Vilnius University Press Scholarly Journals
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High Bifurcation of the Common Carotid Artery with Pentafurcation of the External Carotid Artery: Case Series with Review of Literature
No full textThe bifurcation of the Common Carotid Artery (CCA) is a pivotal anatomical landmark in head and neck surgeries, particularly affecting procedures such as carotid endarterectomy. Typically occurring around the C3-C4 intervertebral disc, variations in its location can complicate surgical access and pose risks of nerve injury. In this case report, three rare bilateral high bifurcations of the CCA at the C2 and C2/3 vertebrae levels are documented. Additionally, an unusual pentafurcation of the External Carotid Artery (ECA) and bilateral superior thyroid artery are observed, arising directly from the CCA. The high bifurcation presents challenges due to its proximity to nerves such as the hypoglossal nerve, potentially leading to complications such as dysphagia or speech impairment. Furthermore, it complicates procedures like carotid endarterectomy, necessitating additional techniques for adequate exposure and increasing risks of Internal Carotid Artery (ICA) thrombosis. Detailed preoperative imaging before surgery is important for effective planning and minimizing the surgical risk. Anatomical variation, such as the vascular structure, can significantly affect surgical and interventional outcomes. Identifying these differences through meticulous evaluation enables surgeons to anticipate potential challenges, reduce complications, and enhance patient outcomes
The Silent Shunt: Traumatic Splenic AV Fistula Revealed and Treated Endovascularly
No full textBackground: Splenic arteriovenous fistula (AVF) is a rare vascular anomaly that can arise from trauma, aneurysmal rupture, or congenital conditions. Prompt diagnosis and management are crucial to preventing complications such as portal hypertension and high-output cardiac failure.Case Presentation: We present the case of a 62-year-old male with a traumatic splenic AVF resulting from a road traffic accident (RTA), associated with a Grade IV splenic injury and multiple pseudoaneurysms. The patient underwent successful endovascular coil embolization and experienced an asymptomatic follow-up.Conclusion: Endovascular coil embolisation is a minimally invasive and effective first-line treatment for traumatic splenic AVFs, particularly in hemodynamically stable patients, providing excellent outcomes and organ preservation
Pathomorphological Patterns of Placental Dysfunction in Late Manifestation of Fetal Growth Restriction
No full textFetal growth restriction is one of the main factors contributing to neonatal mortality, stillbirth, and cardiovascular dysfunction in a fetus and newborn, where one of the common causes is placental dysfunction; it can occur as a result of placental vascular anomalies, which requires clarification and systematization of existing scientific provisions based on the assessment of morphological patterns of fetoplacental circulatory disorders.The aim of the study was to investigate and evaluate morphological markers of fetoplacental blood flow disorders in late manifestation of fetal growth restriction by pathohistological examination of placental tissue.Materials and methods: Clinical and anamnestic features were assessed in 80 pregnant women with late manifestation of fetal growth restriction (the main group of research) and in 40 patients with a timely labour and birth of fetuses with normal fetometry parameters for the gestational age. 32 and 10 placental tissue samples were selected in the main group and in the comparison group, respectively, for pathohistological examination, and a postnatal macro-histomorphological assessment of the placenta was performed.Results: Postnatal macromorphometric characteristics of placental tissue reflect pathological features of its formation, dominated by an abnormal shape (46–57.5%), eccentric umbilical cord insertion (43–53.8%) with main and intermediate types of vascular branching (37–46.2%), and a statistically lower placental weight and diameter. A combination of maternal and fetal vascular malperfusion was noted, with the following most significant markers: infarctions (13–40.6%), distal villous hypoplasia (24–75.0%), increased syncytial nodules as a manifestation of delayed villous maturation as a manifestation of premature maturation (24–75.0%), decidual arteriopathy (13–40.6%). Analysis of histopathological data indicates malperfusion of the fetal vessels, with the proportion of villitis and markers of intrauterine infection verified in one third of the samples (13–40.6%).Conclusions: In cases of late-onset fetal growth restriction, placental lesions occur with the development of maternal and fetal vascular malperfusion. Pathomorphological criteria of maternal vascular malperfusion are statistically significant in the main group: infarctions, distal villous hypoplasia, decidual arteriopathy, and chorionic villous dysmaturation. Fetal vascular malperfusion is characterized by obliteration and thrombosis of the stem vessels of the anchoring and intermediate villi, avascularization, hyalinosis of the villi, and, less frequently, delayed maturation with the development of stromal-vascular karyorexis. In our study, both Type 1 and Type 2 fetal vascular malperfusion in different placentas with fetal growth restriction were found, but the segmental type was still the most common
Obstructed Hemivagina, Uterine Didelphys, and Ipsilateral Renal Agenesis: A Case Report of OHVIRA Syndrome
No full textBackground: Obstructed hemivagina and ipsilateral renal agenesis (OHVIRA) syndrome is a rare congenital anomaly of the female urogenital tract. This report presents the clinical features, diagnostic approach, and management of an adolescent girl with OHVIRA syndrome.Clinical case: A 14-year-old female was admitted with abdominal pain and irregular menstruation. Ultrasonography and MRI demonstrated uterus didelphys with right-sided hematometrocolpos and ipsilateral renal agenesis. External genital examination revealed an intact hymen with a bluish bulge 2 cm above the hymenal ring. Surgical exploration confirmed an obstructed right hemivagina, which was opened while preserving hymenal integrity. Menstrual blood was drained, and a Foley catheter was placed temporarily to ensure patency. The postoperative course was uneventful, and the patient was discharged on the second day.Discussion and Conclusions: This case illustrates successful surgical management of OHVIRA syndrome while preserving hymenal integrity. Early diagnosis and imaging are essential to prevent complications such as hematometrocolpos, endometriosis, and infertility
Validation of the Lithuanian Version of the Parental Burnout Assessment (PBA-LT)
No full textBackground. Parenting is both a complex and stressful activity. When parenting stress severely and chronically overwhelms parents’ resources to cope, parental burnout occurs. The purpose of this study was to validate the Parental Burnout Assessment (PBA) for researching a Lithuanian sample of parents. Methods. Questionnaire included demographics, Parental Burnout Assessment, Emotional Regulation Questionnaire, and Co-parental Cooperation tool. The data were collected from a sample of 208 Lithuanian parents. Results. The value for Cronbach’s alpha in Lithuania was high and similar to other studies. Confirmatory factorial analysis confirmed the four-factor structure of the PBA. The average parental burnout reported was higher than in other studies. The correlations of the PBA-LT with other variables replicate previous studies and serve as evidence for the validity. Younger age, having a child aged 0–4 years, not having a paid professional activity, suppression of emotions, and not having emotion regulation skills are the risk factors of parental burnout. Conclusions. The study supports the high internal consistency of PBA-LT, and the four-factor structure of the PBA-LT has been confirmed
The Model of Associations Between Self-Assessed Critical Thinking Skills, Their Perceived Importance and Work Engagement
No full texthe purpose of this study was to explore the links between the perceived importance of critical thinking skills, self-reported critical thinking skills, and work engagement. The study applied a cross-sectional design, and the sample consisted of 2012 employees; the mean age was 41.93 (SD=11.42). To analyse the links between the constructs, three instruments were used: The Work Engagement Scale (UWES), The Perceived Importance of the Critical Thinking Skills Scale (PICTS), and The self-reported Critical Thinking Skills Scale (CTS). For the statistical analyses, SPSS v.26.0, AMOS v.26.0, JASP v.18, and JAMOVI v.2.2.1 software was applied. Confirmatory factor analyses showed the acceptable model fit and validity of the scales in the Lithuanian population.
The structural equation modelling results revealed the complex model of the links between the perceived importance of critical thinking skills, the self-reported critical thinking skills, and the elements of work engagement, namely, vigour, dedication, and absorption. The findings revealed that both self-reported critical thinking and the perceived importance of critical thinking skills positively contributed to work engagement, thus indicating the need to foster critical thinking in organizations so that to ensure their flourishing and efficacy
Between Reform and Reality: Social Marginalization and Public Health Challenges for Migrant Farmers in Rural China
No full text Migrant farmers in China face severe social marginalization and public health challenges. Through participant observation and 52 semi-structured interviews, this study explores the structural factors and the systemic contradictions between their social marginalization and public health challenges. The findings reveal that inadequate reforms of the household registration system (the hukou system) and the political tasks in agriculture jointly shape the social marginalization of migrant farmers. The insufficiencies of the public health system in addressing migrants’ everyday healthcare needs highlight the relationship between identity and an exclusionary healthcare supply, harming their health and exacerbating potential risks. While reforms in social health insurance have improved the overall coverage, they have failed to fully address issues of underinsurance, marginalized status, and healthcare accessibility, thus leaving the structural inequality of migrant farmers’ healthcare unresolved. Moreover, their marginalized identity significantly impacts their mental health, as they endure persistent discrimination and disciplinary power, which poses long-term risks to their well-being. This study provides valuable insights into the mechanisms of social marginalization and public health challenges faced by migrant farmers in China
Meilė ir metodas. Arentiškosios tradicijos pamokos ir pavyzdys
No full textMaria Tamboukou, Epistolary Narratives of Love, Gender and Agonistic Politics. An Arendtian Approach, London, New York: Routledge, 2024, 182 p., ISBN 978-1032208428Maria Tamboukou, Epistolary Narratives of Love, Gender and Agonistic Politics. An Arendtian Approach, London, New York: Routledge, 2024, 182 p., ISBN 978-103220842
Ką mums pasakoja prelato Kazimiero Stepono Šaulio egodokumentai
No full textPrelato Kazimiero Stepono Šaulio dokumentai, sudarytojas Algimantas Katilius, Vilnius: Lietuvos nacionalinis muziejus, 2024, 292 p., ISBN 987-609-478-081-