoulder Malignancies: Systematic Review and Meta-Analysis.","authors":"Akshat Gupta, Divesh Jalan, Nishith Gupta, Nupur Aggarwal, Kshitish Behera, Princi Jain","doi":"10.15388/Amed.2026.33.1.1","DOIUrl":"10.15388/Amed.2026.33.1.1","url":null,"abstract":"<p><strong>Background: </strong>Limb salvage is the mainstay of surgical treatment for primary sarcomas as well as metastatic lesions of the proximal humerus. This involves wide excision of the involved humeral segment followed by a reconstruction of the defect. The purpose of this review was to determine which reconstruction modality offers a better overall functional outcome.</p><p><strong>Methods: </strong>After registering a review with the <i>PROSPERO</i> database (ID No. CRD 42025642215), <i>PubMed</i> and <i>Cochrane Library</i> databases were systematically screened for relevant studies meeting our inclusion criteria. The <i>Methodological Index for Non-randomized studies</i> (MINORs) questionnaire was the primary <i>Risk Of Bias</i> (ROB) assessment tool. The included articles were compared with respect to their intra-operative parameters, functional outcome scores, postoperative shoulder <i>Range Of Motion</i> (ROM), as well as complication rates.</p><p><strong>Results: </strong>A total of eight studies, involving 348 subjects in total, were included in this review, out of which, only four articles were found eligible for meta-analysis. Primary malignancy of the bone was the most common diagnosis (Osteogenic sarcoma followed by Ewing sarcoma). A higher frequency of axillary nerve sacrifice was seen in patients undergoing spacer implantation. <i>Musculoskeletal Tumour Society Scores</i> (MSTS) were used as the chief functional outcome determinant and were significantly better in patients undergoing arthroplasty (73.7 ± 7.9 versus 68.9 ± 8.5). A similar trend was observed with regards to shoulder flexion, extension and abduction. The most common complication noted with a cement spacer was proximal implant migration followed by implant failure. On the other hand, dislocation or subluxation of the prosthesis was the most frequently reported issue with arthroplasty. Overall, the local recurrence rate was 9.5%.</p><p><strong>Conclusion: </strong>Cement spacers are ideally suited for patients with a poor socio-economic background, aggressive lesions and a shorter life expectancy, while joint replacement is the reconstructive modality of choice in low-grade, well differentiated, isolated malignancies with negligible chances of sacrificing the shoulder abductor mechanism.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"33 1","pages":"6-22"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798835","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":"Chronic Kidney Disease in Lithuanian Children: Single Center Experience.","authors":"Ugnė Rukšėnaitė, Karolis Ažukaitis, Rimantė Čerkauskienė, Dovilė Ruzgienė, Renata Vitkevič, Darija Litvinenko, Augustina Jankauskienė","doi":"10.15388/Amed.2026.33.1.10","DOIUrl":"10.15388/Amed.2026.33.1.10","url":null,"abstract":"<p><strong>Background: </strong><i>Chronic Kidney Disease</i> (CKD) in children is relatively rare but carries high burden due to increased morbidity and mortality rates. Unlike adults, where CKD is often secondary to other conditions, pediatric CKD is primarily caused by <i>Congenital Anomalies of the Kidney and Urinary Tract</i> (CAKUT). In Lithuania, data on pediatric CKD are limited, and center-specific patient characteristics and management practices remain underreported in real life settings. This study aimed to assess the current patterns of pediatric CKD in a major Lithuanian tertiary center and evaluate how current practice aligns with guideline recommendations.</p><p><strong>Material and methods: </strong>A cross-sectional study of children (<18 years) with CKD stages 2-5 at Vilnius University Hospital Santaros Klinikos Pediatric Center was conducted. CKD stages were defined according to the <i>Kidney Disease: Improving Global Outcomes</i> (KDIGO) 2024 guidelines, and the patients were categorized into seven groups according to CKD etiology. Anthropometric measurements, complications, comorbidities, and ongoing treatments were analyzed.</p><p><strong>Results: </strong>A total of 65 children were included (mean age 11.1 years; male-to-female ratio 1.7:1). CAKUT was the most common etiology of CKD (61.5%), with renal hypoplasia being the predominant variant, followed by cystic kidney diseases (13.9%), glomerulopathies (9.2%), and other or unknown causes (9.2%). The mean estimated glomerular filtration rate (eGFR) was 60.5 mL/min/1.73 m², and most children were in CKD stage 2 (66.2%). Differences in age, sex, eGFR, and the CKD stage across the etiology groups were not statistically significant (all <i>p</i> >0.05). Normal weight remained the predominant category at every CKD stage, with a prevalence of 60.0-66.7%. Nearly half of the patients had CKD-related complications, most commonly CKD-mineral and bone disorder, proteinuria, and arterial hypertension. Most children (76.9%) had received at least one treatment for CKD-related complications.</p><p><strong>Conclusions: </strong>Pediatric CKD in Lithuania remains predominantly caused by CAKUT, with most children diagnosed with CKD stage 2. Complications occur even in early stages, and the body mass index distribution does not vary significantly across the CKD stages. Management generally aligned with KDIGO guidelines, but gaps in treating proteinuria, anemia, and growth impairment remain.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"33 1","pages":"128-140"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798881","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":"Stroke and Recurrent Thrombosis of the Coronary Arteries Probably due to Patent Foramen Ovale and Antebrachial Vein Thrombosis in Patient with STEMI - Case Report.","authors":"Anna Konopka, Karolina Marzec, Katarzyna Paschalis-Purtak, Marcin Demkow, Joanna Zalewska, Elżbieta Smaga, Ilona Michałowska","doi":"10.15388/Amed.2026.33.1.16","DOIUrl":"https://doi.org/10.15388/Amed.2026.33.1.16","url":null,"abstract":"<p><p>A 74-year-old woman with a history of cryptogenic stroke in 2010 (during hospitalization at the neurological department, possible reasons of stroke were excluded at that time), with less than one year history of paroxysmal atrial fibrillation (AF), which was being treated with apixaban, and also exhibiting hypertension, diabetes type II, hypothyreotocsicosis and obesity, was admitted to our hospital twice. For the first time, the patient was admitted due to ST segment elevation myocardial infarction (STEMI) and an episode of AF. Coronary angiography revealed occlusion of the left circumflex coronary (LCX) artery, and percutaneous coronary intervention (PCI) with stent implantation was performed. Conversions of AF episodes to the sinus rhythm were spontaneous. The patient was discharged home and readmitted once again three days after the discharge. STEMI of the anterior wall and a new episode of AF were then diagnosed. Immediate plain old balloon angioplasty (POBA) with implantation of an additional stent in the left anterior descending coronary artery (LAD) was performed. Sixty minutes after the procedure, the patient developed symptoms of mild right-sided pyramidal syndrome and slight aphasia. The patient's status was assessed, scoring 3 points according to the <i>National Institute of Health Stroke Scale</i> (NIHSS), and the patient was not qualified for thrombolysis and mechanical thrombectomy of the cerebral artery. Four days after manifesting the symptoms of stroke, CT did not reveal any new significant lesions of the brain, and, on the eighth days after the stroke, aphasia almost completely disappeared. A thrombus in the left atrium appendage was excluded, and a patent foramen ovale (PFO) with the left-to-right flow was revealed. Due to the risk of reverse flow as a possible reason of strokes (now and 15 years ago) and recurrent thromboembolization of coronary arteries along with the presence of thromboembolization of the antebrachial vein, successful occlusion of PFO with an Amplatzer Septal Occluder was performed. The patient was discharged home in good condition.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"33 1","pages":"184-189"},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798807","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}