Acta Medica Lituanica最新文献

{"title":"Pott's Puffy Tumour - Rare and Forgotten, yet Relevant and Life-Threatening: Case Report.","authors":"Himraj Phukan, Donboklang Lynser, Gareth Yobel Lyngwa, Chhunthang Daniala, Himesh Barman, Tamajyoti Ghosh","doi":"10.15388/Amed.2025.32.1.6","DOIUrl":"10.15388/Amed.2025.32.1.6","url":null,"abstract":"<p><p>Pott's Puffy Tumour (PPT) is an inflammation and swelling of the forehead secondary to osteomyelitis of the frontal bone. Multiple aetiologies are associated with this condition, predominately involving a prior sinus surgery or a direct trauma to the frontal bone. There can be intracranial extension with an epidural, subdural as well as intracerebral abscess. We present the case of an 8-year-old boy who presented with swelling in his forehead secondary to trauma. His general condition was poor, and further evaluation revealed multiple subdural empyemas. Although PPT is rare in this modern era of antibiotics, it should be kept as a differential for any inflammation of the forehead. Timely diagnosis and the appropriate treatment by a multidisciplinary team are indispensable in reducing the morbidity and mortality associated with this case.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 1","pages":"206-209"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609833","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":"Calculation of Integral Indicators of the Metabolic Status and Filtration Function of Kidneys in Patients with a Combat Mine-Explosive Injury who Lost Significant Body Weight due to Limb Amputation.","authors":"Nataliia Sydorova, Kateryna Kazmirchuk, Oleh Kolisnyk, Vira Tsaralunha, Yuliia Kobirnichenko, Liudmyla Sydorova","doi":"10.15388/Amed.2025.32.1.2","DOIUrl":"10.15388/Amed.2025.32.1.2","url":null,"abstract":"<p><strong>Background: </strong>The aim of this retrospective cohort study was to investigate the possibility of optimizing the calculation of integral indicators of the metabolic status and filtration function of the kidneys in patients with combat mine-explosive injuries who have lost significant body weight due to limb amputation.</p><p><strong>Methods: </strong>Data from 81 servicemen (all males) with combat mine-explosive limb injuries, including those with isolated severe limb injuries (Group 1, n=34) or traumatic amputations (Group 2, n=47), were analyzed. We assessed demographic indicators and the glomerular filtration rate (GFR), calculated according to the generally accepted formulas with correction for lost body parts in the amputees.</p><p><strong>Results: </strong>The proportion of amputees with obesity as measured by the body mass index in Group 2 without correction for the lost body parts was significantly lower than that in Group 1 and Group 2 adjusted for the lost body parts (2.12% versus 17.65% and 21.28%, respectively, p<0.05 and p<0.01), but it was similar in Group 1 and Group 2 after body weight adjustment for the lost body parts of the amputees (p>0.05). The mean level of serum creatinine in the patients in Group 2 was significantly lower than that in Group 1 (75.19±11.62 vs. 90.93±37.12 μmol/L, respectively, p=0.0206). The estimated GFR according to the <i>Cockcroft and Gault formula</i> (CGF) with adjusted for the lost body part body weight was significantly greater in Group 2 than that in Group 1 (143.63±42.58 and 123.92±26.34 mL/min/1.73m², respectively, p=0.0379) as well as GRF according to CGF corrected for the <i>body surface area</i> (BSA) (131.59±39.94 and 106.17±21.88 mL/min/1.73m², respectively, p=0.0040). Only a few individuals had a moderate decrease in GFR according to CGF or CGF adjusted for BSA, but glomerular hyperfiltration was suspected in a significant number of patients, specifically, 23.53% and 17.65% of the patients in Group 1, respectively, and in 29.79% and 36.17% of the patients in Group 2, respectively (even 51.6% according to CGF corrected for BSA in Group 2 adjusted for the lost body parts).</p><p><strong>Conclusions: </strong>In amputees, it is necessary to calculate their body weight considering the lost body part for an adequate assessment of their metabolic status. To calculate GFR, it is advisable to use CGF considering the lost body parts with or without adjustment for BSA to avoid the possibility of underestimating GFR calculated by other formulas. Special control is necessary for patients with hyperfiltration suspected by CGF, since this sign can be a predictor of future metabolic disorders.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 1","pages":"64-77"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609807","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":"Galectin-10 Characterization in Cleft Lip Palate - Affected Palatal Tissue.","authors":"Alise Elizabete Rone, Mara Pilmane","doi":"10.15388/Amed.2025.32.1.3","DOIUrl":"10.15388/Amed.2025.32.1.3","url":null,"abstract":"<p><strong>Background: </strong>Cleft lip palate is one of the most common craniofacial birth defects in humans. Multiple defense factors have been described to have possible involvement in the failure in palatal shelve elevation, migration and fusion, most importantly, the role of chronic inflammation. A widespread presence of Gal-10 in different local inflammatory processes has been discussed before, however, knowledge of its involvement in local tissue inflammation in the postnatal cleft palate and tissue regeneration is scant. This study focuses on the detection of appearance and a possible role of Gal-10 in the cleft-affected facial tissue regarding its ontogenetical aspect.</p><p><strong>Materials and methods: </strong>Craniofacial cleft tissue material was obtained from 21 children aged 8 months to 12.7 years undergoing veloplastic or uranoplastic procedure with non-syndromic craniofacial cleft diagnosis in milk or mixed dentition. Control groups for milk dentition were 5 subjects without orofacial defects for milk dentition and 3 subjects with plastic of superior lip frenula for mixed dentition. The number of factor positive cells in the control group and the patient group tissue was evaluated by using the semiquantitative counting method. The data were evaluated with the use of nonparametric statistical methods.</p><p><strong>Results: </strong>Elevated levels of Gal-10 were found in the epithelium in correlation with age, from milk to mixed dentition, as well as in both the control and the patient samples. Notable differences in expression can be seen by comparing the milk and the mixed dentition patient muscle tissue, where the milk dentition palate shows a more elevated factor expressed in comparison to the mixed dentition palate.</p><p><strong>Conclusions: </strong>The nearly total absence of Gal-10 in the healthy palate with an increase of its expression in the palatal epithelium from the milk to mixed dentition age of cleft-affected children suggests the possible role of this factor in providing the local defense function and the epithelium barrier function. The palatal muscles are not the main place for Gal-10 expression either in healthy or in cleft condition-affected individuals. The sporadic and insignificant appearance of Gal-10 only in the healthy milk dentition age and the mixed dentition age cleft-affected palatal connective tissue prove individual changes in the palatal tissue which does not depend on the specific disease.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 1","pages":"78-91"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609815","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 Potential Role of Placenta Morphological, Cytogenetic and Histological Findings in Fetal Phenotype Modeling: A Case Report with Unanswered Questions.","authors":"Estere Strautmane, Liene Korņejeva, Dzintra Ločmele, Marta Piksena, Diāna Bokučava, Natālija Vedmedovska","doi":"10.15388/Amed.2025.32.1.8","DOIUrl":"10.15388/Amed.2025.32.1.8","url":null,"abstract":"<p><p>Placental abnormalities significantly contribute to fetal mortality. Maternal vascular underperfusion emerges as the prevailing diagnosis. At the same time, genomic alterations within the placenta might play a role in the development of placental dysfunction. We present a case report of a 24-year-old primigravida with an uneventful medical history, admitted at 21 weeks and 2 days gestation. Despite a low risk for typical trisomies, a high risk for preeclampsia and fetal growth restriction (FGR) was recognized in the first trimester. Anhydramnios, abnormal placental morphology, retrochorial and retromembranous hematomas were observed, prompting the termination of pregnancy (TOP). Histological examination revealed multiple placental abnormalities, while the fetus displayed normal anatomy and phenotype. Discussion encompasses the varied manifestations of histopathological findings, and potential associations with adverse pregnancy outcomes. Our case underscores the importance of meticulous evaluation and multidisciplinary collaboration in managing pregnancies with placental anomalies. Further research is crucial to discern the intricate relationship between placental cytogenetics, morphology, and pregnancy outcomes, thus facilitating better clinical management and counseling strategies.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 1","pages":"240-248"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609838","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":"Neuropsychiatric Manifestations of Lyme Disease: A Literature Review of Psychiatric and Cognitive Impacts.","authors":"Gabija Šegždaitė, Odeta Aliukonytė, Kamilė Pociūtė","doi":"10.15388/Amed.2025.32.1.17","DOIUrl":"10.15388/Amed.2025.32.1.17","url":null,"abstract":"<p><strong>Background: </strong>Lyme disease can lead to neuropsychiatric symptoms like depression, anxiety, and cognitive issues, often mimicking primary psychiatric disorders. This paper examines the connection between Lyme disease and neuropsychiatric outcomes to improve diagnosis and treatment.</p><p><strong>Materials and methods: </strong>The <i>PubMed</i> database was searched for scientific literature sources. Publications published in English in 2019-2024 were selected. All psychiatric symptoms and disorders found to be associated with Lyme disease were included. For neurological symptoms, the analysis focused on studies addressing cognitive dysfunction.</p><p><strong>Results: </strong>Acute neuroborreliosis may have minimal effects on the cognitive function and typically resolves well with treatment. However, some studies suggest that Lyme disease can affect the patients' cognitive abilities, leading to impairments in verbal fluency, attention, and memory, with a few isolated dementia-like cases highlighting the need for careful diagnosis. Nevertheless, recent large-scale studies show no increased risk of dementia. Regarding psychiatric symptoms, findings are also inconsistent, with some studies suggesting an increased risk of depression, anxiety, sleep disturbances, and other mental health conditions, while others find no such association.</p><p><strong>Conclusions: </strong>There is no strong evidence supporting Lyme disease's role in long-term cognitive or psychiatric disorders. However, an early diagnosis and timely antibiotic treatment remain crucial in minimizing long-term consequences and improving patient outcomes.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 1","pages":"6-21"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609831","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":"Successful Endovascular Management of Recurrent Hemoptysis due to Multiple Rasmussen Aneurysms in a Case of Pulmonary Tuberculosis: A Rare Case Scenario","authors":"Shritik Devkota, H. Bhujade, Abhiman Baloji, Nidhi Prabhakar, A. Saroch, U. Gorsi","doi":"10.15388/amed.2024.31.1.25","DOIUrl":"https://doi.org/10.15388/amed.2024.31.1.25","url":null,"abstract":"Background: Hemoptysis is defined as coughing out of blood. Pulmonary tuberculosis is the most common cause of hemoptysis in tuberculosis-endemic countries like India. Rasmussen aneurysm is a pseudoaneurysm arising from the pulmonary artery adjacent to or within a tuberculous cavity. Chest radiographs, chest computed tomography angiography (CTA), and digital subtraction angiography (DSA) are the imaging tools for evaluating a case of hemoptysis.Case: A 32-year-old man with a history of pulmonary tuberculosis presented with complaints of recurrent hemoptysis. On imaging evaluation, multiple pulmonary artery pseudoaneurysms were seen in the left lung. The patient was shifted to the DSA lab and the pseudoaneurysms were subsequently treated by endovascular coil embolization. Hemoptysis resolved following the procedure and the patient was again started on anti-tubercular therapy.Conclusion: Endovascular coiling is minimally invasive, safe, and effective management of multiple Rasmussen aneurysms for preventing possible torrential blood loss and unfortunate death.","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":" 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141372759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knee Extensor Apparatus Reconstruction with Allograft after Patellar Resection: A Case Report","authors":"F. Cosseddu, Martina Cordoni, Elena Bechini, E. Ipponi, F. Campo, A. D’Arienzo, L. Andreani","doi":"10.15388/amed.2024.31.1.24","DOIUrl":"https://doi.org/10.15388/amed.2024.31.1.24","url":null,"abstract":"Background: The extensor apparatus of the knee can be thought of a chain that transmits the muscular strength developed by the quadriceps muscles to the proximal tibia. This complex is essential to allow the extension of the tibia over the femur, being essential to provide knee mobility and stability. In case of lesions which irreparably damage the patella, such as a locally aggressive bone tumor, it is necessary to restore both the apparatus’ anatomical continuity and its strength.Case report: A 39-years-old Caucasian man with a history of lung carcinoma developed atraumatic swelling and soreness in his left knee. Imaging evidence reported a degeneration of the left patella. We performed an en bloc resection of the patella and the nearby soft tissues of the extensor apparatus. The resulting gap was fulfilled with a massive allograft consisting of a quadriceps tendon, a patella and a patellar ligament. No complication or local recurrences were observed. At the patient’s latest follow-up, he did not have any extension lag and quadriceps strength was completely restored.Conclusion: Massive allografts can represent a reliable alternative for the reconstruction of the patella and the knee extensor apparatus in orthopedic oncology.","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"4 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141266649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accidental Intravenous Administration of Simethicone in a 4-Year-Old Patient: A Case Report","authors":"Agnė Lozovskytė, Gabija Laubner Sakalauskienė, R. Badaras","doi":"10.15388/amed.2024.31.1.19","DOIUrl":"https://doi.org/10.15388/amed.2024.31.1.19","url":null,"abstract":"Simethicone is an antiflatulent medication exclusively administered orally, thus its systemic effects remain unknown. We present a case of an inadvertent intravenous administration of simethicone to a 4-year-old patient, precipitating respiratory difficulty, cyanosis, and altered mental status. The patient’s condition improved rapidly with appropriate interventions, leading to discharge in a fully recovered state. To date, only one documented instance of intravenous simethicone administration exists in medical literature.","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"4 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141099998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of Poor Outcome Using the Urea to Albumin Ratio in Thoracic Empyema","authors":"E. Dimitrov, Daniel Valchev, G. Minkov, Emil Enchev, Y. Yovtchev","doi":"10.15388/amed.2024.31.1.21","DOIUrl":"https://doi.org/10.15388/amed.2024.31.1.21","url":null,"abstract":"Purpose: The prognostic performance of urea-to-albumin ratio (UAR) has been assessed in various pulmonary and nonpulmonary conditions, but never in thoracic empyema. Therefore, our aim was to determine whether this marker has the ability to predict outcome in such patients.Methods: A single-center retrospective study was conducted in a Clinic of Thoracic Surgery at a University Hospital between January 2021 and October 2023. A total of 84 patients who underwent emergency surgery due to thoracic empyema were involved. Serum levels of urea and albumin at admission were used to calculate UAR. We analyzed area under receiver operating characteristics (AUROC) curves of UAR, systemic inflammatory response syndrome (SIRS) and quick-sequential organ failure assessment (qSOFA), and compared their prognostic performance.Results: The identified in-hospital mortality was 10.7%. The UAR showed the best ability to prognosticate mortality compared to qSOFA (AUROC = 0.828 vs 0.747) and SIRS (AUROC = 0.828 vs 0.676). We established a sensitivity of 87.5% and specificity of 74.2% at optimal cut-off value UAR > 51.1 for prediction of adverse outcome.Conclusion: In patients with thoracic empyema urea-to-albumin ratio showed significant prognostic performance and a potential for clinical application as a low cost and widely available predictor of death.","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"21 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141100336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Blood Culture Results in Patients with Malignancy in Erzurum Province, Turkey","authors":"O. Aktas, Ozgür Akbaba, M. Uyanık, Hakan Uslu","doi":"10.15388/amed.2024.31.1.17","DOIUrl":"https://doi.org/10.15388/amed.2024.31.1.17","url":null,"abstract":"Background: Bloodstream infections are a serious public health problem that requires follow-up with blood culture; this negatively affects the course of the disease and patient healthcare costs in patients with malignancy. This study aimed to determine the growth frequency of pathogens and their antibiotic resistance profiles in the blood cultures of patients with hematological and oncogenic malignancies.Materials and methods: The results of 7451 blood cultures, obtained from 2926 patients between January 2017 and January 2022, were evaluated retrospectively. Of these cultures, 3969 were obtained from patients with malignancy (diagnostic codes C00-D48 in ICD-10) and 3482 from patients without malignancy. The hospital information management system modules were used to acquire patient data and blood culture results.Results: Various microorganisms grew in 10.1% of blood cultures. Of these organisms, 64.1% were isolated from cases of malignancy. Of the pathogens, 49.2% were gram-negative bacteria, 47.7% were gram-positive bacteria, and 3.1% were fungi. The most frequently isolated bacteria were methicillin-resistant coagulase-negative staphylococci (3.2%), Escherichia coli (2.3%), Klebsiella pneumoniae (1.0%), methicillin-sensitive coagulase-negative staphylococci (0.7%), and Staphylococcus aureus (0.6%). Pathogen positivity was highest in the patient cultures with urinary system cancer (23.9%), thyroid and other endocrine gland cancers (20.6%), female and male genital organ cancers (18.2%/16.9%), and digestive organ cancer (14.2%). Gram-negative bacteria to ampicillin, piperacillin, and sulfamethoxazole-trimethoprim and Gram-positive bacteria to penicillin, erythromycin, and sulfamethoxazole-trimethoprim were highly resistant. Combined resistance to imipenem and meropenem was observed in 25 Gram-negative bacteria. Twelve (48%) of the carbapenem-resistant bacteria were isolated from patients with lymphoid, hematopoietic, and related tissue malignant neoplasia.Conclusion: This study reported microorganisms and their antimicrobial resistance in the blood cultures of malignant patients, a special patient group. It pointed out that the antibiotic resistance of Staphylococcus, Klebsiella pneumoniae, and E. coli is high enough to cause problems in the treatment of patients with malignancy.","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"10 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141100279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}