Acta Medica Lituanica最新文献

{"title":"Werner Syndrome Caused by Homozygous Frameshift Variant c.1578del in <i>WRN</i>.","authors":"Jovita Patricija Druta, Gunda Petraitytė, Aušra Sasnauskienė, Eglė Preikšaitienė","doi":"10.15388/Amed.2024.31.2.9","DOIUrl":"10.15388/Amed.2024.31.2.9","url":null,"abstract":"<p><strong>Background: </strong>Progerias are rare hereditary genetic disorders that cause the onset of aging to occur earlier than generally expected, which initiates the progression of many age-related diseases. Syndromes assigned to this group are usually a compound disturbance of multiple systems. Werner syndrome is among a few well described premature aging disorders associated with a higher likelihood of malignancies.</p><p><strong>Clinical case: </strong>We present a 45-year-old man with a history of painful muscle spasms, general muscle pain and weakness. There was a progression of contractures of the plantar tendons, as well as the atrophy of the subcutaneous adipose tissue of the extremities. The patient was initially diagnosed with secondary small fiber sensory polyneuropathy and myotonia, but further genetic testing revealed the homozygous pathogenic variant c.1578del in the <i>WRN</i> gene associated with Werner syndrome.</p><p><strong>Conclusions: </strong>The c.1578del variant, previously not described in literature in a homozygous state, causes Werner syndrome and is associated with the pronounced hallmarks of early senescence in the proband's fibroblasts. Molecular diagnosis brings better treatment of manifestations and monitoring options for the patients, helping to establish more sufficient and secure patient care.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"31 2","pages":"357-363"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587471","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":"Comparison of Laparoscopic Intraperitoneal Onlay Mesh Repair (IPOM plus) vs Open Rives-Stoppa (RS) Repair for Ventral and Incisional Hernia.","authors":"Hryhorii O Havrylov, Oleg V Shulyarenko, Mykhaylo O Yosypenko","doi":"10.15388/Amed.2024.31.2.11","DOIUrl":"10.15388/Amed.2024.31.2.11","url":null,"abstract":"<p><strong>Aim: </strong>To compare the effects of laparoscopic intraperitoneal onlay mesh plus repair versus open Rives-Stoppa repair for abdominal wall hernias.</p><p><strong>Materials and methods: </strong>A total of 99 patients with midline primary, umbilical or incisional hernias who underwent surgery in \"Medikom\" clinic and Kyiv city hospital #5 in the period from 2016 to 2022 were involved in the study. The group I included 50 patients who underwent intraperitoneal onlay mesh (IPOM) plus, and the group II 49 patients who underwent open Rives-Stoppa (RS) repair.</p><p><strong>Result: </strong>Both groups were comparable in mean age, gender, body mass index, patient distribution based on hernia type, defect size, ASA score distribution (p > 0.05).The operating time in minutes was 75.36 ± 4.99 in group I and 97.85 ± 6.5 in group II (p < 0.05). The blood loss in IPOM plus approach group is on average in 2 times less than in open RS technique (p < 0.05). The pain score 12 hours after surgery was 5.5 ± 0.64 in group I comparing to 7.26 ± 0.78 in group II (p < 0.05). The pain score 24 hours after surgery was 4.46 ± 0.7 in group I comparing to 4.95 ± 0.61 in group II (p < 0.05). The pain score 8 days after surgery in group I was on average in 1.46 times less than in group II (p < 0.05).No significant difference was found in incidence of early complications between two groups (p > 0.05).47 (94%) patients of group I and 46 (93.87%) patients of group II were evaluated over 22 months follow-up period. No one complication was noted.</p><p><strong>Conclusions: </strong>IPOM plus approach for the ventral and incisional hernias repair is a viable and relatively more safe operation by comparing with open RS repair. IPOM plus approach takes significantly in 1.3 less time as compared open RS technique.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"31 2","pages":"288-293"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587483","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":"Thromboembolic Complications after Bariatric and Metabolic Surgery: A Single-Center Experience, Two Case Reports and a Literature Review.","authors":"Žygimantas Juodeikis, Gintautas Brimas","doi":"10.15388/Amed.2024.31.2.23","DOIUrl":"10.15388/Amed.2024.31.2.23","url":null,"abstract":"<p><strong>Background: </strong>Bariatric and metabolic surgery has emerged as an effective intervention for morbid obesity, offering substantial and sustained weight loss along with improvements in various comorbidities. Among the diverse spectrum of potential postoperative complications, thromboembolic events have garnered increasing attention due to their significant morbidity and mortality.The aim of this study is to present a single-center experience of thromboembolic complications following bariatric and metabolic surgery. Additionally, we present two distinctive cases, highlighting the clinical manifestations, diagnostic challenges, and therapeutic interventions associated with postoperative thromboembolism.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed data from patients with obesity who underwent various bariatric and metabolic operations at Republican Vilnius University Hospital from January 2018 to February 2024. All patients, regardless of the type of operation performed, were included. Two patients with thromboembolic complications are presented as illustrative cases.</p><p><strong>Results: </strong>A total of 633 patients were included in the analysis: 278 underwent laparoscopic adjustable gastric banding, 345 underwent sleeve gastrectomies, and 10 underwent gastric bypasses. Thromboembolic complications occurred in only two patients, with one developing portal vein thrombosis and the other developing pulmonary embolism.</p><p><strong>Conclusions: </strong>This single-center experience emphasizes the unpredictable nature of thromboembolic events in postbariatric surgery patients and highlights the critical role of vigilant monitoring, early detection, and individualized therapeutic interventions. Continued research efforts are warranted to refine risk stratification, enhance preventive measures, and improve overall patient outcomes in the landscape of bariatric surgery.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"31 2","pages":"409-415"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587428","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":"Simultaneous Coronary Artery Bypass Grafting and Anterior Rectum Resection: The First Clinical Case in Kazakhstan.","authors":"Anuar Abdikarimov, Serik Aitaliyev, Vladimir Dikolayev","doi":"10.15388/Amed.2024.31.2.8","DOIUrl":"10.15388/Amed.2024.31.2.8","url":null,"abstract":"<p><p>In this case report, we describe the experience of a patient who was initially admitted for rectal cancer treatment. However, during the preoperative evaluation, severe stenosis of the coronary arteries was unexpectedly detected, presenting the medical team with a complex decision-making process.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"31 2","pages":"351-356"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587314","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":"Forensic Assessment of Alcohol Intoxication in Cases of Fatal Road Traffic Accidents in Lithuania.","authors":"Beata Kirstukaitė, Akvilė Paškauskienė, Sigitas Chmieliauskas, Sigitas Laima, Diana Vasiljevaitė, Jurgita Stasiūnienė","doi":"10.15388/Amed.2024.31.1.22","DOIUrl":"10.15388/Amed.2024.31.1.22","url":null,"abstract":"<p><strong>Background: </strong>There is strong evidence that alcohol consumption is a significant risk factor for fatal road traffic accidents. It is estimated that the number of alcohol-related road accidents remains high in the past few years in Lithuania. This study aims to examine the prevalence of alcohol in blood samples collected from the autopsy results of road traffic accident victims.</p><p><strong>Materials and methods: </strong>A retrospective study of 136 road traffic accident victims was performed in State Forensic Medicine Service of Lithuania in the period of 2013 to 2023. We analyzed blood alcohol concentration (BAC) in relation to sex, age, road user type, place and time of the day at death.</p><p><strong>Results: </strong>31% of the victims were under influence of alcohol at the time of death, with mean BAC 1.99 ± 0.92‰. The mean BAC was 2.16 ± 0.8‰ in male and 1.18 ± 1.12‰ in female group. By the type of road users, 23% of the pedestrians (mean BAC 2.45 ± 0.71‰), 32% of car drivers (mean BAC 2.13 ± 0.75‰), 41% of vehicle passengers (mean BAC of 1.73 ± 1.19‰), 37% of the motorcycle riders (mean BAC of 1.28 ± 0.53‰), 37% of the cyclists (mean BAC of 1.15 ± 0.75‰) were found to be intoxicated during the time of accident. Highest mean blood alcohol concentration was found during the night time hours (9 p. m. - 5 a. m.) 2.28 ± 0.91, comparing to in afternoon hours (12 p. m. - 5 p. m.) 1.49 ± 0.99, evening hours (5 p. m. - 9 p. m.) 2.10 ± 0.73 and morning hours (5 a. m. - 12 p. m.) 1.94 ± 1.00. The mean BAC in road traffic accidents during summer was 1.48 ± 0.71‰, spring 2.25 ± 0.76‰, autumn 2.12 ± 1‰, winter 2.42 ± 1‰.</p><p><strong>Conclusions: </strong>Alcohol consumption by road users is a significant contributing factor in road traffic accidents and their outcomes in Lithuania.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"31 1","pages":"169-176"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11227692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559969","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":"Manifestations Reported by Inflammatory Bowel Disease Patients in University Hospital.","authors":"Ieva Renata Jonaitytė, Vita Karpavičiūtė, Gediminas Kiudelis, Juozas Kupčinska, Laimas Jonaitis","doi":"10.15388/Amed.2024.31.1.23","DOIUrl":"10.15388/Amed.2024.31.1.23","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD) may affect organs outside the intestines, it is called extraintestinal manifestations of IBD. Data on the prevalence of mu-cocutaneous manifestations in IBD patients are very limited, therefore, the aim of this study was to assess the prevalence of skin and mucosal lesions and to determine the relationship with demographic factors, clinical features, and systemic treatment.</p><p><strong>Materials and methods: </strong>Prospective study included 162 out-patients with IBD who were managed in the tertiary care center. Ulcerative colitis (UC) was diagnosed in 117 patients, Crohn's disease (CD) in 45. Patients completed the questionnaire containing demographic and IBD data, questions about mucocutaneous lesions (in past or present state).</p><p><strong>Results: </strong>Overall mucocutaneous lesions were reported by 48.1% of IBD patients. Skin lesions were reported by 40.7% of patients, oral mucosal lesions were reported by 16.7%, without significant differences between sexes or IBD types. In 47 (29%) of patients, skin lesions appeared together with IBD or during the course of the disease. The most common skin lesions were psoriasis (8.0%), erythema nodosum (5.6%), pyoderma gangrenosum and acne (3.7% each). UC patients mostly reported about psoriasis (9.4%), while CD patients about erythema nodosum (11.1%). There were more frequent skin lesions in patients with more extensive UC type (p = 0.01), while no difference was noticed between different types of CD. The average duration of IBD in patients with skin lesions was similar to those without lesions (9.3±6.7 vs. 9.4±6.7 years).</p><p><strong>Conclusions: </strong>Mucocutaneous lesions were reported by 48.1% of inflammatory bowel disease patients. The frequency of mucocutaneous lesions does not differ significantly between UC and CD, and a longer duration of illness is not a predictive factor for the appearance of lesions. More extensive UC is related to higher frequency of skin lesions.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"31 1","pages":"177-186"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11227669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559971","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":"Unilateral Absence of Musculocutaneous Nerve and Unusual Supply of Median Nerve - A Case Report.","authors":"Dibakar Borthakur, Rajesh Kumar, Harshit Jain, Pooja Poddar, Monica Baxla","doi":"10.15388/Amed.2024.31.2.22","DOIUrl":"10.15388/Amed.2024.31.2.22","url":null,"abstract":"<p><strong>Introduction: </strong>Anatomical variations of the brachial plexus and its branches are frequently encountered. Absent musculocutaneous nerve with complete or partial takeover of function by median nerve is known. Such variation creates confusion in the interpretation of a clinical or electro diagnostic test for evaluation of peripheral nerve injury.</p><p><strong>Methods: </strong>Institutional guidelines for the use of human cadaver were followed. Routine dissection of the upper limbs for undergraduate medical teaching was performed in a 67-years-old male cadaver following standard methods. Relevant gross anatomical features of the variations were photographed.</p><p><strong>Results: </strong>The musculocutaneous nerve was absent on the left side. A direct small branch arising from the lateral cord supplied the coracobrachialis muscle. Median nerve supplied the biceps brachii and brachialis muscle and further continued as lateral cutaneous nerve of the forearm.</p><p><strong>Conclusion: </strong>The unilateral absence of musculocutaneous nerve with taking over of its function predominantly by the median nerve observed in the present case is indeed a unique situation to be aware of. Additionally the case exhibited independent supply to the coracobrachialis muscle directly from the lateral cord of the brachial plexus. It is proposed that this variation should be placed in a new subcategory in the existing classification system of the classification for musculocutaneous nerve variations.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"31 2","pages":"404-408"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587468","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":"Contemporary Nonpharmacological Strategies to Manage Preoperative Anxiety: Nonsystematic Review.","authors":"Vilma Kuzminskaitė, Agnė Ramaškaitė, Justina Semenkovaitė, Eglė Kontrimavičiūtė","doi":"10.15388/Amed.2024.31.2.17","DOIUrl":"10.15388/Amed.2024.31.2.17","url":null,"abstract":"<p><strong>Background: </strong>Preoperative anxiety affects the majority of surgical patients and has a huge impact on their well-being and recovery. Pharmacological anxiety treatment does not always result in the desired effect and occasionally causes side effects. To address this issue, recent research is focused on inventing and studying nonpharmacological anxiety management techniques.</p><p><strong>Objectives: </strong>To review the diversity of recent nonpharmacological anxiety-reducing methods for adult and pediatric patients and compare their effectiveness and applicability in real-life clinical practice.</p><p><strong>Methods: </strong>The search was performed using keywords 'preoperative anxiety', 'management techniques', 'nonpharmacological', 'pediatric' in PubMed and Google Scholar databases. Full-text original articles or reviews that were published during the last 5 years were selected. Anxiety management techniques were identified and further analyzed for advantages and disadvantages.</p><p><strong>Results: </strong>Patient education, educational videos and music seem to be the most effective and easy to implement in daily practice for adults. While playing rooms and interactive pop-up books are reasonable to manage preoperative anxiety for pediatric patients.</p><p><strong>Conclusions: </strong>The choice of nonpharmacological anxiety management methods is diverse. However, the availability and application in reality highly depend on numerous variables, such as costs, time availability, motivation of the medical team, cultural background, and preference of the patient.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"31 2","pages":"231-244"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587488","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 Fibularis Quartus Muscle: A Cadaveric Case Report with Historical, Embryological, Molecular and Clinical Considerations.","authors":"Dibakar Borthakur, Rajesh Kumar, G R Namaschivayam, Mohammed Ahmed Ansari, Seema Singh","doi":"10.15388/Amed.2024.31.2.12","DOIUrl":"10.15388/Amed.2024.31.2.12","url":null,"abstract":"<p><strong>Introduction: </strong>The fibularis quartus (FQ) or peroneus quartus (PQ) is a supernumerary muscle occasionally seen in the lateral compartment of the human leg. It is a weak evertor and has a role in pronation and lateral stabilization of the foot. FQ arises from the fibularis brevis (FB) in most instances and distally gets attached to the lateral aspect of the base of the fifth metatarsal or the cuboid or the calcaneus bone. The muscle has been implicated in a variety of clinical problems ranging from ankle pain to subluxation and tear of peroneal tendons. We report here a rare bitendinous variant of FQ which might provide new insight to clinical problems related to the presence of this muscle and its possible utility as an autograft in reconstruction.</p><p><strong>Methods: </strong>Institutional guidelines for use of human cadaver were followed. Routine dissection was performed on a 71-year-old male donated cadaver in both the lower limbs. Gross anatomical features were meticulously noted, photographed and measurements were recorded with digital Vernier callipers.</p><p><strong>Results: </strong>A bitendinous muscle was observed in the lateral compartment of the left leg and identified as FQ. The FQ was proximally attached to the FB and adjacent distal third of the fibula, which then formed a flat fusiform muscle belly and eventually terminated through a rounded tendon via its attachment to the peroneal trochlea of the calcaneus. The dimensions of the proximal tendon, muscle belly and the distal tendon were 4.2 cm x 0.7 cm, 5.6 cm x 1.9 cm and 2.6 cm x 0.3 cm, respectively.</p><p><strong>Conclusions: </strong>Clinicians should be aware about all possible variants of the supernumerary FQ muscle considering its role in several lateral ankle pathologies. FQ can prove as an excellent autograft for peroneal tendon tear and can be utilized for strengthening weakened peroneal tendons.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"31 2","pages":"364-371"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587422","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":"Investigating Confined Space Asphyxias: Plastic Bag Involvement and Gas Inhalation - A Case Series and Literature Review.","authors":"Sofija Saulė Kaubrytė, Sigitas Chmieliauskas, Giedrė Kažukauskė, Sigitas Laima, Diana Vasiljevaitė, Jurgita Stasiūnienė","doi":"10.15388/Amed.2024.31.2.10","DOIUrl":"10.15388/Amed.2024.31.2.10","url":null,"abstract":"<p><strong>Background: </strong>Asphyxia within confined spaces, particularly involving plastic bag suffocation and gas inhalation, presents complex forensic challenges. This study explores mechanisms, epidemiology, and forensic considerations of these fatalities, drawing from a comprehensive literature review and analysis of four clinical cases. Plastic bag asphyxia, exacerbated by oxygen depletion and carbon dioxide accumulation, induces rapid loss of consciousness and cardiorespiratory arrest. The method's lethality is increased when combined with inert gases like helium, known for their rapid onset of hypoxia and painless nature. Recent research demonstrates a growing incidence of plastic bag suffocation as a method of suicide. The accessibility of suicide-related information on online platforms contributes to the dissemination of new methods, posing challenges for suicide prevention efforts. Forensic investigations often face obstacles in accurately determining the cause and manner of death, with nonspecific autopsy findings and scene manipulations complicating the diagnostic process.</p><p><strong>Materials and methods: </strong>A literature research was conducted across PubMed and Google Scholar databases, focusing on articles published in the last 5 years, applying keywords relevant to the topic under consideration and their combinations. 34 pertinent articles were selected, supplemented by data from the Lithuanian State Forensic Medicine Service, involving four clinical cases of confined space asphyxia. Autopsy findings, toxicological analyses, and contextual details were thoroughly examined to determine the mechanism and circumstances of death.</p><p><strong>Results: </strong>Plastic bag suffocation, often combined with inert gas inhalation, emerges as a common method in suicides. Demographic analyses reveal distinct patterns, with younger age groups demonstrating an increased tendency for gas inhalation suicides. The accessibility and perceived painlessness of helium contribute to its rising usage for suicide purposes. Forensic challenges include nonspecific autopsy findings, manipulations of death scenes, and difficulties in detecting inert gases postmortem. Enhanced surveillance and efforts to restrict access to these tools are crucial in preventing the spread of new suicide methods.</p><p><strong>Conclusions: </strong>The study highlights the multifaceted nature of asphyxiation deaths within confined spaces and the importance of proactive interventions in suicide prevention. Enhanced surveillance, tailored prevention strategies, and collaborative efforts are essential in addressing evolving suicide methods and reducing their impact.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"31 2","pages":"217-230"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586888","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}