Grabauskytė, Ingrida

The preanalytical phase represents a critical component of laboratory testing, encompassing all procedures prior to sample analysis and exerting a substantial influence on the quality and reliability of laboratory results. To evaluate changes in the concentrations of commonly measured biochemical analytes in blood samples subjected to different preanalytical conditions, including centrifugation duration, storage temperature and storage time. Blood samples obtained from 20 individuals (960 measurements) were analysed for glucose, albumin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG), potassium (K), sodium (Na) and chloride (Cl). Samples were centrifuged for 5, 10 and 15 min, analysed under optimal conditions (within 2 h of collection), and subsequently reassessed after storage for 2, 4, 8, 10 and 14 days at +23, 4 and -20°C. Statistical analysis was performed using the Kruskal-Wallis test. Storage temperature significantly affected HDL, TG, ALT, AST, glucose, albumin, LDL, and TC (p < 0.001) concentrations, with higher HDL and TG concentrations at +23°C ([1.71(1.12-2.50)]mmol/l] and [1.82(0.73-10.19)]mmol/l respectively) and significant AST and ALT concentration decrease at 23°C ([16.0 (4-60)]U/l and [10.0(2-95)]U/l respectively). Storage duration influenced TC, HDL, TG, albumin, ALT, and AST concentrations (p < 0.001). Centrifugation time had a significant effect only on serum chloride and glucose concentrations (p = 0.018, p = 0.025 respectively). Most biochemical analytes were significantly influenced by storage temperature and duration, whereas centrifugation time had a comparatively limited effect.

Introduction. The handbook provides recommendations that regulate the process of preparing the final master's theses (henceforth, FMT) in the integrated study programme Medicine. The document outlines the principles of work planning, research ethics, methodological requirements and scientific communication, thereby ensuring academic quality and the reliability of the research. [...].

Background: COVID-19 is associated with immune dysregulation and an increased risk of thromboembolic complications, including pulmonary embolism (PE). Identification of dynamic immunological predictors of adverse outcomes remains clinically relevant. This study evaluated associations between coagulation, inflammatory, immunological markers, and in-hospital mortality in patients with severe COVID-19. Material/Methods: In this prospective observational study, 47 hospitalized adults with severe COVID-19 and suspected PE were enrolled. Serum cytokines, coagulation parameters, and cardiac injury biomarkers were assessed at enrollment and on hospital day 5. PE was confirmed using computed tomography pulmonary angiography. Univariable and multivariable binary logistic regression was used to identify predictors of in-hospital all-cause mortality. Model discrimination was evaluated using the area under the receiver operating characteristic curve (AUC), with internal validation by bootstrap resampling. Results: PE was diagnosed in 19 patients (40.4%), and 13 patients (27.7%) died during hospitalization. Higher standardized day-5 interleukin (IL)-9 and IL-15 levels were associated with mortality in univariable analyses, but neither remained significant after Benjamini-Hochberg false discovery rate correction across the panel of 15 cytokines measured on day 5 (IL-9, q=0.180; IL-15, q=0.210). In an age-adjusted model, day-5 IL-9 remained associated with mortality (adjusted odds ratio per 1-SD increase, 3.331; 95% CI, 1.289-8.608; P=0.013). Apparent discrimination was moderate (AUC 0.774; 95% CI, 0.563-0.984; P = 0.011), but bootstrap validation showed marked coefficient instability. Conclusions: Day-5 IL-9 levels may reflect an evolving risk in severe COVID-19, but the association was sensitive to multiple-testing correction and model instability. This study’s findings are exploratory and require confirmation in larger, externally validated cohorts.

Įvadas. Mokomojoje knygoje pateikiamos Medicinos vientisųjų studijų programos baigiamojo magistro darbo (BMD) rengimo rekomendacijos. Dokumentas apibrėžia darbo planavimo, tyrimų etikos, metodologinių reikalavimų ir mokslinės komunikacijos principus, užtikrinančius akademinę kokybę ir tyrimų patikimumą. [...]

Background. Studies have revealed the effect of tempera- ture and humidity on respiratory virus stability and trans- mission rates. There is clear evidence that respiratory vi- rus-related diseases peak in the coldest months, with the highest morbidity occurring during this period, confirming seasonal patterns. The low-temperature condition promotes the ordering of lipids on the viral membrane and contributes to the stability of the influenza virus particle. Low relative humidity combined with colder temperatures appears to have the greatest effects on aerosol transmission. However, high relative humidity seems to support droplet and contact transmission, and cooler temperatures may prolong virus survival on surfaces and in droplets. Aim. To evaluate the association between meteorological factors and to forecast influenza and acute upper respiratory infections using a negative binomial regression model in Vilnius and Rîga. Methods. The dataset comprises quantitative monthly count data on reported influenza and acute upper respiratory in- fections (AURI) cases together with corresponding meteo- rological indicators: mean monthly temperature, humidity and precipitation values. Data from Vilnius (2014–2024), Rîga (2016–2024), were used in the analysis. Negative bi- nomial regression (performed using IBM SPSS 30) was ap- plied because overdispersion was present in the analysed data, and the model’s additional dispersion parameter al- lows this excess variability to be appropriately accounted for. Results. The model for Vilnius indicated that air tempera- ture ( o C), relative humidity (%), and precipitation (mm) were statistically significant predictors of the monthly mor- bidity of influenza and acute upper respiratory infections (AURI). For influenza the regression coefficients (B) were –0.537 (p < 0.001) for temperature, –0.063 (p < 0.001) for relative humidity, and 0.210 (p = 0.040) for precipitation, whereas for AURI the corresponding coefficients were –0.038 (p < 0.001), 0.008 (p = 0.039), and –0.071 (p = 0.010). The model for Rîga showed similar results, indicating that air temperature ( o C), relative humidity (%), and precipita- tion (mm) were a statistically significant predictors of the monthly morbidity of influenza. The corresponding regres- sion coefficients were –0.377 (p < 0.001), –0.075 (p < 0.001), and 0.804 (p = 0.001), respectively. In contrast, only temperature was a statistically significant predictor of AURI morbidity (B = –0.043, p = 0.020). Conclusion. In the models for both Vilnius and Rîga, higher temperature and relative humidity were associated with lower influenza morbidity, while higher precipitation was associated with increased morbidity. Higher tempera- ture was also associated with lower AURI morbidity in both cities, whereas humidity and precipitation were significant only in Vilnius.

This study examines five circulating microRNAs (miRNAs) (miR-29a, let-7i, miR-204, miR-142, and miR-328) potentially relevant to the diagnostic and/or prognostic significance of myopia. miRNA expression was analyzed using StepOnePlus™ RT-PCR. miRNA expression was evaluated in whole blood samples collected and stored using Tempus™ Blood RNA Tubes. The expression of five miRNAs was analyzed in 88 participants: 45 in the myopia group and 43 in the control (emmetropic) group. Heatmap analysis revealed differences in the expression patterns of miR-29a, let-7i, miR-204, and miR-142 when comparing individuals with myopia and controls. The intensity of miR-328 expression was similar between the myopia and control groups. A significant correlation was observed between miR-204 ΔCt and spherical equivalent. However, comparison of median values between different degrees of myopia and the control group did not reveal significant differences. The simultaneous evaluation of multiple circulating miRNAs may help to better understand biological processes associated with myopia.

Leidinyje pateikiamos rekomendacijos, reglamentuojančios baigiamojo magistro darbo (BMD) rengimo procesą Medicinos vientisųjų studijų programoje. Dokumentas apibrėžia darbo planavimo, tyrimų etikos, metodologinių reikalavimų ir mokslinės komunikacijos principus, užtikrinančius akademinę kokybę ir tyrimų patikimumą.

Background and Objectives: Cardiovascular–kidney–metabolic (CKM) syndrome reflects the interconnection between metabolic risk factors, chronic kidney disease (CKD), and cardiovascular disease (CVD). Despite increasing awareness, population-based data on CKM syndrome are limited, particularly in Europe. This study assessed the prevalence of CKM syndrome and the use of renal and cardiac biomarkers in Lithuania. Materials and Methods: Health records of 923,329 adults aged ≥40 years from the national Electronic Health Services and Cooperation Infrastructure Information System were analyzed. CKM-associated conditions (prediabetes/type 2 diabetes, obesity, CKD) and cardiovascular outcomes (atherosclerotic CVD, peripheral vascular disease, stroke, heart failure, atrial fibrillation) were identified. CKM stages were defined as stage 0 (no CKM conditions), stages 1–3 (at least one CKM condition), and stage 4 (at least one CVD diagnosis). The use of estimated glomerular filtration rate (eGFR), albumin-to-creatinine ratio (ACR) and N-terminal pro–B-type natriuretic peptide (NT-proBNP) testing was evaluated. Results: Overall, 34.8% of adults met criteria for stage 4 CKM syndrome, and 23.4% were classified as stage 1–3. Obesity (21.2%) and type 2 diabetes (17.2%) were the most common CKM-associated conditions. Heart failure (25.4%) and atrial fibrillation (14.0%) were the most common cardiovascular outcomes, with ≥2 CVD diagnoses present in 15.4% of patients. Among stage 1–3 patients, eGFR, ACR, and NT-proBNP were measured in 53.5%, 9.0%, and 4.9%, respectively. Conclusions: A third of Lithuanian adults aged ≥40 years had stage 4 CKM syndrome. The underuse of biomarker testing highlights missed opportunities for early detection. Broader implementation of biomarker testing and integrated care is warranted to slow progression of CKM syndrome and reduce cardiovascular risk.

Introduction: Cardiovascular diseases (CVD) are the leading cau- se of death globally, responsible for over 20.5 million deaths an- nually. In 2023, 52.1% of all deaths in Lithuania were due to cir- culatory system diseases. Treating dyslipidemia is crucial for re- ducing CVD morbidity and mortality. This study aims to analyze trends in dyslipidemia treatment in Lithuania over the past five years. Methods: Health data from the “e.sveikata” system (2019–2023) was analyzed, including 978,290 patients aged 40 or older with LDL-Ch measurements. LDL-Ch levels were assessed using 1.4, 1.8, and 3 mmol/L thresholds based on 2019 European Society of Cardiology (ESC) guidelines, comparing primary and secondary CVD prevention groups, diabetes patients, and stroke (S), perip- heral artery disease (PAD), high-risk (HR), and CVD subgroups within secondary prevention. Results: Median LDL-Ch levels decreased annually in all groups. From 2019 to 2023, ESC recommended LDL-Ch targets were achieved by 37% of primary prevention patients, 5.2% of secon- dary prevention patients, and 12% of diabetes patients. In se- condary CVD prevention subgroups, target LDL-Ch was reached by 2.9% of PAD, 3.6% of stroke, 5.2% of CVD, and 7.5% of HR patients. Overall, 33% of patients reached target LDL-Ch levels. Discussion: While more Lithuanians are reaching lower LDL-Ch levels, the results remain suboptimal. Focus should be on secon- dary prevention and diabetes patients, where few reach target LDL-Ch levels. Conclusion: Median LDL-Ch levels decreased annually. The hig- hest percentage of patients achieving target LDL-Ch levels were in primary prevention, while the lowest were in secondary pre- vention.

Liquid biopsies enable non-invasive tumor material sampling in patients with pancreatic adenocarcinoma (PDAC). Genetic information, especially alterations in circulating free DNA (cfDNA) levels, might help to predict poorer tumor differentiation, disease progression and might be used as treatment efficacy evaluator. However, the data on this topic is insufficient.