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Clinical, electrical, and mechanical parameters in potassium channel-mediated congenital long QT syndrome /
No full textBackground: Congenital long QT syndrome (LQTS) is a rare cardiac disorder caused by repolarization abnormalities in the myocardium that predisposes to ventricular arrhythmias and sudden cardiac death. Potassium channel-mediated LQT1 and LQT2 are the most common types of channelopathy. Recently, LQTS has been acknowledged as an electromechanical disease. Methods: A total of 87 genotyped LQT1/LQT2 patients underwent cardiac evaluation. A comparison between LQT1 and LQT2 electrical and mechanical parameters was performed. Results: LQT2 patients had worse electrical parameters at rest: a longer QTc interval (p = 0.007), a longer Tpe in lead V2 (p = 0.028) and in lead V5 (p < 0.001), and a higher Tpe/QT ratio in lead V2 (p = 0.011) and in lead V5 (p = 0.005). Tpe and Tpe/QT remained significantly higher in the LQT2 group after brisk standing. Tpe was longer in LQT2 patients compared with LQT1 patients during peak exercise (p = 0.007) and almost all recovery periods in lead V2 during EST. The mid-cavity myocardium mean radial contraction duration (CD) was longer in LQT2 patients (p = 0.02). LQT2 patients had a longer mean radial CD in mid-septal (p = 0.015), mid-inferior (p = 0.034), and mid-posterior (p = 0.044) segments. Conclusions: Potassium channel-mediated LQTS has different effects on cardiac electromechanics with a more pronounced impact on LQT2 patients. Tpe was more prominent in the LQT2 cohort, not only at rest and brisk standing but also during EST exercise and at recovery phases. The altered mean radial CD in the mid-cavity myocardium was also specific for LQT2 patients
Perioperacinių veiksnių įtaka kolorektinio vėžio prognozei ir išgyvenamumui: literatūros apžvalga /
No full textThe social risk of family burden: concept and system of social security measures.
No full textThis paper analyses the concept of social risk of family burden, and by analysing the legislation of the Republic of Lithuania, it reveals the measures of the social protection system that are applied to it. The master’s thesis also analyses the peculiarities of social protection measures provided by the European Union countries to families facing social risk, for example, in cases of childbirth and/or child rearing and care of family members
Knowledge of traumatic dental injuries and their prevention using mouthguards among members of vu health and sports centre.
No full textProblem: Dental injuries are a pressing issue, often occurring during sports and negatively impacting an individual's health and quality of life. Athletes engaged in physical activity are at a higher risk of dental injuries. Insufficient knowledge about dental injury prevention and the importance of protective measures can lead to a higher incidence of injuries. To reduce the prevalence and consequences of injuries, it is crucial to assess athletes' level of knowledge, their attitudes toward preventive measures, and the need for education. Aim: To assess and compare the knowledge of members of VU Health and Sports Centre, involved in contact and non-contact sports, about dental injuries and their prevention using mouthguards. Tasks: 1. To determine and compare the level of knowledge about dental injuries among members of VU Health and Sports Centre engaged in contact and non-contact sports. 2. To determine and compare the attitudes among members of VU Health and Sports Centre engaged in contact and non-contact sports towards mouthguards and their use. 3. To assess and compare whether factors such as gender, age, duration and frequency of sports participation, previous facial, jaw or dental injuries, use of mouthguards, and the frequency of their use during training or competitions influence knowledge about dental injuries among contact and non-contact sport participants. 4. To find out the attitudes of members of the VU Health and Sports Centre towards their knowledge of dental injuries and the need for dental injury education. Material and methods: A voluntary, anonymous questionnaire survey was conducted from September 2024 to January 2025. The participants were divided into two groups based on the nature of their activity – individuals engaged in contact and non-contact sports. Data were collected using a mixed method: paper questionnaires and online surveys via the Google Forms platform. The questionnaire consisted of four main sections: 1) sociodemographic questions; 2) evaluation of knowledge about dental injuries; 3) self-assessment of knowledge about dental injuries and willingness to participate in educational programs; 4) personal experience with dental and orofacial injuries and aspects of mouthguard usage. Statistical data analysis was performed using IBM SPSS 26.0. The significance level was set at p<0.05. Results: A total of 157 respondents participated in the study, of which 36.3% (N=57) engage in contact sports, and 63.7% (N=100) engage in non-contact sports. The median knowledge score of all athletes regarding dental injuries was 5 (IQR=3) out of a possible 11 points. The median knowledge score of contact sport participants (M=6, IQR=4) was statistically significantly higher than that of the non-contact sport group (M=5, IQR=3) (p<0.001). The prevailing level of knowledge in both contact and non-contact sport groups was low. 91.2% (N=52) of contact sport participants know how a protective sports mouthguard works, compared to 49% (N=49) of non-contact sport participants (p<0.001). 92.4% (N=145) of respondents believe that protective sports mouthguards help prevent dental injuries, but only 19.7% (N=31) of all respondents use a protective sports mouthguard, with significantly more contact sport participants using it (45.6%, N=26) compared to non-contact sport participants (5%, N=5) (p<0.001). Conclusion: Knowledge about dental trauma and the use of mouthguards among athletes at VU Health and Sports Centre who participate in contact and non-contact sports is insufficient. Contact sports athletes had better knowledge and higher mouthguard usage compared to non-contact sports participants. In the contact sports group, better knowledge was associated with older age, less frequent training, previous dental trauma, and mouthguard use. Education on emergency management of dental injuries and the use of mouthguards during sports is essential to reduce the prevalence and complications of dental trauma
The effects of the violence prevention program „we are safe“ on adolescents psychological resilience and continuous traumatic stress reactions.
No full textChildhood violence and neglect are among the most traumatic experiences, causing not only short-term but also long-term consequences, especially when violence is experienced constantly. Living in conditions of threat and lack of security can cause continuous traumatic stress reactions, manifested in a reduced sense of security, lack of trust, emotional exhaustion, social isolation, and difficulties in regulating emotions. However, not all adolescents who have experienced violence experience difficulties – some of them are resilient. Such adaptation can be strengthened by various factors, including violence prevention programs that promote children’s protective factors. Thus, the aim of this study is to assess the impact of the violence prevention program “We are safe” on continuous traumatic stress reactions and psychological resilience. The study involved 14-17-year-old Lithuanian school students (N=81; in the control group, n=44, of which 50% were girls; in the exposure group, n=37, of which 51.4% were girls). The instruments used in the study were: “Child & Youth Resilience Measure-Revised”, “The Continuous Traumatic Stress Response Scale” and “Abuse”. A cluster random experiment design with control and exposure groups was chosen for the study. Results: participation in the violence prevention program “We are Safe” reduced the fear and helplessness reactions of adolescents who had experienced violence in their lifetime and in the past 2 months; reduced the exhaustion and detachment reactions of adolescents who had experienced violence for more than 2 months; the program did not affect the psychological resilience of adolescents who had experienced violence
Preeclampsia prevention with aspirin.
No full textPreeclampsia is a pregnancy complication clinically manifested by hypertension and organ dysfunction, leading to significant maternal and neonatal morbidity and mortality. Since the only definitive treatment for preeclampsia is delivery, preventive measures are crucial, with aspirin being one of the most effective options. The aim of this literature review is to evaluate the effectiveness of aspirin in preventing preeclampsia, determine the optimal dosage, timing of administration, and duration of treatment. Analysis of scientific studies suggests that aspirin administration before the 16th week of pregnancy, continued until the 40th week, is the most effective preventive strategy. While some studies indicate that the effectiveness of aspirin is independent of the initiation time, this review identified a trend suggesting that early administration is associated with a lower risk of preeclampsia. The most effective aspirin dosage is 150 mg/day; however, lower doses (60–100 mg/day) are also effective and safe. Additionally, evidence suggests that taking aspirin before bedtime may be more beneficial than administration in the morning or during the day. Overall, aspirin reduces the incidence of preeclampsia, with statistically significant data supporting its effectiveness. Based on the available evidence, it is recommended that high-risk pregnant women take 150 mg of aspirin per day from the 11th–12th week of pregnancy until the 40th week, preferably before bedtime. Future research should focus on determining the optimal aspirin dosage for different risk groups and clarifying its preventive guidelines
Clinical application of chemotherapy efficacy evaluation on individual pancreatic ductal adenocarcinoma organoid models: a literature review.
No full textPancreatic ductal adenocarcinoma is the most prevalent and aggressive form of pancreatic cancer, accounting for over 90% of cases. It is associated with poor prognosis, with a five-year survival rate below 10%, largely due to late-stage diagnosis, a highly desmoplastic tumor microenvironment, and resistance to standard therapies such as chemotherapy and radiotherapy. The molecular pathogenesis of pancreatic ductal adenocarcinoma is driven by genetic alterations, most notably KRAS mutations, which are present in over 90% of cases, along with TP53, SMAD4, and CDKN2A mutations that contribute to tumor progression, genomic instability, and resistance to therapy. The disease progresses from precursor lesions, such as pancreatic intraepithelial neoplasia (PanINs), intraductal papillary mucinous neoplasms (IPMNs), and mucinous cystic neoplasms (MCNs), through the accumulation of sequential genetic mutations leading to invasive carcinoma. The latest scientific literature presents various classification schemes for pancreatic ductal adenocarcinoma subtypes. Some researchers distinguish between classical, squamous, immunogenic, and aberrantly differentiated subtypes, each characterized by distinct transcriptional profiles and clinical implications. However, many studies adopt a more simplified molecular classification approach, often categorizing pancreatic ductal adenocarcinoma into two primary subtypes—classical and basal—based on key molecular characteristics. Despite extensive research, conventional preclinical models, including two-dimensional (2D) cell cultures, genetically engineered mouse models, and patient-derived xenografts, exhibit significant limitations in recapitulating the genetic heterogeneity, stromal interactions, and therapeutic responses observed in pancreatic ductal adenocarcinoma patients. In contrast, organoid models have emerged as a promising platform for studying pancreatic ductal adenocarcinoma biology and treatment response. These three-dimensional (3D) structures, derived from patient tumors, retain the genetic, molecular, and phenotypic characteristics of the original malignancy, allowing for a more accurate representation of tumor heterogeneity. Pancreatic ductal adenocarcinoma organoids can be generated from surgical resections, fine-needle aspiration biopsies (EUS-FNB), and metastatic lesions. These models have demonstrated high fidelity in preserving tumor-specific molecular subtypes and can be used for personalized drug screening and pharmacotyping. Recent advancements in organoid technology, including the incorporation of stromal components such as cancer-associated fibroblasts (CAFs) and immune cells, have improved their ability to replicate the tumor microenvironment. Additionally, innovative methodologies such as 3D bioprinting and microfluidic systems enhance the reproducibility and scalability of these models, facilitating their integration into high-throughput drug screening platforms. Circulating tumor cell (CTC)-derived organoids represent a novel avenue for studying pancreatic ductal adenocarcinoma metastasis and therapeutic resistance, though further validation is required for their clinical implementation. Despite challenges related to culture standardization, tumor heterogeneity, and microenvironmental complexity, patient-derived organoid models constitute a promising research platform for biomarker discovery, individualized treatment optimization, the development of novel targeted therapies, and the refinement of standard clinical therapeutic approaches, ultimately contributing to improved quality of life and enhanced survival prognosis for patients with pancreatic ductal adenocarcinoma
Impact of contact sports on injuries of the head and maxillofacial regions injuries among persons aged 18-25 years in the vilnius region.
No full textRelevance of the study. In today’s society, where physical activity is increasingly encouraged, contact sports are a particularly popular field of activity among young adults. However, contact sports are also closely associated with an increased risk of injury. The relevance of this research lies in the lack of modern, scientific studies on this topic in Lithuania. The study is based on the aim to assess the frequency of head, facial, and jaw injuries and their associated factors among 18–25-year-old individuals in the Vilnius region. The objective of the research was to evaluate the impact of contact sports on head, facial, and jaw injuries in the 18–25 age group within this region. Materials and methods. The study was conducted using a descriptive, cross-sectional research design. Participants were young individuals aged 18–25 residing in Vilnius city and district. Data were collected through a standardized electronic questionnaire consisting of six thematic sections covering physical activity, injury history, use of protective equipment, and respondents’ attitudes toward injuries and their prevention. Data analysis was performed using Microsoft Excel and SPSS 28 software. Chi-square and t-tests were applied to determine statistical significance, and Spearman’s correlation was used to measure associations. Results. A total of 221 respondents participated in the study, of whom 46.2% reported having experienced at least one head, facial, or jaw injury. Individuals engaged in contact sports sustained injuries significantly more often than those who were inactive or participated in non-contact sports (χ² = 23.60, p < 0.001). The injury rate was higher among male respondents compared to females. Only about one-quarter of physically active participants reported using protective equipment, although, overall, its importance was rated highly by the respondents. Nearly 70% of those who had experienced an injury sought medical attention, and the average recovery time was approximately 1.6 weeks. Spearman’s correlation analysis revealed a significant relationship between the perceived severity of injury and recovery duration (ρ = 0.618, p < 0.001). Conclusions. Contact sports significantly increase the risk of head and facial injuries. The hypothesis that young individuals engaged in contact sports experience injuries more frequently than their non-athletic peers was confirmed. The results highlight the need to promote the use of protective equipment and to raise awareness among young people about the risks and consequences of such injuries
Vestibular rehabilitation,neuromodulation and balance: clinical applications in otoneurology.
No full textVestibular disorders can lead to significant balance control problems, negatively affecting patients’ quality of life and limiting their daily activities. Incomplete natural vestibular compensation encourages the search for additional interventions that can enhance neuroplastic mechanisms and optimise functional recovery. Vestibular rehabilitation therapy is considered one of the most appropriate approaches for managing balance disorders, and in recent years, increasing attention has been given to non-invasive neuromodulation. Therefore, it is important to evaluate the role of these methods in modern otoneurological practice. Objective. To review vestibular rehabilitation therapy and non-invasive neuromodulation methods, focusing on their clinical applications in the field of otoneurology, based on scientific literature. Methods. A literature review was performed using the PubMed and ScienceDirect databases, as well as the Google Scholar search engine, employing English-language keywords. Priority was given to scientific publications from the past ten years. Results. Vestibular rehabilitation therapy, based on the principles of adaptation, substitution and habituation, is an effective treatment strategy for managing various peripheral and certain central vestibular disorders. However, rehabilitation outcomes depend on individual factors that may complicate the course of functional recovery. Non-invasive neuromodulation techniques, including repetitive transcranial magnetic stimulation, transcranial direct current stimulation, noisy galvanic vestibular stimulation and transcutaneous vagus nerve stimulation, offer the ability to modulate the activity of central or peripheral vestibular structures and enhance central compensation processes in conditions such as chronic vestibular hypofunction, Mal de Débarquement syndrome, persistent postural-perceptual dizziness, bilateral vestibulopathy or vestibular migraine. Nonetheless, the application of these methods continues to be largely experimental, and their integration into clinical practice still lacks high-quality scientific evidence. Conclusions. Vestibular rehabilitation therapy remains the main evidence-based treatment strategy for managing balance disorders. Non-invasive neuromodulation represents a promising adjunctive approach that may promote neuroplasticity, enhance vestibular compensation and improve functional recovery. In the future, the integration of these innovative methods into clinical practice could significantly contribute to the individualised management of balance disorders in the field of otoneurology