ProQuest Central

Clinical practice is an essential part of nursing education. Mentoring competence of mentors is critical for nursing student’s practical learning. The purpose of this cross-sectional study was to describe and compare how mentors self-evaluate their mentoring competence in the clinical practice of five European countries. The data was collected from mentors who are registered nurses working in healthcare organizations in five countries: Finland, Italy, Lithuania, Slovenia, and Spain during 2016–2019 (n=1604). Data was collected with Mentor Competence Instrument, which includes seven sum-variables and 43 items: mentoring practices in the workplace, mentor’s characteristics, motivation of the mentor, goal orientation in mentoring, reflection during mentoring, student-centered evaluation and constructive feedback. The data was analyzed using statistical methods. The averages of the mentor’s competence varied between 3,30–3,63 (1=completely disagree – 4=completely agree). The highest competence was in the area of reflection during mentoring, whereas the lowest competence was in the area of mentoring practices in the workplace. The Slovenian mentors evaluated their competence highest and Italians evaluated their competence lowest. Finnish mentors evaluated their competence second lowest. The results of this study can be used for developing a mentor’s competence and education. Mentors should be more aware of mentoring practices in the workplace, develop their evaluation skills and pay attention to goal orientation in mentoring. Mentor education should respond to these needs.

Ankylosing spondyloarthritis (AS) is a chronic inflammatory rheumatic disease, strongly related to human leukocyte antigen (HLA)-B27. Cardiac involvement in AS manifests in 2 to 10% of patients as aortic insufficiency, aortitis, mitral valve fibrosis, or disturbance in the conduction of the heart. In this article, we present a case of a 49-year-old male patient with AS, who was referred to our medical institution for elective aortic valve surgery because of severe aortic regurgitation. The histological findings revealed fibrosing endocarditis of aortic valve and nonspecific aortitis of aortic root. Late postoperatively, we observed exacerbation of AS and narrowing of the main left coronary artery (LAD). Our case highlights the importance of proper treatment of AS before and after cardiac surgery. Furthermore, in this case, we suspect association between cardiopulmonary bypass, activity of AS, and coronary artery disease.

The aim of this case report is to show that bone remineralization around dental implants with a history of peri-implantitis is possible after irritant factors are removed and only conservative treatment is performed. Patient came to the clinic after three years of dental implant placement complaining about swelling, sensitivity and gingiva color changes at the posterior part of the maxilla. During radiographic and intraoral examinations peri-implantitis of the #24 implant site was diagnosed. The surgical treatment method was rejected and performed conservative treatment instead. The outcome is promising; periapical radiographs three months later showed bone remineralization as well as stable bone after 10 years. A key clinical message: Bone remineralization around dental implants with a history of peri-implantitis is possible after irritant factors are removed and conservative treatment performed.

Dvidešimtojo amžiaus pirmosios pusės lietuvių poezijoje išryškėja subjektyvi religingumo samprata, grindžiama žmogaus asmeninio tikėjimo paieškų įteisinimu. Subjektyvios religinės patirtys, atsiskleidžiančios literatūros kūriniuose, skiriasi nuo to meto visuomenėje vyraujančios religinės praktikos ir liudija modernėjantį požiūrį į tikėjimą, paremtą modernios religinės savimonės vystymusi. Įprastą religinę poeziją, kurios esmė – tikėjimo tiesų aiškinimas ir Viešpaties šlovinimas, keičia asmeninio tikėjimo paieškos. Šis postūmis itin akivaizdus vieno žymiausių lietuvių poetų, Bernardo Brazdžionio, ikiegzilinio laikotarpio kūryboje (1924–1944 m.). Straipsnyje, pasitelkus komparatyvistinį tyrimo metodą, papildytą interpretacinėmis įžvalgomis, analizuojami religiniai ikiegzilinės poeto kūrybos motyvai, stengiantis išryškinti tradicinio ir modernaus tikėjimo sandūros dramatizmą bei akcentuojant krikščioniškojo egzistencializmo aspektą. Tyrimo rezultatai leidžia teigti, kad B. Brazdžionio kūryba yra persmelkta neokatalikybės idėjų, joje galima stebėti religinės sąmonės brendimo kelią nuo tradicinio iki moderniai suvokto individualaus religingumo. Egzistencinė krikščionybės interpretacija leidžia šį poetą laikyti katalikiškojo egzistencializmo lietuvių literatūroje atstovu.

BACKGROUND & OBJECTIVES: Chronic pancreatitis (CP) and liver cirrhosis (LC) are common gastroenterological disorders but their co-incidence is considered to be rare. This study was designed to identify lifestyle factors that are associated with the development of concomitant LC in patients with CP. METHODS: In a retrospective case-control study between 2000 and 2005 122 patients with both CP and LC and 223 matched control patients with CP and no known liver disease were identified in 11 European university medical centers. Another 24 patients and 48 CP controls were identified in the period between 2006 and 2012. RESULTS: Alcoholism was most commonly regarded as aetiology for both CP (82.2%; 95% confidence interval (CI): 75.0-88.0%) and LC (79.5%; 95% CI: 72.0-85.7%) as compared to controls with CP only (68.6%; 95% CI: 62.7-74.1%). The preferred type of alcoholic beverage and pattern of alcohol intake were the only significant lifestyle factors in multivariate analysis. Frequency of alcohol intake (p = 0.105) and smoking status (p = 0.099) were not significant in bivariate analysis and dropped out of the multivariate model. Recurrent and chronic pancreatic pain was observed more often in patients with only CP, whereas gallstones were more common in individuals with both chronic disorders. CONCLUSIONS: These findings indicate that certain lifestyle factors might be important for the development of concomitant CP and LC. More studies will be needed to identify additional genetic and environmental factors underlying this association.

BACKGROUND: For consistent reporting and better comparison of data in research the revised Atlanta classification (RAC) proposes new computed tomography (CT) criteria to describe the morphology of acute pancreatitis (AP). The aim of this study was to analyse the interobserver agreement among radiologists in evaluating CT morphology by using the new RAC criteria in patients with AP. METHODS: Patients with a first episode of AP who obtained a CT were identified and consecutively enrolled at six European centres backwards from January 2013 to January 2012. A local radiologist at each center and a central expert radiologist scored the CTs separately using the RAC criteria. Center dependent and independent interobserver agreement was determined using Kappa statistics. RESULTS: In total, 285 patients with 388 CTs were included. For most CT criteria, interobserver agreement was moderate to substantial. In four categories, the center independent kappa values were fair: extrapancreatic necrosis (EXPN) (0.326), type of pancreatitis (0.370), characteristics of collections (0.408), and appropriate term of collections (0.356). The fair kappa values relate to discrepancies in the identification of extrapancreatic necrotic material. The local radiologists diagnosed EXPN (33% versus 59%, P < 0.0001) and non-homogeneous collections (35% versus 66%, P < 0.0001) significantly less frequent than the central expert. Cases read by the central expert showed superior correlation with clinical outcome. CONCLUSION: Diagnosis of EXPN and recognition of non-homogeneous collections show only fair agreement potentially resulting [...].

BACKGROUND: Chronic pancreatitis is an inflammatory disorder of the pancreas that is associated with accelerated mortality for patients suffering from this disease. The association between chronic inflammation and accelerated biological ageing has been well described and is often referred to as "inflammageing". In this review we seek to determine how systemic inflammation in chronic pancreatitis may contribute to an accelerated ageing phenotype. METHODS: A systematic literature search with a predefined search protocol was performed on Medline, Embase and Cochrane libraries according to the PRISMA guidelines. RESULTS: The initial search identified 499 studies. After title, abstract and full text screen of the search results, 20 were included for further evaluation. In the 20 remaining articles 41 inflammatory mediators were identified - mainly involved in chronic inflammation, fibrosis and particularly cardinal features of inflammageing such as sarcopenia and osteoporosis. CONCLUSION: Chronic pancreatitis is associated with elevated levels of inflammatory mediators many of which are associated with an accelerated ageing phenotype and may explain some of the clinical sequelae of this disease.

Background: The group of myeloproliferative neoplasms (MPNs) are known for their different phenotypes but similar complications: vascu- lar events. Blood cells, interaction between them, and the activation of coagulation factors play a role in the pathogenesis of thrombosis in MPNs. Platelet-specific polymorphisms, FVII as well as b-fibrinogen single nucleotide polymorphisms (SNP’s) have been never analyzed together in patients with MPNs. Aims: To evaluate the effects of coagulation factor VII, b-fibrinogen and TT genotype of GP c.807C>T single nucleotide polymorphisms, and the risk of thrombosis in patients with PV, ET, and PMF at the Department of Oncology and Hematology of the Institute of Oncology, the Lithuanian University of Health Sciences. Methods: We included 108 patients in this survey. Findings of clinical and hematological analyses were collected. Genotyping was done using PCR and PCR-RFLP analysis. Results: TT genotype of GP c.807C>T polymorphism was more fre- quently found in the group of MPN patients with arterial thrombosis compared to the MPN patients who were thrombosis-free (26.5% vs. 11.5%, P = 0.049). CT genotype of b-fibrinogen c.-148C>T polymorphism occurred significantly more frequently in MPN patients with arterial and total thrombosis compared to the wild type or homozygous genotype (respectively, 57.7% vs. 40.0 vs. 12.5%; P = 0.027), (64.7% vs. 44.4% vs. 25% P = 0.032). The carrier state for 323P10 variant of FVII SNP (summation of P10/10 and P0/10) was significantly more frequent in MPN patients with total thrombosis compared to the wild-type genotype carriers (71.4% vs. 43.4%, P = 0.049). The coexistence of both genotypes - heterozygous b-fibri- nogen c.-148C>T and FVII -323P0/10 SNP - statistically significantly increased the odds of arterial thrombosis in MNP patients (21.1% vs. 3.7%, P = 0.008). Conclusions: We found that 323P10 variant of FVII, TT genotype of GP c.807C>T and CT gen

Background: Ticagrelor is recommended over clopidogrel in patients following percutaneous coronary intervention. Still no SNP‘s were identified to impact ticagrelors‘ antiplatelet effect. Aims: The aim of the study was to reveal whether clinical factors, CYP2C19, CYP4F2 and fibrinogen genotype have a significant effect on platelet reactivity during induction of ticagrelor and aspirin ther- apy. Methods: Totally 86 patients, who had been hospitalized due to acute coronary syndromes at the Department of Cardiology, Lithuanian University of Health Sciences (LUHS), from 09 of 2015 to 01 of 2016 and who followed dual ticagrelor and aspirin therapy for at least 48 h after stent implantation were included into the further study. A stan- dard 90 mg twice per day ticagrelor and 100 mg/day aspirin doses were prescribed to all of the represented patients. The polymorphisms of CYP2C19 *2 (rs4244285), *3 (rs4986893), CYP4F2 G1347A (rs2108622) and fibrinogen C-148T (rs1800787) were assessed in the laboratory of Molecular Cardiology of the Institute of Cardiology of LUHS. This study was done according to the Declaration of Helsinki. Written informed consent was obtained from all patients included in the study. Results: Platelet aggregation after induction with ADP (PA-ADP) was higher in females (n=21) 33.14 12.97 %agr than in males 25.51 11.65 %agr, p=0.01. Also, patients with diabetes (n=24) had higher PA-ADP levels 32.13 15.57 %agr than non-diabetic patients 25.53 10.43%agr, p=0.02. Smoking or proton pump inhibitor use, CYP2C19 and CYP4F2 alleles had no effect on PA-ADP levels. PA-ADP platelet aggregation was significantly higher in fibrinogen CC genotype carri- ers (n=17) 36.88 13.69 %agr compared to CT (n=26) 24.42 11.77 %agr, p=0.002, or TT (n=43) carriers 25.40 10.43%agr, p=0.0009. Conclusions: The results of this study revealed that platelet aggregation during induction of antiplatelet therapy with ticagrelor and aspirin was impacted by patient gender, diabetes

Perioral dermatitis (POD) is a common perifollicular dermatitis of the facial skin. This condition develops as a result of repetitiveirritation of the skin and epidermal barrier dysfunction. Long lasting papulovesicular eruptions occur mostly in the perioral region, less frequently it involves the perinasal or periocular regions. Perioral dermatitis is often associated with prolonged use of topical corticosteroids in the treatment of rosacea or seborrheic dermatitis. Secondary microbial colonization with Demodex mites aggravates clinical manifestations of the disease. Other exacerbating factors of POD include sun exposure, washing detergents or cosmetics. Clinically, POD must be differentiated from rosacea, acne, seborrheic and contact dermatitis, eruptive syringomas or sarcoidosis. Patch testing usually excludes contact allergy. Therapeutic approach should be individually chosen, depending on the clinical severity of facial dermatitis and previously used therapy. In mild forms of POD "zero therapy" and patient education is important. Pimecrolimus 1% cream rapidly improves clinical symptoms in the acute stage and it is the most effective in corticosteroid-induced POD. In moderate disease, treatment includes topical metronidazole, erythromycin or azelaic acid. The first treatment choice for a severe POD is oral tetracycline in a subantimicrobial dose until clinical remission is achieved. Systemic isotretinoin should be considered for patients with refractory POD.