Medicina-Lithuania最新文献

Background: Chainsaw-related injuries vary from skin lacerations to amputation and may cause serious loss of work time in addition to temporary or permanent disability. Most studies in the literature have reported injuries to the lower or upper extremities separately. The aim of our study is to compare the loss of work time between upper- and lower-extremity chainsaw-related non-occupational injuries in rural areas. Methods: Chainsaw-related injuries that occurred in rural areas and were treated in our center between 2012 and 2022 were retrospectively reviewed. The patients' demographics, the injured side and structures, the hand dominance of operators, lengths of hospital stays, the numbers of operations, complications, and loss of work time were recorded. Results: In total, 185 patients (181 males and four females) were enrolled in this study. The mean age was 45.5 years (range: 17-81). The mean follow-up time was 9.3 months (range: 6-24). The lower extremities were affected in 109 patients, while the upper extremities were affected in 76. The loss of work time was 60 and 75 days for lower- and upper-extremity injuries, respectively, and was statistically significantly higher for upper-extremity injuries (p < 0.001). The fracture rate was higher in the upper than the lower extremities, at 50% and 26.6%, respectively. Conclusions: Chainsaws may cause severe injuries in both the upper and lower extremities, and while the lower extremities were affected more frequently, upper-extremity injuries caused a greater loss of work time. Through the use of protective gear and simple precautions, chainsaw-related injuries and the associated loss of work time can be prevented.

Background: Periodontal disease is a chronic inflammatory condition affecting the supporting tissues of the teeth. Early diagnosis is crucial for preventing severe complications. This study investigates and compares the utility of two salivary biomarkers, interleukin-1 beta (IL-1β) and matrix metalloproteinase-8 (MMP-8), in the early detection and staging of periodontal disease. Methods: This study included 189 patients, all of whom were evaluated both clinically and biologically. Each participant provided unstimulated saliva samples, which were analyzed using ELISA methods to quantify IL-1β and MMP-8 levels. Clinical periodontal data, including probing depth (3.9 ± 0.6 mm), clinical attachment loss (3.4 ± 0.6 mm), and Plaque Index (2.35 ± 0.55), were collected for all subjects. Biomarker concentrations were then correlated with these clinical parameters and with disease severity, classified according to the 2018 EFP/AAP criteria. Results: IL-1β levels (210 ± 95 pg/mL) were strongly associated with early gingival inflammation, while MMP-8 levels (185 ± 140 ng/mL) correlated with periodontal tissue destruction (p < 0.01). MMP-8 showed a higher sensitivity for diagnosing advanced stages (p = 0.002), whereas IL-1β was more effective in detecting early inflammatory changes (p = 0.01). Logistic regression identified MMP-8 as a significant predictor of advanced disease (coefficient 0.85, p < 0.001) and IL-1β as an indicator of early inflammation (coefficient 0.25, p = 0.02). Conclusions: Both biomarkers are valuable tools for the diagnosis and staging of periodontal disease. MMP-8 is relevant for identifying advanced cases, while IL-1β supports early detection. Their combined use may enhance diagnostic accuracy and guide personalized periodontal care.

The Special Issue titled "Editorial Board Members' Collection Series: Gastrointestinal and Hepatic Diseases" is a collection of papers from our Editorial Board Members and researchers invited by them [...].

Background and Objectives: Patients of Asian descent are often grouped together despite their diverse ethnicities and genetic backgrounds. Cancer outcomes result from a complex interplay of genetics, environment, and socioeconomic factors. This study aims to describe lung cancer survival outcome variations in Asian ethnic subgroups, hypothesizing that significant outcome differences exist between subgroups. Materials and Methods: A retrospective analysis of the 2020 National Cancer Database identified patients with stage IV non-small-cell lung cancer (NSCLC). Asian patients were subcategorized into nine groups: Chinese, Japanese, Korean, Asian Indian/Pakistani, Vietnamese, Pacific Islander, Filipino, Laotian/Hmong/Kampuchean/Thai, and Other Asian/Asian not otherwise specified (NOS). The primary outcome was overall survival, and the secondary outcome was utilization of palliative care. Kaplan-Meier analysis and multivariate Cox and logistic modeling were used to assess outcomes of interest. Results: A total of 23,747 Asian patients with stage IV NSCLC were identified. Demographic characteristics of the subgroups varied by age, sex, Charlson-Deyo Comorbidity Index, and utilization of palliative care. Relative to Chinese Asians, multivariate Cox analysis showed worse survival outcomes among patients categorized as Japanese, Korean, Pacific Islanders, Filipino, and Laotian/Hmong/Kampuchean/Thai. The rate of palliative care utilization also varied among Asian subgroups. Compared to Chinese patients, palliative care was more likely to be utilized by patients categorized as Japanese and Pacific Islander. Conclusions: Amongst Asian subgroups, variations in survival outcomes and palliative care utilization in stage IV NSCLC patients were observed. Surgeons should acknowledge these disparities and consider disaggregating Asian races in prognosis analysis to enhance understanding of race's impact on outcomes. Recognizing these differences is crucial for guiding personalized treatment strategies, optimizing resource allocation, and informing health policy to ensure equitable cancer care for all Asian populations.

Background and Objectives: Transcranial alternating current stimulation (tACS) at 40 Hz has shown potential to enhance cognitive function. However, research on its combination with cognitive exercises, particularly its long-term effects in a dementia population, remains limited. This study investigated the effects of 40 Hz tACS paired with simultaneous cognitive exercises on cognition, neuropsychiatric symptoms, and the depression status of individuals with dementia in a sham-controlled, double-blind crossover design. Materials and Methods: A total of 42 participants with dementia were randomized into two groups: (1) the R1S2 group received 40 Hz real tACS with cognitive exercises, followed by a ≥8-week washout period, and then sham tACS with cognitive exercises; (2) the S1R2 group received the reversed sequence. tACS was applied at 1.5 mA peak-to-peak with electrodes over the left dorsolateral prefrontal cortex and contralateral supraorbital area. Participants received two 30 min stimulation sessions per day, 5 days per week, for 4 consecutive weeks, paired with cognitive exercises using the MindTriggers app (2.9.1). The primary outcome was the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) and the secondary outcomes included the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Neuropsychiatric Inventory Questionnaire (NPI-Q). All outcome measures were assessed before and after each treatment block. Results: Real tACS paired with cognitive exercises significantly improved ADAS-Cog scores post-treatment compared to pre-treatment (p-value = 0.019), whereas sham tACS did not. Furthermore, real tACS produced significant long-term improvements approximately 2-3 months post-treatment in ADAS-Cog scores compared to sham (p-value = 0.048). Both real (p-value = 0.003) and sham (p-value = 0.015) tACS significantly reduced NPI-Q scores post-treatment. MADRS scores significantly improved (p-value = 0.007) post-treatment for real tACS but not sham. Conclusions: The 40 Hz tACS paired with cognitive exercises improves cognition, neuropsychiatric symptoms, and depression post-treatment in dementia, with sustained cognitive effects. The findings highlight its potential as a non-invasive therapeutic intervention for dementia.

Background and Objectives: Autism Spectrum Disorder (ASD) is characterized by a range of deficits across cognitive, sensory, motor, emotional, language, and social domains, which can significantly hinder daily functioning and social interactions. This study explores the differences in brain activity between children with ASD and typically developing peers, focusing on their responses to face and face pareidolia stimuli. Materials and Methods: A group comprising ten typically developing children (four males, six females), aged between 6 and 16 years, alongside eleven children diagnosed with ASD (three males, eight females), whose ages ranged from 6 to 15 years, were engaged in the pilot study. We recorded brain electrical activity using electroencephalography (EEG) while participants viewed images of face and face pareidolia images. Following face and pareidolia stimulus presentation, delta and theta powers in the 0.5-4 Hz and 4-6 Hz frequency ranges and within the 140-190 ms time window were analyzed for both typically developing children and children with ASD. Results: The research result reveals that children with ASD show lower amplitude and delayed latency in their EEG responses, particularly in the theta and delta frequency bands, when processing images that evoke face pareidolia. Conclusions: The findings suggest that while children with ASD face challenges in recognizing faces, they may still possess some perceptual abilities that could be harnessed for therapeutic interventions. Moreover, this research highlights the potential of the face pareidolia paradigm to provide insights that could inform future strategies aimed at enhancing social attention and interaction skills in children with ASD. Despite the limitations of the current sample size, this study provides a valuable foundation for future investigations. Expanding the participant pool will be crucial for confirming and generalizing these findings.

Background and Objectives: Glioblastoma presents a significant challenge in oncology due to its aggressive nature and poor prognosis, despite advancements in treatment. This study aims to comprehensively evaluate the prognostic significance of coagulation biomarkers, including the novel albumin/D-dimer ratio, in adult glioblastoma patients. Material and Methods: This retrospective study included 74 adult glioblastoma patients who underwent Stupp protocol treatment. Blood samples were collected before radiotherapy to measure biomarkers, including prothrombin time (PT), activated partial thromboplastin time (aPTT), albumin, D-dimer, and the albumin/D-dimer ratio. The prognostic significance of these biomarkers for progression-free survival (PFS) and overall survival (OS) was assessed using both univariate and multivariate Cox regression analyses. Results: The median follow-up time was 12.2 months (range, 1-77.4 months). Univariate analysis revealed that ECOG performance status (p = 0.001), D-dimer (p = 0.03), and albumin (p = 0.001) were significant prognostic factors for PFS. Multivariate analysis identified albumin (p = 0.02) as an independent prognostic biomarker for PFS. For OS, univariate analysis showed that age (p = 0.004), ECOG performance status (p = 0.001), tumor volume (p = 0.007), extent of resection (p = 0.01), radiotherapy dose (p = 0.001), D-dimer (p = 0.02), albumin (p = 0.001), albumin/D-dimer ratio (p = 0.02), and PT (p = 0.002) were significant prognostic factors. Multivariate analysis revealed age (p = 0.04), extent of resection (p = 0.02), and PT (p = 0.04) as independent prognostic factors for OS. Conclusions: Our findings highlight the prognostic significance of coagulation biomarkers, particularly PT, D-dimer, albumin, and the albumin/D-dimer ratio, in glioblastoma. These biomarkers may serve as valuable tools for prognostic assessment and personalized treatment strategies, warranting further exploration in larger prospective studies.

Background and Objectives: Brain natriuretic peptide (NT-proBNP) is a biomarker widely used in diagnosing and monitoring heart failure. Its impact on electrolyte homeostasis is known, particularly for sodium. However, its relationship with serum calcium remains unclear. This retrospective observational study aimed to investigate the longitudinal association between NT-proBNP and serum calcium levels in a cohort of hospitalized patients with the goal of determining whether NT-proBNP could have a direct or indirect impact on calcium metabolism. Materials and Methods: We included 688 patients with 1022 repeated measurements of NT-proBNP and serum calcium collected during hospitalization from March 2022 to February 2025. Linear mixed models (LMMs) were employed to analyze longitudinal associations, adjusting for age, eGFR, estimated plasma volume status (ePVs), CRP, potassium, and albumin. Results: Baseline analysis revealed a negative correlation between NT-proBNP and serum calcium (r = -0.23, p < 0.001). Univariate LMM demonstrated a significant negative association (β = -1.3 × 10^-5, p < 0.001), which remained significant in multivariate analysis (β = -6.9 × 10^-6, p = 0.01), accounting for intrasubject variability. This suggests that as NT-proBNP increases, serum calcium levels decrease within individual patients, independent of confounders. This study's findings indicate that NT-proBNP may influence calcium excretion, possibly through mechanisms involving the sodium-calcium exchanger (NCX) in renal tubules, similar to its effects on sodium homeostasis. Conclusions: This is the first study to evaluate the longitudinal impact of NT-proBNP on serum calcium, highlighting a potential clinical relevance in patients with cardiac dysfunction. Limitations include a retrospective design and a lack of urine calcium data. Further research is warranted to validate these findings and elucidate the underlying mechanisms.

Background and Objectives: This study aimed to assess the impact of early epidural analgesia (EA) on the progression of labor and delivery outcomes among nulliparous women. Materials and Methods: A retrospective analysis was conducted utilizing data from the Birth Registry of the Department of Obstetrics and Gynecology at LUHS. The dataset encompassed women who underwent childbirth between 1 January 2021 and 31 December 2021 and who received EA for labor pain management. A total of 89 women with low-risk deliveries and EA were included in the study. The cohort was divided into two groups: Group I-parturients who underwent early EA with cervical dilatation ≤3 cm-and Group II-parturients who underwent EA with cervical dilatation >3 cm but <7 cm. The results were processed using IBM SPSS. Results: Group I consisted of 25 (28.1%) women and Group II consisted of 64 (71.9%). The prevalence of obesity was higher in Group II (p = 0.021). Bishop score was statistically elevated in Group II (p = 0.018). Upon hospital admission, Group II exhibited greater cervical dilation (p = 0.001). The rate of cervical dilation was higher in Group II at 1.54 cm/h (p = 0.033). Episiotomy was more frequently performed in Group II (p = 0.014). The average durations of the first stage of labor (p = 0.045), the second stage of labor (p = 0.033), and the overall labor (p = 0.023) were prolonged in Group I. Conclusions: The cervical dilation up to 10 cm occurs at a swifter pace when EA is administered following cervical dilation exceeding 3 cm. Notable associations were observed between EA and the incidence of episiotomy as well as the duration of labor stages. Early EA exhibited no impact on neonatal outcomes.

Background and Objectives: This study aimed to examine the relationship between serum calprotectin levels and facial paralysis in patients with Bell's palsy and to determine its prognostic significance. Materials and Methods: This study included 40 patients diagnosed with Bell's palsy and 20 healthy individuals as controls. The patients were categorized into three groups based on their response to treatment: complete response, partial response, and no response. Blood samples were taken before treatment and in the third month after treatment to measure C-reactive protein, white blood cell count, lymphocyte count, neutrophil count, neutrophil-to-lymphocyte ratio, and calprotectin levels. Results: Serum calprotectin levels were found to be elevated in patients with BP compared to the healthy controls; however, no significant correlation was observed between calprotectin levels and disease prognosis. Conclusions: The findings suggest that Bell's palsy patients have elevated serum calprotectin levels compared to healthy individuals, indicating the potential use of calprotectin as a biomarker in Bell's palsy. However, no significant difference in calprotectin levels was observed between patients with varying degrees of treatment response, suggesting that calprotectin may be limited in predicting disease prognosis.