Acta Medica Lituanica最新文献_第4页

Immune Checkpoint Blockade in Melanoma – Earlier is Better? 黑色素瘤的免疫检查点阻断疗法--越早越好？

Acta Medica Lituanica Pub Date : 2024-05-22 DOI: 10.15388/amed.2024.31.1.16

V. Urbonas, A. Dulskas, E. Baltruškevičienė, D. Dabkevičienė

引用次数: 0

An Institutional Perspective on the Number of Stent Retriever Pass and Rate of Recanalization in Mechanical Thrombectomy for Acute Ischemic Stroke: When to Stop? 从机构角度看急性缺血性脑卒中机械取栓术中的支架取出器通过次数和再通率：何时停止？

Acta Medica Lituanica Pub Date : 2024-05-22 DOI: 10.15388/amed.2024.31.1.11

Bheru Dan Charan, Shailesh B. Gaikwad, Savyasachi Jain, Ajay Garg, Leve Joseph Devarajan Sebastian, M. P. Srivastava, Rohit Bhatia, Awadh Kishore Pandit, Shashank Sarad Kale

{"title":"An Institutional Perspective on the Number of Stent Retriever Pass and Rate of Recanalization in Mechanical Thrombectomy for Acute Ischemic Stroke: When to Stop?","authors":"Bheru Dan Charan, Shailesh B. Gaikwad, Savyasachi Jain, Ajay Garg, Leve Joseph Devarajan Sebastian, M. P. Srivastava, Rohit Bhatia, Awadh Kishore Pandit, Shashank Sarad Kale","doi":"10.15388/amed.2024.31.1.11","DOIUrl":"https://doi.org/10.15388/amed.2024.31.1.11","url":null,"abstract":"Background and purpose: Mechanical thrombectomy is the standard treatment modality for flow restoration in acute ischemic stroke. In cases of persistent occlusion, the optimal number of retrieval attempts before considering procedure termination is currently undetermined and is a topic for research. Therefore in this study, we studied the impact of the number of stent retrieval maneuvers on the recanalization of vessels.Methods: In this retrospective single-center observational study we included 52 patients with large vessel occlusion who underwent stent retriever mechanical thrombectomy. Successful recanalization rate was defined as modified TICI (Thrombolysis in Cerebral Infarction) 2b or 3.Result: The overall successful recanalization rate was 44.24%. The recanalization rate per stent retrieval attempt was the highest in 1st attempt (28.84%) and no recanalization was observed with the 3rd, 5th, and 6th attempts (p<0.001). At most 6 retrieval attempts were used.Conclusions: After two retrieval attempts, 91% of the patients were successfully recanalized and other after the 5th attempt could not result in recanalization.","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"3 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141108503","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}

引用次数: 0

The Effect of Calcitonin Gene-Related Peptide Monoclonal Antibodies on Quality of Life among Migraine Patients: Pilot Study at the Hospital of Lithuanian University of Health Sciences Kaunas Clinics 降钙素基因相关肽单克隆抗体对偏头痛患者生活质量的影响：立陶宛健康科学大学考纳斯医院诊所的试点研究

Acta Medica Lituanica Pub Date : 2024-05-22 DOI: 10.15388/amed.2024.31.1.12

Monika Remenčiūtė, Greta Varžaitytė, G. Žemgulytė

{"title":"The Effect of Calcitonin Gene-Related Peptide Monoclonal Antibodies on Quality of Life among Migraine Patients: Pilot Study at the Hospital of Lithuanian University of Health Sciences Kaunas Clinics","authors":"Monika Remenčiūtė, Greta Varžaitytė, G. Žemgulytė","doi":"10.15388/amed.2024.31.1.12","DOIUrl":"https://doi.org/10.15388/amed.2024.31.1.12","url":null,"abstract":"Background: Migraine has a negative impact on patients’ quality of life, with the frequency of attacks being associated with greater disability and poorer health status. Frequent migraine-type headaches require prophylactic treatment, which has so far been of limited effectiveness until advent of calcitonin gene-related peptide (CGRP) monoclonal antibody.Materials and Methods: A prospective analysis was conducted of data from 41 migraine patients who experienced 4 or more monthly migraine days (MMD) longer than three months. At the beginning of the study, treatment with monoclonal antibodies against CGRP (fremanezumab 225 mg or erenumab 70 or 140 g per month) was prescribed according to the indications. The effect of the medications was evaluated after 3-month period.Results: The mean age of patients was 37.17 (±11.78) years. It was found that 17 patients (41.5%) had episodic migraine (EM) and 24 (58.5%) had chronic migraine (CM). Fremanezumab was prescribed to 26 patients (63.4%) and erenumab to 15 patients (36.6%); among the latter, 13 patients used 70 mg/month and 2 patients used 140 mg/month. Three months after treatment, CM changed to EM for 19 patients (79.2%), 27 patients (65.9%) had ≥50% reduction in the number of MMD and total migraine disability assessment (MIDAS) score was reduced by >50% in 31 patients (75.6%). Also, all areas of quality of life of patients were improved after 3 months continued treatment compared to baseline.Conclusions: For more than half the patients using fremanezumab or erenumab after 3-month period, MMD decreased by ≥50% and total MIDAS score by >50 points. All areas of quality of life were improved after prophylactic treatment of migraine.","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"18 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141111536","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}

引用次数: 0

Mechanical Thrombectomy in Medium Vessels Occlusion (MeVOs): An Institutional Experience with M2 Divisions of Middle Cerebral Artery 中血管闭塞（MeVOs）的机械血栓切除术：大脑中动脉 M2 分部的机构经验

Acta Medica Lituanica Pub Date : 2024-05-22 DOI: 10.15388/amed.2024.31.1.18

Bheru Dan Charan, Shailesh B. Gaikwad, Savyasachi Jain, Ajay Garg, Leve Joseph Devarajan Sebastian, M. P. Srivastava, Rohit Bhatia, Awadh Kishore Pandit, Shashank Sarad Kale

{"title":"Mechanical Thrombectomy in Medium Vessels Occlusion (MeVOs): An Institutional Experience with M2 Divisions of Middle Cerebral Artery","authors":"Bheru Dan Charan, Shailesh B. Gaikwad, Savyasachi Jain, Ajay Garg, Leve Joseph Devarajan Sebastian, M. P. Srivastava, Rohit Bhatia, Awadh Kishore Pandit, Shashank Sarad Kale","doi":"10.15388/amed.2024.31.1.18","DOIUrl":"https://doi.org/10.15388/amed.2024.31.1.18","url":null,"abstract":"Background: Mechanical thrombectomy has been established as a safe, standard and effective treatment option for occlusions of the proximal segment of the middle cerebral artery (MCA), as demonstrated in numerous studies. However, performing thrombectomy in the M2 divisions of MCA presents inherent challenges. In this institutional experience, we aim to delineate the recanalisation rates achieved through mechanical thrombectomy in cases involving the M2 segment of the MCA.Methods: We conducted a retrospective analysis of patients who underwent thrombectomy due to M2 MCA occlusions in the period from January 2018 to December 2021. Various factors affecting recanalisation rates were assessed.Results: A total of 15 patients with M2 segment occlusions of the middle cerebral artery were included in the study, comprising 11 in the superior division and 4 in the inferior division. The successful recanalisation rate was 72.33%, with notably higher success observed in cases of inferior division occlusion. The primary outcome of our study was the mTICI recanalisation status, categorised as successful recanalisation (mTICI = 2b or mTICI = 3) and unsuccessful recanalisation (mTICI = 1 or mTICI = 2a) and mRS at 6 months. None of the predictors assessed reached statistical significance.Conclusions: Mechanical thrombectomy demonstrates favourable efficacy and recanalisation rates in cases of M2 MCA division occlusion. Notably, inferior division occlusions exhibit a higher likelihood of successful recanalisation.","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"55 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141113458","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}

引用次数: 0

A Systematic Review about Cervical Pregnancy and our Experience 关于宫颈妊娠的系统回顾和我们的经验

Acta Medica Lituanica Pub Date : 2024-05-22 DOI: 10.15388/amed.2024.31.1.13

K. Nikolettos, Efthymios Oikonomou, Sonia Kotanidou, Nektaria Kritsotaki, Dimitrios Kyriakou, Panagiotis Tsikouras, Emmanouil Kontomanolis, A. Gerede, Nikos Nikolettos

{"title":"A Systematic Review about Cervical Pregnancy and our Experience","authors":"K. Nikolettos, Efthymios Oikonomou, Sonia Kotanidou, Nektaria Kritsotaki, Dimitrios Kyriakou, Panagiotis Tsikouras, Emmanouil Kontomanolis, A. Gerede, Nikos Nikolettos","doi":"10.15388/amed.2024.31.1.13","DOIUrl":"https://doi.org/10.15388/amed.2024.31.1.13","url":null,"abstract":"Background: Cervical ectopic pregnancy is a relatively rare type of ectopic pregnancy and has no standardized guidelines for management.Methods: This systematic review is based on the collection of case reports, published in PubMed/MEDLINE about the resolution of ectopic cervical pregnancies over the last decade and the presentation of a case managed in our healthcare unit. Studies involving cervical pregnancy in the first trimester with the presence of a viable embryo and β-hCG in the serum below 100.000 mIU/mL were included, while heterotopic pregnancies were excluded.Results: Nineteen articles reporting twenty-three case reports are demonstrated explicitly emphasizing on the management techniques. There is no established approach for the management of this type of ectopic pregnancy.Conclusion: It is important to consider the conservative approaches as first-line treatment in all cases of cervical pregnancy preserving fertility. Minimally invasive methods are also described and preferred as second-line treatment, as reported in our literature review.","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"60 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141110460","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}

引用次数: 0

The Assessment of CDX1, IHH, SHH, GATA4, FOXA2, FOXF1 in Congenital Intra-Abdominal Adhesions CDX1、IHH、SHH、GATA4、FOXA2、FOXF1 对先天性腹腔内粘连的评估

Acta Medica Lituanica Pub Date : 2024-05-22 DOI: 10.15388/amed.2024.31.1.15

Helēna Freijere Pope, M. Pilmane, Anna Junga, A. Petersons

{"title":"The Assessment of CDX1, IHH, SHH, GATA4, FOXA2, FOXF1 in Congenital Intra-Abdominal Adhesions","authors":"Helēna Freijere Pope, M. Pilmane, Anna Junga, A. Petersons","doi":"10.15388/amed.2024.31.1.15","DOIUrl":"https://doi.org/10.15388/amed.2024.31.1.15","url":null,"abstract":"Congenital abdominal adhesions are a rare condition that can result in a small bowel obstruction at any age, more frequently in pediatric populations. The cause remains unknown, and the importance of aberrant congenital bands is related to the difficulty of diagnosis, and cases of death with late detection have been documented. This research examines the expression of Caudal Type Homeobox 1 (CDX1), Indian Hedgehog (IHH), Sonic Hedgehog (SHH), GATA Binding Protein 4 (GATA4), Forkhead Box A2 (FOXA2) and Forkhead Box F1 (FOXF1) gene expression in human abdominal congenital adhesion fibroblast and endothelium cells by chromogenic in situ hybridization, with the aim of elucidating their potential association with the etiology of congenital intra-abdominal adhesion band development. The potential genes’ signals were examined using a semi-quantitative approach. Significant correlations were observed between the expression of CDX1 (p <.001) and SHH (p=0.032) genes in fibroblasts from congenital intra-abdominal adhesions compared to fibroblasts from control peritoneal tissue. Statistically significant very strong correlations were found between the CDX1 and IHH comparing endothelium and fibroblast cells in congenital abdominal adhesion bands. There was no statistically significant difference found in the distribution of IHH, FOXA2, GATA4, and FOXF1 between the fibroblasts and endothelium of the patients compared to the control group. The presence of notable distinctions and diverse associations suggests the potential involvement of numerous morpho-pathogenetic processes in the development of intraabdominal adhesions.","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"42 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141109874","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}

引用次数: 0

Survival after Consecutive Myocardial Infarction and Stroke: A Case Report 连续心肌梗死和中风后的存活率：病例报告

Acta Medica Lituanica Pub Date : 2024-05-22 DOI: 10.15388/amed.2024.31.1.14

Kristina Ratautė, Greta Burneikaitė, Jolita Badarienė

引用次数: 0

Double Parathyroid Adenoma Presenting as One Mass: A Case Report 双甲状旁腺腺瘤表现为一个肿块：病例报告

Acta Medica Lituanica Pub Date : 2024-05-22 DOI: 10.15388/amed.2024.31.1.20

Rugilė Petruokaitė, V. Eismontas, N. Samalavičius

{"title":"Double Parathyroid Adenoma Presenting as One Mass: A Case Report","authors":"Rugilė Petruokaitė, V. Eismontas, N. Samalavičius","doi":"10.15388/amed.2024.31.1.20","DOIUrl":"https://doi.org/10.15388/amed.2024.31.1.20","url":null,"abstract":"Background and Objectives: Primary hyperparathyroidism is a common endocrinological condition, which is usually caused by solitary parathyroid adenoma. The aim of this article is to present a case of double adenoma presenting as one and literature review on this topic.Case presentation: 56 years old female suffering from generalized fatigue, bone pain, unstable body weight and palpitations was diagnosed with primary hyperparathyroidism. Further investigation revealed elevated parathyroid hormone (PTH), ionized and total calcium levels. Imaging showed two adenomas merging into one. Parathyroidectomy was performed and final intraoperative PTH (IOPTH) decreased by 71.6%. Parathyroid adenoma measuring 40 mm x 15 mm x 11 mm and weighing 1 g 483 mg was excised. 7 weeks after surgery patient was feeling well but her PTH level was elevated again.Conclusions: As far as we know, the double parathyroid adenoma presented in this case report is the largest reported in the Northern Europe and the first one that presents as one mass within the region. Double adenoma increases the risk of recurrent primary hyperparathyroidism (PHPT) and requires more careful and longer follow up after surgery than solitary adenomas. Final IOPTH must decrease by at least 50% within 10 minutes. This case shows that despite final IOPTH drop by more than 50%, after few weeks normocalcemic elevated parathyroid hormone (NCePTH) phenomenon was noticed. This phenomenon does not indicate surgical failure.","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"59 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141110605","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}

引用次数: 0

Imaging and MR Spectroscopy in Papillary Craniopharyngioma 乳头状颅咽管瘤的成像和磁共振波谱分析

Acta Medica Lituanica Pub Date : 2024-05-22 DOI: 10.15388/amed.2024.31.1.10

Ashima Mahajan, Bheru Dan Charan, Sushant Agarwal, Vinay Goel, Leve Joseph Devarajan Sebastian, Vaishali Suri, Ashish Suri, Ajay Garg

引用次数: 0

Beyond Benign: A Case of Subependymal Giant Cell Astrocytomas Provoking Hydrocephalus in Tuberous Sclerosis Complex 超越良性：一例结节性硬化症复合体腮腺下巨细胞星形细胞瘤引发脑积水的病例

Acta Medica Lituanica Pub Date : 2024-05-22 DOI: 10.15388/amed.2024.31.1.9

A. Navarro-Ballester, Rosa Álvaro-Ballester, Miguel Ángel Lara-Martínez

{"title":"Beyond Benign: A Case of Subependymal Giant Cell Astrocytomas Provoking Hydrocephalus in Tuberous Sclerosis Complex","authors":"A. Navarro-Ballester, Rosa Álvaro-Ballester, Miguel Ángel Lara-Martínez","doi":"10.15388/amed.2024.31.1.9","DOIUrl":"https://doi.org/10.15388/amed.2024.31.1.9","url":null,"abstract":"22-year-old male diagnosed with Tuberous Sclerosis Complex (TSC), a genetic disorder characterized by benign tumors in various organs, with a focus on neurological implications. Central to the study is the development of Subependymal Giant Cell Astrocytomas (SEGAs), leading to hydrocephalus in the patient. The diagnosis of TSC was made in the patient’s childhood, and he was monitored regularly. The study highlights a significant growth in a subependymal nodule, leading to monoventricular hydrocephalus. MRI scans played a crucial role in identifying the progression of SEGAs and the subsequent hydrocephalus. The treatment approach involved endoscopic surgical removal of the SEGA, with histopathology confirming the diagnosis. Post-surgical outcomes over an eight-year follow-up period showed a normalization in ventricular size and the stability of other subependymal nodules, without any complications. This case underscores the importance of regular monitoring for TSC patients, early intervention for complications like hydrocephalus, and the need for a multidisciplinary treatment approach. The case study provides valuable insights into the management of neurodevelopmental disorders and the complexities surrounding TSC and SEGAs.","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"5 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141110959","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}

引用次数: 0