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A standardised model for stool banking for faecal microbiota transplantation: a consensus report from a multidisciplinary UEG working group
No full textBACKGROUND: Fecal microbiota transplantation is an emerging therapeutic option, particularly for the treatment of recurrent Clostridioides difficile infection. Stool banks that organise recruitment and screening of feces donors are being embedded within the regulatory frameworks described in the European Union Tissue and Cells Directive and the technical guide to the quality and safety of tissue and cells for human application, published by the European Council. OBJECTIVE: Several European and international consensus statements concerning fecal microbiota transplantation have been issued. While these documents provide overall guidance, we aim to provide a detailed description of all processes that relate to the collection, handling and clinical application of human donor stool in this document. METHODS: Collaborative subgroups of experts on stool banking drafted concepts for all domains pertaining to stool banking. During a working group meeting in the United European Gastroenterology Week 2019 in Barcelona, these concepts were discussed and finalised to be included in our overall guidance document about fecal microbiota transplantation. RESULTS: A guidance document for all domains pertaining to stool banking was created. This document includes standard operating manuals for several processes involved with stool banking, such as handling of donor material, storage and donor screening. CONCLUSION: The implementation of fecal microbiota transplantation by stool banks in concordance with our guidance document will enable quality assurance and guarantee the availability of donor feces preparations for patients
Alcohol control policies in Former Soviet Union countries: A narrative review of three decades of policy changes and their apparent effects
No full textIssues: The last Soviet anti-alcohol campaign of 1985 resulted in considerably reduced alcohol consumption and saved thousands of lives. But once the campaign's policies were abandoned and the Soviet alcohol monopoly broken up, a steep rise in mortality was observed in many of the newly formed successor countries, although some kept their monopolies. Almost 30 years after the campaign's end, the region faces diverse challenges in relation to alcohol. Approach: The present narrative review sheds light on recent drinking trends and alcohol policy developments in the 15 Former Soviet Union (FSU) countries, highlighting the most important setbacks, achievements and best practices. Vignettes of alcohol control policies in Belarus, Estonia, Kazakhstan, Lithuania and Uzbekistan are presented to illustrate the recent developments. Key findings: Over the past decade, drinking levels have declined in almost all FSU countries, paralleled by the introduction of various alcohol-control measures. The so-called three 'best buys' put forward by the World Health Organization to reduce alcohol-attributable burden (taxation and other measures to increase price, restrictions on alcohol availability and marketing) are relatively well implemented across the countries. Implications: In recent years, evidence-based alcohol policies have been actively implemented as a response to the enormous alcohol-attributable burden in many of the countries, although there is big variance across and within different jurisdictions. Conclusion: Strong declines in alcohol consumption were observed in the 15 FSU countries, which have introduced various alcohol control measures in recent years, resulting in a reduction of alcohol consumption in the World Health Organization European region overall
Evaluation of chromosomal structural anomalies in fertility disorders
No full textBackground and objectives: Reproductive disorders may occur not only due to environmental factors (air pollution, stressful lifestyle, previous abortions or the use of contraceptives) but also due to genetic factors. Materials and Methods: The aim of the study was to identify the range and frequency of chromosomal aberrations in couples (n=99) with infertility or recurrent miscarriages in Lithuania. The data were collected from the out-patient medical histories. The couples were divided into three groups based on pregnancy, childbirth and the number of miscarriages. [...]
Impulsivity mediates associations between problematic internet use, anxiety, and depressive symptoms in students: a cross-sectional COVID-19 study
No full textBackground: Problematic internet use (PIU) is a serious global mental health issue that especially manifested during the Coronavirus disease (COVID-19) pandemic. Engagement in PIU as an impulsive coping with mental distress may pose a long-lasting threat to develop anxiety and depressive disorders. The first aim of our study was to investigate the prevalence of PIU and mental distress symptoms during the COVID-19 pandemic among university students in Lithuania. The second aim was to test the hypothesis that PIU affects anxiety and depressive symptoms through the mediating role of impulsivity. Methods: The cross-sectional study was comprised of 619 university students (92.9% females and 7.1% males) with a mean age of 22 ± 3 years who participated in an online survey from May to November, 2020. Participants completed the following scales: the Problematic Internet Use Questionnaire-9, the Generalized Anxiety Disorder Questionnaire-7, the Patient Health Questionnaire-9, and the Barratt Impulsiveness Scale-11. K-means cluster analysis and one-way multivariate analysis of variance were used for group comparison in terms of internet use time and habit change during COVID-19 pandemic. Structural equation modeling was applied to examine the mediating effect of impulsivity in association between PIU and mental distress, while controlling for age. Results: In sum, 45.1% of the participants reported PIU and 38.1% had markedly expressed symptoms of anxiety while 43.6% of the students reported moderate to severe depressive symptoms. During the COVID-19 pandemic 76% of the students reported at least moderate increase in their internet use time. Anxiety and depressive symptoms were significantly higher in the group of frequent internet users. The results of the structural equational modeling analysis showed a statistically significant effect of PIU on subjective anxiety symptoms and the statistically significant effect of PIU on subjective depression symptoms, both mediated via impulsivity. Conclusions: During COVID-19 pandemic, PIU, anxiety and depression symptoms are highly prevalent among students. Findings also suggest that relationships between PIU, anxiety and depressive symptoms are mediated via impulsivity. These results underscore the importance of the inclusion of impulsivity factor in the studies analyzing longitudinal effects of PIU on mental distress during COVID-19 pandemic
Outcome of treatment of MDR-TB or drug-resistant patients treated with bedaquiline and delamanid: results from a large global cohort
No full textThe World Health Organization (WHO) recommends countries introduce new anti-TB drugs in the treatment of multidrug-resistant tuberculosis. The aim of the study is to prospectively evaluate the effectiveness of bedaquiline (and/or delamanid)- containing regimens in a large cohort of consecutive TB patients treated globally. This observational, prospective study is based on data collected and provided by Global Tuberculosis Network (GTN) centres and analysed twice a year. All consecutive patients (including children/adolescents) treated with bedaquiline and/or delamanid were enrolled, and managed according to WHO and national guidelines. Overall, 52 centres from 29 countries/regions in all continents reported 883 patients as of January 31st 2021, 24/29 countries/regions providing data on 100% of their consecutive patients (10-80% in the remaining 5 countries). The drug-resistance pattern of the patients was severe (>30% with extensively drug-resistant -TB; median number of resistant drugs 5 (3-7) in the overall cohort and 6 (4-8) among patients with a final outcome). For the patients with a final outcome (477/883, 54.0%) the median (IQR) number of months of anti-TB treatment was 18 (13-23) (in days 553 (385-678)). The proportion of patients achieving sputum smear and culture conversion ranged from 93.4% and 92.8% respectively (whole cohort) to 89.3% and 88.8% respectively (patients with a final outcome), a median (IQR) time to sputum smear and culture conversion of 58 (30-90) days for the whole cohort and 60 (30-100) for patients with a final outcome and, respectively, of 55 (30-90) and 60 (30-90) days for culture conversion. Of 383 patients treated with bedaquiline but not delamanid, 284 (74.2%) achieved treatment success, while 25 (6.5%) died, 11 (2.9%) failed and 63 (16.5%) were lost to follow-up
Pandemic coronavirus pneumonia diagnostics: clinical features, laboratory tests and radiology examination
No full textHuman coronaviruses are positive chain RNR viruses and belong to Coronaviridae family. Three types of coronaviruses were transmitted from animals to humans resulting in epidemic and global pandemic in the last twenty years. The clinical course of these infections vary from completely asymptomatic or mild respiratory symptoms to severe pneumonia with acute respiratory distress and multiple organ dysfunction syndromes. The main diagnostic method for all 3 types of viruses is Reverse transcriptase - Polymerase chain reaction (RT-PCR). Other laboratory tests and imaging methods are helpful for following clinical course of infection and diagnosing complications caused by it but are not necessary for the initial diagnosis. Aim: The purpose of this analysis is to discuss the main clinical findings, laboratory and radiological diagnostic methods for SARS-CoV-1, MERS, and SARS-CoV-2. Methods: the review of literature was managed by using “PubMed” medical database, selecting publications which investigated coronavirus pneumonia clinical features, laboratory and radiology diagnostics. Conclusion: after review of the literature clinical symptoms, laboratory and radiology examination are presented
Internet usage habits and experienced levels of psychopathology: a pilot study on association with spontaneous eye blinking rate
No full textIncreasing availability of the internet has resulted in the increased prevalence of problem-atic online behaviors. Reliable and affordable neurobiological and psychological biomarkers thatdistinguish problematic internet use (PIU) from functional online activities are of utmost importance.Previous studies have shown a relationship between spontaneous eye blinking rate (sEBR) andchanges in dopamine regulation in neurological and psychiatric disorders, including substance usedisorders. In this study, we utilized sEBR to examine the potential link between individual differencesin dopaminergic neurotransmission and PIU. In sum, 62 subjects participated in this study (medianage 25, IQR 6 years, 34 females). The Problematic Internet Use Questionnaire (PIUQ-9), Beck Depres-sion Inventory (BDI-II), Beck Anxiety Inventory (BAI), Clark–Beck Obsessive–Compulsive Inventory(CBOCI) and Barratt Impulsiveness Scale (BIS-11) were used for psychological assessment. The sEBRswere assessed with an electrooculogram recorded from above and below the left eye and from theright and left outer canthi. The group with PIU (PIUQ-9 > 20) expressed higher levels of impulsivityand compulsive behavior symptoms than the control group. In the group with PIU, impulsivitylevels were inversely related to sEBR, and a trend of negative association of sEBR with compulsivebehavior was observed. Future research should enroll subjects with high levels of PIU and stronglyexpressed psychopathology levels to further address the utility of sEBR as a potential biomarker
Epidemiology of chronic kidney disease in children: a report from Lithuania
No full textBackground and Objectives: The data on the prevalence of chronic kidney disease (CKD) in the pediatric population are limited. The prevalence of CKD ranges from 56 to 74.7 cases per million of the age-related population (pmarp). The most common cause of CKD among children is congenital anomalies of the kidney and urinary tract (CAKUT). With progressing CKD, various complications occur, and end-stage renal disease (ESRD) can develop. The aim of the study was to determine the causes, stage, prevalence, and clinical signs of CKD and demand for RRT (renal replacement therapy) among Lithuanian children in 2017 and to compare the epidemiological data of CKD with the data of 1997 and 2006. Materials and Methods: The data of 172 Lithuanian children who had a diagnosis of CKD (stage 2–5) in 1997 (n = 41), in 2006 (n = 65), and in 2017 (n = 66) were retrospectively analyzed. Physical development and clinical signs of children who had CKD (stage 2–5) in 2017 were assessed. Results: The prevalence of CKD stages 2–5 was 48.0 pmarp in 1997; 88.7 in 2006; and 132.1 in 2017 (p < 0.01). Congenital and hereditary diseases of the kidney in 1997 accounted for 66% of all CKD causes; in 2006, for 70%; and in 2017, for 79%. In 2017, children with CKD stages 4 or 5 (except transplanted children) had hypertension (87.5%) and anemia (50%) (p < 0.01). Children under ≤2 years with CKD were at a 3-fold greater risk of having elevated blood pressure (OR = 3.375, 95% CI: 1.186–9.904). Conclusions: There was no change in the number of children with CKD in Lithuania; however, the prevalence of CKD increased due to reduced pediatric population. CAKUT remains the main cause of CKD at all time periods. Among children with CKD stages 4 or 5, there were more children with hypertension and anemia. In children who were diagnosed with CKD at an early age hypertension developed at a younger age
Algorithm for automated foot detection in thermal and optical Images for temperature asymmetry analysis
No full textInfrared thermography has been proven to be an effective non-invasive method in diabetic foot ulcer prevention, yet current image processing algorithms are inaccurate and impractical for clinical work. The aim of this study was to investigate the accuracy of our automated algorithm for feet outline detection and localization of potential inflammation regions in thermal images. Optical and thermal images were captured by a Flir OnePro camera connected with an Apple iPad Air tablet. Both thermal and optical images were merged into an edge image and used for the estimation of foot template transformations during the localization process. According to the feet template transformations, temperature maps were calculated and compared with each other to detect a set of regions exceeding the defined temperature threshold. Finally, a set of potential inflammation regions were filtered according to the blobs features to obtain the final list of inflammation regions. In this study, 168 thermal images were analyzed. The developed algorithm yielded 95.83% accuracy for foot outline detection and 94.28% accuracy for detection of the inflammation regions. The presented automated algorithm with enhanced detection accuracy can be used for developing a mobile thermal imaging system. Further studies with patients who have diabetes and are at risk of foot ulceration are needed to test the significance of our developed algorithm
Global study of human heart rhythm synchronization with the Earth's time varying magnetic field
No full textChanges in geomagnetic conditions have been shown to affect the rhythms produced by the brain and heart and that human autonomic nervous system activity reflected in heart rate variability (HRV) over longer time periods can synchronize to changes in the amplitude of resonant frequencies produced by geomagnetic field-line and Schumann resonances. During a 15-day period, 104 participants located in California, Lithuania, Saudi Arabia, New Zealand, and England underwent continuous ambulatory HRV monitoring. The local time varying magnetic field (LMF) intensity was obtained using a time synchronized and calibrated network of magnetometers located at five monitoring sites in the same geographical locations as the participant groups. This paper focuses on the results of an experiment conducted within the larger study where all of the participants simultaneously did a heart-focused meditation called a Heart Lock-In (HLI) for a 15-min period. The participant's level of HRV coherence and HRV synchronization to each other before, during and after the HLI and the synchronization between participants' HRV and local time varying magnetic field power during each 24-h period were computed for each participant and group with near-optimal chaotic attractor embedding techniques. In analysis of the participants HRV coherence before, during and after the HLI, most of the groups showed significantly increased coherence during the HLI period. The pairwise heart rhythm synchronization between participants' in each group was assessed by determining the Euclidean distance of the optimal time lag vectors of each participant to all other participants in their group. The group member's heart rhythms were significantly more synchronized with each other during the HLI period in all the groups. The participants' daily LMF-HRV-synchronization was calculated for each day over an 11-day period, which provided a 5-day period before, the day of and 5-days after the HLI day. The only day where all the groups HRV was positively correlated with the LMF was on the day of the HLI and the synchronization between the HRV and LMF for all the groups was significantly higher than most of the other days