Acta Medica Lituanica最新文献

Background: Renal vascular injuries, like renal artery pseudoaneurysms and arteriovenous fistulas, are rare but serious complications following renal procedures and trauma. Standard management requires costly microcatheters for angioembolization. This study investigates a cost-effective method using diagnostic catheters and affordable coils in a low-resource setting.

Methods: We analyzed five patients from December 2023 to June 2024 who had persistent hematuria or hemoglobin drops after renal intervention or trauma. CT angiography identified their injuries, and angioembolization was performed with diagnostic catheters and coils, reducing procedural costs.

Results: The use of diagnostic catheters and coils successfully managed all cases. Patients experienced resolution of hematuria and were discharged in 2-3 days. Follow-up over three months revealed no recurrence or significant renal function issues.

Conclusion: Diagnostic catheters and coils offer an effective method for managing renal vascular injuries in resource-limited settings, achieving satisfactory outcomes with minimal morbidity.

Background: Nonsuicidal self-injurious behavior in children and adolescents is a major concern that requires mental health professionals' attention. The aim of this study is to analyze clinical care aspects of children and adolescents who self-harm in psychiatric hospitals.

Materials and methods: In 2023, 30 various specialists from five different child and adolescent psychiatric units in Lithuania were interviewed. The survey used a semistructured interview consisting of twelve questions related to complex clinical care methods of children and adolescents who self-harm. The interview responses were summarized and grouped into 5 categories: assessment and monitoring, methods and consequences of self-injury, safety measures, prevention and treatment, insights from staff.

Results: Self-injurious behavior in psychiatric inpatient settings was managed through risk assessment, monitoring, communication, medication, counselling, removal of sharp objects, patient allocation, and a several of other methods such as safety contracts, rewards or alternate pain-inducing or self-harm mimicking stimuli. Despite the hospital's safety procedures patients frequently devised alternate methods to self-harm, such as hitting and scratching themselves and using nonspecific materials.

Conclusions: The management of self-harm in children and adolescents psychiatric settings remains insufficient. Further research is needed to explore alternative ways of managing self-injurious behavior in child and adolescent psychiatric hospitals.

During the routine dissection of lower limb in a female cadaver of age 61 years, a rare variation in the extensor digitorum longus (EDL) muscle was noticed on the both legs. An EDL muscle with small belly dividing into two slips, which inserted on to the second and third digits on the right leg, whereas on the left leg divided into three slips, which inserted on to the second, third and fourth digits. There was also an accessory EDL muscle arising from the middle third of the medial surface of the fibula and inserted on to the fifth digit in the left foot, and it inserted on to the fourth and fifth digits in the right foot. To our knowledge, such variation hasn't been reported in literature and apprehension of such variations is important for surgeons and orthopaedicians with regards to contractures and surgical procedures concerning the anterior leg and dorsum of the foot.

Background: The distal tibia is one of the rarest sites for the onset of malignant and locally aggressive bone tumors. When diagnosed, these lesions should undergo surgical resection with wide margins to eradicate the disease. In the era of limb-sparing surgery, several reconstructive approaches have been proposed and described in modern literature for reconstructing the distal tibia and the ankle. The 3D-printed custom-made prostheses represent an innovative and promising reconstructive option. Several authors highlighted that despite being expensive and prone to some complications such as talar collapse or loosening and soft tissue necrosis, the megaprostheses of the distal tibia could lead to good functional outcomes, also allowing a better range of motion compared to the most common arthrodesis.

Materials and methods: We report two cases who suffered from malignant bone tumors localized in the distal tibia and treated with wide resections and the implant of 3D printed custom-made megaprostheses to replace the distal tibia and the ankle.

Results: Both patients had excellent functional results (MSTS 30/30) one year after surgery. No local recurrence occurred during the patients' latest follow-up.

Conclusions: Our results support the effectiveness of custom-made implants in replacing the distal tibia and the ankle in orthopedic oncology.

Background: The objective of this study is to assess the clinical and electrophysiological effectiveness of electrical stimulation in patients diagnosed Bell's palsy (BP), and to examine its impact on potential complications that may arise during the course of the illness.

Methods: Thirty patients diagnosed with BP were enrolled and randomized into two treatment groups of 15 patients each. The treatment group (TG) received 15 sessions of electrical stimulation (ES), infrared, and exercise therapy, 5 days a week for 3 weeks, while the control group (CG) received sham ES, infrared, and exercise therapy. Evaluations were conducted by electromyography before treatment and at 1 and 3 months after the end of treatment for all patients.

Results: When evaluating patients in both groups based on the side where the BP developed, electrophysiological examination showed an increase in the rate of synkinesis in both the TG and CG. However, there was no statistically significant difference between the two groups. The study found that ES did not reduce the presence of synkinesis in denervated muscles. However, the nerve conduction studies of the studied branches of the facial nerve showed a decrease in distal latencies and an increase in amplitudes of compound muscle action potentials, indicating that ES has a positive effect on nerve regeneration.

Conclusion: ES resulted in a notable reduction in distal latency values within the treatment group. Additionally, ES was found to significantly alleviate depressive symptoms, although it did not result in an improvement in overall quality of life. Therefore, ES is considered a safe treatment method that can be used in the treatment of BP.