Briedė, Kamilija

Atopic dermatitis (AD) is a chronic inflammatory skin disease increasingly prevalent in adults. Vitamin D plays an important role in regulating immune responses, cellular differentiation, and inflammation. Several single-nucleotide polymorphisms (SNPs) in the vitamin D receptor (VDR) gene have been suggested as biomarkers of AD susceptibility and severity. The aim of this study was to investigate six SNPs in the VDR gene (rs3847987, rs731236, rs7975232, rs1544410, rs2228570, and rs11168293) and their association with AD and blood biomarkers. Genotyping was performed in 91 adult patients with AD and 102 controls using real-time polymerase chain reaction. The genotype and allele distributions did not differ significantly between AD patients and controls. However, the G and T alleles of VDR rs731236 and rs1544410 were more frequently detected in individuals with serum 25-hydroxyvitamin D (25(OH)D) levels above 30 ng/mL. In contrast, the VDR rs7975232 C allele appears to be associated with lower odds of having a serum 25(OH)D level above 30 ng/mL. In genotype-stratified analysis, the T allele of VDR rs11168293 was more prevalent among individuals with eosinophil counts of 300 cells/μL. These findings suggest that VDR polymorphisms may contribute to variability in vitamin D status and inflammatory responses in adults with AD.

Background and Objectives: Transcatheter aortic valve replacement (TAVR) in large aortic annuli poses challenges due to limited valve-size options and increased complication risks. The aim is to evaluate the safety and performance of XL sizes (30.5 mm and 32 mm) of the Myval transcatheter heart valve (THV) for treating patients with severe aortic stenosis and large aortic annuli. Material and Methods: This retrospective observational study included consecutive patients undergoing TAVR with XL sizes of the Myval THV between December 2023 and December 2024 at a single centre. During this period, 146 TAVI procedures were performed, of which 15 patients (10.3%) with large aortic annuli (mean systolic annular area 786.5 ± 48.2 mm2) received XL valves and were included in the present analysis. Patients were followed up at discharge, 3–6 months, and 1 year. Patient evaluation included echocardiography and clinical assessments following the Valve Academic Research Consortium-3 criteria. Results: All patients were male, with a mean age of 79.1 ± 5.9 years. Technical success was achieved in 100% of cases. At discharge, none of the patients had moderate or greater paravalvular leakage (PVL); 11 patients had no PVL, while 1 had trace and 3 had mild PVL. The mean effective orifice area (EOA) improved from 0.75 ± 0.15 cm2 at baseline to 2.31 ± 0.21 cm2 at discharge (p < 0.0001). At the 12-month follow-up, the mean EOA was 2.4 ± 0.3 cm2, and no moderate or severe PVL or major adverse clinical outcomes were observed. One patient required a permanent pacemaker implantation due to an atrioventricular block. Conclusions: The XL sizes of Myval THV showed both safety and efficacy in patients with large aortic annuli, demonstrating acceptable hemodynamic performance and low complication rates. However, large-scale studies with longer follow-ups are needed to validate these findings in diverse populations.

Introduction and objectives Rosacea is a chronic inflammatory skin condition with varying prevalence and multifactorial etiology. Recent data suggest that rosacea may be more common in diverse populations, with prevalence rates of 4.0% in East Asia, 3.5% in Latin America and 3.1% in Europe [1]. This study aimed to evaluate the prevalence of rosacea and its association with demographic risk factors in Lithuanian population. Materials and methods A cross-sectional population-based study was conducted in Kaunas, the second largest city in Lithuania, located in the southern part of the country (population: 304.210 residents). Participants (n=3131) were randomly selected from the population register of Kaunas city. Clinical signs of rosacea such us persistent erythema, phymatous changes, telangiectasia, flushing, inflammatory papules and pustules on the face were examined according to the American National Rosacea Society Expert Committee (NRSEC, 2017) classification. Rosacea for each subject was established, if at least one clinical sign was present. Other data were collected through structured questionnaires (sunscreen use, smoking) and clinical assessment (demographic and phenotypic characteristics, body mass index (BMI)). Statistical analysis was performed using IBM SPSS Statistics, Version 30.0 (IBM Corp., Armonk, NY, USA) and included chi-square test and logistic regression. A pvalue <0.05 was considered statistically significant. Results A total of 3131 participants (mean age 49.3 ± 11.1 years, 55.4% female) were included. Rosacea was identified in 61 individuals, corresponding to a prevalence of 1.95% (95% confidence interval (CI) 1.49- 2.50%, mean age 49.6 ± 10.8 years). Both genders were affected with prevalence of 1.6% among men (95% CI 1.00-2.40%) and 2.2% among women (95% CI 1.59-3.04%). The highest prevalence was observed in the 30-45 age group (2.3%, 95% CI 1.45-3.35%). The prevalence of rosacea among individuals with normal BMI was 2.2% (95% CI 1.44-3.25%), and those with BMI ≥ 25.0, correspondingly 1.8%, (95% CI 1.27-2.50%), and the majority of rosacea cases (59.0%, 95% CI 45.68-71.45%) were observed in participants with BMI ≥ 25.0. Conclusions Both genders were affected with rosacea prevalence of 1.6% among men (95% CI 1.00-2.40%) and 2.0% among women (95% CI 1.59-3.04%). The highest prevalence was observed in the 30-45 age group (2.3%, 95% CI 1.45-3.35%).

Background/Objectives: Sun exposure and ultraviolet (UV) radiation significantly affect human health, especially concerning skin and eye conditions. Sun exposure is a risk factor for both cutaneous melanoma (CM) and cataract. To investigate the association between CM, cataract and the number of common melanocytic nevi (CMNs) in the Lithuanian population. Methods: A case–control study with 180 primary diagnosed CM subjects and 182 healthy controls was conducted. Participants underwent ophthalmic and dermatological examination, where a counting of the common melanocytic nevi (CMNs) on the face, outer surfaces of the upper arms, lower arms and hands was performed. A detailed ophthalmic slit lamp examination was conducted; additionally, lens status and cataract formation were evaluated according to the Lens Opacities Classification System III (LOCS III). Results: Subjects with an LOCS III grade of nuclear opalescence (NO) ≥3 had a 1.82 times higher risk of CM, and patients with a nuclear color (NC) grade ≥3 had a 2.02 times higher risk of CM. LOCS III evaluations of cortical (C) and of posterior subcapsular (P) cataract showed a 5.24 and 6.34 times increased risk of CM, respectively. The CMN number on the face increased CM risk by 1.25 times; on the outer surface of the upper and lower arms, correspondingly 1.05 and 1.04 times; and on outer surface of hands—1.29 times. Conclusions: All types of cataracts were found more often in patients with CM than in healthy subjects. The number of CMNs on the face and outer surfaces of arms and hands could be an indicator of higher risk for CM.

Introduction & Objectives: Toxic epidermal necrolysis (TEN) is a rare but severe cutaneous reaction to medications characterized by extensive epidermal detachment, with mortality rates ranging from 14.8% to 48% [Wasuwanich P, 2023]. TEN poses a significant clinical challenge due to its rapid progression and life-threatening complications. Lamotrigine, an antiepileptic and mood-stabilizing agent commonly prescribed for epilepsy and bipolar disorder (BD), has been linked to TEN, particularly during the initial weeks of treatment or following rapid dose escalation [Jang Y, 2021]. [...].

Įvadas. Siekiant pagerinti atopinių ligų diagnostiką ir gydymą, svarbu detaliai išsiaiškinti jų patogenezę ir nustatyti provokuojančius veiksnius. Vitamino D kiekis serume ir jo receptoriaus geno (VDR) polimorfizmai gali būti svarbūs atopinių ligų išsivystyme ir dalyvauti reguliuojant imuninio atsako mechanizmus. Šio tyrimo tikslas įvertinti vitamino D ir VDR geno vieno nukleotido polimorfizmų reikšmę imuniniam atsakui atopinių ligų metu. [...].

Atopic diseases, including atopic dermatitis (AD) and allergic asthma (AA), are characterized by complex immune responses involving various T cells subsets and their cytokine profiles. It is assumed that single nucleotide polymorphisms (SNPs) in the Vitamin D receptor (VDR) gene and the Vitamin D-binding protein (GC) gene are related to the action of Vitamin D and, consequently, play a role in regulating the immune response. However, there is not enough data to unequivocally support the hypothesis about the relationship between T cells profile and VDR or GC SNPs. Two hundred sixty-six subjects (aged > 18 years) were involved in the study: 100 patients with mild or moderate AD, 85 patients with mild or moderate AA, and 81 healthy individuals. Blood cell counts were determined by standard methods. Flow cytometric analysis was used to evaluate CD4+ T-helper (Th) cell subtypes: Th2, Th1, Th17, and T regulatory (Treg) cells in peripheral blood. Measurements of cytokines, total immunoglobulin E (IgE), and Vitamin D levels in serum were evaluated by ELISA. Significantly higher levels of Th1, Th2, and Th17 cells, along with lower levels of Tregs, were found in patients with atopic diseases compared to healthy individuals. Additionally, higher serum levels of interleukin (IL) 5, IL-17A, and transforming growth factor-β1 (TGF-β1), as well as lower levels of IL-10, were observed in patients with atopic diseases than in control. The study established associations between VDR SNPs and immune profiles: the AA genotype of rs731236 was associated with increased Th2 and Th17 cells and a higher Th1/Th2 ratio; the GG genotype of rs731236 was linked to decreased serum IL-10 and TGF-β1 levels; and the TT genotype of rs11168293 was associated with increased IL-10 levels. Additionally, the GG genotype of GC gene SNP rs4588 was associated with reduced Th2 and Th17 lymphocytes, while the TT genotype of rs4588 was linked to decreased IL-10 levels. Furthermore, the CC genotype of rs7041 was associated with higher levels of Th2, Th17, IL-10, and IL-35, as well as reduced levels of TGF-β1, while the GG genotype of rs3733359 was associated with reduced IL-10 levels. In conclusion, our study demonstrates that the Vitamin D receptor gene single nucleotide polymorphisms rs731236 and rs11168293, along with polymorphisms in the Vitamin D-binding protein gene (rs4588, rs7041, rs3733359), are significantly associated with variations in T cell profiles in atopy. These variations may play a crucial role in promoting inflammation and provide insight into the genetic factors contributing to the pathogenesis of atopy.

The global incidence of cutaneous melanoma (CM) is rising, necessitating early detection and identification of risk factors across different populations. A case-control study with 180 patients with primary diagnosed CM and 182 healthy controls was conducted. Participants underwent ophthalmic and skin examinations, where the identification and counting of common melanocytic nevi (CMN) and atypical melanocytic nevi (AMN) was performed. During ophthalmic examination, high-resolution slit lamp iris images were taken. Images were categorized according to iris periphery, collaret, and freckles. There was no difference in iris periphery and collaret color between groups. However, blue/grey iris periphery and blue collaret with or without freckles were the most common patterns. The presence of pigmented iris lesions and 2-5 mm and ≥5 mm in diameter CMNs was strongly associated with CM risk. The evidence from this study indicates that blue or grey periphery and blue collaret iris pattern with iris freckles are 2.74 times higher in the CM group than controls. Further research is needed to explore iris patterns' association with CM risk in diverse populations.

Tyrimo tikslas. Remiantis naujausia literatūra, apžvelgti dažniausių randėjančių ir nerandėjančių alopecijų gydymo metodus ir jų veiksmingumą. Tyrimo metodai. Atlikta 2013–2023 m. mokslinių publikacijų analizė „Google Scholar“ ir „PubMed“ informacijos paieškos sistemose vartojant reikšminius žodžius. Rezultatai. Praktikoje dažniau susiduriama su tokiomis nerandėjančiomis alopecijomis, kaip androgeninė, difuzinė, židininė alopecija arba trichotilomanija. Randėjančios plaukų ligos, pavydžiui, planopiliarinė kerpligė arba frontalinė fibrozuojanti alopecija, yra mažiau paplitusios ir joms būdingas negrįžtamas plaukų slinkimas. Skirtingoms alopecijoms yra prieinami įvairūs gydymo būdai. Išvados. Siekiant veiksmingai gydyti plaukų slinkimą, labai svarbu nustatyti tikslią diagnozę. Dažniausiai tam užtenka klinikinių požymių, tačiau gali prireikti ir kitų papildomų tyrimų, pavyzdžiui, odos biopsijos. Dauguma alopecijų patogeninių mechanizmų nėra pakankamai aiškūs, o dėl ilgo plauko augimo ciklo pastebėti pirmus gydymo rezultatus gali užtrukti iki 6–12 mėn. Šioje literatūros apžvalgoje dėmesys skiriamas dažniausiai nustatomoms alopecijų formoms ir jų gydymo būdams, stengiantis padėti gydytojams nustatyti ir gydyti šias ligas, vadovaujantis naujausiomis gydymo gairėmis.

The dry-pericardium Vienna transcatheter aortic valve system is repositionable and retrievable, already premounted on the delivery system, eliminating the need for assembly and crimping of the device before valve implantation.